This is the web version of VoxCare, a daily newsletter from Vox on the latest twists and turns in America’s health care debate. Like what you’re reading? Sign up to get VoxCare in your inbox here.
I, quite obviously, do a lot of writing about health care at Vox. But I also do a lot of reading — and in my humble opinion, 2017 has been a wonderful year for health care journalism.
There were many great stories about the Republican efforts to repeal the Affordable Care Act. And there were so many other great stories that had nothing to do with the drama in Washington — stories about disparities in the American health care system, our sky-high prices, and what that means for people all across the country. This is not a complete list of every story I enjoyed this year; rather, it's a roundup of those that taught me the most, and influenced my views of how health care works in America.
"GOP health bill jeopardizes out-of-pocket caps in employer plans" —Stephanie Armour and Michelle Hackman, Wall Street Journal
This story came in May, the morning of the day House Republicans were set to vote on their plan to repeal the Affordable Care Act. It relied on an analysis from the Brookings Institution's Matt Fiedler that showed, perhaps unintentionally, that the House health care plan would once again allow insurance companies to cap their spending on each enrollee's health care.
This story is an especially memorable one for me because it showed the consequences of rushed legislation. We were only learning how the House health care bill worked moments before Congress would vote on it. What's more, it showed what President Trump would remark a few months later: Health care is "complicated." Tweaking one provision of the Affordable Care Act (the essential health benefits), it turns out, changes many other parts of the law (like the ban on lifetime limits).
"The Company Behind Many Surprise Emergency Room Bills" —Julie Creswell, Reed Abelson, and Margot Sanger-Katz, New York Times
A wonderful data deep dive into EmCare, the largest emergency room doctor staffing company in the United States. The Times worked with Yale's Zack Cooper to show how EmCare would often have its physicians bill as out-of-network providers, even when patients were being seen at an in-network hospital. It shined a light on why emergency bills can be astoundingly high — and one little company's role in that.
"How we found Tom Price's private jets" —Dan Diamond and Rachana Pradhan, Politico
I picked one story of many that Dan Diamond and Rachana Pradhan reported on Tom Price's private jet habit — stories that ultimately lead to the health and human services secretary's abrupt resignation in late September. Their reporting proved vital in holding public officials accountable.
I loved this story in particular because it tells the backstory of how the reporting came together — complete with a plane-watching trip to Dulles International Airport, which led to the first spotting of Price with a private jet. If you want to understand the work that goes into great stories, then read this.
"Seven days of heroin: this is what an epidemic looks like" —Cincinnati Enquirer and Media Network of Central Ohio staff
This multimedia project from the Cincinnati Enquirer — which involved more than 60 reporters and photographers — told the incredibly human, incredibly devastating story of what a normal week in the heroin and opioid epidemic looks like in one city. The short dispatches are wrenching. I couldn't stop thinking about this story after I read it.
"An Iowa Teenager Didn’t Wreck His State’s Health Care Market. Here’s Who Did." —Jonathan Cohn, Huffington Post
Dylan Scott reminded me to include this fantastic story from Jonathan Cohn, who tracked down a patient in Iowa who had unintentionally become famous in health policy circles.
For months, there had been chatter about an Obamacare enrollee with multimillion-dollar bills who was supposedly wreaking havoc on the Iowa insurance marketplace. Local insurers cited this specific patient as their reason for quitting Obamacare.
Cohn tracked down the patient — and found that the story was much more complicated, and had a lot to do with decisions that Iowa made about how to implement the Affordable Care Act.
"The last person you'd expect to die in childbirth" —Nina Martin and Renee Montagne, ProPublica and NPR
ProPublica's year-long series "Lost Mothers" has been essential reading for 2017. We've seen, for years now, statistics that show the United States has an astoundingly high maternal death rate — much higher than our peer countries. This story and others in the series put a human face on those statistics, exploring who dies in childbirth and why those numbers are currently increasing in the United States.
"How Doctors Are Getting Rich on Urine Tests for Opioid Patients" —Fred Schulte and Elizabeth Lucas, Bloomberg and Kaiser Health News
Did I expect one of my favorite health care stories of the year to be about pee? To be honest, I did not. But this deep dive into how spending on urine testing has quadrupled in four years (hitting $8.5 billion in 2014) shows what happens when there are "no national standards regarding who gets tested, for which drugs, and how often."
Chart of the Day
Life expectancy in the United States is declining
:format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/9935375/exceptionalism.101556.png)
The United States is falling behind on life expectancy. New CDC data shows American life expectancy declining for the second straight year. Chris Ingraham at Wonkblog puts this change in context: "A person born in Canada today will live, on average, three years longer than someone born across the border in the United States." Read more here. Also read Bill Gardner's piece in the Incidental Economist about why these numbers represent a "catastrophe."
Kliff’s Notes
With research help from Caitlin Davis
Today's top news
- “House Republicans reject Mitch McConnell's plan to 'move on' from Obamacare repeal”: “McConnell told NPR on Thursday that he thinks the Senate will 'move on to other issues' instead of trying for repeal and replace in 2018. But several top conservatives in the House made it clear they wouldn't mind taking another shot.” —Robert King, Washington Examiner
- “McCaskill seeks answers from Anthem over its ED policy”: “Sen. Claire McCaskill (D-Mo.) is taking on insurance giant Anthem over its controversial policy to deny coverage for emergency department treatment for cases that are later determined not to have been an emergency.” —Steven Ross Johnson, Modern Healthcare
- “Reintroduced bill could give data brokers more options under HIPAA”: “Patients will be able to request their records from clearinghouses the way they can now request data from their healthcare provider. Because clearinghouses have longitudinal records compiled from multiple sources, the theory is that this will make it easier for patients to get access to accurate, complete versions of their own records.” —Jonah Comstock, Healthcare Finance
Analysis and longer reads
- “Arthritis Drugs Show How U.S. Drug Prices Defy Economics”: “Wholesale prices for Humira and Enbrel, the two most commonly used treatments for rheumatoid arthritis, known as RA, increased more than 70 percent in the past three years. Since the first RA drug came to market a decade ago, nearly a dozen have been added. If basic economics prevailed, RA treatments and patients would have benefited from competition.” —Julie Appleby, Kaiser Health News
- “The uninsured are overusing emergency rooms — and other health-care myths”: “The idea that uninsured people are clogging emergency rooms looks more and more like a myth, according to a recent study published in Health Affairs. Uninsured adults used the emergency room at very similar rates to people with insurance — and much less than people on Medicaid.” —Carolyn Y. Johnson, Washington Post
- “Proposed Obamacare Rule Could Weaken Benefits”: “Under the proposed rule, state insurance regulators in the 39 states that use the federal HealthCare.gov exchange could choose categories of benefits from health plans offered in other states, or they could come up with their own set of benefits with approval from the HHS. States that are struggling to maintain individual market coverage under the ACA may try to reduce premiums by looking for plans in other states where benefits are skimpier.” —Sara Hansard, Bloomberg Health Care Blog
Join the conversation
Are you an Obamacare enrollee interested in what happens next? Join our Facebook community for conversation and updates.
