“Health Care Reform” vs. “ObamaCare”: Partisan Framing of FOX, MSNBC, NYT, and WSJ

Abstract

This study explores the differing ways in which liberal and conservative American mainstream media framed the Obama administration’s health care initiatives during the critical period of 2009-2010. Using a framing analysis as its methodology, it examines news coverage in The New York Times, The Wall Street Journal, Fox News and MSNBC. It concluded that the framing generally reflected the political ideology of each news organization. For example, while the NYT and MSNBC commonly described proposed legislation as “health care reform,” the WSJ and Fox News usually referred to it as “ObamaCare,” implying that the impetus for its origins lay mainly within the White House. In addition, this study found that news outlets on all sides of the political spectrum tended to frame opposing points of view as extreme while claiming the ideological middle-ground for themselves. Use of the terms “far Right” and “far Left” were especially prevalent during this period. Also this study examined how journalists attempted to situate the debate over U.S. health care policy within the context of globalization, and found that the experiences and health care systems of foreign countries were used by American media to support their own particular points of view regarding the issue.

**Key words: Framing, Health Care, Qualitative Analysis, Partisan Media

Introduction

Healthcare reform has long been one of the major political issues in the United States. This issue demonstrates the deeply rooted philosophical differences between the political parties, as it requires fundamental changes in the status quo (Helco, 1995). On March 21, 2010, after a fierce battle between the Democratic and Republican parties in 2009-2010, the House of Representatives passed the Patient Protection and Affordable Care Act by a vote of 219 to 212. This healthcare bill constituted a major part of President Obama’s domestic agenda. Obama’s health care overhaul is considered one of “the most expansive social legislation enacted in decades” (2010, March 23).

When President Obama signed the bill in the East Room of the White House on March 23, 2010, he emphasized that this bill enshrined “the core principle that everybody should have some basic security when it comes to their health care” (2010, March 23). In contrast, on the same day in another part of Washington, John A. Boehner, the House Republican leader, opined that “This is a somber day for the American people….by signing this bill, President Obama is abandoning our founding principle that government governs best when it governs closest to the people” (2010, March 23). Since health care reform embodies a considerable degree of intrinsic complexity and is, by its very nature, a contentious issue in American politics, it is understandable that both journalists and politicians have interpreted or defined Obama’s health care proposals to their own advantage.

Considering the opposing views about Obama’s bill, it might be reasonable to ask why universal health care should elicit such a heated political controversy among political factions in the United States. Unlike other Western industrialized nations, the U.S. has not established a universal health care system. Since health care is a fundamental defining policy of the modern state, and since Obama’s health care reform can be seen as an expansion of the role of government, it can be analyzed in a global context. This study also investigates how partisan media framed Obama’s health care reform, in both different and similar ways.

Methodology

This study takes a constructionist approach to framing analysis (Gamson & Lasch, 1983; Gamson & Modigliani, 1987; Gamson & Modigliani, 1989). In 1983, Gamson and Lasch proposed that the frame is “a central organizing idea for understanding events related to the issue in question” (398). This study is also based on Entman’s (1993) definition of framing as the selection of “some aspects of a perceived reality and make them more salient in a communicating text, in such a way as to promote a particular problem definition, causal interpretation, moral evaluation, and/or treatment recommendation for the item described” (p. 52). Frames can be recognized and classified when they possess not only “identifiable conceptual and linguistic characteristics,” but also are “reliably distinguishable from other frames” (Cappella & Jamieson, 1997). One effective way to detect a frame is “to look for recurring words or phrases and/or words that [hold] special cultural significance” (Wall, 2006, pp. 114-115).

This study regards the hegemonic function of framing as important. The concept of “hegemony,” proposed by Gramsci (1971), refers to the process by which the dominant social groups in a society legitimize the established political system and social order through the diffusion of privileged values. Carragee and Roefs (2004) consider the framing process to be “central to both the production of hegemonic meaning and to the development of counterhegemonic ways of seeing” (pp. 227-228). Framing research can contribute to unveiling “the connection between media frames and ideological hegemony” (Carragee & Roefs, 2004, p. 221).

One of the fundamental premises in the concept of “journalistic objectivity” has been said to be “the separation of the press from party politics,” making neutrality and impartiality the “basis for news provision” (Tumber & Prentoulis, 2005, p. 64). This principle of journalistic objectivity distinguishes the work of journalists from that of “publicity agents,” whose job is to promote shaded versions of the truth (Tumber & Prentoulis, 2005, p. 64). Since the U.S. media considers claims to consider objectivity to be “the core of journalism’s unique selling proposition,” they make an effort to appear objective and unbiased to their viewers, listeners and readers (McNair, 2005, p. 31).

