Tuesday, June 10, 2014

Now, THIS is health care reporting

In an era of prosaic, he-said-she-said health care reporting by the estbalishment media in his own state and north of the border, Richard Asinof's coverage of the issue in ConvergenceRI provides a clinic for journalists everywhere.

Check out this recent story:

Politics is the story of who gets what, when and how, so there was nothing shy or surprising about the latest power move by CVS Caremark.

The retail pharmacy chain had been upset by the conditions imposed by Dr. Michael Fine, the director of the R.I. Department of Health, in a May 14 decision approving the licensing of seven MinuteClinics in Rhode Island, following an involved, lengthy public process before the R.I. Health Services Council.

In response, the Woonsocket-based corporate behemoth, which earned $126 billion in revenue and $8 billion in operating profits in FY 2013, went straight to the offices of Rep. Nicholas Mattiello, the new R.I. Speaker of the House, to get the conditions watered down.

Mattiello, in turn, called Gov. Lincoln Chafee. Behind closed doors, in private, in a meeting that included Richard Licht, head of the R.I. Department of Administration, and Peter Marino, director of the R.I. Office of Management and Budget, as well as CVS and MinuteClinic officials, discussions were held on how to cut out conditions that CVS didn't like. 

Asinof notes:

Mattiello proudly championed his successful intervention. “Speaker Mattiello . . . was pleased to have been able to facilitate a positive result for one of the state’s largest businesses that will be adding jobs through seven MinuteClinics. He will continue to oppose overbearing regulations that hamper the growth of Rhode Island’s economy.”  

Asinof adds substance to the story by presenting a section by section analysis of the changed conditions, showing their impact on real people in the state:

What was the problem with the initial conditions? CVS has not commented specifically in public about what it found to be unfriendly to business. What can be determined is what changes occurred between the initial and final, revised conditions. 

And then he concludes with the broad picture about this kind of policy intervention:

Beyond the immediate results of CVS being able to revise what it considered to be problematic conditions to its bottom line, the ability of political leaders to rewrite conditions behind closed doors raises questions about how future health care policy decisions will be made – and by whom. 

That ConvergenceRI, with limited financial resources, can produce this kind of piece on a regular basis is a gift to the people of Rhode Island.  It is also an example to the establishment media that their shallow coverage just does not make the grade.


BenK said...

"That each MinuteClinic have a collaborating licensed physician available to be on-call during MinuteClinic hours, and that CVS pay $25,000 annually to the Rhode Island Physician’s Loan Replacement Fund for each MinuteClinic location that does not have a primary care provider within a five-mile radius to receive referrals for MinuteClinic patients."

In short, at least some of the conditions are not about the quality of the care or qualifications of providers - but instead about subsidizing the physician guild of which Dr. Fine is a member. Could this also be the news item?

Paul Levy said...

Good point, BenK. What I like about the story is that it splays all these issues out for people to interpret as they like.

Anonymous said...

I am really torn about BenK's comment. I understand and agree about the guild issue, but 1) my daughter visited a Minute Clinic for a skin rash and an NP prescribed a completely inappropriate course of steroids at a too-high dose for too long (luckily her parents are both physicians so we nixed it - the rash went away on its own) and 2) an NP missed an acute compartment syndrome following a leg injury to a friend, resulting in several emergency surgeries, months-long rehab and permanent damage.
Can I say that a physician would have done better? Not for sure, but I think there would have been a better chance. This is not a simple issue.

nonlocal MD