In an age when newspapers are supposed to be dying, and small papers are supposed to be dead by now (or at least on life support by press release), it was refreshing and somewhat reassuring to see three small market papers do some fine health coverage of late. They weren’t the big blockbuster stories written for Pulitzer juries, but good, everyday stories relevant to their audiences—the kind of reporting that too many papers have abandoned.
A laurel to the El Paso Times for its post-election coverage of the struggles faced by the one-third of El Paso’s population that is uninsured. The series gives an important voice to those left out of the reform dialogue by the policy wonks, the pollsters, and most of the media. It also does something we at CJR have been urging the media to do: tell how ordinary people would be affected by the candidates’ proposals.
The paper did that by looking at how some El Pasoans would fare under Barack Obama’s campaign proposals. For example, when Nora Arzate, her husband, and their five children get sick, they use drug store remedies or cross the border to see a doctor in Juarez. They can’t afford one in El Paso. Paying a doctor ranks behind putting food on the table, paying the mortgage, and their other bills. Without Medicaid, her kids would have no insurance. Her husband Javier works as a janitor at a small private school, and his salary doesn’t allow the family to spend even a few hundred dollars a month for coverage. The paper talked about how the family might benefit if the school, a small business, could get a tax credit of up to 50 percent of the premiums. We hope the paper will keep these people in mind as the health care tug of war begins, and go back to see if they will indeed be helped by what comes out of the legislative sausage grinder.
A laurel to the Dayton Daily News for exploring the local boom in hospital construction. The headlines asked the right questions: “Is hospital construction boom good for area?” and “Hospitals keep building in hard times.” Those are fundamental questions that strike at the heart of health reform: What’s causing the relentless rise in medical costs? Hospitals, which account for about one-third of U.S. health care expenditures, have hardly been mentioned this year. It’s almost as if the media have declared them off limits, since they wear the halo of good angels in this business.
But the Dayton paper took a hard look at area hospitals, which have embarked on twenty-two projects totaling more than $1 billion. Hospitals defended their construction spree, saying that they are bringing health care closer to where patients live and giving area residents top quality specialty treatment. But the paper pointed out that more beds, more equipment, and more facilities mean more unnecessary procedures that raise costs and lead to poorer outcomes. It noted that the payment system is perverse—providers do more procedures to keep beds full and the money flowing in, all of which adds to the national tab. To drive home how much money is involved, the paper created a chart that listed all twenty-two projects, which health network was sponsoring them, what each would do, and how much each one cost. The numbers are staggering.
The paper has given itself a news hook for the future. Just how will reform legislation affect one of the major cost drivers in the American health care? Will it curtail the building boom in Dayton and elsewhere, which some observers believe must happen in order to put a brake on hospital spending? We hope the Daily News stays on top of this story. And while they’re at it, they might look at primary care in their area. There is a shortage of primary care docs all over the country. Does Dayton really need more treatment from specialists—even if they are as top quality as the hospitals say?
A laurel to the Colorado Springs Gazette for its story on problems at Memorial Health system, a city-owned health care provider that has fallen on hard financial times. Gazettereporters uncovered a memo from hospital administrators that laid out the hospital’s grim financial outlook. The memo, which talked of layoffs, told the system’s 4,000 employees that the money situation will worsen, but that they should “not become paralyzed in the fog of fear.” The story touched on a theme that deserves further investigation by that paper and others. Municipal hospitals all over the country are having trouble, and the current economic crisis makes the situation worse.
As the cost of care increases and insurers pass on those costs to patients, patients begin to use fewer services, particularly elective procedures. They delay hip and knee replacements—and that’s bad news for hospital budgets. Some experts believe in making patients responsible for cost containment by forcing them to use the system less. But when they do that, as we see in Colorado and other places, some hospitals suffer, particularly the ones that serve poor people in inner city neighborhoods. We hope that the Gazette will stay with the story, and that other papers will explore this topic and look at how reform will change the financial picture for these hospitals, if at all.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.