Category Archives: Health policy

Marijuana debate: Taxes, research and regulation #ahcj14

About April Dembosky

April Dembosky is a health reporter for The California Report at KQED public radio in San Francisco. She is attending Health Journalism 2014 on an 2014 AHCJ-California Health Journalism fellowship, which is supported by The California HealthCare Foundation.

Photo by Phil Galewitz

Photo by Phil Galewitz

Legalizing marijuana in Colorado has been a boon not just to people who want to use marijuana recreationally, but also to medical researchers who want to study its effects.

The state public health department wants to channel tax revenues from marijuana sales into human research trials — permitted by the new law — and plans to ask the state legislature for authority to spend $10 million on these studies. Continue reading

Reporter focuses on chronic pain for series on opioid use

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Lisa Bernard-Kuhn

Lisa Bernard-Kuhn

When The Cincinnati Enquirer set out to look at the societal costs of the deadly opioid crisis, reporter Lisa Bernard-Kuhn was assigned to look at the role of chronic pain.

During more than eight months of reporting, she looked into how doctors measure pain, how effect opioids are at treating pain, patients’ expectations and more.

In an article for AHCJ, she explains how she was able to get doctors and patients to talk on the record and shares some of her most useful sources and lessons learned.

Uncovering the real drivers of obesity in young people

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Image by phalinn via flickr.

Image by phalinn via flickr.

It’s great that the rapid rise in youth obesity since the 1980s has started to level off. But there’s an unsettling trend hidden in the data: Progress has largely been limited to kids from more educated and higher income families, according to a recent analysis that got less news coverage than it should have.

Robert Putnam and colleagues at the Harvard Kennedy School compared outcomes by education and income using data from two nationally representative health surveys (the 1988–2010 National Health and Nutrition Examination Surveys and the 2003–2011 National Survey of Children’s Health).

Among teenage children of parents with a college degree, they found that the prevalence of obesity began to drop about 10 years ago, while it continued to climb among the teenagers of parents who have at most a high school degree. They found the same trend when they used estimates of family income, rather than education, to measure socioeconomic status. (The growing gap is not merely a reflection of racial or ethnic differences, they say, because it persisted even when they limited the analysis to non-Hispanic whites.)

Los Angeles Times reporter Melissa Healy raised an important point in her coverage: Continue reading

Comparing U.S., Canadian health care systems

Trudy Lieberman

About Trudy Lieberman

Trudy Lieberman, a former president of AHCJ, is a contributing editor to the Columbia Journalism Review, where she blogs about health care and income security issues. She is a fellow at the Center for Advancing Health where she blogs about paying for health care. At Consumer Reports, she specialized in health care and health care financing. She has won more than 25 awards and five major fellowships.

Lieberman recently returned from a monthlong visit to Canada as a Fulbright Senior Specialist, where she lectured on the American health care system and learned much about how Canadians get their medical care. She interviewed hospital executives, physicians, academic experts, former health ministers, reporters covering health care, and ordinary citizens. Lieberman also toured hospitals and long-term care facilities. This is the first of four posts reporting on that visit.

canada-flagOne thing Americans and Canadians can agree on is that we don’t want each other’s health care systems. In truth, most Americans don’t know how Canada’s system works and Canadians don’t know much about the U.S. system.

What Americans know has come mainly from the negative talking points of politicians and others who have argued for years against national health insurance. Two decades ago The New York Times reported that Canadian women had to wait for Pap smears, a point vigorously refuted by the Canadian ambassador who shot back in a letter to the Times editor: “You, and Americans generally, are free to decide whatever health care system to choose, avoid or adapt, but the choice is not assisted by opinions unrelated to fact.”

Yes, there are waiting lists for some services – as I will explain in another post – but, no, Canadians are not coming across the border in droves to get American care.

There’s misinformation among Canadians, too. Wherever I went, Canadians told me they thought, mostly based on what they said they heard on CNN and Fox, that Obamacare meant America was getting universal health coverage like their country has.

Continue reading

Mercer survey shows cost increases to remain low but warns of issues to watch next year and beyond

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Employers’ health insurance cost increases will remain relatively low next year at 4.8 percent, according to preliminary results from Mercer’s National Survey of Employer-Sponsored Health Plans 2013. Last year, benefits consultant Mercer reported cost increases for 2013 were 4.1 percent, a 15-year low.

The preliminary results come from a survey of 2,000 employers. The full survey will be released next month and will include results from 2,800 companies, according to an article by Jerry Geisel in Business Insurance.

Geisel added that employers will see health plan costs rise in the coming years as they implement provisions in the Affordable Care Act. For health care journalists, how employers react to these changes will be a trend to watch. Continue reading

Health reform D-Day? Or not for a few more months?

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

At the AHCJ event we had in Washington, D.C., a few weeks ago, I talked about why there’s nothing magical about Oct. 1 – and why it’s also such a pivotal day.

From a strictly policy viewpoint, today is just the start of a six-month open enrollment period that ends March 31. We won’t really know for some time how many people the exchanges are enrolling or what the emerging risk pool looks like (men versus women, older versus younger, sicker versus healthier). We will probably hear about people having problems getting on the exchange websites or call centers – we won’t necessarily hear as much about people who don’t encounter problems. We’ll find out about glitches – computer problems, call center snags. Some may be serious – but if they are fixed relatively quickly, they aren’t fatal. The Medicare drug benefit had all sorts of snags when it opened, but within a few weeks it was working quite well.

