“Your investigations are extraordinary and a real benefit to the public.”
“Keep up this Awesome Investigative Journalism!!!”
“On behalf of everyone, we greatly appreciate your research and attention to this matter.”
There’s been a lot of talk lately in the news industry about restoring trust in journalism. Accusations of “fake news,” clickbait and irrelevancy are common from outside the newsroom, along with news industry anguish, introspection and academic studies, against a backdrop of vanishing revenue, layoffs and a general air of crisis.
It is widely thought that news organizations need to work to regain trust from their communities. The CUNY Graduate School of Journalism just announced the News Integrity Initiative, a $14 million project “that aims to cultivate informed citizens who trust the news.” The John S. and James L. Knight Foundation announced that it will give $1 million to fund 20 projects aimed at “concerns about trust in news (including the fake kind), media literacy, and factchecking.” Jay Rosen, the prominent New York University professor, is working with the Dutch news organization De Correspondent to roll out in the United States, in a newsroom “optimized for trust.”
Against this backdrop, I want to point to our work and especially our Cracking the Code launch in New Orleans, with partners WVUE FOX 8 Live television and NOLA.com I The Times-Picayune. What we do: Collect health care price information for common, “shoppable” procedures locally; invite our community members to share their prices via the web, email or voicemail; and then do journalism focused on price variations, how to understand the market, and how to navigate through it and save money.
One remarkable aspect of our work was the wave of positive feedback from readers and viewers. There are a few reactions at the top of this post, and I put a slew of them below.
How we did it
Few people ever see anything like this outpouring of approval and admiration in their work lives — and even fewer journalists experience this. So what happened?
Our partners are respected and widely read in the community. Yet they — like many journalists — are frequently criticized for their coverage of other stories, such as the hot-button Confederate monument removal controversy, which took place during May as we launched our first flight of reporting.
But in our “Cracking the Code” work, we encountered pretty much universal admiration.
In building our “community-created guide to health costs,” and in listening to our communities, we helped people save money (this woman saved $3,786) and understand how the health care marketplace works. We showed them how their friends and neighbors are grappling with the same problems, say a “free” colonoscopy that costs $2,500 — that they are not alone.
We explained how to figure out health costs — and one reader responded with thanks, adding, “We have started asking the right questions now and have saved hundreds already! <3” There’s something of a taboo on talking about money and health care, but we let people know we’re listening.
People responded by the hundreds and thousands: They sent in their bills. They filled out our online forms. They sent us extremely personal health information. They said they were happy to help. They commented on our stories. They mailed us their bills and insurance paperwork. They gave their bills to friends to mail to us. They brought their bills to our partners’ offices. They snapped screenshots of their benefits statements and emailed them to us on their Cricket smartphones.
They called our voicemail line to say: “I’m not privy to the Internet, but I want you to have my bills. How do I get them to you?”
People stopped our reporters at Jazzfest, at their kids’ schools, at parties, in the office and on the streets. They searched our database by the thousands. They shared our stories by the thousands. And they’re still doing it.
And our community members have thanked us for doing what we do: Journalism. Digging out the facts, and reporting them.
We are revealing secrets, and joining hands with people in an act of co-creation: Building great journalism together with our communities.
People continue to thank us, again and again, for protecting and defending them, righting wrongs in their name. Our community members signal to us that they are not sure anyone’s looking out for them in this important realm — not providers, not insurers, not government. But we are.
One recipe for building trust
So for anyone who’s looking to establish or re-establish trust in news, here’s one recipe, much like what we have been doing:
- Find out what people care about.
- Meet them where they are.
- Listen some more.
- Help them solve their problems.
- Show them their experiences in the context of their neighbors’ experiences, and in their community.
- Keep listening.
For a fuller picture, take a look at this page cataloging all our New Orleans coverage.
We’ve been doing this work for several years now, both on our home site and in partnership with other newsrooms nationwide. Here’s a page about all our partnerships.
Another important point: this signals the power of local news. Our partners are trusted local institutions. When they tell you that you can get the same common blood test for $19 one place and $522 not far away, it’s relatable and actionable — in a way that a story about partisan bickering in Washington over health care is not. The value of local reporting is immense.
In addition to the written feedback, we received so many voicemails to our query line that we could use only a small sample in our reporting. These voicemails are incredibly moving. (You can hear some of them here, in Lee Zurik’s introductory piece to our first flight of reporting.)
By letting people know that we want to hear from them, and that we want to help them solve their problems, we found a mountain of trust.
a sampling of COMMUNITY Feedback
Here’s some of the feedback we received. I’ve set off new speakers using quotes and italics, for clarity. (Yes, there are a lot of them. You can stop reading at any time, but I urge you to keep reading: these voices are remarkable.)
