Media skew health care debate by casting public plan option as left-most proposal

In a pattern similar to their flawed coverage of economic recovery legislation, the media are once again ignoring a position embraced by many progressives, this time on health care -- helping to skew the debate and potentially ensure that the legislation that Congress and the Obama administration work out will fall short of what the administration and the public are advocating, which itself is less than many progressives say is necessary. In their coverage of a proposal by Sen. Kent Conrad (D-ND) for a system of health coverage "cooperatives" as an alternative to the inclusion of a public plan option, the media have often portrayed the co-op system proposal as a compromise between the public plan option, which President Obama is advocating, and a plan free of any government involvement, which many congressional Republicans are advocating, without noting that the public plan option is itself a compromise for many progressives, who advocate a single-payer system. Indeed, in the view of many progressives, the public plan option is the least that must be included for health care reform to be successful.

Specifically, Media Matters for America searched the Nexis database between June 1 and June 23 for references to or portrayals of Conrad's proposal as a compromise between the public plan option and the GOP's position. The review consisted of programs available in the database from broadcast news (ABC, CBS, PBS' NewsHour, and NBC) and cable news (CNN, Fox News, and MSNBC), and National Public Radio, as well as articles from USA Today, The Wall Street Journal, The New York Times, The Washington Post, and the Los Angeles Times. Out of 26 instances in which the Conrad proposal was presented as a compromise or in which the public plan option was presented as the progressive position that will likely have to be "watered down," in only six instances did the reporter or anchor indicate that the public plan option itself represents a compromise for those who advocate a single-payer system.

In a June 11 blog post, Clinton administration Labor Secretary Robert Reich demonstrated how, for many progressives, the public plan option is the compromise. He wrote: "As long as single-payer is off the table, then we need a real public option." The Washington Post's E.J. Dionne has also noted that Obama's health care proposal is already a compromise from a single-payer plan. In his June 18 column, Dionne wrote:

As it is, President Obama and the Democrats have already compromised a great deal. They are not proposing a government takeover of health-care financing, as single-payer advocates prefer.

Additionally, in an April 2 letter to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid, Reps. Lynn C. Woolsey (D-CA) and Raúl Grijalva (D-AZ) -- co-chairs of the Congressional Progressive Caucus, which includes 76 House members and Sen. Bernie Sanders (I-VT) -- wrote:

Regarding the upcoming health care reform debate, we believe it is important for you to know that virtually the entire 77-Member Congressional Progressive Caucus (CPC) prefers a single-payer approach to healthcare reform. Therefore, it will come as no surprise as you work to craft comprehensive health care reform legislation, that we urge the inclusion of a public plan option, at a minimum, in the final legislation.

As Media Matters noted, during the stimulus bill debate, the media consistently ignored the position by many economists that the economic recovery bill as proposed by the Obama administration was too small. Instead, the Obama position was portrayed as one end of the debate, with the Republicans' position that any economic recovery legislation should be made up of tax cuts as the other end; the view by economists that the administration's proposal did not go far enough was largely absent from the media's coverage of the debate. The result was a skewed public debate focused almost entirely on the question of whether Obama was proposing to spend too much.

Similarly, the media are depicting the public plan option as one extreme and contrasting it with what "centrists" purportedly want, rather than portraying it as the compromise for progressives that it is. The Washington Post Co.'s Greg Sargent points out that, given polling showing strong public support for a public plan option, advocacy of that option is the centrist position.

In a June 22 New York Times column, Nobel Prize-winning economist Paul Krugman similarly wrote that advocacy of the public option represents the centrist position: "The real risk is that health care reform will be undermined by 'centrist' Democratic senators who either prevent the passage of a bill or insist on watering down key elements of reform. I use scare quotes around 'centrist,' by the way, because if the center means the position held by most Americans, the self-proclaimed centrists are in fact way out in right field."

But the consequence of the current depiction by the media of the public plan option as one extreme could be a bill that falls significantly short of what the public wants and what many progressives say is essential for real reform.

The media's failure in this regard has taken several forms. On June 16, interviewing House minority leader John Boehner, CNN's Wolf Blitzer gave a clear demonstration of the media's practice of presenting a public plan option as lying at one extreme and "a private-run plan" as the other, with a cooperative system constituting a compromise:

BLITZER: I know you don't want a government-run health insurance plan. You want a private-run plan. What about this proposal, this compromise, in between? Kent Conrad, the Democratic senator, suggesting co-ops, where you -- you band together hundreds of thousands of people, and you create a co-op that's not government run. It's privately run. But it -- but it would potentially do the same thing.

Similarly, on June 12, Blitzer characterized a cooperative plan as "designed to bridge the gap between the left and the right."

Also on CNN, on June 18, senior medical correspondent Elizabeth Cohen said: "[B]ecause people who don't like this public health insurance option, what they do like is they like health insurance co-op." In Cohen's formulation, the only alternative in the minds of "people who don't like this public health insurance option" is health insurance coverage cooperatives. She did not note that some people, including reportedly Obama's Chicago physician, "who don't like this public health insurance option" favor a single-payer system.

By contrast, NPR's Julie Rovner made clear that the real choice of many progressives -- legislation to establish a single-payer system -- was not even on the table:

ROVNER: Well, one of the big reasons is to keep the private insurance industry obeying the new rules that they think they are going set down to have prices at least affordable and to make sure that they don't discriminate against people who have pre-existing health conditions. I think another important reason to include this public plan is because there are so many Democrats who want a single-payer health system, the idea of getting the private insurers out entirely and having just a government plan. That's not going to happen, but at least having a public competitor would be a step toward saying, "Yes, we're going to acknowledge that what you want will have a public plan there for people to choose if they wanted."

Media Matters identified the following instances in which media characterized a cooperative system as a compromise without noting that the public plan option itself is a compromise:

Media Matters identified the following instances in which media characterized a cooperative system as a compromise but also indicated that the public plan option itself is a compromise:

Methodology: Media Matters reviewed transcripts and articles from ABC, CBS, CNN, Fox News, the Los Angeles Times, MSNBC, NBC, The New York Times, NPR, PBS, The Wall Street Journal, The Washington Post, and USA Today between June 1 and June 23 (inclusive) in the Nexis database. The search used was "health! AND (Conrad OR cooperative OR co-op)."

--L.K.A, M.K., & R.S.