The American Healthcare Debate

The American Healthcare Debate

It's really not my intent for this to turn into a political blog, but a lot of the things I have to say lately are politically inclined. Our nation has become so emotionally driven around every political issue that we need to return to some civil debate over things.

One of the most valuable college courses I ever took was logic. I thought it odd, that logic was a prerequisite for the computer programming course required for my business degree, but in the end it made perfect sense. Learning how to craft a logical argument that leads to a desired conclusion is the perfect way to understand how computers process data.

In my career as a writer, this skill has also proven valuable. Recognizing fallacious arguments during a debate and challenging them with logical ones that lead to the desired conclusion is a winning approach. As writers, it's a skill that can set us apart in our profession.

With all of that in mind, I'd like to address the ongoing debate over health care that's been dominating the national media lately. It's an incredibly complex issue that cannot be solved by mere emotional rhetoric. Hence, this is an extremely long blog post; I apologize in advance.

Why I'm addressing this issue

A recent social media post by someone on the left in response to a question about why Republicans oppose the Affordable Care Act (also known as "Obamacare" or the ACA) said the following:

...my understanding from conservative friends is that it's "socialism".

As a conservative, I appreciate the sentiment behind this, but mere "socialism" does not summarize opposition to the ACA. This post contains my observations on the issue. Even if I can't deduce a solution to the problem in this one blog post, taking a closer look can help us all understand the facts behind health care and the government's role in it.

One observation, to start off: "Obamacare" is really a misnomer. Nancy Pelosi and Harry Reid were the chief politicians behind the ACA. They directed its writing and pushed it through Congress before most legislators even had time to read all of it, with the approving vote along strict party lines. Obama may have signed it into law, but blame for the mess created by it should fall primarily onto the shoulders of Pelosi and Reid.

Who benefits from the Affordable Care Act?

My belief is that the ACA was designed to fail. It was an intermediary step to get the majority of American citizens clamoring for single payer - i.e., having the government control the entire healthcare system - rather than the private medical/insurance industry we have now. Having control over a population's health - and at times, whether someone lives or dies - is a tremendous amount of power. And if career politicians in Washington have taught us anything, it's that power is the most addictive drug ever known to humankind.

The ACA was also designed by politicians, which means that lobbyists had a heavy hand in crafting the horrendously complex legislation behind it. I have heard that insurance industry lobbyists actually wrote much of the bill, naturally favoring their industry in doing so. That may or may not be true, but the law does little to tackle the underlying problems it was supposedly designed to address.

What's the goal of an insurance company? The same as any large corporation: to deliver value to their shareholders, which means raising net profits by increasing income and reducing expenses as much as possible. Paying an insurance company premiums increases their income. Making a claim on a policy increases their expenses. Which do you think is of more value to them?

Insurance companies do not want the federal government to nationalize health insurance. This would dramatically impact their industry. So the input they had for the ACA made sure that health insurance would still be sold to the public - by them - even if the government administered the program.

Insurance companies want to sell more policies. The ACA not only makes that possible, it mandates that American citizens buy their product. And who enforces this mandate? The most powerful arm of the U.S. government: the Internal Revenue Service. If that doesn't frighten you, it should.

If you own stock in an insurance company - and many pension plans do, so even if you don't personally hold stock in one, their well-being may affect you - you want them to succeed financially. To have insurance companies failing the way banks did in the late 2000s would not benefit the American economy. The insurance industry employs millions of people and provides their livelihood. So it's easy to understand why politicians want to treat insurance companies favorably. Having millions more unemployed people is not going to benefit any of us.

Some individuals who were unable to buy insurance before have now been able to under plans offered as part of the ACA. They are often huge fans of the plan, ignoring its flaws because of their own personal benefit from it. Their reason for the inability to purchase insurance may have been pre-existing conditions that insurance companies refused to cover. Or their problem may have been more economic in nature. Subsidies provided under the ACA are either helping them pay the premiums, or allowing insurance companies to lower the policies' costs due to more healthy people being forced to buy insurance.

Who doesn't benefit from the ACA?

But there's another industry and a lot more people involved in this debate: health care. One in every eight U.S. citizens is working in this industry, which includes not only doctors, nurses, and various types of technicians, but people working for companies that make medical devices and equipment, others that operate hospitals, some that provide services such as software for electronic medical records to those physicians, and still others that operate or build ambulances, bloodmobiles, etc. Just like the insurance industry, the health care industry also employs millions of people and provides their livelihood. So we certainly want to make sure it's also treated favorably.

People working in the health care industry have not seen many benefits from the ACA. Several doctors I know personally have retired early because of it. Others have advised their children not to pursue a career in medicine. How did being a physician, which used to be one of the most respected professions in our society, fall so far from grace? This bears closer examination, which I will do in the sections below.

Some individuals have also come out worse under the ACA. My premiums have quintupled under it. That's five times more expensive than they were before it. Deductibles were also on the rise in recent years, even before the ACA, so I can't say for sure that it's made deductibles any worse. But the deductible aspect of a policy is a hardship to many. Those have, on the whole, greatly increased under Obamacare from what others are telling me.

Small businesses just on the cusp of being large enough to be forced to offer their employees health insurance under the ACA are suffering greatly from it. Some have been forced to shut their doors, or lay off some employees to take them under the threshold for offering insurance. This impedes the surviving companies' ability to grow and provide more employment opportunities to others.

While pro-government types tend to vilify business owners, they are what drive our nation's economy. Without people willing to take the risk, invest the money, time, and effort into building small companies, our economy would stagnate and wither. Large corporations and the government cannot employ everybody. Smaller companies may someday grow into larger ones, and are needed to challenge the status quo and provide an innovative spark that moves us forward.

Far from exploiting their workers, these companies provide them with opportunities to grow with the businesses. But when too many constraints are placed on them, all that effort it takes to establish and grow a small business does not provide enough income to sustain the owner during the startup phase. Without that incentive, what's the point? Is anyone going to put everything they own on the line to build a business if the government is going to regulate that business out of existence?

The rise of comprehensive health insurance

As a sickly child, I required a lot of medical attention. My mother was always taking me to the doctor, and I was hospitalized eight times over a three-year period with asthma. The insurance my father had as a part of his compensation at work, however, did not cover the office visits to the doctor. In those days, my parents paid for most doctor visits out of pocket. Health insurance was called "major medical" or "hospitalization" and was designed to cover outrageous expenses.

What's more, my parents had to pay for those expenses up front, then submit paperwork to the insurance company to get reimbursed for them. While this didn't necessarily make them shop around for health care, physicians understood that they needed to keep their own prices affordable for people who would often be waiting a long time for the insurance company's check.

People were closer to their doctors in those days. There were less group practices and more individual physicians practicing alone. Patients respected the doctor's opinion; there was no internet for them to consult for another viewpoint. While doctors were not always right and people sometimes sought second opinions from another one, the physicians and their patients determined those patients' courses of treatment for whatever ailed them.

Only the larger companies in those days even provided health insurance for their employees; smaller ones could not afford to do so. As insurance companies saw their profits rising from selling group insurance plans to corporations, they wanted to expand that and designed different plans they could sell to smaller companies, as well.

Those plans then expanded to include more than major medical costs. Soon, health insurance covered every doctor visit, even routine check-ups and physicals. To minimize losses from these new expenses, insurance companies covered only a portion of their actual cost. Patients still felt like they were coming out ahead, since the office visits used to not be covered at all.