“Thank you Fox 8 for doing the research on this. It’s very helpful to me and many others. We have started asking the right questions now and have saved hundreds already! <3”
“Thanks to this Times Picayune series on healthcare costs I actually found a mistake on my bill. I was coded for an expensive procedure I did not get that I owed $250 out of pocket for. The only reason I found the error was because I was trying to enter the information into the online tool. So thanks for that!”
“I have been reading and occasionally commenting in NOLA.com since it’s inception. I believe this ‘Cracking the Code’ piece of Investigative Reporting on medical procedures is one of the best concepts that NOLA.com has embarked on. I look forward to each new article on this subject.
“The idea of having readers/patients input their actual billing information is genius. Once the information provided by enough patients with their billing on various medical procedures hits a ‘critical mass’ level, then, NOLA.com can provide a list of ‘expected’ cost for various medical procedures in the New Orleans area.”
‘I have been a critic in the past .. but I give [you] a 100% on this important subject’
“Keep up this Awesome Investigative Journalism!!!”
“I have been a critic in the past as to some of NOLA’s articles but I give them a 100% on this important subject. We need more articles like this to identify how problematic the delivery of health services is! Health Insurance is separate from healthcare.
“Unfortunately, it is too difficult to separate them because the ‘consumer’ is not attached to the decision making much like their vehicles or any other type of service. Mystery is advantageous to this industry.
“Thank you so much for these segments and articles because it’s really made me second guess what these facilities are charging. They’ve been getting away with overcharging for a very, very long time and I will not get any “work” done without first shopping around for prices because every time I go to the doctor I go in with high blood pressure knowing I’m about to get screwed on the bill and I have insurance.”
“Thank you Lee for uncovering and exposing this ! Please keep up the fight !”
‘I have a horrible personal story’
“Keep up the great job..Appreciate you!..”
“Great Job on investigating the medical cost problems in the n.o. Area!!???????????????? we always enjoy watching cracking the code. I have a horrible personal story on surgery procedure pricing at two different facilities. The cash quotes were thousands of dollars apart. (Wrist arthroscopy surgery) Is this the email to send my story to? I’d like to stay anonymous but feel the need to get my story out. Thx!”
On one of Jed’s stories: “That response from Tulane is pathetic: ‘the amount patients are asked to pay for hospital services typically is determined by the insurance coverage they have. If patients have questions about their deductible or co-pay, they should review their plan with their insurance company.’….Yes, but that does not explain why the procedure at your facility costs over $5000 vs $672…”
“it’s quite shameful and rather tone deaf for Tulane to attack the paper over this, rather than acknowledge the problem — nobody knows how much procedures cost, making it very difficult to price shop procedures. this is just how they want it.”
“THANKYOU FOR YOUR WONDERFUL REPORTING AND ANY HELP WITH THIS. I am retired and on a fixed income!”
‘Friends asked me to send these. They don’t have internet access.’
“Some friends asked me to send you these attached EHBs, as they don’t have internet access and they’re not able to enter the info on the online forms.
“I hope this info helps your investigation. On behalf of everyone, we greatly appreciate your research and attention to this matter. We hope your coverage will result in policy changes that will make health care costs more transparent, uniform and accessible for all.
“I’d like to commend Lee Zurik on his investigative reports that corroborates what health services researchers have hypothesized and are increasingly able to demonstrate; that price of procedure and quality of outcome are not related. …
“Best regards and thanks for your contribution to this timely issue
“Richard Culbertson, PhD
Professor and director
Health Policy Systems Management
School of Public Health
LSU Health Sciences Center
“I think it’s great that you are doing this! Medical billing seems to be a mystery even to those that do it for a living. Another frustrating aspect is these hospitals and affiliated clinics that gouge patients also have the benefit of being non profits. Ochsner, Touro and Tulane, among others, pay nothing in property taxes!”
“Great article. It’s about time these hidden facility fees get exposed. I have received them from ochsner and Tulane. I called to complain to the department of insurance last year but because I had a self funded insurance product they would not address it.”
“These are excellent articles exposing the rampant money grab by healthcare providers, hospitals, and healthcare organizations.”
‘What a Good & Necessary service y’all are doing for the area!’
“So that’s what happened to me! Thank you.
“6. If you think the prices are high, you may be right. Hospitals generally charge more for things like an MRI than a self-standing radiology center does. If your provider is offering a $2,300 MRI, you might feel comfortable asking if you could go to the place up the street that charges $500. Ask around.”
