Health Care Debate: Opponents Won By Words, Says Pew

[Bricker]

From here: I see two interesting propositions. One is that if there is a liberal media, it was absent or clueless during the coverage of this subject.

Two is that liberal talk show hosts devoted nearly twice as much time to discussing the issue as their conservative counterparts, and their coverage was not uniformly positive. (I infer that the conservatives' coverage was more or less uniformly negative).

Is that a fair summary of the Pew report?

The Washington Post's Chris Cillizza opines further:

While official Washington waits with bated breath for the Supreme Court to announce its decision on the constitutionality of President Obama’s health care law, a new study from the Pew Research Center makes it abundantly clear that the political fight over health care is already over. And Republicans won.

I tend to agree with the conclusion, but I am not sure that's what the Pew study says. Cillizza buttresses the claim with Post polling data.

So: did the liberal media take a day off, completely screw up, or are they not so liberal as that? And have the Republicans won the hearts and minds of the American populace on the subject of Affordable Care Act boos and jeers?

[Amasia]

I think that the study shows that the liberals and the associated "liberal media" never whole-heartedly endorsed the version of the ACA that was passed. The ACA is/was a negotiated agreement with insurance companies about access to care. Many liberals viewed this as an unacceptable compromise that failed to address core issues surrounding healthcare cost and of course, implement universal coverage through a national single-payer system.

There was a rally around the bill when it became clear it was the only option. But many liberals held serious doubts about key components of the bill (for instance, a lack of evidence supporting transition to EMR), as well as the feasibility of the implementation timeline and the reality of resulting cost reductions. People immediately began talking about the ACA as a step in the right direction and a catalyst to change- not the solution to our health care crisis that many had (simplistically) hoped for.

Combine that hesitancy with a violent opposition from conservatives and some moderates, and it's not difficult to see how the public's perception that the bill is flawed has developed. As far as the long term view of the ACA- it depends. If it is upheld and if it is not defunded, then there is a chance that the public could come around on it. In one way, the ACA is an absolute victory for healthcare reform because it has caused an irretractable shift among policy makers and government leaders to focus on quality of care and measurable health care reform efforts. It has shifted the conversation to necessitating health care reform- of one type or another.

[twhitt]

Chris Cillizza seems to simply be wrong. A plurality of Americans are opposed to the health care reform bill, yes, but that's not the right question to be asking. It's incorrect because the public has been deliberately misinformed about the contents of the legislation as passed. When asked,

In general, do you support, oppose or neither support nor oppose the health care reforms that were passed by Congress in March of 2010?
Total support 33%
Total oppose 47%

I grant this point, but instead Mr. Cillizza suggested that the fight over health care is over. That's not at all what the public wants.

If the Supreme Court rules that the health care reforms passed in March 2010 are unconstitutional, what do you think the President and Congress should do about the health care system? Do you think they should:
Start work on a new health care reform bill 77%
Leave the health care system as it is 19%

The public wants health care reform. In fact, they even want almost all of the specific proposals in the legislation that was signed. They simply don't know what those proposals are, and they don't know that the legislation has them. There's a tremendous information asymmetry problem, and you may even be right that it's the result of a media bias, but it has little to do with a liberal media bias - if such a thing even exists. There are a small number of liberal broadcasters and pundits, but statistically no one watches their programs.

[Captain Amazing]

I think it's not a secret that Republicans are better at framing issues than Democrats, and a lot of that is thanks to one man; Frank Luntz. Luntz is a Republican pollster/political consultant, and a pretty smart guy. He first came to prominence in 1994, working for Newt Gingrich, and is basically the guy who wrote the Contract with America. Luntz specializes in the use of language to shape debate, and he's the one responsible for a lot of terms still in use..."climate change" rather than "global warming", "death tax" rather than "inheritance tax", "tax relief" rather than "tax cuts".

