President Obama’s Healthcare Reform Initiative: Who’s Setting The Agenda?
Mainstream Media or Social Media
President Obama’s healthcare reform initiative has been an issue that has gained a
great deal of public attention and debate, especially since the passing of the Patient
Protection and Affordable Care Act (PPACA) in 2010. While this issue is relevant to
millions of Americans, it is important to know how the American people have gathered
personal information about “Obamacare” and who it is that has been setting the agenda
for this national initiative. This paper will include a brief introduction to Obamacare
followed by an analysis of whether mainstream media or social media has been the
agenda force behind the reform, grounding it in McCombs and Shaw’s Agenda Setting
Theory.
The Theory
Communication scholars McCombs and Shaw coined the term agenda setting in
1972 after the researchers studied the 1968 presidential election national news coverage.
They accumulated what the top issues were and compared them to public opinion polls to
understand whether what was on the news was in fact salient in the minds of the public.
In effect, they were comparing the news agenda to the public agenda. They found that the
media were very well capable of transferring what was on their agenda to the public, and
the effect was called the agenda setting effect. This finding was groundbreaking because
at the time scholars had thought that the news that was in the media was a reflection of
what society wanted to know. McCombs and Shaw’s research demonstrated it was not
the case (as cited in Dainton & Zelley, 2011).
McCombs and Shaw were not the first researches to identify the agenda-setting
phenomenon. In their article titled, “The anatomy of agenda-setting research” published
in 1993, Rogers and Dearing were able to identify the origins of agenda setting and track
it from its conception till their present day. These researchers monitored 223 publications
that mentioned agenda setting over 70 years, and they documented interesting findings.
They found that Walter Lippmann, in his 1922 book titled Public Opinion, was the first
person to identify agenda setting without calling it so. Additionally, they found that
researcher Cohen in 1962 conceptualized that the press “may not be successful much of
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the time in telling people what to think, but it is stunningly successful in telling its
readers what to think about.” As previously discussed, it was only in 1972 when
McCombs and Shaw granted this phenomenon a title, namely agenda setting (Rogers &
Dearing, 1993).
Since its conception, agenda setting theory grew from an “effect” to a fully blown
theory with three levels. Most recently, researchers Guo, Hong Tien, and McCombs in
2012 identified the third level of agenda setting, calling it the Network Agenda Setting
Model. Whereas the first two levels of agenda setting focus on how public perception is
affected by the media and the capability of making issues salient in the mind of the
public, the third level focuses on a hierarchy of effects. The authors wrote, “This
theoretical model asserts that the news media can bundle sets of objects or attributes and
make these bundles of elements salient in the public’s mind simultaneously” (Guo, Hong
Tien & McCombs, 2012).
In a more practical study, researchers Gross and Aday in 2003 wanted to test the
theories of agenda setting and cultivation to understand the effect of watching local
television news compared to the effect of actually experiencing a personal crime or
victimization. The researchers found that the people living in the metropolitan area who
watched local news about crime had an increased likelihood to think that crime was an
important political issue for their community; however, these residents did not cultivate
fear of being victimized. On the other hand, the residents who had a personal experience
with a crime or victimization had no agenda-setting effect, but they did have a cultivated
fear of being victimized again (Gross & Aday, 2003).
The Situation
Since the Affordable Care Act was signed into law by President Obama in March
of 2010, there has been a great deal of media coverage on this topic both in mainstream
media as well as on social media platforms. The law put in place reforms that would
potentially allow everyone access to healthcare coverage at an affordable price without
having to supposedly succumb to any abusive private health insurance companies. This
issue has become controversial as people begin analyzing potential harms that may
emerge as a result of the reforms. Some of the controversy has emerged from people
worrying that the reform would use taxpayer dollars to fund abortions; that the reform
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would harm businesses who provide employees with insurance; that businesses would
stop offering their employees insurance, and that the government would have a hand on
healthcare (Health Reform, n.d.).
Since this controversial national healthcare reform has become extremely salient
in the minds of Americans, it is vital to know whether mainstream media or social media
have been more effective in setting the agenda.
According to Chen and Ruggiano in their article “Creating a Social Media
Agenda for Healthcare,” the use of social media is an extremely import tool that can no
longer be neglected in the healthcare industry. The authors identified corporations with
best social media practices, one of which is Humana, the insurance provider. The authors
said, “The Humanaville online community includes real-world-style locations and
activities such as a town square, health clinic, library, fitness center, games, and
relaxation spots. While in these locations, members can interact through online
chat and community discussion forums where they can post original content and
topics, ask questions, and respond to each other on those topics (Chen &
Ruggiano, 2012).