However, Eisinger, Veenstra and Koehn (2007) point out that “the presence of systematic ideological bias” is prevalent in American media and “would contradict claims of neutrality” (p. 19). In fact, the American news media have been frequently criticized for their so-called ideologically biased reporting. While some conservative politicians and journalists criticize the media for having “a liberal bent,” liberals often claim that the media are “inherently conservative” (Eisinger et al., 2007, pp. 17-18). It is undeniable that partisan media tend to describe public issues and politicians in partisan ways. Previous studies have demonstrated a growing ideological divergence in American media in the coverage of public issues and figures (Groeling, 2008; Iyengar & Hahn, 2009).

On one side of the ideological divide lies the Fox News Network, whose target audience is conservatives (Iyengar & Hahn, 2009; Baum, 2011). Indeed, a study by Jamieson and Cappella (2008) claims that Fox News and The Wall Street Journal (both owned by Rupert Murdoch), together with Rush Limbaugh’s talk radio show, constitute an “echo chamber” which promotes a conservative viewpoint and defends the Republican Party. By contrast, The New York Times and MSNBC cater to a liberal audience (Brady & Ma, 2003, Nov. 16; Baum, 2011).

Given this context, the present paper considers a wide spectrum of ideological positions. It analyzes the news coverage of Obama’s health care initiative by two conservative media (Fox News Network’s The O’Reilly Factor and The Wall Street Journal’s editorials) and two liberal media (MSNBC’s Countdown with Keith Olbermann and The New York Times’ editorials). The news stories were retrieved from the Lexis-Nexis database. “Obama,” “Health care,” and “Insurance” were used as the keywords. The time period is from Jan. 20, 2009 (Obama’s inauguration day) to March 22, 2010 (the day the health care bill was passed). After excluding the irrelevant stories, the researcher analyzed the following: The O’Reilly Factor = 166 stories; Countdown with Keith Olbermann = 152; The New York Times = 39; The Wall Street Journal = 22.

Globalization and Health Care

Politicians’ endeavors to expand access to quality health care date back to the 1910s when Theodore Roosevelt advocated for a national health insurance plan (Jacobs & Skocpol, 2010). As presidents, Franklin Roosevelt, Harry Truman, John F. Kennedy, Richard Nixon and Jimmy Carter all pursued an expansion of health care for the American people, without achieving any meaningful success (Jacobs & Skocpol, 2010). In 1993, President Bill Clinton emphasized the urgency of fixing the U.S. health care system, claiming that “this health care system of ours is badly broken, and it is time to fix it. . . .we must make this our most urgent priority, giving every American health security” (1993, Sept. 22).
Jacobs and Skocpol (2010) claim that the U.S.’s health care system is unsustainable and uncompetitive, when compared with other countries:

American’s outsized spending on health care is particularly worrisome given that all other industrial nations provide their entire populations with health coverage. They do it in a lot of different ways, sometimes with a central role for government, but in some instances like Germany and Switzerland by regulating private insurance companies and helping all citizens afford coverage. However they manage to ensure universal health care, other nations get hugely more bang for the buck than the United States does, and they manage to keep a tighter rein on rising health-care costs. (p. 22; emphasis added)

Conservative and liberal media frequently bring up the health care system of other countries in their coverage of Obama’s health care initiative. On one hand, the WSJ framed Obama’s health care as a duplication of the European economic model. It warned that Obama’s health care efforts could result in “a vast new entitlement, financed by European levels of taxation on business and individuals” (2009, Nov. 9). In particular, the WSJ tried to disparage other countries’ health care models as government-controlled and undesirable systems. For example, the WSJ claimed that “if health planners won’t accept the prices set by the marketplace – thus putting themselves out of work — the only other choice is limiting care via politics, much as Canada and most of Europe do today” (2009, March 27). Further, the WSJ criticized President Obama’s health care bill: “We fought this bill so vigorously because we have studied government health care in other countries, and the results include much higher taxes, slower economic growth and worse medical care” (2010, March 22).

However, in the WSJ editorials, not only successful cases of universal health care in other countries, but also the hardships faced by the insured in American society are were rarely mentioned. This was also true of Fox’s O’Reilly Factor program. Similarly, O’Reilly highlights the negative aspects of the health care system in foreign countries. He seemed to be interested in eliciting the problems of the British health care system in an interview with Dr. Bill Frist, the former Republican Minority leader of the Senate:

O’REILLY: You — you worked in the British health-care system.
FRIST: I did. I spent almost a year as a heart surgeon.
O’REILLY: Was it chaos there?
FRIST: It was rationed health care.
O’REILLY: It was rationed?
FRIST: People waited a lot longer to come see…
O’REILLY: And that can happen here, right?
FRIST: … Bill Frist, the heart surgeon. Well, if you went to a socialized or nationalized and then socialized system, it would have to occur here.
O’REILLY: Right.
FRIST: It definitely would occur here. (2009, July 28)

As this dialogue suggests, O’Reilly framed the British health care system as a government-controlled, rationed system and, thus, as contradictory to the free market and competition. O’Reilly emphasized the Canadian health care system’s “imploding” at the beginning of the quoted program, saying, “as you may know, some liberals point to the Canadian health care system as what we should have here in America. But do we really want a health system that’s imploding?” (2009, August 20). He then asked Brian Day, a Canadian doctor, “Dr. Day, what is the biggest problem with your health care system in Canada?” O’Reilly consistently emphasized problems in the Canadian system without paying attention to the strengths of the health care systems in it and other foreign countries.

