Health Care Face-Off
When the Terminator outlined his plan for universal health insurance coverage in California on January 9, news media declared the plan “bold,” “ambitious,” “innovative,” “ground-breaking” and a “sweeping remedy.”
“Well there’s definitely – is a crisis,” “Good Morning America” anchor Robin Roberts said, “And it’s good to see that, at least trying something, something especially to help those that are uninsured.”
In contrast, President George W. Bush’s plan to use tax reform to provide people with a means to purchase their own insurance, announced during the State of the Union address on January 23, earned plenty of media scorn.
It “doesn’t sound like it’s that bold and that innovative,” said CNN anchor Soledad O’Brien on the January 24 “American Morning.”
Rather than an “ambitious” and “ground-breaking” plan, NBC’s David Gregory called Bush’s domestic agenda, including the health insurance plan “modest” on the January 24 “Nightly News.”
The president’s plan was even misrepresented in news coverage as an “overhaul.” CBS reporter Harry Smith stated that the idea would be “an overhaul of the health care system, including a tax on employee-financed health care benefits,” on January 24 “Early Show.” But Smith left out an important fact – that the plan includes a tax deduction – as he introduced Bill Plante’s report on the State of the Union speech.
The president’s plan included two proposals. The first would be to begin counting insurance premiums paid by employers as income, and then offering a standard tax deduction of $15,000 to all families and $7,500 to all individuals.
According to the president, “this proposal would mean a substantial tax savings [for those purchasing their own insurance]… And for the millions of other Americans who have no health insurance at all, this deduction would help put a basic private health insurance plan within their reach.”
The plan would result in a tax increase for people whose insurance premiums are higher than the deduction offered. The president said that revenue could help fund “Affordable Choices” grants to provide private health insurance to the poor and sick.
The tax increase would affect 30 million people, roughly 10 percent of the U.S. population, who have the best benefits, if they choose not to find less expensive coverage, said Katherine Baicker of the president’s Council of Economic Advisers.
Despite the tax increase on those with strongest insurance plans, experts from conservative and libertarian groups like Cato Institute, The Heritage Foundation, The Tax Foundation, American Enterprise Institute and the Galen Institute have voiced support for the proposal because it would make the health insurance system more competitive and therefore, better for consumers.
Proponents of “universal coverage” which would be paid by the taxpayers and in the case of California by higher taxes on doctors and hospitals, aren’t supporting this redistribution of wealth. According to ABC’s George Stephanopoulos, “Democrats say that’s robbing Peter to pay Paul.” Stephanopoulos interrupted George Will during “This Week” as Will explained “the President, as I understand it, wants to tax certain gold-plated health care plans and use the revenue to pay for [those who need assistance],” on January 21, 2007.
ABC’s Lisa Stark was concerned about the plan too. “Some worry this proposal will encourage businesses to stop offering health insurance,” she said on the January 24 “World News with Charles Gibson.”
But experts like the Tax Foundation’s Gerald Prante explained that could actually be a good thing. “Economists have long observed that fringe benefits such as generous health plans should be counted as income, and it would unquestionably be a good idea to treat all health insurance purchases equally in the tax code, ending the current preference for business purchases,” Prante wrote in his January 22 Fiscal Fact.
“Ideally, the income tax code would not be used to subsidize certain industries and individual purchases,” Prante said. “The income tax could collect the same amount of revenue with much lower rates, but exemptions, deductions and credits continue to accumulate, as politicians see the tax code as a vehicle to solve social problems.”
The discussion has also been framed by the media as a “health care” debate instead of a “health insurance” debate. Referring to Bush’s proposals, ABC’s Charles Gibson called it a reform overhaul of the “health care system,” as did CBS’s Harry Smith on January 24. But the plan wouldn’t directly change the health care system – it deals only with taxation of health benefits, which affects who chooses and pays for insurance.
By framing this as a “health care” question, rather than as health insurance the media makes it sound like Americans are dying because they cannot get treatment. But the uninsured are not simply going without care. According to the National Center for Policy Analysis, uninsured individuals on average receive about $1,500 worth of free health care a year.
… And No Representation
Stark’s report only included one proponent of the president’s plan: an employee of a small computer store who must buy his own insurance. But ABC relied on opposition from longtime supporters of universal health care. Stark quoted Ron Pollack of the liberal group Families USA and at the conclusion of the report, anchor Charles Gibson interviewed ABC medical editor Dr. Timothy Johnson – who championed Hillary Clinton’s universal health care ideas in the 1990s.
“First, it doesn’t make any kind of major dent in the horrible problem of the uninsured. And even more significant, I think, all the focus on taxes has diverted attention from the real problem, which is the terrible waste and inefficiency in our health insurance system,” Johnson said on the January 24 “World News.”
Back in 1994, Johnson gushed that “Everyone is applauding, I think, in the health care community, the emphasis on universal access.” On the Jan. 26, 1994, “World News Tonight,” Johnson said “the insurance companies are the focal point for the dynamics of denial that are part of our present for-profit system.”
