Covering Dollars and Doctors

By Ashley Macha

Health care in the United States is a broad and often complicated topic that holds a high-interest for the public and makes for an interesting and necessary business story. With the amount of money spent on doctor visits, surgery and insurance on the rise coupled with a changing economy, business reporters should remain on their toes about what to cover next.

In fact, when Marshall Allen, a health care reporter for the Las Vegas Sun, was starting out he was surprised that every story is really a business story. Health care, he said, is really just about money.

Shannon Brownlee, a freelance health and business journalist, whose stories have appeared in The New York Times Magazine, BusinessWeek and The Washington Post, among others, agrees, but noted that covering the business side of health care does have its own peculiarities. She said business reporters should always remember that health care doesn't work like other markets.

“The usual assumptions that we have about supply and demand don't hold true in health care, and the failure to understand that underlies much of our failure to contain health care costs,” Brownlee said.

In the medical industry, Brownlee said demand does not determine supply. It is instead based on a variety of other factors including the personal and career agendas of medical professionals. “It is not patient demand that determines what doctors deliver, the doctors control that,” she said

With that in mind, here are three health care issues seasoned reporters suggest paying attention to:

1. Health reform: As the presidential elections head toward a November finish, proposed health care plans, initiatives and reforms will remain a part of our national dialogue. Allen said reform is significant issue because it affects insurance companies, Medicaid, Medicare, the uninsured and the cost for health care. Thus, business reporters should keep a heavy eye on politicians and their plans. “The reality of reforming the system is so complicated,” Allen said. With pharmaceutical and insurance companies as powerful as they are right now, they will be fighting presidential health care reform every step of the way, he said. As a result, business reporters should stay educated on the reform policies and which health insurance or pharmaceutical companies are playing. These stories will only heighten when a new president is elected.”
2. Medical device technology: The health care market sees an influx of new – and often hyped –medical devices on a regular basis, but what are the impacts of these often pricey innovations? While a wider use of medical technology has been said to improve the quality of care and reduce medical errors, there are two sides to the issue. New medical technology also is often quite costly not only for medical centers or doctors who purchase new devices, but the investment can subsequently raise the price of their services, affecting patients.“Business reporters have been letting the device industry have a free ride,” Brownlee said. Often the evidence or research for improving health isn’t there yet for a device, but the high premium is already paid, she said. Allen said electronic health records (EHR) is a particularly notable topic for business journalists.The product has created skepticism among doctors and medical centers who believe that switching paper documents to electronic versions will cost more in the short term, whether from worker time spent transferring records or the cost of the actual technology.
3. Biotechnology: Biomedical research is widespread  all over the world, but often, it comes at a price. “These products are hard to make and harder to make them work in people,” Brownlee said. “And it is highly expensive.” Furthermore, without a proper understanding of research and thorough reporting, journalists run the risk of spotlighting a product or technology not yet proven clinically effective. And coverage can stimulate  momentum within the public sector that is hard to reverse – leading to unnecessary costs. At a bare minimum, business journalists must have an understanding of the company behind a specific product,  how much it costs, how far along it is in the clinical pipeline and what insurance companies will  cover the cost.

Copyright © 2008 Donald W. Reynolds National Center for Business Journalism