Newspaper websites offer no cure on health-care reform

Helpless to stop their print world from being pulped, newspapers are blowing a golden opportunity to use the Web to recapture relevance and audience. The occasion is a story that affects every man, woman and child in America – health care and how to universalize quality without busting the entire U.S. economy.

News about health-care reform is, obviously, all over the media, including newspaper websites, 24/7, but too much of it has a Washington dateline when, in fact, the issue is basically local. People seek care where they live, not on either end of Pennsylvania Avenue NW or on K Street NW in Washington. Most of the $2.2 trillion-plus in health spending is rung up within mostly compact triangles of doctor offices, hospitals and outpatient centers in thousands of communities.

In June and July, when Congress was grappling with five reform bills at the committee level, attention had to be on what was happening in Washington. But with Congress going on summer recess, the focus is shiftingto kitchen tables and town halls all over America.

Newspapers, with their still formidable local resources, should own this story as the locus shifts to their backyards. At a time when 63 percent of Americans say the overall health care issue is “hard to understand,” newspapers could make their websites the authoritative place for people to go for the A-B-C’s – how they would be affected personally, not as part of a statistical mashup that may or may not be accurate. Newspaper sites could become not only locally tailored information centers, but also help influence how reform will be shaped when Congress returns from recess. After all, Congress is made up of lawmakers who depend on votes from people who live in thousands of communities, all of which are covered – at least in theory – by local newspaper websites. But papers aren’t planting their flag in their own territory.

Yes, newspaper sites do features about local individuals and families that can’t get care they need because they’re not insured or are under-insured, or who have gone bankrupt because of catastrophic illnesses. But these publish-and-run stories amount to scattered, quickly fading pixels that don’t let users see the whole picture.

To cover a story that has such major and pervasive effect on every household, and which will be around for months, if not years, to come, newspaper sites should have a strategically developed, attractively designed and well-promoted special section on health care – and the emphasis should be local, local and again local.

Every newspaper site, no matter how modest, could be health care central for its community. A starting point could be comparing the cost of care at local hospitals. There is a wealth of published local data that newspapers could access free. One major source is the Health Care Intensity Index, produced by the Dartmouth (University) Atlas of Health Care, which compares Medicare-related costs – 22 percent of all health-care costs – among local hospitals and against the national median.

The Dartmouth Atlas offers Excel versions of its data, which means a newspaper site editor can, with just a few minutes’ work, show how local hospitals’ costs compare with other hospitals’. Here’s a chart I quickly produced comparing a selection of hospitals in Houston – which is in the high-cost range nationally – with the low-cost Mayo Clinic’s St. Mary’s Hospital in Rochester, MN:


The obvious question is why does the Mayo Clinic – whose health-care quality is rated among the highest in the country – spend far less per patient than most hospitals in metro Houston?

Editors at any local newspaper site could do any comparison – within the metro area, statewide or nationally, all within minutes.

More spending on care, especially in the form of expensive testing and elective surgery, doesn’t produce better outcomes, data shows. It would take a bit of shoe-leather reporting, but newspapers could find out why costs vary so widely within their metro area. Instead of just being passive platforms for rants, newspaper sites could invite (or, if necessary, arm-twist), local doctors, hospitals and outpatient centers to participate in live forums where they would explain and justify the disparities and answer user questions. The sites would provide the same platform for local small businesses and labor unions, insurers whose plans cover local residents, advocacy groups and – especially important – local members of Congress. Of course, community residents – insured, under-insured and un-insured – would be able to tell their stories and ask questions about contradictory claims.

Multiply all this content generated from the more than 3,400 hospital service areas in the country, and you’d have a powerful, instructive mosaic of health care as it is delivered and priced. You’d also have, very likely, hundreds of thousands of opinions – leavened by now easily accessed, locally driven facts and figures – on how much reform Americans want.

No longer would there be a vacuum that is now filled by the demagogues and naysayers who often make things up and get away with it because there’s so much confusion about the issue.

You’d have more – much more – than another Internet “conversation.” You’d have grassroots America, with the assistance of local newspapers, helping to shape the legislation that will ultimately emerge from Congress probably by the end of the year. But newspapers have to use their still-considerable local resources to exploit the untapped potential of the Web to turn talk into action.

Newspapers’ print world will probably be a quaint media niche by the end of the next decade. What will happen to newspaper websites – will they fade into the empty quarter of cyberspace?

About Tom Grubisich

I write about hyperlocal grassroots sites regularly for Online Journalism Review. What I've seen checking out proliferating sites has not been encouraging. The content is generally dull "happy news" or aggregated wire stories and doesn't seem to tap into what's special about the communities being covered.

