Why Is It That So Many Reporters Seem to Know So Little about Obamacare? – Part 1

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“Just because your voice reaches halfway around the world doesn’t mean you are wiser than when it reached only to the end of the bar.” 

~ Edward R. Murrow

­­­Long before the advent of the Internet,  Edward R. Murrow, the newsman who stood up and  exposed the lies spread by Senator Joe McCarthy in the early 1950s, understood that while “the speed of communication is wondrous to behold, it is also true that speed can multiply the distribution of information that we know to be untrue.”

Murrow was right. Today, as  traffic on the information highway has picked up speed, it often seems that, the Information Age that we celebrated in the 1990s has become an Age of Misinformation .

Today, not only CBS, the network that brought us Murrow, but the media as a whole seems to have forgotten his plea to his fellow journalists: “Just once in a while, let us exalt the importance of ideas and information.”

                              The Media and Obamacare

When it comes to covering the Affordable Care Act (ACA), not only televison networks but our major newspapers have fallen far short of Murrow’s fearless standards.  Instead of ideas and information, the mainstream media serves up opinions and anecdotes.

Tall tales about “Obamacare’s victims” have become standard fare. In recent months I have deconstructed two faux fables: one that appeared in the Ft. Worth -Star Telegram,(URL), another that aired on CBS stations nationwide.

Let me add, I am just one of many skeptics who have taken a close look at some of the “ginned-up stories” that, as the Los Angeles’ Times Michael Hiltzik puts it, “have led millions  to think that a program manifestly in their best interests is something bad.” 

Hiltzik, Eric Stern, Erik Wemple, Igor Volsky,Paul Waldman, Glen Kessler,Tommy Christopher, and ColoradoPols.com   are among those who have done a superb job of fact-checking these “horror stories.”

Hiltzik detects a pattern: “What a lot of these stories have in common are, first of all, a subject largely unaware of his or her options under the ACA or unwilling to determine them; and, second, shockingly uninformed and incurious news reporters, including some big names in the business, who don’t bother to look into the facts of the cases they’re offering for public consumption.”

In some cases, it is clear that writers, editors, pundits and producers are purposefully slanting the news.  Fox News comes to mind. But in many other cases, the problem seems to be sheer ignorance, combined with a striking lack of interest in the most important piece of legislation to have passed congress in roughly 45 years.
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Gun Control: Quote of the Week

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Asked if he could outspend the National Rifle Association (NRA), former NYC Mayor Mike Bloomberg casually replied, “Oh sure.”

(Forbes estimates his net worth at $33 billion)

Bloomberg, who strongly supports gun control,  added  “I’m not the only funder of this.”

For decades, no one has been able to out-gun the NRA. I would love to see Bloomberg lead a group of benevolent billionaires (and millionaires) willing to take on this all-too-powerful organization.

 

Are You Worried That We Won’t Have Enough Doctors to Care for Millions of New Patients?

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Not long ago, I published a post on the theguardian headlined “Obamacare isn’t creating a doctor shortage, it’s solving it.”

It drew quite a bit of attention, and it occurs to me that many HealthBeat readers might well be interested in the subject. Just click on the title.

Let me suggest that you also pay attention to any legislation in your state that is designed to make better use of nurse-practitioners. .

The Ukraine: What Ukranians Have to Say

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The situation in the Ukraine is far more complicated than many realize.

Think Progress just published an excellent piece titled “Why Much of What You’ve Read About Ukraine isn’t Quite Right, As Explained by Ukranians.”

It begins: 

“Though protests had been raging in the capital city of Kyiv and cities across Ukraine since November, the eyes of the world turned sharply toward the former Soviet republic at the end of February when then-president Viktor Yanukovych fled to Russia and Russian president Vladimir Putin decided to directly insert himself in his neighbor’s internal turmoil. Citing an imminent danger to Russians living in the southern Ukrainian region of Crimea, Putin sought permission from Russia’s parliament to send military forces into Ukraine. As of Monday, Ukrainian officials said 16,000 Russian troops were in Ukraine and in a Tuesday press conference from his Moscow home, Putin said they “reserve the right to use all means to protect” Russian citizens in Ukraine, but denied having sent Russian forces there.

With all of the speculation regarding Russia’s motives and endless posturing over what’s in Ukraine’s best interest, the perspectives of those that matter most, actual Ukrainians, seem to get lost along the way. “The radical voices are always the loudest,” said Olga, a native of Sevastopol, Crimea who moved to the U.S. in 2007. “I wish there were some moderate voices in between that would be heard.”

