Are insurers to blame for rising costs?
The San Francisco Chronicle’s Carolyn Lochhead and Victoria Colliver use the recent furor over insurer Anthem’s rate hikes to explore just how much of the blame for rising health care costs should be shouldered by insurers. The reporters find that, in the end, insurers are just another one of the cartels (others include device makers and providers) and operate inside the opaque world of medical pricing and snag hefty cuts for themselves. Lochead and Colliver put it thus:
While the Anthem case has raised a political storm, the underlying surge in costs gets far less scrutiny. But each sector of the health industry points fingers at the other for driving up prices, and all are raking in money.
Insurers blame hospitals and doctors, doctors blame insurers, and hospitals blame doctors and medical devicemakers in what academics call an inscrutable medical-industrial complex that rivals anything the defense industry ever invented. All these groups are combining into what many experts describe as cartels.
The reporters write that, despite their best efforts, they weren’t able to get many folks on the record. When they did find someone who was willing to talk, it was often a source we’ve seen before in other cost stories. It’s a tough theme to get quotes on, as nobody wants to burn bridges with their professional suppliers and everybody’s got some sort of skin in the game. They did, however, manage to find a local source who offered an original and illuminating anecdote:
Christina Bernstein, a medical-device engineer and independent sales representative based in San Francisco, sells disposable surgical tools made mostly out of plastic that she estimates are manufactured for about $40 each. These are marked up and sold to hospitals for as much as $350, she said, for a single use in a surgery on a patient.
“But if you were to get a detailed bill of what the hospital was charging the insurance company for the insured patient, those things get marked up to something like $1,200,” Bernstein said. “It’s ridiculous. There’s no open competition.”
(Hat tip to AHCJ Immediate Past President Trudy Lieberman, who wrote a column on CJR.org praising the Chronicle’s story.)
Lieberman: Media bought into heart docs’ fight
Filed under: Health care reform, Health journalism, Hot Health Headline
Using one-sided sentences published by newspapers nationwide as evidence, AHCJ Immediate Past President Trudy Lieberman takes her media peers to task on CJR.com for blindly advancing the agenda of the American College of Cardiology in their push against Medicare reimbursement cuts.
The ACC aggressively fought what Lieberman describes as “a new Medicare rule, which took effect January 1, that cut projected total revenues for cardiologists by 13 percent on average over four years while increasing the revenue of internists, family doctors, and general practitioners.” Lieberman writes that the rule change will effectively put more money toward much-needed primary care specializations and that it was widely mischaracterized in the press, thanks to ACC’s machinations. Lieberman:
… for the most part (news articles) passed along the cardiologists’ complaints, threats, and warnings without any hint that there was another side to the story. Between the slanted newspaper articles and audio news releases from the ACC, millions of Americans learned that the incomes of heart doctors, which can be upwards of $400,000, could take a hit.
Lieberman: Joe’s looking out for folks at home
Sen. Joe Lieberman (I-Conn.) has been a vocal burr in the saddle of the Democrat majority’s push for health care reform. Writing for CJR.org, Trudy Lieberman seeks to explain why Joe Lieberman has so vigorously opposed measures like the “public option” and the long-term care CLASS Act. Trudy Lieberman says the senator’s position would seem to have something to do with his constituent base.
Independent Sen. Joe Lieberman at the 2008 Republican National Convention. Photo by NewsHour via Flickr.
Joe Lieberman comes from Connecticut, and Hartford is America’s insurance capital. It’s home base to Aetna, one of the country’s largest health insurers and a huge lobbying force this year, not to mention some lesser carriers that dabble in the health insurance business.
Trudy then goes down Lieberman’s reform stances issue-by-issue, pointing out exactly how vested interests in his constituency could have influenced each one.
There certainly seems to be some data to back Trudy Lieberman’s insights. OpenSecrets.org shows that the “Finance, Insurance & Real Estate” sector has been the largest donor to the senator.
