The Albuquerque Journal ‘Needs To Change Its Tune’

January 14th, 2014 · No Comments · health care reform, journalism

By Denise Tessier

I read with interest this morning’s column “New Mexico Needs To Change Its Tune,” by Albuquerque Journal business writer Winthrop Quigley.

This link-line from the Journal’s web front page pulled me into the article:

If a culture is defined by the words used to describe it, we need to find new words.

That actually puts into words what I’ve been thinking about the framing of stories by the Albuquerque Journal — that it needs to change its tune.

With sincere apologies to Quigley, I would submit that one could read his premise that detrimental tone and “tune” help impede New Mexico’s progress and apply that premise to the way the Journal frames and highlights politically contentious issues, and how that treatment impedes progress, rather than encouraging solutions, especially when talking about how the Journal frames the Affordable Care Act.

Quigley wrote:

For many of us, deriding New Mexico is second nature, a habit, almost a verbal tic. We harm ourselves with such words. A culture is defined by the words used to describe it.

I contend that New Mexico’s long-standing failure to thrive economically is in some significant measure a function of our culture. We speak of our state as a failure, so it remains a failure.

Quigley led the column with an anecdote from a speech to business leaders by Gov. Susana Martinez:

She defended her decision to use Obamacare dollars to expand Medicaid coverage to low-income adults in New Mexico, which led her to mention, correctly, that our health care system competes well with other states’ systems.

“Imagine that!” she said with a chuckle. The audience laughed.

Martinez also reminded the audience, as if a reminder was necessary, that New Mexico finds itself ranked at the bottom of many of the lists assembled by those people who assemble lists.

So, New Mexico’s health care system competes well with other states’ systems. The news isn’t all bad.

That’s not the impression left from reading the Albuquerque Journal.

Let’s look just at some of the stories about the rollout of affordable health care Act, as seen by the Albuquerque Journal:

Obamacare increases city, county costs,” top of Page 1, Nov. 6. (Sub-headline said, “Fees to help offset low-income subsidies.”) This story said much of the increase – a whopping $3 million in 2015 alone — lay in per-month fees ACA requires states to collect to help states fund high-risk insurance pools. New Mexico was ahead of the nation with its New Mexico Federal High Risk Insurance Pool, which will close when ACA fully takes effect because insurance companies may no longer reject patients with pre-existing conditions. Could the state somehow get credit for that? Is it all doom and gloom? More on that later.

“NM insurers: Obama reversal too late; Thousands of health care policy cancellations can’t be undone,” top of Page 1, Nov. 15. This reader is among those who received a cancellation notice, but then in late December, I received another invoice and was able to pay to continue my coverage through January – as was my spouse on a completely different provider plan. But readers are left with “reversal too late.”

More headlines:

“Exchanges slow to attract young, healthy,” Nov. 16, A3.

“Obama struggles to rescue his health care law; Odds are ACA likely to survive,” Nov. 17, A4.

“Obamacare cuts pay for doctors,” Page 1, Nov. 23.

“Poll: Young dislike Obamacare,” Dec. 5, 2013, A6.

“Heath plan sticker shock may be ahead; Picking cheapest premiums may not pay off in long run,” Page 1, Dec. 23, 2013.

“Tarnished Obamacare at crossroads; Main benefits take effect today, along with mandate” Page 1, Jan. 1.

“Obamacare numbers in NM uncertain; Insurers say enrollment information flawed,” Page 1, Jan. 1.

“Underinsurance issue looms; High out-of-pocket expenses may threaten patients’ finances,” A5, Jan. 4.

“Health law threatens firefighting system,” Jan. 6. The story here was that many states that considered volunteer firefighters employees for tax purposes are sorting out how to keep giving firefighters health care – along with other perks like free gym memberships – in light of the ACA. Not exactly threatening the entire “system.”

One of the most galling examples to this reader was the Associated Press story the Journal put on page 1 Jan. 3: “ER visits rise after Medicaid expansion; Study says recent enrollees used service 40 percent more often than others.”

Nowhere in the story was there any mention that “recent enrollees” might not understand that their medical conditions could be treated less expensively in a doctor’s office or urgent care clinic than in hospital emergency rooms. Nor was there mention that most of these recent enrollees – who likely had no insurance before – likely had no primary care physician either.

If they’re not used to taking advantage of healthcare, they probably don’t know how to go about accessing care. The solution would be an education program to complement the rollout of the ACA.

But the AP story didn’t quote anyone suggesting this, and the Journal didn’t see this angle either, instead choosing to further denigrate expansion of Medicaid by publishing an editorial Jan. 7: “Expansion of Medicaid didn’t curtail use of ER .”

The editorial, which primly asserted that the emergency room use “shouldn’t be a surprise,” proposed an imposition of co-pays so that patients will have an “incentive” to choose a less expensive option, such as a doctor’s office. Lest one misunderstand how opposed the Journal’s official position is to expansion of health care, the editorial pronounced this verdict against Medicaid:

This study and earlier ones together indicate Medicaid expansion increases health care spending and does not significantly improve the patients’ physical health in measurable ways.

Add to that a slew of Op-Ed pieces, including one by an individual who is planning to run for Congressional office from New Mexico, entitled “Obamacare just a series of lies; time to repeal and replace.” (That the Journal gives candidates space for such electioneering is fodder for another post).

Here’s another headline, topping a piece by a “research associate” with The Heritage Foundation: “Obamacare bad deal for young.” The Heritage Foundation is the group that essentially came up with the template for the health care reform Mitt Romney adopted and used in Massachusetts, which both Heritage and Romney turned against when the plan was put forth by President Obama.

And of course, the Journal continued to run the usual columns on the editorial page, like this one from Cal Thomas: “Memo to Obama: Tyrants lie” (Nov. 13, 2013).