Here's a memo he wrote Republican leaders regarding the health care debate:

http://wonkroom.thinkprogress.org/wp....pdf?mobile=nc

I think there have been (and I'll have to find) polls suggesting that Americans support most of the individual parts of the health care law, but oppose the law itself. That suggests it's a framing issue...that the opposition to the law isn't so much in what it does, but in the way it was packaged and spun.

[John Mace]

Originally Posted by twhitt

Chris Cillizza seems to simply be wrong. A plurality of Americans are opposed to the health care reform bill, yes, but that's not the right question to be asking. It's incorrect because the public has been deliberately misinformed about the contents of the legislation as passed. When asked, I grant this point, but instead Mr. Cillizza suggested that the fight over health care is over. That's not at all what the public wants. The public wants health care reform. In fact, they even want almost all of the specific proposals in the legislation that was signed. They simply don't know what those proposals are, and they don't know that the legislation has them. There's a tremendous information asymmetry problem, and you may even be right that it's the result of a media bias, but it has little to do with a liberal media bias - if such a thing even exists. There are a small number of liberal broadcasters and pundits, but statistically no one watches their programs.

The problem with the bill is that it costs money to implement those programs. That money was supposed to come from the individual mandate, and people who wouldn't have otherwise bought insurance. So it's nice that people support the various components of the bill, but if they don't support the structure put in place to pay for those components, then all we know is that they'd love to get a bunch of stuff for free. Well, that's true of almost anything!

I never liked the fact that this bill looked like, to quote Bill Maher, a big blow job for the Insurance Companies. I don't know that the country is ever going to be ready for real Health Care reform at the federal level in my lifetime. I'd prefer to see things done at the state level. That way, the people in MA and NY can get the healthcare they want and the people in MS and GA can get the healthcare they want. And those of us out in CA don't need to bother with any of them.

[CandidGamera]

I think it illustrates that the idea of a liberal media is a myth and that Republicans are the best at lying.

Of course, neither of those is news to me.

[Simplicio]

a new study from the Pew Research Center makes it abundantly clear that the political fight over health care is already over. And Republicans won.

If Republicans won the political fight over the Health Care law, wouldn't there not be a Healthcare law? It seems a little silly to define a "political fight" as something separate from the fight to pass the legislation.

I'd agree the GOP won the public relations fight. They lost the political fight two years ago.

[John Mace]

Originally Posted by Simplicio

If Republicans won the political fight over the Health Care law, wouldn't there not be a Healthcare law? It seems a little silly to define a "political fight" as something separate from the fight to pass the legislation.

I'd agree the GOP won the public relations fight. They lost the political fight two years ago.

I think the politics go beyond the HCRB itself. For example, is it going to help or hurt Obama get re-elected? Is he out touting his accomplishment on the campaign trail, or is Romney making gains by trashing it?

[Simplicio]

Originally Posted by John Mace

I think the politics go beyond the HCRB itself. For example, is it going to help or hurt Obama get re-elected? Is he out touting his accomplishment on the campaign trail, or is Romney making gains by trashing it?

It seems a little perverse to say the main political struggle regarding the HCRB (ACA? someone needs to standardize acronyms) is whether or not it will get Obama re-elected. The point of elections is to pass legislation, not vice-versa.

I never liked the fact that this bill looked like, to quote Bill Maher, a big blow job for the Insurance Companies.

quoting myself from an earlier thread:

As for Insurance Companies, I don't really care about them one way or the other. If reform screws them over, I'm not real worried about it, but I think the current idea that any reform that doesn't screw them over is somehow not worth it is silly.

Reform should expand coverage to everyone, decrease the rate of increase in private and public Medical costs and end the chance of people being dropped from insurance after they become ill, have a funding mechanism that covers any increase in federal spending and at least do something to wean away from the current paradigm of work-linked insurance. This bill makes progress in all those areas.

Providing a strong kick in the nuts to the Executive Board of Cigna isn't on my list.

[John Mace]

Originally Posted by Simplicio

It seems a little perverse to say the main political struggle regarding the HCRB (ACA? someone needs to standardize acronyms) is whether or not it will get Obama re-elected.