By contrast, in the view of the NYT, the current health care system in the U.S. was presented as both regrettable and shameful. It also did not meet the global standard for a major industrialized nation. The NYT claimed “the fact that 46 million people in this country have no health insurance should be intolerable. Every other major industrial country guarantees health coverage to its citizens, yet the United States, the richest of them all, does not” (2009, Dec. 30). Keith Olbermann also contextualized Obama’s proposal as inevitable in terms of globalization: “Look, the fact of the matter is, this is not just about the 46 million people who don’t have health insurance. This is about the future of the American economy. We’re not just losing jobs to China, we`re losing jobs to Canada — because their health care system is better for business than our health care system is” (2009, June 8).

The public discussion about universal health care in the U.S. is sharply divided, on a partisan and ideological basis. Opponents of Obama’s healthcare plan claim that “America has the most technologically advanced health care in the world, the finest hospitals and most expert doctors” (Jacobs & Skocpol, 2010, p. 22). Also, opponents point out that U.S. healthcare spending amounts to 15.3% of GDP (Gross Domestic Product), the highest among the 31 industrialized countries tracked by the OECD (the Organization for Economic Cooperation and Development).

The NYT and Olbermann’s Countdown tie Obama’s health care reform to the American economy in a globalization context. The NYT states, “This is going to be a tough fight. Mr. Obama must keep reminding Americans that reforms are essential for their personal health and the nation’s economic health” (2009, April 29). The NYT also emphasized that the restructuring of the current health care system is a necessary and economically sensible way to revitalize the national economy and to decrease the costs of health care for all Americans.

Olbermann has been an ardent proponent of Obama’s public health care proposal. For example, on July 31, 2009, the American newspaper, Investors Business Daily, asserted that “people such as scientists Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” Stephen Hawking, the British physicist, has had Lou Gehrig’s disease for 40 years. Olbermann sarcastically dismissed the assertion by Investors Business Daily as being, simply, ignorant: “Do you realize Dr. Hawking is from the U.K., and National Health has helped to keep him flourishing these last 45 years?” (2009, Aug. 11). Perhaps more significantly, Hawking himself also said, “I wouldn’t be here today if it were not for the NHS . . . I have received a large amount of high-quality treatment without which I would not have survived” (2009, Aug. 12).
Overall, the idea of “global competitiveness” is manifested in both the liberal and the conservative media’s rhetoric about American health care. However, in order to increase jobs within the U.S. and to improve American companies’ global competiveness, conservative and liberal media seem to propose different solutions to the current American health care system. Liberal media support public and universal health care, while conservative media defend private health care, without any government intervention or role.

“Health Care Reform” vs. “ObamaCare”

The most defining contrast between liberal media and conservative media was found in the way President Obama’s health care proposal is labeled. Countdown with Keith Olbermann and The NYT consistently referred to President Obama’s proposal as “Health Care Reform,” while The O’Reilly Factor and The WSJ repeatedly termed it “Obamacare.” The NYT has supported the health care plan proposed by President Obama. In particular, it has consistently championed the necessity of Obama’s proposal of a universal health care system in the U.S. from the time he began his presidency in January of 2009. In February, 2009, a NYT claimed that “coverage should be universal, affordable, portable and there should be investments in prevention and improved quality of care” (2009, Feb. 27).

Whenever Obama’s health care efforts were criticized by the opposition party and conservative groups, the NYT urged the President not to give up the idea of universal health care. One of the most serious crises in Obama’s health care efforts occurred when Democrat Martha Coakley was defeated by Republican Scott Brown in the race to fill the Senate seat held by Edward Kennedy. As a result, the Democratic Party lost the 60-seat super-majority needed to avoid a filibuster, which refers to a legislative tactic allowing a minority of U.S. senators to block the majority party’s potential legislation (Fisk & Chemerinsky, 1997). The NYT claimed in its editorial entitled “Don’t Give Up Now” that “it would be a terrible mistake for Democrats to abandon comprehensive health care reform just because voters in the Massachusetts Senate race last week decided that they liked the Republican, Scott Brown, more than the Democrat, Martha Coakley” (2010, Jan. 26). It also added, “this is a once-in-a-generation chance” (2010, Jan. 26). In its editorial on February 27, 2009, the NYT also asserted that universal health care is a destination that the U.S. must reach, even though there are many obstacles on the journey.
In contrast, The WSJ was generally cynical toward President Obama’s handling of the health care issue. Criticizing Obama’s health care plan as “ObamaCare,” it opposed any government-run health care system in general:

Keep in mind that every version of ObamaCare now under consideration essentially turns all private insurers into subsidiaries of Congress…. ObamaCare doesn’t bother with incentives, instead merely increasing government command and control of private insurance while making it more expensive in the process. That’s why a trigger will inevitably lead to the public option, and also why ObamaCare will make all of our current health problems worse. (2009, Sept. 8)

The WSJ’s repetitive usage of the term “ObamaCare” reveals its distrust of Obama’s proposed health care legislation and serves to trivialize it. Similarly it also branded the Clinton administration’s health care proposal in 1994 as “HillaryCare” (2009, June 3). In 1994, President Clinton inaugurated the Task Force on National Health Care Reform and appointed his wife Hillary as its head. The Clinton government’s health care bill was also condemned as an expansion of big government liberalism.

