Television Hospital Dramas Often Draw on Public Policy Debates for Story Lines, Study Says

Television hospital dramas regularly feature national health policy issues such as patients' rights, managed care and racial health disparities, but they do not feature some of "the most hotly debated" health topics, such as prescription drug coverage for seniors or health coverage for the uninsured, according to a study of the 2000-2001 television season prepared for the Kaiser Family Foundation. About one scene per episode of a medical drama deals with a health policy issue, the study, titled "As Seen on TV: Health Policy Issues in TV's Medical Dramas," says (KFF release, 7/16). The study examined 74 first-run episodes of four hospital-based dramas: "City of Angels" (CBS, cancelled), "ER" (NBC), "Gideon's Crossing" (ABC, cancelled) and "Strong Medicine" (Lifetime) (Rovner, Reuters Health, 7/16). On "ER," for example, story lines have dealt with the legality of distributing clean needles to drug users and an HMO's denial of pain management care to a woman with terminal breast cancer. An episode of "Strong Medicine" featured a critically ill low-income patient without access to prescription drugs in an inner city neighborhood.

Findings
Among the study's findings:

Of scenes on medical dramas dealing with public health policy issues, 48% presented "both sides of the issue in an even-handed manner," while 26% of scenes favored current policy and 26% of scenes were against current policy (KFF release, 7/16).
Most of the public health policy issues raised during medical dramas were not explored in "great depth," and only one in five issues continued over several scenes.
Of scenes dealing with health policy, 78% concerned ethical issues, while 13% concerned issues such as access to or cost of care and 9% concerned both types of issues.
About half of scenes dealing with health policy concerned issues being considered by Congress or federal agencies, while 32% concerned malpractice cases and 9% concerned hospital policies (Greene, CNN.com, 7/16).
Shows frequently featured groups and individuals involved in national health policy debates, including hospital administrators, lawyers, government agencies, insurance companies and HMOs. HMOs, insurance companies and lawyers were portrayed more negatively than positively as compared with other groups. Specifically, all six references to HMOs throughout the television season were negative.

A separate survey found that of the 44% adults who had heard of the movie "John Q," more than seven in ten said they believe insurers refuse to pay for treatments as portrayed in the film, with 42% saying care denials happen "a lot" and 30% saying they happen "sometimes." The story line of the movie centers on a young boy who is denied a heart transplant (KFF release, 7/16). Study authors Joseph Turow and Rachel Gans of the University of Pennsylvania note in the study, "Clearly, the primary mission of prime-time hospital series, like virtually all network TV, is commercial entertainment. Nevertheless, we found that the program's creators often draw on public policy debates for their stories and that characters in them become involved in intense health care policy arguments" (Reuters Health, 7/16). Vicky Rideout, a foundation vice president, added, "Fictional TV shows reach a much wider audience than most news programs, and in many ways they can be even more powerful. Instead of bill numbers and budget figures, health policy issues are portrayed through the lives of characters the viewer cares about, often in life or death situations" (Courrege, Scripps Howard Foundation Wire, 7/16).

Resources
The study, "John Q" survey and other related materials are available online.
A HealthCast of the forum -- including comments from American Association of Health Plans President Karen Ignagni; "John Q" screenwriter James Kearns; Mark Morocco, medical supervisor for the NBC dramas "ER" and "Third Watch"; Families USA Executive Director Ron Pollack; and Turow -- is available online.
In addition, an NPR "Morning Edition" report on the study and AAHP's hiring of talent agency William Morris is available online in RealPlayer Audio.

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Television Hospital Dramas Often Draw on Public Policy Debates for Story Lines, Study Says

More From KFF Health News