U.S. newspaper coverage of Medicare part D legislation: A framing analysis

This study focuses on the coverage of prescription drugs in United States (U.S.) newspapers prior to the signing of and leading up to the implementation of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MPDIM Act). This study investigates whether Lule's master myths are used by reporters to frame their stories of health care legislation. This study used only staff written English language articles published in the U. S. LexisNexis Academic was searched for phrases "cost of prescriptions" and "prescription costs" to select articles published between January 1, 2000 and December 31, 2005. A total of 2,688 newspaper articles published in the U.S. were coded using Lule's seven myths, as well as coded for effect (effect on individual, corporations or governments) and mitigation categories. The Holstis method of reliability produced scores ranging from .95 to .98. Out of 1,722 articles that used the phrase "prescription costs" 72.99% had at least one of the seven Lule myths discernible in the story frame. This result was replicated in a non-overlapping set of 976 articles that used the phrase "cost of prescriptions", 70.70% of which framed a story around a myth. The most prevalent myth was the trickster myth that described the government or corporation misleading the general population concerning the benefits of the legislation. The second most common myth was the hero myth, which was observed in articles that developed a story of an individual standing up for the greater good of the population. Third was the Victim myth that manifested itself as the individual having to pay too much for medications that were available overseas at a much reduced price.;Most articles (84.32% of the articles "prescription costs" and 81.36% "cost of prescriptions") focused on the individual. Reports offered a variety of mitigation strategies, such as seeking prescription medications from abroad, pill splitting, comparison shopping, or letting Medicare negotiate with pharmaceutical companies on medication rates. The use of different myths shifted to the trickster myth after the signing of the MPDIM Act. This myth portrayed the government as having sold the population on something less than adequate.;The study design enabled replication of findings in two non-overlapping samples of articles. Overall, there is strong evidence that newspaper framing of the MPDIM Act favors mythological constructions in which healthcare consumers are exposed to tricksters and in which they are presented as victims. In addition, heroic constructions are often used in stories of local government officials who attempt to find creative cost saving measures. While this evidence suggests a pattern in how newspapers might have shaped public opinion on the issue of the MPDIM Act, it is premature to extend these findings to non-newspaper framing of MPDIM stories. Much is to be learned in how lay people frame their stories of critical social issues and this understanding can be gained by analyzing internet blogs, tweets and other types of social media.