The murder of a health insurance CEO gave journalists an opportunity to listen. Most failed.

The commentary and coverage of the murder of United Healthcare CEO Brian Thompson troubled me. This newsletter isn’t about generic news stories or media commentary, but I decided to take some time to mull over why it had irked me. Ultimately, I realised that it was because it felt like journalists weren’t listening. Most of the coverage felt like journalists were circling the establishment wagons, and a lot of commentators seemed genuinely surprised that Americans were boiling over with rage about the health-industrial complex. Really?

Even outlets I normally admire have tilted toward sensationalist coverage obsessing over suspected killer Luigi Mangione’s rising status as a social media-age folk hero and the all-too-common violent rhetoric on social media. The Financial Times declared Mangione represented a “new era of villainy”. The New York Times had pieces about the social danger when a killer’s looks overshadow a violent crime and revulsion towards the anger at the US healthcare industry on social media. As my wife would say, the coverage is full of “pearl clutching” about people swooning over the “hot assassin”. What society had come to by glorifying a killer?

I know the business and how commissioning works, and I’m sure these stories were popular. However, the establishment media was reflexively defensive about a crime against a successful business leader. Reporters showed surprise that Americans are upset with a healthcare system that is more expensive than any other developed country and has poorer outcomes than other developed countries, largely due to shockingly bad outcomes along racial and socio-economic divides.

Some of the New York Times coverage was particularly surprising because their past coverage of US healthcare has generally been good and clear. The paper has examined why drug prices are nearly twice what they are in other rich countries, and in 2019, they compared the much higher prices for common procedures in the US versus other advanced economies. In the US, an angioplasty costs $32,000, but in other countries, it’s just $6400.

They also did an incredibly hard-hitting piece in 2021 showing the wildly variable costs for procedures based on your insurer.

The Times has done excellent coverage of the issues with the US healthcare system over the years, but it’s almost as if the desks covering the murder didn’t talk to their healthcare reporters.

Morality versus outcomes in media coverage

The media have cast this killing as a morality play with the protagonist being a fallen son of privilege, and they have expressed surprise at this desperate act. The media often engage in moral framing as opposed to consequentialist framing. Hot takes are all about seizing the moral high ground often at the cost of the bigger picture. In the context of Brian Thompson’s murder, the framing has focused on the morality of the killing and social media lionisation of Mangione while superficially engaging with fundamental shortcomings in US healthcare.

In the US, the primacy of market dynamics and the presumption that a business's role is to maximise shareholder returns don’t allow the framing of healthcare as a public good. Public goods are prone to market failure, which means they suffer issues with pricing and distribution. This means that discussions about the morality of access to healthcare are almost absent. It’s baffling to most people who live in other developed countries, I can tell you.

Instead of talking about the poor outcomes of the current healthcare system or the morality of bankrupting people who were unconscious and couldn’t give consent for out-of-network care, Americans get served up superficial coverage of the morality of killing a CEO.

The shock of the new(s) reinforces a sense of helplessness in Americans

On one level, news focuses on what is new, and frustration with US healthcare and insurers isn’t new. Journalism, even generally high-quality outlets, like the FT and the New York Times, can fall into the trap of struggling to cover long-simmering issues, whether those are issues like US healthcare and gun control where powerful interests stymie any change, or complex ones that play out over long-time scales such as climate change (well, there are fairly powerful interests that prevent change with that too).

Brian Thompson’s murder was a shocking new development in a larger story, so it received outsized coverage. But in the rush to fill column inches, the broader context was stripped away and journalists failed to examine or explain the systemic problems in the healthcare system which had led to his killing.

On the face of it, healthcare is like so many issues in the hyper-partisan United States: The two main political parties have fought each other to an impotent stalemate arguing over culture war issues instead of finding solutions to long-simmering problems. Americans had given up hoping that positive change could happen until they got a ripped vigilante to rally behind. The rage felt by people across the political spectrum erupted in a rare moment of national unity. Journalism could have recognised that, listened to it and pushed politicians to engage with the issue.

