Health Care

What We Have Learned from the Health Care Debate

Dec 16 '09

One thing that’s most impressed me amidst this debate is the relative sophistication of some political commentary about the policymaking process. Brendan Nyhan rightly singles out Matt Yglesias as one such commentator (e.g., see this post). Ezra Klein is another. I assume others would fall in this category, although surely not enough.

The pathologies of reporting and commentary on policymaking are well-known: various proposals are simplified into a very few competing alternatives and reporting on these alternatives treats them in horse-race fashion. See, for example, this article by Regina Lawrence on welfare reform.

The specific pathology that Brendan, Matt, and Ezra debunk is a fixation on the president in the policymaking process. Presidential power is assumed to be essentially limitless — e.g., if Obama would just say so, Joe Lieberman would roll over and vote for a single-payer system. (I exaggerate, but only a little.) When members of Congress don’t do exactly what the president wants or when (God forbid) the president “lets” Congress do actual legislating, reporters start in with “news analysis” like this silliness from John Broder in Sunday’s New York Times. Here, climate change is framed around what Obama can or cannot accomplish, complete with portentous questions like:

bq. Can Mr. Obama surmount those problems in his latest effort to save the world?

A while back, I posted about a Ted Lowi essay in which he characterized this sort of news coverage as “unbelievably primitive.” And it is. Understanding policymaking means taking Congress seriously and treating legislators as autonomous. It means acknowledging (repeatedly) the multiple veto points that are built into the system. Policy change is not solely a matter of presidential will or skill — as I and others have noted.

Of course Obama has an agenda with regard to health care, climate change, etc. And of course legislative success or failure has implications for his presidency. But Yglesias and others have rightly pounded away at the notion that policymaking should somehow be framed around the president’s goals, actions, and standing. This frame gets the policymaking process wrong, and it arguably hurts our understanding of the policies themselves, whose details are subordinated to armchair quarterbacking about the president’s decisions or lack thereof. At its worst, you get this stunning contempt from David Broder for the fact that making policy is a process and that the point of the process is to (try to) make the right decision:

bq. …the urgent necessity is to make a decision — whether or not it is right.

I know the usual excuses: presidents are visible figures, they make for easier news stories, public policy is boring, the horse race is fun, etc. I actually think that it’s not that much of a stretch for journalists to improve coverage of policymaking. Herbert Gans noted that political journalism has an implicit value of “altruistic democracy”:

bq. …news implies that politics should follow a course based on the public interest and public service.

You see this value implicit in many stories about campaign finance, political corruption, and the like. I don’t see why better coverage of policymaking wouldn’t also align with this value. When certain problems are widely acknowledged — e.g., the untenable growth in the cost of health care — why not focus news coverage around the frame “What are our elected leaders doing to solve these problems?” as opposed to “Can Obama save the world?” I don’t think that frame crosses the line into advocacy — no solution is being endorsed — any more than do other stories that imply a belief in altruistic democracy.

Of course, I could be depressed that this post even needs to be written. If you are 18 years old and you have been sitting in Political Science 101 for maybe a week or two, you will know more about the separation of powers than is evident among political commentators who act as if presidents make policy. But I will choose not to be depressed, and instead will celebrate how much boilerplate political science is seeping into the mainstream political media.