Panel focuses on health reform anniversary
Filed under: Health care reform, Health journalism
Support for health reform has been complicated by political rhetoric and the general public’s lack of knowledge about the Affordable Care Act, according to officials who spoke at last week’s AHCJ Chicago chapter meeting.
Chiquita Brooks-LaSure, the director of coverage policy in the Office of Health Reform at the Department of Health and Humans Services, Michael McRaith, director of the Illinois Department of Insurance, and William Santulli, chief operating officer for Advocate Health Care, gathered to tell 25 journalists and students where the Act stands as its one-year anniversary approaches. Bruce Japsen, a Chicago Tribune health care reporter, moderated the panel.
The talked about the most common misnomers about the health care reform effort, how health insurance exchanges are being implemented, the concept behind accountable care organizations and more.
AHCJ members can read more about the discussion and download audio of the panel.
Health care reform implementation glossary debuts
Filed under: Health care reform, Health journalism, Tools
HealthReformGPS, the George Washington University and Robert Wood Johnson Foundation project aimed at making health reform implementation easier to understand, has come out with a glossary of more than 200 key reform terms.
It keeps each entry brief while still covering general ideas, such as “Patient Protections,” as well as more specific ones, such as “Urban Indian” and “Culturally and linguistically appropriate and competent services.” All of this makes it perfect for bookmarking, or for a quick refresher. Take a minute to scan the list and I’m sure you’ll stumble across at least a couple entries that make you say, “Oh, so that’s what that really means.” Chances are, you’ll also come away with a story idea or two to boot.
Reform opponents got millions from industry
Filed under: Conflicts of interest, Health care reform, Health policy, Hot Health Headline, Public records
Caitlin Ginley, of the Center for Public Integrity, used data from the National Institute on Money in State Politics to demonstrate that the state officials who have joined forces to file a lawsuit challenging American health care reform have, together, received more than $5 million in campaign contributions from hospitals, pharmaceutical companies, doctors and insurers. Among the governors and attorneys general in the 20 states supporting the suit, a few stood out.
… the Center found that top recipients of industry money include Texas Attorney General Greg Abbott, who has received more than $1 million from health care professionals since 1996, and former Georgia Governor Sonny Perdue, who took in at least $970,163 from the industry starting in 1992, when he was a state senator, until he left the governor’s office this week. Other major recipients involved in the lawsuit include former Pennsylvania Attorney General and newly-elected Governor Tom Corbett, who has received about $830,000, and Mississippi Governor Haley Barbour, with more than $770,000.
Ginley provides details on the donations each of those officials received, as well as several others. No word on how this compares to other samples of 40 high profile state politicians. Physician groups and private doctors played a major role in many of the cases she examined.
PEJ: 2010 saw less coverage of health care
Filed under: Health care reform, Health journalism, Health policy
Every year, the Pew Research Center’s Project for Excellence in Journalism breaks down news coverage by topic and medium, then determines what percentage of the news hole each topic filled in a given calendar year (more on methodology here). Spurred by politics-oriented reform coverage and the H1N1 pandemic, health had dominated the news in late 2009 and early 2010, but by year’s end it had fallen behind the economy (14 percent), the mid-term elections (10 percent) and the BP oil spill (7 percent).
Interestingly, it seems that as the supply dropped, public demand for health coverage was actually surging. April’s health care debate ranked behind only the BP oil spill in Pew’s list of events for which public interest exceeded media coverage. Health was also one of many subjects which ranked in the top five in blogs and traditional media, but couldn’t even crack the top 10 on Twitter. For the record, Twitter’s four favorite topics were Apple, Google, Twitter and Facebook, in that order.
Elizabeth Edwards fervently urged health care journalists to inform the public
Elizabeth Edwards, wife of former presidential candidate John Edwards, passed away today after her long battle with cancer. She advised her husband on his plan for health care reform and later served as an adviser to Barack Obama.
Elizabeth Edwards spoke about health care reform at Health Journalism 2008.
As the keynote speaker at Health Journalism 2008, Elizabeth Edwards urged journalists to make sure candidates told the truth about their health care plans and that journalists have the responsibility to “make the American voting public more informed.”
Edwards said health care reform is “real life with real life consequences if this is put into place.” She talked about living with her diagnosis and her access to the best medical care but said that, on the campaign trail, she met many women with similar conditions who don’t have the resources and care that she does. “Don’t let those people stand alone,” she told the journalists.