Both “Health Care Reform” and “ObamaCare” are ideographs as they refer to the “basic structural elements, the building blocks, of ideology” (McGee, 1999, p. 459). McGee (1995) described the concept of an ideograph as “a high-order abstraction representing collective commitment to a particular but equivocal and ill-defined normative goal” (p. 459). For him, an ideograph “warrants the use of power, excuses behavior and belief which might otherwise be perceived as eccentric or antisocial, and guides behavior and belief into channels easily recognized by the community as acceptable and laudable” (p. 459).

Perhaps as part of the “echo chamber” effect previously mentioned, the “ObamaCare” ideograph was repeatedly used on The O’Reilly Factor: “A lot of taxpayers oppose Obamacare” (2010, Dec. 2); “Most people are against Obamacare” (2010, Dec. 14); “Obamacare is a powerful divide between conservatives and liberals, no question” (2011, Jan. 4); “Because people oppose Obamacare” (2011, Jan. 5). O’Reilly did not accept Obama’s proposal as “a reform” and tied the policy to the president personally. “Obamacare,” he subliminally tells his audience, is not true reform.

The ideograph “Obamacare” personalizes the health care issue by using the president’s name, suggesting that health care reform is part of the president’s personal agenda and his pet project, not one that has broader support and consensus. In addition to “Obamacare,” other ideographs, such as “Government Takeover,” (2009, Aug. 10) “Socialized Medicine,” (2009, July 21), “health-care rationing” (2010, Feb. 25), “Death panel,” (2009, Aug. 14) and “government-imposed euthanasia” (2009, Dec. 23) routinely appeared in the coverage of Obama’s health care plan on The O’Reilly Factor. Although O’Reilly did not literally call President Obama a “socialist,” he did repeatedly bring up the ideograph “socialist”: “I just want everybody to know I have no partisan dog in this hunt. I want everybody to know that. All right. I’m not coming at this like Obama’s some socialist nitwit. That’s not what I do here. OK?” (2009, July 22). However, O’Reilly did successfully link Obama’s bill to the idea of a government takeover of the whole health care system in the U.S.

Conservative commentators were more frequently invited to The O’Reilly Factor , just as liberal commentators were more common on Countdown with Keith Olbermann. For example, Ann Coulter, a conservative commentator, tied the ideological roots of President Obama to socialism on The O’Reilly Factor. She said, “I did expect Americans to turn against the socialist program of Obama” (2009, Sept. 10). The ideograph of “socialism” also brings to mind socialist countries such as the Soviet Union, Cuba and China, which have long been identified as “enemies of the U.S.” Connecting Obama to socialism is aimed at fueling the concern that President Obama is a threat to American’s freedom and constitution.

By repeating some ideographs over and over again, The O’Reilly Factor problematizes the constitutionality of Obama’s health care reform: “Forcing Americans to buy health insurance of any kind may be unconstitutional. According to a number of scholars, the feds can’t force us to buy anything” (2009, Aug. 24). In the same vein, Laura Ingraham, a guest host on The O’Reilly Factor also asked, “why should the government go into someone’s home and have a consultant talk about the end of life issues?” (2009, July 17). The WSJ also criticized the fact that “Speaker Nancy Pelosi defied policy logic and public opinion late Saturday night, ramming through the House a nearly 2,000-page health-care leviathan that counts as the biggest expansion of the federal government since the New Deal” (2009, Nov. 9).

In the same vein, former comedian Dennis Miller, now a Fox News contributor and radio talk show host, denounced Nancy Pelosi, the Democratic House Speaker and a strong supporter of Obama’s health care reform: “I view Pelosi as a karma compromise” (2009, Aug. 12). He explained that “I wouldn’t even go near Nancy Pelosi….there are people in life who I think are karma compromises. If you hang out with them, you literally put yourself in harm’s way as far as karma, because they’re that bad a person” (2009, Aug. 12). Jonathan Haidt, a psychologist, claims that “karma is not an exclusively Hindu idea. It combines the universal human desire that moral accounts should be balanced with a belief, somehow or other, they will be balanced” (2010, Oct. 16). He also asserts that the Tea Party Movement, which strongly criticized Obama’s health care initiative, should be understood as the restoration of “karma,” not of liberty:

“…the law of karma says that for every action, there is an equal and moral commensurate reaction. Kindness, honesty and hard work will (eventually) bring good fortune; cruelty, deceit and laziness will (eventually) bring suffering. No divine intervention is required; it’s just a law of the universe, like gravity” (2010, Oct. 16).

