In September, after 22 years as a New York Times correspondent, Elisabeth Rosenthal will take over as editor-in-chief of the nonprofit Kaiser Health News. Rosenthal, an emergency room doctor by training, wrote a lengthy, well-received series for the Times about the high cost of American healthcare, “Paying Till It Hurts.” With the series, she told me in early 2014, she hoped to “start a very loud conversation” about costs and incentives in our healthcare system that will be “difficult politically to ignore.” We sat down recently to talk about that objective and how she intends to broaden the ambitions and reach of Kaiser Health News—which, earlier this year, expanded its California presence–and elevate the profile of health journalism.
This interview has been edited for length and clarity.
What interested you in the Kaiser job?
One appealing factor was that it is nonprofit and foundation-funded—supported as part of the operating budget of the Kaiser Family Foundation—so it doesn’t need a new business model that most media companies are struggling to find. If you look at TV stations, there are so many ads for high-cost drugs and cancer centers. That makes me uncomfortable. It’s liberating for Kaiser Health News not to have to do that. Hopefully that puts us in a better position to disseminate and break health journalism stories. I’ve been a great admirer of KHN as it has grown up. For even longer I’ve admired the parent foundation, which is such a respected name in healthcare research and information. It’s exciting to be there when there’s so much to do and resources to do it.
What are the strengths and weaknesses of KHN?
For strengths, it’s independent and has reliable funding through Kaiser Family Foundation. That’s huge. It’s really a gift in today’s media world. The staff has a tremendous depth of knowledge about healthcare and great reporting instincts—it has attracted some of the best health reporters in the country. As for weaknesses, it’s young. We’re still trying to figure out our partnerships. We’re trying to figure out the structure that will support the really ambitious reporting we want to do. The weakness is also a benefit. There’s tons of room to try new things as we continue to grow.
What’s your vision for KHN?
The first message I have to get out is that Kaiser Health News, which is part of the Kaiser Family Foundation, has nothing to do with Kaiser hospitals or Kaiser Permanente [the big medical group]. A lot of people don’t know that. Even some of my colleagues in journalism ask if we’re like the Mayo Clinic newsletter. The Kaiser name is associated with many different organizations, but we have to get out that KHN is independent, nonprofit journalism, not an offshoot of a company or hospital chain.
Kaiser Health News is now a big and growing organization with more than 40 journalists and over 100 distribution partners from the washingtonpost.com to NPR. The plan is now to build out more enterprise and investigative projects. One of my jobs is to be an idea generator at Kaiser. As a result of the Times series, my Facebook group and my [forthcoming] book, I have many more tips for stories than I can do. There are so many things to investigate. American healthcare is like a smorgasbord for good health journalists. I hope to seed a lot of good projects that we’ll share or co-report with our partners.
What specific subject areas do you have in mind?
Although KHN’s newsroom is primarily supported by Kaiser’s endowment, we now have grants from the Laura and John Arnold Foundation, The SCAN Foundation, The John A. Hartford Foundation and the Gordon and Betty Moore Foundation to focus on special project areas like prescription drug prices, end-of-life care, and rural healthcare. We want to take on those subjects and others that affect Americans, such as the rise of for-profit urgent care and the manipulation of scientific studies for business purposes. I like beginning with local examples and then nationalizing them with data to show their relevance to audiences across the country.
Can you give an example?
The KHN story from April that found there were more potentially fatal bacterial infections from improperly cleaned gastrointestinal scopes than had been previously estimated. What does it say about the national picture? There are certainly bad doctors and bad hospitals, but it’s the system that’s allowed it to happen. My goal would be to start with the scope story in Los Angeles and then look more broadly at how devices are regulated. That’s what I mean by broadening the focus of our reporting.
What other stories come to mind?
KHN has done some incredibly nice work on healthcare in Baltimore. I hope we can add an investigative edge. I would like to see more accountability in stories. Even in our shorter stories I want to have a focus on accountability. In a healthcare story about Baltimore, ask the CEO of Johns Hopkins what are they doing for the community. We need to ask people the uncomfortable questions that make them accountable.
What are your expectations for local reporting?
We are doing a bunch of hiring right now. One aim is to get more reporters in some places like Florida or Texas, or the Midwest. Our reporting resources are weighted towards California. We want to take the temperature in other places. The people being hired are not hired to do local coverage but to bolster our resources to do more theme-based reporting. The California team will be part of that. We consider them a great success.
What about international coverage?
We have a lot of problems nationally with healthcare. International is not a first priority. For now it’s health policy as it relates to making some improvements in the US health system.
Is there a danger that most of health journalism will eventually come from Kaiser?
In journalism today more interesting things are done in partnerships. Some of the most interesting projects don’t come out of pure newspapers or pure TV. They are collaborations. There will always be health journalism at other publications, and there’s a lot of good journalism at them. I hope we will be the go-to content provider at the best media outlets over time.
How are you going about getting more partnerships?
I’ve been a healthcare reporter and you’re often asked to do a lot of daily stuff. There’s a need for more partnerships to utilize all the different media forms that exist today–to combine the strengths of print, the web, visuals, audio, and data. We’re standing at the ready to be that partner. My goal is not to place stories according to who you know at other publications but be more systematic about who and where to place content.
Who is your biggest competitor in the health journalism space?
I don’t think anyone is doing what Kaiser Health News is doing. It doesn’t have a real equivalent out there. My approach to journalism is not to see others as competitors. I am looking to see what we can do to have an impact. Our goal is a good health system.
Who do you see as your audience?
Everyone. Everyone has to understand how the health system works for it to become a voting issue, a political and a patients’ issue. There’s an opportunity to move the focus away from the health policy community, to everyone, to general readers. You don’t want to abandon the people who rely on you for health policy. But healthcare is a pocketbook issue and there are people dealing with it up and down the socio-economic spectrum, on the right and left. I want our readers to be everyone and anyone who is struggling with the healthcare system and wants answers. That’s why different venues for distribution will help.
What are new areas of coverage you are considering?
My new areas are the business interests that guide our healthcare and the consumer rights issues and what people are entitled to and should be entitled to. People don’t know where to complain to or how to complain. They need to understand what’s going on and rise up.
My goal is to bring anecdotes and policy together. I don’t want health journalism to be just a story about science, or just about business, or just about policy. It makes me crazy to see drug stories that don’t talk about the price. You have to talk about the business behind the story as well as the patient who uses it.
Should there continue to be beats in the health journalism field?
It’s not where I want to go because it’s not how healthcare reporting should be done. Healthcare is all these things—business, science, economics—interacting when you walk into a hospital. The departmentalizing of health stories has made too many of them less than they should be.
What’s the ideal health story?
It combines smart policy with real people, science, and economics. It has a hard edge, asks for accountability, and uses different platforms to get the story out in different ways. If we do that all of the time, we will be perfect.