As we head into a new presidential campaign with health care likely to be one of the defining issues, Campaign Desk thought it a good idea to talk to some health beat reporters who try to bring the story home to people in their communities. This new series will feature journalists who translate the political story into kitchen table terms while tossing other kinds of health reporting into their mix.
A couple months ago the RAND Corp. released one of the most important health policy studies to show up in a very long time. Using a large sample of more than 800,000 medical claims, the study demonstrated that high deductible health plans, which are seen by many experts as the way to control health care costs, deter people from getting medical treatment, even preventive care. The press missed the story big time. But not Boston Globe reporter Kay Lazar. As soon as the press release showed up on her computer, she was on the phone to RAND asking to talk to one of the researchers. “I hadn’t seen a whole lot of studies that measured the impact on real consumers,” she told me.
Since most of the policies sold through the Massachusetts Health Connector, the state’s insurance exchange, carry high deductibles, she wanted to know what the study meant for the state. The number of residents with these policies had nearly doubled, from about 50,000 people in 2009 to about 93,000 last year. “To me the story was a no-brainer,” she recalled. Still, she wondered if she if she had overblown the story since others didn’t pick it up: “Am I out of touch for not following the pack?” Clearly not. Her story connected with readers; plenty of them called to talk about their high-deductible insurance.
Lazar came to health reporting late in her career. Now age fifty-three, she has been at the Globe seven years after having worked at the Boston Herald, the Asbury Park Press, and the Philadelphia Inquirer. Until she was thirty-five, Lazar was a broadcast journo working as a writer/producer at CBS and ABC. At the Globe, she started covering municipalities, but found herself gravitating to health stories, which she thought were cool, like the one she wrote about hospitals trying to accommodate the needs of their patients who were immigrants. When the Globe’s health writer left, she got the job, and began climbing what she calls a “steep learning curve.”
“I wanted to inject more humanity into the beat,” she said. “I wanted to know how health policy was working for people.” One of her early pieces was about dental care for residents newly insured under the Massachusetts health reform law. “It has intrigued me that dental health is not considered health.”
Lazar seems to have learned quickly. Earlier this year, the Association of Health Care Journalists honored Lazar for beat reporting. One story her editors submitted described the overuse of anti-psychotic drugs in nursing homes; another revealed shortcomings of the Massachusetts reform law. Many residents were buying the required insurance only when they were sick and needed it, which meant higher premiums for everyone else. The state has now ended that practice.
Lazar is an old-fashioned reporter, using old-fashioned techniques that may seem quaint to newbie journos today. But to those schooled in the old ways, these techniques work, often producing stories that are far ahead of the pack. Sometimes Lazar sits in on meetings of the Health Connector board and attends insurance regulatory hearings to sniff out stories and understand how the state’s insurance law works. Last year she was the only reporter to attend a public hearing that Gov. Deval Patrick had called to find out why health insurance rate hikes were disproportionately hitting small businesses, a big problem in the state. She discovered that executives from the state’s largest hospitals were no-shows. To be exact, only two of the seventeen invited to testify had bothered to come. That made a dandy story a reporter could get only by observing that Boston hospital bigwigs were MIA.
“I get a lot of education at those meetings,” she told me. “They are great even if they don’t produce a story for the next day. They give an explanation of the bigger picture and they help you save string.” She’s not much into data, the currency of the realm for journalists today. The Globe, however, has been hammering the Centers for Medicare and Medicaid pretty hard for not releasing data on the use of antipsychotic drugs in nursing homes. Lazar doesn’t do much number crunching herself, and her work shows that you don’t always need zillions of databases to tell a good story.