Category Archives: Health policy

Covering an ACA grant for ‘super-users’ in Lehigh Valley, Pa.

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.

Photo: Chris Wong via Flickr

Photo: Chris Wong via Flickr

Most of us have heard about “super-users” – patients who are constantly in and out of the hospital, running up large bills. Most have multiple chronic diseases, are poor, and often have mental illness or substance abuse problems. Most live alone, and some are homeless.

Four communities – Lehigh Valley, Pa.; Kansas City, Mo.; San Diego and Aurora, Colo. – have received grants under the Affordable Care Act to tackle the super-user problem. (Other non-ACA-funded initiatives are also underway). Investigative reporter Tim Darragh, formerly of The Morning Call in Allentown, Pa., spent a year tracking the grant in the Lehigh Valley. The super-user innovation grants, which were issued in 2012, provide $14.3 million and (at least for Lehigh) expire in mid-2015.

Darragh, now a reporter at The Star-Ledger in New Jersey, looked at a broad range of issues in the project. He also was able to weave narrative into the policy reporting. The Morning Call recently published five pieces:

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In sad, compelling stories, journalists are documenting a mental health care system in crisis

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.

Photo: Jan Bommes via Flickr

Photo: Jan Bommes via Flickr

Imagine the outcry if patients with cancer or any other chronic condition lacked standard, appropriate care. Such ill treatment would not be tolerated.

Yet the U.S. health care system routinely fails to provide basic care to Americans with mental illness, says Patrick J. Kennedy, a former congressman from Rhode Island and co-founder of One Mind, an organization seeking new treatments for neurologic and psychiatric diseases of the brain.

For a series of articles in USA Today, Liz Szabo quoted Kennedy on mental health care in America: “The failure to provide treatment and supportive services to people with mental illness – both in the community and in hospitals – has overburdened emergency rooms, crowded state and local jails and left untreated patients to fend for themselves on city streets.”

The burden of inadequate mental health care falls on individuals and families, but also on emergency rooms, hospitals, jails and other institutions, making this topic well worth the rich and deep coverage Szabo and other journalists have committed to it. Such coverage is important, as reporters have found in Colorado, Idaho, Oklahoma, and Wisconsin, and it can be rewarding because it forces journalists to confront and explain some most challenging health care issues in our society. Continue reading

AHCJ members report on health spending in Mozambique

Kris Hickman

About Kris Hickman

Kris Hickman (@the_index_case) is a graduate research assistant for AHCJ, pursuing a master’s degree in public health. She has a bachelor's degree in anthropology, with a minor in journalism, from the University of Missouri. She spent two years in Zambia as an HIV/AIDS community education volunteer in the Peace Corps. She aspires to be an epidemiologist and science writer.

Noam Levey, who received a 2013 AHCJ Reporting Fellowship on Health Care Performance, recently reported on health care spending in Mozambique for the Los Angeles Times. In the piece, Levey pointed out that Mozambique’s economy is booming – but in contrast, its health care spending is lagging.

The decision to limit health resources had an especially profound effect in remote areas of Mozambique. Levey reported from Chokwe, a rural town about 100 miles north of the coastal capital of Maputo, and described  a newborn baby boy who stopped breathing shortly after his birth, just before sunset.

Nurses were able to revive him with a ventilator and a suction machine. But if he had been born only two hours later, he would have died – limited resources mean the ward is staffed only until 7 p.m.

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Connections between housing, health: Finding stories and getting the reporting right

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @rojasburke.

Photo by Till Westermayer via Flickr

Photo by Till Westermayer via Flickr

Megan Sandel, M.D., M.P.H., an expert on the impact of housing on child health, says journalists would do well to broaden the conversation about health care to include questions about social support – especially support for safe, affordable and stable housing.

Sandel has contributed a tip sheet that includes key stories to pursue and critical insights on the housing-as-health-care trend.

Find out why housing has an enormous impact on educational attainment and economic stability, how unequal enforcement of health and safety codes creates disparities and what the three essential elements of healthy housing are. See the tip sheet now.

 

Health care industry reacting to overtesting, overtreatment

Carla K. Johnson

About Carla K. Johnson

Carla K. Johnson (@CarlaKJohnson) is a medical writer at The Associated Press and has covered health and medicine since 2001. She is a member of AHCJ's board of directors, serving as liaison to the association’s local chapters and leading the one in Chicago.

Photo: Carla K. Johnson Chicago Tribune reporter Julie Deardorff chats with health writer Evelyn Cunico at the May 12 event in Chicago.

Photo: Carla K. Johnson
Chicago Tribune reporter Julie Deardorff chats with health writer Evelyn Cunico at the May 12 event in Chicago.

The American health care system wastes an estimated $750 billion a year, according to the Institute of Medicine. At a recent AHCJ chapter event in Chicago, four panelists discussed one source of that waste: unnecessary tests and procedures.

Moderated and organized by AHCJ member Kevin B. O’Reilly, senior editor of CAP Today, the panel looked at the issue through the lenses of doctors, journalists, health system executives and academics.

Holly Humphrey, M.D., dean for medical education at the University of Chicago Pritzker School of Medicine and vice chair of the American Board of Internal Medicine Foundation’s board of trustees, discussed the foundation’s Choosing Wisely campaign. Continue reading

Experts warn against ‘one-size-fits-all’ health care, benefits

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.

Photo by Truthout.org via flickr.

Photo by Truthout.org via flickr.

So many health care strategies are aimed at controlling costs that we may be missing the point about value. The trouble inherent in focusing on low cost is that it does not necessarily equal better care.

This point is one health policy experts are starting to deliver to the federal Centers for Medicare & Medicaid Services and to other health care payers, such as managed care companies and health insurers. Focusing on low-cost strategies may be doing a disservice to patients and health plan members, they say.

Writing in The Hill newspaper on April 22, Kenneth Thorpe, Ph.D., chair of the Department of Health Policy & Management in the Rollins School of Public Health at Emory University, criticized a recent proposal from the Medicare Payment Advisory Commission, which advises Congress, on using the “least costly alternative” when making policy decisions. Doing so puts patients into a “one-size-fits-all” model of care delivery, he explained.

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, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @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.

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