Tumulty’s story didn’t fully explore the crucial connection between the accompanying consumer tips box and the rhetoric about bringing people affordable coverage—especially those people who must buy in the individual market. The box warned consumers that high deductibles (Patrick’s policy carried a $2,500 deductible) could leave them uninsured; so could limits on benefits and services and the pre-existing condition clauses that let companies like Assurant Health off the hook. Cheap, affordable policies contain these provisions. That’s what makes them cheap. Time could have really scored had it connected a few dots and framed the trade-off between cheap, affordable policies and the skimpy coverage that leaves people stranded in health care never-never land when illness strikes. That will be another flashpoint of reform.
The magazine did present five options for reform, such as preventing disease, realigning doctors’ incentives, reinventing hospitals, adopting electronic medical records, and covering everyone. They echo the conventional wisdom. But their presentation was so sketchy that it would be hard for any reader to really understand them. Did “Cover Everyone: It’s Cheaper” mean an individual mandate that certainly will be expensive for some of the currently uninsured? Most readers wouldn’t get the recommendation to “pay for holistic success.” I’m not sure what the writer meant. And the suggestion that hospitals are medical “cafeterias” that should not all provide the same services is not likely to fly with hospitals that are fighting viciously with each other to win patients who need the most lucrative services. Plus, trying to steer patients to centers of excellence for various procedures has already been tried by the HMO movement—and consumers resisted. They wanted to go to hospitals close to home, even though the cost may have been higher and the quality lower.
Time’s failure to be more forthright about solutions may reflect the magazine’s internal dissent, or it could mirror the lack of national consensus about how to solve the problems Tumulty so vividly illustrates. There appears to be only a rhetorical consensus—things are bad and something must be done. Which raises the question: Are we headed toward a Fast Food Nation-style conclusion, which posited that food consumers could choose whether or not to eat Chicken McNuggets? When health care consumers get really sick, they usually have no choice. That’s the problem.