1) pluralism

2) hyperpluralism

-use example of health care area to illustrate difference

a) fears that press not doing a good job

-concern that changes in the media and in the political system have weakened the traditional oversight that journalists exercise in the system

b) to look at these controversies, we will examine the media and public policy

-discuss changes in political system

-new role of interest groups

-consequences for how media cover policy controversies

c) then, we will take a closer look, using a case study of health care area to illustrate the general points that have been made about media coverage of public policy issues

1) One of the most important changes in our political system has been the rise of aggressive and well-funded interest groups

-proliferation of groups since 1960s

-Jack Walker study shows dramatic increase in number and variety of groups

-public interest groups, business organizations, labor, civic organizations, non-profits, and tax-exempt groups

-different kinds of groups than in past

-previous groups centered on economic interest--labor and business

-now, we have groups contesting social policy, government reform, the environment, civil rights, gay rights, and a whole panoply of other causes

2) at one level, all these changes are good

a) pluralism seems alive and well in U.S. (large number of interest groups across political spectrum)

-great number of interest groups contesting public policy

-many interests which previously were under-represented now lobby Congress and state legislatures to make sure their voices get heard

b) but there are some aspects of the new interest group system that raise trouble for policymaking

-most important is resource differentials

-widening income gap in U.S.--rich getting richer and poor falling further behind

c) implications for political organization arising from gap between haves and have-nots

-empowers large and wealthy interests over others

-allows some interests to take advantage of new technologies and changes in media system in ways not available to less advantaged interests

a) group advertising

-groups today run ads, conduct polls to find saleable messages, and lobby members of Congress directly

-not exactly new, but some interesting twists on previous activities

-groups now contesting elections and policymaking through air waves

-used to be candidates ran ads, and ads disappeared after election

-now groups run ads during election and between elections

-in 1996, for example, one-quarter of all ads run were broadcast by groups

-has now risen to 40% and expected to keep rising

b) group influence on policymaking

-most famous example--Harry and Louise ads run by insurance group during health care debate

-more recent cases--Sierra Club, labor, term limits, abortion, global warming

-Reason--direct control of message content and timing

c) rise of secret campaigns

-new court rulings allow groups to hide participation in political activities through ad hoc coalitions and non-profits

-hire think tanks to undertake research and then have them put out your study

-way to piggy-back on top of their higher public credibility

-use other groups to front polls

-variety of techniques to participate without revealing sources of funding

d) raises host of problems in terms of democratic accountability

-secrecy endangers public right to know

-threatens fairness of process

-can lead to lop-sided policy decisions that favor one set of interests over others

-so the entire situation raises very important questions about how our society and political system operate

-The changes in interest group system poses special problems for mass media

a) dependency on commercial advertising and viewers and readers

-can reporters cover the news when some of the very same interests they are following run ads in their newspapers or on their TV stations?

-classic problem for local television

-car dealers are one of largest source of advertising for local news

-what happens when there are consumer complaints about shoddy car sales practices or unethical conduct?

-poses serious problems for news organizations and shows the dilemma between market pressures and good news practices

b) local news problem now magnified at national level

-as more and more groups contest national policymaking and run ads, conflicts grow between station revenues and news coverage

-if your station receiving a lot of money from business interests or labor unions or abortion groups, will that affect tone or content of coverage

-since this kind of group activism is relatively new, we don't know the answer to that question

-but it is an issue you should follow as you watch the news and see how policy controversies get covered

The Health Care Dilemma
-one way to look at the link between mass media and public policymaking is case study of health care

-health care is one of the most important policy challenges we face

-one-seventh of Gross Domestic Product (14%)
-problem of uninsured (16% of American population)
-cost versus coverage tradeoff
-political complexity of health care reform--conflicting interests of doctors, hospitals, HMO's, insurance providers, lawyers, consumers

-institutional fragmentation of government--multiple veto points -difficulty of large-scale policymaking

This documentary reviews President Bill Clinton's 1993 and 1994 effort to reform our nation's health care system. Featuring coverage of the uninsured and new procedures for making health care available, this reform was rejected by Congress and led the way to the GOP takeover of Congress in the 1994 election. This video shows how the health care debate unfolded and interest groups sought to influence the course of the discussion.

-role of talk radio and Limbaugh

-polls, ads, news coverage

Clinton's Reform Plan (1993)
-centerpiece of domestic agenda (1994 State of the Union address)
-American Health Security Act (1,364 pages in length)
-universal coverage, regional purchasing alliances, employer mandate requiring employers to pay 80% of health care costs of average person, national health board, ban on benefit terminations for preexisting conditions
-stunning scale and complexity

News Media Coverage
-massive coverage--2,000 newspaper, magazine, and TV stories between Sept. 1-Nov. 30, 1993
-unsatisfactory coverage--42% rated coverage excellent or good, compared to 48% only fair or poor
-view that coverage did not explain how reform would affect ordinary people personally
-too much attention to strategy, horserace, and game of politics (similar to campaign coverage) -negative coverage by talk radio

-ads targeted on key areas

-used to personalize issue
-extraordinary spending--Pharmaceutical Research and Manufacturers of America spent $20 million, while Health Insurance Association of America spent $14 million (mostly on Harry and Louise ads)
-targeted ads buys in DC and NYC and on CNN to reach policymakers
-groups opposed to Clinton plan spent twice as much on ads as pro-Clinton forces (although Clintons had White House bully pulpit)
-too much attention to strategy, horserace, and game of politics (similar to campaign coverage)

-little media oversight of group appeals (few Ad Watches)

-news media amplification of groups ads

-inaccuracy of ads (60% were misleading, unfair, or false according to Jamieson study)

-appeal to emotions

-well-financed ads with tie to 800 numbers to call members of Congress

-blur of news and entertainment

-use of codewords (socialized medicine, bureaucracy, uncaring Republicans)

impact of scandal politics

-use ads to drive news

-Harry and Louise mentioned over 700 times

Public Response
-early national polls--67% approved of Clinton plan, while 20% disapproved
-targeted ads buys in DC and NYC and on CNN to reach policymakers
-erosion of public response as Clinton popularity declined
-ad impact--public versus elite effect (rolling the elites)

-end result--death of Clinton package

-failure of health care led to politics of small ideas (smaller-scale proposals to address parts of problem)

-patients bill of rights designed to strengthen legal options of health consumers

-does not address fundamental problems--the uninsured, prescription drug costs

-biggest public opinion change since 1994--drop in confidence toward HMOs

-Gallup Poll in 2001 showed HMOs dead last in public confidence in various institutions

-only 15 percent had a lot of confidence in HMOs, compared to 66% in military and 60% in organized religion

Lessons for Media Coverage of Policy Issues (such as Environment and Abortion)
-need for better news oversight of group ads (unlike campaign spots)

-media role quite problematic-conflict frame not good for public deliberation and consideration of complex policy issues

-need to relate policy controversy to daily lives of citizens so they can understand personal impact
-go beyond traditional reliance on official government sources
-should worry about power of large, well-organized interests in public policy debates

-pluralism alive, but inequitable resources pose problems for journalists and politicians

-problem of excessive group activity and influence

-problems for media in covering group activity

-is there too much group activity in American politics?

Theda Skocpol, Boomerang: Clinton's Health Security Effort and the Turn against Government in U.S. Politics, Norton, 1996

Bob Woodward, The Agenda: Inside the Clinton White House, Simon & Schuster, 1994

Paul Starr, The Logic of Health Care Reform: Why and How the President's Plan Will Work, Penguin Books, 1994 

Paul Starr, The Social Transformation of American Medicine, Basic Books, 1982.