Lessons from a Radio Reporter on Tackling Health Stories

“A warm tropical bring signals the start of a spring morning in Brownsville. Noisy black birds called urracas blanket the tops of palm trees. The roads are lined with trucks headed to the local ship yard.”

Even by radio standards, that scene-setter from Brownsville, Tex. is not your typical opening for a policy story about the state’s decision not to support Medicaid expansion. But for Sarah Varney, who filed the story for NPR’s Morning Edition, that’s exactly the point: Hiding health policy stories inside portraits of places can effectively dispel the boredom or fatigue that might otherwise set in on heavily trafficked policy beats.

“I want to tell a story about health policy but do it in a way that kind of sneaks it in,” she told fellows at the 2013 National Health Journalism Fellowship in L.A. this week.

Figuring out how to couch health policy stories in broader narratives can be a challenge, but trotting out different storytelling approaches becomes increasingly important when it comes to policy topics such as Obamacare that are in the news every day.

Varney employed a similar strategy for a potentially wonkish story about Mississippi’s decision not to require health plans sold on the new state exchange to cover bariatric surgery and other obesity treatments.

“We really did it as a story of Mississippi: We had sounds from the delta, we had sounds from a blues bar,” Varney explained. “We really tried to paint a picture of Mississippi and within that talk about health policy.”

As with her Texas piece, the challenge was folding policy talk into a more broadly interesting tale.

“Just in terms of trying to sell these stories to your editors, I think that there’s going to be a lot of fatigue pretty soon, particularly as we get into the fall and certainly next year,” she said, referring to the mounting glut of Obamacare coverage. “It’s going to be a matter of trying to figure out how can I tell these stories in a way that’s compelling.”

But as her evocations of place suggest, that doesn’t always mean starting out with the provocative anecdote or what one of Varney’s editors refers to as “poverty porn” – the potentially voyeuristic glimpse into the lives of the most afflicted.

“I’ve really tried to challenge myself in the last couple years in trying to get away from those opening leads and build the story with something else,” Varney said. “And have those characters be there as supporting voices, for sure.”

For example, her Texas story featured a 22-year-old Brownsville resident named Mark Buitron. He works 44 hours a week scrapping old cruise ships yet makes less than $15,000 a year and has no health insurance.

“He’s exactly the type of person the Medicaid expansion was meant to target,” Varney says in the piece. Yet she didn’t start out with his story – he appears near the end.

Another solid storytelling strategy takes a cue from novelists’ penchant for characters that change and evolve, either landing in a different place from where they started or having their beliefs severely tested along the way. Or as Varney put it, she keeps an eye out for policy stories that present conflicts between ideology and reality.

“I’m really drawn to stories that are about people or elected officials who are really changed by the people that they meet and are changed by the circumstances they’re put in,” she explained. “One way to think about it is people who have an ideology that’s really challenged by some sort of pragmatic problem.”

By way of illustration, Varney pointed to a story she did for KQED’s The California Report on Kern County, a staunchly conservative bastion of Republicanism that nonetheless voted to accept billions of federal dollars in an early expansion of health insurance three years ago. Another of Varney’s stories took her to Alturas, a small town in the most conservative county in California, where residents were wrestling over the issue of whether they should tax themselves to save their local hospital. Stepping past Confederate flags as she visited rural homes, Varney interviewed locals, many with Tea Party sympathies, who worried losing the hospital would cripple the city and yet loathed the idea of taxing their way out of the crisis.

Or if you are going to write a profile, consider writing a portrait of a leader who is trying to bring out large-scale institutional changes in the way health care is delivered. Varney pointed to figures such as Mitch Katz, director of Los Angeles County’s Department of Health Services, whose day job “is really essentially trying to reshape a huge organization for life in the 21th century.”

But such stories require rich characters capable of speaking frankly.

“I think it’s important to find somebody who will not just give you the party line, who will really talk about what they struggle with, and what they talk about with their spouses or friends about at night,” Varney said.

Throughout it all, Varney says she tries to ferret out some laughter as one way of trying to keep both the reporter and her audience sane.

“I often am trying to look for stories that have some humor, because I feel like after a while of doing these sort of stories you want to just go into bed and pull the covers over your head and not get out.”

Image by M. Keefe via Flickr