Censored 2012 (72 page)

Given the broad support for single payer, especially among the Democratic base, one would expect that under a Democratic White House and Congress, single payer would at least be considered in the health care debate. However, quite to the contrary, the debate was highly scripted to lead the public to a preconceived idea of health care reform outlined by Jacob Hacker, a fellow at the New America Foundation,
⁶
and single payer was actively excluded. Though the debate was directed by the White House and congressional leadership, the corporate media and other allies in Washington, such as the Center for American Progress and other “progressive” organizations, followed the script with rare deviation. It was recently discovered that Jim Messina, deputy chief of staff for operations for President Obama, held regular meetings with heads of progressive organizations during the health reform process to instruct them in conveying their messages consistent with policy supported by the White House.
⁷

The call for public input into the reform process in early December 2008 demonstrated the degree of scripting that occurred. Americans were encouraged to hold health care house parties in which they invited friends to participate in discussions using materials created by the Obama campaign. Though former Senator Tom Daschle, then the point person on health, said, “These Health Care Community Discussions are a great way for the American people to have a direct say in our health reform efforts,” the prepared materials led the participants down a specific path that concluded that Americans wanted health insurance exchanges—i.e. a centralized way to shop for plans from different insurance providers.
⁸
The final report on the community discussions contained a single small paragraph that stated, “Supporters of a single-payer system submitted numerous reports, in part due to the encouragement by advocacy groups to participate in Health Care Community Discussions.”
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Not only did the report fail to adequately portray the majority support for single payer, but it also discounted any support for single payer as being driven primarily by the urging of advocacy organizations.

As in the 1990s, during the recent health reform process the relationship among corporate media, industry lobbyists, and the White House was quite cozy. This was exposed in the summer of 2009 with the discovery that Katharine Weymouth, publisher of the
Washington Post
, was issuing invitations for the three entities to meet for a “salon” in her home at the price of $50,000 per event.
¹⁰
Similar meetings have been arranged by other corporate media outlets such as the
Wall Street Journal
and the
Los Angeles Times
. Industry influence on the media also takes the form of “interlocking directorates” in which board members of large corporations sit on the boards of media outlets as well.
¹¹

It is then no surprise that a study looking at the early months of 2009 showed little mention of single payer, with the views of single-payer advocates were rarely included. In the week leading up to the first White House Health Summit, there were hundreds of stories about health care reform in both major newspapers and on television outlets. Single payer was mentioned only eighteen times and single-payer advocates were quoted in only five interviews.
¹²
In that same time period, T. R. Reid quit Frontline over the public affairs series’ limited coverage of alternative reforms for the US in their hour-long documentary called
Sick Around America
, a follow-up to Reid’s previous
Sick Around the World
.
¹³
Frontline only offered the Massachusetts health reform as a model in the US. Not surprisingly, this was the same model being used for the Obama administration’s preferred health reform.

Another obvious example of exclusion of single payer was ABC News’ White House Health Forum in June 2009. President Obama’s personal physician of twenty-two years, Dr. David Scheiner of Chicago, was invited to participate in the forum. One week prior to the forum, Dr. Scheiner was interviewed by
Forbes
magazine.
¹⁴
He criticized the president’s plan and instead advocated for a Medicare for all approach. Dr. Scheiner was subsequently disinvited from the White House forum.

When single-payer health reform was discussed in the corporate media, most often the coverage was negative. Certain key phrases were used repeatedly to describe single payer such as “socialized medicine” or “government-run” medicine. The messaging was so successful that some senior citizens in the August 2009 town hall meetings held signs protesting government-run health care without realizing that their very
own Medicare was government-run. An extreme example of this was a September 2009 article in the
New York Times
by Katharine Q. Seelye, “Medicare for All? ‘Crazy,’ ‘Socialized’ and Unlikely.”
¹⁵
Corporate media focused on the flaws in Medicare such as the low reimbursement to physicians, which occurs in some areas of the country, and the fact that Medicare and single payer are financed through taxes.
The New York Times
article quoted an economist who directs a managed-care company and a fellow from the Heritage Foundation, who both falsely stated that the tax increase under a single-payer system would be a financial burden.
The Times
mentioned only parenthetically that single-payer advocates argue that the tax increase would be neutralized by decreased out-of-pocket expenses and lack of premiums.

Another technique employed to sway public opinion against single payer was the sensationalism of certain medical cases from Canada and the United Kingdom. Shona Holmes, a Canadian citizen, received extensive media coverage in the summer of 2009. She was portrayed as having a brain tumor and as having to wait for so long to receive treatment in Canada that she sought care at the Mayo Clinic instead.
¹⁶
In truth, she had a benign congenital cyst in her brain, which is very different from a cancerous tumor, but this distinction was not made in the media.
¹⁷
Investor’s Business Daily
published an article in August 2009 claiming that people with disabilities such as Stephen Hawking “wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.”
¹⁸
They failed to realize that Hawking has received quality health care from the British NHS for his entire life.

