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Interpreting the Complexities of Health Care Reform

Apr 19, 2010  •  Post A Comment

By Dinah Eng

As the spotlight on health care reform has intensified, health reporters have been challenged to explain what policy changes mean to the consumer, especially since political and business reporters seem to have taken the lead on the political front.

Some experts say if health reporters took a deeper look at new medical procedures and products every day, consumers would be better able to understand the complexity of the health care reform debate.

“Health stories would be so much better, helpful, accurate and balanced if we got across a couple of simple themes: In health care, more is not always better, and newer isn’t always better,” said Gary Schwitzer, who is leaving his post as associate professor at the University of Minnesota School of Journalism and Mass Communication to devote full-time efforts to publish HealthNewsReview.org.

“Helping the audience become more health literate means helping people to see both the potential benefit and potential harm in things. We need to get tougher about who’s promoting this treatment or that product, and what do they stand to gain?”

HealthNewsReview.org has reviewed nearly 1,000 health stories in the past four years about new medical treatments, products and procedures.

“You get a good look at the medical arms race playing out in the country,” Schwitzer said. “About 70 percent of the stories we review fail to discuss cost, benefits and harms of the idea. Health care reform coverage has become reporting on the politics, not the content and meaning of the legislation being considered, and a lot of that stirs up polarization.”

He cites several examples of excellent health stories, including The New York Times’ series, “The Evidence Gap,” which raises questions about the evidence for new technologies, and a Milwaukee Journal Sentinel series on “Side Effects,” which looks at conflicts of interest in health care practices.

“If we started framing stories that way tomorrow, I think the cumulative effect on the news-consuming public could be dramatic,” Schwitzer said. “People who work this beat know how difficult it is. You’re constantly reminded of what you don’t know.”

The health care overhaul will be a major topic at the Association of Health Care Journalists national conference (April 22-25 in Chicago), said Charles Ornstein, president of the association and a senior reporter for ProPublica.

“I wish editors and news directors would see that at its core, health care reform is more about policy than politics,” Ornstein said. “The whole way the system works is something people don’t understand. I think a lot of the stories are being done by political reporters, and it’s about who’s up and who’s down, but there have also been serious stories about the cost and implications of health care reform.”

Ornstein said the Association of Health Care Journalists offers reporters a periodic series of webcasts dealing with health issues, including health care reform, and regularly issues tip sheets about covering insurance and the business of health care.

“You can deal generically with cost in stories, but ultimately health care comes down to the decisions made by individuals and their physicians,” Ornstein said. “What’s wrong with the health care system is not an easy answer. It’s not just about insurance company profits and patients wanting more and more. It needs time and space to be covered properly, and I think health reporters have done a great job on the issue.”

Noam Levey, health policy reporter for the Los Angeles Times, covered Capitol Hill before moving to concentrate on the health care reform debate from Washington.

He said major newspapers have done a good job of trying to explain what’s in the bill from a policy perspective, as well as what the legislative process entails, adding that cable TV and Web sites seem to have concentrated on the political aspects of the story.

“All of us have tried to explain what it means to a consumer,” said Levey, who has done articles on insurance reform efforts in New York, and controversies around the cost and use of mammography and colonoscopy screenings. “When the brochure about alleged death panels exploded, it was classic deception by the opponents of the health care reform bill. It’s challenging to correct a lot of misperceptions.”

Julie Appleby, senior correspondent for Kaiser Health News, a journalist-run nonprofit news service that covers health care, has been covering health care issues for more than a decade. She said before the health care reform debate went to Congress, business reporters generally covered the issue.

“But as it became a big story, everyone threw more reporters on it,” Appleby said. “After the election, some of the political reporters started to take it. The same thing happened last time during the Clinton administration, and it was even more of a political story then.”

Appleby said some recent polls show that the American public is split between whether they like the policy changes or not, but when pieces of the legislation are broken out, the public shows a lot of support.

“Many people don’t know those elements are in the bill, so is the media not covering the debate well enough, or are people not paying enough attention?” Appleby said. “The details are out there, but people have to go and look for them.

“I think people relate to ‘How will this affect me and my family,’ over ‘What are the politicians fighting over today?’ A lot of Americans got turned off by the ideology, so that means those stories are important, too.”

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