Sunday, April 5, 2009

Getting a Health Policy When You're Already Sick

This article is ultimately a series of tips on dealing with health insurance, but it has the great news tie-in that Congress may make it impossible for the health insurance industry to charge higher premiums or deny coverage to people with health problems. The article leads with that, but then explains that it may be months before this is settled. A great quote from Karen Pollitz helps shift the article from the news aspect to guidance about insurance.

Insurance is not the most interesting thing in the world to read about, so it was a good choice to format the article the way it is, with bold headings for each section. Konrad chose to address "you" in the article, but I think it works to keep readers engaged and make it feel like an advice column more than a list of policies. Konrad uses very simple terms ("In reality, most insurers deny individual coverage to sick people.") and keeps our attention with quotes that sound like people actually said them. We get even more of the personal aspect when we hear the story of a woman who went through a struggle with obtaining health insurance. More advice is given about what to do if you're in her situation.

The article ends with one last warning about temporary insurance policies, a popular remedy that could lead to big problems. This article could have been painful to read, but by making it newsworthy, breaking it up visually, and keeping the human element in the story at all times, it held my attention.

Do You Know What Your Doctor Is Talking About?

I read another of Pauline Chen's doctor-patient columns in March, but I enjoyed this one much more. The column addresses the serious issue of "health literacy" for patients, and talks about the shared understanding that is sometimes missing between doctors and patients. Although it is a column, it provides supporting statistics and quotes that drive Chen's point home.

The article begins with a powerful--although slightly long--illustration of the danger of limited health literacy. She uses the story of a patient who ended up dying because he didn't follow his instructions for at-home care. Chen now realizes that she may not have been connecting with him on a level at which he could understand and act on what he was hearing.

Chen connects Jack's story to a larger trend of limited health literacy. Chen defines the term and then points to the trend. Tens of billions of dollars in health care costs go to people who are hospitalized repeatedly because of this problem, Chen says, and then cites an even more powerful study statistic: elderly patients with limited health literacy are twice as likely to die.

Next, Chen quotes Dr. Rebecca Sudore, associate professor of medicine, at length. However, all of the Sudore quotes have a point, are clear, and support Chen's opinion that health literacy and doctor-patient understanding is important. The article ends with Sudore's advice on how to achieve this understanding. This makes the article important for both patients and doctors. All in all, this column was very clear and well-written and makes a great case for the importance of health literacy.

Your Old Man

One problem, I think, with reading the Times online is that there's none of the context of reading the actual newspaper. I went into this article as though it were a news article, but by the end I realized it was probably in the Opinion pages. The sidebar said that Belkin has something called the "Motherlode Blog," and by the end I felt like I was reading someone's blog as opposed to an actual newspaper article.

The beginning of the article does a great job of tying together the larger implications of an Australian study. The study showed that children born to older fathers have lower IQs than those born to younger fathers. Belkin cites several other studies in which the age of the father made a difference to the health difficulties of the child and in which the mother's age did not matter. A useful graphic on the side of the screen also illustrated that the risk increases as age increases. Then comes the helpful summarizing quote from the expert, where Dr. Dolores Malaspina tells the reader, "It turns out the optimal age for being a mother is the same as the optimal age for being a father."

It's at this point that the article undergoes a complete shift. Belkin starts using "we" to talk about women, discusses the differences in social attitudes about age towards men and women, and predicts that older men may "gasp!" start to date women their own age. I wish she would've written a newsy article with this new information, used the sources that she used and perhaps gotten a psychiatrist to weigh in on the social attitudes part, and saved her own opinions for her blog.

Regimens: Creepy, Maybe, but It Seems to Work

The headline of this article completely drew me in. And it definitely paid off. This short article was about the use of live maggots in the healing of leg ulcers. It was basically all oddity because I doubt this is really going to catch on. The maggots work just as well as chemical dressing but are more expensive and more painful. "On the whole, the researchers concluded, there is little difference between the two treatments, and the choice should be left up to the patient." This cracked me up--"Okay, so it's your call. Do you want maggots to be eating your leg? They work the same as our chemical but they're more expensive and more painful." Tough decision. But that's where the article gets even more surprising--people actually do want this because they're in such pain they're eager to try any new method. Over all, it was not the biggest health news of the decade, but fun to read about.