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From the Declaration of Independence to the Federalist Papers to the U.S. Constitution, our founding fathers left us with guiding documents that remain amazingly relevant and vital more than 200 years later. Their forward-thinking and vision may have parallels in ancient societies, although there is little in more recent times that can claim those qualities. Nevertheless, the architects of American democracy were not omniscient. No matter how foresighted, they could not have anticipated the other driver in PCM: the career politician.
At the founding of our republic, the legislature wasn't full-time, and representatives to government were businessmen, farmers, and the like. These citizens took time from their "real lives" to help govern the fledgling country and then returned to the bank, the dry goods store, the farm, or whatever. Today we have a full-time legislature and politicians who view Congress as a career. While it is tempting to blame the news organizations for wall-to-wall coverage, career politicians are only too happy to keep PCM going. They seem to have a pathological need for media exposure.
Yet the most damaging effect of PCM isn't on the news media itself, but on the receiving end, in the living rooms of America. Most adults have learned, for the sake of their mental health, to tune out some (or all) of the "noise." In the old days, which I define as prior to the founding of Cable News Network in 1980, those who chose to educate themselves about the issues of the day were readers. They read one or more newspapers and generally took the time to learn about the detail and nuance of issues. Detail and nuance, however, have long since left the building.
Newspapers are slowly becoming media dinosaurs. Declines in readership and advertising revenue, whether caused by our devotion to electronic media or not, have shrunk major newspapers' profitability to (excuse the metaphor) paper-thin margins.
Viewers' attention spans have diminished significantly. The broadcast media have responded by blurring or obliterating the lines between reporting and commentary, and covering more stories with less depth. As one example, on The Fox Report on Fox News Channel, anchor Shepard Smith often presents up to 70 stories in a one-hour broadcast. No matter how diligent and engaging the show may be, airing 70 stories in a one-hour program (42-45 minutes after commercials) doesn't leave a lot of time for any kind of detail or analysis.
Thus, inevitably, we are reduced to sound bites and video snippets, catering to and nearly legitimizing the sloganeering of interest groups. In 1957, Vance Packard wrote The Hidden Persuaders to detail the relationship between merchandising and commercial products. Fifty years later, we are awash in the merchandising of politics and political thought.
It has been said that, "In America, everyone is entitled to their own opinion; they are not, however, entitled to their own facts." Yet the use and selective citing of "their own facts" is corroding a domestic health care industry that spends $2 trillion a year to diagnose, treat, and manage sickness. Unlike the first incarnation of HillaryCare in 1993, however, the authors of today's misinformation in health care policy are leaving both blue and red fingerprints on their work.
But the media isn't our problem. Hillary isn't our problem. The slow demise of the newspaper industry isn't our problem. Our problem is us. Our problem is that most of us sit on the sidelines without challenging the sound bites and the shallowness of flawed arguments. The faulty data and half-baked conclusions offered by interest groups (and career politicians) are repeated so often that they register as "fact" in the minds of a public uneducated to the real systemic problems and unable to recognize real opportunities for change.
We are flogged with the "fact" that there are 47 million uninsured Americans. It is indisputably true that there are millions of uninsured Americans. Some are intentional self-payers; we can help them with efforts to drive out inefficiency and thus drive down costs. Others are in between jobs and thus in between employer coverages; we have helped these individuals with very strong COBRA rights. Others are in the twilight between Medicaid and higher-paying jobs and legitimately can't afford to purchase most coverage; we can help these people with a variety of government programs that are available to them today.
I've previously reported on Phil Lebherz' efforts with his Foundation for Health Coverage Education (www.coverageforall.org). Lebherz's research has shown that if you dissect the various "uninsured" populations, you get a number that is far, far less than 47 million. Both FHCE and the National Association of Health Underwriters (www.nahu.org) have simple Web-based programs to help people who are in these circumstances find the insurance they need. Governments (both federal and state) created these programs and are funding them with our tax dollars, yet they do almost nothing to inform citizens about them. That is a newsworthy story.
We are barraged with similar "facts" about "access to care." Federal law requires hospitals to treat patients in need of emergency care. Despite the yammering in the press, many hospitals treat far beyond the "stabilization" required in the law and then bill Medicare or Medicaid for the treatments. Many patients are referred to other provider entities (clinics and such) for further treatment. Is this the right way to treat these patients? No. Do they lack access to the systems? No.
What they lack is the kind of ongoing, in-depth treatment afforded to insured patients. We can (and should) change the parameters for treating these individuals, especially at not-for-profit hospitals, where their tax incentives require them to be more expansive in treating these patients. We can help these patients by making sure they know about and are enrolled in most or all of those many programs.
I know that it is more difficult today than ever before for producers to run profitable practices. Commissions are lower than in "the good old days," and company margins are razor thin. With that said, we all ought to consider adding a pro-bono component to our commerce. Some of our trade associations make that ridiculously easy, with facts, information, and Web-based programs that are readily available. If we don't step up to the plate, the career politicians may try (again) to take the bat out of our hands.
If nothing else, we need to understand the insidious nature of the current political climate. To be sure, there are some (a few?) members of Congress who are sincerely concerned with public policy. Others, and you know who they are, focus on continuing their political careers and will (knowingly or unwittingly) seize on half-baked statistics to throw health care red meat to their constituents -- all the while ignoring existing options and opportunities in the system. Our apathy and complacency only perpetuate these myths, which undermine an industry that does a tremendous amount of good.
Amid the political "fiction," we may want to take our lead from a fictional character. The 1976 movie "Network" opens with fictional anchorman Howard Beale (Peter Finch) having just been fired because of low ratings. In protest, he announces that he is going to commit suicide on-air. Once station management believes that they have calmed him down, they allow him to go back on the air to issue what they believe will be a dignified "farewell." Instead, Beale galvanizes viewers with an amazing rant: "But first, you've gotta get mad! You've got to say, 'I'm mad as hell, and I'm not going to take this anymore.'" We all need to get "mad as hell" about what is happening to a noble industry. But let's not wait until our ratings get so low that we get fired.
Readers may write to David Saltzman at Carolina Care Plan, Inc., 201 Executive Center Drive, Columbia, SC 29210. David is a past president of NAHU and has been a health, disability, life and employee benefits consultant and broker for more than 25 years. He is the director of the large group segment for Carolina Care Plan.