For the conservative politicians and media, government welfare policies, such as the Obama health care plan, are examples of federal activism and, thus, are in violation of the law of karma. Haidt claims that there is a big difference between liberalists and conservatives in their understanding of fairness: “Liberals think about fairness in terms of equality, whereas conservatives think of it in terms of karma” (2010, Oct. 16). Conservative media view Obama’s health care plan as unacceptable government intervention, to be implemented in order to help undeserving people.

Health care opponents’ rhetoric is also hooked up to the concept of American exceptionalism. O’Reilly praised Walter Cronkite, the late CBS news anchor, in order to disparage the liberal journalists sympathetic to Obama’s health care. He claimed that “he [Cronkite] believed the USA was essentially a noble nation…. His [Obama’s] health care plan will create more debt the country will ever be able to repay no matter how much it taxes.”(2009, July 20). In O’Reilly’s view, the government-centered health care system is unacceptable because the U.S., a noble country, is about to adopt an outdated, socialistic system. His view leads to the conclusion that the U.S. is a superior country and, thus, does not need to launch a universal health care system. He said, “Americans are a generous people. We give more money to the poor than any other country on earth. But if you harm the fundamental economy of the nation, you’re hurting far more people than you’re helping. And that is what the president does not seem to understand” (2009, August 20; emphasis added).

O’Reilly’s view is tied to the concept of American exceptionalism, a political ideology which imagines the United States, in contrast to all other countries, as constituting something fundamentally unique. American exceptionalism is based on the belief that “The United States was exceptional in starting from a revolutionary event, in being ‘the first new nation,’ the first colony, other than Iceland, to become independent” and, thus, “America continues to be qualitatively different” (Lipset, 1996, pp. 18, 26). In American exceptionalism, five values —liberty, egalitarianism, individualism, populism, and laissez-faire— are especially cherished (Lipset, 1996).

Even though conservative politicians and scholars tend to emphasize American exceptionalism in relation to foreign affairs both during and after the Cold War, American exceptionalism also influences the public discourse about Obama’s health care. Opponents of Obama’s universal healthcare also claim that healthcare can be best when it is in the hands of the private sector. However, the news coverage, which dramatically shows the suffering of the uninsured, was not detectable in the WSJ’s editorials or on Bill O’Reilly’s program.

The O’Reilly Factor consistently implied that Obama’s health care program infringes on the freedom of individuals. O’Reilly asserted, “President Obama’s ultimate goal is to turn the nation into a Socialist country. And he wants to dismantle the capitalistic system” (2009, Nov. 2). O’Reilly’s view is quite similar to the WSJ’s editorial which claimed that “this year’s legislation will hone in on traditional liberal concerns of social equity —— covering the uninsured” (2009, June 3). The WSJ went further to assert that “Mr. Emanuel echoes his boss and says a government health plan is needed to keep the private sector ‘honest,’ but then why don’t we also need a state-run oil company, or nationalized grocery store chain? (Or auto maker? Never mind) ” (2009, July 9).

In fact, the WSJ’s mocking view of social equity is not a new phenomenon, because the popular U.S. media tend to justify the current social inequality. Thomas (1986) claimed that even though “wealth and power are not evenly distributed,” the popular U.S. media serves “to make this system of imbalanced conditions acceptable to those who might otherwise find cause to resist” (p. 612). One of the common themes, emphasized by the U.S. media, is “Anyone Can Achieve,” which means “anyone has a decent chance of accomplishing upward social mobility” (Thomas, 1986, p. 613). Conservative media’s advocacy of the doctrine of American exceptionalism, and their view of the current, capitalist, American health care system as being superior, reflect the U.S. news media’s tendency to make the public perceive the current social order to be desirable.

Labeling the opponents as extremists

Both conservative and liberal media tried to defame those opponents who do not agree with their ideological point of view or causes. On one hand, the conservative media tried to characterize the overall process of health care reform as “chaotic,” “messy,” and “cloudy.” This strategy sought to convert public misgivings about Obama’s health care legislation into outright fear:

President Obama’s health care vision [is] in deep trouble. Simply put, it’s chaotic. And according to the Congressional Budget Office, very expensive. (2009, July 28); So what we have here is a crisis of leadership. There’s no question about it. Health care’s in chaos. (2009, Aug. 25); Finally, the president must know that his health care vision is in serious trouble and he must adjust quickly. Blaming dissenters and news agencies like FOX, who do not demean legitimate protests, actually is hurting the president” (2009, Aug. 24); This trillion dollar health care deal is as chaotic as anything I’ve ever seen here in Washington. (2009, Dec. 15); First of all, President Obama’s intentions are good. He wants to clean up the health-care mess that’s hurting millions of Americans. What’s wrong with that? Nothing wrong with that. But his plan is chaotic and the expense ill-defined. (2009, July 22); And the country is heading for the California cliff. (2009, July 20). [emphasis mine]

In this context, O’Reilly faults President Obama’s leadership and moral judgment: “the big issue is the president himself. He has lost power. There’s no question about it” (O’Reilly, 2010, Jan. 20).

