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The Media vs Managed Health Care
Are We Seeing a Full Court Press?
David B. Bernard, MD;
David J. Shulkin, MD
Arch Intern Med. 1998;158:2109-2111.
Background Despite the fact that medical coverage for many Americans is shifting rapidly from traditional insurance to managed care, studies suggest that most citizens have limited knowledge or understanding of the implication of this change.
Objective To evaluate the predominant message being portrayed by the lay press on managed care.
Methods We conducted a review of newspaper articles dealing with managed care from several leading national newspapers. Surveys, editorials, letters to the editor, or nonclinical articles were excluded. The articles were examined to evaluate their likely effect on the reader's willingness to join a managed care organization, and were scored using a standardized survey instrument. The final analysis included data from 85 articles from an original pool of 277.
Results In only 8% of cases, the articles were considered likely to have had a positive influence on the reader and, thus, encourage them to join or remain with a managed care organization. More important, in fully two thirds of cases, we believed the articles portrayed so unfavorable a message that the reader was less likely to join, or might even decide to leave, a managed care organization. The articles dealt most frequently (67%) with patient concerns with managed care, focused mainly on cost and quality issues, and managed care representatives were the people whose opinions were most commonly (53%) solicited.
Conclusions It seems highly likely that public perception of managed health care will be influenced by the strongly negative representation being portrayed by the newspapers. While debate over the good vs bad features of managed care continues, available evidence suggests this form of health care coverage continues to grow. The press is likely to remain an important source by which information about managed care is transmitted to the public and will certainly influence public decision making on the issue. If the current negative representation continues, we may soon begin to see a widespread backlash of public opinion opposing this form of health care.
From the Division of General Internal Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
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