When I was at Barron’s, I wrote about Russia and went there twice. I also have a friend who recently immigrated to the U.S. from the Ukraine. What I read in this post rings true.

You will find the rest of the post here: http://thinkprogress.org/world/2014/03/04/3356621/ukraine-russia-invasion/

 

 

Health Wonk Review Is Up

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David Harlow, author of David Harlow’s Health Care Law Blog hosts the newest edition of HWR.  Harlow offers a meaty summary of some of the most provocative healthcare posts that have appeared in recent weeks.  

–On Healthcare Collaboration, Dr. Kenneth Cohn suggests that if you want to herd cats, you probably have to let the cats figure out how to herd themselves: “Most physicians enjoy bottom-up processes more than top-down edicts.  They prefer being inspired to being supervised.  The only way that I know to develop a common culture is to allow physicians to play a role in shaping it. I agree. You can’t bribe them. You can’t bully them. They have to want to do it because they realize that if they work as a team, they and their patients will be better off.

—Over at Managed Care Matters Joe Paduda reports that recent analysis indicates that some states’ active efforts to hinder enrollment are working,, and are partly responsible for the shortfall in Exchange enrollment
He also points out that  CMS may require health insurers selling via the federal exchanges to make sure at least 30 percent of “essential health providers” are in-network in 2015.  This in response to some complaints about networks that are allegedly too narrow.
Paduda’s note: “Which is kind of ridiculous; smaller networks are better at controlling costs and that’s a BIG part of the success criteria for health reform.”  I agree. Moreover, if you Google “Consumer Reports,” and “NCQA” and “HMO’s” you will find that the best HMOs deliver higher quality care than open-ended plans.

–Writing on Colorado Health Insurance Insider, Louise Norris explains that folks purchasing health insurance on the exchanges need to be sure they understand drug formularies. An important point.

–As the demand for high tech and mobile surges, Julie Ferguson of Workers’ Comp Insider reminds us that more and more cell tower workers are being killed. The intense pressure to meet unrelenting deadlines is undermining workers’ safety.

—Brad Wright, at Wright on Health, wonders if we can make health care prices transparent so that patients can “comparison-shop.”  Wright  worries (rightly, I think, pun intended,) that even with better information, consumers aren’t likely to change their behavior much, because health care economics does not operate according to traditional market principles. When you’re sick, you’re not bargain-hunting. Most people assume (wrongly) that health care that is more expensive must be better.

—Folks from the Brookings Institution have a piece up on the Health Affairs Blog, titled “Paying For a Permanent, or Semi-Permanent, Medicare Physician Payment Fix. They emphasize  that a plan that includes “off-sets for physician payment reform that support improvements in care as well as lower costs . . . could assure beneficiaries and other health care providers that these savings are not just payment cuts that must be absorbed, but steps to help reduce spending through reforms that improve care.”

This is just a small sample of some of the best recent posts. You’ll find more here.

 

How A CBS Video About An Obamacare Victim Misled Millions- Part 2 (What the “Victim” Revealed in Our Final Interview)

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“Woman Battling Kidney Cancer Losing Company Health Plan Due To Obamacare.”

That was the headline on a story that CBS’ Washington Bureau sent to its affiliates last fall.

CBS correspondent Susan McGinnis narrates the piece: “During the 10 years that Debra Fishericks has worked at Atkinson Realty, the company has provided group health insurance with manageable premiums,” McGinnis explains –“until owner Betsy Atkinson learned the policy would be terminated because it doesn’t meet the requirements of the Affordable Care Act.

“Debra has scoured the website looking for a new policy,” McGinnis adds, referring to healthcare.gov, but “so far, she cannot afford the premiums.”

“They just keep going up higher and higher when there is a pre-existing condition,” says Fishericks.

McGinnis wraps up the story: “Debra hopes that eventually she will find a plan that fits her budget so that she can still makes trips to Indiana –to visit her grandson.”

The camera then turns to Fishericks, sitting at her desk, looking at a photo of her grandson.  “If I can’t go to see him—that’s the worst,” she says.  And she begins to cry.

I was astonished: I thought most people understood that, under the Affordable Care Act, insurers can no longer charge a customer more because she suffers from a pre-existing condition.

