GMA interview of Obama health care team ignores progressive concerns

In an interview with members of the Obama health care team, GMA's Diane Sawyer did not ask any questions based on progressive concerns about health care reform.

In a June 22 Good Morning America interview with members of the Obama administration's health care team, none of anchor Diane Sawyer's questions reflected progressives' concerns or positions. Indeed, some echoed conservative arguments and talking points regarding Obama's health care reform efforts.

Some conservative media, including several hosts on Fox News, have sharply criticized ABC News over the upcoming health care special, which Sean Hannity described as a “Mickey Mouse-sponsored infomercial” -- criticism that Howard Kurtz, CNN and Washington Post media critic, suggested might be an effort to “work the refs.” In a conversation with Kurtz on Reliable Sources on June 21, Sawyer defended the upcoming ABC News special, saying that it will include “questions from every single vantage point.” But Sawyer's GMA interview with administration staff ahead of the Wednesday “town meeting” did not include “questions from every single vantage point,” notably omitting issues raised and positions taken by progressives.

For example, Sawyer did not articulate the progressive position with regard to any of the following:

  • Single-payer. President Obama has said that while a single-payer health care system could make sense if we were "starting a system from scratch" and that “there are countries where a single-payer system works pretty well," he believes that health care reform in the United States should build on the current private insurance system. Many progressives support a single-payer system, yet Sawyer did not mention the issue.
  • Strong public option. Many progressives believe that for any health care reform effort to be effective, it must include a public insurance plan that will compete with private insurers and will drive down costs and improve quality throughout the market. While Sawyer stated in introducing the interview that, at the “town meeting on Wednesday night ... Americans can ask the president, question him about everything -- what will work, what will not work -- including the president's call for a public insurance option to hold down medical costs,” Sawyer did not ask on GMA if the president regards a public plan option as essential to an effective health care reform plan. In a subsequent interview with Minority Whip Eric Cantor (R-VA), co-anchor Robin Roberts mentioned a public plan option, saying, “72 percent of Americans support a public government-run plan as one of the health care options” and saying to Cantor: “Does it appear that there is -- there is a growing group that would like to see the government take a little bit more control.” But she also did not note that many progressives say that it is essential to health care reform.
  • Co-op proposal. Many progressive economists and health care experts say that Sen. Kent Conrad's (D-ND) cooperative health insurance proposal is not a plausible alternative to a public insurance option. Sawyer did not note these challenges to the proposal, which is actively being considered in Congress, or ask the White House for its view of cooperatives.

Below is a list of questions asked by Sawyer in the GMA interview ABC aired that echo conservative arguments or talking points.

  • SAWYER: I began with Secretary of Health and Human Services Kathleen Sebelius to ask her about the public fear of a towering $1-to-2 trillion cost. Can Americans afford it?

Sen. Mike Enzi (R-WY), ranking member on the Senate Health, Education, Labor, and Pensions (HELP) Committee said of the potential costs of the bill:

First, this bill in its current form would have a devastating impact on our nation's deficit. In his speech before the American Medical Association on Monday, President Obama stated that, “Health care reform must be and will be deficit neutral in the next decade.” According to the Congressional Budget Office, this bill falls far short of the President's commitment to deficit neutrality. Preliminary estimates on this incomplete bill find that if enacted, this legislation would increase spending by more than $1.3 trillion over the next ten years. It is astonishing to me that such a policy could even be contemplated in this current fiscal environment.

  • SAWYER: We went back and checked Medicare, and, in 1965, everyone was told the projected cost of Medicare over 25 years would be $12 billion. And, of course, it turned out to be $107 billion. And people think, there's no way this isn't going to cost a lot more and that's going to mean more taxes.

From congressional Republicans' health care talking points, published on May 11 (emphasis added): “Democrats are pushing for a government takeover of health care that would have devastating consequences for families and small businesses. A government takeover of health care will raise taxes, ration care, and let government bureaucrats make decisions that should be made by families and their doctors.”

  • SAWYER: But, of course, that raises the phrase, “rationed care,” to everyone. And as we know, Newt Gingrich, who is the -- probably the most vocal spokesperson for the Republican side, has been saying things like this.

GINGRICH [video clip]: If we have been endowed by our Creator with certain inalienable rights, how can a government bureaucrat tell you, you don't deserve the best possible medicine, the best possible procedure, the best possible hospital.

In addition to Gingrich's statement, in a memo titled, “The Language of Healthcare 2009: The 10 Rules for Stopping the 'Washington Takeover' of Healthcare,” conservative pollster Frank Luntz cited the following statement from Sen. Jim DeMint (R-SC) as an example of “words that work”: “We don't need some committee rationing care and telling people what they can and can't have. We need to give patients the best choices of health plans and doctors and let them make their own decisions.”

