Newspaper Messages about Public and Private Health-Care Services in Australia: The Entrenchment of Unequal Choice

Media representations of health care can perpetuate stereotypes about public and private systems that unequally shape consumers’ perceptions and enactment of health-care choice. For instance, recent research about Australians’ (dis)trust of public and private health care suggests that participants’ concerns about long public hospital waiting lists echo prominent media messages, which might in turn contribute to the fact that one in two Australians supplement Medicare (the universal public health insurance scheme) with private insurance. As part of a larger study about health-care choice, we seek to understand ways in which the media represent both public and private health services, and their role in structuring different ‘choice’ pathways through Australia’s health-care maze.

This paper presents results from an analysis of newspaper reporting of public and private health care.  The sample consists of newspaper articles and letters dealing with public and private health services, private insurance and Medicare from ‘broadsheet’ and ‘tabloid’ newspapers in three Australian states (2011-13). These texts were coded for positive, negative and neutral messages about public and private care and examined for representations of choice, trust and responsibility. In line with the theoretical framework for our study, we also focused on articles that presented different aspects of ‘health-care capital’ – economic, social, cultural, symbolic or geographic – as influencing consumers’ capacity for health-care choice. The analysis reveals variation by state, newspaper, and over time.

We found that articles in the populist tabloid papers are dominated by negative, frightening messages about the “crisis” in public health systems and, to a lesser extent, the threat of rising costs of private health insurance. The ‘quality’ broadsheets present more balanced accounts, with articles typically combining positive, negative and neutral messages. Media representations thus contribute to the differential structuring of health-care choice, potentially compromising quality of care and exacerbating inequality.