Dan Diamond, Executive Editor
I think I read 10,000 articles about health care last year—at least.
Some of those articles whipped by in the middle of a busy news day. Others I skimmed late at night, or early in the morning, as we decided whether to include them in the Daily Briefing's news roundup.
(Senior Editor Juliette Mullin and I did some back-of-the-envelope math, and we figured the Daily Briefing team collectively reviews at least 100 stories every day. That's not counting the articles I read for my work at Forbes and California Healthline, either.)
Why am I telling you this? Because I'd like to share my favorite health care stories from 2014—and I'd like you to know the context.
Let me caveat that I'm not on the level of Trudy Lieberman, CJR's excellent health care press critic. And I'm skeptical of Gladwellian pronouncements, specifically that sheer volume confers expertise.
But thanks to those 10,000-plus articles, I trust that I saw about as much health care journalism as anyone last year, and had to make judgment calls over which stories belonged in the Daily Briefing, which we send to 150,000 health care executives, analysts, and reporters every day. And a few dozen stories really stood out.
I posted many of these wonderful pieces on Twitter in December, and wanted to collect the rest of them in one place, which you'll find below. Whether or not you agree with the sentiments in each article, I think the mix does a fair job rounding up what made news in 2014—two dozen or so stories that reflect the ever-interesting, ever-changing health care industry.
Affordable Care Act implementation
Mississippi, burned. Writing in Politico magazine, Sarah Varney's much-praised story reviewed how the state with some of the worst health outcomes in the nation got further "left behind" by the Affordable Care Act. (The piece was a Politico/Kaiser Health News collaboration.)
Obama's trauma team. Steven Brill's cover story for TIME magazine was an unparalleled look inside the administration's frantic effort to repair the broken HealthCare.gov site. (Full disclosure: Jeff Zients, who Brill favorably profiles in the piece, was CEO of the Advisory Board Company when I started.)
Obamacare sign-ups were inflated with dental plans. Bloomberg's Alex Wayne had arguably the year's biggest health policy scoop: His November story revealed that HHS only hit its ACA sign-up target number by including hundreds of thousands of dental plans.
Rethinking the Gruber controversy: Americans aren't stupid, but they're often ignorant—and why. The inimitable Princeton economist Uwe Reinhardt often cuts through the schlock, and his Health Affairs post in late December summed up what Jonathan Gruber's remarks actually revealed about the ACA and the American political process.
Predicting the fallout from King v. Burwell—Exchanges and the ACA. Nicholas Bagley, David Jones, and Tim Jost wrote the essential primer on the biggest legal challenge looming for the Affordable Care Act this year, and why states might not be saved by simply issuing executive orders.
Medicare: Not such a budget-buster anymore. In this post for the New York Times "Upshot" blog, Margot Sanger-Katz and Kevin Quealy detailed the remarkable slowdown in Medicare spending, helping reframe how we think about the public program's finances.
Restoring trust in VA health care. After the wait-time problems in the VA health system roiled the health care community, and revealed deep systemic problems, Ashish Jha and Ken Kizer's essay in NEJM cogently diagnosed what was going wrong and proposed three practical solutions.
Vermont's single-payer dream is taxpayer nightmare. Bloomberg View's Megan McArdle often staked out unique, critical positions that were sometimes contrarian and often prescient. For example, Vermont announced in December it was pulling the plug on its single-payer experiment—but back in April, McArdle's story predicted exactly that.
Physicians behaving badly (or not)
ProPublica's Treatment Tracker: The doctors and services in Medicare Part B: This interactive tool and ongoing investigation from the ProPublica team of Charles Ornstein, Lena Groeger, and Ryann Grochowski Jones used recently released Medicare billing data to shed light on how individual doctors were treating Medicare patients, and whether their tests and charges were justified.
What big data can't tell us about health care. Now, from the other side: Lisa Rosenbaum tracked down one doctor who was named the 17th highest biller in the nation by Medicare's data release, and explored what the numbers reveal (and what's impossible to know) in this New Yorker piece.
Doctors cash in on drug tests for seniors, and Medicare pays the bill. Drug-testing grandmas for PCP? In the words of one doctor, "urine testing is how I pay the bills." The Wall Street Journal's Christopher Weaver and Anna Wilde Mathews dug deep for this story on how the well-intended war on pain-pill addiction has led to an unintended consequence: drug-testing some patients now pays better than treating them.
Three people, three stories
The day I started lying to Ruth. In a year when the health system grappled with Being Mortal, this unforgettable story by Peter Bach in New York magazine made a very difficult conversation very real: What happens when a cancer doctor wrestles with telling his wife the truth about her cancer? It still hurts to think about this one.
