Sep
25
2007

Stossel's Healthcare Distortions

One-sided report omits context--and facts

ABC's 20/20 host John Stossel got an hour of prime time on September 14 to launch a one-sided attack on single-payer healthcare, and advocate for the so-called "free market" solutions that Stossel and his favorite sources prefer.

"Tonight, we ask some provocative questions about your healthcare. We get some surprising answers," explained Stossel at the beginning of the "Sick in America" special. But "surprising" is not the first thing that comes to mind for anyone familiar with Stossel's journalism; as usual, Stossel relied largely on interviews with people who endorse the ABC host's platitudes about the virtues of the marketplace ("Private sector does everything better because they compete," for example). Except for an appearance by filmmaker Michael Moore, which serves to set up some of Stossel's complaints, the experts interviewed all share Stossel's vision: right-wing think tank spokespeople, a Harvard business school professor, a CEO who offers employees "health savings accounts" instead of insurance, a senior fellow at Manhattan Institute identified only as a "Canadian doctor" who criticizes his country's health system, and so forth.

Stossel tries to make the familiar argument that public healthcare programs in countries like Canada and Great Britain don't live up to the hype. "Many people say that healthcare in countries like France, Germany, Britain and Canada is great because it's free. Government pays for everything. No one has to worry. And free is good, right? Well, not so fast." In an effort to debunk the idea that "free" is always good, Stossel presents footage of giveaways for gasoline and ice cream causing chaos.

This is a classic straw-man attack, as actual advocates for single-payer healthcare rarely describe it as "free"; instead, they accurately point out that governments that provide healthcare for everyone spend far less money than the United States does to provide healthcare for some. It's a central point of his opponents' argument that Stossel never directly addresses.

When Stossel does get around to the quality of care under public systems, he relies on showcasing a few anecdotes, omitting mention of research that would undermine his point. "Waits are so long, some people do it themselves," he says, before launching into a string of anecdotes--each premised on the assumption that Americans are accustomed to timely care. But studies of these systems arrive at a strikingly different conclusion; when the Commonwealth Fund studied (5/15/07) various government healthcare systems--including Britain--all but one (Canada) were found to have shorter wait times than the United States. It's a staple of Stossel's journalism to showcase a few anecdotes when more careful research would undermine his point.

Later in the special, Stossel admits, "Now, I should say all of Canadian healthcare is not long lines." But this is merely a set-up for another slam on Canadian care--that animals get better healthcare than humans.

Stossel claims another advantage for for-profit medicine--that it drives medical improvements: "People competing for profit-- that's lifted us out of the 13th century and given us 21st century medicine. Drug companies looking to make money create things that improve our quality of life and save lives." When Stossel notes that government researchers do research of their own, one of his favored guests--Grace-Marie Turner of the pro-free market Galen Institute--responds, "Government is responsible for 4 percent of the drugs on the market today." Stossel follows up with a reference to an earlier guest's medical care: "Those expensive cancer drugs Vicki needs? They were made by companies looking to make a profit. So were these amazing artificial legs and artificial hearts. All invented for profit."

Actually, many of the advances Stossel referred to received significant public sector research support. Reporter and medical industry expert Merrill Goozner summarized the evidence that undermines this industry-friendly argument (American Prospect, 11/30/02):

Every independent study that's ever looked at the sources of medical innovation has concluded that research funded by the public sector--not the private sector--is chiefly responsible for a majority of the medically significant advances that have led to new treatments of disease.

Goozner cited a Joint Economic Committee of Congress (JEC) report that

pointed to a 1997 National Bureau of Economic Research study showing that public research led to 15 of the 21 drugs considered to have the highest therapeutic value introduced between 1965 and 1992. The JEC also cited a 1990 study by Robert Maxwell and Shohreh Eckhardt, "Drug Discovery: A Casebook and Analysis." That study found that 60 percent of 32 innovative drugs would not have been discovered or would have taken much longer to discover without research contributions from government labs and noncommercial institutions.

Goozner also pointed out that the National Cancer Institute had sponsored research for most anticancer drugs (as of 1995). It's also worth pointing out that artificial heart research has received significant government research funding over the years (New York Times, 12/10/87). Once again, Stossel's simple free-market fable turns out to be much more complicated in real life.

Stossel is critical of the health insurance industry, but largely because he views health plans that cover a wide range of care and treatment as interfering with the discipline of the market. A better alternative, he argues, are health savings accounts, where employers give workers a fixed amount of money and a high-deductible plan, and care is paid for out of that fund. Healthy workers who don't need care can save up the money themselves, making it a free-market dream. Stossel's account is based almost entirely on the case presented by guest and Whole Foods CEO John Mackey, a staunch supporter of this approach to healthcare.

A balanced report would have interviewed critics of health savings accounts, who point out that while this arrangement works well for younger, healthier workers, it would have little effect on total healthcare spending, since a relatively small number of patients who require much greater levels of care incur the majority of total healthcare costs (Center on Budget and Policy Priorities, 6/12/06).

Stossel also championed healthcare providers who avoid traditional insurance and sell their services directly to consumers. His leading example is laser eye surgery, which is not often covered by insurance. These doctors are competing and keeping costs down for consumers, enthused Stossel: "Prices dropped, even though doctors pay for advertising."

Stossel may have made a stronger point had he chosen a different example, though: Two major laser eye surgery providers were cited for deceptive advertising by the Federal Trade Commission in March 2003.

Such inconvenient facts can't stop Stossel from reaching utterly predictable conclusions: "Where consumers decide for themselves rather than having governments or insurance companies make decisions for them, competition erupts. And competition gives us more choices.... Choice gives us power."

Ironically, Stossel criticizes Michael Moore for not interviewing more health insurance companies for his documentary Sicko ("Why didn't you confront them?"). But the same should be asked of Stossel: Why was his "Sick in America" special so heavily slanted in favor of the arguments he favors?

ACTION: Ask ABC why John Stossel was allowed to present a completely one-sided special on health care in America. You can also write to Stossel himself, and ask him to respond to FAIR's criticism of his report.

CONTACT:

ABC 20/20 feedback form:

http://abcnews.go.com/Site/page?id=3271346&cat=20/20

ABC News Senior VP, Editorial Quality, Kerry Smith

212-456-4446

John Stossel, ABC News

JohnStossel@abcnews.com