CNN’s “American Morning” also excluded free-market viewpoints from reporter Alina Cho’s story on January 24. Instead Cho’s report included one policy expert who has donated thousands of dollars to Democrats over the past 10 years.
Die in the Streets, Eh?
Unlike the stories about the president’s plan to modify the tax code to make insurance more accessible, the media loved Arnold-care when it was announced on January 9. Schwarzenegger’s plan to provide all Californians with health insurance would be paid for by an additional 2 percent tax on doctors’ incomes, 4 percent on hospitals and $5.5 billion in increased federal aid.
ABC’s Brian Rooney called it “ambitious,” Diane Sawyer called it “bold,” and Robin Roberts called it “sweeping.” CBS’s Katie Couric also called it “ambitious,” while NBC’s Meredith Vieira said it was “ground-breaking.”
“Well, there’s definitely – is a crisis,” declared Robin Roberts, “And it’s good to see that, at least trying something, something especially to help those that are uninsured,” on “Good Morning America” the same day.
The media coverage of President Bush’s health insurance plan and Gov. Schwarzenegger’s revealed a bias for universal health coverage, like ABC’s Dr. Tim Johnson who was worried that without “universal access” some people would “die in the streets.”
Then reporters should look north to a country with universal care for information about how well the system works. Canada has “universal” care, but is it really better than the current U.S. system? One huge problem in Canada is how long patients must wait for treatment.
According to Dr. Richard F. Davies, in a single year 71 patients died waiting for scheduled coronary artery bypass graft surgery in the province of Ontario. Another 121 were taken off the waiting list “because they had become medically unfit for surgery,” and 44 chose to go outside the province for the surgery, including to the United States.
A 2005 documentary called “Dead Meat,” made by On the Fence Films, interviewed Canadians who went blind waiting for cataract surgery and became addicted to prescription pain killers while waiting for surgeries. The filmmakers also found a man whose neck surgery was cancelled, a couple who were told that there was a two-year wait for a hip surgery consultation, and a family facing uncertainty as the mother’s brain surgery was cancelled twice.
“Any specialized doctor you’re gonna wait a long time, that I’m not happy with. It doesn’t even make sense,” said Bridget Gordon, a Canadian who had to wait two years for knee replacement surgery while enduring constant pain.
Sometimes that wait kills. In “Dead Meat,” Vancouver resident Sean Gorsuch tells the story of how his mother needed heart surgery. She didn’t get a surgery date until a couple of years after her diagnosis, and her surgery date was cancelled twice. Gorsuch’s mother died waiting for heart surgery.
But none of the stories praising Arnold-care included this criticism of “universal” coverage plans.
While the media provided plenty of support for the California plan, they left out facts and voices of support for Bush’s plan.
The Galen Institute, a non-profit organization that researches health policy, was one group supporting the proposal. Galen President Grace-Marie Turner said of the president’s plan that “he has offered a remedy for a root cause of the health sectors high costs and consequent high uninsured rates.” Turner went on to say the plan is a “win/win/win/win/win” because it will benefit millions of uninsured, the states, employees, the health care industry and taxpayers.
The media just didn’t see it that way. CBS “Evening News” elaborated on old news about Massachusetts’ universal health care plan instead of discussing the president’s plan from two days earlier in its January 25 report.
By stating that “Perhaps the biggest hurdle [for Massachusetts]: changing the culture so that insurance is seen not as a luxury but as a necessity,” made reporter Kelly Wallace’s opinion that all people need health insurance obvious.
But is it a necessity as Wallace thinks? Two economists from the National Bureau of Economic Research concluded that 25 to 75 percent of the uninsured can actually afford health insurance, but choose not to purchase it.
Wallace’s report did not include criticism of Republican Gov. Mitt Romney or Republican Gov. Schwarzenegger’s plans for universal coverage.
Stuart M. Butler and Nina Owcharenko of The Heritage Foundation had a different view of taxing health benefits. Currently “the unlimited tax advantage for compensation earmarked to pay for health coverage encourages workers to accept more generous (and expensive) health care benefits in lieu of higher wages,” they wrote in a Newsday.com editorial. Most people don’t know the value of their health benefits are about $11,000 a year for an average family.
“The change also will foster a competitive marketplace in which health insurers and providers will have to compete for consumers,” according to Butler and Owcharenko.
Lack of that competitive marketplace for insurance is a problem said Cato Institute’s director of health policy studies Michael F. Cannon: “Though economists on the left and right have been screaming it [the tax code change] for decades, few politicians understand that the unlimited tax exclusion for employer-sponsored health insurance does enormous damage to America's health care system.
That damage comes in the form of skyrocketing health care costs over and above inflation, according to tax policy expert Dan Mitchell of Cato and that is because the current tax code drives people into third party payment systems.
Mitchell told the Business & Media Institute that getting rid of the “really foolish tax break” that exempts company insurance premiums from taxable income would help change that and would be “a small first step in the right direction” to getting government out of the way.