I am senior web editor at the World Bank in Washington, D.C., where I help develop blogs and other content aimed at broadening the Bank's audiences around the world.

Earlier in my career, I was managing editor of news for Digital City/AOL and before that co-founder of the free-circulation weekly Connection Newspapers in Northern Virginia. Earlier yet, I was a reporter and editor at The Washington Post. For more information, consult, Who's Who in America (2008 edition). I'm reachable at [email protected]


  1. Two more points:

    First, Talking Points Memo has done some great work to uncover the attempt by some lobbyists to “astroturf” anti-reform protests at town hall meetings on health care. If you’re reporting on protests, and not reporting who orchestrated them, you’re not only missing the news, you are playing into the hands of orchestrators.

    Second, if you’re running an independent local news website, or thinking about starting one – here’s your chance to build an audience. If your local newspaper website is falling down, like Tom describes, don’t wait for them to pick it up. Take their audience away with aggressive coverage like Tom describes.

  2. Tom Grubisich says:

    I’d like to add that the Washington Post has had some good Washington-based coverage of health-care reform. Columnist David Broder has written several on-the-mark pieces, including this one on the pro’s and con’s of the proposed Independent Medical Advisory Council to help get control over soaring costs and improve the ragged quality of care — Post reporter Dan Eggen did a great piece on the flow of health industry lobbying money to legislation drafters — But where is the Post’s (and reporter Michael Dobbs’) wonderful repurposing of Pinocchio as “the Fact Checker” that was such a big hit in the 2008 presidential campaign?–and_o.html

    I’d love to see the length of the noses that would be attached to the anti-reform claims that are coming from Republicans and Blue Dog Democrats.

  3. Freeda Z says:

    Health care reform that guarantees quality, affordable care for everyone in the United States is one by one being realized. Now people are up in arms over HR 3200, and maybe they should be. HR 3200 is a health care bill, and what it does is that it will provide affordable health care for all, and curtail medical costs. It also makes it mandatory for all Americans to have health insurance, but creates a government run (taxpayer funded) alternative to private insurance, prohibits exclusion on basis of pre-existing condition, and then (here’s the kicker) places a surtax on all households that earn more than $350,000 to pay for it. (To be fair, they don’t need sympathy.) The bill HR 3200 is likely to be wildly unpopular, even if it might mean fewer people needing emergency cash loans to see a doctor.

  4. says:

    I have a hard time understanding how anyone other than the executives and shareholders of the private insurance companies could think that our current healthcare system is meeting the needs of the American people. I’m a medical professional myself and support universal health care reform. I’ve written my Congressman, Senators, and the President on more than one occasion and have also called their offices to voice my support for reform. I’ve also spent countless hours researching what the best overall way is to bring down long term costs in order to provide everybody accessible and affordable health care. Here’s my solutions –

  5. says:

    Hi Tom,

    Great article. This is true for most media outlets. However, has a “The state of your health care” section, which encompasses coverage of Obama’s reform plan, California health cuts, County health cuts. In addition, we’ll have stories on alternative medicine and preventive care. It also includes opinion pieces.

    It’s a working page that will be updated each week.

    Please check it out and let me know your thoughts.

    Hoa Quach

  6. says:

    I have taught undergrads in an introductory health journalism course how to use the Dartmouth Atlas to tell the kinds of stories you long for.

    In two courses the past two years, students have shown a mastery of the Atlas database.

    Wherever you live in this country, there’s a story in the Atlas data – whether you live in a high-use, low-use or midpoint region. It shows that we don’t know what the right rate is, and that, as Jack Wennberg says, “Geography is destiny in U.S. health care.” This should be at the core of any health care reform discussion – and any journalism about health care reform.

    Gary Schwitzer
    Associate Professor
    University of Minnesota
    School of Journalism & Mass Communication
    Publisher, htttp://

  7. Tom Grubisich says:

    Why can’t newspaper web editors do what Gary is teaching his students to do so successfully? With a bit of browsing and a few keystrokes at the Dartmouth Atlas of Health Care site, the editors could produce revealing news about the quality and cost of health care in their communities — news that could help shape the outcome of health-care-reform legislation.

  8. says:

    I was traveling and just saw this now, but just wanted to say thanks. I’ve been on a big soapbox about this issue for several days now and have been beseeching local media in my city (Memphis) to do some digging as you’ve suggested.

    Although resources are drastically down in newsrooms, this is the kind of story we should OWN. And it’s also the kind of story – like WMD in Iraq – that we later regret not watchdogging hard enough while the decisions were being made.

    Carrie Brown
    Assistant Professor of Journalism
    University of Memphis
    Twitter: @brizzyc