POTUS TV: Paging Dr. Obama

On June 24, ABC debuted a controversial new medical drama: Barack Obama, M.D. Actually titled Questions for the President: Prescription for America, the town-hall forum sat the POTUS down to field questions about his plans to overhaul the health-care system. Before it aired, Republicans criticized it as an infomercial that would allow Obama to sell his platform to a vast prime-time audience.

That critique turned out to be off on two counts. The questions–from an audience including a former Bush Medicare official and the CEO of Aetna–focused mostly on the worries of the already insured about what would happen to their choice and coverage. More important, the special drew a mere 4.7 million viewers, barely half as many as NBC’s earlier Inside the White House, in which Brian Williams ate burgers with the President and petted First Dog Bo.

In prime time, it seems, the medical issues that score with audiences are, Does Izzie survive? And will House hook up with Cuddy? As Obama rolls out his reform plans, the networks are rolling out a slew of new medical shows–which just may do more to shape views of medicine than Charlie Gibson ever could.

TV doctor series have long been enmeshed with politics. In the 1960s the American Medical Association–which was vehemently fighting Medicare–signed off on Dr. Kildare and Ben Casey scripts, seeking to promote a positive image of status quo medicine. (By the 1970s, doctors complained that Marcus Welby was too unrealistically wonderful.)

As HMOs spread and the ranks of the uninsured grew, however, TV handed out fewer lollipops to the medical profession. In 1994, at the peak of the Clinton health-care fight, NBC announced ER, on which overwhelmed County General hospital treated the underinsured masses who didn’t have access to preventive medicine. As Anthony Edwards reminisced to the New York Times, “It was the beginning of the era when the emergency room became primary care.”

There have been many doctor series since then–Scrubs, House, Grey’s Anatomy. But several new medical shows focus instead on the nurses and paramedics who provide so much actual hands-on care in the age of overscheduled M.D.s. In these shows, saving patients is a chaotic, bureaucracy-plagued process–when it happens at all.

On Showtime’s Nurse Jackie, Edie Falco’s title character runs up against a hospital administration that wants to wring every possible dime out of patients. “All Saints [Hospital] is in the business of flipping beds,” Jackie tells a colleague. “That’s it. End of story. The fact that you have even the slightest inclination to help people puts you miles ahead of 100% of the population.” (In real life, Falco is a health-care-reform activist.) Jada Pinkett Smith also plays an overworked nurse taking on bureaucracy, on TNT’s Hawthorne. On NBC’s fall drama Trauma (not to be confused with CBS’s Miami Trauma), a supervisor warns a paramedic not to let a mother assist with her son’s emergency tracheotomy: “It’s a lawsuit waiting to happen!”

Even USA Network’s escapist Royal Pains has a class-conscious premise. Idealistic Dr. Hank Lawson gets fired when he chooses to save a young patient’s life before treating a hospital board member. He takes a job as a “concierge doctor” to rich summer people in New York’s Hamptons, treating everything from hemophilia to deflated breast implants. It’s fluff, but with a theme of modern medical feudalism: top docs attending the richest like courtiers. If your hospital waiting room has cable, watch it sometime!

In all, prime time depicts a medical system in which the technology is amazing but access is terrifying and sometimes random. Nurse Jackie, Hawthorne and NBC midseason nurse drama Mercy present nurses butting heads with doctors who demand incorrect treatments, with dangerous or fatal results.

Still, medical TV is in a sense idealized. Whereas ER and St. Elsewhere were set at cash-strapped urban hospitals, TV now prefers upscale settings. Patients generally get well, and you don’t see them bankrupted by bills. (If you really want to make a show about the insurance crisis, set it at a repo agency.)

These ideal images, though, may only make people more critical when real-life care doesn’t measure up. CBS’s fall debut Three Rivers, set at an élite transplant center, could underscore our luck-of-the-draw access to lifesaving resources. Or it could remind viewers of the top-shelf procedures that Obama’s critics say will be threatened by “socialized” solutions.

One thing Obama may have going for him is timing. In 1994, ER made it on air just as the Clinton plan was declared dead. This time the politics and the programming are in sync. Now to see if the U.S. is a country truly ready for health-care change, or if it just plays one on TV.

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