But because doctors were not receiving the money they had received before for them, the charges for these visits began to rise. They had to ask for more than they actually needed in order to get enough to cover the costs of providing the service. After all, their costs had not declined. They still had to pay office rental, staff salaries, utilities, and the cost of supplies to keep their offices running. Many doctors saw their own pay declining.

And here's an interesting statistic: If you look at the cost of health services over time, those not covered by health insurance - mainly things like plastic surgery and therapies such as chiropractic, acupuncture, etc. - have remained relatively stable. While not the same price they were 40 years ago, they have not risen as greatly as those covered by insurance. Services covered by insurance have skyrocketed in price. Why do you think this is?

Rather than patients paying up front and waiting for reimbursement, many doctors' offices also began offering the service of filing insurance claims for patients. The plans grew more complex, which required hiring additional staff specially trained in the bureaucracies of various insurance companies. As paperwork became electronic, specialized computer software was developed to streamline this process. But rather than replacing employees, the software now required staff trained in its intricacies. These were additional costs that had to be covered, which also resulted in higher costs for visits to the doctor.

The process of doctors auto-filing their patients' claims further evolved into patients paying a "co-pay" up front that would not be covered by the insurance company. Patients started to think that co-pay was the amount a doctor visit actually cost; they no longer had a clue how much the actual total would be. Doctors who were getting additional patients from all the additional people now covered for doctor visits by their health insurance were seeing more patients, but insurance companies were not reimbursing them enough to cover their costs of providing the services and paying their staff. Some doctors would bill the patients for this additional amount, while others merely wrote it off.

Problems arising from comprehensive health insurance

Over the decades, these practices became normalized. People began to expect that health insurance would be offered by their employers as a part of their compensation...but not really viewed as compensation, more as an entitlement. People also expected that they would not have any up-front medical bills to pay; everything should be covered by their employer-provided insurance.

As their costs for paying claims rose, insurance companies looked to the government-run Medicare program to determine "fair" costs for medical services. Whatever Medicare paid for something became the industry standard. This was great for insurance companies; it helped them control costs and gave them someone else to blame if doctors said that wasn't sufficient to cover their costs of operation.

The idea that health care is an entitlement all people should receive for free is naïve. Whenever someone says this to me, I ask them what they do for a living, and if they think they need to be providing that service to people for free.

Doctors and others in the health care industry have spent years gaining the knowledge needed to do what they do. Not everybody can do it. Most of them have incurred hundreds of thousands of dollars in loans for this education, and must pay those off with the proceeds they earn from their work. It is an insult to their profession to demand that they provide those services for which they have studied many years without charge.

Should the government cover health care?

When people say that "the government" should pay for health care, this is another argument that doesn't hold water when examined more closely. The federal government does not manufacture any products. The only money they have is what they have seized from the citizens through taxation. So when you say that "the government" should pay for something, you're really saying that every U.S. citizen should pay higher taxes for providing that service.

Do you know how much you pay in federal taxes? Most people don't. Their federal income and Social Security taxes are withheld from their paychecks before they even see them. Sold to people under the guise of convenience, this is a slick way of making it less apparent to people how much they're actually paying out of each paycheck in federal taxes. Start adding that up every month, and you'll be amazed at how much is withheld from the total money you earned.

But what comes out of your paycheck is not all of what you pay in federal taxes. Consider how many embedded taxes you pay that drive up the cost of things like gasoline. Every time you fill up your car with gas in 2017, you are paying the federal government 18.4 cents on each gallon. That may not seem like much, but if you have a 12-gallon tank, that's $2.20. If you fill it up weekly, that's almost $115 per year you spend on gasoline taxes. If you have a 15-gallon tank, that rises to more than $143/year.

Diesel fuel federal taxes are even higher: 24.4 cents. You may not realize it, but that drives up your costs for shipping of products. This is more apparent as more people shop online and have items shipped to their homes, but it has always driven up the prices of items shipped to retail stores. Not just shopping for frivolous items, either, but everyday things such as groceries.

Gasoline is not the end of it, however. For example, there are federal taxes on every cell phone bill you pay. According to a 2010 report on National Public Radio, a national think tank known as the Tax Foundation estimated that the average American paid just over 24% of their income in taxes then. The Motley Fool did a 2017 article to calculate the number, and determined that it had risen to 31.85% of your income since then.

"I'd be happy to pay more in taxes if everybody had health care!" people say. Again, this is a naïve notion. Remember the examples of government mismanagement of Medicare, Medicaid, and the VA? Those costs, once established as a government entitlement are always going to escalate. They will never go down, and they will never go away. When the federal income tax was instituted by the 16th Amendment in 1913, the top rate was 7% on income over $500,000. Most people paid 1%. Compare that to today's top rate of 43.4%.

Of course there are expenses for running the federal government. As outlined in Article 1, Section 8 of the U.S. Constitution, the federal government is granted three types of powers:

1.  Expressed powers: these include coining (or printing) money, regulating commerce, declaring war, raising and maintaining armed forces, collecting taxes, and establishing a Post Office
2. Implied powers: these are what give them the right to make laws needed to accomplish its expressed purposes
3. Inherent powers: these are powers that exist for all governmental entities around the world, including acquiring new territory through exploring or occupying it.

Nowhere in there does it say anything about providing health care to American citizens or nationalizing a private industry. And be aware: merely printing money does not give it value; international marketplaces regulate the value of the U.S. dollar. Printing more money does not magically create more wealth for the nation. Wealth is generated in the private sector: only when businesses prosper does the nation's wealth grow.

As the above illustrates, the federal government is not a big bag of money from which each citizen should be trying to get their "share." It is more akin to a big collection plate into which each citizen must contribute money in order to underwrite whatever it does. And over the past two centuries, the federal government has grown into a bloated, bureaucratic, unsustainable mess.

The illusion of cure-all drugs

Another contributing factor to unaffordable health care is an increase in the cost of prescription drugs. And this is another area regulated by the federal government. Many Americans travel south to Mexico or north to Canada to obtain prescriptions they need at cheaper prices than they can buy them here in the U.S.

Why does the government protect prices of pharmaceuticals, making them more expensive for our own citizens? This is another complex issue and it involves another private industry that employs over 854,000 people. Reasoning is that if the companies invest millions in researching new drugs, they deserve to make that money back by selling them for more before the formula is copied and allowed to be copied and sold as generic equivalents.

Perhaps the bigger question here is this: why do we need so many drugs? There are natural or nutritional solutions for most health problems that we face. The costs for those tend not to be covered by most health insurance plans. Coincidentally, they also tend to be cheaper than pharmaceutical solutions. They do, however, require more time and diligence to work, and people tend to want a quick fix to their problems.

Antibiotics have been over-prescribed because doctors want to make their patients happy, so they'll write them a prescription when they don't really need one. Now we have antibiotic-resistant strains of bacteria that are causing serious infections. Now the country is facing an opiate crisis because pain medications have been over-prescribed and are commonly misused or stolen by addicts. Breaking our psychological dependence on the pharmaceutical market is going to be tough, but would go a long way toward reducing the cost of health care.

The specter of lawsuits over health outcomes

One of the main drivers of increasing health care costs is the cost of malpractice insurance. This differs greatly by state, and is influenced by the growing number of lawsuits against doctors and hospitals.

