Too often during this campaign season health care stories have failed to explain the real issues in health reform. Oh yes, news outlets have dutifully quoted what the candidates are saying: “We’ll lower premiums by up to $2,500 for a typical family,” says Barack Obama. “We’re going to offer every individual and family in America a credit to buy their health care,” says John McCain. And the media have boiled down the essence of each candidate’s plan: Obama will build on the current system; McCain’s plan is more radical, because it could potentially tear up employer-based health insurance. That’s it—as if people could understand what such simplistic talk means to them.
Along comes the Catholic Courier, a newspaper owned by the Diocese of Rochester, New York, with an incredibly good story (“Confronting the cost of health care,” by Amy Kotlarz) that explains the stakes while giving enough background and context so that readers can get the whole picture. The paper covers religion, Christian society, and culture; health care, historically the province of Catholic hospitals and clinics, certainly fits into the paper’s mission. Kotlarz’s story starts with a statistic—18,000 people in the U.S. die needlessly each year because they have no health insurance—before transitioning to an anecdote about a 50-year old waitress in Wolcott, N.Y., who might eventually be a health care casualty herself.
Robin Salerno, who has adrenal cancer, works six days a week at a diner and earns $17,000 a year—too much to qualify for Medicaid or Family Health Plus, New York’s inadequate program for the uninsured. Although she could qualify for another inadequate New York initiative—Healthy NY, available to small businesses and their workers—she might have to wait a year for her cancer to be covered. (Some deal!) Unlike so many anecdotes that make you wonder if they are really representative of the larger problem, this one is. Salerno typifies working people whose incomes are too low to buy insurance and too high to qualify for the state’s chintzy programs. Plus, she is sick.
If all politics are local, then so is health care, a point that has been lost in the reportage so far. The Courier’s story is strong because it shows various ways in which health care hits home. The story summarized the state’s failure to expand coverage and quoted liberally from interviews with local health care providers. The president of Fidelis Care, the health insurance plan sponsored by New York’s Catholic bishops which works with state programs, was candid, acknowledging that millions of residents aren’t eligible for the managed care plans his company provides through state programs because, like Salerno, they earn too much money but still can’t afford their own policies. Then, in realistic terms, he listed ways to make health care more affordable.
How refreshing to see a health care executive eschew the usual nonsense that health information technology or exercise programs at the office will magically make health insurance cheaper. Instead, he noted the trade-offs inherent in real cost containment measures, like reducing benefits to cover more people, capping medical costs, freezing providers’ reimbursement rates, mandating coverage, and rationing (yes, the story dared to use the word) to limit high-cost or high-risk procedures. Such solutions, let alone their trade-offs, are seldom mentioned by the press.
The good reporting doesn’t end there. A retired physician who volunteers at Rochester’s St. Joseph’s Neighborhood Center talked at some length about the virtues of a single-payer system, something else that is rarely mentioned. The doc, a member of Physicians for a National Health Program, explained why single-payer proposals do not equate to socialized medicine, despite charges to the contrary. (On the other side, a man who attended a Rochester health care forum got to say he was afraid if the government took over the health care system, that would be the end of it.) The reporter also presented the views of Blue Cross Blue Shield companies, which, predictably, complained about the restrictive regulations that made coverage for small business and individuals unaffordable. The piece ended with a discussion of the Catholic Health Association’s moral argument for reform, and noted that, rather than endorsing any specific approach, the Association advocates reform standards like fair financing, transparency, and accessibility.
All in all, the piece was fair, balanced, and informative. I have just one quibble: Early on, the story says that Obama would create a “national health plan available to all and funded in part by employers who do not offer health insurance.” There’s that word “national” again. The word has come to imply universality of coverage and a national health insurance program, like those in other developed countries, funded through a national financing system and available to everyone as a matter of right. Neither candidate proposes that, and it’s best that reporters get the terms straight. But more on that in another post.
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.