  • SAWYER: One headline of this then -- to say to Americans, you will be healthier with fewer tests. Trust us. Is that what you're saying?

In his memo, Luntz cites a statement by Sen. Tom Coburn (R-OK) as an example of “words that work”:

The axiom in medical schools all across this country is “if you will listen to the patient, they will tell you what is wrong with them.” We've had a shift in our country, as physicians have tried to keep up with the declining reimbursements: they can't listen as well. The practice guidelines they have to follow totally disregard the art of medicine.

I can give you example after example of people who I've diagnosed with diseases that don't fit in the guidelines. In these situations, diagnosing through the art of medicine has saved their life. And the guidelines would have never captured what was needed to save their life.

Under this approach we ignore 40% of the physician's capability to actually make a difference in somebody else's life because we force them to practice cookie cutter medicine that a bureaucrat in Washington decides on.

Luntz also wrote: “Healthcare quality = 'getting the treatment you need, when you need it.' That is how Americans define quality, and so should you. The key opportunity here is that this commitment goes beyond what the Democrats can offer. Their plan will deny people treatments they need and make them wait to get the treatments they can actually receive. This is more than just rationing. To most Americans, rationing suggests limits or shortages -- for others. But personalizing it -- 'delaying your tests and denying your treatment' -- is the concept most likely to change the most minds in your favor” [emphasis in original].

On its “Talking Points” page, congressional Republicans similarly stated that Democrats would deny access to medical care and treatments, claiming, “The Democrats' government-takeover of health care will deny access to medical care and life-saving treatments.”

Other questions Sawyer asked that were aired include:

  • SAWYER: But if the -- the president said there have been unnecessary CAT scans, unnecessary tests. Who is going to decide what is necessary and unnecessary?
  • SAWYER: What percentage of American medicine then do you think is doctors doing unnecessary tests because they're caught in some cycle of unnecessary testing?
  • SAWYER: Can't let you go without talking about prevention, because there are a lot of people who say, look, Doctor Mehmet Oz, for instance, says repeatedly, we want to be good Americans. Just come out and announce today that if you are an American, you have to walk 30 minutes a day and that will cut health care costs probably faster than anything else we could do in the country.
  • SAWYER: So financial incentives to the people who take care of themselves.
  • SAWYER: So my potato chips are un-American?

From the June 22 edition of ABC's Good Morning America:

SAWYER: Now, this is a week Americans we hope will engage in the whole debate about health care reform in a whole new way. ABC News will be having a town meeting on Wednesday night where Americans from the frontlines of health care -- Americans can ask the president, question him about everything -- what will work, what will not work -- including the president's call for a public insurance option to hold down medical costs. Tomorrow, Robin has an exclusive interview with the first lady, Michelle Obama, about health and prevention.

And recently, I sat down with three women on the frontlines from the administration -- the president's top domestic policy adviser, Melody Barnes; the White House health czar, Nancy-Ann DeParle; and I began with Secretary of Health and Human Services Kathleen Sebelius to ask her about the public fear of a towering $1-to-2 trillion cost. Can Americans afford it?

[begin video clip]

SEBELIUS: Well, Diane, what we know is that cost currently is crushing families and businesses. Unless we do something, we won't be able to afford the health care we have, the health care we need.

SAWYER: We went back and checked Medicare, and, in 1965, everyone was told the projected cost of Medicare over 25 years would be $12 billion. And, of course, it turned out to be $107 billion. And people think, there's no way this isn't going to cost a lot more and that's going to mean more taxes.

BARNES: I think people are thinking that this is brand-new money that's being printed. There's already $2 trillion worth of health care that's being spent already. This is redirecting that money, so that it's more efficiently and effectively used and so that people are getting better quality health care.

SAWYER: But, of course, that raises the phrase, “rationed care,” to everyone. And as we know, Newt Gingrich, who is the -- probably the most vocal spokesperson for the Republican side, has been saying things like this.

GINGRICH [video clip]: If we have been endowed by our Creator with certain inalienable rights, how can a government bureaucrat tell you, you don't deserve the best possible medicine, the best possible procedure, the best possible hospital.

SAWYER: So --

DePARLE: They do deserve the best possible procedure and the best possible hospital. That's what the president is trying to guarantee.

SAWYER: But if the -- the president said there have been unnecessary CAT scans, unnecessary tests. Who is going to decide what is necessary and unnecessary?

DePARLE: Clinicians will make those decisions. When we look around the country, we see that there are areas where there's a lot more utilization, a lot more volume and intensity of testing and unnecessary things.

SEBELIUS: Nobody is going to tell your doctor, he or she can't do a procedure, but there'll be a set of protocols that we know, at the end of the day, actually produce a better result for you and are less intrusive. I don't know a single patient who would, if they thought they could have one MRI instead of three, if they thought, you know what, a drug regime would work as well as surgery, wouldn't say, “Well, don't cut me open. You know, do what works best for me.”