While genuine medical malpractice should absolutely be controlled, many of the lawsuits being filed today are frivolous. Babies are sometimes born with birth defects. People die every day. People become disabled from accidents every day. Some of these things happen because of an honest mistake made by someone caring for a person. Should every one of these instances be subject to a million-dollar lawsuit? Of course not.

Differentiating between honest mistakes and negligence, incompetence, or malicious intent, however, is what judges must do in these medical malpractice lawsuits. Lawyers are quick to urge people to sue, knowing that they will win a huge portion of whatever the settlement is. And healthcare providers are quicker to settle when their malpractice insurer is the one paying the bill. Often settling frivolous lawsuits out of court is cheaper than going to court to prove their innocence, even if they have done no wrong. It has become an expected expense of operating any business that provides health care to people.

What's the solution? That's a tough question. Limiting the amount for which people can sue a health care provider may not work because it would seem to increase the likelihood that unscrupulous providers would enter the marketplace. But without some type of tort reform, malpractice claims - and premiums - will continue to escalate.

Problems...or opportunities?

One of the biggest problems with insurance companies covering most medical expenses and nobody paying for anything out of pocket is this: nobody really knows what health care costs any more. Some of the aspects of the ACA were supposed to make people "shop around" for health care. Physicians can't base their rates on what it actually costs them to provide the service, because their rates are, in essence, regulated by the federal government via Medicare and Medicaid. And patients are oblivious to how much they should be paying for anything because it's been so long since they actually paid out of pocket for medical care.

For power-hungry politicians, this ignorance is bliss. It means that the average voter doesn't understand what's at stake in the health care debate. They can play power games between the big players - insurance companies and large health care companies - lining their pockets with donations from both and reassuring voters that their interest is being put first...all the while making promises they know they can't keep once re-elected.

And make no mistake: getting re-elected is a politician's ultimate goal: that's what feeds their power addiction. Any desire to actually make a difference or do good they may have had when first elected goes out the window once they taste the sweet perks of power in Washington. Of course they meet with constituents and reassure them that they will fight for their interests...and some actually think they are. Those are typically are being played by others whose primary motivations are perpetuating their own wealth and power. Politics is an ugly business.

Chicago Mayor Rahm Emanuel once said, "Never let a serious crisis go to waste." He and many like-minded politicians view such times as opportunities to seize more power and subjugate the intent of the U.S. Constitution. But the purpose of that founding document was to limit the powers of the federal government, not expand them.

This gets back to the long-debated issue of "statism" - i.e., a strong, autocratic federal government that micromanages the nation's affairs - versus "federalism" - the argument that government is more effective when closer to the people, so most things should be regulated by local or state laws rather than the federal government. Even the Founding Fathers debated this issue, but the more revered of them were federalists.

If health care issues provide any opportunity, it should be the opportunity to improve the first word in that phrase: health. If Americans stay healthy, we won't need as much medical care. Everybody gets sick sometimes, but many of today's chronic diseases are caused by poor life choices: eating unhealthy foods (and too much of all of them), and not getting enough exercise. Those choices aren't something the federal government needs to mandate, however.

The health insurance safety net

For a long time, we have had a few "safety nets" for those who cannot afford private health insurance. The first example of this is called Medicaid. It's a disaster. Fraud is rampant in it, and billions of dollars have been wasted in this system. Criminals who view the federal government as a big bucket of money create companies with the sole purpose of defrauding the Medicaid system. Illegal aliens have flooded across our southern borders to get "free" health care in our nation's hospitals.

The second example of the government running a health insurance program is Medicare, designed for people over age 65 (approximately), or those who are permanently disabled. This is also a system rife with opportunities for fraud. It's far easier to collect a small government check than it is to work, and there are people who think that's a grand idea. They go to great lengths to hide their good health so they can continue to live on their government disability checks...I know one woman personally who did this for several years before she was old enough to go on Medicare due to her age.

Others, for example people who have children with severe chronic conditions or handicaps, depend heavily on help from Medicare to get the help their children need. It is a lifeline for many families.

Medicare, remember is the agency that sets reimbursement rates for most medical procedures...the ones followed by private insurance companies. According to physicians, they do so with little understanding of the actual costs involved in providing those services. Bureaucrats who have never worked one day in the health care industry are sitting in offices and arbitrarily setting these rates, oblivious to any new treatments or procedures that could save patients' lives if they were covered. Many procedures or drugs that are helping people in other countries around the world are not covered by Medicare.

The final example is one of an actual government-run health care system. It's called the Veterans' Administration, or VA for short. Ask a veteran who's waited years for treatment or surgery for a serious health issue if they think the entire U.S. health industry should be controlled by the government...but do so with the understanding that you won't get a response that would be repeatable in polite company.

Do you really want the entire healthcare infrastructure in this country to be run like Medicaid, Medicare, or the VA? These are the three examples we have of what it looks like when the government runs a health care or health insurance system.

But there are other safety nets that have been in place for decades, and they're too often overlooked in this debate. Emergency rooms are required by law to treat people who come there, regardless of their ability to pay. Too many who could never afford health insurance before the ACA were using these as their safety net for regular health care, which was one of the justifications used by politicians for creating it: the cost of providing regular health care in emergency rooms is much higher than if it's provided at a clinic. But to make the claim that people were dying because they couldn't get emergency treatment is dishonest; those facilities exist and must treat emergency patients.

And non-emergency clinics serving the poor exist, as well. Physicians regularly donate their services to community-based programs to provide health care to the nation's homeless and others who can't afford health insurance. Many other people of means contribute to these local organizations all over the country. These clinics may not provide Cadillac-style health care, but they cover the basics normally covered by someone's family physician.

Where's the patient in all of this?

Probably the biggest problem in today's health care system is this: the expectation that a person's health care is between that person and their physician is no longer the norm. Insurance companies and the government have poked their noses into this relationship that used to be very private. In many cases, they now dictate to us whether we're allowed to receive treatment for a disease. If it costs too much to treat, or if we're "of a certain age" we're told that we're not worthy of receiving that treatment.

Now, with the advent of electronic medical records, we all have to worry about any hacker gaining access to our private medical information, and how it may be used against us. Will we be denied credit due to a medical issue that should have been private? Or employment?

And perhaps, as we've ceded paying for our health care to insurance companies, this is something we've brought on ourselves. When our parents and grandparents paid for health care, they lived simpler lives. Not everybody had all the perks of modern life we all think are entitlements now: TVs, cars, cell phones for every family member, McMansions...at one time, these things were not the norm. Our entertainment-obsessed culture has driven us to value material goods above the basic necessities of life.

There is significant personal responsibility on the patient in health care. We have a responsibility to keep ourselves healthy: to eat good foods, get some exercise, and tend to minor health issues before they develop into major ones. If we neglect to do these things, why do we think that someone else should suddenly become responsible for our care?

The worst is yet to come

The worst provisions of the ACA are only now beginning to fully kick in. It's my belief that was by design, so that whoever succeeded Obama in the Oval Office would get the blame for those parts of it, even though they had been there from the beginning.

With the media only too eager to vilify Donald Trump for everything, this is certain to happen, no matter what steps he takes to correct the problems with the ACA. If he lets it fail, it'll be his fault. If he tries to correct it and anybody loses coverage or has to pay more, it'll be his fault. It's a no-win proposition for him. Ah, politics.

