Tag Archives: obama

AHCJ, other journalism organizations protest removal of data from public website

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 AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

The Association of Health Care Journalists, joined by the Society of Professional Journalists and Investigative Reporters and Editors, sent a letter to the Obama administration today protesting its decision to pull offline a public database of physician discipline and malpractice payments.

Read the letter sent by the journalism organizations to Mary K. Wakefield, administrator of the Health Resources and Services Administration.

Stories using the NPDB

The Kansas City Star

• Doctors with histories of alleged malpractice often go undisciplined
• Obama’s HHS shuts down public access to doctor malpractice data

Duluth (Minn.) News Tribune

• AHCJ article: Duluth News Tribune exposes malpractice allegations
• As Duluth hospital reaped millions, surgeon racked up complaints
• Multiple allegations against former St. Luke’s doctor
• Ailing patients speak out about former Duluth doctor
• Wisconsin restricts former Duluth doctor’s license
• In Texas, former Duluth surgeon may be sanction-free
• Federal database of malpractice cases doesn’t make public doctors’ names, or where they practice

Propublica

States Fail to Report Disciplined Caregivers to Federal Database

St. Louis Post-Dispatch

• Reporters encounter hospital’s lack of transparency
• Tip sheet from Bernhard & Kohler on researching health professionals.
• Award entry: Who Protects the Patients?
• Serious medical errors, little public information
• Caution urged with facedown restraints
• Doctor lost hospital privileges but kept clean record
• Girl, 16, dies during restraint at an already-troubled hospital

Milwaukee Journal-Sentinel

• Dangerous Doctors
• AHCJ article: Records show ‘dangerous doctors’ rarely face discipline
• Tip sheet from Gina Barton on state oversight of health professionals

Connecticut Health Investigative Team

• Disciplined Docs Practice Freely In State

West Hawaii Today

Medical malpractice in Hawaii
Diagnosis-related claims among top reasons for suit

Public Citizen

• Hospitals avoid reporting disciplined docs: The nonprofit group released a report showing that hospitals nationwide are taking advantage of  loopholes to avoid reporting disciplined physicians to a national database.  The Miami Herald‘s John Dorscher, the Detroit Free Press‘s Patricia Anstett and the Contra Costa Times‘ Sandy Kleffman reported local versions of the story that are no longer available online.

Earlier stories about access to NPDB:

• Data Mine reports on access to practitioner data: The Center for Public Integrity focuses on the National Practitioner Databank and the lack of public access to information in the database.
• Access to list of disciplined health workers in limbo: NPR’s Joseph Shapiro looked into the status of the Healthcare Integrity and Protection Data Bank.
• Public Citizen posted an open letter to HHS Secretary Kathleen Sebelius explaining why the database is important, and details the consequences of keeping it under wraps.

AHCJ, SPJ and IRE called for the government to immediately restore access to the Public Use File of the National Practitioner Data Bank. The government has made this file available online for years, and reporters have used it to call attention to lax oversight of physicians across the country.

Pursuant to the law, the public version of the database does not identify physicians by name or address, but it does provide other useful information about hospital sanctions, malpractice payouts and state disciplinary actions against every doctor in the country.

As an example, the database would allow a reporter or researcher to discover that certain, unnamed physicians have been sanctioned repeatedly by their hospitals but never were disciplined by their state’s medical board. It would also be possible to find doctors with lengthy trails of malpractice who continued to enjoy clear licenses.

The groups also expressed their deep disappointment that the U.S. Health Resources and Services Administration threatened a reporter from The Kansas City Star with financial penalties if he proceeded to write a story about a local neurosurgeon using information he gleaned from the public version of the database on the agency’s website. The newspaper published its story anyway on Sept. 4. The doctor’s attorney complained to the agency, prompting officials to remove the database from its website on Sept. 1.

The government said that it had to act now because reporters were able to link information in the data bank to specific doctors, and the law prohibits the public use file from identifying doctors. A HRSA spokesman said the data bank will be offline for at least six months and may never return unless the physician privacy concerns are adequately addressed.

AHCJ President Charles Ornstein said he was puzzled by HRSA’s sudden action because reporters have used the public version of the data bank for years to assist in their reporting and learn additional details about physicians they already had been researching.

“We are troubled that the Obama administration appears to have placed the interests of physicians ahead of the safety of patients,” Ornstein said. “Attempting to intimidate a reporter from using information on a government website is a serious abuse of power.”

