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Less "Horse-Race" Reporting on Health Care

By Andy Alexander

Sunday’s column on the need for less horse-race coverage of health-care reform sparked a large reader response. One was from New York Times columnist Paul Krugman, the Nobel prize-winning economist. The column “hits on a pet peeve,” he wrote in his Sunday blog: “reporting that focuses on how policy proposals are supposedly playing, rather than what’s actually in them.”

Krugman believes that reporters often gravitate to horse-race stories because they are easier to research, easier to write and “safer” to cover. “If you cover policy, and go beyond dueling quotes, you have to make some factual assertions -- and people who prefer to believe otherwise will get mad.”

I believe The Post needs to provide horse-race coverage because it has a large and devoted readership of political junkies and wonks. In that regard, it’s done a superb job. But my column argued for much more baseline reporting for ordinary readers who are confused about even the most fundamental health-care concepts and proposals.

In his blog post, Krugman wrote: “It’s easier to research horse-race stuff. To report on policy, a reporter has to master the policy issues fairly well. That’s not easy, especially for journalists who have specialized in up close and personal rather than wonkery -- and policy issues change from year to year.”

Stuart M. Butler, a Heritage Foundation vice president and health care authority, made a similar point when I interviewed him for the column last week. In his experience, he said, journalists covering health care “in general...almost always have very little knowledge of it.” And he said a number of journalists who cover the issue have told him their editors believe that if they write primer-type stories “their readers will be bored by it.”

Butler noted that providing basic educational-type stories is not common for most news organizations, including The Post. “They tend to look at it as a political issue,” he said of the media. He also speculated that much of the anger expressed at the recent town hall meetings on health care was because citizens are confused by the issue.

“Americans want to know what’s going on here,” he said. “People are very confused by health care. They don’t understand the system. And they’re frightened by change. So if the press doesn’t help them understand it better, who will? When people don’t understand things, they get frightened and angry and they oppose things.”

While conceding the complexity of the issue, Butler believes that news organizations such as The Post “can take a complex issue like health care and really reduce it to language people can understand without dumbing it down.”

I think The Post did that well in a large graphic on June 9 titled, “In Search of Health-Care Reform.” The content was provided by lead health-care reporter Ceci Connolly and graphics reporter Karen Yourish. This clear-headed graphic presentation allowed readers to digest complex data in easily consumed bites. In brief paragraphs, it provided a glossary of basic terms (such as “Third-party payer” and “Employer mandate”) and described key players (insurance industry, doctors, drug companies, employers, hospitals, etc.). It tracked the increased spending for health care with a visual that showed where the money comes from and where it goes. And it laid out “most likely options” for reform in short bulleted summaries. The entire thing had a “Health-Care-For-Dummies” feel to it, which is precisely what many readers have said they want.

Connolly also narrated some similarly smart and basic “info graphics” on The Post’s Web site.

Finally, The Post recently published the first of what will be a series of truth-squadding features on health care. Titled “Under the Microscope,” it will examine the competing claims of interest groups to help readers cut through the fog of rhetoric.

That’s the kind of reporting readers say they want. As a reader identifying himself as “MrCleaveland” wrote in response to Sunday’s column: “I don’t care about reading virtually identical stories about protests or blue dogs or greedy insurance companies blah blah blah. I would like to know how this would work if it passes. I have no idea.”

By Andy Alexander  | August 31, 2009; 12:34 PM ET
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Yes, health care and the reform proposals are complex. But we the people realize that reform affects each of us personally so we are highly motivated to understand these proposals. Surely it is the core responsibility of our great American press to clearly and concisely describe these proposals. Paul Krugman, Andrew Alexander and others have observed rightly that this essential core has been blotted out by showy town meeting screamers. Please give us real news.

Posted by: Phil34 | August 31, 2009 5:03 PM | Report abuse

“The Post recently published the first of what will be a series of truth-squadding features on health care. Titled ‘Under the Microscope,’ it will examine the competing claims of interest groups to help readers cut through the fog of rhetoric.”

I can’t say I’m impressed by this first effort. The whole article addresses whether President Obama’s claim that people will be able to keep the coverage they have now if they like it after a reform bill passes is true. The article concludes that Obama’s statement is not true, not because the reform bill would directly remove any existing plans, but because the requirements of the reform bill might cause insurers to cease offering plans rather than meet the requirements.

The President would do better to rephrase his claims, but under our current “system”, we certainly have no assurance of keeping any health insurance plan. I am limited to whatever plans my employer offers. This past period, I was offered a plan with the same insurer that I previously had, but with me paying more than 50% more than the previous year plus higher co-pays. Is that the same plan?

I’ll be more impressed if you address the claims made by the Republicans: that older people will be advised to just die and get out of the way, Sarah Palin’s claim that her Down Syndrome child would have to face a ”death panel”, or that if Steven Hawking were under British health care he would be dead, even though Hawking is British and has been under British health care his entire life and is alive.

