Public opinion on health care reform is shifting rapidly. Public
disapproval of Obama's "handling of health care" rose from 42 percent
in June to 52 percent in July according to a Quinnipiac University
poll. As the New York Times reports, "President Obama's ability to
shape the debate on health care appears to be eroding as opponents
aggressively portray his overhaul plan as a government takeover that
could limit Americans' ability to choose their doctors and course of
treatment."
This ten percent change in opinion in less than a month is dramatic
considering that public opinion scholars rarely find such large shifts
in such a short period. What is it that accounts for this dramatic
change? The primary factor is probably not the substance of health
care reform itself, since no bill has yet emerged from Congress. Five
proposals are still floating around in committees, and information on
which will win the day is scant. This suggests that some other factor
is at work in changing public attitudes. A more likely cause is the
effort on the part of Republicans in Congress and town hall crashers to
muddy the reform debate.
It is undeniable that those who are protesting Obama and the Democrats
are guaranteed the first amendment right to speak up against government
and that they are entitled to be as rude as they like in public forums.
Whether this kind of discourse is harmful to a vibrant democracy,
however, is another question.
There is little indication that the screaming and shouting in town hall
meetings constitutes an open dialogue on health care. Sarah Palin's
fabricated claims - disseminated faithfully by conservative media -
that an emerging health care bill will establish "death panels" that
allow the state to kill elderly people - do little to encourage
democratic debate. Town hall crashers often attack health care reform
by relying on emotion over substance. Demonization of the Obama
administration for promoting "big government," "socialism," health care
"rationing" and "death panels" does much to incite public outrage,
while distancing town hall crashers from a productive discussion of
reform.
While the liberal commentators at MSNBC stand behind the president and
the "public option," Fox News pundits lambaste not only Obama's plan,
but single-payer health care. Very little effort is made to explore
the differences between the public option and single-payer, as they are
lumped together as a singular "socialist" threat. My review of all Fox
News programming from July 29th to August 11th finds that 18 programs
referenced single-payer health care, most of them failing to
distinguish between Obama's proposed reforms and single-payer proposals
(single-payer proposals, to date, do not seriously enter into
Democrats' plans). Of course, demonization and incitement are not the
only ways to kill discussion on single-payer care. The most popular
way to do this is simply by refusing to mention it as an option - a
tactic preferred by mainstream media (see the FAIR study: "Media
Blackout on Single-Payer Healthcare").
A responsible reframing of the public debate on health care requires tackling a number of issues:
Socialism, Big Government, and Rationing
Obama's former physician David Scheiner is speaking out publicly in
favor of single payer health care (a.k.a. Medicare-for-all). On the
charge of socialism, Scheiner says that a single-payer health care
system still relies on "private doctors, private hospitals, private
clinics, private companies making the [medical machines], the only
thing that's national is the insurance." At best, then, to claim that
the system is socialized is an exaggeration, if not an outright
distortion.
On the issue of "rationing" health care, Scheiner explains that under
private health care, "every patient I see, the insurance people are in
the room watching me telling me what I can do and what I can't.
Medicare [as a single-payer system] has never interfered with
me...Medicare doesn't tell us which hospital to go to, doesn't tell us
which specialist we can use. It's extraordinarily rare that it ever
denies a procedure. Private insurance is doing this all the time."
Addressing anxiety over "big government," Scheiner fires back that "we
[already] spend $400 billion a year in handling administrative costs of
health care that would cover the 50 million who are uncovered" under
Medicare-for-all.
While the mass media and town hall crashers play an integral role in
demonizing Medicare-for-all, polling firms also play a role in limiting
debate. I've seen little evidence in the polls I read of any questions
probing the public on whether they support Medicare-for-all, in
contrast to the more limited public option supported by Democrats.
What very little survey data I can find on Medicare-for-all suggests
that people do support it, despite the media blackout. Polling from as
far back as 2007 shows that 64 percent of Americans support "a national
health insurance program for all Americans, even if this requires
higher taxes." A July 2009 poll from the Kaiser group finds that, as
of July 2009, 59 percent of Americans support "having a national health
plan in which all Americans would get their insurance through an
expanded, universal form of Medicare-for-all." What's truly fascinating
is that the Kaiser poll finds that, when the words "single-payer" are
added to the same question, support drops by nearly 10 percent. This
is a strong indication that political officials and media are able to
manipulate public opinion and demonize a program, not in substance, but
through buzz-word phrases.
Mass media, pollsters, Republicans in Congress, and town hall crashers
are creating a perfect storm in order to demolish health care reform.
Unfortunately, the use of name calling and slogans is replacing
reasoned, open debate on how to move forward. Of course, it's not too
late to promote a respectful dialogue. The sooner we realize the
toxicity of today's mudslinging, the quicker we can promote a real
discussion of the problems that burden the American people.