What needs reform even more than health care?

Not only the mainstream media, but a lot of smart policy wonks have failed to address a paradox at the heart of the health care reform debate. For example, former Clinton Administration labor secretary Robert Reich blogs (hat-tip Krugman):

A new president -- even one as talented and well-motivated as Obama -- can't get a thing done in Washington unless the public is actively behind him. As FDR said in the reelection campaign of 1936 when a lady insisted that if she were to vote for him he must commit to a long list of objectives, "Maam, I want to do those things, but you must make me."

Reich makes a valid point, but puts the cart before the horse. The underlying problem is not lack of support for the health care bill. Rather, it's lack of knowledge.

Do Americans know what the proposals on the table actually are? How many Americans know that the purpose of H.R. 676 is "to provide for comprehensive health insurance coverage for all United States residents?" How many Americans can point to any of the intended benefits of H.R. 676? Few, I suspect, given that so much of what passes for health-care reporting amounts to interviewing uninformed people and then passing along their misconceptions without comment.

The US news media bombards Americans with dollar figures, but provides no way for readers to put big numbers in context. "Senators claim $1 trillion bill in reach" reads one headline. Judging by this headline and so many others like it, you would think entire purpose of the health bill was to add a trillion dollars to the deficit! It's as if the United States has become a bubble-world inhabited by a people who can tell you the price of just about everything, the value of nothing.

But is there any data that backs-up such anecdotes?

Yes. But first, I will show you why the lack of public support for the Obama plan is a paradox.

When polled about what they really want in health care reform, the public seems to be clearly behind the main thrust of the Obama health reform bill. That is, Americans say they support the main principle that the Obama plan happens to embody. A recent CBS/NYT poll indicated that 72% of Americans support a "public insurance option." A NBC/WSJ poll (Pdf) indicated 76% of Americans considered it "somewhat important" or "very important" to give people a choice of a government-administered public plan.

But how many Americans know that HR-676 is a means by which the country could realize this ideal -- one they yearn for? Surprisingly few. Two recent polls have included questions that indicate just how little knowledge Americans have about the specifics of the health care reform legislation.

The first was the NBC/WSJ poll mentioned above. In the poll only one third of respondents said they thought the Obama health care plan was a "good idea." About as many thought it was "a bad idea." Concerning this poll, Sam Stein of the Huffington Post blogged,

In short: the administration has yet to complete the sale. An additional 30 percent of the public had no opinion of Obama's proposal for reform. But when read a description of the general outline . . . . the number of respondents in support rose to 55 percent.

The second poll, a Washington Post/ABC News survey of 18-21 June also revealed that Americans have low regard for Obama's health reform plan. When asked, "if the system is changed" will things get "better, worse, or remain the same," only 16% said things will get better; but 31% said things would get worse, and half said things would stay the same. Some other findings:

• Over half of Americans report being "very concerned" that the Obama plan would have a negative impact on quality, personal cost, efficiency, and treatment options. In the dark about the plan, Americans are scared of... the dark.
  
• Only 27% of Americans "strongly approve" of the way Obama is handling health care and another 26% "somewhat approve." Imagine that! The president wins the support of only a bare majority for taking decisive action on an issue that up to 76% of the population supports.

No wonder Americans are not marching in the streets in support of the Obama health care plan. They don't understand the proposal before Congress. They are clueless as to the gist of it. They are lacking in knowledge. One is reminded of polls taken in 2006 showing that many Americans still believed weapons of mass destruction had been found in Iraq.

The mainstream media has scarcely reported on this key paradox of the health care reform debate. One citizen who perceived what was happening months ago and tried to spread the word was Eliza Jane Dodd. Not having heard anything about the bill before, Dodd describes Americans she contacted as being "blown away" by HR 676, asking her "How can we get it!"

Who is responsible for this state of affairs? I contend that if the mainstream media covered this issue adequately, Obama's plan would likely have all the public support it needs. It looks as if news media reform might need to come before health care reform.