I would have a lot more respect for your paper if you didn’t repeat the mindless and untrue statements by opponents of health care reform as if they were actually rational arguments, but rather pointed such statements out for the fear-mongering lies that they actually are.

Posted by: hgillette | August 31, 2009 7:45 PM | Report abuse

My first and most important point is that this is way too little and way, way too late. Where was the Post a year ago, two years ago when this might have made some difference before the brilliant PR campaign of the insurers had poisoned the minds of many with lies and misrepresentations?

My second point is that the Post still obeys the prime rule of health reform coverage:

Thou shalt write nothing that might endanger the obscene compensation of insurance executives and the high returns to their rich stockholders.

Here are two of many examples. The Post has never written of the enormous waste of the high overhead and vast compliance costs of patients and physicians due to the for profit insurance companies. This alone could pay for decent health insurance for everyone, and we would not have people dying, suffering and going bankrupt while we work on further savings by reforming medical practice.

Recently the Post has begun to look at the success of other countries in achieving better health care at much lower cost. But look at panel 9 of the large graphic ( Mr Andrews refers to above. It contains astonishing information about the comparison of our system with the government run universal systems in other countries, BUT the voice of Ms Connolly says NOTHING about the data on the chart. She merely talks about the red herring of changing medical practice which, while important, will be extremely difficult because it will be strongly resisted by many physicians. She never points out that other countries either have minimized private insurance or, in a few cases, strongly controlled it. Of course she doesn't because that would be a violation of the prime rule.

Posted by: lensch | September 1, 2009 7:55 AM | Report abuse

I have to agree with user hgillette regarding the truthiness of the first Under the Microscope piece. Listen. A couple years ago, my private employer switched us from Cigna to Aetna. No big. It happens. Everyone already knows private employers can do that.

What people have been asking is whether GOVERNMENT will be able to force people to leave their current providers; it won't. EMPLOYERS may make that choice, same as they do now (but with more competition, hopefully), but the government isn't going to force anyone to do anything.

You're doing a heck of a job, Postie.

Posted by: dkp01 | September 1, 2009 4:19 PM | Report abuse

Here's a Novel idea, what about telling the "TRUTH", that would be a good start. I've had the displeasure of reading some of the columns. Are the columnist even talking to one another. One Columnist writes a column one way while on the same day another columnist writes a totally opposing column.

It's a small wonder most of your readers a confused It's like walking through a Maze, reading your paper and website.

When the post goes front paper with a story about Sarah Palin, saying that the President wants to set up "DEATH PANELS", for senior citizens, what would you expect?

Does anyone in your newspaper have any common sense? Telling Senior Citizens something like that should be a Crime.

If you want to contribute to the debate, report the news, and not some outrageous claims made by a very derange Lady.

There are enough Media outlets spreading LIES, and Misleading information about the Health Care Reform Debate, they don't need any help from the Washington Post.

Selling newspapers is one thing, spreading Lies, and character assassination, are grounds for a Law Suit.

Posted by: austininc4 | September 1, 2009 11:30 PM | Report abuse

I understand that WAPO is devoted to ardent followers of the political horserace, and I try to always keep that in mind when I read your paper every AM. Nevertheless, as a health care provider I am often offended by the narrowly focused reports that discuss policy that will result in life and death power over my patient's lives as though all it were was political gamesmanship. The triviality of the stupid jockeying for oneupmanship in the endless soap opera that is partisan politics rankles, when one faces the tragedy and irrevocable loss of the human consequences of the policies that are bandied about like so many Facebook friends.

I read your paper to see where we who need health care reform stand in that Beltway realm - one so far removed from the realities of dying patients and grieving family members that the dissociation terrifies any sane human being. It might as well be another planet, that is how little it represents anything relevant to the lives of those at stake in this battle.

I often wish your paper went to greater lengths to relate the real time effects of Beltway politics on Americans, and perhaps supply a historical perspective, instead of merely logging the minutiae of Washington's "Days of Our Lives". Perhaps that is asking too much, but reaching for greatness in journalism once in a while couldn't hurt.

Posted by: Firstresponder | September 5, 2009 1:27 AM | Report abuse

You seem pretty committed to a false dichotomy. You seem to think so-called average readers need health care for dummies treatment, avid policy wonks want horse-race coverage. Perhaps wired-in beltway types want a media discourse that is trivialized and maleable, so that "average readers" remain "dummies".
What you don't do is fully acknowledge how skewed the balance is between issue and horse-race coverage, and the very clear problem that horse-race coverage drives the issue coverage, and not the other way around. Looking at recent polling on health care issue is reminiscent of polling in the lead up to the Iraq war: the American public seems to be systematically misinformed. Shouldn't that be your paper's real concern?

Posted by: fgww | September 5, 2009 2:50 AM | Report abuse

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