Emory University psychologist and political consultant Drew Westen in the weekend Washington Post offers a troubling view of the public's role in health care reform. While reform's reality involves complicated technical issues like insurance exchanges, public plan governance, physician and hospital payments and who will pay higher taxes, the public's understanding of these issues is virtually non-existent, Westen assumes.

Instead, public knowledge comes from a media environment where Republican consultants craft messages about a government takeover of health care and Democratic consultants (the author among them) promise a family doctor for everyone. Never mind that neither message even remotely resembles reality.

Nowhere in the article does Westen pay homage to the democratic ideal that an informed electorate has a role to play in policy debates like health care reform. Nor does he lament the passing of an informed electorate. Such statements used to be a staple in discussions about political messaging and the impact it was having on policy debates.

It hasn't always been thus. I've been reading "Lords of Finance: The Bankers Who Broke the World" by Liaquat Ahamed, a former investment banker who spent the past ten years researching the errors made in the late 1920s and early 1930s that led to the Great Depression. Near the end of the book, he recounts how President Roosevelt explained the bank holiday declared immediately after he took office. His first fireside chat carefully detailed for average Americans the complicated workings of banks that had forced his hand. The next day, folk humorist Will Rogers marveled at the speech's clarity. In a letter to the New York Times, he wrote: "Our president took such a dry subject as banking . . . (and) made everybody understand it, even the bankers."

Today, few media outlets even bother to explain the intricacies of policy choices. Politicians, the special interests and the communications experts who craft their messages can safety assume the public will have a poor grasp on reality. Marshall McLuhan has been turned on his head. The message is now the medium.