Partisan journalists also labeled their opponents as extremists, perhaps because they assume that attacks on extremists or zealots will be seen as justified. O’Reilly describes Obama’s health care supporters as “the far left:” “in the health care debate, left wing loons are insistent that the government run the entire health care system. They call it social justice. ‘Talking Points’ believes the Obama administration is intimidated by the far left and fear their zealotry” (2009, Aug. 18); “It looks like the far left will lose again as a modified health care bill will most likely pass soon. The question tonight, will the bill bankrupt the country?” (2009, Dec. 16); “Simply put, the country is nowhere near as left wing as President Obama obviously is. And he never had a mandate for this type of radical change” (2009, Aug. 14).

In contrast, Olbermann characterizes the opponents of health care as “the far right”:
In particular, Olbermann labels Obama’s health care opponents as “the right-wing mob” (2009, Aug. 6). The term “far right” is also frequently used by Olbermann: “And so the far right escalates the rhetoric and the level of threat, just a little more” (2010, March 22); “The far-right and big pharma, the insurance giants, the hospital monopolies move to disrupt anyone who stands up for the patient instead of for the corporation” (2009, Aug. 3).

Another strategy was to portray the opponent as insincere, deceitful and hypocritical. Conservative journalists described the opponent as being unintelligible, saying that they cannot understand Obama’s health care plan. This strategy encouraged public concern and doubt about Obama and his proposal. They claimed that Obama’s health care bill was not understandable and therefore should be rejected. It seemed that the only acceptable Obama health care bill would be one easily understood by all. As O’Reilly said:

I am wanting to understand how President Obama is going to improve your life and my life in the health care, the vital health care realm. I want to understand. I have a master’s degree from Harvard University that cost me $30,000 to get. I do not understand what the man is saying. (2009, July 22).

And it [Obamacare]’s basically a confusing hodgepodge of stuff nobody can understand, including the president. (2009, Dec. 17).

The bill was just released in the last 48 hours. 20,000 plus pages. This long manager’s amendment now that as far as can I tell very few people really understand. (2009, Dec. 21).

Furthermore, by incessantly repeating the word “lie” in his mentioning of Obama, O’Reilly implies that Obama is dishonest. This is intended to stress Obama’s insincerity:
“He can say whatever he wants, but if he lies, he loses. If he lies, he loses” (2009, Sept. 10); “Barack Obama a true believer in what he said? Or is he misleading the public consciously? ” (2009, Sept. 14); “Now, President Obama, very clear, and I don’t believe that he lied. He can’t possibly include illegal aliens in his health care bill. He would be a one-term president. It would be, you know, no read my lips no, new taxes by a thousand if that happened” (2009, Sept. 28); “Well, they do all the time. And the difference is they just boo generally. Last night, we had Obama telling lie after lie. (Coulter, Sept. 10, 2009); “Really? You think the guy is a liar? (2009, Sept. 14); “You guys want this built into the health care bill. Obama would have to veto it or he looks like a liar” (2009, Dec. 8).

O’Reilly tries to highlight the hypocrisy of interest groups and politicians that supports President Obama’s health care reform. He targets AARP (the American Association of Retired Persons), probably because AARP backed Obama’s health care proposal. In O’Reilly’s view, AARP’s advocacy for Obama’s health care proposal is not understandable: “the nation’s most powerful lobbying group for senior citizens, the AARP, is perceived to be firmly behind President Obama’s health care vision. That’s causing some controversy” (2009, Aug. 10).

Even though O’Reilly questions the lobbying of AARP, he did not attack the lobbying of the health care or drug industry on his program. In the same vein, in order to damage the cause of Obama’s health care reform, O’Reilly accentuates the hypocrisy of Edward Kennedy, who was one of the most outstanding liberal politicians and who strongly backed the establishment of universal health care in U.S. In Obama’s health care legislation, Kennedy’s seat in the Senate was very important; if the Democratic Party lost Kennedy’s Senate seat after his death, it could not prevent a filibuster by the Republicans. The O’Reilly Factor spotlights the hypocrisy of liberal politicians:

Senator Edward Kennedy is gravely ill. So he has asked that the Massachusetts legislature change its law about appointing a senator to take his place. Rather than wait for the five-month election cycle, Kennedy wants a temporary appointment by the Democratic governor, Duvall Patrick, before the special election. But it was Kennedy who championed the five-month election option back in 2004, because he feared that Republican Governor Mitt Romney would appoint a Republican to take John Kerry’s place if he won the presidential election. This is called politics. Kennedy wants what he wants when he wants it. (O’Reilly, 2009, Aug. 19).

