A health care primer for media who should already know this stuff

As has been repeatedly noted here, despite Howard Kurtz's protestations to the contrary, the media's best efforts to report on the debate over health care reform have resulted in a public that believes any number of false claims opponents have made about the legislation. Perhaps the reason that has happened is because even though health care has been among the top issues under discussion since President Obama took office, prominent media figures remain woefully ignorant of its elementary details.

For example, Lou Dobbs seems to have a problem absorbing basic facts about health care:

DOBBS: Is universal health care, the so-called public option, or single-payer, which -- however you want to break it down…

Similarly, earlier this month, Chris Wallace stated:

WALLACE: Congressman Rangel, here's a top House Democrat saying the Republicans are right, that the public option is a stalking horse for a single-payer government takeover like we see in Britain or Canada.

Ok, full stop. Let's “break it down” in a way that doesn't involve journalists who should know better conflating a bunch of terms that mean different things: Universal health care is different from the public option, which is different from single payer. Britain and Canada have very, very different health care systems.

Universal health care refers to the goal -- not any specific policy proposal – to provide quality, accessible health care to everyone in the country. There are many different ways you can get there; we currently aren't following any of them.

The public option is a proposal included in the Senate health committee and House bills that would establish as one option among many a government-run health insurance plan. It would not be open to anyone who wishes to enroll in it, and those who are eligible would be able to choose it from a list of other, private options. CBO estimates that if the public option passes in the form envisioned by the House draft bill, only about 11 or 12 million people would be enrolled in it by 2019.

Single-payer is a health care model wherein a single source – usually the government – finances all or almost all health care expenditures; basically, everyone in the country has government-provided health insurance. You go to the doctor or the hospital, they treat you, the government pays. Our Medicare program is effectively a single-payer system for the elderly. Canada's health care system features single-payer insurance available to all citizens, with doctors working in public or private practices, but receiving payment for most treatments from the government. There is no proposal currently under serious discussion that would institute a nationwide single-payer system.

The United Kingdom has a single-provider health care model, wherein the government owns and operates the health care system, employing all doctors and other medical personnel through the National Health Service and paying them for all medical services. Our own VA is a single-provider system for veterans. There is no proposal currently under any level of discussion whatsoever that would institute a nationwide single-provider system.

Yes, this stuff is a little complicated – at least, it requires media figures to actually study the issue a bit and develop some understanding of the basic facts at hand. Then again, that's theoretically what they get paid for – to learn about the issues and educate their audience.

Or, you know, they could just keep talking about the politics of it all. That's worked out pretty well so far, right?