Project for Excellence in Journalism

How the Press Covered Health Care Reform

June 21, 2010

Overview

It was a wild political donnybrook and the defining policy initiative of the Obama presidency to date. A Democratic chief executive was staking the crucial first year of his presidency on health care reform -- a legislative achievement that had eluded several of his predecessors. And he was facing off against an equally determined opposition spearheaded by a new groundswell of fear about exploding government intervention.

There was a third major player in the health care debate as well. Much of the battle over health care reform, and much of what the public knew or thought about it, played out through a changing media system.

Prior to the legislative battle, curiously, health care had often flown below the news radar screen. Though the system affects virtually every American and represents about one-sixth of the U.S. economy, it accounted for less than 1% of the overall media coverage in 2007 and 2008 according to data from the Pew Research Center's Project for Excellence in Journalism.

It also amounted to the first long-running policy debate the press would have to cover in what was in some ways a new media era. It was one in which bloggers were recognized at White House briefings, cable news and talk radio seemed to play an ever larger role in the media landscape and new technologies such as Twitter and social media had become important components of politics.

Adding to the challenge was the health care industry itself, a particularly complex and often confusing topic. And the cacophony of charges and countercharges, commentary and criticism from advocates on both sides further complicated efforts to comprehend the issue. Indeed, as the coverage continued, the public seemed more confused.

A solid majority of Americans consistently said the health care debate was hard to understand -- a number that increased from 63% in July 2009 to 69% in December 2009, according to surveys from the Pew Research Center for the People & Press.

So how did the press cover the most divisive issue of the past year and President Obama's top domestic priority? A comprehensive study of more than 5,500 health care stories in the mainstream media from June 2009 through March 2010 reveals six key facts about how the press handled the most divisive issue of the year, according to a new report by the Pew Research Center's Project for Excellence in Journalism.

• Health care coverage was the No. 1 story in the mainstream press from June 2009 through March 2010. There were numerous ebbs and flows to the health care coverage. But in the 10-month period studied, the topic registered at 14% of the newshole, edging out economic coverage (12%) and the conflict in Afghanistan (6%).
• The health care debate was tailor-made for ideological talk shows. No media sector devoted as much time to health care as the political and polarizing talk show hosts. Accounting for 31% of the airtime from June 2009 through March 2010, the subject was more than twice as big in the talk show sector as it was in the overall media (14%).
• Liberal talk show hosts devoted more airtime to health care than conservative hosts. Left-leaning talk hosts, who broadly supported health care legislation, spent 44% of their time talking about health care issues during the time studied. The right-tilting hosts, who vigorously opposed it, devoted 26% of their time to the subject.
• Opponents of health care legislation won the message war. A Nexis search of key terms in the health care debate finds that opponents' terms appeared almost twice as often (about 18,000 times) as supporters' top terms (about 11,000). In short, the opponents' attacks on government-run health care resonated more widely than the supporters' attacks on the insurance industry.
• The debate centered more on politics than the workings of the health care system. Fully 41% of health care coverage focused on the tactics and strategy of the debate while various reform proposals filled another 23%. But only 9% of the coverage focused on a core issue -- how our health care system currently functions, what works and what doesn't.

• Barack Obama was a dramatically diminishing presence in the health care story -- until he re-emerged in 2010. President Obama by far generated the most headlines in health care coverage, registering as a lead newsmaker in 22% of the stories from June 2009 through March 2008. But his coverage fluctuated, falling off dramatically in late 2009 before spiking again early this year.

 Continue reading the full report at journalism.org.