Not only has it been reported that social media is effective in the healthcare
industry in general, it was also reported that the White House has started a six-month
social media campaign to educate citizens about the current healthcare reform. According
to David Morgan, author of “Tweet That! White House to Use Social Media for
Obamacare Promotions” published in MedCity News on September 25, 2013, “Next
week, consumers in most states will begin to see more social media promotions
from the Obama administration, targeting young adults in urban areas that are
home to many of the nation's estimated 47 million uninsured people, according to
senior administration officials” (Morgan, 2013).
Nevertheless, there are also research findings that confirm that the mainstream
media has been a main catalyst in setting the agenda for major news. This finding was
reported in a report by Nic Newman titled, “Mainstream Media and The Distribution of
News in the Age of Social Discovery” published in the University of Oxford Reuters
Institute for the Study of Journalism in September 2011. Newman said, “It is mainstream
media brands that drive the majority of news conversations in social media. The news
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itself may emerge first via Twitter, but it is the mass media that pick it up and package it
for a mass audience” (Newman, 2011).
The Relevance of Agenda Setting
The Agenda Setting Theory is quite relevant to our specified situation since we
are trying to understand who has been the main agenda setter regarding president
Obama’s healthcare reform.
From a more general point of view, with the emergence of social media, this new
media platform has given researches more opportunities to understand how audiences
receive their information, adding additional knowledge to the limited effects paradigm
through agenda setting theory, which tells audiences ‘not what to think but what to think
about’. Therefore, agenda setting theory here is a valuable backdrop for current day
technologies in understanding which has become more effective in setting the agenda –
mainstream media or social media.
The Appropriateness of Agenda Setting
Agenda setting theory is quite appropriate when it comes to a national healthcare
issue. Grounding coverage of a national healthcare reform in agenda setting builds on a
wealth of knowledge already established that links politics to agenda setting.
Additionally, agenda setting theory is extremely appropriate to the current
situation of the healthcare reform, particularly because we have seen numerous agenda
setting studies already conducted within the realm of political issues like presidential
elections. In fact, agenda setting theory has already been recently used in research to
address the issue of Obamacare. In her research article titled “Addressing the ‘Medical
Malady’: Second level agenda setting and public approval of ‘Obamacare,’” Bethany
Anne Conway looks into how second level agenda setting may have influenced the
approval of the PPACA act in 2010. She finds that “when affective attributes are
measured cumulatively, the tone of coverage became increasingly negative over
the nine-month period (Conway, 2011). This provides support for previous
finding that suggest print and broadcast media tend to emphasize negative news
on certain national issues” (as cited in Conway, 2011).
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The Conclusion
In this article, it has become clear that both mainstream media and social media
have done their fair share of reporting and setting the agenda for the national healthcare
reform. The articles referenced herein have demonstrated that both entities have been and
can be effective in setting the agenda; therefore, agenda setting is an appropriate theory in
which to ground this situation. However, in order to understand whether agenda setting
has been more effective with mainstream media compared to social media, a content
analysis of Obamacare coverage has potential for future research. Whether a content
analysis will actually be done on this issue, no one knows. There is one thing we know
for sure though. Now that social media is the new communication platform, many
communication scholars will surely look into its effectiveness as the latest platform
contributing to the ever-expanding Agenda Setting Theory.
References
Chen, D., Ruggiano M. (2012). Creating a social media agenda for healthcare.
Customer Strategist. Retrieved from
http://www.teletech.com/media/15159111/customer_strategist_v3_i4_industry_in
sight_healthcare.pdf
Conway, B. (2012). Addressing the 'medical malady': Second-level agenda setting and
public approval of 'Obamacare'. Conference Papers -- International
Communication Association, 1-30.
Dainton, M., Zelley, E. (2011). Applying communication theory for professional life: A
practical introduction. Los Angeles: Sage.
Gross, K., Aday, S. (2003). The scary world in your living room and
neighborhood: Using local broadcast news, neighborhood crime rates, and
personal experience to test agenda setting and cultivation. Journal Of
Communication, 53(3), 411-426.
Health Reform (n.d.). White House. Retrieved on September 29, 2013. From
http://www.whitehouse.gov/healthreform
Lei, G., Hong Tien, V., McCombs, M. (2012). An expanded perspective on
agenda-setting effects. Exploring the third level of agenda setting. Revista De
Comunicación, 1151-68.
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Morgan, D. (2013, September 25). Tweet this! White House to use social media for
obamacare promotions. MedCity News. Retrieved from
http://medcitynews.com/2013/09/tweet-white-house-use-social-media-obamacarepromotions/
Newman, N. (2011). Mainstream media and the distribution of news. Reuters Institute for
The study of Journalism. Retrieved from
https://reutersinstitute.politics.ox.ac.uk/fileadmin/documents/Publications/Workin
g_Papers/Mainstream_media_and_the_distribution_of_news_.pdf
Rogers, E. M., Dearing, J. W. (1993). The anatomy of agenda-setting research.
Journal of Communication, 43(2), 68.
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