PBS, NPR, & the Refusal of Public Media to Engage in Class Analysis

On the way to work this morning, I happened to catch a NPR/WNYC story discussing new Uber and Lyft programs which allow healthcare providers to arrange and pay for patients’ rides to receive care. According to the report, and two earlier NPR and PBS stories posted on their websites, these programs are being created because nearly three and a half million people miss scheduled appointments or choose to skip or delay care every year because they are unable to physically get to the doctor or hospital. Apparently, doctors and and hospitals lose millions of dollars every year due to these missed appointments. A 2008 study found that the lost revenue to providers for each missed appointment was just under $200, on average.

It was an interesting story, but something was missing. This morning’s radio report, and the NPR and PBS articles cited above, failed to do any kind of class-based analysis of the problem. In fact, they made it seem as if there was no need for deeper analysis, at all. As they discuss it, some people have trouble getting transportation to the doctor; this problem can be alleviated by providers using Uber and Lyft to transport them. At no point did they attempt to explain why there are so many people who cannot get to their appointments. Who are these people? The closest they get to addressing this is that the NPR article identified them as “vulnerable,” without explaining why or in what way they are vulnerable. The problem, as they see it, is that these people are less likely to own a car, and are more likely to rely on public transportation. But why? Could it be that these are vulnerable, non-car owners are overwhelming poor or low-income? The answer, of course, is yes, but you would never know that from reading these articles.

Beyond just being a fairly obvious and logical conclusion, there is actually quite a bit of easily accessible data available to back up this claim. After about 30 seconds of basic google searches, I was able to find an article in The Atlantic that cited (with links) several fairly recent studies on that very topic! These studies provided a great deal of evidence that those living at or near poverty often have difficulty.

“More recently, a 2012 survey of 698 low-income patients in a New York City suburb reported that patients who rode the bus to the doctor’s office were twice as likely to miss appointments as patients who drove cars. And in 2013, a review published in the Journal of Community Health found that around 25 percent of lower-income patients have missed or rescheduled their appointments due to lack of transportation. The patients who reported issues with transportation also missed filling prescriptions more than twice as often as patients without that same problem. “These consequences may lead to poorer management of chronic illness and thus poorer health outcomes,” the study authors wrote.”

In addition to ignoring the deeper analysis, reading these NPR ad PBS articles might even lead readers to take away with a more insidious conclusion: that the solution to this problem was found in “free market” forces. In order to increase their profits (or limit their losses), some medical providers are willing to spend a smaller amount on Uber/Lyft fees in order to get “vulnerable” patients to their offices so they can make a larger profit by providing their services. Who needs altruism when we can send the Invisible (helping) Hand to the rescue!

In reality, it is our over reliance on a free market based system that has led to the mass poverty at the root of this problem in the first place. America is suffering from massive inequality today, the worst in nearly a century. One of the leading causes and inequality is found in the rising costs of medical treatment in our for-profit healthcare system. That is why the entire rest of the industrialized world has abandoned for-profit healthcare systems and most countries now use some form of government funded healthcare, with better results and lower costs than the U.S.. On top of the fact that tens of millions of Americans, uninsured and underinsured, often skip needed medical treatment due to the cost, there are now also many who cannot even afford the transportation.

In fairness, other articles on PBS and NPR do mention poverty, but they tend to do so in articles specifically on the topic of poverty. What they have failed to do is tie poverty and inequality to the other issues that they report on. Thus, poverty appears to be a stand-alone issue, as opposed to an over-arching issue that impacts and is impacted by almost every other issue imaginable. In the end, it leaves its readers to ponder the unfortunate circumstances in which some people find themselves, while avoiding the question of agency, as if their misfortunes are the inevitable result of perfectly nature processes. Failing to address root causes makes it impossible to solve problems or even determine what the true problems are. The problem is not that some people cannot get to a doctor. The problem is POVERTY. The solution is not having your doctor pay for your Uber. The solution lies in deep structural changes to our entire political and economic system to address the root causes of poverty.

Ron Widelec is a progressive activists on Long Island,NY and a high school teacher in New York City.

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