In the first of a three-part series on health care costs in America, NPR’s Alix Spiegel tells the story of the birth of the Dartmouth Atlas, how some of its founder’s earliest research changed the health care delivery system in Maine and what it tells us about health and money. Spiegel unspools the story as a series of questions, the answer to each of which pushed researchers and physicians closer to an understanding of what drives health care costs in America.
The story kicks off in the mid ’60s when John Wennberg, now famous (among health reporters, at least) as the father of the Dartmouth Atlas, got a grant to study the best way to expand health technology to rural Vermont. To answer that question, Wennberg asked what health care was actually delivered in the state. From there, he discovers massive geographical differences in the frequency of procedures such as hysterectomies, and the questions and answers tumble neatly into line like so many dominoes.
Part two of the series, focusing on how active patient participation drives up costs, will air next week on NPR’s Morning Edition. In the third installment, Spiegel will examine the cost impact of direct-to-consumer advertising of prescription drugs.
A new NPR series, Dollar Politics, looks to, both figuratively and literally, turn the camera away from the politicians up on stage and train it on the army of lobbyists and special interest representatives that has descended upon the city.
Between 1998 and 2008, the number of registered lobbyists on health care more than doubled, to 3,627, according to the Center for Responsive Politics. The statistic doesn’t include players who don’t engage in lobbying as defined by federal law — among them, grass-roots organizers, producers of TV campaigns and former members of Congress who remain in Washington as senior advisers to corporate clients.
Spending on lobbying jumped even higher over the past decade. Organizations lobbying on health care spent $484.4 million in 2008, more than two and a half times the spending in 1998.
In addition to looking at where the money is coming from and why its being spent, NPR reporters Peter Overby and Andrea Seabrook also considered the effects of this massive cash infusion, writing that with so many interests pushing and pulling on every decision, gridlock may set in. As the series goes on, they hope to track even more of the money and connect the lobbying dots.
NPR’s April Fulton recently blogged about a phenomenon familiar to anyone with a subscription to the FDA’s recall e-mail list, or their RSS feed, or their Twitter account: a late rush of random recall messages that would require a prohibitive amount of time to sort and research. For example, in a two-minute span on June 15, @FDArecalls on Twitter buzzed with messages about multivitamin labels, fish, organic chocolate peanuts, white peppers and soy sprouts. Fulton also notes that many of the notices come out late in the day.
She proposes some sort of flagging or rating system to make it easier to figure out which stories are big deals and which aren’t. She may be on to something. The FDA could make these releases more accessible and useful for journalists and consumers. At the very least, it should be possible to explain the location and magnitude of the public health danger in a way that could be understood at a glance.
What other tips or tricks help you figure out which recalls are relevant to your readers? Do you have suggestions as to how the FDA could makes its releases more accessible or useful? Let us know.