Health Reform: Where Do Journalists Go From Here?

Here's a recap of the latest developments on the health reform front, along with some helpful resources and story ideas for your community.

March 21, 2010, 10 p.m. PST

219 to 212. That was the historic vote that pushed health reform legislation over the top after a century of previous efforts failed. Now it's off to the Senate, but not until at least Tuesday, when President Barack Obama is expected to sign the bill. The legislation faces legal challenges in Virginia, Florida and South Carolina, just for a start, but it was the Democrats' night. "This is what change looks like," Obama said in brief remarks just before midnight EST.

March 21, 2010, 4 p.m. PST

Anti-reform protestors rallied outside the U.S. Capitol as members of the U.S. House of Representatives prepared for their historic vote on health reform legislation. By afternoon, Democrats were reporting that they had more than the necessary 216 votes for passage after a deal cut with anti-abortion Democrats including Bart Stupak. Stay tuned here for more updates and check out the New York Times' Prescriptions blog, which is live-blogging the proceedings today. You can also find resources for local react stories at ReportingonHealth's Accidental Wonk blog.

February 22, 2010 President Obama publishes his proposed health reform compromise on the White House website in advance of the Feb. 25 bipartisan health reform summit and the criticism begins. The biggest news in the plan: a proposal giving the federal government the power to prevent health insurers from levying large rate increases like Anthem's 39 percent rate increase in California. Here's a New York Times analysis of the Obama plan, some criticism from Republicans and Jonathan Cohn's analysis.

February 1, 2010

Democratic leaders publicly put job growth on the front burner - but quietly continue to work on salvaging health reform legislation, which had been passed in both houses and was close to reconciliation before Scott Brown's upset win in Massachussetts.

January 19, 2010

The election of Massachusetts Republican Scott Brown to the U.S. Senate seat held by the late Sen. Edward Kennedy throws pending health reform legislation into chaos.

December 24, 2009 

The U.S. Senate passed its historic health reform bill this morning. By the numbers: A 60 to 39 vote. A 10-year, $871 billion piece of legislation. The potential for covering 31 million uninsured Americans. Now begins the reconciliation process between House and Senate reform bills.

Reuters has a forward-looking analysis of what's going to be a highly partisan and fractious reconcilation negotiation. Jonathan Chait, writing for The New Republic, offers a partisan but comprehensive overview of the politicking that led up to this point. The Washington Post's Ezra Klein has been asking health policy experts what they'd like to see added to a reconciled bill, which offers some future story angles for reporters. Scott Hensley at NPR's health blog has a good wrap-up of the key react quotes of the morning, and the Associated Press also offers assorted reactions from key players. 

Kaiser Health News offers a consumer's guide, in Q&A form, to next steps and how health reform will affect the average American. 

If you're looking to calculate how much people might save under both the House and Senate bills, check out this handy subsidy calculator from the Kaiser Family Foundation, a health policy think tank.

And, for a bit of comic relief, read this recap of Senate Majority Leader Harry Reid's (D-Nev.) "no-I-mean-yes" vote on the bill he shepherded.

After you're done with your person-on-the-street react coverage, scroll down for some more story ideas, or just click here.

Oh, and Merry Christmas!

December 21, 2009

The U.S. Senate's health reform bill is almost a done deal, thanks to a 1 a.m. vote today. Now you're looking for fresh ways to cover the health reform debate in your community, during a slow holiday week, no less. (Thanks, senators!)

First, a brief round-up of the coverage: The New York Times has a definitive recap of the historic, if procedural, vote and a detailed overview of the goodies obtained by holdout senators in exchange for their votes. The Christian Science Monitor reviews what will happen next and the San Jose Mercury News examines when Americans will start to see changes from health reform legislation.

And some resources for the wonks in the room: The Wonk Room, policy blog of the Center for American Progress, compares the current and previous Senate bills here.  The Commonwealth Fund has an updated overview of the provisions of the various bills here, and a worthwhile blog post examining the cost of inaction on health reform proposals during the Nixon, Carter, and Clinton administrations. In the Accidental Wonk blog, I recently highlighted two reports on the impact of health reform on Californians and must-read blogs for anyone covering health reform.

