Anecdotal evidence: Little details make a huge difference in story examples

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Published on
June 1, 2009

Don't you want to help this woman out?

Renata Celona lost both of her parents at a young age, victims of high blood pressure, the second leading preventable cause of death.

She checks her blood pressure at least once a day, avoids salt and tries to squeeze in trips to the gym between working two jobs and raising three kids on her own.

"I tell my kids that I am always going to be there for them," Celona, 47, says. "Even if I can't always pick them up from school, they know I will be tucking them into bed at night."

She takes a generic medication for her high blood pressure, but there's a new drug on the market that promises even better results. Trouble is, her insurance won't cover it. Renata is considering taking on a part-time job at night just to pay the $500 a month it would cost to buy the drug, called Cardeze.

This is the type of story that is written or broadcast nearly every day by health care reporters, especially now that health care reform is back on the political agenda.

It resonates because so many people know someone like Renata or are living her exact situation, albeit with a variation on the medication: a cholesterol drug, a diabetes drug, an arthritis drug. She is an instant sympathy winner. She's trying to do the right thing and her insurance company and the drug company are conspiring against her, in a way.

But what if you change one small detail?

She takes a generic medication for her high blood pressure, but there's a new drug on the market that promises even better results.

Trouble is, her insurance won't cover it. Renata is considering taking on a part-time job at night just to pay the $500 a month it would cost to buy the drug, called Cardeze. Her doctor says there is no medical reason to switch drugs, but she says she wants to be as happy and as worry free as the people in the Cardeze advertisements.

"I know it sounds silly, but they just look like they don't have a care in the world," Celona says. "I'm hoping the drug can do that for me, too, because, Lord knows I have enough worry in my life already."

Sympathy disappears. Is this woman crazy or just stupid? Should the state take her kids away?

This is exactly the reaction that people had when they participated in a recent study by the Center for Healthcare Decisions and were presented a similar set of facts. I spoke with the center's director, Marge Ginsburg, last month in advance of her group's "What Matters Most" report. The report is out, and it's full of interesting findings about what people value in health care coverage. Some of the results are especially instructive for reporters trying to find that perfect anecdote. Give it a read, and pay special attention to the section that shows comparisons between case studies.

As might be expected, a lot of weight was given to whether the treatment was medically necessary. About 86% of people supported insurance coverage for a generic drug that would help someone like Celona. But when told that a switch to a brand name drug was not medically advised, that support dropped to 46%.

People also care about personal responsibility. Are patients trying to help themselves or just waiting for a doctor or a drug to fix their problem for them?

And people are divided when it comes to personal fulfillment. Tell people that a knee surgery would help a person walk without pain, and support for insurance coverage for knee surgery hits 90%. If the knee surgery is mainly to help a person play recreational soccer, then support falls to 63%.

This is a great way to help you think about your audience before you even start reporting a story. Who best illustrates the trend you are trying to describe or problem you are trying to uncover. Nobody is a perfect example, and you should try to show them, unsightly (but non-life threatening) birth marks and all.