And that's really what we're talking about, not cheaper medicine, better medicine each and every time.

SAWYER: One headline of this then -- to say to Americans, you will be healthier with fewer tests. Trust us.

SEBELIUS: You bet.

SAWYER: Is that what you're saying?

SEBELIUS: You bet. Right now, we pay doctors based on how many times they touch a patient, how many tests are given, how many procedures are run, not how well the patient is at the end of the day.

SAWYER: What percentage of American medicine then do you think is doctors doing unnecessary tests because they're caught in some cycle of unnecessary testing?

DePARLE: Well, there have been estimates that as much as 30 percent of it is unnecessary -- but that's not really what this is about. What we're really trying to do and the president is trying to get a system where we can have lower costs for all families and businesses.

SAWYER: Can't let you go without talking about prevention, because there are a lot of people who say, look, Doctor Mehmet Oz, for instance, says repeatedly, we want to be good Americans. Just come out and announce today that if you are an American, you have to walk 30 minutes a day and that will cut health care costs probably faster than anything else we could do in the country.

DePARLE: That's right.

BARNES: Right. I mean, we know that 75 percent of the costs spent on health care go to treating chronic diseases that are preventable - you know, heart disease and others. Some of that is about personal responsibility, but it's also making sure that there are incentives so business -- and we were working with CEOs recently who came in and said, we're working with our staff to make sure that we're reducing obesity rates, that we're working on tobacco cessation -- so those are the kinds of things we need to build up this system.

SAWYER: So financial incentives to the people who take care of themselves.

SEBELIUS: But this is something everybody can do. Parents can turn off the TV and, you know, walk around the block, walk around the room. They can encourage their kids to eat healthier foods. We've got to work with schools to get better food in the cafeteria and more physical activity.

SAWYER: So my potato chips are un-American?

SEBELIUS: Well, once a week.

DePARLE: Well --

BARNES: Well, yeah.

SAWYER: OK. Thank you so much.

[end video clip]

SAWYER: And our thanks to the three of them. And, of course, even on prevention, the Republicans say there's so much that can be done without government involvement.

ROBERTS: But Republicans do agree that changes are needed in the health care system but, Diane, as you said, their prescription is different. A few minutes ago, I talked to House Minority Whip, Congressman Eric Cantor of Virginia.

[begin video clip]

ROBERTS: Congressman Cantor, thank you so much for joining us this morning. We certainly do appreciate it. And you just heard from Secretary Sebelius and she said that the cost of health care is, quote, “crushing families and businesses.” Of course, you disagree with much of the Democratic plan. What is the Republican plan going forward?

CANTOR: Well, first of all, Robin, the most important thing for us to make sure is that we do increase coverage to a basic plan for more Americans, and the way we're going to do that is by starting with where people get most of their health care and that's with their employer. And if 70 percent of the people in this country get their health care through their place of work, we've got to be sure to make it so that those employers can keep their costs down.

ROBERTS: There is a new poll as well, Congressman, that says 72 percent of Americans support a public government-run plan as one of the health care options, and 57 percent said that Democrats were more likely to improve health care. Only 18 percent felt that way about Republicans.

Does it appear that there is -- there is a growing group that would like to see the government take a little bit more control. They feel that the government could get answers where individuals have failed to get answers from some insurance companies.

CANTOR: A government plan, no matter what you call it, will increase costs. It will reduce choices, and, essentially, it will not allow you to keep what you have. And that is the essence of what the health care system in this country is about. That's what families are looking for.

ROBERTS: But the Democratic plan would make it illegal for insurance companies to cancel these policies. Again, these are people who have paid their premiums, they got sick, and the Democratic plan would say, no, you cannot do that. Are you ready to say that the Republican plan would do that as well?

CANTOR: Well, what the Republican plan will do is it will look more towards the individual and will say, if you have a plan, your insurer and you are going to determine the length of that coverage. But also, if somehow you lose your job and that's how you get your coverage, we're going to make sure that you've got the flexibility under that plan to take that coverage with you.

ROBERTS: Can you tell us how you plan to pay for it?

CANTOR: When you give employers the flexibility, as well as the employees, and provide some incentive for folks to exercise -- if you do that, you are rewarded with lower premium costs in some of these plans. We ought to allow for more competition so that people can have a choice. You can have a choice of what kind of health care coverage you want. Maybe you're young and healthy and you don't want to purchase coverage for hair transplants or other elective procedures. And maybe you just want a basic plan. We ought to allow for that.

ROBERTS: Congressman Eric Cantor, have a good day. Thank you.

CANTOR: Thanks, Robin.

[end video clip]