“Americans distrust any ambitious change in the realm of medical care,” says the Chicago Tribune‘s Steve Chapman (9/15/17)–ignoring the polls that show majority support for single-payer.
MICHAEL CORCORAN FAIR September 20, 2017
For many years, corporate media have largely ignored a single-payer system as a possible solution to the United States healthcare crises (FAIR.org, 3/6/09). This silent treatment, however, is increasingly hard to justify now that the most popular politician in the country has forced the issue into the mainstream of the Democratic Party.
Sen. Bernie Sanders’ Medicare for All bill now has 16 cosponsors, up from zero when he introduced a similar bill in 2013. Meanwhile, in the House of Representatives, a record 119 of 194 Democrats are cosponsors of HR676, John Conyers’ single-payer legislation. The math is simple enough: 135 of 242 Democrats in Congress (and counting) are on the record as supporting the federal government assuming responsibility for the costs of healthcare.
Unable to continue ignoring the policy, corporate media have, with predictable uniformity, undermined it as utopian nonsense. The typical elite narrative since Sanders’ bill was announced last Wednesday has been to amplify the same kind of scare tactics that have been injected into the national discourse for decades (at a considerable expense) by the for-profit health industry, the American Medical Association (AMA) and right-wing think tanks.
The False Equivalency of Sanders’ Bill and GOP Plans
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The media, however, are now peddling a new and particularly dubious angle: equating Sanders’ bill with GOP efforts to repeal the Affordable Care Act as similarly “extreme” alternatives. This is particularly disingenuous, given that a single-payer system, which would provide universal coverage, is supported by a slight majority of the public in recent polling (Quinnipiac, 7/27/17–8/1/17 ; Kaiser Family Foundation,6/14–19/17), while every recent GOP proposal would throw millions of Americans off insurance (Congressional Budget Office, 5/24/17, 6/26/17, 7/27/17) and is wildly unpopular (Washington Post, 6/30/17).
Consider the New York Times’ “Medicare for All or State Control: Healthcare Plans Go to Extremes” (9/13/17), which compares Sanders’ Medicare for All with the regressive “Cassidy/Graham” policy. Reporter Robert Pear’s premise is that the Sanders proposal is the left-wing “extreme,” the mirror image of the the GOP’s equally radical proposal to repeal the ACA.
On the one hand, you have a bill that establishes healthcare for all, which is a norm in the industrialized world (OECD, 7/22/16). On the other hand is yet another regressive version of Trumpcare (Center for Budget and Policy Priorities, 9/13/17), the Republican proposal to slash Medicaid and repeal requirements that protect patients with pre-existing conditions. Given these dramatic differences, this comparison seems to be doing readers a disservice.
If these plans represent the ideological extremes, as the Times suggests, what would be a rational, non-extreme proposal? The status quo, which leaves us with 28 million uninsured, and the most expensive, wasteful system on the planet? Some minor tweaks to it? Pear doesn’t say. This is a classic dilemma when you treat the world, as the Times often does, as if the Democratic Party represents the left, the GOP represents the right, and magical solutions exist in some undefined center.
Pear’s sourcing is also rather lopsided, with the following people quoted: Bernie Sanders, Donald Trump, Sen. Lindsey Graham (R.-S.C.) and a representative of the major insurance lobby, American Health Insurance Plans (AHIP), who capped off the article with a warning that “government-run healthcare won’t work.” In other words, Sanders, three militant opponents of single-payer and a false equivalency.
Another piece about how “single-payer healthcare could trip up Democrats” (New York Times, 9/11/17) quotes former Obama administration appointee Andy Slavitt comparing single-payer to the GOP’s promise to “repeal and replace” Obamacare, saying it “could be the Democrats’ version of the thing that they promised to do for seven years and couldn’t do.” Again, the distinction is lost that one policy would provide healthcare to all while the other would take it from millions.
The Times’ Paul Krugman—who was frequently dismissive of Sanders during the 2016 presidential campaign (FAIR.org, 11/27/16)—also compared Sanders’ single-payer bill to the GOP’s health and tax proposals. In his column “Politicians, Promises and Getting Real” (9/15/17), he warned that Sanders’ bill could lead the Democrats to a “Trumpcare-type debacle.”
Krugman, who used to be supportive of single-payer (New York Times, 7/25/05, 3/23/06), has wavered recently in favor of private plans, falsely suggesting the ACA is a pathway to universal care. “It more or less achieves a goal—access to health insurance for all Americans—that progressives have been trying to reach for three generations,” he wrote (New York Times, 1/18/16). In Krugman’s worldview, a bill that leaves 28 million uninsured, does not cut costs and has no pathway to universal coverage (CBO, 3/20/10; Truthout, 6/9/16) is “more or less” the same thing as actual guaranteed care for all.
Krugman says he doesn’t “mean to suggest that these cases are comparable,” but this seems disingenuous, given that the article is structured around the very comparison he claims he is not making.
The tone of the Washington Post’s coverage was clearly evident to those who saw the giant headline “Healthcare for All, and Higher Taxes,” on the Kindle version of one of its articles (9/13/17). The emphasis on higher taxes is telling. It is true that single-payer would require higher taxes. But studies (and the experience of other nations) show new taxes would be offset by dramatic administrative and out-of-pocket savings that would decrease overall spending (BMC Health Services, 11/14). If only the press chose to be so judgmental about past endeavors: Would “A War in Iraq, and Countless Corpses” have made it past editors when the paper helped enable that tragedy years ago (FAIR.org, 3/19/07)?