AHCJ President Charles Ornstein, a senior reporter at ProPublica, remembers the event:
“I vividly recall, both talking to Elizabeth Edwards and listening to her speech, the passion she had for health care. She told us how fortunate she was to have good health coverage and implored health journalists not to forget those who were not as lucky. She was spirited, witty and direct. I feel fortunate to have met her.”
By then, her husband was no longer in the presidential race but her fast-paced talk focused mainly on John McCain’s health care plan, which she said would not solve the problems in this country.
She pointed to McCain’s plan to allow health insurers to practice nationwide as problematic because states have widely varying regulations that would allow health plans to be based in states with fewer mandates. She predicted patients would experience issues with pre-existing conditions or have high deductibles.
Read more about Edwards’ talk with links to audio, video and a transcript.
Reporter uncovers $86 million from insurers to fight reform
Filed under: Health care reform, Health journalism
The flow of money into politics in general, and health reform in particular, has been thoroughly opaque this election season, yet Bloomberg’s Drew Armstrong has still managed to pull back the curtain and figure out that insurers gave $86 million to the U.S. Chamber of Commerce, which then lobbied heavily to either hamstring reform or to reshape it in the insurers’ favor. Armstrong traced the money to America’s Health Insurance Plans through classic reporting tools: public records and well-placed sources.
Tax forms require organizations to list only the amounts granted or received from other groups, not the organizations’ identities. Health insurers expressed opposition to parts of the health-care legislation while they conferred with congressional Democrats writing the bill and the White House. At the same time, the Chamber of Commerce was advertising its opposition.
The Chamber spent $45.5 million on a campaign against the bill in 2009, according to TNS Media Intelligence/Campaign Media Analysis Group, an Arlington, Virginia-based company that tracks political advertising.
The Chamber began in March 2010, weeks before the bill became law, another $10 million effort focused on pressuring lawmakers to vote against the bill. Blair Latoff, a spokeswoman for the Chamber, wouldn’t say how much of the money was spent in 2009 and how much, if any, was used in 2010.
Dialysis program: Experiment in socialized medicine comes with high costs, risks
Filed under: Europe, Government, Health care reform, Health data, Health journalism, Health policy, Hospitals, Hot Health Headline, Pharmaceuticals, Public health, Public records, Tools
ProPublica’s Robin Fields has put together an artful examination of the nation’s Medicare-funded dialysis system. Part history and part investigation, it explains how this massive anomaly of government-run medicine came to be, and how it demonstrates the promise and peril of so-called socialized medicine.
The reporting has had an immediate impact, both upon the dialysis industry (read leaked plans for their response here) and upon the federal government. For health journalists, the federal response is particularly interesting, as it involves the disclosure of previously hidden data, and a classic government excuse.
ProPublica first asked CMS for the clinic-specific outcome data it collects — at taxpayer expense — two years ago under the Freedom of Information Act. The agency declined to say whether it would release the material until last week, as this story neared publication. It subsequently has provided reports for all clinics for 2002 to 2010. ProPublica is reviewing the data and plans to make it available for patients, researchers and the general public.
The reasons CMS has given for withholding the information until now is that some measures are disputed or lack refinement. Regulators and providers can put the data in perspective, officials had said, but patients might misinterpret the information or see it as more than they really want to know.
As befits something destined for publication in The Atlantic, Field’s piece might take more than one sitting to fully digest. And, if you haven’t yet had that second sitting, you’ll have missed some particularly nifty bits of comparative journalism, particularly where Fields compares the U.S. system to that in Italy, where the costs are significantly less and patients “got half the average dose of Epogen given to U.S. patients, perhaps because there’s no profit incentive to give them more.”
In Italy, about one in nine dialysis patients die each year. In the United States, that number is one in five. In dialysis treatment, there’s a trade-off between speed, cost and outcomes. And even high-rated Italy has had to make a few sacrifices, as evidence by comments from an Italian doctor:
“The decision to make dialysis faster wasn’t a scientific decision, it was a managerial decision,” he says. “It’s to allow you to do four shifts a day and make money.” He schedules just two shifts a day to accommodate longer treatment times.
Fields ends the piece on a high note. There’s hope for future efficiency in the dialysis system, thanks to a new program of bundled payments that will supplant the current system in which clinics see the actual dialysis as a “loss leader” and profit instead from heavy use of well-reimbursed drugs.
