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Jim Steele |
Jim Steele is the co-author, with Donald Barlett, of Critical Condition: How Health Care in America Became Big Business -- and Bad Medicine. Barlett and Steele have worked together for 30 years, first at the Philadelphia Inquirer and, since 1997, at Time Inc., where they are editors at-large. They have won dozens of awards including two Pulitzer Prizes and two National Magazine Awards. The authors of America: What Went Wrong, a 1991 paperback bestseller that grew from a newspaper series, the Washington Journalism Review called Barlett and Steele "almost certainly the best team in the history of investigative reporting."
Brian Montopoli: Has the press failed America when it comes to health care reporting? Do people have a sense of what's going on?
Jim Steele: Everyone knows that health care is in chaos, but there is almost no reporting as to the cause. It's not an easy story to get at, but if you look deeply enough you can see the source of the turmoil: the ill-conceived idea that health care is just like any other business. It's not, and until we face this misperception, the crisis will persist.
Beyond that, there is a reporting failure that's even more worrisome. We say "reporting," but the real failure may well be with timid editors who don't want to offend or challenge or who are looking for quick and easy hits. The press is filled with tales of the latest wonder drug or a procedure that will dramatically improve our well-being. They read like PR handouts and play to the public's anxieties about health. There is seldom a hint of skepticism.
In our investigations, we like to place a subject or issue in historical context. In other words, give the reader a reference point. What we found in reporting Critical Condition is that much of the media's coverage of prescription drugs, and especially that of television news, has been downright embarrassing. Go back and look at the stories at the time Vioxx was introduced and you will see just how far off the tracks our business goes. Like so many drugs, Vioxx was portrayed as a great breakthrough. But the warning signs were there from the beginning. The news media just failed to examine them. It's a failure that has been repeated over and over, from hormone replacement therapy to anti-depressants to anti-obesity drugs.
When was the last time you read stories about the latest "miracle drug" that included, among other things, a rundown on the previous work of the researchers who conducted the clinical trials or their ties to the pharmaceutical industry? Or how about the health history of those selected for the clinical trials? Or the placebo effect in the trials? Or a detailed look at side effects beyond the obligatory recitation from the drug maker?
BM: How should reporters get readers involved in stories like this, which are more important, but less salacious -- on the surface, anyway -- than the Laci Peterson-type stuff that so often dominates the news? A lot of people tend to tune out when they hear the words "health care" or "Social Security."
JS: People do glaze over when they hear terms like that, but this is a problem with the writing -- not the subject. Readers want substance, but we have to make it more attractive to them by telling stories in a compelling way that directly affects them. We can't just dish up information and expect everyone to be interested in it simply because we say it's important. Sometimes readers can be hooked with a poignant anecdote, sometimes by just looking at statistics in a different way -- and then putting the readers in the middle of those statistics.
BM: When you begin working on a series or a book focusing on a broad topic, like health care -- or, to go back a bit, an even broader one, like what went wrong with America -- how do you attack it? What's your entry point? It seems like, at the outset, projects like these must seem a bit overwhelming.
JS: We always start small, by looking at specific examples -- individuals or companies or programs -- to see what larger lessons can be learned. The Chinese have a saying for it: "A journey of a thousand miles begins with a single step."
BM: How did the success of America: What Went Wrong? change things for you? Did you have more freedom to do the stories you wanted and the time you needed to do them? Do most reporters lack the time and resources they need for significant, in-depth investigative reporting?
JS: We have been fortunate to work for editors who value long-range projects, so America: What Went Wrong? didn't change the way we worked, but it did show enterprising reporters and editors that there is a huge audience for articles about economic issues that affect average Americans and that it is possible to make a big topic human and accessible. People often ask us what is the single most valuable tool for an investigative reporter, and the answer has been the same for 30 years. It's not specialized training, not knowledge of a specific subject, not some fancy database. It's time -- time to research and time to write, then rewrite, and then rewrite some more.
BM: You've worked with Don Barlett for 30 years. At this point, do you know him better than most members of your family?
JS: Nobody can believe we have been a team this long. Somebody once introduced us as "two guys who have worked together longer than most people stay married." Early on, we saw that two of us could tackle more ambitious projects than either one alone, assuming we could work together. So far, so good.