But that’s the staid policy viewpoint and all of us know that – as the government shuts down, as the “Obamacare wars” are well into year 4 – this is not just a policy story. Even the wonkiest, most policy-minded reporters among us know this is a political story, a political dynamic, too. So we aren’t going to be deluged with press releases that say “Health insurance exchanges open – let’s give it six months to make a judgment.” We’re going to be hit with a tidal wave of advocates and enemies trying to seize the message and declare victory or defeat. It will be a battle of the “I told you sos.”

And since the enrollment period – with all its problems and challenges – will go on for three months until the actual health coverage begins on Jan. 1, that’s three more months to focus on problems without being able to point to benefits. That lag will be politically challenging for supporters of the law.

It won’t just be politicians and advocates making snap judgments – some of us may also face pressure from editors to come up with a grand and definitive and immediate answer – it’s working, or it flopped. By, like, noon.

Try hard to keep your eye not just on what happens in the coming hours – but the far more important question of what’s going to happen in the coming weeks, months and years.

Facing growing health care costs, Mass. tries containment #ahcj13

Priyanka Dayal McCluskey

About Priyanka Dayal McCluskey

Priyanka Dayal McCluskey is a business reporter at the Worcester (Mass.) Telegram & Gazette. She is attending Health Journalism 2013 on an AHCJ-Healthier Beat Fellowship, which is supported by The Leona M. and Harry B. Helmsley Charitable Trust.

Massachusetts is famously ahead of other states when it comes to health insurance coverage. Ninety-eight percent of Bay State residents have insurance.

But the state is also way ahead in another area: health care costs. The cost of care is the highest per capita in the country and, consequently, the world, according to Andrew Dreyfus, president and CEO of Blue Cross Blue Shield of Massachusetts.

Insurers, providers and government regulators have been working, with some success, to curb the rate of health care costs in Massachusetts. Continue reading

Higher quality health care at a lower cost: challenging and achievable #ahcj13

Anna Gorman

About Anna Gorman

Anna Gorman is a staff writer at the Los Angeles Times. She is attending Health Journalism 2013 on an AHCJ-California Health Journalism Fellowship, which is supported by The California HealthCare Foundation.

Working together in teams and investing in primary care can improve health outcomes and reduce spending in the American health care system, a panel of experts told a packed room at Health Journalism 2013 Friday afternoon.

“You cannot tell me that better care and lower costs don’t go together because I’ve seen it,” said Donald Berwick, former administrator of the Centers for Medicare and Medicaid Services. The best examples come from communities not policymakers, he said during the session entitled, “Controlling health care costs while improving quality.” And they inevitably involve patients, doctors, nurses and other providers working together, he added.

Berwick cited a healthcare project in Alaska, where team-based care has resulted in 50 percent fewer hospital bed days, 53 percent fewer emergency department admissions and 65 percent fewer specialty visits.

Berwick said the fact that the U.S. health care system continues to provide low value at high-cost is a “crisis” and people are scrambling to figure out how to fix it. Among the biggest problems that have led to waste in the health care system are pricing failures, uncoordinated care and unnecessary treatment, Berwick said. “More is not better,” he said. “We are going to have to change the way we think.” Continue reading

Mass. governor welcomes journalists, focuses on cost containment #ahcj13

Larry Dreiling

About Larry Dreiling

Larry Dreiling is a senior field editor at the High Plains Journal. He is attending Health Journalism 2013 on an AHCJ-Rural Health Journalism Fellowship, which is supported by the Leona M. & Harry B. Helmsley Charitable Trust. Follow him on Twitter at @ldreiling.

Photo by Len Bruzzese

Expanding access to health care and improving quality while containing costs are issues Massachusetts Gov. Deval Patrick says are central to his administration.

Patrick delivered the opening welcome to members of the Association of Health Care Journalists on March 14 in Boston, where the group is holding its annual meeting, Health Journalism 2013.

The governor called the 2006 Massachusetts health insurance reform law a success in that it gives residents nearly universal care, with more businesses offering health care and nearly 90 percent of residents having a primary care physician.

He said more cancer screenings are being performed than before while visits to emergency departments have decreased.

“We are healthier because of it,” Patrick said. “Women, minorities and low-income people have experienced the biggest health improvements, but it’s been true, really, across the board.”

Continue reading

Insurance co-ops faded from view but still ripe for analysis

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Former AHCJ president Trudy Lieberman, in a CJR “Second Opinion” post, recently pointed out a story that was largely untold– and put it in a helpful national and political context for those of you who may still tell it. That’s the “incredible shrinking insurance co-ops.”

The co-ops’ funding was slashed in the New Year’s fiscal cliff deal. With all the other economic and political aspects of the “cliff,” the co-op story was not widely reported, including in some of the states where they may have made a difference.

Why does it matter? Remember the long battle in 2009-10 over the “public option?” The Consumer Operated and Oriented Plans were the alternative – arguably a sort of consolation prize – to the public option. The co-ops were a way to have a nonprofit health plan alternative to the largely private commercial plans expected to dominate the exchanges.

Lieberman quotes John Morrison, Montana’s former insurance commissioner, now president of the National Alliance of State Health Cooperatives, as saying the co-ops were scrapped not so much to save a few billion dollars for the fiscal cliff deal but as “a gift to the insurance companies” that didn’t want to compete with them. They were expected to have been particularly useful in giving small businesses more choice in rural areas dominated by one or two health insurance carriers. Continue reading