Q&A with Lisa Zamosky: Former Insider Now Writes About Health Insurance

Few health writers in the country understand the whys and hows of health insurance as well as Lisa Zamosky. She has had the rare experience of working deep within the insurance industry before turning her attention to writing about insurance and other health care issues.

Like a lot of freelancers, Zamosky has several gigs that keep her busy. She writes about health care, health insurance and health policy for California Healthline. She writes the Health Insurance Navigator blog for WebMD. She writes the Health 411 advice column for the Los Angeles Times. And she has written children's books, too, on topics such as World War II, Louis Pasteur, and The Buddha.

I suggested recently on Antidote that writers may need to find new ways to reinvent themselves in order to survive, and Zamosky is a great role model. For this Q&A, I took some cues from ReportingonHealth's community manager Angilee Shah, whose great Career GPS blog often taps writers for "how they did it" advice. I reached Zamosky via email. Here is the first part of our interview, which has been edited for clarity. The second part will run later in the week.

Q: You started out working in hospitals and clinics in New York City. What exactly did you do and how did that segue into your work in the insurance industry?

A: I have a Master's degree in clinical social work. After graduate school, I moved from Los Angeles to New York City and worked as both an outpatient mental health therapist and inpatient psychiatric social worker for a while. This was in the mid-90s when managed care began to take hold. I became interested in what was going on at the macro level in health care and decided to leave clinical work. I took a job researching, writing and developing educational seminars for executives in the health care industry, trying to get a handle on the impact of managed care on all aspects of their business. After nearly two years doing that, I was offered a job with a large behavioral health managed care organization. I started by working with a team that developed and wrote benefit programs for large corporations and state governments. Ultimately, I oversaw all provider network operations for the states of New York and Connecticut, and I led a team responsible for negotiating contracts with hospital systems, individual and group health care providers. I then spent about two years working for a health care IT company that aggregated data used to prevent medical errors.

Q: When you were working in the industry, what were some of the common misperceptions you saw by journalists writing about health insurance and health care?

A: I think there was a lot about the inner workings of the business and how it impacted both consumers and health care providers that wasn't understood. Here's an example of what I mean: A few years ago, stories began publishing in the popular press about how insurance companies pay widely different amounts to different hospitals for the same services. It seemed to be revelatory at the time which, honestly, floored me. Those negotiations and the terms of those contracts have always been driven by a host of factors that vary from one market, one hospital to another. I sort of kicked myself for not realizing this wasn't widely understood. Had I thought about it as an outsider, I would have pitched that story years earlier myself.

Q: What were some of the problems with the industry that you felt deserved more attention?

A: The insurance industry was undergoing a period of mass mergers and acquisitions at the time. The company I worked for was comprised of three legacy companies. Attempting to integrate the IT and other business functions among the three organizations was an utter nightmare. Often, the left arm had no idea what the right arm was doing and many basic functions were very difficult to carry out. That has a huge, and usually negative, impact on consumers and the provider community contracted to work with insurers. One of the biggest lessons I learned during that time was how what sometimes appears evil can, in reality, be the outcome of pure incompetence.

Q: How did both of those experiences inform the types of topics you were drawn to and the way you approach reporting?

A: I have chosen to focus on health insurance, the intersection of health and personal finance, and helping consumers navigate the system. It's an area I know from a number of different angles and there's such a strong need for this kind of information. The fact is that the cards are heavily stacked against the consumer. You can't beat the system, but, with information, people can do a much better job for themselves and their families when it comes to accessing and paying for health care.

Q: Here's something that most health writers don't have on their resume: author and editor of more than 40 children's books. How did you get into that line of work, and has it influenced your other writing work?

A: I had just started working for myself as a freelance writer and a close friend who worked in educational publishing needed help writing a children's series. He asked if I could help, and, although I had never written a children's book before, I said yes. It was a great experience and the more I did it, the more projects came my way.

That experience has definitely influenced my current work in that it taught me how to write about complex topics in a way that is easily accessible. It turns out to have been great preparation for writing about health insurance and policy for consumers.

Q: You and I have something in common. We both write for multiple outlets and wear a lot of different hats. Describe for me a typical week in your writing life.

A: I would say a typical week involves me having to meet at least three deadlines, research several topics I'll be writing about the following week, developing interview questions based on my research, identifying and setting up interviews and then conducting a number of telephone interviews. A truly crazy week means four or five articles due with as much research and as many interviews to conduct. It's all about my Google calendar, juggling, and coffee, lots of coffee.

Next: How to write an advice column with the proper perspective