Newspaper coverage of health care reform in Califorina in 2007

Background: News coverage influences policy makers and the public by setting the agenda and framing the debate on key policy issues. In January 2007 Governor Schwarzenegger said, “In Sacramento this year, we are going to make history…we will fix California's broken health care system and create a model that the rest of the nation can follow.” This study analyzed how the debate over reforming health care in California was framed in newspapers across the state. Methods: A quantitative and qualitative analysis of health care reform news and opinion pieces published between August 1-October 31, 2007, in the highest-circulation newspapers in California's top 5 markets: the Los Angeles Times, San Diego Union-Tribune, Fresno Bee, Sacramento Bee, and San Francisco Chronicle. We searched the content of each newspaper available in the LexisNexis database, using the following key words: health care or reform or insurance or coverage or Schwarzenegger. Search results were vetted for relevance, and we included only news and opinion articles that dealt primarily with the 2007 health care coverage and reform debate in California. Results: We found 248 news and opinion pieces, distributed by newspaper as follows: Los Angeles Times (41), San Diego Union-Tribune (35), Fresno Bee (38), Sacramento Bee (93), and San Francisco Chronicle (41). Much of the coverage was dominated by concern over the budget impasse, and how this would reduce the time and energy available for tackling health care reform in California. We found seven frames that supported action on health care reform, including system is broken, health care is a right, paying your fair share, people are hurting, and profits over patients. Eight frames, including don't rush reform, unfair burden, we need “real” reform—not a band-aid, and government incompetence took issue with the proposed reform plans. The Governor's initial framing of the existing health care system as broken was rarely disputed; neither was his clear assumption that government should have a hand in the reform of the health care insurance system. Implications: Although the Governor put health care reform on the state's agenda and a majority of Californians favored change, the reform effort ultimately failed for many reasons. While the Governor clearly identified the problem and his frame was rarely disputed, that alone was not enough to support policy change in the near term.