Lieberman: Work got better with blogging
Heath Meriwether of the CUNY Graduate School of Journalism’s Write Stuff blog interviewed AHCJ Immediate Past President Trudy Lieberman about her transition from print outlets (including the Detroit Free Press and Consumer Reports) to blogging on cjr.org.
Lieberman
Lieberman said that once she made the jump to blogs and embraced the new format, her “work only got better.” She let loose and relied on her experience and reporting skills to “cut through the BS and be totally honest.”
The discussion includes a number of technical writing tips for bloggers, as well as a stern reminder that blog posts must be reported just as exhaustively as any other sort of journalism.
Lieberman picks apart Baucus changes
In her latest post on CJR.org, AHCJ immediate past president Trudy Lieberman picks apart the Baucus bill, with a special focus on the Montana senator’s latest changes. Lieberman pays special attention to Baucus’ concessions, and takes care to point out exactly who benefits and how.
Her assessment of the bill’s provision insurers to vary rates based on age (within limits) is particularly incisive:
In exchange for issuing policies to sick people, insurers get to jack up premiums for older people, a kind of proxy for medical underwriting. Baucus essentially allows companies to charge older people more for their coverage. Initially, he wanted to charge them five times more than a younger person, but now he suggests letting them charge four times more. A 58-year-old, for example, who has lost employer coverage and is struggling to pay the premiums for an individual policy may not see that as much of a gift.
Is Baucus’ excise on ‘Cadillac’ plans too broad?
The New York Times‘ Reed Abelson writes that the excise tax on premium health insurance plans that Montana Sen. Max Baucus is counting on to pay for about a quarter of his $774 billion reform proposal will hit urban families and union workers as hard as it will Goldman Sachs executives. Proportionally, in fact, union workers with less disposable income will suffer even more from the tax, which hits any plan that costs more than $8,000 for individuals or $21,000 for families, than high-flying white collar types.
The current national average for family policies is around $13,375, and only 1/10 of them would fall under the tax. But, Abelson reports, the pace of health premium inflation is such that far more policies will be caught in the tax net by the time the excise would go into effect in 2013.
The tax is based on the theory that it will help control health care costs by discouraging insurers from offering fancy plans that cover too many unnecessary tests and procedures. AHCJ immediate past president Trudy Lieberman writes for CJR.org that even this attempt to rein in costs will likely just increase them further as insurers pass the costs onto customers and the weaker coverage and corresponding rise in underinsurance forces folks faced with catastrophic conditions into financial difficulty or bankruptcy.
Decoding Obama’s message; highlighting coverage
Filed under: Health care reform, Health journalism, Hot Health Headline
AHCJ president Trudy Lieberman writes at CJR.org that, in his speech last week, President Barack Obama didn’t put anything new on the table, he just arranged the existing place settings to make them look more palatable to three key groups of constituents: the insured, the uninsured and those on Medicare.
In other words, the public option, should it exist, will be very limited, there will be an individual coverage mandate and Medicare won’t be footing any of the reform bill. Lieberman ends her column with the polite request that the media not allow itself to be sidetracked by South Carolina congressman Joe Wilson’s “You lie!” outburst and instead focus on how the president’s proposals would affect their readers.
In a related piece, Lieberman took the time to praise two outlets which managed to squeeze past all the political posturing and report on the real issues surrounding health care reform. The Kansas City Star’s Diane Stafford looked for answers to hard questions about the enforcement of an individual insurance mandate, while Kaiser News Service’s Jordan Rau explained just how expensive the individually mandated coverage could be.
As part of her ongoing Who will be at the Table series, Lieberman points out that Gun Owners of America, the NRA’s smaller rival, is opposing current reform proposals because they’re afraid gun-related medical information would end up in a national health database, and because they’re wary of an individual insurance mandate.
In another report, Lieberman posted the results of her interviews with another group, small business owners and employees in a Midwest college town, who sounded unsure about whether they were even at the table or not.
AHCJ board names new officers
The AHCJ board of directors elected a new set of officers to take their seats at the upcoming fall board meeting.