Scroll down for some story ideas, or just click here.

November 9, 2009

So, health reform. Your editor is on the prowl for new angles after the U.S. House of Representatives passed a historic bill over the weekend. From you. Today.

No, you can't cover Sarah Palin's rehashing of her previous death panel comments on Facebook. (Well, please resist the impulse.)

Before you get started, read these incisive overviews from bloggers Jonathan Cohn, Bob Laszewski and Ezra Klein. Take a bit more time to read David Leonhardt's examination of health care costs in Sunday's New York Times Magazine. Then, start thinking about what's local and what's doable. The trick for journalists who aren't based in Washington and aren't covering the legislative sausage-making is to not focus on the bill's minutiae (as interesting as some of it might be). It's to hone in on the big picture issues that will resonate with your audience.

Here are some ideas:

1. What is this going to cost me? Because the bill will go through many changes in the coming months as it is meshed with whatever bill comes out of the U.S. Senate, it's difficult to answer this question right now. That doesn't mean you shouldn't be talking to people in your community about their current health care costs, how those costs affect how they receive care, and how they might be planning for the changes ahead.

2. Rationing care. With all the dire warnings from health reform critics about how health care will be rationed in the future, it's clear to most of us that care is rationed under our current system. It's a good time to check in with your local safety net clinics and public hospitals to find out how they care for uninsured or underinsured people who need expensive treatment such as chemotherapy or organ transplants. Do they simply wait for care or not get it at all?

In addition, here are some ideas from a previous Accidental Wonk blog post about localizing the health reform debate.

3. State-level reform. What small health reforms are percolating in your state while the national debate plays out? California tried to come up with its own version of health reform in 2007 and failed. Now, the state's budget crisis means a bit of nibbling around the edges, says Anthony Wright of the California advocacy group Health Access. For example, California Gov. Arnold Schwarzenegger recently signed a bill preventing gender discrimination in the cost of health insurance policies. When health reform passes, however, "there will be an explosion of activity at the state level, whether it's insurance regulation or management of Medicaid, (issues) that are the purview of states," Wright said.

4. But what about the status quo? When writing about health reform, don't forget to include the impact of doing nothing. A good resource is "The Cost of Failure to Enact Health Reform: Implications for States," a report for the Robert Wood Johnson Foundation and the (again, left-leaning) Urban Institute.

5. Employers. Focus on employer-based coverage, not just the public option. "I've been amazed how little attention is paid to what employer requirements (for health coverage) are in future bills," said Ken Jacobs of the UC-Berkeley Center for Labor Research and Education. What are small and larger employers in your area saying about the proposed reforms from a business perspective?

6. Keep it simple (as much as you can). "There's a lot of talk about health care that gets unnecessarily complicated," says Anthony Wright. Wright would like to see basic stories that identify groups of people and examine what health reform means for each of these groups. He explains: "Most people get coverage from work. If you do, this is what it means to you: there would be more security in what employers are required to provide to you. If you get health coverage through Medicare, the doughnut hole would close. More people would get on Medicaid. Finally, the individual health insurance market is the place where the world fundamentally changes. You break it down in terms of how the consumer experiences it. It's sort of like an iPod: we want (health reform) to be simple on the outside even though it's going to be complex on the inside."

Finally, here are some ideas from an essay that famed investigative journalists Donald L. Barlett and James B. Steele wrote for ReportingonHealth before the health reform debate started in earnest. They still stand up.

7. Insurance denials. Find out the most common conditions and illnesses that insurers refuse to cover in your area, and what people do as a result.

8. Nonprofit cash reserves. Look at nonprofit hospitals and health providers in your area, many of which are beginning to resemble private corporations because of their deep cash reserves. Why are they accumulating cash, and what is the justification?

9. Small business views. Interview small business owners. Whether they're running a Mom and Pop corner grocery or a small law firm, proprietors of small businesses probably have strong views on the health care system. Many can't afford to offer group coverage to their employees - or even provide it for themselves. What are their fears and hopes about health care, and what would they like to see done?

10. The in-betweens. Examine the especially onerous financial and emotional burden on the many Americans between ages 50 and 65 who must figure out how to secure health insurance for themselves after losing group coverage for one reason or another.

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