If you couldn't afford to buy insurance, even with the plans available through the ACA exchanges, you're now going to be hit with a fine for that. But if you could afford to pay such a fine, you would have been able to afford to buy insurance! How did the logic of that not escape those who wrote this flawed law? It's probably the most egregious problem with the ACA. The answer: it didn't. They were fully aware of this clear imposition on the poorest among us. But they delayed this provision of the ACA until Obama was safely out of office so they could blame it on somebody else.

What other alternatives are there?

Those in favor of a single-payer health care system run by the U.S. government point to similar systems in other countries that they claim work beautifully and cost little. Canada! Cuba! Sweden! Denmark! The UK! According to them, every country in the world has better health care than the U.S.

But closer examination of those systems does not reveal any one that actually works without considerable costs or problems...the lack of awareness among individuals covered by the plans does not negate those problems' existence. People from other countries travel to the U.S. for many major medical procedures. Why would they do that if their own countries' health care systems were so spectacular?

I once had a client from Sweden who told me their socialized medicine program there was so bad that doctors basically gave people a pill and told them to go home and get better. The rate of suicide among Swedes suffering from gender dysphoria - one of the darling groups to the same people clamoring for a similar healthcare system in the U.S. - is astronomical. If they cannot afford to travel to other countries to get the treatment they need, they have no hope under the Swedish health care system. Many take their own lives as the only form of relief. Is that what we want here?

Federal regulations prohibiting insurance companies from selling policies across state lines cause premiums to differ widely between states. Why not open up the entire country to any insurance company that wants to sell policies there?

Insurance companies should also be offering different levels of policies to people, cafeteria style: younger, healthier individuals may want to purchase a hospitalization-only policy and pay for regular office visits to their doctors out of pocket. They should be able to. Women who are beyond their childbearing years shouldn't need to pay for coverage of those expenses. Let people pick and choose the things they want included in their plans. More customization should equate to savings for patients, and better assessment of risks for insurance companies.

Thankfully, there is some thinking outside the box when it comes to covering health care expenses: MediShare and Liberty HealthShare are two examples of systems in which people pay into a pool that covers the costs of its members. These operate similarly to insurance companies, offering different levels of coverage and pricing coverage on each member's age and household size. With MediShare, submitted medical expenses are posted monthly, with costs shared among the members, who contribute a monthly amount for coverage. These companies have been around for decades and have shared billions of dollars in medical expenses. They are real people providing real solutions without government help.

Many private physicians are setting up their practices as "boutique" medical coverage, where they essentially offer their patients their own form of insurance. Patients pay a monthly or annual fee and receive office visits or other specified services in exchange for that fee. These plans remove the insurance companies from the equation altogether, returning to the patient-doctor relationship as the primary one in health care.

Assessing the root problems in health care

Ensuring adequate health care for everyone is such a complex issue that it will never be addressed simply. Instead, efforts to address it need to start getting to the root causes of the problems being experienced. We can only do this by asking, "Why is that?" every time a problem is expressed. Starting at the highest level, with the problem itself, we would then work backwards to focus on solutions for the root causes of that problem.

Some of the key issues that led to the passage of the ACA, expressed in the simplest of terms, are these:

• Some people who need expensive health treatments cannot afford them on their own.
• Some people who have chronic health issues are unable to get health insurance.
• Health care costs are spiraling out of control.
• Health insurance premiums are unaffordable for many people.
• Health insurance deductibles are unaffordable for many people.

Taking the first of these, if we start asking "Why is that?" we can identify a number of answers:

Problem: Some people who need expensive health treatments cannot afford them on their own.
Why is that?:  Some health care treatments cost a lot. Some people are not making enough money to afford the basic needs of life, much less extra expenses like this. Some people cannot find jobs. Some people do not have family who could help them with their unaffordable expenses. Some people made poor life choices that have given them serious medical conditions that could have been avoided.
Each of these "Why is that?" answers will take us into deeper steps if we ask the same question. For example, again taking the first answer to the above problem's question:
Problem: Some health care treatments cost a lot.
Why is that?: Research into health issues is expensive, and companies making this kind of an investment need to be able to make enough on the results to justify the cost. Medical equipment used for some treatments can be expensive. Some treatments require medical experts with a high level of knowledge, which costs more to acquire and thus more to deliver. Insurance companies typically reimburse only a percentage of the amount requested, so medical providers ask for more than they need to hopefully get enough to cover their costs and pay their owners.
And taking it a step deeper with the first issue raised above:
Problem: Research into health issues is expensive, and companies making this kind of an investment need to be able to make enough on the results to justify the cost.
Why is that?: There are government standards for testing of medical devices, drugs, etc. that must be met. Medical testing must be done in appropriate facilities, which can cost a lot to set up and maintain. Companies or universities that conduct these studies have expenses: employees, facilities, supplies, sometimes payments to people participating in studies, and shareholders who expect to make money on their investment in that company.
People who research such matters will need to conduct in-depth reviews of each issue raised during these sessions to get to the root causes of each problem with our current health care system. This will arrive at the root causes of the issues and help us design better solutions for them.

Conclusions?

My view is that the government does not need to run the health care industry. Nor do they need to run the health insurance industry. Federal bureaucrats have made a mess out of the portions of health care they have already taken over. When the free market is given a chance without government intervention, it regulates prices. Any solutions implemented by the federal government need to keep this basic truth in mind.

Any type of federal solutions to health care issues also need to address the realities of our capitalistic economy. Everybody deserves to get a paycheck for the work they do, and everybody has to make a living to support themselves and their families. Nobody should be expected to provide products or services for free, unless they voluntarily make the decision to donate some hours for the good of their fellow man.

People need to take more personal responsibility for staying healthy. This is not something that can be regulated by the government. Nor is it something for which we need to feel guilty about neglecting to cover when those people need medical treatment. Better education about good health habits can help with that.

By addressing the root causes of the problems being experienced in today's health care world, which can only be identified by continuing to ask the right questions, we can perhaps start to find real solutions, instead of trying to seal a a gaping wound with one small stitch.

Regardless of what problems our U.S. health care system has, there are many things we do well. People travel to this country from others for medical procedures all the time. The ACA threw out a lot of these good aspects of our medical care system to extend care to a minority of the population that didn't have it. Some of those people didn't even want it. It was poorly crafted legislation, unnecessarily cumbersome, and needs to be repealed.

Sources: "U.S. Health Care Force Larger Than Ever" All Things Considered, NPR, March 19, 2012;  "Adding it up: How Much Does a Taxpayer Pay?" Tamara Keith, NPR, September 8, 2010; "How Much Does the Average American Pay in Taxes?" Brian Feroldi, The Motley Fool, March 14, 2017; "History of Federal Income Tax Rates 1913-2017" Bradford Tax Institute; "The Founders and Federalism" American Government, USHistory.org; "Pharmaceutical and Biotech Spotlight" Select USA

Are the News Media Biased?

Are the News Media Biased?

President Donald Trump has been criticized for "attacking" the media and accusing them of being biased. Are they? Let's take a closer look and see.

Caveats Against Bias in Reporting

A time-honored principle of journalists has been not to "editorialize" - i.e., inject any opinions into their news stories. For generations, newspaper stories were dry and dull. A Dragnet approach: "Just the facts, ma'am," was how proper news reporters were supposed to write their stories.

Opinion columns were reserved for a select few, and usually relegated to the editorial pages of the newspaper. They were clearly identified as opinion columns. Everything else in the newspaper that wasn't advertising was expected to be purely factual.