Later, when I interviewed Fishericks, I realized that she honestly believed she was going to have to pay more for coverage because she had been diagnosed with cancer. Like a great many Americans, she didn’t understand how the ACA would protect her. Given how hard Obamacare’s opponents have worked to obscure the law’s benefits, I probably shouldn’t have been surprised.

But what shocked me is that no one at CBS’s Washington Bureau seemed to realize that what Fishericks had said just wasn’t true: not the correspondent who narrated the story, not the reporter who went down to Virginia Beach and interviewed Fishericks, not the person who edited the video.

Fifty-eight CBS stations aired the piece. Newspapers and bloggers ran with it. Nationwide, millions of Americans were left with the impression that under Obamacare, cancer patients may not be able to afford insurance.

How had this happened?

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The French Way of Cancer Treatment–Part 1

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By Anya Schiffrin

Below, the opening of a compelling essay describing what happened when a cancer patient who was being treated at NYC’s Memorial Sloane Kettering went to Paris. (I have included a link that will take you to the rest of the essay, which originally appeared on Reuters.)

For a great many years, we have been told that the U.S. offers the best cancer care anywhere. Anya Schiffrin will make you think about whether that is true—and what we need to do.

At the end of the piece I’ve added a note (MM)

When my father, the editor and writer Andre Schiffrin, was diagnosed with stage four pancreatic cancer last spring, my family assumed we would care for him in New York. But my parents always spent part of each year in Paris, where my father was born, and soon after he began palliative chemotherapy at Memorial Sloan Kettering my father announced he wanted to stick to his normal schedule — and spend the summer in France.

I humored him — though my sister and I didn’t want him to go. We felt he should stay in New York City, in the apartment where we grew up. I could visit him daily there, bringing takeout from his favorite Chinese restaurant and helping my mother.

I also didn’t know what the French healthcare system would be like. I’d read it was excellent, but assumed that meant there was better access for the poor and strong primary care.. Not better cancer specialists. How could a public hospital in Paris possibly improve on Sloan Kettering’s cancer treatment? (my emphasis–mm)

After all, people come from the all over the world for treatment at Sloan Kettering. My mother and I don’t even speak French. How could we speak to nurses or doctors and help my father? How would we call a taxi or communicate with a pharmacy?

But my dad got what he wanted, as usual. After just one cycle of chemo in New York, my parents flew to Paris, to stay in their apartment there. The first heathcare steps were reassuring: my parents found an English-speaking pancreatic cancer specialist and my dad resumed his weekly gemcitabine infusions.

My parents were pleasantly surprised by his new routine. In New York, my father, my mother and I would go to Sloan Kettering every Tuesday around 9:30 a.m. and wind up spending the entire day. They’d take my dad’s blood and we’d wait for the results. The doctor always ran late. We never knew how long it would take before my dad’s name would be called, so we’d sit in the waiting room and, well, wait. Around 1 p.m. or 2 p.m. my dad would usually tell me and my mom to go get lunch. (He never seemed to be hungry.) But we were always afraid of having his name called while we were out. So we’d rush across the street, get takeout and come back to the waiting room.

We’d bring books to read. I’d use the Wi-Fi and eat the graham crackers that MSK thoughtfully left out near the coffee maker. We’d talk to each other and to the other patients and families waiting there. Eventually, we’d see the doctor for a few minutes and my dad would get his chemo. Then, after fighting New York crowds for a cab at rush hour, as my dad stood on the corner of Lexington Avenue feeling woozy, we’d get home by about 5:30 p.m.

So imagine my surprise when my parents reported from Paris that their chemo visits couldn’t be more different. A nurse would come to the house two days before my dad’s treatment day to take his blood. When my dad appeared at the hospital, they were ready for him. The room was a little worn and there was often someone else in the next bed but, most important, there was no waiting. Total time at the Paris hospital each week: 90 minutes.

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Single-Payer Health Care: Is That What Makes France So Different? (The French Way of Cancer Care – Part 2)

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In “The French Way of Cancer Treatment,”  Anya Schiffrin writes eloquently about the care that her father, Andre Schiffrin, received when he was diagnosed with stage-four-pancreatic cancer, and decided that he wanted to go to France, his birthplace, for treatment. Schiffrin had been undergoing chemotherapy at New York City’s Memorial Sloane Kettering, and his family was concerned: how could a public hospital in Paris compete with a world-class cancer center?

