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Problems with media coverage of health policy…and some suggested solutions

Health policy, let’s be honest, is a turn off for most media managers and editors. Given a choice between a cancer breakthrough (even if it is only in rats) and a change to how health services are delivered or financed, you know which one will get the splash.

Who can blame them, really. Health policy is confusing – it’s difficult to ever confidently say that doing X will cause Y – and it’s made even more so by the strife of interests that dominates policymaking and public debate.

So it’s not really at all surprising that a recent study of media coverage of health care reform in the US found most media reports tended to focus on the biff rather than the policy issues.

But one trouble with this, as the study suggests, is that media coverage can exacerbate public confusion about important policy issues, rather than helping to clarify them and contribute to an informed community.

The study, released by the Pew Research Center’s Project for Excellence in Journalism and available in full here, involved more than 5,500 health care stories in the mainstream media from June 2009 through March 2010.

One conclusion is that the opponents of health care legislation won the message war. A Nexis search of key terms in the health care debate found that opponents’ terms appeared almost twice as often (about 18,000 times) as supporters’ top terms (about 11,000).

“In short, the opponents’ attacks on government-run health care resonated more widely than the supporters’ attacks on the insurance industry,” the researchers said. “Boiled down to its essence, the opponents’ attack on big government resonated more in the media than the supporters’ attack on greedy insurance firms.”

Another key finding was the debate centered more on politics than the workings of the health care system. 41% of health care coverage focused on the tactics and strategy of the debate while various reform proposals filled another 23%. But only 9% of the coverage focused on a core issue – how the US health care system currently functions. And this for an industry that consumes one-sixth of the US gross domestic product and affects virtually every citizen.

The authors noted: “The health care issue could be covered from various angles. There is the politics of the issue. There is the substance of the bill. There is the lobbying effort. There is the impact of the economic crisis on health care. And there is coverage of the health care system itself, what works and what doesn’t, what needs to be fixed and what is all right.

“While there was certainly a lot of coverage of the bill, the framing and mix of what got covered may have contributed to the public’s confusion on the issue. While the largest component, by far, focused on politics, only a small fraction highlighted the issue at the core of the debate—how the U. health care industry actually functions.”

Newspapers were the only sector to really devote significant coverage to the workings of the health care system.

A few quick thoughts about the relevance of the study for Australia:

• It would be useful to have a similar study done here. It might help inform health reform efforts over coming decades, and it would be interesting to know both the similarities and the differences between US and Oz reporting.

• These findings are, of course, not only relevant for health policy but salient for reporting of all complex policy issues. In case you missed it, the ABC’s Jonathan  Holmes analysed the reporting of the resource super profits tax at The Drum recently. He had some useful suggestions, including that media outlets should consider linking from news articles to background analytic/explanatory pieces.

This could work well in health. Every time, the Daily Telegraph or whoever runs a story about a hospital patient’s preventable death, this could link to a backgrounder on quality and safety issues, giving some broader context to both the problems and the policies that are attempting to address these issues.

I’m sure Croakey readers could think of plenty of other common health headlines where a backgrounder piece might be useful.

If media organisations don’t take up these suggestions, perhaps there’s room for the academic or not-for-profit sector to do so.

Perhaps a health policy variant of the Behind the Headlines service in the UK, which tends to focus on clinical issues and aims to provide “an unbiased and evidence-based analysis of health stories that make the news”.

Something like this for health policy stories could be very helpful, for both the media and our audiences.