You're right, of course, which is why I didn't say it was.

quoting myself from an earlier thread:

Another false dichotomy. Just because I don't want to kick them in the butt doesn't mean I want to drop to my knees and blow them.

[Simplicio]

Originally Posted by John Mace

You're right, of course, which is why I didn't say it was.

So we agree that the main question of the "political fight" regarding the HCRB was whether or not there'd be a HCRB? I read your comment as disagreeing with that, apologies if I misread.

Another false dichotomy. Just because I don't want to kick them in the butt doesn't mean I want to drop to my knees and blow them.

Whatever metaphor you want to choose. My point is that a fixation on what the bill does or doesn't do regarding the metaphorical nether regions of healthcare insurance executives is a distraction. The point of the bill is providing universal coverage and limiting the growth of healthcare expenses to something manageable. The degree to which it helps or hurts the insurance investors bottom lines is (or at least should be) a distant third-place concern.

Its particularly frustrating when it becomes evident that for some supposed liberals like Maher, the whole point of Reform isn't strengthening healthcare access for the poor or protecting the solvency of social safety-net programs, but attacking some imagined Mr. Burns type evil healthcare CEO's.

(FWIW, while the HCRB is a short-term boon, I doubt its in the longterm interest of private insurers. Presumably they agree, which is why the industry has put so much money into killing the bill).

[John Mace]

Originally Posted by Simplicio

So we agree that the main question of the "political fight" regarding the HCRB was whether or not there'd be a HCRB? I read your comment as disagreeing with that, apologies if I misread.

No worries. I just said that I can see it having more political dimensions than just whether it passed or not.

Whatever metaphor you want to choose. My point is that a fixation on what the bill does or doesn't do regarding the metaphorical nether regions of healthcare insurance executives is a distraction. The point of the bill is providing universal coverage and limiting the growth of healthcare expenses to something manageable. The degree to which it helps or hurts the insurance investors bottom lines is (or at least should be) a distant third-place concern.

Its particularly frustrating when it becomes evident that for some supposed liberals like Maher, the whole point of Reform isn't strengthening healthcare access for the poor or protecting the solvency of social safety-net programs, but attacking some imagined Mr. Burns type evil healthcare CEO's.

(FWIW, while the HCRB is a short-term boon, I doubt its in the longterm interest of private insurers. Presumably they agree, which is why the industry has put so much money into killing the bill).

Maybe it's too much of a hijack to get into Maher's particular take on it, but he's not usually a "stick it to the rich" liberal.

Anyway, we'll see how this all plays out in this election year. For myself, I just saw my HC premiums jump > 20% last month. And this is after a big jump last year, too. If this whole thing is supposed to make HC more affordable, it's not doing so in my case. I'm sure a lot of folks are happy that they get to keep their "children" covered until they are in the mid twenties, but I'm not so crazy about paying for that.

[Simplicio]

Originally Posted by John Mace

Anyway, we'll see how this all plays out in this election year. For myself, I just saw my HC premiums jump > 20% last month. And this is after a big jump last year, too. If this whole thing is supposed to make HC more affordable, it's not doing so in my case. I'm sure a lot of folks are happy that they get to keep their "children" covered until they are in the mid twenties, but I'm not so crazy about paying for that.

Can't speak to your premiums specifically, obviously, but Health-care costs in general have been growing more slowly over the last two years then at any point in the last five decades. Obviously to what degree thats due to the still partly unimplimented ACA as opposed to the recession is debatable, but in any case, I don't think you can blame national trends for your increased costs.

[DirkGntly]

The reasons your premiums are increasing is because costs to the insurance companies are increasing, specifically having to cover "children" to age 26, who won't pay into the system themselves, and the requirement to cover pre-existing conditions.
I work in healthcare - there are some ridiculous restrictions in place, imposed by government, that keep costs high. For example, according to Medicare/Medicaid rules, a hospital cannot advertise pricing; it would be classified as attempting to attract "customers" which Medicare/Medicaid prohibits! Personally, I'd love to have the choice of "shopping" my healthcare - but I can't, because of these rules that prevent hospitals pricing procedures to the public.
There are a thousand different little ways to reduce healthcare costs, most of which involve REMOVING government from the equation, and it's vain attempts to equalize the industry.
Naturally, there are other non-government fixes that can be put in place, too, but the price fixing that goes on between hospitals and insurance companies is a major issue...which is solved by open pricing to the public.