One of the definitions of "editorialize" in Merriam-Webster is, "to introduce an opinion into the reporting of facts." But the principle goes beyond how reporters write their stories. The Society of Professional Journalists has a code of ethics. It states that news reporters should, "remain free of associations or activities that may compromise integrity or damage credibility." Reporters are also supposed to refuse any "gifts, favors, fees, free travel, and special treatment" as these gifts may influence their objectivity in covering the news. This code of ethics urges journalists not to:

• moonlight at any secondary job
• become involved in any political campaign
• run for public office
• serve in any community organizations

All of these are viewed as activities that could compromise the journalist's integrity and objectivity.

In today's contentious society, we all seem to be obsessed with "FACTS" that have become more elusive than ever before. Who's really telling the truth? Is any given story "fake news" or is it true? And who is the ultimate arbiter of truth?

More importantly, why have we become so intolerant of those whose opinions differ from our own, and so quick to embrace as "real truth" any opinions that match our own? Let's examine how we got here.

Major Changes in the News Industry

Increasing competition in the news industry has caused a shift in the traditional approach to how news is written. As this shift occurred, editors who used to frown upon editorial opinions in news stories soon began viewing those opinions as "humanizing" stories to appeal to a wider audience.

There was a time when we used to get our news from either a daily newspaper, a brief radio station break, or a half-hour show on TV in the evenings. When we think of old-time TV newsmen like Edward R. Murrow or Walter Cronkite, we think of serious, no-nonsense men who relentlessly pursued the truth and told us about it from our TV screens every night. They didn't blather on about their opinions on every story, just told us the facts of the story and moved on. There was no time in a half-hour broadcast for them to do much more.

In the print media, you may recall a reporter named Jayson Thomas Blair. He wrote for one of the nation's most respected newspapers, The New York Times, but was forced to resign after it was revealed that some of his stories were untrue. He'd merely made up the stories, fabricating "sources" that were mere figments of his imagination. Many of his stories that weren't made up had been plagiarized, outright stolen from other writers. What type of pressure would drive a journalist to do such things that completely betray the ethics of the profession? He certainly made a name for himself in the field, but it wasn't in a good way.

Even seasoned journalists, however, are not immune to such pressures. Dan Rather used to be a highly respected reporter, one who had covered the Vietnam War embedded with the troops. Families saw footage of him over the dinner table each night on the news. He was chosen in 1981 to succeed Cronkite as host of CBS's Evening News broadcast. Then his own bias caused him to use fabricated information as a source in a story about then-President George W. Bush. He didn't verify it as a journalist should do; he wanted so badly for the information in the document to be true that he used it without making sure it was. Suddenly a storied career was over.

What could cause someone so grounded in the traditions of responsible journalism to think he could get away with injecting such bias into his reporting? Was the competition that fierce, that he felt the need to make up a story?

The competition is certainly real. In recent years, we have far more options on where to turn for news...no longer are the daily newspapers and major TV networks the only people in control of the messages we hear. A few of these news industry changes bear closer examination.

The Rise of "Infotainment"

Traditional news is often referred to as "hard news" - the types of stories that would appear on the front page of a newspaper, lead the TV news broadcasts, or run first in an online news feed. These include major developments in the world, politics, crime, natural disasters, celebrity deaths, etc.

But there has always been "soft news" around - stories about things like sports, entertainment, home decorating, fashion, cooking, automobiles...these stories typically include more editorializing. They're viewed as human-interest stories that were never meant to be taken seriously as "news," even if they cover new developments in these areas.

Many soft news subjects are covered in magazines targeted specifically to an audience. As newspapers expanded into multiple sections, they also found their way into local newspapers. Weekly news magazines such as Time, Newsweek, Life, and U.S. News and World Report would delve into more depth on hard news stories, sometimes crossing the line into editorializing.

Late-night TV talk shows as far back as the 1950s discussed issues of the day in a less-formal manner, usually with some humor injected. These led to the popularity of daytime TV talk shows like The Mike Douglas Show, which debuted in 1963. Celebrity guests and human-interest stories were fodder for these types of shows. They would occasionally interview controversial guests or meander into "hard news" areas. But their daily bread was their soft-news approach. Guests and the host would all comment on the stories, with no pretense of objectivity.

In 1981, a TV show called Entertainment Tonight debuted on CBS. It was billed as an "entertainment television newsmagazine" that covered goings-on in the Hollywood movie scene, as well as the music and TV industry. The stories they covered would rarely qualify as hard news. In fact, news insiders condescendingly referred to its genre as "infotainment" -- and while it contained some information, the emphasis was definitely on the entertainment portion of the storytelling. Its anchors became celebrities in their own right, and readily offered commentary on the stories they were covering.

The success of ET spawned several other infotainment shows such as Hard Copy and Inside Edition. Major TV news networks began airing news-magazine programs such as 60 Minutes, 20/20, and Dateline that examined news stories in more depth and strayed into editorializing about them.

Then came the rise of comedy news sketches on Saturday Night Live, The Daily Show and The Colbert Report, all of which used the germ of actual news stories to build satirical pieces. Many viewers of these sketches began to perceive these satirical stories as real news, even though the shows' producers, directors, and actors were not abiding by the professional journalist's code of ethics. They hadn't even studied journalism in college, so they knew nothing of the profession's policies. The comedy was in the commentary itself, so the two were inextricably woven together in these shows.

But changes in the news media were not limited to these...far from it.

The 24-Hour News Channels

The year before Entertainment Tonight first aired, an entrepreneur named Ted Turner launched his Cable News Network, a 24-hour news station based in Atlanta, Georgia. Americans accustomed to having to wait for the nightly news to hear a roundup of what happened that day could suddenly find out about it at any time, day or night!

Since impactful hard news is not something that goes on all the time, CNN was faced with the challenge of how to fill 24 hours of programming with news-like stories. Their coverage of events that may have been given less than 60 seconds of time on a half-hour news broadcast would drag on for hours and days. Anybody remember little Baby Jessica, who fell down into the well?

CNN's anchors became celebrities and started hosting their own talk shows on the network. The rise of single-interest TV networks grew as more homes moved from antennas to cable TV, where they had multiple channel offerings. Movie fans had their HBO, sports fans had their ESPN, kids had their Nickelodeon, and soon pop music fans had their MTV. Early viewers of any of those stations would hardly recognize them today.

CNN soon expanded to a second network that kept repeating the day's top headlines every 30 minutes, keeping the main CNN station for more in-depth and opinion stories. The line between fact and opinion began to blur more and more as the popularity of these shows increased. They dropped any pretense of objectivity and openly editorialized.

Not to be outdone, the old TV networks began launching their own all-news channels: NBC launched CNBC in 1989, then partnered with Microsoft to debut MSNBC in 1996, the same year FOX News began.

Each of the 24-hour news networks had its own editorial slant, to appeal to a specific audience. Most were leftward-leaning. FOX News built its reputation on being a voice of the right in a sea of leftist journalists who were regularly injecting their opinions into stories. While far from being "fair and balanced" as it claimed, FOX's conservative slant nevertheless did provide balance to the other news channels on cable TV.

With so many 24-hour news channels, they're all competing for viewers. Which stories get shared the most on social media to drive up numbers of viewers? The most controversial. Which stories are most controversial? Those that include bias.

News was never again to be what it once had been...but the changes continued. And there was a big reason for that.

Socialist Professors in Journalism Schools

In the second decade of the 20th Century, Russia underwent a Marxist revolution. The communist regime that rose to power at that time and became the Soviet Union ultimately killed tens of millions of their own country's citizens. America stood strong against communism as the world's most successful capitalist country.

