Media Coverage Of Managed Care: Is There A Negative Bias?

PROLOGUE: Since the rapid emergence of managed care as the insurance alternative favored by private and public purchasers, many persons believe that media coverage has heavily influenced public opinion regarding it. The American Association of Health Plans, the Washington-based voice of managed care, has taken strong exception to the most sensational coverage, asserting that because much of it is usually based on individual anecdotes, the public's opinion of the whole enterprise is distorted. However, no one has systematically analyzed media coverage to determine whether it is balanced or unduly negative. In this lead paper, authors Mollyann Brodie, Lee Ann Brady, and Drew Altman report the results of an ambitious content analysis of how major newspapers and television networks have covered managed care in the 1990s. Their results should certainly provide food for thought for the industry and the media. Brodie, who holds a doctorate in health policy from Harvard University, is senior researcher and director of special projects at the Henry J. Kaiser Family Foundation in Menlo Park, California. Brady is senior project director of media analysis studies at Princeton Survey Research Associates in Princeton, New Jersey. Altman, who holds a doctorate in political science from the Massachusetts Institute of Technology, is chief executive officer of the Kaiser Family Foundation. Altman is the leading architect of the view that foundations can best fulfill their public trust by providing information to policymakers and the public. This belief, which a number of other health care foundations have embraced, has made private philanthropy a more active force in health policy making. ABSTRACT: We conducted content analysis of media coverage (both print and broadcast) of managed care over the period 1 January 1990 to 30 June 1997, examining in detail more than 2,100 randomly selected stories. Coverage changed noticeably over the seven and a half-year period, with early years focused on managed care as a business story, and later years focused more on patient care and concerns about backlash. Coverage differed substantially depending on media source. The large majority of all media coverage of managed care was neutral in tone. However, the tone of coverage has become more critical over time and differs dramatically by source of media. The most visible media sources—television and newspaper special series—conveyed negative stories in more than half of their coverage and most often used anecdotes in telling their stories.