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Health Care Coverage Tests Perceptions of the Media

August 31, 2009 at 12:00 AM EDT
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The more heated the fight over health care reform becomes, the more many Americans grow skeptical of how the media is covering the fiercely partisan debate. Jeffrey Brown reports.

JIM LEHRER: Finally tonight: coverage of the news coverage of the battle over health care reform, and to Jeffrey Brown.


JEFFREY BROWN: It’s one statement from President Obama this contentious August that no doubt everyone can agree with…

REP. BARNEY FRANK, D-Mass., Financial Services Committee Chairman: Trying other have a conversation with you…

JEFFREY BROWN: … as the debate over health care reform has played out on television and other media — the town hall meetings.

SEN. JOHN MCCAIN, R-Ariz.: We don’t shout at my town hall meetings.

JEFFREY BROWN: The cable TV talk.

BILL O’REILLY, host, “The O’Reilly Factor”: When we cover the town hall meetings, we don’t describe the protesters as loons.

RACHEL MADDOW, host, “The Rachel Maddow Show”: Will Democrat do what they did last time Republicans changed the rules?

JEFFREY BROWN: Political scorekeeping.

REPORTER: The president’s aides continue to insist that he supports a public option and dismiss talk of division among Democrats.

JEFFREY BROWN: And the attempts to sort fact from fiction.

REPORTER: Opponents of health care reform insist the proposed changes would put private insurance companies out of business. That’s false.

JEFFREY BROWN: No surprise the issue has also dominated newspaper and magazine coverage this month and stirred strong back-and-forth on the Internet — all in all, a lot of heat, but how much light?

CAMPBELL BROWN, CNN: The truth is getting lost amid all the noise.

JEFFREY BROWN: And we talk about quantity and quality in the health care coverage now with Trudy Lieberman, contributing editor at the Columbia Journalism Review and director of the Health and Medicine Reporting program at the City University of New York, Roger Sergel, managing editor of medical — of medical coverage at ABC News, and Tom Rosenstiel, director of the Project for Excellence in Journalism, a research group that analyzes news coverage from numerous outlets every day.

Well, Trudy Lieberman, as a general proposition first, what stands out to you about the coverage?

Coverage doesn't explain the debate

TRUDY LIEBERMAN: Well, there are three things.

One, the debate has really flown over the heads of most ordinary people. I think most people don't quite understand what it is all about. And what's more important, they don't understand how it affects them.

The other thing I would say is that we have had way, way too much coverage of the process of reform, the process, the politics, and not really very much coverage of the substance: What does this reform really, really mean to me?

JEFFREY BROWN: And was there a third?

TRUDY LIEBERMAN: Well, that was two of them.

TRUDY LIEBERMAN: I guess I combined the first two.

JEFFREY BROWN: Oh, OK. I paused. I was waiting. That's OK. I will come back to you.

Roger Sergel, how do you balance this mix of process and politics and substance, when you are trying to make decisions on what should be covered?

ROGER SERGEL: Well, at ABC News, we're -- we have a number of different approaches. Obviously, you cover the day-to-day issues with the correspondents who regularly do that.

We also, you know, use live coverage, with interviews with such things on "Good Morning America" and "This Week," where you get the opportunity to hear in greater depth the views of the leaders, and also to challenge them in the live format.

And then we have had fact check on, in which we will take a look at some -- some of the issues, you know, end-of-life care vs. death panels, and try to determine exactly what the facts are in the situation.

And those are some of -- and, of course, then we -- then we also have, of course, ABC News chief medical editor, Tim Johnson, who will come on live. And, so, we -- we try to use all of those different kinds of things to provide different levels of coverage and to go beyond just what the day-to-day coverage is.

JEFFREY BROWN: And, staying with you, to what degree does that become more difficult as the rhetoric rises, as the debate becomes louder?

ROGER SERGEL: It -- it becomes more difficult.

One of the things that we try to do is another level of how we attempt to cover this, is, there is a need for some -- an effort to ensure that we have a wide range of responses. And we set up back in 2000 an e-mail network of -- of experts mainly at academic institutions and think tanks.

And what we will do is, that group is now up to nearly 200 people. When there is an issue in the news, such as, say, co-ops vs. public option, we will send e-mails to that group and invite their comments. And then we will circulate those comments throughout ABC News and with the people who will be covering the story.

And that will give us an opportunity to not only get information about the different points of view that -- that are out there, but also hear from people like at academic institutions, who sort of make this their live's work, in terms of research.

JEFFREY BROWN: Tom, what do you see, given what we have just heard? Take the protests, for example, that get a lot of attention. A lot of people wonder why. And how are news organizations deciding how much they -- how much attention they should get, as opposed to other things here?

Protests dominate news

TOM ROSENSTIEL, director, Project for Excellence in Journalism: Well, first of all, the protests have been the second biggest component of the coverage all year long. We -- we actually count these things.

And the protests have gotten more coverage, actually, than description of the health care plans, or -- and twice as much coverage as the stories about the state of the health care system.

