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Health care reform has been a prominent issue in American politics for the past century. With the exception of the passage of Medicare and Medicaid legislation in 1965, Congress has not significantly reformed health care legislation in recent history. One attempt at reform, the case of Bill Clinton's National Health Security Act (HSA), stands out. HSA was "one of the most comprehensive domestic policy proposals made by an American president in this (20th) century,"1 one of the longest-lasting (1993-1996) and most intense policy debates, and it led scholars to conclude that the media played a role in its eventual failure.2Researchers generally confirmed the public's perception that, with only 44 percent of Americans thinking that the media were doing a "good job" of covering the issue in September 1993 and only 32 percent thinking so in August 1994, "the media flunked the job."3 Reporters affected the result by failing to provide the public with the quality of information that, as Gans puts it, is necessary for the proper functioning of society.4 Journalists treated the debate like they tend to treat elections, focusing on "tactics over issues, attack over advocacy, and scandal over substance."5Yet the media had another chance. With health care expenditures rising from $714 billion in 1990 to more than $2.2 trillion in 2007,6 health care was a central election issue in 2008 and a priority for President Obama. And while the issue got off to a slow start-Pew reported that only 7 percent of news coverage was devoted to it in mid-June 20097-health care accounted for a third of all news coverage in August8 and was one of Americans' most closely followed issues throughout the fall.9 This was true despite the public perception of low-quality news coverage. For, just as in 1993, public comprehension fell as coverage rose: 63 percent of Americans said the issue was hard to understand in July 2009, and 67 percent said so in September. Moreover, Americans regarded coverage to be defined by conflict.10While such allegations would be alarming about any news coverage, they are especially discouraging if true about health care reform. Because reform could affect Americans of every age, state and tax bracket, it is likely that citizens would attempt to inform themselves of the issues, form an opinion on the proposed legislation, and finally voice their opinion in a process that leads to the ideal of participatory government.11 As Tuchman put it, "The news media set the frame in which citizens discuss public events and the debate necessarily depends on the information available."12 The question, then, is if newspapers in 2009 and 2010 provided citizens with the type of news needed to make informed decisions, or, to the contrary, followed the lead of the 1993 press coverage. To answer this question, the authors applied news framing theory to analyze how three elite newspapers covered the 14-month health care debate and sought to further framing and policy research by also investigating sourcing, the change in frames and sources over time and the source-frame relationship.Literature ReviewJournalists frame events, actors and issues "through the use of selection, emphasis, exclusion, and elaboration."13 News frames can highlight and legitimize particular aspects of reality while marginalizing others,14 and scholars have found that frames can shape citizens' support of various policies.15Scholars have recognized and defined certain generic frames that are applicable to different news topics.16 Perhaps the best regarded is the issue frame, because it is based on "hard news" and substantive information that "is presumably important to citizens' ability to understand and respond to the world of public affairs."17 An issue-framed story includes the core facts of who's involved, what's involved and what's at stake. It puts information in context and explains its history or implications.18While arguably allowing the media to fulfill their social responsibility best, the issue frame may not be a popular choice of market-driven journalism because it's costly and perceived as failing to attract readers who seek human-interest, emotional news. …

To prepare students for the 21st century, educators must reexamine their educational paradigms and look far into the future. An Information Age audit might be a good way to start.