Corporate media also employed specific messaging to distract from the real crisis. Wendell Potter discussed this health insurance industry practice in his recent book,
Deadly Spin: An Insurance Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans
. He described how, rather than focus on the growing number of uninsured, citizens have been told that many of the uninsured are undocumented people or “young invincibles” who choose not to buy insurance. And rather than focus on the growing number of underinsured and the resulting personal bankruptcies, we have been told that health care consumers need to take more personal responsibility and have more “skin in the game” so that they can make
wise decisions about how to spend their health care dollars. The soaring cost of health care has been blamed on the American love for technology, people overusing health care services, hospitals and physicians pushing procedures, and the aging baby boomer population. That much of the US population delays or avoids necessary care altogether because of out-of-pocket costs, which leads to a high number of preventable deaths, and that health care costs in the private sector rise much more rapidly than in the public sector, has been ignored. And finally, Wendell discussed how our crisis was frequently blamed on the need for tort reform despite the fact that malpractice costs are a small percentage of our overall health care costs and tort reform has not been proven to reduce health care costs or improve health outcomes.
¹⁹

As a result of the exclusion of single payer, advocates sometimes went to great lengths for media coverage. In May 2009, thirteen people (including this author) were arrested at two Senate Committee on Finance health reform hearings. These events received some coverage because they took place while C-SPAN cameras were covering the hearings live. In fall 2009, national days of protest at health insurance offices were organized through a campaign called the Mobilization for Health Care For All. Over one thousand people signed up to risk arrest in order to spread the improved Medicare for All message. Days of action included up to two dozen protests across the country, including one action during which protesters were locked overnight in the lobby of Humana in Louisville, Kentucky, without access to bathrooms, food, or water.
²⁰
Doctors were present at many of these actions and several were arrested. Despite this, there was only minimal coverage by local news stations. On two occasions, national networks agreed to cover the protests, but the story was bumped both times, first by the “Balloon Boy” hoax in October, then by the shooting at Fort Hood in November.

A common excuse for the lack of coverage during the health reform process was that the national media accepted the idea, perhaps prematurely, that single payer was no longer on the table as an option. Single-payer advocates who organized public educational events and rallies for single-payer systems heard this repeatedly when they sought media coverage. Due to public pressure over the lack of coverage of
single payer by National Public Radio, the ombudsman was forced to address the issue.
²¹
“This issue is not getting a lot of attention from NPR because it’s simply not on the table in Congress,” said Julie Rovner, NPR’s lead reporter covering the health care overhaul. In other words, NPR was only willing to cover what Congress would consider rather than what the majority of the public desired.

When single-payer events were covered by major television outlets, it was primarily Fox News and international media. Russia TV, Catalunya TV, Real News Network (Canada), Al Jazeera English, Atlantic Television News (Denmark), and Swedish Television interviewed single-payer advocates repeatedly and covered rallies in and around Washington, DC, throughout the health reform process of 2009–10. Al Jazeera English produced a full
Fault Lines
episode on the reform process that included a broad range of views, from single-payer advocates to health insurance industry lobbyists.
²²
In contrast, the Frontline documentary
Obama’s Deal
, released shortly after the health reform law passed in March 2010, edited out references to single payer in an interview with this author.
²³

Media coverage of American health care is very different in the European news, where industry influence does not reach. European media frequently highlight the high number of uninsured people in the United States and the suffering that occurs as a result.
²⁴
When the health reform law was passed, French press hailed the US entry into the twentieth (not twenty-first) century. And while there was little mention in the US corporate media of industry influence over our politicians, this fact was not missed in European media.
²⁵
The British medical journal the
Lancet
featured this quote on the cover of the December 2009 issue: “The health-care reform process exposes how corporate influence renders the US Government incapable of making policy on the basis of evidence and the public interest.”
²⁶

The medical-industrial complex succeeded this time in shaping public discourse and the political process to its advantage. The new health law mandates the purchase of insurance, providing hundreds of billions of public dollars to the insurance industry to subsidize this purchase. The losers are the people of the United States, as we continue to live in the only industrialized nation that does not have a universal health system. Under the new law, the current trend away
from employer-sponsored insurance and toward individual consumer-driven (underinsurance) health plans is expected to continue, and personal bankruptcy due to medical costs will continue to occur. Tens of millions of people, who are either exempt from the insurance mandate or undocumented, will remain uninsured.
²⁷
None of this would occur in a single-payer national health system. Thus, the prevention of an honest debate about the health care crisis and the benefits of the single-payer option come at a very human cost: the unacceptable continuation of human suffering and countless preventable deaths.

MARGARET FLOWERS, MD, IS
a Maryland pediatrician who serves as Congressional Fellow for Physicians for a National Health Program and sits on the board of Healthcare-NOW!

1
. Kip Sullivan, “Two-Thirds of Americans Support Medicare for All,” report, Physicians for a National Health Program, 5,
http://www.pnhp.org/sites/default/files/docs/2011/Kip-Sullivan-Two-thirds-support-medicare-for-all.pdf
.