The Power of Anecdote

The morning papers are filled with relevant health reform stories, but two stand out. They weren't reported by journalists, but were experience-based opinion pieces offered by people on the front lines of delivering and insuring health care.

The first comes from the Washington Post, where a family practice physician reports on the battery of tests he received after checking into the local emergency room for excruciating eye pain while on vacation. Despite an ultimately accurate self-diagnosis of shingles, he submits to his physicians' orders for an ever escalating battery of tests. My takeaway lesson from his story is that if a skilled physician cannot resist orders for expensive tests and unnecessary drugs, there is no chance that individual consumers, even if they have more skin in the game, will be more successful. 

The second story comes from an op-ed in the New York Times, where a Texas regulator, who served on that state's ill-fated attempt in the 1990s to set up an insurance exchange for small businesses, concludes either a strong public plan or very tight regulations are needed to make exchanges work. Otherwise, he states, insurance companies will cherry pick the insurance pool and doom those with high-cost employees and family members to unaffordable plans.

It's telling that I found those stories much more compelling than the best journalism in today's papers. There was a solid Post story about how the U.S. lags in preventing deaths that could be prevented through health care interventions. There was also a Times take out on insurance exchanges, which included a brief sidebar on a Utah exchange aimed at small businesses that sounds suspiciously like the failed Texas model.

It's not that the good reporters who wrote those stories couldn't deliver powerful pieces. But the sad truth is that quick turnaround stories based on studies, or overviews based on numerous telephone calls to policy wonks, the thin gruel now offered by ever-shrinking newsrooms, will never have the power of well-reported, anecdote-driven stories that can only be produced by reporters spending serious time on the ground with real people and practitioners. 

The key here is whether the anecdote illustrates a broader, true dynamic, or an anomaly. Here we've the former.