This list doesn’t include any of the negative stories about the ACA website, because that was inherently a negative story; the site didn’t work correctly.

This past Sunday, the Journal started an in-depth series on New Mexico’s shortage of doctors. The first two stories in the series by Colleen Heild filled most of the front page and a full page inside, and those who read the stories should come away with the knowledge that the shortage pre-dates and is independent of the ACA, and that New Mexico has been trying to correct the shortage for years. New Mexico is ahead of the game, in fact, in that it has a clearinghouse, New Mexico Health Resources, Inc., specifically to keep tabs on potential recruits in and out of state.

But the paper also ran on the Sunday Dimension page, “Doc shortage next hurdle for the ACA,” a story that tied a potential nationwide shortage to the ACA in its headline and as its main premise, saying that as more people are insured and using the health care system, it could become harder to find a primary care doctor, dentist or mental health professional.

Heild’s pieces make this point, too, but it’s possible readers who skim the paper will come away with the idea that ACA created the shortage, even though the shortage pre-dates ACA and is attributable to other factors, not least of which is the difficulties physicians face with the current insurance industry-controlled business model that is utilized in American health care.

Meanwhile, the Journal did run positive articles in the Journal about the ACA, but nearly all were columns on the Op-Ed page, not the news pages. Among them:

Affordable Care Act fee assessment temporary, beneficial,” Nov. 14, 2013.

This is a follow-up to the front-page story listed first in this post as an example of negative Journal ACA coverage. But instead of reporting this additional, mitigating information as a news story, the Journal let former New Mexico Lt. Gov. Diane Denish do the follow-up via a column. It goes without saying that the negative story ran at the top of page one, and Denish’s column ran far back in the A section, on the Op-Ed page. Most importantly, there was another whole side to the story that didn’t make it to the news pages, which should and do carry more weight with readers. As Denish pointed out, the city assessments are temporary, lasting three years.

Further, as her column pointed out:

The assessments actually go down in ensuing years and then disappear in 2017.

Second, this amounts to 2 percent of the total cost of premiums for the city. Over the last decade, insurance premiums have increased between 7 percent and 10 percent every single year – sometimes doubling in a decade.

Third and most important: Once Medicaid expansion kicks in, the city of Albuquerque will find that a majority of the uninsured currently served will qualify for Medicaid. So yes, the city will pay more for city employees on one hand, but will also save substantial amounts of money when their uninsured residents are covered. This will leave the city with a fair chunk of change to fund other priorities.

Among the other positive Journal headlines on the ACA:

“Obamacare works, despite flaws,” editorial page column by syndicated writer E.J. Dionne, Oct. 25, 2013, who wrote: “. . .it would be unconscionable to give up on the goal of expanding the ranks of the insured because of tech failures.”

“Obamacare fulfills broken promises,” Op-Ed page, Dec. 25, by Roxane Spruce Bly, talking about the benefits of the ACA to Native Americans.

“Many are about to benefit from Obamacare,” Op-Ed page, Jan. 1, a not-surprising official statement/column from U.S. Heath and Human Services Secretary Kathleen Sebelius.

Medicaid for all a poverty solution,” Op-Ed page column Jan. 12 by Albuquerque resident and third-year medical student James Besante. This thoughtful column made some important points, including the fact that Medicare was a key component of Lyndon Johnson’s “War on Poverty” that had been launched 50 years before, on Jan. 11, 1964.

Besante, who wrote that he takes part daily in the care of “New Mexicans who live on the ‘outskirts of hope’,” wrote that “Obamacare is not the answer because it relies on an inefficient patchwork system of private health insurers who are the cause of our current troubles,” concluding that Americans need an “Improved Medicare For All”:

In the case of Medicare, millions of Americans age 65 and older were given access to health care overnight. The new law went far beyond insuring the uninsured elderly; it reduced poverty by lifting crushing medical debt from the shoulders of America’s seniors and their families.

In the years that followed, Medicare continued to dramatically reduce poverty among the elderly. The scope of benefits expanded, and the health of America’s seniors improved, regardless of race or income.

Congress eventually extended Medicare coverage to the severely disabled, and today the program covers approximately 51 million Americans.

To the free-market advocates who push for further privatization by corporate insurers, Besante said:

It is true the American health care system is hemorrhaging money.

But Medicare, with overhead costs of 2 percent, operates far more efficiently than any private health insurance plan, with overhead costs of anywhere from 15 percent to 25 percent.

The private insurance middlemen are the ones raising the costs of the system, without adding value.

To those who say the U.S. can’t afford improved Medicare for all, Besante pointed to the U.S.’s “sky-high health spending” – 18 percent of the gross domestic product – with “worst health indicators of any First World county” as the result, not to mention bankruptcies due to medically incurred debt.

The sad reality is that our current system weighs heaviest on the poor and working class. In the U.S., the poor live sicker and die younger, and the sick die poorer. Illness is both a condition of the poor and a structural barrier, which recreates poverty in America.

Medicare is not the problem, but the solution. . . .

So, back to framing and how we use words: Of course problems should be stated – i.e., use of emergency rooms is expensive and those costs need to be brought under control so consumers and employers don’t have to foot the bill. Hospital emergency rooms need a breather from overuse as well.

But we’re in a transition with this new health care law.

The Journal could do a better job highlighting benefits and simple solutions – like advocating and helping educate the newly insured about how to find a doctor and where the nearest urgent care center is found – and not leaving a solution to the feds by suggesting they amend the law to impose co-pays.

It could start with a story about how our health care system competes well with other states’ systems, as the governor pointed out in her talk to the business people.

And it could work on changing its tune – developing a journalistic vision that is more in touch with its readers and residents, more in touch with reality and truth, one that removes political ideology and blinding corporate scales from its eyes.

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