“A Viewers Guide to Health Reform”

This year, news about healthcare reform will be prominent and the role journalists play in filtering what’s covered will play a huge role in the outcome. The combination of our 24/7 news cycle and the prominence of “Repeal and Replace” in Campaign 2016 means every corner of our industry will be in the spotlight. Consider last week’s storylines:

·       Georgia Representative and orthopedic surgeon Tom Price become our new Health and Human Services Secretary in the wee hours Thursday morning. He’s tasked with leading the administration’s replacement for the Affordable Care Act.

·       DC Federal Judge Amy Berman Jackson squashed the $54 Anthem-Cigna deal on the heels of Judge John Bates’ decision last month against the $37 billion Aetna-Humana merger.

·       Town hall meetings hosted by prominent Republican House of Representatives leaders Jacob Chaffetz (UT, Chm. House Oversight Committee) and Diane Black (TN, Chm. House Budget Committee) were disrupted by protests against their ‘repeal and replace’ posture drawing national media attention.

·       CNN hosted a two-hour debate between Senators Bernie Sanders (I-VT) and Ted Cruz (R-TX) on the “The Future of Healthcare” showcasing their dramatically contrasting views.

·       And the White House, in tandem with GOP leaders Ryan and McConnell, walked back their plan to immediately Repeal and Replace the ACA. Instead, their plan will be crafted by the end of the year thus assuring partisan wrangling about health reform in Campaign 2018 and beyond.

And in the next 100 days, there will be even more to coverage…

·       Insurers will learn how HHS intends to address their concerns about the individual insurance marketplaces and bigger issues about the regulatory constraints under which they’ll compete going forward.

·       The FY18 federal budget will be presented wherein how funding for Medicaid and Medicare obligations are addressed.

·       Dr. Price will commence his pro-physician strategy initiating relaxation of burdensome reporting requirements in meaningful use and suspending mandatory bundled payment programs.

·       Secretary of Veterans Affairs David Shulkin will be confirmed and advance his Veterans’ Health modernization strategy.

·       Supreme Court nominee Neil Gorsuch will begin his Senate confirmation journey which, no doubt, will draw attention to his opinions in key 10th Circuit Court cases challenging the ACA’s contraception coverage provisions (Hobby Lobby v Sebelius, Little Sisters of the Poor v. Burwell). In each, he sided with the challengers that the ACA could not compel religiously affiliated organizations to adhere to its coverage dictum.

·       4th quarter 2016 earnings announcements by health industry heavy weights in every sector will continue drawing attention to expected strong profits in the device and biopharma sectors.

·       And members of Congress, who begin a 10-day recess this week, will be in their districts hosting town halls about the future of the Affordable Care Act and their views about what’s next.

The good news: media coverage about our health system and its future is once again prominent. The bad news: some of what’s reported is misleading or factually inaccurate and it doesn’t appear the public’s better informed in spite of the avalanche of coverage. That’s the inherent risk associated with a free press and sophisticated spin machines that seek to direct popular opinion toward their particular points of view. It’s compounded by the fragmentation of the media industry itself: viewers and readers seek information from a handful of sources they trust and screen out all others.

The public’s views about our health system are not based on the reporting in Modern Healthcare, Beckers, HHN, Healthcare Executive, Health Leaders, Health Executive and other industry media sources. They’re based on network coverage, social media and prominent newspapers: each of these attracts a core audience and filters their healthcare reporting to suit their tastes. The result: opinions vary widely and vary based on the veracity of their underlying facts.  Never before has there been so much coverage of healthcare and so little consensus and undeniable facts. Who would have thought we’d hear about ‘alternative facts’ and ‘fake news’, but they’re now in the lexicon of our journalism.

Here’s my take: healthcare reform is too important to be delegated to our broken political process. While officer seekers and holders pursue public service in good faith, party machinery that controls access to campaign funding and media attention trumps meaningful discussion and informed debate. The two-hour Sanders-Cruz debate Tuesday night on CNN reflected a sharp contrast of viewpoints and a few nuggets about what “access” means and how drug prices might be contained. But for the most part, civil discourse organized by journalists seeking to inform like this debate is rare. We need more of these.

The inconvenient truth is this: the foundational concepts about our healthcare system embraced in our two-party system pit vastly different views of its future: neither party has a lock on how the health system should evolve nor a franchise on how clinical innovations might re-shape how care is delivered. The media are complicit in dumbing down the healthcare debate, allowing politicians and partisan surrogates to bark talking points sans probing of their rationale and underlying facts. (I find myself wishing members of Congress on both sides would spend more of their time studying the issues and policies they profess to understand and less time seeking TV star status). 

So here’s a viewers’ guide to the debate forthcoming about ‘Repeal, Replace, Repair and Recover’ intended for those seeking to better understand key arguments and ideas:

As the replacement or repair of the Affordable Care Act proceeds, the role journalists play in holding public officials honest and in informing the public without bias is more important than ever. Regrettably, the ubiquitous coverage healthcare gets is not resulting in a more informed citizenry. Communications about healthcare has never been more important to our industry. Perhaps local media in tandem with Chambers of Commerce might host town halls where there’s ample time for elected officials and industry stakeholders to answer questions about how their solutions might work, how proposed changes could be implemented and at what cost. Perhaps other networks will join CNN in sponsoring forums focused on specific elements of reform i.e. the future of health insurance, how unnecessary care can be reduced or how those with uninsurable medical conditions can be covered. Perhaps leading hospital, insurance and medical organizations might co-host symposia seeking to find common ground based on hard data to promote public understanding. Hopefully, this Viewers’ Guide will be a useful start, but it’s only a start. More information is needed before, as an electorate and society, we’re able to define the future for our health system. Paul

As the replacement or repair of the Affordable Care Act proceeds, the role journalists play in holding public officials honest and in informing the public without bias is more important than ever. Regrettably, the ubiquitous coverage healthcare gets is not resulting in a more informed citizenry.

Communications about healthcare has never been more important to our industry. Perhaps local media in tandem with Chambers of Commerce might host town halls where there’s ample time for elected officials and industry stakeholders to answer questions about how their solutions might work, how proposed changes could be implemented and at what cost. Perhaps other networks will join CNN in sponsoring forums focused on specific elements of reform i.e. the future of health insurance, how unnecessary care can be reduced or how those with uninsurable medical conditions can be covered. Perhaps leading hospital, insurance and medical organizations might co-host symposia seeking to find common ground based on hard data to promote public understanding.

Hopefully, this Viewers’ Guide will be a useful start, but it’s only a start. More information is needed before, as an electorate and society, we’re able to define the future for our health system.

Paul