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The Atlanta Journal-Constitution Tries to Redeem Itself

A better job on health care, but still a ways to go

October 23, 2008

As part of an ongoing series examining what the candidates’ plans might mean for Georgia, the Atlanta Journal-Constitution took another crack at health care Sunday. A few weeks earlier, the paper ran a story called “Issue in-depth: health care: in their own words,” which simply was a bunch of paragraphs lifted from old stump speeches made by John McCain and Barack Obama, and a box listing bullet points for each candidates’ health plan. Not so good, we said especially for a once venerable newspaper like the Journal-Constitution.

Its latest effort began with a decent enough anecdote about uninsured people coming to the Good Shepherd Clinic, staffed by volunteer physicians who struggle to keep it open for eight hours each week. There, the ills of the health system meet. The AJC told of thirty-nine-year-old Shanta Head, a diabetic woman with high blood pressure and high cholesterol. She can’t afford insurance from her employer, and, even if she could, it wouldn’t cover her conditions for a year, anyway. When she tried to buy cheaper coverage on her own, insurers turned her down. Big surprise. But the paper stopped there, missing a great chance to reinforce other points it tried to make.

The story veered predictably into the standard reportage on health care these days—that the candidates have different visions for health reform. It told of McCain’s tax credit proposal, and quoted a local insurance expert who said that many workers who now have coverage would come out ahead, at least at the beginning. But Shanta Head doesn’t have employer coverage; how would she be helped by this plan?

The story cited a recent employer survey jointly produced by a consulting firm and an outfit called the American Benefits Council. (It did not provide any background information about the Council, which advocates in Washington for employer-sponsored benefits.) The survey found that taxing the value of health benefits, as McCain also proposes, would have a “strong negative effect” on their employees. Then came the counterargument from the conservative American Enterprise Institute, which said that employers would not pay an extra tax for health insurance under McCain. The last I heard was that employees who get health insurance from their employers might have to pay an extra tax, not employers. So this bit of information was puzzling at best. But maybe, by then, readers had stopped reading.

The story noted that McCain would spend billions to fund high risk pools for people with health conditions, pointing out that “such state risk pools cover about 200,000 people nationally, far short of the millions with chronic problems, and a bigger pool would be very costly.” Another missed chance to mention Shanta Head. Most pools are way underfunded, and consumers who use them must pay very high premiums to keep them afloat. How could Head pay these premiums when she can’t even afford coverage from her employer—who most likely is already paying a portion of them? The paper could have also used that opportunity to explain why Georgia doesn’t have such a pool, while some thirty other states do. No funding source, or what? Who was against it? Finding out would have been helpful to locals who are trying to understand the sound bites about each candidate’s plan.

The story touched on Obama’s proposal, saying that, under his plan, “no one would pay a higher premium for an existing condition.” Where did that assertion come from? Obama has said he would require insurers to insure everyone, but little has been said about how much policyholders would pay. Currently, if an insurance company agrees to insure people with, say, high blood pressure, they have to pay more money—sometimes a lot more. This was another missed chance for the Journal-Constitution to investigate what the state’s major carrier, Blue Cross Blue Shield, charges residents with high blood pressure. It was another way to tell readers how they fit into the business of charging more to sick people.

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But alas, the paper didn’t do that. How nice it would have been for the AJC to link Shanta Head and other patients at the Good Shepherd Clinic to the proposals it described. Although this time the paper did a bit of its own reporting, that reporting didn’t go far enough or deep enough to explain health care to Georgians. Here’s a case where an anecdotal lede went nowhere; it probably drew readers into the story, but they may have stopped reading after the fourth graph. As professionals, we say we’re for humanizing a story, but here was a case where the Journal-Constitution fell down on the job.

Another thing we say is let’s eliminate the jargon—the wonk talk—that confuse, yes, Joe the Plumber as well as university professors. The paper again ran its bullet point box summarizing the two plans. In the McCain box, it used the words refundable to refer to tax credits, and talked about allowing individuals with multiyear insurance policies costing less than the tax credit to put money into a health savings account. In the Obama section, we read about a government-run health plan and an insurance exchange. Next time, please tell us what these mean.

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.