US Healthcare Debate Reveals Sick Media


There was a lot of hope engendered by the use of new media technologies by the Democrats and progressive political groups in the election of Barack Obama. Had the left finally found a way to reach out to gather and organise a new constituency — in spite of the stacked deck that was the US’s national mediasphere? It’s true that the online component of the election campaign was successful, but the jury’s still out as to whether Obama’s online campaigning was effective in winning people over to his side, or whether it simply improved the "supply-chain" of volunteer organisation and donations.

In any case, outside of election season, it has to be said that well funded American Republicans are at least as good at using the internet to affect policy activism as the Democrats — and that perhaps they’re even better at serving up consistent messages to their constituency over a wide network.

The US healthcare debate is something of a catastrophe, but it is instructive insofar as it reveals the right’s advantages in political communication. Efforts to reform the USA’s inefficient, ineffective health system have been dominated by apocalyptic smears and deliberate falsifications on the part of hard right, "movement" conservatives. Some have put the successful transmission of hard right messaging on healthcare down to the irrationality of the right’s constituency. Such diagnoses reveal the extent of the progressive left’s frustration with the right’s capacity to mobilise public opinion but they have severe limits as analytical frameworks. It’s better, I’d argue, to think instead about the sheer number of channels the right has at its disposal and the increasing structural weakness of the US mediasphere.

From Australia, the proposed healthcare reforms look modest. At present, 47 million people — mostly full-time workers earning less than US$30,000 — are neither eligible for the limited medical safety net, nor capable of paying for private health insurance. The US spends 16 per cent of its GDP on healthcare — or US$2 trillion annually — and gets less in return than any other comparable industrialised nation. The plan is to close the gap with subsidies, an extension of Medicaid and, maybe, a government-backed insurer (although the last part of the plan is looking less likely to happen with each passing day). Over time, this should mean that Americans get more for their health spend, and more importantly, that more people will have access to healthcare when they need it.

A major problem in health reform efforts is that the status quo benefits corporate insurers and big pharmaceutical companies. They have connections, not least as funders and sponsors, with the labyrinth of movement conservative institutions, commentators and organisations who still dominate the American right. Movement conservatives see even minor health reform as creeping socialism and they’ve hit back hard against the proposals. Over decades, they’ve built a "noise machine" that’s brought them to occupy the commanding heights of much of the US news media. In the current debate, they’ve used that advantage to propagate spin and outright untruths about Obama’s plans and they’ve had them accepted in some quarters either as fact, or as legitimate perspectives.

Some of the biggest and most outrageous lies in this debate have been told about "death panels". The right have deliberately distorted provisions for "living wills" — in which people can spell out if they want treatment suspended in the case of painful, terminal illness — painting them as a plan for the forcible euthanasia of the untreatable. (Of course, living wills have been around for some time, and even the Catholic Church — hardly euthanasia advocates — allow for patients to refuse "extraordinary measures" to prolong life in such cases.) After Sarah Palin wondered, mischievously and publicly, if these provisions might have brought about the death of her disabled child, conservative organs from Fox News to the Patriot Post eagerly spread the "death panels" meme. Worse still, these and other distorted claims about the healthcare reforms featured in "serious" political broadcasts and newspaper columns. This is because, like the Australian hard right, though over a longer period and far more successfully, a key culture wars strategy of movement conservatives has been to demand space in formerly respectable press and broadcast outlets for disruptive partisans running lines and deliberate falsehoods — all in the name of "balance".

This noise machine has been in overdrive during the healthcare debate; it has managed to up the ante by putting people into the "town hall meetings" convened to discuss healthcare reform, with the goal of making them unworkable. A measure of the success of movement conservatives on healthcare is the extent to which they have persuaded Americans from those parts of the country, and those demographics who would benefit most from healthcare reform, to argue for a cause that is so clearly detrimental to their own economic interests.

As an avid subscriber to a number of movement conservative email newsletters, websites and podcasts, I can attest that the "death panels" meme spread like wildfire. It was spread in crafty and innovative ways too, like being incorporated into jokes that readers could themselves take to their offline social network — their office, their bar, their family barbecues. The policy unity and message control of movement conservatives is such that they dominate discussion across media — unlike other political networks whose propagation of debate can work to fragment their core message. There may well be a principled conservative position on healthcare reform but it is being crowded out by movement madness.

Perhaps their job is made easier by the diminishing importance of the "news of verification" (as opposed to "news of opinion") in the current, much discussed "crisis" of journalism. Television and radio news have always drawn heavily on newspapers but the problems with which the print media is currently grappling mean that many Americans are getting poorer and less information with which to make their minds up about important issues of public policy.

The travails of the newspaper industry have perhaps been raked over enough, but what’s talked about less often is the fracturing of the post-broadcast audience for news and current affairs content. The high-choice media environment that includes cable and the internet has been a boon for news junkies seeking bottomless public affairs content. But as political scientists like Markus Prior have shown, it has also made it easier for people who’d rather be entertained to avoid the news altogether.

The audience for network news and daily newspapers has shrunk; cable news and the internet have grown (though they’ve not stopped some people drifting away from news altogether). Prior shows that as more moderate "entertainment seekers" move away from news and political engagement, the remaining pool of politically engaged people tend to act and think in more partisan ways. The tenor of public debate cannot but be affected. And there’s no sign that Americans are going to be able to reconstruct common ground or shared understandings for political debate any time soon.

Here in Australia, our political context is different, not least because the local branch office of the hard right lacks the entrepreneurial verve of its American equivalent. But it’s worth considering the results when the public sphere is not carefully tended, when right-wing victim politics allow hard-right messaging to proliferate across the mediasphere, and when there are fewer venues where the nation can come together to consider important public initiatives in a measured way. The media here are less diverse in terms of ownership than their American equivalents, and this week has shown once again that they’re not immune to the collapse of the business model of commercial journalism.

The eruption of a vibrant online public sphere with a plurality of voices and perspectives is welcome, but it could be that learning from the US experience, we do need to think about the importance of maintaining a truly national outlet for important public policy discussions. One thing we do have in our favour is a relatively strong public broadcaster. It’s perhaps there that we should focus our efforts on ensuring that serious analysis and debate carry the day in news coverage, and that a noise machine which is only interested in derailing debate does not get an easy a ride.

Launched in 2004, New Matilda is one of Australia's oldest online independent publications. It's focus is on investigative journalism and analysis, with occasional smart arsery thrown in for reasons of sanity. New Matilda is owned and edited by Walkley Award and Human Rights Award winning journalist Chris Graham.