In one of the more interesting pieces by the New York Times, they interviewed the people who polled Americans about their attitudes towards healthcare.

Michael Perry, a pollster who has run hundreds of healthcare focus groups, said he used to find a gap between how the wealthy talked about their healthcare and everyone else. “I don’t hear that anymore,” he told the Times. “The wealth gap has closed, and there is no amount of money that can buy you good insurance.”

How Constructive Journalism can address these issues

Journalists bemoan news avoidance and a lack of trust in what they do. When political leaders don’t listen to people, journalists must. That didn’t happen with this story. Americans are furious about healthcare, and some of the clueless coverage isn’t helping. Seeming out of touch on this story plays into the hands of the autocratic populists who are attacking journalism.

Fortunately, there is a model of journalism that can help cover the complex stories our societies are grappling with and reinvigorate trust in and engagement with journalism. Constructive journalism goes beyond simply covering solutions, (although that is important), and outlines a process in which positive social and societal outcomes are the goal.

Constructive Journalism grounds its approach in a mission to contribute to democracy, not simply by being watchdogs. It uses a three-pronged approach to provide a new approach to journalism and counteract the results of overly negative, sensationalist cover that has fed the pernicious partisanship and anti-democratic populism.

1. Focus on solutions

2. Cover nuances

3. Promote Democratic Conversation

Constructive journalism focuses on highlighting solutions to societal problems and adds active engagement with audiences. It advocates for creating opportunities for democratic conversations to bring people with differing ideas together to solve these problems.

An example of this is Zeit Online’s My Country Talks project that “matched more than 200,000 political opposites for 1:1 discussions in a bid to bridge social and political divides”. This is an example of how to increase bridging capital that grows trust not only in journalism but also among people. Bridging capital is US political scientist Robert Putnam’s phrase for the social bonds between dissimilar people whether based on age, race, class or education. Putnam is famous for his 1995 essay and subsequent book about the collapse of civic participation in the US, Bowling Alone, which is now seen as prophetic about the pandemic of loneliness in the country.

It’s going to take active engagement to make our societies and democracies better. I used to think that simply providing people with information would empower people to make decisions that would improve our societies, make them more equitable and deliver better outcomes for the many, not just for the few. I have realised over my career as a journalist and a consultant focused on communications and community that it will take more than simply providing good information. It will require active engagement and positive efforts like Constructive Journalism to turn the tide in our societies and restore our sense of community and trust. Between Putnam’s ideas, which are the foundation of the Aspen Institute’s Weave project, and Constructive Journalism, I have hope for 2025 and beyond.

Headlines: A look back at AI and journalism in 2024

And now a few links after that epic newsletter, which has been brewing for a few weeks.

If you talked to me in the early 2000s, I probably fell into the category of techno-utopian. I was so hopeful that technology would create a better society and expand opportunities. I now think we need to return to first purposes: What kind of societies do we want? And does a technology support our societal goals or not? If it doesn’t, then we shouldn’t adopt it.

A new EY survey finds that workers and company leaders are experiencing “AI fatigue”. If we don’t want to feed into the feelings of helplessness that I’ve talked about already, we need to have discussions about how AI works for us not against us.

One of the issues we need to grapple with in terms of technology adoption: Does it lead to greater or less equitable solutions? What I mean by that is that so much of the technology revolution is rooted in neoliberal economic assumptions that have led to rising economic inequality that erodes the foundations of democratic, free societies. Many of the AI deals prejudice large-scale news organisations and add more hurt journalism that serves local communities. Rasmus is right to say that AI isn’t going to be lucrative for many news organisations. adds

A very smart framing from my friend and former colleague at the BBC - Alf Hermida. Again, we are faced with choices. Will AI be a “substituting force or a complementary force”. As I wrote in my last newsletter, it’s really down to the business model.

A good roundup of all of the research from the Reuter’s Institute and how it can help prepare our thinking to tackle the issues in 2025.