The Message Is The Medium

GooznerEmory University psychologist and political consultant Drew Westen in the weekend Washington Post offers a troubling view of the public’s role in health care reform. While reform’s reality involves complicated technical issues like insurance exchanges, public plan governance, physician and hospital payments and who will pay higher taxes, the public’s understanding of these issues is virtually non-existent, Westen assumes.

Instead, public knowledge comes from a media environment where Republican consultants craft messages about a government takeover of health care and Democratic consultants (the author among them) promise a family doctor for everyone. Never mind that neither message even remotely resembles reality.

Nowhere in the article does Westen pay homage to the democratic ideal that an informed electorate has a role to play in policy debates like health care reform. Nor does he lament the passing of an informed electorate. Such statements used to be a staple in discussions about political messaging and the impact it was having on policy debates.

It hasn’t always been thus. I’ve been reading “Lords of Finance: The Bankers Who Broke the World” by Liaquat Ahamed, a former investment banker who spent the past ten years researching the errors made in the late 1920s and early 1930s that led to the Great Depression.

Near the end of the book, he recounts how President Roosevelt explained the bank holiday declared immediately after he took office. His first fireside chat carefully detailed for average Americans the complicated workings of banks that had forced his hand. The next day, folk humorist Will Rogers marveled at the speech’s clarity. In a letter to the New York Times, he wrote: “Our president took such a dry subject as banking . . . (and) made everybody understand it, even the bankers.”

Today, few media outlets even bother to explain the intricacies of policy choices. Politicians, the special interests and the communications experts who craft their messages can safety assume the public will have a poor grasp on reality. Marshall McLuhan has been turned on his head. The message is now the medium.

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sikişCraig F KinghornWendell MurrayStephen Schimpff, MDerythropoeitin, md Recent comment authors
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thanks for all admin
information is the most beautiful treasures

Craig F Kinghorn
Craig F Kinghorn

With all due respect, Mr. Goozner, you are wrong both on form and on substance. To begin with, Westen’s article does not have to “pay homage” to the idea that an informed electorate plays a role in policy debates like health care reform; it presupposes it. That is precisely why he quotes political strategists like Luntz and Lake. Effective communication of complex ideas in simple, relatable terms influences the public’s attitudes and, consequently, their willingness to support (or not support) any of the multitude of health care reform plan variations currently being proffered. Second, while I agree that media outlets… Read more »

Wendell Murray

I would certainly agree with Dr. Westen’s assessment of the public’s knowledge of healthcare policy issues – almost entirely non-existent with respect to key issues. Mixture of lack of interest for whatever reason and of the explicit intention of vested interests to keep the public as confused as possible I have heard both President Obama and Peter Orzag make straightforward comments about the true state of the healthcare system in the USA, but all directly involved legislators in Congress, not to mention any Republican politician, are only unwilling or perhaps unable – out of either intentional ignorance or knowing venality… Read more »

Stephen Schimpff, MD

You are correct that we seldom hear about the real or underlying issues that are broken in our delivery of medical care system in America. The media tends to overlook them or just does not understand them. The politicians skip over them. No one takes the time to give a straight forward yet simple explanation of the problems. The result is that we have a large number of misconceptions about our medial care delivery system and what needs to be done to improve [or “reform”] it. The first misconception is that we have he world’s best healthcare. That is simply… Read more »

erythropoeitin, md
erythropoeitin, md

Great report, Gooze. Kool aid is being produced and sold by a number of factions. Take, for instance, the HIT kool aid. It was brewed by HIMSS who allied with CITL to produce “research” and “opinion” that was served in crystal goblets to Congress, all the while CCHIT was assuring those drinkling it that it will not make them experience peristalsis in reverse. The media liked its color and only reported on how good it made every one feel. Then, they read about the letter to D. Blumenthal (below), the deaths in Sweden, the DOD’s HIT debacle, the UK’s HIT… Read more »