At the first of two Democratic debates (6/26/19), MSNBC host and moderator Lester Holt asked the presidential hopefuls, “Who here would abolish their private health insurance in favor of a government-run plan?” He asked the same question the next night (6/27/19), and prefaced another question to Sen. Bernie Sanders: “You basically want to scrap the private health insurance system as we know it and replace it with a government-run plan.”–

At a glance, this seems entirely unremarkable. The terms “private health insurance” and “government-run plan” are everywhere in US media.

The question at the first debate, however, was asked just a day after a new report came out from the National Economic and Social Rights Initiative (NESRI). The report, “Parroting the Right: How the Media, Pollsters Adoption of Insurance Industry Spin Warps Democracy,” demonstrates how power brokers in the for-profit health industry have worked to make this exact language (“government-run healthcare”) the boilerplate description for a national health system in major media outlets.

“In framing a national health system as ‘government-run,’ the press is helping the insurance industry systematically frame the debate in their own interests,” lead author Ben Palmquist told FAIR.

Though “socialized medicine” was used in attacks going back to Medicare’s founding in the 1960s, the report concludes that “before the 1990s, the term ‘government’ was rarely used to define publicly financed healthcare programs,” the report says.

NESRI tracks the origin of this effort to 1989, when the insurance industry began using the term. The largest insurance lobby’s report from 1988 has no mention of the term, instead using the more neutral “public” and “private” to describe insurance choices; one year later, they used the term “government-run” 35 times in one publication.

When the industry geared up to fight Bill Clinton’s health reform proposals—which actually preserved a large role for for-profit insurance–it ran the notorious “Harry and Louise” ads, warning that “the government may force us to pick from a few plans designed by government bureaucrats.”

In time, it became a doctrinal assumption in corporate media: Any kind of publicly financed medical insurance is government-run healthcare. The NESRI report found 13,300 Google News results with the phrase “government-run health care.” By contrast, there were just three with the phrase “corporate-run health care,” a ratio of 4,433 to 1.

Frank Luntz, the GOP polling consultant, explained the significance of the terminology on Fox News in 2009 (8/19/09): “If you call it a ‘public option,’” Luntz explained, “the American people are split. If you call it the ‘government option,’ the public is overwhelmingly against it.”

A few months later, Fox News producers were told by Fox managing editor Bill Sammon (Media Matters, 12/09/10) to “please use the term ‘government-run health insurance’…whenever possible.”

The NESRI report’s credibility is boosted by industry and partisan documents showing the plotting of these actions in plain sight. It quotes then-Republican National Committee chair Hayley Barbour laying out GOP talking points (New York Times, 3/4/94):

We can’t afford a government-run healthcare system financed by a massive payroll tax…. We don’t have to have a government-run healthcare program to do healthcare reform.

The Koch Brothers-funded Citizens for a Sound Economy are quoted boasting in 1994 that it was

the first to label the Clinton approach “government-run healthcare”—a term that ultimately would help kill the myriad plans that subsequently were offered.

Why ‘government-run’ is inaccurate

NESRI argues that not only does this language amplify elite interests, but it’s simply inaccurate. The report notes:

Describing the entire healthcare system as “government” healthcare is simply wrong. Medicare, Medicaid, public options and Medicare for All are all publicly financed insurance programs that leave most of the healthcare system—including hospitals, physician practices, and drug and medical device manufacturers—in private hands.

The language is also “fundamentally biased” against public healthcare:

By drawing a contrast between “government” and “private” insurance, the media and polling organizations explicitly invoke government control of public insurance while rendering private insurance companies invisible.

A tool for journalists

While the report is an impressive piece of media criticism, Palmquist was adamant that the goal is to have constructive dialogue with editors and reporters to try and improve reporting on healthcare reform. With this goal in mind, the organization devoted a section in the appendix which uses examples to demonstrate how the media misused language and how they can fix it.

For instance, the report argues journalists should “not equate insurance with the entire healthcare system”:

There is much more to the healthcare system than insurance. The healthcare system includes hospitals, clinics, dentists, pharmacies, drug and medical device companies… All of these sectors span the public and private sectors.

The report provides examples of biased language vs. balanced language. The report also analyzes the industry impact on individual media outlets, Congress, pollsters and more. The amount of data available will also aid media critics and journalists to follow up on any number of related topics–or study media coverage of other industries and look for similar patterns.

“This is just a snapshot in time,” Palmquist said. “The primary goal is to try and encourage people to think about these things from 10,000 feet. To think about how these industries exert influence.”

Unsurprisingly, media coverage about the debates has continued to frame healthcare in the insurance industry’s preferred terms–focusing on protecting “private insurance” over issues like inequality, health outcomes or healthcare costs. In fact, CBS News, Politico, The Hill, Yahoo! News, the New York Times, the Daily Caller, Vox, Newsweek and many others all used the term “government-run” healthcare in their June 28 coverage of the debates.

Feautured image: NBC‘s Lester Holt moderating the first Democratic presidential debate of the 2020 campaign.