April 12, 2005

Why Does The Media Hate Single-Payer?

Ezra Klein points out, quite rightly, that the health care debate in America is never going to get very far so long as the conventional wisdom is that health care alternatives in other countries suck. Good point! But it's also worth asking why this is the conventional wisdom. To some extent, it's because conservatives, spearheaded by the insurance industry, have bamboozled us into thinking it's so. Nevertheless, you'd think that if other systems were indeed better—as I think they are—that the media would eventually pick up on this.

Sadly, no. Media coverage of national health care systems in other countries is dismal. And I can think of three main reasons why:
  1. Reporters just don't know all that much. Let's face it, covering health care issues is awfully hard—it's a complex topic!—and not many reporters do it well, even when they're writing about issues here in the United States. You pretty much have to devote yourself full-time to the subject, as, say, Robert Pear of the New York Times has. And that's just to learn the U.S. system... Not surprisingly, reporters have an especially shallow grasp of health care programs in other countries, so the coverage tends to degenerate, more than usual, into "he said, she said" affairs. In fact, I'd have to do a Nexis search, but I'd wager that it's usually not a paper's resident health expert doing stories on single-payer in, say, France or Canada. It's probably an international reporter who has a million other beats and no time to learn all the gritty details of this or that system.

  2. Anecdotes count for more than statistics. This is something of an off-spurt of #1, but also a problem with the media in general, and it's especially detrimental to health care coverage. Reporters lo-o-o-ove covering the poor grandma who waits months for a hip replacement—it's a human interest story! Or those long lines for surgery. Yeesh! But here's the thing: These stories say nothing at all about health care. Everyone has a story: For every grandma waiting for a hip replacement in France, there's an uninsured American who has to pay $95 for a doctor visit to make sure she doesn't have strep throat. Cold, hard, bloodless statistics are all that really matter here, but news coverage of health care in other countries tends either to skimp on statistics or bury them in favor of the attention-grabbing anecdote.

  3. Health care professionals in single-payer systems have reasons for drumming up "crisis" rhetoric. This is something that doesn't get noticed very often. For instance, in a national health care system like Canada's, every year the government has to set a budget for hospitals, limit how much doctors can charge, etc. It's a big debate, and to gain leverage, doctors of course love to talk about how there are shortages and people can't get necessary treatments and so on and so forth. Naturally, their complaints get picked up by the Canadian media and trickle on into American papers. But no one stops to think that these health care professionals are all self-interested actors who have their own reasons for playing up the system's faults.
There are probably other reasons. Nevertheless, it's important to realize that the press isn't merely the victim of a mass disinformation campaign against single-payer, wrought by the insurance and pharmaceutical industry. There's that, but there are also structural explanations for why coverage of foreign health care systems is so horrendous. And, as a result, few Americans have even the vaguest idea of what French health care, or Canadian health care, or Swedish health care, is really like.
-- Brad Plumer 2:39 PM || ||