ProPublica promises more stories about this throughout the week, so be sure to check back its site for developments. Fields discussed dialysis on NPR today, as did Dr. Barry Straube, the chief medical officer at CMS.
Lieberman: Election is evidence media got reform coverage wrong
Filed under: Health care reform, Health journalism
In her column on CJRorg, AHCJ Immediate Past President Trudy Lieberman writes that this week’s elections showed just how thoroughly the media missed the mark on health care reform coverage.
After the economy (62 percent), health care (19 percent) was the second most important issue to voters. And while the media (and the administration) trumpeted the benefits of health reform and “glossed over” the drawbacks, public opinion soured. The biggest oversight, Lieberman writes, was the national insurance mandate, a policy that was more Republican than Democrat.
Lieberman says it best:
If the media failed to discuss in detail the law’s less attractive points, it also missed one of the campaign’s biggest ironies. Republicans, with their repeal and replace slogans, stirred up discontent about a law that was basically built with Republican and conservative ideas. That irony escaped the media.
She doesn’t explicitly frame it as such, but Lieberman’s column leaves me with the distinct impression that with the health care debate reignited by a Republican landslide, journalists are being given a second chance to provide the public with a clear understanding of what’s going on in Washington, an impression that’s cemented with her final sentence:
Whatever happens, the U.S. health system is still its dysfunctional, fragmented, costly self, in need of repair or wholesale reform. Going forward, this is the story the media need to tell.
Understanding the administrative side of implementation
Coverage of health care reform implementation has generally focused on the issues and effects of the roll-out, rather than the arcane governmental mechanisms involved. It makes sense, of course, as “here’s how you can now get coverage despite your pre-existing condition” is significantly more relevant to most readers than “23 states miss federal 90-day deadline for creation of high-risk pools, partly because already established pools don’t always conform to reform requirements, and partly because it’s too much hassle and they’d rather let the feds do it for them.”
Service-oriented as it may be, this focus has led to a few gaps in my understanding of the administrative moving parts involved in implementation. Which is why the Robert Wood Johnson Foundation’s guide to state and federal roles in the implementation of health care reform is such a handy document. It’s worth a quick scan, if only to give all those implementation stories a little context. It’s got everything from “how informal rulemaking becomes law” (hint: it involves both “notice” and “comment”), to the aforementioned business about why some states ceded control of their high-risk pools to the federal government. And it’s only four pages long.
Mass. reform, cost-cutting crush safety net hospital
Filed under: Government, Health care reform, Health policy, Hospitals
Boston Medical Center has been pushed to the financial brink by a mix of politics, economics and expanded health coverage. In Boston Magazine, Eileen McNamara examines the forces that are dragging down the commonwealth’s largest safety net hospital, in the process painting a cautionary tale of what happens when universal health care and cost-cutting collide. If it keeps eating through its financial reserves at the current rate, the hospital will become insolvent next year.
Photo by Wade Roush via Flickr
BMC is in a unique position, thanks to a legal mandate (not shared by its wealthier, Harvard-affiliated competitors) that it “consistently provide excellent and accessible health care services to all in need of care, regardless of status or ability to pay,” McNamara writes. In return, the state is supposed to compensate for its disproportionate load of low-income patients. Instead, the state’s clamping down on Medicare reimbursement.
BMC is locked in a battle with the Patrick administration over dramatic cuts in how the state pays for treating the poor. Barring a last-minute settlement, a Suffolk Superior Court hearing on September 29 will consider the state’s motion to dismiss a BMC lawsuit that challenges Massachusetts’ reimbursement rate. (The state currently pays the hospital 64 cents for every dollar it spends on patients with Medicaid.)
BMC says the new reimbursement formula violates state and federal law, and will sound the death knell for the state’s largest safety-net hospital. The commonwealth says it has the power to set any rate it wants; if BMC finds the payments inadequate, it can simply stop taking Medicaid patients. The state’s argument might have some merit in the case of doctors being free to choose their patients, but it’s a ludicrous posture to adopt toward an inner-city hospital that is required — by state law — to serve all comers.
On MedpageToday, Kevin “@kevinMD” Pho, who trained at BMC, pulls no punches as he riffs on McNamara’s article.
Universal coverage makes great headlines, helps get politicians elected, and, to be fair, is something that needed happen. But doing so without adequately addressing its cost is going to bankrupt hospitals, especially inner-city ones like BMC. That will hurt the Medicaid and Medicare patients dependent on them.
And that’s a goddamn shame.
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