In a new “Perspectives” piece in the New England Journal of Medicine, Victor R. Fuchs, Ph.D., and Arnold Milstein, M.D., M.P.H., examine why cost-effective health care has been slow to catch on in the United States.
They point to a number of factors, including insurance companies’ desire to protect profits, large employers that don’t want to alienate employees, legislators who collect campaign contributions from the health industry, hospital administrators protecting their revenue, doctors who are generally resistant to change, manufacturers that fear losing market share and more.
The authors also point blame at the media, saying it doesn’t adequately explain who really pays for health care:
Great harm is done when employment-based insurance is discussed as if it were a gift from “generous” employers rather than an alternative to wage increases.
They also mention a topic that is surely familiar to Covering Health readers: relative risk vs. absolute benefit.
The media also mislead the public by emphasizing the relative benefit of clinical interventions (“reducing risk of death by one third”) when the absolute benefit (“reducing risk from 0.03 to 0.02”) is usually more relevant.
“Misleading headlines, designed to attract larger audiences,” also get a share of the blame.
What do you think? Does media coverage have an effect on how cost-effective care is accepted? If so, do you have suggestions on what reporters could do differently?