Another Post article (9/14/17) about Sanders praising the Canadian health system also links Sanders’ Medicare for All bill to GOP policies. The article quotes the libertarian Cato Institute’s health analyst Michael Cannon arguing, “If Bernie wants the United States to move in the direction of Canada’s healthcare system, he should be advocating not ‘Medicare for all’ but ‘Medicaid block grants for all,” Cannon said:
Interestingly, it is actually Senate Republicans who are proposing to move in the direction of Canada’s healthcare system, while Bernie Sanders wants even more federal control.
It is hard to make sense of this comment, given how radically different the two proposals are in purpose and design. While it’s true the Canadian Health Transfer channels healthcare funds through the provinces, it does so with a principle of “universality” that guarantees that each Canadian citizen gets comparable coverage, no matter where they live or how much they earn, which is not the case with the GOP proposals for Medicaid block grants.
The false comparisons continue. An op-ed in the Post by Catherine Rampell, headlined “Sanderscare Is All Cheap Politics and Magic Math” (9/14/17), argued the bill proves that the “lesson the Democrats seem to have taken from the 2016 electoral trouncing is that they need to become more like Republicans,” and described “single-payer” as a catchphrase no different from “repeal and replace.” “Will Mexico pay for it?” she quips, comparing Sanders’ bill to Trump’s proposed border wall.
Where Are the Medicare for All Advocates?
Also glaring is how few advocates of Medicare for All are quoted or published in major media outlets. The New York Times did publish an op-ed by Sanders (9/13/17) on the day his bill came out; but outside of that, finding an article that is not dismissive or hostile, let alone supportive of the plan, proves difficult. This is despite popular support for Medicare for All, according to numerous polls (e.g., Economist/YouGov, 4/2/17).
Consider the Boston Globe, which conservatives would have you believe is the ideological equivalent of the Socialist Worker. Its search engine shows three major articles about Sanders’ proposal. The headlines alone leave little doubt as to the tone of the coverage. “Single-Payer May Sound Appealing, but It’s Complicated,” reads one (9/13/17). The same day, the paper ran a column by former Clinton speechwriter Michael Cohen, headlined “Single-Payer Snake Oil” (9/13/17). The third (and so far final) major article it published was called “Not Everyone Agrees on Bernie Sanders’ Healthcare Plan. But Everyone Wants to Vote on It” (9/15/17), which emphasized the GOP’s eagerness to run against the bill.
There is, of course, nothing wrong with writing skeptically, or even critically, of single-payer. Every plan has winners and losers, and the public has a right to know about these scenarios: job churn for those in the insurance industry, the trade-off between tax increases and overall savings, and so on. But the coverage focuses almost entirely—sometimes hysterically—on the potential losers, and very little on who would win: the vast majority of Americans, who would pay less overall and never have to worry about losing their insurance due to job loss or lack of income.
And the lack of pro-single-payer voices is glaring. The Globe coverage reflects this bias; as of this writing, there are no positive op-eds or editorials in favor of the bill to counter the mostly negative news coverage or Cohen’s angry retort, which made the same comparison as others to GOP repeal efforts: “The great irony of the push for single-payer is that it ignores the lesson from the GOP’s recent failure to repeal Obamacare — don’t rock the boat.”
Cohen offered that “if the goal is to get America to universal coverage there are plenty of ways—other than single-payer—to achieve that goal.” But none of the proposals he mentions—a Medicaid buy-in/public option, stabilizing the individual market with government funds or extending CHIP—would do that.
The CBO scored a public option (11/13/13), for example, and found it to have “minimal effects” on access or the number of the uninsured. The Medicaid buy-in or public option is widely believed to lead to “adverse selection” (Urban Institute, 9/16), or a disproportionate amount of poor and sick people joining the public plan, making it less efficient.
When progressives pushed for the retention of a public option in the healthcare reform plan of 2009–10, they were told by President Obama that it was an unessential “sliver” of his proposal (New York Times, 8/17/09). When progressives lamented Obama’s decision to drop this policy (Extra!, 4/10), they were portrayed by the Times (12/17/09) as ideological militants who were “smacking the pragmatic president in the face.” Now Krugman and Cohen would have you believe it is the obvious, viable solution to our healthcare problems.
It seems that in the dominant media narrative, anything progressives want —regardless of specifics—is extreme and reckless. Anyone who offers this point of view, and pursues less bold changes, is “pragmatic.”
This is also a curious departure from how the dominant media covered much of the GOP health reform efforts. When the House version of Trumpcare was being debated, the media focused on right-wing critics of the bill who claimed the proposal was too generous (FAIR.org, 3/15/17). Left critics of the ACA who pushed for single-payer were virtually ignored by the press when that bill was being made.
When All Else Fails, Resort to Mockery
The current debate over Sanders bill is not all that different from the debate over his proposals during his presidential campaign. At that time, the New York Times (2/15/16) quoted Ezra Klein and others who mocked Sanders’ plans as “wishful thinking,” “fairy tales,” “puppies and rainbows” and “magic flying puppies with winning Lotto tickets tied to their collars.”
It seems some things never change. Steve Chapman recently wrote an op-ed for the Chicago Tribune (9/15/17) where he echoed this tired joke: “[Sanders’] proposal really should be called Medicare for All and a pony. It’s everything you could want and then some.”
Maybe some people find that funny. But given the extent of our healthcare problems, there is little to laugh about.