As Facism rose in Germany, Italy and Japan in the 1930s-40s, once again the United States emerged as one of the free world's greatest superpowers, quashing oppressive regimes in favor of free-market capitalism. Journalists of the day were unabashedly pro-American, and their bias was accepted as society's norm.

During these years, communists still existed within the United States. They tried to gain a foothold among labor unions, but those heavily depended on the success of capitalism to exist. Where could they turn for influence? They found a willing partner in higher education.

The Frankfurt School of philosophy, which incorporated the views of philosophers Jean Jacques Rousseau and Karl Marx into what has become the leftist/socialist views of today, moved from Germany to the U.S. during WW II. Gaining a foothold at Columbia University, its proponents soon moved into all the higher education institutions across the country. If you attended any U.S. university after about 1960, your outlook on the world has been influenced by professors espousing these views.

Major principles of the Frankfurt School included infiltrating every aspect of society -- its arts, educational system, clergy, and media -- to instill their beliefs. The values they injected into these institutions include anti-capitalism, political correctness, tolerance (but only of their beliefs, not of anyone else's), androgyny, and what they call "cultural pessimism." These values have been embraced by the Democrat party of today. What used to be known as the "working man's party" has evolved into quite something else.

Econ Journal Watch published a study in 2015 revealing that professors at major universities who were registered Democrats outnumbered registered Republican professors by 11.5 to 1. Is anyone naïve enough to believe that their own personal beliefs don't influence how they teach? There are many anecdotal reports of students being humiliated or otherwise punished for expressing a view contrary to their professor's.

The Media Research Center looked into the Columbia University School of Journalism and discovered that of its 40 full-time faculty members, 27 of them -- two thirds -- also worked for far-left-leaning news outlets. This violates one of the main imperatives of the Society of Professional Journalists' code of ethics...and these are the professors teaching the nation's journalists of the future.

As America's journalism schools turn out class after class of new journalists indoctrinated by left-leaning professors with no balance in the ideas they are being taught, their influence on society as a whole grows. And so it has been doing for at least the past half-century.

This goes far beyond journalists; popular culture does a lot to shape opinions in this country, as well. A 1994 study by S. Robert Lichter, Linda S. Lichter, and Stanley Rothman revealed that 93% of TV writers, producers, and executives never attended a church or synagogue, at a time when about 40% of Americans did. That reflected a fairly significant difference in values. And these people were the ones shaping the opinions of the nation's youth through their entertainment culture.

Now, if you embrace a leftist philosophy, you will undoubtedly view this section as having been biased. Of course it is; this is my blog, so in effect it's my own opinion column. But understand, as well, that our society today has been conditioned to view anybody whose opinions differ from our own as "biased" while seeing those who agree with our own biases to be "objective." Stay with me through this post, and you may find a new way to look at the world that is neither leftist nor rightist, but more objective than both.

The Centralization of News Reporting

While readership of daily print newspapers has declined sharply in recent years, a lot of people do still get at least some of their news from them. Millennials, who never do, may be the largest generation in American history, but subtract those 92 million people born after 1980 from the total population and you still have 138 million Americans who likely read a daily newspaper at least some of the time.

Many cities have lost their daily newspapers altogether. Most larger cities used to have separate morning and evening editions; these are also a thing of the past. As circulation of these print papers declined, advertising revenue also fell. And with it fell the budget to support a large staff of reporters to cover the news.

Each local reporter who used to cover a specific "beat" saw their territory greatly expanded, with less time available to cover any one area like they used to. Newspapers that had one reporter stationed in the state capital and perhaps another in Washington, D.C. to cover governmental affairs could no longer afford this.

Large media companies started buying more and more local newspapers, running a network of them across several states. Few were locally owned any more. The same consolidation was taking place among TV and radio stations. Most of these today are owned by huge corporations based in big cities, not by anyone local to their markets. This differed from past network affiliations with locally owned stations; this was outright ownership by a non-local entity.

At about this same time, USA Today arose as a "national" daily newspaper. It gained mainstream acceptance by giving away copies to hotels catering to business travelers. The newspaper relied more on colorful infographics to illustrate news concepts that did away with wordy explanations. These appealed to increasingly busy readers on the go, but often oversimplified complex issues, with plenty of bias thrown in.

Local newspapers had always carried national and international stories from the wire services - the Associated Press (AP) and United Press International (UPI). As their staff numbers declined, they were forced to rely more and more on these wire services for their stories on state, national, and international news. If there was bias in the wire service stories, that bias carried over into local newspapers, regardless of their owners' positions on issues. Without the staff to review and rewrite these stories to match the newspaper's own editorial slant, the wire stories were often run exactly as they came over.

And who are these wire services hiring to write their stories? Journalists turned out by the nation's finest universities...those same universities whose classes are run by Frankfurt School disciples espousing Marxist views. These students have been indoctrinated to believe that those views are "right" and that any others disagreeing with them are "wrong." Their bias leans almost exclusively to the left. Because they never hear any opinions differing from the biases they have been taught, they cannot perceive what they are writing as biased.

Busy readers who don't have time to fact-check every story they read must rely on openly biased news in their supposedly unbiased news sources. Local newspapers, however, are far from being the only source of news these days, even in their online versions. Yet more changes in the news media!

The Rise of Conservative Talk Radio

As Frankfurt School disciples had infiltrated all media outlets by the early 1980s, the bias they included in their stories may have gone unnoticed, but for one thing: the rise of conservative hosts on the radio.

Talk radio was nothing new; it had been around since the 1940s. Into the 1970s and '80s personalities like Paul Harvey regularly hosted brief commentaries, even on stations playing mostly music. Dr. Ruth Westheimer captured the public's imagination with her show that talked openly about sex. Call-in shows in the middle of the night became popular with insomniacs. Morning hosts like Howard Stern were syndicated across the nation.

Most all-talk formats were on low-power AM airwaves. But with the 1987 repeal of the "Fairness Doctrine" that required stations to allow equal air time for all sides of an issue, talk radio suddenly burst into the limelight as more and more people identified with the new conservative hosts on its airwaves. AM radio was revived, with many stations also broadcasting these shows concurrently on their sister FM stations.

Rush Limbaugh opened the door with his nationally syndicated show that began airing in 1988. He was the first to question the narrative being spun by most of the media. Ratings for his show soared. Within three years, he was the nation's top syndicated radio host. Limbaugh was quickly followed by other conservative show hosts: Sean Hannity, Michael Savage, Laura Schlesinger, Michael Medved, Mark Levin, and more.

Once people started hearing viewpoints that contrasted with what they were being told by other major media outlets, more and more noticed the bias in news stories. Suddenly things were not so black-and-white as before. Many gray areas on complex issues were now revealed.

The Shift to Digital Debate

As internet accessibility expanded, the power of individuals to express their own take on things expanded with it. Many writers with syndicated newspaper columns began writing blogs online. They were quickly joined by rising stars within the blogosphere, those who could turn a word well enough to gain a following. In an interesting departure from the print and broadcast journalism world, and likely a result of conservative media's success, in the digital world there were bloggers on both sides of the political aisle.

Social media, most especially Twitter and Facebook, have given people a quick way to react to stories when they may only have part of the story. Even reporters, who are supposed to always remain unbiased, have fallen prey to the temptation to post social media comments revealing their bias (contrary to their professional ethics code). And having a U.S. President who expresses his personal reactions to events in tweets only fans the flames of emotional reaction to brief impressions of news stories that few have read to completion. It seems that we're all ranting on, half-cocked and unaware of the real issues.

