Devil's in details about uninsured

Biased coverage by newspapers often revealed in facts that went unreported

by David Kopel

Mar 15, 2003, Rocky Mountain News

Last week was "Cover the Uninsured Week," a campaign co-sponsored by the Robert Wood Johnson Foundation, an organization that advocates socialized medicine. The newspaper coverage of the issue provided a good example of how media bias is most often demonstrated not by stories with factual errors, but by the facts that are omitted.

The Rocky Mountain News (March 11) informed readers that there are "41 million Americans without health insurance." This ubiquitous figure has appeared in the News nine times and The Denver Post six times since October.

First of all, while the figure is regularly touted as the number of "Americans" without health insurance, that's incorrect. According to a Census Bureau report on which the 41 million figure is based ("Health Insurance Coverage: 2001"), the number includes 9 million legal and illegal immigrants. So the number of "Americans" without health insurance is actually about 32 million, not 41 million.

Does the absence of health insurance mean that these 32 million aren't healthy? Not necessarily. Wage earners are significantly more likely to have health insurance than the self-employed.

Yet a study by the National Bureau of Economic Research (Working Paper No. 8490) found that "the lack of health insurance among the self-employed does not affect their health. For virtually every subjective and objective measure of their health status, the self-employed and wage earners are statistically indistinguishable from each other."

The whole premise of "Cover the Uninsured" is that not having health insurance causes health problems. But the NBER scholars explained, "The self-employed thus appear to be able to finance access to health care from sources other than insurance. Perhaps the source is their own wealth, or perhaps they have better access to borrowing than wage earners. In any case, to the extent that the goal of public policy is to increase the utilization of health-care services among the self-employed, providing them with health-insurance subsidies may not be an efficacious measure."

There are poor Americans who can't afford basic medical care, yet don't qualify for the state-federal Medicaid program. The Census Bureau reported that the number of poor people who were uninsured was 10 million. Of these, at least a quarter would not be Americans. So there are millions of Americans who can't afford health care, but this situation is not as dire as the "41 million Americans" factoid implies, when the figure is used without background data.

Coverage of state government's recent decision to stop paying Medicaid for legal immigrants has rarely raised the question of whether private charities and communities might have a responsibility to help provide for the poor. For example, Denver's Jewish community is, on the whole, quite prosperous, but the articles in the News (March 8) and Post (March 9) about elderly Russian Jews who will soon lose their Medicaid benefits never asked what, if anything, Denver's Jewish community could do to help these people. Many of the people featured in the stories live in apartments subsidized by the Allied Jewish Federation, and the News story quoted an official of Jewish Family Services. It would have been helpful if the reporters had asked these and similar organizations what steps, if any, the Jewish community is taking to help such people.

A few weeks ago, the U.S. Supreme Court ruled that the federal Racketeer-Influenced and Corrupt Organizations Act (RICO) could not be used against abortion clinic protesters. A Washington Post story in The Denver Post (Feb. 27) succinctly explained the legal basis of the high court's 8-1 decision: the disruption of the abortion clinics, while illegal, was not "extortion." The article also explained that a separate federal law (the 1994 Freedom of Access to Clinic Entrances Act) still prohibits interference with abortion services. A Denver Post story on the case's impact in Colorado confirmed that clinic interference remains illegal.

Yet the Post's online poll asked if readers agreed with the court decision to "lift bans on protests that interfere with abortion clinic business." As the articles right next to the poll question had explained, the high court did not legalize interference with abortion clinics.

News coverage of the case was much inferior to that of the Post. The News used an Associated Press article that never addressed the legal issue: whether civil disobedience not intended for financial gain could be considered "extortion."

According to Reuters, Serbian Prime Minister Zoran Djindjic died after he "was shot in the chest by two large caliber sniper bullets fired from a distance." The news agency referred to this event as an "apparent assassination." Well, if there's no real doubt about something, a story shouldn't use hedge words like "apparent." Thus, the Post (March 4) short item on the French colonial war in Algeria should have reported the undisputed fact that the French engaged in widespread torture (as French officials have admitted) - rather than writing that the French were "widely accused of torture."

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