On the other hand, Olbermann castigates the hypocrisy of the Republican politicians. One of Olbermann’s targets is Sarah Palin, the Republican vice-presidential candidate in the 2008 election. Olbermann criticized Palin’s labeling of part of Obama’s health care plan as establishing “Death Panels.” Palin wrote on her Facebook site: “The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil” (2009, Aug. 7).

Olbermann strongly criticizes the “death panels” characterized by Palin and duplicated by other conservative celebrities. He attacks “Death Panels” as fear-mongering and shameful:

Madam, you [Palin] are a clear and present danger to the safety and security of this nation. Whether the ‘death panel’ is something you dreamed, or something you dreamed-up, whether it is the product of a low intellect and a fevered imagination, or the product of a high intelligence and a sober ability to exploit people, you should be ashamed of yourself for having introduced it into the public discourse, and it should debar you, for all time, from any position of responsibility or trust in the governance of this nation or any of its states or municipalities. (2009, Aug. 10).

Olbermann also attacks Republican politicians’ opposition to health care reform as being the result of an immoral relationship between the health care industry and the Republican Party. In his eyes, the Republican politicians are a hypocritical group. He claimed:

Because the insurance industry owns the Republican Party. Not exclusively. Pharma owns part of it, too. Hospitals and HMO`s, another part. Nursing homes, they have a share…. You said the Democrats’ plan was for “government run health care that would disrupt our current system, and force millions of Americans who currently enjoy their employer-based coverage into a new health care plan run by government bureaucrats.” That`s a bald-faced lie, Senator…. But, as corrupt hypocrites go, Senator, at least you`re well paid. What was that one statement worth to you in contributions from the health sector, Senator Thune? Five thousand dollars? Ten? (2009, Aug. 3, emphasis added).

Olbermann also framed Republican politicians as the hostages of the health care industry:

You can always tell, can’t you, Congresswoman, when the hostage is reading her own ransom note, and when she is reading one written for her? So much for Congresswoman Brown-Waite. There are so many other Republicans, bought and sold — like that unfortunate Congresswoman there — by the Health Sector. Minority Leader McConnell of the Senate? You`re worth 3.1 million to the Health Sector? A million and a half just for last year`s election? And I`m supposed to think you aren`t a sellout, a liar, a paid spokesman, a shill, a carnival barker? So much for Sen. McConnell. (2009, Aug. 3; emphasis mine)

No. Actually, Mr. President, you`re wrong. It is. Remember — you just said the insurance companies were holding us hostage? (2009, Aug. 17)

On the other hand, the WSJ views “doctors, hospitals, insurers, pharmaceutical and device makers” (but not ordinary citizens) as the hostages of the Obama administration (2009, June 3). The WSJ claimed that these groups “seem to be experiencing Stockholm Syndrome,” because “Democrats have so far succeeded in conjuring an illusion of political inevitability, which has kept industry groups in line lest they be shut out of the negotiations” (2009, June 3). Stockholm Syndrome refers to “the psychological tendency of a hostage to bond with, identify with, or sympathize with his or her captor” (Merriam-Webster). Contrary to Olbermann, the WSJ proposed that “even shell-shocked CEOs [of the health care industry] might stir up their courage to resist” a public insurance program (2009, June 3). In the WSJ’s view, the industry’s resistance to Obama’s health care proposal was courageous.

While conservative media tended to attack perceived failures of Obama’s health care plan, liberal media often attributed any opposition to it as personal bias against the President. Liberal media claimed that racism lay behind much of the opposition to a sweeping initiative proposed by a black president, and echoed former president Jimmy Carter’s concerns: “There is an inherent feeling among many people in this country that an African-American ought not to be president and ought not to be given the same respect as if he were white.… Those kinds of things are not just casual outcomes of a sincere debate over whether we should have a national program in health care or not” (2009, Sept. 16). Olbermann similarly pointed out right wing racism: “Limbaugh repeatedly played a song called ‘Barack the Magic Negro’ and called him a half-rican American. Congressman Westmoreland of Georgia referred to Mr. and Mrs. Obama as, quote, ‘uppity’. The chair of a California Republican women’s group issued Obama food stamps showing him with watermelon” (2009, Sept. 15). Olbermann sarcastically concluded, “No, there’s no racism from the right. Not there. Not in this country” (2009, Sept. 15).

By linking the anti-Obama demonstrators to racism, Olbermann attempted to minimize the legitimate arguments against “ObamaCare.” While both Fox and the WSJ tried to characterize the demonstrations against ObamaCare as part of a voluntary civil movement, with the purpose of protecting the American constitution and fundamental freedoms, Olbermann used the charge of racism to trivialize his ideological opponents’ concerns.

