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Just Giving It Away

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Last night, I attended the 18th Annual National Institute of Health Care Management Awards, where my feature story, “Tragic Tale,” won an honorable mention for Print Journalism in the Trade Publications category. This was a huge honor, since our entry was accompanied by some incredible journalism from noteworthy publications.

When I accepted the award, I was given a chance to share a few words at the podium. Being as long-winded as I am, I suddenly grew nervous – not about speaking in public (I love speaking in public) but that I would yammer on for so long they would have to break out the shepherd’s crook for me. I don’t recall exactly what I said, since I did not prepare remarks in advance, but they went something like this:

In today’s publishing world, especially in the business-to-business or trade publication space, there can be great friction between the editorial desire to create compelling and uncompromising content, and the need to make sure the bills get paid. With this story, one of our advertisers looked fairly bad, and that was a concern for me. (Enough so that I reached out to that advertiser while writing the story to offer them as much room in the story as they wanted to tell their side of it. They appreciated the offer but declined.) When I brought this concern to my executive editor, I was told to proceed. This is why we are here; to not be afraid to tell stories with uncomfortable truths in them. It is alright if we are hard, so long as we are fair. That is so important to keep in mind: be fair.

Our modern health care system is a Gordian knot of conflicting priorities, and the sad story of Bill Mantlo illustrates that in grim detail. At some level, most people feel that in a country as rich and as advanced and as developed as ours, anybody should have access to the health care they need to fix the problems with their body. Everybody gets sick or injured in this country. Everybody knows where the medical help is. Nobody refrains from going because they can’t afford it. Meanwhile, there is a private health insurance mechanism in place that is only there because it manages to turn a profit. This mechanism funds health care, but it is not actually delivering health care. That is what doctors and nurses do. So insurers have no Hippocratic oath to uphold. Rather, they have shareholders to appease. And with that pressure on them, is it any wonder that they must pursue claims aggressively to keep costs down? Somewhere along the line, we have developed starkly mismatched expectations of our health care infrastructure, and that, more than anything, is helping to keep people from getting the care they need, and from making the system operate at its peak efficiency. Because right now, not everybody is getting what they need, and both before and after PPACA, the system is not even close to operating at peak efficiency.

Many people see health care reform in terms of black and white, us versus them, right and wrong, socialism and capitalism. It is not that simple. It has never been that simple. I appreciate the passage of health care reform – despite the legislation’s gargantuan structure and many flaws – because it has forced a practical discussion of how to overhaul health care itself. Surely, it went about this in a heavy-handed manner, and it has precipitated the discussion of fundamental political issues that will shape our nation for generations to come. I have heard health care reform referred to as this generation’s civil rights movement. I’ll let the historians decide on that one, but surely it appears that the first could easily change our daily lives as much as the second did. No wonder why folks are so eager to argue over it. But in so doing, we must not lose sight of the fact that making our health care system better is an incredibly complicated problem with no single solution in sight,and if we are to craft an outcome that does the most good for the most people, we need to reconcile ourselves to the facts that nobody is going to get everything they want from this process, and that resorting to alpha-and-omega characterizations of health care reform isn’t being part of the solution. It’s being part of the problem.

Finally, the great challenge of health care reform – and of health insurance, really – is that it becomes easy to forget, when you focus on the big picture, that all of this ultimately deals with people. People like you and me. People who hurt. People who bleed. People who suffer. People who die. People who simply want to get better with dignity and to not feel like a number. That is what has happened to Bill Mantlo, by the way, which is why his story is as sad as it is. As he has been crunched by the gears of health care financing and delivery, he has become somebody’s case file, a forgotten claim, a person too painful to spend time with. And meanwhile, that same person wakes up every day, stares at the walls, has hopes and dreams and pains and fears, and knows that for him, things may never get better.

The prize I won from NIHCM came with a check for $2,000. I could not, in good conscience, keep this money when I knew that Bill Mantlo needed it a whole lot more than I did, and so I never even took custody of the money. I had the check made out to Bill’s trust fund, which is handled by his brother and legal guardian, Mike. $2,000 is not a heck of a lot of money, really, when you consider the scope of Bill’s problems. But I am glad to have given it away, all the same. I like to think that journalism can make a difference. At least in this case, I know it did. (At this point, I must tip my hat to the charitable efforts of the life and health industry, whether it is coordinated by my friends at the Insurance Industry Charitable Foundation, or done through solo efforts, like Cigna’s sponsoring of the Achilles International. Every little bit helps. It can be hard to see that when you don’t need charity yourself. But those who need it – and get it – never forget the kindness of strangers.)

Thanks to everybody to read this story, commented, shared it and posted it elsewhere. Thanks to my colleagues who helped produce this story and lent it an objectivity when I had no more to give. Thanks to my managers who encouraged the development of this story; a few years ago, this story would never have been approved, let alone published by National Underwriter Life & Health, and I see this not as a high point, but as a benchmark to surpass. Thanks to my friends and family who let me talk their ears off about this project. And thanks most of all to the Mantlo family for their openness on a subject that is still very painful for all of them.

Thanks again, everyone. Until next time.


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