Charles Ornstein of ProPublica was selected as president, Karl Stark of The Philadelphia Inquirer was named vice president, Ivan Oransky of Reuters Health was named treasurer and Julie Appleby of Kasier Health News was named secretary. Trudy Lieberman, board president for the past five years, assumes the new role of immediate past president.
A new board was seated after July elections by the entire AHCJ membership. The board members then voted on officers.
Other members of the board of directors are Felice J. Freyer of The Providence Journal; Phil Galewitz of Kaiser Health News; Andrew Holtz, a Portland, Ore., independent journalist; Carla K. Johnson of The Associated Press; Maryn McKenna, an independent journalist and author; Mike Stobbe of The Associated Press; and Irene Wielawski, an independent journalist from Pound Ridge, N.Y.
The Association of Health Care Journalists is an independent, nonprofit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. AHCJ is housed at the Missouri School of Journalism.
CJR: Where did ‘death panels’ come from?
Filed under: Government, Health care reform, Health journalism, Health policy, Hot Health Headline, Public health, Studies
AHCJ president Trudy Lieberman, writing for CJR.org, traced rumors of “death panels” in the Obama reform plan back to radio appearances and op-ed pieces by a familiar face, former politician and academic Betsy McCaughey.
Betsy McCaughey
McCaughey first gained prominence when her notorious New Republic article “No Exit” helped submarine the Clintons’ health reform proposal in the early ’90s. Lieberman explains that the widely misinterpreted provision in the health reform proposal is actually just an expansion of a process put in place by the first Bush administration in which, once every five years, Medicare will reimburse patients for visits with medical professionals to discuss what kind of end-of-life care the patient chooses. (See McCaughey’s explanation on The Daily Show and New York Times blog post about the appearance.)
In a related piece in the Columbia Journalism Review, Greg Marks reviewed academic research to explain just how difficult it is to chase mythical creations like “death panels” from the national consciousness. “Once factually inaccurate ideas take hold in people’s minds,” Marx writes, “there are no reliable strategies to dislodge them — especially from the minds of those for whom the misinformation is most ideologically convenient.”
Finally, also in CJR, Megan Garber documents the sheer absurdity of the town hall shenanigans and spices up the account with a few choice examples and ends with the conclusion that our only hope may be to try “to ensure that the facts will simply make more noise than the fictions.”
Lieberman, Schwitzer on health reform, coverage
Filed under: Conflicts of interest, Health care reform, Health journalism, Health policy, Hot Health Headline
FAIR, a media watch group, interviewed AHCJ members Trudy Lieberman and Gary Schwitzer in an attempt to cut through the politicized hollering to the issues themselves. FAIR includes its own analysis of the recent health care coverage, calling for increased fact-checking and extra care when associating certain reform ideas and political associations.
Lieberman explained that, under all the noise, today’s debates are almost identical to those that took place during the Clinton-era push for health care reform. Politicians and industry mouthpieces said the same things and debate raged over the same options. This time around, Lieberman said, it looks like the lofty campaign for health reform has been downgraded to an effort to change and improve heath insurance.
While joining FAIR in pointing out some weaknesses in media coverage, Lieberman did point out a few pieces she regarded as noteworthy:
Every now and then I do see something really good. A year ago, NPR did a spectacular series on health care in five countries in Europe, and they did really good investigation and showed very clearly that people in those countries—France, Germany, the Netherlands, Switzerland, and the UK—were very, very happy with their coverage, and then they compared and contrasted it with someone in our country who had the same illness and showed the travails of getting care in the U.S. And then just this week, I found another excellent story, and this was in Business Week, and the reporters dug into the lobbying by United Health Care, which is the country’s largest insurer. And I think that’s very instructive about what kind of behind the scenes activities are going on by the lobbyists, and we should have more of those kind of stories.
In his interview, Schwitzer focused on his recent summary of the myriad shortcomings of health segments on morning shows.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