Stories written by reporters using the public version of the National Practitioner Data Bank have drawn attention to troubled physicians and state inaction. Recent examples include the St. Louis Post Dispatch, the Duluth (Minn) News-Tribune and the Star. Other examples over the years have included The Hartford (Conn.) Courant and the Raleigh, N.C., News & Observer.

Some of these stories have resulted in new legislation and other steps that protect patients, by increasing transparency and sometimes toughening requirements on doctors.

The groups wrote that if HRSA determines the public version of the database violates the law in any way, it should seek swift legislative changes to remedy the problem and once again make the database available.

“In one stroke, the very administration that promised greater transparency not only excludes information of obvious public value to patients across this country but threatens legal action against a reporter for using public records,” said SPJ President Hagit Limor. “This is clearly outrageous.”

IRE President Manny Garcia said, “The removal of the Public Use File – whose very name means for public use – eliminates a valuable tool for journalists whose goal is to educate and protect the public. This database has allowed reporters to uncover flaws that have toughened legislation, and without a doubt, saved the lives of patients across the country.

“We are also stunned that a public servant has the hubris to threaten a health care reporter for doing his job. HRSA should be delighted that journalists are using public information to help saves lives, but in this instance the response is: get lost or get fined.”

HHS unveils ‘National Prevention Strategy’

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Today, in a live webinar and a companion piece in the New England Journal of Medicine, the Department of Health and Human Services released its “National Prevention Strategy,” a broad effort to realize the preventive care goals set forth in the Affordable Care Act. The specifics of implementation are still taking shape, but the release centered around four primary talking points:

  • The ACA seeks to “remove cost as a barrier” to “clinical preventive services,” by requiring new private plans to cover preventive services in the “strongly recommended” and “recommended” categories (examples include certain vaccines and screening procedures) with no cost to the beneficiary. Medicare will take a similar approach, and state Medicaid plans will be incentivized to do the same.
  • It promotes workplace wellness initiatives through new grants and a re-evaluation of existing programs.
  • It seeks to involve communities and local governments through community-based efforts. “Community Transformation Grants,” for example, “promise to improve nutrition, increase physical activity, promote smoking cessation and social and emotional wellness, and prioritize strategies to reduce health care disparities.”
  • It makes preventative health a federal priority through “a newly established National Prevention, Health Promotion, and Public Health Council, involving more than a dozen federal agencies,” which “will develop a prevention and health promotion strategy for the country.” It also promises a “national strategy to improve the quality of health care,” and “improved data collection on health disparities.”

In addition to the four big messages, HHS officials pointed to initiatives designed to address specific, salient concerns such as smoking, obesity and the looming shortage of primary caregivers.

Presidents of AHCJ, SPJ call for more openness from Obama administration

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 AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

The presidents of the Association of Health Care Journalists and the Society of Professional Journalists published an op-ed in The Washington Post this morning, criticizing the lack of openness within the Obama administration and calling on officials to improve the flow of information to journalists and the public.

Charles Ornstein

Charles Ornstein

“Democrats criticized the Bush administration for not making decisions based on the best science,” wrote AHCJ’s Charles Ornstein and SPJ’s Hagit Limor. “But the Obama administration now muzzles scientists and experts within federal agencies. When they are allowed to talk about important public health issues, a chaperone often supervises every word. These constraints keep the public from learning whether decisions are science-based or politically motivated.”

AHCJ has been very active in advocating for government openness, including a recent series of meetings in Washington, D.C., with officials from the U.S. Department of Health and Human Services and its related agencies. The organization has urged the FDA to re-examine a policy that prohibits reporters from sharing embargoed materials with sources before the embargo lifts for the purpose of obtaining outside comment and context. Board members from AHCJ also have worked with state health directors to encourage dissemination of more information during public health outbreaks.

“We remain hopeful that our ongoing conversations with HHS and its agencies will help improve the current climate, which isn’t working for journalists or the public,” Ornstein said. “Our members are interested in timely, meaningful responses to their questions, additional access to scientists and health experts, and speedier responses to their Freedom of Information Act requests.”

Lieberman: Election is evidence media got reform coverage wrong

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In her column on CJRorg, AHCJ Immediate Past President Trudy Lieberman writes that this week’s elections showed just how thoroughly the media missed the mark on health care reform coverage.

