About AHCJ: General News

President’s Corner: Renewing our reporting focus on the health aspects of health reform Date: 07/01/12

Charles OrnsteinThis column originally appeared in the Summer 2012 issue of HeatlhBeat.

By Charles Ornstein

After months of suspense, the Afford­able Care Act survived its day in court.

Within minutes of the Supreme Court’s decision, elected officials and po­litical candidates unleashed sound bites and slogans to try to win the message wars. Pundits and prognosticators wasted little time talking about whether the de­cision would change the outcome of this year’s presidential race.

If we were all political reporters, we would spend the next five months duti­fully chronicling this silly horse race. But for those covering health, the task is more nuanced and difficult.

The life-and-death stories in our communities aren’t going away because of the ruling or the political campaign under way. Community clinics are fight­ing for their survival amid state budget cuts. Small business owners are deciding whether they can afford to offer health coverage. Hospitals, doctors and insurers are alternatively collaborating and com­peting aggressively for patients’ business.

Covering health reform has been an exhilarating, exhausting and frustrating process for AHCJ members over the past two years. For some, it’s been a two-de­cade labor of love since the Clinton pro­posal faltered with “Harry and Louise.”

But the court’s decision isn’t the end of the story. In fact, recent stories and polls show that we have a lot of work to do – to simply educate the public about what’s in the Affordable Care Act and what it means for them.

Take the lede of a recent story by Alec MacGillis for Kaiser Health News, The Tennessean and The New Republic:

“As Robin Layman, a mother of two who has major health troubles but no insurance, arrived at a free clinic here, she had a big personal stake in the Su­preme Court’s imminent decision on the new national health care law. Not that she realized that.”

“What new law?” she said. “I’ve not heard anything about that.”

There’s plenty of blame to go around, but the media itself deserves at least a little.

An interesting report from Pew Re­search Center’s Project for Excellence in Journalism found that most of the coverage of the health reform bill from June 2009 to March 2010 (when it was signed into law) centered on the political machinations and consequences, not the content of the bill or the state of the U.S. health care system.

“The press focused far more on the horserace aspects of the legislative struggle than on examining the system it was de­signed to reform,” the report’s conclusion said. “…All of which raises the question of the extent to which the media shed light versus heat when it came to health care reform. Certainly, many outlets did good work covering the numerous layers of the complex issue. But it’s also true that the public seemed consistently confused by the health care debate and had a dif­ficult time sorting out fact from fiction.”

Indeed, polls show that many of the same people who say they disapprove of the law also say they approve of individual components of it.

Not everybody is a critic. When I have read stories many of you have writ­ten, I have been proud of your thought­ful coverage, which has tried to shine light on health issues in your area or state and not simply regurgitate talking points. I’m not the only one who feels that way. Harold Pollack, writing on The Health Care Blog, called reporting on the Affordable Care Act the “best-cov­ered social policy story, ever.”

“I’ve just been really impressed by the depth and volume of what is writ­ten,” Pollack wrote. “Some is produced by the expected stars. Much is produced by dozens of lesser-known but highly-skilled peers.”

A few thoughts going forward. First, as health reporters, it is our job to cover the underlying health system and how changes (both caused by the law and those happening in spite of it) are impact­ing patients.

Second, now that the law has been up­held, we have to chronicle its implemen­tation. This includes the big issues—such as whether states will set up their own ex­changes and opt into the Medicaid expan­sion—and smaller ones as well. There are literally hundreds of provisions in the law that affect states and regions.

Finally, we have to be strong advocates with editors that covering the politics of health care is not enough.

AHCJ is here to help. We have an outstanding topic page on health reform available on our website: www.health­journalism.org/reform. Updated almost daily by Joanne Kenen, our health re­form topic leader, these resources include tip sheets, explainers, a glossary and data. Joanne also blogs for Covering Health, AHCJ’s blog, which is highlighted on the health reform page.

The day after the court ruled, I mod­erated a terrific AHCJ webcast with three experts about how reporters can localize the story. If you missed it, you can lis­ten online at healthjournalism.org/ supremecourt.

As health reporters, we can’t control how political journalists and talk show hosts cover health care. But we can con­trol what we do. We owe it to the public to get it right.

Charles Ornstein, a senior reporter with Pro­Publica in New York, serves as president of the AHCJ board of directors.