And the reason for this, I think, is interesting. It -- it represents a whole new calculus, I think, in the way that news people make decisions. Even five or six years ago, if you were going to have a live camera or a film camera that was going to make the national news at a lawmaker's constituent meeting, you would have had to persuaded a TV news crew to come to that event.

Today, you can organize that event yourself, get your protesters there, have your own amateur camera there, post that material on YouTube, generate enough hits, and that can, by itself, make the event newsworthy.


JEFFREY BROWN: By the number of hits, so the news organizations...

TOM ROSENSTIEL: On YouTube, on your channel.

JEFFREY BROWN: ... say, OK, some news just happened?

TOM ROSENSTIEL: Right, whereas, a few years ago, you would have had to have persuaded that news crew: You should come to my event. I think something newsworthy is going to happen at my constituent meeting, you know, while -- while the Senate is in recess.

It just wouldn't have happened. And I think this is the same thing that happened -- you know, we used to say, a president now is -- should always assume, when they are in public, that they are going to be on the record.

With "macaca," the -- the video of a senator in -- from Virginia getting caught putting his foot in his mouth during a campaign, we began to say, OK, if -- any moment that you are running for office in a campaign, you should assume you are now on the record and it is going to be public.

Now I think any lawmaker in any situation in public, even at a -- even at constituent meeting that, a few years ago, you would have assumed was fairly low-level, you are now going to assume that you are on camera. This is in the -- in a sense, the "macaca-ization" of being in public life generally.

JEFFREY BROWN: Trudy, what -- what do you -- what do you make that? What -- why -- why -- you started with by saying that we're not -- that most people are not getting the basic facts. Why do you think that is?

TRUDY LIEBERMAN: Well, I think it's much easier to cover a protest. It's much easier to cover a rumor. It's much easier to cover death panels or death care. It's really, really much harder for somebody in the media to cover age-rating or the mechanics of risk pools and all those things that really are going into what is going to come out in this health care bill.

And what we haven't had is a lot of reportage that explains what is really in those bills or likely to be in those bills, because some of it is fairly hard to do.

ROGER SERGEL: One of the...

JEFFREY BROWN: Go ahead, Roger. You want to jump in?

'Herding cats'

ROGER SERGEL: Well, the -- the process of coverage also is a little bit like herding cats right now.

You essentially have a large number of people focusing on something that isn't clearly defined yet. And, so, what you're doing is, you are trying to cover something, and are you getting reaction to something, where you can have many people saying, you know, what they think it is, when, in fact, we don't really know what it is.

JEFFREY BROWN: Well, Roger, I know you...

TRUDY LIEBERMAN: Well, I think, in...

JEFFREY BROWN: Well, go ahead. Go ahead, Trudy.


I think, in some ways, we really do kind of know what the outlines are. And there was a story I was reading this morning that says that there's a lot of agreement already in the Congress on some issues, and there's major disagreement on other issues.

So, some of us who have been covering this for many, many months now really do sort of know what those outlines are. For example, we know that there's going to be an individual mandate, which means that people will be required to carry health insurance one way or another.

That has hardly not been discussed at all. The financing mechanism has gotten a little bit of attention, but not that much. So, what I am saying and what I have been arguing in a lot of my posts for is that we should be having a lot more discussion.

People are interested. They really are. And they really want to knows what's going on, and particularly how it affects me.

I had somebody tell me the other day at my neighborhood Starbucks that, well, I guess it means I can keep my own insurance, and maybe the rates are going to drop.

Well, it's a little bit more complicated than that.


TOM ROSENSTIEL: I mean, it's true that the -- that the programs, that the proposals are fluid.

What, really, I think, surprises me in the coverage is how little coverage there is of how our health care system works, what's wrong with what -- what's wrong with it, and what the alternatives could be, based on other countries, other systems, alternative programs in the United States.

That represents only 8 percent of all the coverage that we have seen this year, vs. 55 percent about the political horse races and battles over this, and another 16 percent of the coverage on the protests.

I think, before the public can even come to a conclusion about what kind of reform is needed, we need a better understanding of how our health care system works. If the -- if health care reform and the debate over it is a -- potentially, a teaching moment for the country, a learning moment, it's passing us by, by and large, and we're getting another lesson in how our political system works.

JEFFREY BROWN: Well, Roger, we just have a minute. I will give you the last word on that subject, a teaching moment that may be passing us by.

You have been covering health care for a long time. Is something different in this debate? Are -- are -- are we somehow failing to -- to get it this time?

ROGER SERGEL: Well, I think -- I can't really speak, you know, for all of coverage.

But, you know, the fact is, is that we're not done. And there are going to be opportunities to -- you know, to go further into things. As the debate changes and as we, you know, try to understand, you know, what are the important issues to focus on, the news can, you know, make adjustments in terms of what they are doing. And that is what we are trying to do at ABC with -- with the way we are approaching this.

JEFFREY BROWN: All right. All right.

Roger Sergel, Trudy Lieberman, and Tom Rosenstiel, thanks very much.