Is this current emphasis on the high cost of care a journalistic breakthrough?
Journalism is like the Supreme Court. It follows as it leads. Interest in costs is bubbling out there, but it’s unfocused and most people don’t understand the origin of our high costs. I like to think one service of journalism is that it educates, explains and helps organize those vague concerns bubbling in society. I think—I hope—“Paying Till It Hurts” articulates the problems and choices faced by American healthcare, and by doing so sets off an informed national conversation that will lead to action. I sense that is happening as I’ve been speaking to policy groups and medical schools all over the country.
Why the interest now?
There are a lot of reasons why healthcare pricing is coming to the fore now. The ACA has made people think about healthcare more. And more people have high deductible plans, so they’ve feeling more of the costs. We’re following the frustration people have with the system. We are also leading and causing people to question when they see this crazy money tossed around. We’re also promoting understanding that some of the health systems we’ve demonized for so many years are dealing more effectively with these issues. I hope we can corral this outpouring and spark some kind of effective movement or pressure. Hopefully someone will figure out a way to continue this momentum. Legislators are seeing there’s pressure and momentum.
How should journalists be covering this?
I think the voice that journalists need to represent is that of the patient. Is this plan delivering good care at a price that people (and the country) can afford? That’s all that really matters and other countries manage. It’s that classic journalistic mission of giving “voice to the voiceless.” Well, no one else is representing patients in our system these days.
How can journalists keep the story fresh?
That’s a bit hard because our system will likely take a long time to transition. But patient stories and good characters are always compelling. That’s why so many physicians become novelists. Also, our healthcare market is broken in so many ways there are an endless number of stories. My dilemma this year has been which to do first and which can wait.
How are you going to continue covering this? More stories? More follow-ups?
We’d originally planned six in 2013, but we are continuing the series into 2014 after realizing how much there is to do. Although the focus has been on the six long, front-page narrative stories so far, I’ve also written news analyses, blog posts and five stories for the Sunday Review. Some went in the paper; a few went online only. Some were conventional stories. But the series also included data-driven interactive graphics and video clips of patients I took on my iPhone. The series also contained some quirkier elements like an online quiz asking readers to view a series of photos and decide if each was taken in a hospital or hotel. The idea was to get readers thinking about how much American hospitals spend on hotel-like amenities rather than healthcare. One of the great things is how many tools journalists have to tell stories these days.
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