After the economy (62 percent), health care (19 percent) was the second most important issue to voters. And while the media (and the administration) trumpeted the benefits of health reform and “glossed over” the drawbacks, public opinion soured. The biggest oversight, Lieberman writes, was the national insurance mandate, a policy that was more Republican than Democrat.

Lieberman says it best:

If the media failed to discuss in detail the law’s less attractive points, it also missed one of the campaign’s biggest ironies. Republicans, with their repeal and replace slogans, stirred up discontent about a law that was basically built with Republican and conservative ideas. That irony escaped the media.

She doesn’t explicitly frame it as such, but Lieberman’s column leaves me with the distinct impression that with the health care debate reignited by a Republican landslide, journalists are being given a second chance to provide the public with a clear understanding of what’s going on in Washington, an impression that’s cemented with her final sentence:

Whatever happens, the U.S. health system is still its dysfunctional, fragmented, costly self, in need of repair or wholesale reform. Going forward, this is the story the media need to tell.

Understanding the administrative side of implementation

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Coverage of health care reform implementation has generally focused on the issues and effects of the roll-out, rather than the arcane governmental mechanisms involved. It makes sense, of course, as “here’s how you can now get coverage despite your pre-existing condition” is significantly more relevant to most readers than “23 states miss federal 90-day deadline for creation of high-risk pools, partly because already established pools don’t always conform to reform requirements, and partly because it’s too much hassle and they’d rather let the feds do it for them.”

Service-oriented as it may be, this focus has led to a few gaps in my understanding of the administrative moving parts involved in implementation. Which is why the Robert Wood Johnson Foundation’s guide to state and federal roles in the implementation of health care reform is such a handy document. It’s worth a quick scan, if only to give all those implementation stories a little context. It’s got everything from “how informal rulemaking becomes law” (hint: it involves both “notice” and “comment”), to the aforementioned business about why some states ceded control of their high-risk pools to the federal government. And it’s only four pages long.

Get up to speed on Sept. 23 insurance changes

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Start with this primer from the AP’s Carla K. Johnson, an AHCJ board member. The big lesson is that you’ll see some changes, but only if your insurer has changed your plan significantly since the reform law went into effect on March 23, 2010. And, as we’ve established, insurers are very cognizant of these dates and are managing plans accordingly.

Johnson’s article (and others like it) emphasize the big-picture, top-level implementation issues, but things start getting more interesting when the rubber hits the road and each state sets up a slightly different system. For more on how each state is a unique reform lab, see Lynn Blewett and Sharon Long’s piece in the Health Affairs Blog.

From there, the gaps are filled by a slew of specialized articles detailing how reform will impact different sectors of the population. Some issues to look for:

A number of major insurers appear to be playing a high-stakes game of chicken with regulators over children’s health coverage. As N.C. Aizenman reports in The Washington Post, insurers like Anthem, Humana, WellPoint, Cigna and Aetna have decided to “stop offering new child-only plans, rather than comply with rules in the new health-care law that will require such plans to start accepting children with preexisting medical conditions after Sept. 23.”

The insurers cite “uncertainty” in the market, a concept which Julie Rovner ably explains in the NPR health blog. The issue, industry representatives say, is that the law would effectively allow children to sign up for insurance after they get sick, which may not be conducive to a sustainable business model for the companies. It is, after all, the very dilemma that led to the universal mandate vs. no denial for pre-existing conditions tradeoff which forms a key pillar of health care reform legislation.

More about children’s coverage

Q&A: Extending children’s health coverage, Chicago Tribune
Health reform: Will your kids be covered? Reuters Finance
New Health Law’s Protections For Adult Children Start Tomorrow
, Kaiser Health News & USA Today

College kids
5 Ways Health Reform Affects College Students, U.S. News & World Report

Small businesses
Lightening the Health Care Load for Small Businesses, The New York Times

The long-term ill
Insurance Companies To Remove Benefit Caps, WBUR

The overweight and others in need of preventive care
Few Insurers Provide Coverage For Weight Loss Treatment, Kaiser Health News

And, of course, politicians
A Tale of Two Campaigns: Repeal vs. Reinforce, California HealthLine

Tool for tracking implementation

The Kaiser Family Foundation has added “Health Reform Source” to its stable. The site is dedicated to helping readers understand laws and regulations behind health reform, and to tracking their implementation, both locally and nationally. The site’s heavy on graphics, video and nifty interactive bits.

For those just looking for a feed full of reform implementation news to add to their Google Reader, I recommend The Scan (RSS) which, though Kaiser heavy, includes reports from all over.