[jtgain]

Originally Posted by John Mace

I'm sure a lot of folks are happy that they get to keep their "children" covered until they are in the mid twenties, but I'm not so crazy about paying for that.

I hope this isn't too much of a hijack, but what in the hell in the rationale for saying that 26 year olds are "children"? Is there any rational point to this other than a simple welfare program to young people?

[Really Not All That Bright]

Isn't this pretty much what you'd expect? There was an active campaign to overturn or repeal PPACA. Since it had already been passed, it seems obvious that the media wouldn't spend much time reporting on support for it.

I mean, no candidate for elected office is going to campaign on preserving a law. "Support me, and I'll make sure health care reform got enacted!" It's the same reason you never hear very much about pro-choice groups and campaigns - from the our point of view, things are pretty okay. If we're going to get het up about stuff, it will be subsidiary issues like contraception or Planned Parenthood funding or whatever.

Presumably, if you looked at the same metrics for the period during debate and passage, it would be reversed (or more likely, roughly equal).

[Simplicio]

Originally Posted by jtgain

I hope this isn't too much of a hijack, but what in the hell in the rationale for saying that 26 year olds are "children"?

Children in the sense of offspring. Not an uncommon usage (second definition at dictionary.com.)

Is there any rational point to this other than a simple welfare program to young people?

Young adults are the most likely group not to have access to group health insurance, as they're usually in crappy entry level jobs or college. As the goal of the legislation is to provide universal coverage with minimal disruption to the existing system, letting young adults join their parents group plans seems an obvious solution.

(and its not really a "welfare program" in the usual sense. They aren't getting health-care paid by the gov't, they still pay premiums. Just the group-rate premiums instead of paying in as individuals.)

[Jas09]

Originally Posted by jtgain

I hope this isn't too much of a hijack, but what in the hell in the rationale for saying that 26 year olds are "children"? Is there any rational point to this other than a simple welfare program to young people?

I'm confused by your question - are you asking why 26 year olds are called children or are you asking John why he used scare quotes on children.

Because obviously children can be any age.

As to why 26-year-olds should be covered under their parents policies I believe it has to do with the fact that many of them are starting careers or are looking for work or otherwise don't have an employer that provides coverage. Additionally, they are generally extremely healthy and don't buy insurance, but poor enough that they wouldn't pay a penalty under the mandate. So if you want them in the pool of insured (which, in general, you do to spread risk), you get them covered under their parents policies.

[2ManyTacos]

An earlier poster said that one of the main goals of health reform was to slowly wean us off of our stupid system in which our health insurance is tied to our jobs. On that note, my own two cents:

I still expect the law to be upheld completely (I'd put the odds of that at just over fifty percent, maybe 55% or something), but if the mandate falls (along with the guaranteed issue and community rating provisions) a lot of the key goals of health reform would still be able to go into effect ss long as the state-based insurance exchanges and the Medicaid expansion are able to survive SCOTUS scrutiny. In that event, what we'll essentially be left with is universal coverage for poor and lower middle-class people but further difficulties for everybody else at the middle-income levels; still, the exchanges and federal subsidies to buy insurance would at least help to disengage us from the employer-based coverage model we have now, and that alone is worth applauding.

Onto the OP: Yes, I think that it's safe to say that the Pubs did an excellent job at demonizing health reform in the eyes of the general public, but a lot of that was facilitated by the Dems' stupidity. I've said it before, but seriously, it was a fuckin' boneheaded decision to not have the bulk of the ACA kick in until FOUR FUCKING YEARS after the bill actually passed. Maybe they thought that the public would instantly warm up to it, or that the GOP would eventually stop its health reform witch hunt, but in any case the law should have been fully rolled out within the first year or two of its passage in order to garner up public support. People would've realized the benefits immediately and (probably) would've loved the law, but instead all they've had up until now is the GOP screaming into their ears about some hypothetical future reality in which health reform has turned the US into communist Russia or something.

