Institutional rules for framing healthcare policy issues in national,financial, and specialized newspapers

By considering the role of institutional rules for news making, this study examines news frames embedded in 1162 stories from national, financial, and specialized newspapers with respect to four healthcare policy issues: “the decrease in pharmaceutical prices,” “the comprehensive medical payment system,” “swine flu,” and “humidifier-related lung disease.” Conflict, economy, crisis, and policy execution are dominant frames in stories about the policy issues, and these four frames are also major frames used by the newspapers. This phenomenon is understood as “concentration of healthcare frames.” We conducted in-depth interviews with 19 news reporters to identify institutional rules that might influence the formation of news frames. In-depth interviews revealed that similar types of frames resulted from institutional rules (e.g., journalist’s autonomy, news value, newspaper’s mission statement, and characteristics of readers). The findings suggest that health journalists follow institutional rules that govern the creation of news frames. To provide diverse perspectives on healthcare policy issues, newspapers need to reconsider their institutional rules.