“What a Good & Necessary service y’all are doing for the area!!! I live in Utah & Wish we had Health Cost Disclosure!!!”
‘We are getting held up at needle point that’s the bottom line’
“The Times-Picayune and WVUE Fox 8 has done a tremendous service for the New Orleans area.”
“Thank you for what you are doing. In spite of the attention that healthcare and insurance gets in the news, it seems to me that the real issues are never addressed. Please keep up the good work. “
“These companies can do what they want. How do we fight those big companies? They know you don’t have the money to fight them so they just do whatever they want.”
“This is just nuts. Thank you for the excellent reporting!”
“Excellent reporting. What an insane system.”
“It’s NOT complicated. It’s FRAUD. Obscenely Inflated billings just because some people will pay without a dispute.”
“If you are in a non-emergency situation, it is well worth your time to ask the doctor for the specific procedure he/she will be ordering and then call around and compare prices for that service (some facilities even publish their prices on their webpage). The money you save can be significant.”
“We are getting held up at needle point that’s the bottom line.”
‘your investigations are extraordinary and a real benefit to the public’
“i agree — a big part of the problem is that the prices are hidden. when i ask service providers how much they often “it depends on your insurance” rather than give a baseline price to use for comparison. this makes it impossible to comparison-shop.
“they want it this way.
“our must-have- it-all attitude as consumers justifies wildly incoherent (and predatory) market forces.
“I mean, what would you or I charge if we knew people would pay whatever it costs?”
“Don’t trust government healthcare? Well, don’t trust the private sector health industry either. Self sufficient healthcare cost management – always force hospitals, clinics, doctors, out-patient services to quote cash prices (and get your insurance coverage prices) or go to another provider. That’s the competition healthcare fears – an informed public.“
“This program referred to in the article seems like it has the potential to help a lot of people, so cool yeah let’s spread the info.”
“Thanks to NOLA.com | The Times-Picayune and WVUE Fox 8 News as well.”
“I would like to contribute to the medical bill investigation. Please see attached itemized statements.”
“your investigations are extraordinary and a reall benefit to the public”
‘We always enjoy watching cracking the code’
“Of course Tulane’s CEO is blasting Lee Zurick’s investigation – he has been exposed! He points the finger at the insurance companies, who certainly play a part, yet does not accept responsibility that his prices fluctuate from office to office, are above other providers, and that his staff has the power to work with insurance companies to provide patients’ copay responsibilities upfront. I work for a specialty pharmacy and we dispense medication that is covered under Blue Cross/Blue Shield’s major medical benefits and we go to their website and look at the patient’s plan in order to quote the patient their copay responsibility upfront prior to dispensing their medication. Why would they not do this?”
“This is a great documentary being supplied to the public….thanks so much for caring!”
“Thank you so much for what you are doing to help bring transparency to health care! People often talk about the health care crisis in our country but if providers were held to ethical billing practices I believe most of the problems in health care would take care of themselves. Thank you again for all you are doing to help!”
“Keep up the good work of exposing the real nationwide problem in heath care – pricing. Plus, ‘Cracking the Code: The Real Cost of Health Care’ is a great project to help bring this issue to light.”
“I very much appreciate what you all are doing…THANK YOU!
“With insurance this would have cost me triple. Paying cash saved me $1200.”
“Thank you all so much for the article “Cracking the Code”, by Jeanne Pinder, in the Times-Picayune today (5/10/17). Lexie Montgomery, pictured on the front page today, is a reflection of me, and many others. I am a licensed social worker, and worked for a Medicare Advantage plan in the New Orleans area for 11 years (retired in November of last year). I am currently on Humana Total Care Advantage, a Medicare Advantage plan. I am so distressed by the constantly rising rates of healthcare for us all (from office visits to hospital stays to pharmacy), and the mass confusion surrounding charges and insurance. I don’t know if it’s greed, over-regulation, mismanagement, or a combination of each, but I think it’s making us all more sick!…”
“I cannot imagine what others, that do not have the experience working for a health insurance company, do about issues such as this. I think people throw up their hands, pay the bills and end up in financial and medical disasters because they cannot afford the unexpected costs. The confusion about consumer rights, miscommunications and misdirection by insurance company representatives (and the HUGE difficulty experienced in even getting to a human being on the phone), consumer confusion about coverage, pharmaceutical advertising, and healthcare run by corporate entities are all combining to create disastrous outcomes. I don’t know where all of this will head, but it isn’t looking good for any of us. I very much appreciate what you all are doing to help, by reporting on this and providing those of us that read the articles with helpful direction and information. THANK YOU!”
