The Media, the White House, and Health Care: A Conversation with Veteran Journalists Joanne Kenen and Margaret Talev
By Kee B. Park
At a White House press conference following last month’s midterm elections, CNN’s chief White House correspondent Jim Acosta was stripped of his press pass after a series of questions morphed into a verbal confrontation with President Trump. While the revocation of Acosta’s pass has since been reversed by a Federal judge, the incident is just one example of the highly contentious relationship between the current administration and the press who cover it. The President himself discounts and denies critical media coverage, frequently using labels like “fake news” and “enemy of the people” to deflect negative coverage and instill antagonism towards journalists among his followers.
Unsurprisingly, many viewed the recent elections — which saw the highest midterm turnout in a century — as a referendum on Trump’s polarizing presidency. But what truly drove voters to the polls, and ultimately won races, were issues related to health care. While health care was mentioned in just 10 percent of Democratic candidate ads in 2016, the topic featured in over half of their airings this year, leading some experts to call 2018 “the health care election.”
To discuss the midterm elections and share insight into the media and policy landscape that shaped their results, the Voices in Leadership series welcomed two veteran journalists — Joanne Kenen and Margaret Talev— to the studio on November 13, 2018.
Joanne Kenen currently serves as executive editor for health care at POLITICO. A recent Senior Leadership Fellow at the Harvard T.H. Chan School of Public Health, Kenen has decades of experience covering health policy and politics in Washington as a journalist for POLITICO and Reuters. In addition to leading public policy forums and appearing on NPR, BBC, and MSNBC as a commentator, Kenen is a regular on the Kaiser Health News “What the Health” podcast.
Margaret Talev covers Washington as a senior White House correspondent for Bloomberg News, and is currently a Fall 2018 Fellow at the Institute of Politics at the Harvard Kennedy School. Frequently appearing on CNN as a political analyst, she reported on the presidential campaigns of both Barack Obama and Hillary Clinton, as well as Obama’s tenure in the White House. Talev has served as the president of both the White House Correspondents Association and the Washington Press Club Foundation.
Joined by moderator Dr. Robert Blendon, Richard L. Menschel Professor of Public Health and Professor of Health Policy and Political Analysis at the Harvard T.H. Chan School of Public Health, Talev and Kenen analyzed the media, the White House, and health care, and gave expert advice on what public health professionals must consider when communicating with the public.
Understanding the new media norm
Talev and Kenen began by discussing the media status quo — where fact and fiction are increasingly difficult to distinguish. Talev described the origins of this phenomenon and the expansion of non-news media:
“Back as early as 2008 … Facebook and Twitter and some of these really new technologies in that first Obama term … began taking hold as tools that shaped how people talked about elections, how they shared information, how voters could be kind of corralled — or choose off — into their own groups… And then when it comes to the media itself, social media and the technological platforms have greatly expanded the world of media. And I think when we talk about these issues, there’s the difference between news — which is a much smaller section — and media writ large.
Kenen echoed the sentiment, adding that — in addition to the changing media landscape — the lives of journalists have also changed dramatically:
“I think that there are 100 fundamental differences between our lives as journalists now and everything we’ve done prior to this administration. And I mean, one of the differences is before, we were both the beneficiaries of and the protectors of the First Amendment, and now we are the ‘enemies of the people.’ And being called the ‘enemies of the people’ is a really profound change.”
But amid the chaos, Talev says the current climate has not impacted her “hopelessly old school” mission as a journalist:
“[M]y mission is what it’s always been, which is not to take a side, to leave my feelings at the door, and to try to find out the pros and the cons of any idea … [I] try to give people a good sense of what are the facts and what context … those facts exist in.”
Breaking down the midterms
Kenen was frank about the President’s ability to easily rouse support from his followers. But according to her, it was what Trump didn’t say that cost his party valuable seats this November:
“I think one of the things that really struck me is that whatever you think of President Trump, he’s a very effective communicator. With one clip soundbite from a rally, or one tweet, or whatever he does, he has the ability to move the opinions of millions of Americans to where he wants them to go. And yet, he never really found his voice on health care this year. They lost the election, and they lost it in large part because of health care.”
Kenen went on to call pre-existing conditions “the single most salient issue for American voters in health care” during the midterms, adding that although many Republican candidates claimed to be for it, “the voters didn’t really believe them” given records of previous repeal attempts.
The issue may have played a pivotal role in the Democratic wave that swept the House — the largest margin of victory since Nixon’s Watergate Scandal.
Talev was particularly surprised by “how big a deal” the issue of Medicaid expansion became, and not just in traditionally blue states. Kenen elaborated on the point:
“I think there were three fascinating races in Utah, Nebraska, and Idaho. These are redder than a beet states. These are really, really red states. They voted to expand Medicaid, and they voted pretty easily … They didn’t flip the legislature, they didn’t change their elected government … But they said to that government, I’m voting for you as a Republican … but I want Medicaid expanded in my state.”
Effective delivery of facts in healthcare
Conveying concise messages to their intended audiences is paramount when communicating science and health evidence to the public. But even seasoned journalists admit the task can be a struggle. Kenen summed it up simply:
“Health policy — as our president did say — it’s complicated.”
So what advice do they have for public health campaigns? Talev pointed towards the powers of repetition and a multichannel approach:
“There is evidence that repetition of facts works, and there is evidence that delivery of facts through multiple venues and sources — rather than just one — also works. Which is why you see things like celebrity endorsements…And interactivity can be a way to make something stick with a person if they are part of it, rather than just an observer.”
Still, both journalists admitted they don’t have a definitive answer as to what makes people listen to facts or actively ignore them. They suggested that Harvard and “the next generation of leaders” that emerge from it should continue exploring the science of effective communication.
“I think you actually could — and probably should — do entire courses of study on behavioral psychology and these sorts of questions,” said Talev.
Given the midterm election results and the role health issues had on the outcome, what can we expect come 2020?
Talev described two “health care trends to look for” — Medicare-for-All and drug prices.
First, expect Medicare-For-All or public option to feature in the 2020 elections, especially the Democratic primary. According to Kenen, the discussion has “already started.”
Second, expect to see movement on addressing the high costs of prescription drugs. President Trump, who has stated his intention to bring down the prices, proposed in October to benchmark how much Medicare will pay for certain drugs according to an “international pricing index.” As Talev put it:
“President Trump himself has really tried to stake out a position as the guy who’s going to rein in drug prices for people.”
Finally, Kenen added a third area to watch: Bipartisan policy addressing the opioid epidemic:
“[I]f you want to find one bipartisan area that you can feel good about, there is bipartisan work on opioids … We may need to do a whole lot more [in] this country on opiate addiction and other drug problems and mental health, but it is one of the few areas where there actually is some consensus and cooperation. We haven’t solved it, obviously, but it is sort of reassuring if you cover Washington to at least see a public health emergency where the two sides are actually having a constructive … conversation and moving in a public health direction.”
The future leaders in public health — including us students at the Harvard T.H. Chan School of Public Health — have an important role in this age of information obfuscation. We must become adept at communication to help the public understand, appreciate, and act on the work of our field. Just as critically, we must hold ourselves to the highest standards of transparency, to ensure we earn the right to the public’s trust.
Story by Kee B. Park, a student in the Master of Public Health program at the Harvard T.H. Chan School of Public Health. Kee is also a Lecturer at the Department of Global Health and Social Medicine on faculty for the Program in Global Surgery and Social Change.
Story edited by Justin Kaplan, Managing Editor of the Voices in Leadership student blog and a second year student in the Master of Public Health program in Health and Social Behavior at the Harvard T.H. Chan School of Public Health.