Opting against Ebola drug for ill African doctor. Well before America began to really grapple with the threat of Ebola, Andrew Pollack was filing gripping reports to the New York Times of the fight taking place in Africa. His tale of the last days of Dr. Sheik Umar Khan stuck with me.
Kaci Hickox fights back: Flying back from Sierra Leone, the nurse stepped off a plane and into a political controversy over whether health care workers who treated Ebola patients should be quarantined. In an essay for the Dallas Morning News, Hickox detailed her harsh, inconsistent treatment and stood up for her rights (and the rights of other health care workers).
Vox's coverage of the Hobby Lobby and Halbig cases: Last year's big ACA court challenge (Hobby Lobby) centered around religious liberty, companies' rights, and contraception coverage under the health law; this year's (Halbig) will focus on whether the law's insurance subsidies are legal in states that opted for the federal insurance exchange. Sarah Kliff, Ezra Klein, and Adrianna McIntyre ran point as Vox filed dozens of posts explaining the cases, translating the legal developments for lay readers, and capturing a flurry of breaking news. Here's their story stream for Hobby Lobby and their story stream for Halbig.
Remaking medicine: Reports from Louisville. By focusing on one American city, Abby Goodnough's ongoing New York Times series remained a terrific microcosm for how the ACA implementation played out. For example, this story from March went inside Louisville physicians' debate over accepting new Medicaid patients, and this September piece captured how the ACA was helping Kentucky voters—while hurting Democrats' votes.
Paying till it hurts. A second New York Times health care series, this one authored by Elizabeth Rosenthal, also continued to be essential reading in 2014. Rosenthal's series takes old health care problems—like why specialists' income has risen so dramatically, especially compared to primary care doctors—and made them new, and front-page news. Here's a link to the series.
Kaiser Health News's series on readmissions penalties. Jordan Rau's great data journalism for KHN was encapsulated by his approach to Medicare's readmissions penalties: A guide to readmissions penalties, a feature ;story, a sortable look at average penalties by state, and downloadable hospital data to boot.
The Incidental Economist(s). I check this site so often, it was impossible to pull just one or two stories from the dozens of quick-hit posts that make sense of the day's health policy news. But I thought Aaron Carroll's public-health focus, like debunking the vaccine-autism connection, was always laudable; Austin Frakt's detailed policy analysis, like this look at the Sustainable Growth Rate that appeared in the New York Times, was consistently essential; and the pair's occasional team-ups, like this review of "zombie Medicaid arguments," were laudably essential.
The man with all the numbers. Charles Gaba, a self-described "numbers geek," launched ACAsignups.net and immediately became a valuable resource for anyone covering the ACA exchanges' first open enrollment period, or merely curious about how it was going. (His site's transparent reports were a striking contrast to the administration's opacity.) And Gaba's site continues to be a terrific bookmark for all exchange-related information; here's the archive of 80 or so posts about Oregon's sign-up data and exchange woes, for example.
A few more worthy stories that got sent to me after I polled my Twitter friends for suggestions. (Note: These were all nominated by people who weren't the authors.)
Cure hunters: Sam Baker's terrific National Journal magazine profile of the doctors who are fighting—and frequently failing—to solve Alzheimer's, Ebola, and other devastating diseases. One doctor spent 15 years on 13 different malaria vaccines, infecting himself at one point to feel what it was like to be a patient.
GOP's Obamacare fears come true. In a compromise with Republicans, the Democrats crafting the ACA intended that the law would set up 51 different insurance exchanges, run by 50 states and D.C. However, the states' ongoing practical and financial problems mean that one national exchange run through HealthCare.gov has become increasingly plausible, Politico's Jen Haberkorn and Kyle Cheney argued in this interesting June story.
Walking the uninsured through Obamacare sign-ups is tiring and tedious. It also works. In this vivid piece for the Huffington Post, Jeff Young sat with the 15 health workers trying to sign up the 20,000 uninsured people who lived in Maryland's Lower Eastern Shore area during the ACA's first open enrollment period.
Here's why health care should be talking about net neutrality. At Modern Healthcare, Darius Tahir's path-breaking story explained how the nation's net neutrality debate (which isn't on the radar screen for most health care executives) could shake up electronic health care records, telemedicine, and much more.
One of a kind. Seth Mnookin's emotional New Yorker piece dove into the torture of being a parent to a child with a newly discovered disease—and the incredible lengths that those parents will go to fight for awareness, research funding, and the dream of a cure.
A singular look at one of health care's peskiest problems
Why we didn't vaccinate our child. This post probably isn't what you think.
Health Insurance Exchanges,