By Carol Eisenberg
Keep in mind that everything associated with the Affordable Care Act – everything – is filtered through the lens of partisan politics.
A good example is the controversy over the price tag on insurance policies to be sold in the online insurance marketplaces or exchanges. Foes of the health care law argue the law is driving up premiums. Supporters contend it will make coverage more affordable. Each side is likely to be partly right and partly wrong, and it is your job to parse that. (See this “Covering Health” post for more specifics on this issue.)
The first caveat is that making apple-to-apple price comparisons will be impossible since the new policies must cover a package of so-called essential benefits, which were not required in the past.
Second, whether your insurance premiums go up or down will depend on your age, sex and health status. Most analysts are predicting that young, healthy men will likely be paying more for an individual health policy than they would have in the past – but they’ll also be getting much more comprehensive policies for their money and have no yearly or lifetime limits on coverage. Many of them will also be eligible for subsidies. Older, sicker people who might have been rejected for coverage in the past will be able to purchase it; others will pay less than they had since they cannot be charged more because of chronic health issues – and only so much more for their age. So the picture is a complicated one.
Check with expert sources and don’t settle for either side’s sound bites.
Understand that health care is a big business – and the business models are changing under the health law.
When a hospital (including a nonprofit hospital) announces a new service, be it a trauma center or a hyperbaric medicine department, assume there is more than public service at play. How profitable is the new service expected to be? What is the expected downstream effect in terms of generating referrals to profitable lines at the hospital? What is the evidence of need? How does this reflect the hospital’s effort to grow a particular line of business in a competitive marketplace?
Answers to these questions can sometimes be tough to get from local hospital officials, but can be addressed by consultants, academics, consumer advocates and, in the case of medical issues, by medical experts at the various specialty boards.
Don’t take a pitch, or a press release, at face value.
Assume that the organization (doctors, hospital, business) pitching a story will profit from it – and watch out for words like “groundbreaking,” “breakthrough” and – above all – “miraculous.”
Find out what independent experts have to say about the development, whether it’s significant and, if so, why. If the story is about a new screening test, for instance, what evidence is there that it leads to better outcomes, not just earlier detection of disease? What is the cost? Is it more or less expensive than the approach used now? What risks might be associated with it? Do the doctors promoting it have a conflict of interest? Talk to consumer groups, industry experts and academics who might provide broader context.
Given the unsustainable growth in U.S. health care costs, never forget that one person’s (or hospital’s or medical specialty’s) revenue is another’s cost.
Avoid the jargon trap.
Try not to write the way doctors and even worse, health policy wonks, talk. Stories should read like real people talk – or else your readers, viewers and listeners could be awash in jargon and acronyms. Admittedly, some of the concepts we write about are not simple. All the more reason to explain them in ways that people without advanced degrees in health policy or microbiology can understand.
There are groups that try to help journalists translate challenging medical and health policy concepts – among them, consumer and disease advocacy groups such as the Alliance for Health Care Reform, the Commonwealth Fund and the Kaiser Family Foundation (of which Kaiser Health News is an editorially independent program). Use AHCJ’s Health Policy glossary and key concepts resources to translate. This tip sheet on coaxing everyday language from your sources may be helpful.
Ask yourself why your Aunt Agatha should read your story.
In other words, why is the development significant? What is its impact on consumers, or on the health care system or on society as a whole?
The story should answer what is potentially changing – and include the caveats.
Carol Eisenberg, a senior editor at Kaiser Health News, has spent more than 30 years as a reporter and editor.
