Health Journalism 2009: Some of the year's most noteworthy stories

ReportingonHealth's Antidote blogger, William Heisel, recently posted his 10 favorite stories of the year. Most of them had an investigative bent. Now, it's my turn.

My "Top 10 list" focuses a bit more on health policy and infectious disease, because of the top health stories of the year: health reform and H1N1. This definitely isn't a best-of list, and admittedly, it's print-centric. There's lots of excellent work out there that I didn't have a chance to read or view or listen to. But the five stories below (I'll post the other five on Thursday) are worth reading, and learning from.

The Cost Conundrum: What a Texas town can teach us about health care, Atul Gawande, The New Yorker

Surgeon Atul Gawande's detailed dissection of health care costs in McAllen, Texas, published in June, was a welcome corrective to a summer of ill-informed "tea parties" and talk of "death panels" during the contentious health reform debate. Required reading for anyone covering health reform or health policy. Here's an excerpt:

"The greatest threat to America's fiscal health is not Social Security," President Barack Obama said in a March speech at the White House. "It's not the investments that we've made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation's balance sheet is the skyrocketing cost of health care. It's not even close."

The question we're now frantically grappling with is how this came to be, and what can be done about it. McAllen, Texas, the most expensive town in the most expensive country for health care in the world, seemed a good place to look for some answers.

Cancer Center Ads Use Emotion More Than Fact, Natasha Singer, New York Times

Natasha Singer digs into emotion-laden hospital advertising and finds its claims wanting in a story that takes on a subject so visible we tend to tune it out: the barrage of medical advertising from brand-name drugs to hospitals to insurance companies.

Here's an excerpt:

Highest cure rates. Lowest risk. What evidence does the medical center have to back up such superlatives?

The ad's claims are based on the successful results of Dr. Samadi's operations and testimonials from his patients, said Jane Zimmerman, Mount Sinai's chief marketing officer.

In medical science, such anecdotal data would not be considered statistically valid. But ads for nonprofit medical centers are not held to scientific standards of evidence.

8 Questions About Health-Care Reform, Ceci Connolly and Alec MacGillis, Washington Post  

This isn't a story, exactly, but an "explainer," in question and answer format, with graphics that helped spell out the complexities of the issues involved in the health reform debate. A model of clarity, with one nit: online, it should be date-stamped.

Much is given by hospitals, more is asked, Scott Allen and Marcella Bombardieri, Boston Globe

A classic examination of hospital charity care policies at nonprofit hospitals. Here's an excerpt:

Nonprofit hospitals are popular institutions, especially in Boston, home to seven major tax-exempt teaching hospitals that attract billions in federal research grants and patients from around the world. Mass. General's parent, Partners HealthCare, is not only the state's number one private employer, but one of its most successful companies, with an investment portfolio valued at more than $4 billion.

However, as hospitals have prospered and grown, so too has the value of the breaks on state, federal, sales, and property taxes they enjoy as charities. And that fact has triggered a growing debate, among policy makers and politicians, about whether the public is still getting its money's worth from an exemption that dates to the 19th century and was created to encourage hospitals to treat the poor.

Mercurial flu keeps rewriting the rules, Helen Branswell, The Canadian Press

Helen Branswell, who covers medicine for Canada's version of the Associated Press, is considered one of the best, if not the best reporter in the world on pandemic flu. She's dogged H1N1/swine flu all year, with many scoops along the way, but I like this overview as an example of her work.

Here's an excerpt:

Flu scientists repeat almost as a mantra that the only thing predictable about flu is its unpredictability.

Yet despite decades of evidence that influenza will repeatedly rewrite the rules, flu dogma emerges and takes hold. Scientists keen to sift patterns from chaos agree X is true about Y -- until the virus sets them straight yet again. Flu scientists repeat almost as a mantra that the only thing predictable about flu is its unpredictability.