Introduction
By Erin Brodwin / 3 minute read
Health care in the United States is a fraught business. For you, as an editor of health-care stories, your most valuable asset is your skeptical eye: Powerful institutions shape much of the narrative but often cause unseen harm to patients and consumers along the way. These institutions include health-insurance companies, hospitals, drug makers and — increasingly in recent years — technology behemoths, as well as their public-relations apparatus.
By comparison, patients and society do not possess the financial capital, time, or professional support to thoroughly vet the claims made by drug makers, hospitals, insurers, or tech giants, nor do they have public-relations professionals working on their behalf to present their needs to those institutions. The U.S. health-care system prioritizes later-stage, costly procedures and cutting-edge technological innovations over basic, quotidian care.
We want patients to receive the best care available. We also want consumers to pay less. And we don’t want to bankrupt the government or private insurers. Something must give.
– Sendhil Mullainathan, Roman Family University Professor of Computation and Behavioral Science, University of Chicago Booth School of Business
This results in worse outcomes for patients and society, and has significant implications for journalism: Although innovative surgeries and glamorous new medical devices often receive more attention, everyday interventions focused on increasing access to basic care are at least as important, if not more so. The incentive structures underlying the U.S. health-care system — more money for more “care,” more and better care for the insured than for those without insurance — mean that underrepresented groups, particularly Black Americans and other people of color, experience disproportionately worse care — and receive less care overall — than white Americans do.
Your job as editor is to play the triple role of storyteller, watchdog, and investigator. The stories you edit should be fair and balanced — not because they present two opposing views, but rather because they weigh equally the potential benefits of every new treatment or intervention with its potential risks and harms to patients and to society.
Peer-reviewed medical research provides one key means of cutting through the noise generated by pharmaceutical companies, insurers, and the like. So I’ve devoted a large section of this chapter to reviewing best practices involving studies. Even clinical trials, however, are subject to bias and conflicts of interest. Keep in mind, for example, that most medical-research involves white males, even though the demographic groups that experience the worst health-care outcomes in America include Black men and women of color.
Meanwhile, health-care inequity is expected to worsen. In 2018, the proportion of Americans without health insurance rose for the first time in a decade; that figure is predicted to grow even more on the heels of the coronavirus pandemic and its resulting job losses.
Because of these challenges, your job is now more important than ever. The stories you will edit will help draw attention to injustice, analyze new health technologies and discoveries, and debunk dangerous misinformation.
And the stakes are high. Just as a slip-up in the operating room can impair a patient for life, a misleading or erroneous health-care story can spur a vulnerable patient to seek out something dangerous without understanding its consequences. Similarly, stories that further stigmatize critical issues, including mental illness and disability, can keep someone in need from seeking care.
Here are some basic pointers to keep in mind as you make your way through this chapter.
Don’t
- … use the word “cure.”
- … treat a press release as a research study.
- … assume that because a study has been peer-reviewed, it is free from bias or other limitations.
Do
- … use words like “treat” and “address.”
- … review the evidence, possibly with the help of experts.
- … encourage reporters to be mindful of potential gaps or limitations in research, especially with regard to race, gender, and potential conflicts of interest.
Now that you’ve had a chance to review the basics, let’s dive in.