Best of 2011: Trudy Lieberman

CJR's health and entitlements reporter picks her top stories from the past year

Peter G. Peterson Goes to School: Organizations funded by Peter G. Peterson, a former Wall Street investment banker and long-time foe of Social Security, have had a powerful influence in shaping this year’s debate over Social Security. The media have liberally quoted representatives of these Peterson-funded groups. The website Remapping Debate took a deep look at one Peterson-funded activity—the creation of a questionable curriculum to educate high school teachers about the U.S. economic system. The Peter G. Peterson Foundation gave Columbia University’s Teachers College $2.4 million to design the curriculum which Remapping Debate reported contained “errors of commission and omission.” The piece offered a rare glimpse at the nexus between big money, ideological agendas, and the academic enterprise.

A Missing Health Policy Story: The usual eager beavers on the health policy beat missed a big one when they did not report on a major study from the RAND Corp. which showed that patients did indeed put off going to the doctor and getting needed care, including preventive services, when their insurance policy deductibles rose into the stratosphere. They skipped preventive care, even if their insurance covered it. The higher the deductible, the less patients spent on medical care, meaning they used fewer services. Making patients think twice before using medical services is a cost-control measure envisioned by health policy wonks and politicians. It’s a thread woven throughout the health reform law. The RAND study was well done and based on a very large sample, which makes it so credible. What’s remarkable is that too many journos writing on this subject months after the study went public have failed to examine what it said.

A Good Social Security Story—At Last: For most of the year, shallow reporting has characterized media coverage of Social Security. So when Emily Kaiser of Reuters penned a fine piece that moved beyond the one-sided framing that had become the norm, I was overjoyed. Kaiser dug into the Social Security archives to begin her story with a compelling lede about Robert Ball, a civil servant who devoted most of his career to making sure Americans had an income base when they got old, became disabled, or when a breadwinner died. She provided history and context for people to understand the attackers and defenders of the country’s most popular social program. Kaiser tackled the rhetoric of the debate and brought voices into her piece that had been missing up to that point.

An Interview with Don Barlett: Journalists have heroes, and Don Barlett of the famed Philadelphia Inquirer reporting duo Barlett and (Jim) Steele ranks right up there for me and other reporters. Barlett’s illuminating interview should be required reading for all reporters especially newbies. Barlett discussed their series “America: What Went Wrong,” and the lessons it gives for what has gone awry in America today, two decades after the series appeared. During the interview we talked a lot about the disconnect between the news media and their audiences. “Today’s journalists often forget the audience earlier generations wrote for—the average person,” Barlett told me. “Now they write for Wall Street or Silicon Valley or Capitol Hill or cable television talking heads.” Barlett noted that too often a reporter’s questions are framed in economic terms not in moral terms—is something right or wrong. Moral outrage in the newsroom is gone. “Journalists have literally lost their moral compass,” he said. Something to ponder as the new year begins.

The Intense Health Reform Drama in the Maine Legislature: This is one of the most important health policy stories of the year. Yet the media missed its significance. If health reform is to succeed, most experts agree there must be strong state regulation of insurance rates. Insurance companies see it differently, and fought a seminal battle in the Maine legislature. The result: insurance carriers got lawmakers to agree to effectively eliminate rate regulation in the individual and small group markets. The state now has little oversight of the premiums that insurers can charge to small businesses and individuals buying policies on their own. Mila Kofman, one of the strongest insurance commissioners in the country, resigned. How the industry killed good regulation in Maine may be a template for what is to come in other states.

Joe Lieberman and his Medicare Gift: The senator from Connecticut and his Senate colleague, Tom Coburn of Oklahoma, have proposed a package of changes to Medicare that affect all seniors. Many advocacy groups aren’t keen on those ideas, which have gotten little attention. On the surface some of them sound OK, like capping out-of-pocket expenses and creating a single deductible for all services. But deeper examination shows that the millions of seniors who have Medigap policies will have to pay out-of-pocket $3750 right off the bat before their policies would pay a dime. It’s part of the drive to make patients have “more skin in the game.” That is, require them to pay more for their care. Lieberman and Coburn also want to beef up the means-testing people for in the program—making those with higher incomes pay more for their medical and drug coverage (Parts B and D). Experts fear that as more and more seniors with higher incomes pay more, they will lose support for Medicare and opt out of the program in favor of private market coverage. That, of course, would provide business opportunities for Lieberman’s constituents, the big insurance companies headquartered in his state. Lots for the press to explore amid all the talk of vouchers and privatizing Medicare!

Revisiting the Man in the Middle: Another in a continuing conversation between Campaign Desk and Jermey Devor, a man with five kids who earns the U.S. median income of around $49,000 and lives in Salem, Illinois, right in the middle of the country. The health reform law will not help Devor. The rules are designed to exclude him from government help paying his premiums. Nor will he or his wife and kids be able to buy an insurance policy in one of the new state shopping services. Devor has insurance from his employer, but the deductibles and coinsurance result in high medical bills he still has to pay. He also struggles to pay the premiums, and finally he took his wife and kids off the employer’s policy. His wife is uninsured and will probably stay uninsured when health reform takes effect. His kids qualified for a state program. Larry Levitt, a senior vice president at the Kaiser Family Foundation, explained Devor’s dilemma. “The upside (of the law) is that people didn’t have to change their coverage. The downside is that families who can’t afford employer coverage or the coverage is inadequate will not be helped by the new law. They will be people in the lower-to-middle income range who will be affected.” Stay tuned for more about the Devors.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman. Tags: , , , ,

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