August 16, 2009

Bill Moyers did an excellent segment with Kathleen Hall Jamieson and Drew Altman on health care reform, and in this segment they discuss how the polling and narratives being driven by the mainstream media and the 24 hour "news" cycle are actually preventing there from being an honest debate on health care reform.

BILL MOYERS: Kathleen, what's playing out here?

KATHLEEN HALL JAMIESON: People who are angry and frustrated and not necessarily well informed in part driven by people who are on the other side of the reform effort. And it's driving into news evocative visuals that are leading the public, I think, to overgeneralize the extent to which there is principal, reasoned dissent from health care reform.

DREW ALTMAN: It's part of our democracy, but I think it's actually kind of sad because the left, doesn't like this legislation a lot. They're not really enthusiastic about it. They would prefer a single-payer approach with more government. And on the conservative side, they're not crazy about it either. They would like a market approach, people getting vouches or a tax credit and just shop in the marketplace. This is down-the-middle legislation. And yet we see these fears and concerns as if this were a radical approach. It's not a radical approach. It's just a down-the-middle approach.

KATHLEEN HALL JAMIESON: But you're also seeing something else. In your clip you see a woman who says, "Is it coming out of my paycheck?" She's raising a legitimate question. But when people are shouting at each other, the answer doesn't get through. And when you're impugning the integrity of the person who's answering the questions, the member of Congress, that person's response isn't going to be believed if it is able to be articulated and isn't simply shouted down.

And so it's not creating context in which misinformation on both sides can be corrected. And that's the problem. We don't have a deliberative process here taking place in public to inform public opinion.

Instead, we're potentially distorting it.

DREW ALTMAN: But I think what also happens is, the concerns of most Americans, of average Americans, just get lost in this process. This whole debate began because of the real problems and worries that average people are having paying their health care bills. And what we really have here are the strong concerns and fears-- and you don't want to minimize them; it's part of our democracy-- that some people have about this legislation.

But the worries that average people have that we see in our polls about paying their bills get lost. And in instead we're debating other things, fears that people have that really aren't there in the legislation.

BILL MOYERS: How do we decide who these people represent? I mean, are they just a fringe element that are like honey to the cameras of the press? Or is there something else going on that's difficult at this moment to measure?

KATHLEEN HALL JAMIESON: I'm not sure that we should be trying to measure it. I worry about public opinion polls coming into this environment and asking questions that may actually distort our understanding of what the public knows. Unless you start by asking the public in a poll what they know, what the baseline level of knowledge is, it doesn't matter what the public thinks ultimately about a piece of legislation or not because you can be reflecting uninformed public opinion.

But the nature of public opinion it's expressed in "USA Today" in-- at a front-page piece that appeared on Thursday of this week which says "Protests Tilt Views on Health Care Bill." Now that's reflecting the results of a poll that asked about people's response not to the health care bill but to the protests about the health care bill.

But the headline leads you to think it's about the health care bill itself. And it suggests that public opinion is now shifting dramatically away from the Obama health care reform efforts.

BILL MOYERS: So the protests seem to be making some people more sympathetic to the protesters?

KATHLEEN HALL JAMIESON: And potentially the press then picks that up, polls, finds that sympathy, creates a structure that suggests that health care reform initiatives are losing support. Now polls have driven press coverage which says "Obama on the defensive. Obama struggling to explain. Obama trying," when, in fact, the dynamic under that has been created by a news structure that decided to cover this in a certain way, to do polling in a certain way. And those two things played into the process to make it more difficult for the discussion to actually happen about the substance of what's going on.

DREW ALTMAN: So it's exactly right. So we have the protests, the media coverage, especially the 24-hour news cycle, follows the protests and the town meetings. Then the polls poll about the media coverage of the protests. And we create almost an alternative reality about what is occurring out there.

When you look at the real polls about where the public actually is, what you see is there's been a little bit of a tick down in public support and people are getting a little anxious as they follow the media coverage. But still the majority of the American people are for moving forward with this.

And we have seen more people begin to say, "Gee, I'm not so sure that this is good for me and my family," but it's still a small number. It's only 20, 22 percent who say, "I'm a little bit worried about this." And a much bigger number say, "I still think this is good for me and my family." And then you've got a group in the middle who's not so sure. And everyone's fighting for that group on both sides.

KATHLEEN HALL JAMIESON: And imagine if you're trying now as just a person who's sitting in your home and you do all sorts of other things, you have a job, you have children, you know, you have all sorts of concerns. And what you get of this debate is what comes through news. The pictures that you're seeing are-- because the news is focusing on conflict and attack, are a very angry people shouting at representatives.

First, no substantive information. But secondly, what aren't you seeing? Well, you aren't seeing something that actually was featured on the front page of "The New York Times" this week. "Free health care draws thousands. Thousands of people came to the forum in Englewood, California, for free dental care and free medical and vision services." People at protests-- people protesting health care reform shouting at legislators as opposed to people waiting for free health care and dental care--

DREW ALTMAN: Who can't afford it otherwise.

KATHLEEN HALL JAMIESON: Who can't afford it otherwise.


KATHLEEN HALL JAMIESON: Now suppose we saw more of these pictures and fewer of those or just a balance of the two. You'd have a completely different sense of what's at play in the debate. Pictures matter. Evocative visuals lead us to generalize to what's important to the framing of the debate, how we should see this discussion. And also they help shape the answers to those public opinion polls. More pictures of people dissenting, more sense that maybe we should hold back a little in our support. More pictures of people in need of care, people just like us who don't have it, greater sense that maybe there's a social concern here. And then the question might I, the insured, at some point be in that situation?

DREW ALTMAN: And you really got to feel bad for just the American people who, from the beginning, have just been trying to answer one question. Will this help me with my health care bills? That's the question they're trying to answer.

And so they're turning on the television and they're seeing a debate about whether this is Russia or it isn't Russia and whether there are death panels and whether it's a government take over of the health care system. And they just want to know "my premiums are going up $1 thousand every five years. And is this going to help me with that 'cause I can't pay my rent or my mortgage? I'm having trouble paying for my food because of my health care bills." That's really the question they want answered.

Can you help us out?

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