Although Olbermann often decried ad hominem attacks on Obama, he did not hesitate to launch his own personal insults against health care opponents. For example, he blamed “Sarah Palin’s functional illiteracy” and “a senator’s dysfunctional pandering” for killing “reimbursement for end-of-life counseling,” rhetorically asking, “Is Senator Grassley a charlatan, an idiot or did the health care sector simply threaten to cut off the $2.5 million he’s gotten from them in campaign contributions?” (2009, Aug. 12). Similarly he often satirized MSNBC’s competitor, Fox News, as “Fixed,” or “Faux News” [Faux meaning ‘false’ in French]. He even occasionally used obscene language to express his thoughts about his ideological adversaries: “You people … are seriously F****d up” (2009, Sept. 1).
The NYT portrayed Obama’s health care through the prism of secularized morality. Thus, The Times put an emphasis on humanism and social equity in its health care coverage: “We continue to believe that covering the uninsured is a moral imperative — and sound economics” (2009, Oct. 11); “We consider it a moral obligation and sound policy to provide health insurance to as many people as possible” (2009, Dec. 30); “It is a good step toward universal health coverage through a combination of public and private plans, as proposed by President Obama. And there is no question that it will help millions of uninsured children.” (2009, Jan. 31).

In the views of the NYT, American politicians should not “throw away a once-in-a-generation opportunity to fix this country’s broken health care system” (2010, March 4), because “the fact that 46 million people in this country have no health insurance should be intolerable” (2009, Dec. 30). Thus, two prominent frames were put forward in the news coverage of Obama’s health care reform by the liberal media: (1) the economic frame; (2) the morality frame. Above all, liberal media packaged Obama’s health care as the solution to revitalizing a debilitated economy, resolving natioanl deficits and alleviating the suffering of both the insured and the uninsured: “they [the Republicans and the insurance industry] are really much more interested in themselves than they are [in] the future of the country” (2009, June 8).

Conclusion

This study examined how the NYT, the WSJ, FOX and MSNBC, four mainstream media outlets in the U.S., framed President Obama’s health care legislation in 2009-2010. One salient framing strategy used by these media was to label Obama’s health care plan in a way consistent with their own view of health care as a public issue in American society. The WSJ and Fox News’s The O’Reilly Factor repeatedly trivialized the Obama administration’s health care proposals as “ObamaCare,” while the NYT and MSNBC’s Countdown with Olbermann praised them as “Healthcare reform.” This divergence of terms between conservative and liberal media used to describe the same set of policies reflects their differing evaluations of the issue of health care.

Another framing strategy used by some journalists in their coverage was to belittle their opponents as partisan extremists, while depicting themselves as independent conductors of fair and balanced journalism. Some positioned themselves as part the moderate middle while attempting to situate their ideological adversaries at the ends of political extremes. For example, O’Reilly labeled Obama’s health care supporters “the far Left”; while Olbermann called opponents of the President’s plan “the far Right.”

Both conservative and liberal media discussed Obama’s health care plan within a global context. O’Reilly and the WSJ tried to connect the negative aspects of other countries’ health care systems to the Obama’s proposals. Often O’Reilly tried to highlight the undesirable aspects of the British and Canadian public health care systems. Indeed, O’Reilly seemed to suggest that Obama’s universal health care plan was contradictory to the principle of “American Exceptionalism,” according to which the U.S. is an exceptional country and one which is unrivaled in the world. This logic requires that, if America is exceptional, so too must the American health care system be exceptional. It must be the best in the world. To think otherwise would simply be unpatriotic.

In contrast, the NYT and MSNBC saw the health care system of other countries as role models for the U.S. and linked health care reform to economic progress and American prestige. Specifically, these liberal media framed the current U.S. health care system as not only dysfunctional and damaging to the U.S.’s global competiveness but also as contrary to the moral responsibility of American society to take care of its poor and uninsured.

In conclusion, this study showed that President Obama’s health care reform plan not only divided the American public and its political parties, but the American media as well. The NYT, the WSJ, FOX and MSNBC framed President Obama’s health care reform plan very differently, each according to their own point of view and with varying degrees of partisanship. These media often displayed cynicism toward opponents who did not agree with their own judgments of Obama’s initiative and used sarcastic language to demean them.

Perhaps the public discussion of Obama’s health care legislation by these media can best be summarized by a remark by Keith Olbermann: “This is not a debate, it’s a civil war” (2009, Aug. 6). Howard Dean, the former DNC Chairman and a guest anchor on Countdown, concurred, defining the health care debate as a “health care message war” (2009, July 29). A clash of partisan framing between conservative and liberal media characterized much of the news coverage of Obama’s proposals during 2009 and 2010. Although the media reported the “facts,” too often these “facts” ended up being used in the service of journalists’ ideological agendas.

Whoever conservative or liberal journalists may be, the partisan journalists’ health care narrative in 2009-2010 may also be understood in the context of Michele Foucault (1980)’s ideas about power and knowledge, because the news media not only represent some politicians’ views, but also tend to present partial knowledge which is advantageous to their own economic and political interests. Even though journalists are expected to be “analysts, interpreters, and sense-makers” (McNair, 2005, p. 36), the partisan media’s coverage of health care in 2009-2010 sometimes more closely resembled propaganda reporting, which aims to spread ideological codes and push collective attitudes in a preferred direction.

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