One of the main characteristics of blogging and social media is the ability for readers to respond to posts with their own comments. Debate can get heated here, as people sitting behind a computer keyboard think they can write things they'd never say to another person's face.

More and more, people are choosing to circulate in echo chambers of others who only agree with their particular point of view. Any contrary views are dismissed as "biased" or the latest buzz-phrase, "fake news." Anyone posting a different opinion must be a "troll," at least according to the mob-mentality judgment of the online community.

Political debate has always been heated, going all the way back to the dawn of democracy in Athens, Greece. Our second U.S. President, John Adams, was referred to as "His Rotundity" by his political opponents. There has been at least one incident of a congressional representative physically attacking a senator with a cane on the Senate floor. Some people in his time referred to Abraham Lincoln, now widely hailed as our greatest President, as a "gorilla." And who can forget the duel in which Aaron Burr killed Alexander Hamilton? Heated contention is certainly nothing new.

The incivility of today's political debate likely seems worse because there's simply so much more of it. Having so many ways to interact with others we only know online gives us many more opportunities to snipe at each other. Thankfully, we're not dueling with pistols any more...for the most part.

It should be fairly obvious to anyone that there is much bias in news reporting, as well as there being bias within our own minds. Each side holds up certain media outlets as certified truthful, while others are pointed to as unreliable. Not surprisingly, lists from those on the left and those on the right do not match. And as history has shown us, reliable news outlets can still have individual reporters who fall short of the profession's ethical ideals.

So how do we identify bias in reporting, without our own biases getting in the way? First, we need to understand how bias is achieved.

Subtle Ways of Inserting Bias Into News

As a longtime writer, I've learned many tricks over the years. There are ways to say something without saying it...or simply by not saying it at all. Having a good command of the English language is key in sneakily including your opinion in a story that's supposedly neutral. The next sections go into more detail on a few of the ways it's possible for news outlets -- whatever their medium -- to inject bias into their reporting.

Bias Through What News is Covered/Omitted

The first way for a media outlet to inject bias is by determining which stories they cover. Ignoring certain news while playing up other news can whip an audience into a frenzy, over a completely manufactured premise not based on reality.

When I briefly toyed with going into journalism as a profession in college, one of the courses I took as a prerequisite was a philosophy course in Logic. This class taught us how to build logical arguments, and how to spot fallacious ones. ("Fallacious" is defined as "based on a mistaken belief.")

Back in the old days of unbiased journalism, it was important for journalists to know how to construct an argument that would lead to a logical conclusion based on facts. But if an argument never even gets to the table, it doesn't matter how factual it is. Some publications, news shows, and bloggers use their power of choosing which stories to cover as their way to inject their own bias into their coverage of the news.

Sadly, we don't always know what we don't know. If none of the major news outlets covers a news story and we hear about it from an online blogger as our only source, did it really happen? How can we find out? There have been several instances where news sources frowned upon as "tabloids" have actually broken actual major news stories ignored by the mainstream press. Several of the sites that supposedly tell us whether or not something is true have also been proven guilty of bias.

Many of the news stories coming out these days are unbelievable...but that doesn't mean that they're untrue. Say what you will about Trump, he's changed the paradigm for what's normal in American politics.

How to combat news omission bias: Get your news from a variety of sources, both online and off. And don't limit those sources to those that agree with your point of view. Mix it up to get news biased in both directions, knowing that the truth lies somewhere in between them. What facts do they have in common? Where do they differ? How many sources from differing viewpoints have similar nuggets of truth? What I try to do is keep an open mind and remember hearing certain things, but not put too much stock in any one news story. Even those often repeated can be based on untrue information. Sometimes it's best to wait and see what happens over time rather than rushing to judgment and flying off the handle when you only know part of the story.

Bias Through Placement of News Stories

Another way in which a media outlet can inject bias is by determining where to place a news story. In the old print-newspaper world, they could "bury" a story in an inside or "gutter" column on one of the obscure interior pages that frequently got overlooked by most readers. Stories they wanted to play up would be on the front page, ideally "above the fold."

In the online world, above the fold refers to the stories you can see without scrolling down on your computer or, increasingly, your phone. Whatever that top story is, it's going to be their biggest story. When nobody has the leisure time to sit down and read a whole newspaper any more, it's far easier to bury stories online. So a story's merely making it into "print" or onto a news site doesn't mean that anybody will ever see it.

TV news outlets can do this by covering what they deem less-important stories at times when not as many people are watching. The biggest news stories get covered at the top of the hour, with less important news at the end of the show. Most local TV news stations have several hours of news a day, with a morning show, sometimes a midday news show, and evening shows in the early and late evening hours. That's a lot of time to fill. And they have ratings figures for every hour they're on the air, so they can easily bury stories they don't want to emphasize by putting them during their least-watched time periods.

How to combat news placement bias: Try to read at least one print newspaper from cover to cover once or twice a week. Local newspapers from a decent-sized city are fine. Don't just read the front pages, look at those interior pages where news can often be buried. Scan for headlines that catch your eye; you'd be surprised how often a story that has great significance in world events can be buried on some of those back pages. Read the editorial pages, including the letters to the editor, to be exposed to different viewpoints. The business section may seem boring, but it can provide some good insights to what's going on with the economy.

Bias Through News Headline Writing

Reporters may write the news stories, but it's always been a print newspaper's editors who wrote the headlines. Whoever writes them these days, it's easy to spot bias in them. Here are a few news headlines written on actual stories, from both the left and right perspectives:

Left-leaning Headline	Subject of the Story	Right-leaning Headline
USDA gay-sensitivity training seeks larger audience	The USDA rolls out new gay-sensitivity training	Obama Bureaucrats Imposing Radical Homosexuality Sensitivity Training?
Israeli soldier sentenced to 18 months for killing a wounded Palestinian in a case that roiled the nation	An Israeli soldier was sentenced to 18 months in military prison for shooting a Palestinian who attacked him with a knife	Israeli soldier gets 18 months over shooting of Palestinian knife attack suspect
Michele Bachmann’s First Dude	A profile on the husband of then-presidential candidate Michelle Bachmann	The Left Launches Attack on Bachman’s Husband
Truck ploughs into pedestrians in Jerusalem ‘terrorist attack’	A truck rammed into a group of soldiers on foot in Jerusalem, injuring 15 of them and killing 4	Jerusalem attack: Four dead after lorry driver rams soldiers
Malaysia police slammed for cattle-branding women	Police in the northern region of Malaysia chained women charged with prostitution and marked their heads and chests with an X	Malaysian Muslims Cattle-Brand Prostitutes
Obama Bashers: Critics, or Crazies?	A 2011 story on the validity of documents presented to show President Barack Obama was born on American soil	Obama birth record ‘definitely fraudulent,’ Sheriff Joe Arapaio says
AP poll: Economic worries pose new snags for Obama	An Associated Press poll showing less than 50% of people favored the re-election of Barack Obama	AP: Obama Has a Big Problem With White Women
Donald Trump says Mexicans are ‘killing us’ in latest inflammatory speech	Comments made by Donald Trump in a speech that the government was “killing us” with their business policies	Crowd applauds Trump saying he loves the Mexican people
NY Officials Want Schools to Teach About Unwanted Baby Laws	A proposal in New York to include lessons in high school curriculum on what mothers can do if they give birth to a baby they don’t want	NYC Public Schools Teaching How to Abandon Your Baby?
Democrats, Students and Foreign Allies Face the Reality of a Trump Presidency	Donald Trump wins election as America’s 45th president	The Media Never Thought Trump Could Win – and They Were WRONG
Dollar Weakens, Treasuries Gain as U.S. GDP Growth Slows; Stocks Advance	A 2011 report on the state of the economy showed the value of the U.S. dollar falling on international monetary markets	U.S. Dollar Getting Murdered
Vaccination debate flares in GOP presidential race, alarming medical experts	Republican Senator Rand Paul of Kentucky made comments connecting vaccinations to autism	Media Bias Rears Ugly Head in Vaccine Controversy
Mandela asks to meet Michelle Obama	A surprise visit Michelle Obama paid to Nelson Mandela while on a tour of South Africa	Michelle Obama Snubbed in Africa, But Looking Forward to Private Safari

