It's time for better healthcare journalism

Let's start 2014 with some inside baseball. Allow me to offer some cautionary words to my colleagues who cover healthcare in the mainstream media and trade press.

There is little doubt that we cover what is still the biggest domestic story of our time: how the U.S. will meet the twin challenges of guaranteeing every American basic health insurance while keeping a tight rein on government healthcare spending, even as the retiring baby boomer generation every day adds 10,000 people to the Medicare rolls and will for the next 10 years.

Those challenges aren't the only reasons why healthcare and healthcare reform will remain front and center in the daily news cycle. The political assault on the Patient Protection and Affordable Care Act will pick up as soon as Congress comes back into session.

With the mid-term elections looming in November, Republicans on Capitol Hill have promised to highlight the issue as they seek to retain control of the House and capture the Senate. They still control the bully pulpit that comes with the power to call congressional hearings and order investigations. They will use those tools to highlight every drawback and flaw in reform's rollout, its impact on some consumers and the glitches in its ongoing operations.

Their message will be amplified by the unprecedented advertising assault that will come from independent actors—mostly ultraconservative—who operate behind thinly veiled political action committees. It's impossible to know whether the wealthy individuals and corporate entities who are funding this advertising onslaught are true believers in free-market healthcare, have contempt for the people who provide healthcare, simply don't want to provide their workers with insurance or see Obamacare as a convenient whipping boy for some other agenda.

In the end, the answer doesn't matter. Given the U.S. Supreme Court's decision in Citizens United, they will be as much a part of the landscape going forward as those 10,000 baby boomers who retire each day.

That's why it is so important that reporters and editors who cover complex healthcare stories take the educational component of their mission seriously. As I read the press during the holiday-shortened final two weeks of the year, I saw far too many stories that failed miserably at that task.

Take, for instance, one story that appeared in the nation's leading financial paper that reported how patients were racing to cram in last-minute tests and procedures “before the health law starts.” The story blamed the phenomenon on the rise of narrow networks, never once stopping to analyze how much of the phenomenon—hard to measure under the best of circumstances—could actually be tied to people who lost their old plans and obtained new ones with restricted networks.

The story caught my eye because over the course of my reporting career, I wrote several end-of-the-year stories on the rush to get procedures and tests done. Of course, before Obamacare came along, analysts and economists tied the phenomenon to “use it or lose it” health savings accounts. That factor was never noted in this year's story.

Another story that appeared in several outlets reported how healthcare patients and consumers were absorbing higher copays and deductibles—a “cost-shifting” due to Obamacare. That might have been true for a limited group of people who once had comprehensive individual plans they could no longer buy at the same price on the exchanges. But the vast majority of people facing higher copays and deductibles in 2014 are in employer plans that are changing to high-deductible.

This is a phenomenon that predated Obamacare and is accelerating because employers are trying to escape bearing the brunt of rising healthcare costs. We'll see that when final survey numbers are published for 2014. The percentage of Americans in high-deductible employer-based plans (that's 159 million souls) is certain to jump sharply from the nearly 20% reported for 2013.

Finally, there is the ongoing coverage of “outrageous” hospital charges, which in the past year have been the subject of numerous features and book-length articles. There is no doubt that Americans pay the highest prices in the world for healthcare and get results that on a population basis are middling at best. But does an unrelenting media focus on the trumped-up chargemaster prices that hit a handful of consumers—those without any form of insurance—really explain why we pay more?

When will we start seeing stories about what goes into the hospital price: the cost of labor and the cost of supplies, for instance, which make up 75% of all hospital costs? Where do our doctors rank on a global salary scale? What do we pay for drugs compared to the rest of the world? For implantable devices?

Our new year's resolution at Modern Healthcare is to cover these stories fully and fairly. The goal will be to shed light on these complex issues, not just generate heat.

Follow Merrill Goozner on Twitter: @MHgoozner