Urban healthcare is in crisis and most media could care less
Originally published for theHill.com.
Listening to many of my media colleagues, the average reader could easily conclude that the only health care debate worth covering today is the partisan bickering over efforts to repeal the Affordable Care Act (ACA), more commonly known as Obamacare. Washington squabbles aside, there are many more concerning stories about the healthcare challenges in towns and cities across the country. When they remain untold or half-told, our public debate suffers, as do patients who can least afford it.
Since the beginning of 2010, a number of hospitals have closed, limiting access for at-risk patients in both rural communities and urban centers. And more closures may be imminent as the operating conditions worsen for providers. A few media outlets and watchdogs, including the Maynard Media Center on Structural Equality, have honed in on this growing problem:
“About half of the nation’s 50 million uninsured are people of color, many with jobs that provide no insurance or just nominal coverage … Vernellia Randall, a professor of health care law at the University of Dayton School of Law and author of ‘Dying While Black,’ says the problem of hospital closures in black neighborhoods began in the 1930s. ‘Back then, there were more than 200 hospitals located in minority neighborhoods,’ … ‘You’d be lucky to find 20 now. The problem is becoming more obvious and getting more attention now because they’re beginning to close hospitals in communities that, although they have large numbers of blacks, also have a large percentage of whites… .’”
As healthcare providers scramble to find solutions to their problems, which often center around cash flow challenges stemming from expensive federal mandates, an aging population and falling reimbursement rates from both public and private insurers, many are seeking to enter larger hospital systems or join practices in order to pool resources and increase efficiency. However, the wave of hospital consolidation that’s occurred since the 2010 passage of the ACA, though, has come under intense criticism, much of it stemming from insurers and their allies. Their main conclusion, that consolidation results in higher prices for consumers, is dubious at best. As recent studies have shown, there has been “very low hospital price growth despite waves of consolidation.” Despite this, the volume of criticism from industry-backed supporters has only grown louder.
Oddly, these arguments seem to ignore both the on-the-ground realities hospitals are facing, as well as the intense consolidation of insurance companies in recent years. According to the Government Accountability Office, between 2010 and 2013, “the three largest insurers had at least 80 percent of the total [private insurance plan] enrollment in at least 37 states.” Regular people know this, as their options for choosing insurers have shrunk while their premiums have risen. Hospitals know this, squeezed as they are at the negotiating table with the insurance giants in their area. And yet media and regulators seem to be embracing a one-sided narrative, skewed heavily in favor of the insurance companies that have a direct interest in weakening the negotiating position of hospitals and other providers.
I’ve worked in healthcare on both sides of the coin, as a private sector executive and a public sector matchmaker. I know that, first and foremost, government regulators should look to empower, rather than restrict, private sector solutions to help the most vulnerable among us. Telemedicine is growing by leaps and bounds. It’s shifting the size of the markets hospitals compete in, from local to global, and turning competitors into collaborators with widespread patient benefit. Growing hospital and health care systems are providing improved quality of care, by the way, that at the same time delivers cost-savings to taxpayers. And that is critical.
Responsible media reporting that refocuses the lens on this side of the debate as a critical piece of the story can greatly impact the trajectory. Instead of simply recycling political arguments, or offering an open forum for insurance industry funded narratives, it behooves us to ensure a better-informed public and present what’s really at stake when empty rhetoric creeps in to take precedence over patient needs.
Tara Wall is chairman of the PTP Foundation for Media Arts, and a veteran broadcast journalist and media analyst covering urban and cultural affairs. She is also a former healthcare executive and Public Affairs director at the U.S. Department of Health & Human Services Administration for Children & Families.