How to combat news headline bias: Headlines are like advertisements for the stories they're selling. Recognize them for that, and understand that they are often written just like "clickbait" is on social media posts: they want to get you to read the story. The more inflammatory they are, the more likely you are to at least begin exploring what the story says. Don't let them anger or excite you on their own, without finding out more.

Bias Through Emotional Wording in News Stories

A few of the above headlines are also guilty of this subtle way in which opinions are injected into news stories. Remember, journalists are not supposed to editorialize unless they are writing an opinion column. But inflammatory wording can do just that in a news story that is supposed to be impartial.

Here's an example of a sentence that opened a recent news story, as written by the Associated Press:

"After seven years of fervent promises to repeal and replace 'Obamacare,' President Donald Trump and GOP congressional leaders buckled at a moment of truth Thursday, putting off a planned showdown vote in a stinging setback for the young administration."

Wow! Let's start with the adjectives used in that sentence: "fervent," "stinging," and "showdown" are all expressing judgments on the facts of the story. Those are opinions. They don't belong in a news story. The writer's choice of the verb "buckled" was also one that conveyed an opinion about the facts of the story, as did reference to the incident as a "moment of truth" and the choice to refer to the Affordable Care Act as Obamacare, put into quotation marks. Referring to the move as a "stinging setback for the young administration"is clearly an opinion, not an expression of news. Here's a sentence about the same event, written without bias:

"After seven years of promises to repeal and replace the Affordable Care Act, GOP congressional leaders withdrew the replacement bill prior to a vote."

Now, the raw news doesn't sound as exciting as the journalist's opinion, but news about politics is not supposed to "sound exciting," it's supposed to inform us of the facts so that we can formulate our own opinions. Do you want your opinions dictated to you by a news reporter? Of course not! But that's what has been happening for a long time when bias is allowed to intrude in the news.

Another way that journalists inject opinions into stories is by using quotes from others. But this is okay. It's an ethical way of influencing the opinions of readers in a story. A person being interviewed can express any type of opinion. What's not allowed, ethically, is for the journalist to offer his/her own opinions on the interviewee's comments, or on the story as a whole.

Here's how some of the opinions in the above sentence could technically have been ethically included in the sentence using the technique of attributing them to others:

"After seven years of promises to repeal and replace the Affordable Care Act, GOP congressional leaders withdrew the replacement bill prior to a vote, in a move some are calling a stinging setback for President Donald Trump's young administration."

Merely inserting that "some are calling" phrase shifts the focus off the reporter's opinions and puts them into the mouths of "others." The opinions are still there, but the reporter is not writing them as though they are facts, merely stating that some people think this. Without identifying who thinks it, the journalist has injected opinions into a raw news story to influence readers' opinions on the story.

Remember, the reporter should remain a cool outsider telling you about events observed. Here's an even more ethical way the reporter could have done that:

"After seven years of promises to repeal and replace the Affordable Care Act, GOP congressional leaders withdrew the replacement bill prior to a vote, in a move Democrat congressional leaders are calling a stinging setback for President Donald Trump's young administration."

With this version, those expressing the opinion are clearly identified, making the gist of the story clearer to readers: political parties in Congress are disagreeing, yet again.

This type of bias is extremely obvious...when you disagree with the opinions being presented. But if you agree with them, you're far more likely to view the story as unbiased.

In case you missed the bias in the above example because you agreed with it, here's another example that leans the opposite direction as the first one:

"North Carolina Republican lawmakers and Democratic Gov. Roy Cooper said late Wednesday that they have agreed on legislation to resolve a standoff over the state's 'bathroom bill' through a replacement measure that still restricts LGBT nondiscrimination protections."

This one uses a double negative to cloud the issue at hand: if you "restrict nondiscrimination protections" aren't you allowing discrimination? Readers would have to stop and think about it for a moment to get that, but a journalist writing the sentence could realistically claim, "I never said that."

Reference to the law as the "bathroom bill" -- in quotation marks, just as "Obamacare" was put into them in the first example -- may be seen by some as inflammatory, since the law requiring people to use the restroom matching their gender at birth was the subject of much debate and protest from the time of its introduction. Identifying each side by their political party is technically accurate, but its usage when not really applicable to the story's lead sentence could be seen by some as fanning the flames of political divisiveness in the nation today. And the word "standoff" evokes the image of a wild west gunfight.

Here's a less biased version of the above sentence:

"North Carolina lawmakers have agreed with Governor Roy Cooper on legislation to replace the state's controversial bill restricting bathroom usage."

While the term "controversial" is an adjective, it is a factual one; everybody knows that this law has been controversial. It has sparked demonstrations and cost the state several convention bookings. All adjectives are not bad in news reporting, but any of them used by a reporter should express facts, not the writer's opinions.

How to combat emotional wording bias: Watch first for adjectives. Those are the quickest and most succinct way for a journalist to inject opinions into news stories. Next look for inflammatory verbs: these can come across as snarky. Or they may just sound like very colorful language. Then look at the nouns, specifically how things are identified in the story: are terms used by one side or the other in a heated debate used instead of more neutral language for them? Often, such terms are put into quotation marks, as if to question their validity.

In your mind, can you rewrite the story so that the bias is not in it? Or with bias to the other side? Once you start doing this, the bias in news stories becomes more and more apparent.

Remaining Alert to Bias in News Sources

Now that you're aware of bias in news reporting, it's up to you to maintain that awareness and look for it. Once your eyes are opened to it, you can't stop seeing it! Bias springs up at you from every story you see, no matter where you view it.

Rather than to provide a list of "unbiased" or "reputable" news sources, I think it's far healthier to assume that every news source has some bias, identify it, and then move beyond it to see the reality of the story behind that bias.

We each have bias within ourselves, as well, that colors our perception of the news stories we read. Everything we each read or write runs through that filter within ourselves. Unraveling bias within the news media forces us to examine our own biases. Why do we think this way? Where and when did it originate? What experiences of our own have shaped our opinions? Have we missed anything that indicates a need to broaden our horizons? Asking these questions of ourselves could make us like the guy in the Chik-Fil-A commercial who thinks he's in a groove, then finds out he's really in a rut!

To quote the old TV show The X-Files, "The truth is out there." Do we have it within us to look beyond our own and the news media's bias, to find that truth? While there are some truths that may never fully be revealed, we can all do a better job of looking at the news we encounter every day with a higher awareness and a sincere desire to get to that truth.