EXTRA Unpacks the Media’s Medicare Coverage

Are journalists writing for doctors or for patients?

I don’t know Amy Poe, a writer and Medicare consumer based in Little Rock, Arkansas. But I like a piece she wrote for EXTRA, a monthly magazine of commentary and criticism of the press. I suspect most Beltway reporters and those who toil in smaller circles don’t know much about FAIR, a progressive media watchdog group that publishes EXTRA. But Poe’s piece is worth a read because of the message it sends: “Coverage of Medicare’s budget struggles has been perfunctory and shallow.”

Indeed it has been, as I’ve argued in this space for the past year. Poe also argues that seniors on Medicare, aka patients, have not been the focus of the media’s reporting. In fact, she notes in her lede that trying to understand Beltway brinkmanship over such pocketbook issues as extending payroll tax cuts and doctor fees “could be an exercise in frustration.” Poe reported that “Medicare users learned nothing about the billions of dollars in program reductions” slipped into legislation that, among other things, would protect the docs from an automatic 27 percent cut in Medicare reimbursements this year. As a result, she says, “those doctors’ neediest patients could find it harder to get co-payment debts forgiven or be treated at some hospitals”—a trade-off that got passing mention in MSM coverage, if at all.

She took to task members of the Washington press corps who cover Medicare for reporting the “doc fix” story, as this recurring Washington staple is sometimes called, from the doctors’ point of view. She noted the Los Angeles Times used the word “disastrous” to describe the fee cut’s impact on doctors, and pointed out that both NPR and The Washington Post interviewed physicians whose confidence, WaPo reported was “eroded” by “hair raising negotiations,” and who threatened—as they always do—to turn away Medicare patients. As one doctor who’s worried about his income told NPR: “Disgruntled is probably just too soft of a term for this. It’s really devastating to try to run an office in this environment.” She did note that both the Post and NPR did report most doctors were not likely to abandon the Medicare program.

Where do seniors fit into this reportage? Apparently nowhere, says Poe. She critiqued a Boston Globe story, which she said “expressed surprise that a bill ‘heralded as a bipartisan nod to working families’ would also slash funds for local medical providers.” The legislation would cut nearly $10 billion in Medicare funds for bad-debt forgiveness and lab tests, as well as money for rural hospitals and hospitals that treat large numbers of the poor; and it would reduce by one third the $15 billion the health reform law provided for preventive and community health programs. The front-page Globe story, she wrote, reported that the deal “has Massachusetts hospitals reeling over a little-noted section that will cost them tens of millions of dollars.”

Poe also mentioned another seldom-reported story—how much Medicare beneficiaries will be asked to pay for their health care. She noted, as Campaign Desk has many times, the burden of paying for care is gradually being shifted to seniors themselves. A WaPo,/i> blog, she said, stated blandly “Research suggests that the more individuals pay for health services out of pocket, the less likely they are to consumer unnecessarily expensive care.” People who must pay more do reduce spending, but research also shows they have a hard time discriminating between necessary and unnecessary care.

Poe acknowledged the difficulty of writing about Medicare. “Granted, convoluted regulations don’t make snappy copy,” she wrote. “But media shortchange the public if they fail to note the insulated position providers enjoy in a time of cutbacks.” Ah, the privileged position of business in the American political process. Reporters don’t think about it enough.

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Trudy Lieberman is 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. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman. Tags: , , , , ,