If the law survives SCOTUS review and is allowed to be completely implemented, it'll likely go down as one of the most popular pieces of legislation in history. If not...well, state-by-state reform is going to be the way forward for the foreseeable future. The problem with that, though, is that most states don't want to touch health reform.

[RTFirefly]

Originally Posted by Bricker

So: did the liberal media take a day off, completely screw up, or are they not so liberal as that?

Is this a serious question?

[mister nyx]

Originally Posted by Really Not All That Bright

It's the same reason you never hear very much about pro-choice groups and campaigns - from the our point of view, things are pretty okay.

What?

[Grumman]

Originally Posted by twhitt

Chris Cillizza seems to simply be wrong. A plurality of Americans are opposed to the health care reform bill, yes, but that's not the right question to be asking.
...
The public wants health care reform.

No, yours is the wrong question. If people want Not-A, that does not mean they want B. Just because reform is needed does not mean your reforms are what are needed.

[Leaper]

But I think his basic point is that its opponents seem to think much the same thing, only their "B" is either "don't do anything" or "absolutely nothing that's in the bill." (Hmm, I hope that's clear...)

[tomndebb]

Originally Posted by Bricker

So: did the liberal media take a day off, completely screw up, or are they not so liberal as that? And have the Republicans won the hearts and minds of the American populace on the subject of Affordable Care Act boos and jeers?

The "liberal media" has never really existed, being more often liberal on social-specific issues such as civil rights and more often conservative on issues of economy or defense. Since the health care plan consisted of aspects of both perspectives, the "media" (outside Fox News), found itself in a quandary that interfered with its ability to choose sides.

The liberal pundits, however, were divided, with a number of them pushing for the plan as written in Congress on the grounds that something was better than nothing while a different set of them argued against it on different grounds than the consevative pundits, mostly opposing the lack of a single payer proposal and many objecting to the corporate enrichment provision of requiring everyone to purchase private insurance if it was not provided by their employer.

So we have a corporate friendly right leaning media standing off from the issue and liberal pundits disagreeing over the basics of the plan, leaving only the conservative pundits to provide a unified voice on the topic.

[Grumman]

Originally Posted by Leaper

But I think his basic point is that its opponents seem to think much the same thing, only their "B" is either "don't do anything" or "absolutely nothing that's in the bill." (Hmm, I hope that's clear...)

I understand you. The point is still wrong, though. Only a fool thinks in terms of "We have to do something!" without considering what that something might be. In this case, it's a health care reform bill built on a foundation of religious discrimination: the requirement that members of certain religions must buy a product from a third party or be punished, while the members of other religions may choose not to.

[fumster]

Originally Posted by Grumman

I understand you. The point is still wrong, though. Only a fool thinks in terms of "We have to do something!" without considering what that something might be. In this case, it's a health care reform bill built on a foundation of religious discrimination: the requirement that members of certain religions must buy a product from a third party or be punished, while the members of other religions may choose not to.

The idea that the healthcare bill was "built on a foundation of religious discrimination" is simply a lie. That was not the foundation in any sense of the word. The religious exemption is more like a side building to hold unattractive but crucial things like lawnmowers and snow shovels. It's a balancing act between religious accommodation and widespread avoidance of the mandate.

[Bryan Ekers]

I'm not sure how an issue like this would be decided if not by words. It's not like the Republicans and Democrats are going to select champions for single combat to the death.


Though that would certainly make the process far more interesting.

[tomndebb]

Originally Posted by fumster

The idea that the healthcare bill was "built on a foundation of religious discrimination" is simply a lie.

Accusations (and imlications) that other posters are lying are prohibted in this forum. Do not do this again.

[ /Moderating ]