In his inaugural address, the president did not talk about bringing health care within the reach of every American—a moral issue, according to some, akin to the civil rights struggle that made it possible for Obama to reach the highest office in the land. In his lone reference to health care, Obama said we would “wield technology’s wonders to raise health care’s quality and lower its cost.” During the campaign, he hailed health IT as the savior for America’s health care dysfunction, touted it as if it were unvarnished goods, and promised that it would not only improve medical quality care but lower the price of health insurance by precisely $2,500.
The peril and the promise of health information technology cry out for careful scrutiny, an examination yet to be done by the press, of whether IT can really lower health care costs at what price to consumers who may have lots to lose from its implementation. It is a big story. In the first of our Excluded Voices series, Yale professor Ted Marmor, an expert on U.S. health care, said “No other industrialized democracy has hit a cost control home run with information technology, and it’s provincial of us to think so,” adding it “might cost a fortune and become a boondoggle.” Indeed, New York Times reporter Robert Pear made that point Sunday, when he wrote “So far, the only jobs created have been for a small army of lobbyists trying to secure money for health information technology.”
Pear went further and described the coming battle between technology proponents hungry for profit and patient and consumer groups worried about a lack of privacy controls. For example, will insurers check a person’s pharmaceutical history and reject those who use too many expensive drugs? Will those using costly drugs be easy prey for companies wanting to sell the expensive stuff because they will now know exactly who their customers are?
For those eager to wade into this thicket, here are some more questions to explore:
• What privacy provisions are needed?
• How will those opposing such provisions wage the war?
• How will the different systems now on the market talk to one another? If your electronic medical record at the doctor’s office doesn’t work with the one in the ER when you’re brought in with a heart attack, what good is it?
• Who is making money from health IT? That journalistic maxim “follow the money” is important here.
• How will IT really lower costs without serious cost control measures used in other countries?
• What will make the nation’s autonomous and independent-minded health-care providers embrace the helpful aspects of the new technology?
Finally, let’s start by explaining to our audiences just what we mean by health information technology. Perhaps a lexicon is in order. –Trudy Lieberman
Will his “clean energy revolution” be a practical one?
Science and environment writers have long worked in relative newsroom obscurity, disconnected from mainstream politics, business, and culture. It is for their beat, more than any other, that Barack Obama’s inauguration signals a new prominence and relevance. The new president’s commitment to a clean energy revolution is one of the most expansive and challenging stories of our time. It will be science and environment reporters’ responsibility to inject more practicality into their coverage of that effort, however.
First and foremost, reporters must identify the tools that we have and the tools we need to accomplish such vast change in the global energy economy. Time magazine, for example, recently published a persuasive piece arguing that the United States could make significant progress by simply using efficient technologies already on the market. Its only shortcoming was that it did not address the opinion of many well respected scientists—including the new Energy Secretary, Steven Chu—who believe that the world needs new technologies to get the job done.
When covering those tools that still lie on our energy horizon, however, reporters must be careful to avoid sensationalism and defeatism alike. We recently criticized CNN for overselling an immature and fringe energy technology, but, likewise, outlets must not be afraid to revisit new and better generations of previously disappointing technologies like ethanol and batteries. In addition to these sources of energy, journalists must also pay more attention to our energy infrastructure. A “smart” national energy grid and an efficient passenger rail system are two of the obvious components of that infrastructure. A more inconspicuous, but no less important, piece of that infrastructure is our educational system and the need, as The New York Times has incisively put it, to inspire a culture of “innovation.”