Was too! Reply to Kilkenny over media coverage of health reform

Andrew Sullivan believes "Harold Pollack goes out on a limb" in calling health reform the best-covered news story ever. Allison Kilkenny believes that "Harold Pollack went out on a limb, and unfortunately fell off the edge." At least they spelled my name right.

Kilkenny and I agree about many things. I'll lay out the chunk of her piece that hits the main issues, but you should read the entire piece.

Pollack cites the Wall Street Journal (circulation 2 million), Fox News (the highest rated basic cable channel in primetime), and Investor's Business Daily (circulation 210,000) as a few examples of the "bad journalism" which peddled the worst kinds of healthcare miseducation nonsense. He's absolutely correct that these forums engaged in shoddy journalism, but their low-quality gutter-dredging techniques successfully brainwashed millions of readers and viewers. That's a big "FAIL" for the state of journalism right there. The worst journalmalism reached the most people.

The reason Pollack believes healthcare is "the best-covered news story, ever" is because a select group could seek out very accurate information if they had the right tools to do so.. Even Pollack acknowledges that only a small part of the population could do this ("I concede that one needed to know where to find this information"). This hypothetical person would first need to be aware that the mainstream media was lying to them. Then, they would need access to the internet (and specifically probably broadband internet). Then, they would need to know where to look for accurate information that delves deeper than 99.9% of the healthcare coverage, which obsessed with the horse race aspects of reform (who's up, who's down, who's mad at Nancy Pelosi this week, blah, blah, blah...)

Yes, it's very cool that people could read the health care bill online, but how many Americans actually did that? We'll probably never know, but it seems likely that far more people tuned in for Fox "death panel" propaganda than sat down to read the health care bill. For people who work two jobs and/or have five kids, it's just easier to turn on the teevee.

This is an argument among friends ( though I don't know Kilkenny personally). In part, I'm just more of a situational optimist. I think she is overly pessimistic about the opportunities open to good journalists and the accomplishments journalists have made in getting the word out. One is right to be worried, but not because the mainstream media did such a poor job.

One reason I am more optimistic: the world of serious news consumers is larger than one might suppose. Sixty percent of U.S. households have high-speed internet. Any parent will tell you that this is a mixed blessing, but this provides most Americans with instant access to incredible resources. If kids (and adults) use much of this bandwidth to find racy Angelina pics, it remains noteworthy that school debaters cite Congressional Budget Office analyses of coverage numbers and the individual mandate. (The admixture of cognitive and hormonal stimulation is not unfamiliar to many readers of the Huffington Post.)

Nieman Journalism Lab identified the top 15 newspaper sites in the United States for 2008. The New York Times free website averaged more than 19.5 million unique visitors every month. The Washington Post's free website achieved a monthly readership exceeded 10 million. For that matter, the same people reading red-meat diatribes against "OBAMACARE" on the Wall Street Journal editorial page could back up a few pages or click on the real-newspaper section of WSJ to get very good reporting. One could get a lot of good reporting at the Huffington Post.

I'm concerned about the threat posed to print journalism and to regional newspapers by national web outlets. Yet in the case of health reform, these national sites routinely included a cornucopia of resources that allow readers to go astonishingly deep.

Sure, only a frighteningly obsessed tiny minority read big chunks of the health care bill. Yet anyone who wanted to could put their family income into the Washington Post's "what does the health care bill mean to me" calculator. Reporters in the thick of health reform coverage--Karen Tumulty and Joe Klein at Time, Ezra Klein and Ceci Connolly at Newsweek and the Washington Post, and many, many others--are not fringe figures. When I start to draw up a list of prominent reporters

Even the talk radio playing is more even than you might think. NPR reaches about 30 million people every week. Morning Edition's weekly audience is about 14 million. Its ratings are lower than Rush Limbaugh's, but Morning Edition kills pretty much every other conservative talk radio show in the country. In terms of average income, political and social influence, NPR reaches a very pivotal audience. (By comparison, the O'Reilly Factor crows about a nightly audience of 3.6 million.)

Kilkenny also underestimates the indirect influence of not-especially-famous reporters and issue experts on the broader public debate. One of the most important roles of the New England Journal, Kaiser Health News, and other specialized sites is to educate reporters and other opinion leaders. A local TV reporter lacks the time and staff help to replicate KFF's side-by-side comparisons of the House and Senate bills. She does have access to that information. She can't match Howard Gleckman's expertise on disabilities or Tim Jost's knowledge of state insurance regulation. She can call these experts, and many reporters do. Even though these experts are not widely known outside their professional communities, their impact is significant. In similar fashion, the reporter may not be in the room when Julie Rovner, Robert Pear, or my TNR colleague Jonathan Cohn interviews a key newsmaker. She can translate this information to reach a broader audience.

Congressional staffers care what appears in the New Republic's Treatment section, where most of my own health policy writing appears. I presume we have a smaller audience than nytimes.com. They are right to care, because policymakers, reporters, and advocates carefully read what is written there. I've spent a lot of time talking to local reporters and TV producers about the health reform bill. They didn't always get it right; they were often denied the time they needed to properly tell the story. On the whole, thy made strong good-faith efforts, and my time was usually well-spent.

I'm still worried

Although I believe the media has done a good job, I remain very concerned about what the future holds. I fear that if we bash the media for particular health reform stories, we might miss some of these deeper problems.

First, experience suggests that the media road show will move on long before the lobbyists will. The critical rule-making and implementation decisions will be even more obscure, complicated, and boring than the House and Senate bills. It's easier to mobilize people around the public option than it is to ensure strong federal oversight of insurance exchanges or to discipline overspending in Medicare home care. The latter issues are no less important.

Second, much of the best media reporting and commentary relied on a strong, credible, and relatively diverse foundation and academic infrastructure that was not created by news organizations, and that is not available for other issues. We can't rely on the Kaiser Family Foundation and JAMA for climate change. The mainstream media organizations are also weakening. They have a weaker bench to cover many important concerns.

Third, there is only so much the media can do about the bias, ignorance, and stupidity that is rampant among millions of voters. If people choose to watch and believe Sean Hannity and Sarah Palin rather than nytimes.com (or if you prefer, CNN and USA Today), they are making an active decision. There's only so much we can do.

Acknowledging the many shortcomings of the media, I think it's a mistake to overlook how good much of the coverage actually was. We make bad actors such as Sean Hannity and the Wall Street Journal's editorial page writers seem bigger than they actually are. That's unwise.

For all their screaming, health reform passed. Outside the conservative base, most Americans realize that Republican critics of OBAMACARE included many lies. Health reform is a complicated 2500 page bill. I wish Americans understood it better. They understand more than they used to, because hundreds people in the media did their jobs well. Attention should be paid.