To their amazement, they discovered that “the French way” of caring for a cancer patient was much better suited to Schiffrin’s wants and needs—and this was not because he had been born in France.

At the end of her essay, Schiffrin suggests that “the simplicity of the French system meant that all our energy could be spent on one thing: caring for my father.”  Back in New York, she confides, “every time I sit on hold now with the billing department of my New York doctors and insurance company, I think [of] all the things French healthcare got right.”

                                      A Hybrid Public/Private System

 Many readers might assume this means France has a single-payer system, and that is the key to its simplicity and success. But in fact, France relies on a hybrid system that is not unlike Obamacare. The government picks up the tab for only about three-quarters of the nation’s healthcare bill.

(In 2013 the U.S. government paid for roughly 48% of medical care, though, this year, with the expansion of Medicaid, and millions of uninsured and under-insured Americans joining the Exchanges where the majority will receive government subsidies, Washington will cover more of the bill.  And in the years ahead, as baby- boomers age into Medicare,  government’s share will grow.

In France, “everyone is covered to a certain extent by the government’s Assurance Maladie,” explains Claire Lundberg, a New Yorker now living in Paris where she recently had a baby. “But most people also have private insurance, called a mutuelle that is either offered through their employer or bought on the private market. There’s a thriving private insurance market in France. . .  Private medical insurance is advertised on the sides of buses and alongside movie previews in theaters.”

Ninety-two percent of the French have supplemental private insurance. Many are insured through their employers, as they are here.  Patients pay 7 percent of all health care costs out of pocket.

In France payroll taxes, paid by both the employer and the employee, along with income taxes help finance the 73% of the  bill that the government covers. All told, French workers contribute around 13% of what they earn to the public sector healthcare fund.

Government Regulation Means Lower, Transparent Pricing

 While the French government does not pay all healthcare bills, it does regulate prices. Because it sets fees for medical services, pricing is transparent

This is why, in France, Schiffrin didn’t have to spend hours on the phone talking to her doctors’ and insurers’ billing departments. There was no uncertainty as to what doctors and hospitals would or should be paid.

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Subsidies: Would You Qualify? Consumer Reports Has A User-Friendly Tool That Will Tell You

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Check out this online tool from Consumer Reports. It allows you to quickly and easily find out if you–or a relative–would be eligible for a subsidy. A great many young people don’t realize how little insurance would cost after applying the tax credit. Do them a favor, and find out for them. https://www.healthtaxcredittool.org/

Why Are So Many Americans Confused About Obamacare? How a Video Produced by CBS’ Washington Bureau Misled Millions –Part 1

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For nearly four years, poll after poll has shown that the majority of Americans remain flummoxed by Obamacare.  Many are confused; some are afraid. They don’t know what the Affordable Care Act (ACA) says, and they don’t know how it will affect their lives

From the beginning, many in the media have blamed the White House.

Early in 2011, when a CBS poll showed that only 56% of Americans said the bill’s impact had not been explained well—or even “somewhat well”– CBS senior producer Ward Sloane summed up the prevailing view: “To me, that is a Monumental Failure by the Obama Administration. . . . [my emphasis]  And it opens up a big hole for the Republicans which they have driven through with, you know, several tanks.”

Because Democrats had botched explaining the legislation, Sloane argued, Republicans “can say whatever they want about the healthcare bill … whether it’s true or not, and  . . . it will resonate . . .  People are afraid. People are afraid of things that they don’t understand and they don’t know. . . The Republicans are playing to this fear and they’re doing a masterful job.”

Sloane slid over the role that reporters might play in helping the public understand an enormous—and enormously important– piece of legislation.  If Republicans were spreading disinformation, shouldn’t news organizations like CBS try to separate fact from fiction?

Network and cable news shows are in our living rooms every evening. President Barack Obama and Health and Human Services Secretary Kathleen Sebelius are not. In speeches and in press conferences Obama and Sebelius can address a handful of questions, but they cannot explain the hundreds of interlocking details that will benefit millions of Americans. The public needs an independent, informed press that will dig into the major provisions of Obamacare and explain them, not once, but again and again.

There was just one problem: As Sloane suggested, the Republicans were doing “a masterful job” of misleading the public. What he didn’t take into account is that journalists are part of “the public.”

                      The Networks Spread Fear and Confusion

Fast forward two years to the fall of 2013.

Little has changed; most Americans still don’t understand the Affordable Care Act, and many are convinced that they have been betrayed by the president they elected.

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