As goes Massachusetts; so goes the nation—at least when it comes to healthcare. In 2009 and 2010, in the midst of the debate on Obamacare, I wrote a series of 10 posts examining the Bay State’s 2006 law that served as a the blueprint for the Affordable Care Act. It’s time for an update. This is the first of an occasional series about Massachusetts healthcare and how the press is covering it.
The Globe’s Spotlight Team examined the reasons why health care costs so much in Massachussetts. In doing so, the team took on the state’s largest health insurer, Blue Cross Blue Shield, and the state medical powerhouse, Partners HealthCare, which runs two of the country’s premier teaching hospitals, Massachussetts General and Brigham and Women’s Hospital.
The Globe story, part of an ongoing series entitled “Unhealthy System,” disclosed how Blue Cross and Partners, the state’s largest private employer and its biggest health care provider, sealed a deal in 2000 that raised health insurance costs across the state…[I]t reveals the difficulties in containing medical costs when dominant players and their market power seem to set the market’s rules.
I was reminded recently of that series thanks to news of a preliminary antitrust settlement between Partners and Massachussetts Attorney General Martha Coakley after “five years of government inquiries into Partners’ pricing, competitive practices, and market power.”
And yet, looking at the Globe’s coverage of this latest Partners news—the settlement in play allows Partners “to complete its long-planned acquisition of three community hospitals in Eastern Massachusetts, in return for accepting limits on expansion and prices for the next five to 10 years”—it’s almost hard to believe it comes from the same news outlet that in 2008 was so dogged and thorough on the question of whether “medical giant Partners Healthcare [is] good for Massachussetts,” as the paper’s 2008 series put it. The “is this good for Massachussetts” question is just as relevant today, in light of the proposed agreement. So, where’s the scrutiny? Where’s the accountability spirit?
The Globe’s coverage, instead, has been workmanlike, tepid, and very ho-hum: the business desk has covered the play-by-play since the tentative deal came to light in mid-May. Since then, readers have learned that: “Supporters, critics weigh in;” local groups call for “independent scrutiny” of the deal (so where’s the Globe’s scrutiny?); “AG still negotiating final settlement with Partners”; “Partners, Coakely file agreement on expansion;” “Partners rivals seek to intervene in antitrust settlement;” the settlement is put on hold at the end of June; and, in mid-July, a judge grants Coakley a delay on the deal. Readers have also heard about the politics of it all (there’s a gubernatorial race in the Bay State this year and Coakley is one of three Democratic candidates). A June 9 Globe editorial sang the settlement’s praises (“will help contain health costs”); a June 28 editorial allowed that “rival hospitals deserve chance to challenge” the deal. No probing, no digging, no hard questioning!
In other words, the Globe has covered the story. Just without the tenacity, detail, and accountability mindset of 2008.
Paul Levy—who once ran Boston’s Beth Israel Deaconess Medical Center (which is among Partners’ competitors and is opposing the AG’s settlement) and now runs the Not Running a Hospital blog, offered a similar criticism in late May. The Globe’s 2008 series, Levy wrote:
stands as an excellent example of journalism and shows what happens when the major newspaper decides to put its resources into a story of regional importance. From that pinnacle, the paper now offers prosaic stories using the “on the one hand/on the other hand” approach. It included a few comments from academics pointing out flaws in the deal to balance out the positive ones offered by the AG and a health care consultant. What is striking about the coverage is the degree to which the newspaper did not draw on the knowledge and perspectives of other key players in the region, the expanded information available from state agencies like CHIA, or even on material from its own previous stories.
Speaking of resources and reportorial manpower, I notice the Globe recently devoted time and space (over 3500 words) to what’s more or less a puff piece on Blue Cross Blue Shield CEO Andrew Dreyfus, “the last healthcare optimist” who heads the state’s largest insurance company—written, just like most of the Globe’s recent Partners coverage, by Robert Weisman.