An underinsured man holds a hospital hostage after it refused to give his son a heart transplant.
A careless HMO physician misdiagnoses a woman with asthma when a simple blood test would have shown she had advanced leukemia.
A doctor performs surgery on an HIV patient after the gunshot-wounded patient refused to sign a consent form for surgery.
These TV medical drama and movie situations bring to life the hotly debated health policy and ethical issues confronting the public and legislators in an influential way,according to a Henry J. Kaiser Family Foundation study released Tuesday.
“Fictional TV shows reach a much wider audience than most news programs,and in many ways they can be even more powerful,” said Vicky Rideout,a vice president of the foundation. “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.”
The study analyzed content from every hospital-based TV drama on the air during the 2000 to 2001 season. Shows evaluated included “ER,” “City of Angels,” “Gideon’s Crossing” and “Strong Medicine.”
And,with shows such as “ER” attracting 20-to-30 million viewers each week,the study found entertainment TV can be more powerful than news in shaping the public’s opinion on issues.
“There is a lot of policy discussion in the programs – on average,one or two times per show,” said Joseph Turrow,the study’s author. “The predominant kind of discussion is not cost related but ethics. A real attempt in the programs is made to deal with the complexity of the issues.”
Turrow said entertainment media hold a substantial amount of power in influencing people’s opinion,but the danger comes in misusing it. During a panel discussion Tuesday,some argued that misusing this power can portray reality inaccurately.
“The findings that concern me are that a relatively small percentage of the content focuses on the economics of health care,” said Karen Ignagni,president of the American Association of Health Plans. “For these matters to not get representation is a very significant problem.”
The shows almost always portrayed insurance companies and lawyers in a negative manner. The shows never promoted or endorsed HMOs.
“Hollywood has no obligation to be accurate whatsoever,” said Mark Morocco,”ER” medical supervisor. “It’s important for consumers to remember that all of these entities are profit-making entities. It’s a movie or show made to entertain,not a public policy vessel.”
Of the issues raised in the shows,most were not discussed in great depth. More than 65 percent of health policy topics were dispatched in just one scene.
“I think the problem is we can’t be too dry or boring,” said James Kearns,”John Q” screenwriter. “We have to tell stories in an emotional way. The public needs to understand that we have to tell stories of conflict and dimension,and that we may not portray it (in the most educational])way.”
In addition,the study found virtually no discussion of issues such as long-term care,the uninsured,prescription drug coverage and non-HMO insurance issues.
“We know Hollywood has the power to produce visual images in a memorable and enduring way,” said Dianne Rowland,the Kaiser Family Foundation’s executive vice president. “It is the faces and stories that really do connect with our legislators and lawmakers,and that is why the entertainment media are so important.”