“Thank YOU for exposing these frauds!”
“Thank U for putting together this much needed website. Wish it was avail for all communities!
Thanks for sharing this……now I am educated more on my MRI and procedure.You guys rock!”
‘If I knew it was going to cost this much, I would have never allowed the blood work to be done’
“This is ludicrous. I don’t want to pay that as I never agreed to it. I don’t know where to go from here. … I was wondering if your investigations would lead to any additional guidance in this situation.”
“Thank you for bringing awareness to these issues! I’m sure it will help prevent this in the future.”
“I’m so glad you are doing this!
“First, let me tell you about my background.
“I received my RN from Charity and a BS in Nursing from LSU
“My husband was a physician and I managed his practice.
“I’m 79 years old so have seen a lot of both sides of the delivery of medical care over a period of many years.
“Attached are two experiences: my husband’s own experience in 2006 and my most recent in Dec. 2016.
“I would just add one other possible solution to an individual’s health care dilemma and that is bringing your situation to the attention of the state insurance commissioner. That is what I did in 1991 with the help of my surgeon.”
“I would like to create a fb group in regards to your investigation. I would like to see our state officials response as well. Would you mind if I create such a group? I think that your research is by far the best information we have to fight rising healthcare cost.”
“I personally asked Conexis/Cobra to call Blue Cross Blue Shield of Louisiana twice but they stated that they don’t make outside phone calls. I am unsure of who is at fault for this. What do you do in a situation like this? It feels that they would rather my Father die than take care of the insurance business properly. … If you require any further information please do not hesitate to ask. Medical cost is a very important issue to me.”
“Thank you so much for taking on this topic. It is one that has troubled me for a long time and seems integral to understanding and improving our health insurance coverage issues. I have long wondered why this discussion has not been out in the public and news media. Good luck with your investigation.”
“I feel like they were looking for extra charges by having the cardiologist request separate blood work. I felt you may be interested in hearing this. I appreciate your great work.”
“I informed her that if I knew it was going to cost this much, I would have never allowed the blood work to be done. How can these medical offices do whatever they want without providing the patient with an estimated cost. Thanks for your help,”
‘Please accept these documents for your research’
“im not able to have full use of my arm, so it is hard to type. please accept these documents for your research, so that WE THE PEOPLE, have more KNOWLEDGE.”
“I was surprised to see such high bill for a simple stress echo stress test. I had such a test done in India for less than $100. I was not made aware of the cost of the test. The costs and transparency by the hospitals and the whole system is outrageous. I comments you all for this very important initiative and would like to offer my help whatever way I can. I also have a huge problem with he pharmacies – this morning I went to pick up my medicine, they did not have one of the medicines and when I asked how much is the medication they said we can not tell you until we receive the medication which is absolutely outrageous, how can one do comparative shopping when they do not give you the price.”
“I worked for a large medical manufacturing company that was involved in unethical billing practices. I have no idea if it still occurs. Is this something of interest to you?”
“Hope this helps you out with your investigation. Thanks for all the hard work you do with your special investigations. It does open our eyes to what’s not typically reported in the media.”
“Thanks so much for this info !”
‘I was so furious while composing the previous email , I forgot to tell you my name.’
“First, I would like to thank you covering this story. I am furious of how pink eye treatment is costing and United Healthcare $2158.00 Let me walk you this story…(snip)
“I was so furious while composing the previous email , I forgot to tell you my name. ????
“Thanks again for covering this story,”
“If you ask the cost of a procedure the standard answer is ‘we don’t know, we cannot break down that information, because we are not sure what and how much medication you will be administered. What equipment will be used. If there is an unexpected complication, we can’t give a price.’ “
“If I can be of help on this project I would like to offer my experience. I know how nursing homes operate, home health agencies, DME companies, doctor’s offices and hospitals. “
“The total charges at Lakeview Regional were $31,402.65. My insurance discounted $14,759.22 and paid $11,142.37 leaving a balance of $5,501.03 for me to pay. I was also billed $1,231.00 by the ER doctor at Lakeview and owed $246.20 after the insurance payment and discount. In addition to all of the above mentioned bills I received bills from pathologists, cardiologists, the neurologist, and radiologists. The total amount I owed was over $9,239.44 for two days! … Thanks for all you do with your investigative reporting!”
“After watching cracking the code, I thought that I should contribute to the problems that our country is having with health care.”
‘I am 79 years old. I want to participate.’
“I am 79 years old. I want to participate. May I mail you a copy of our EOBs. It is easier for me to do because your directions are too complicated for me. . .Let me know an address and I will copy them and send them to you.”
“Really good series on health care pricing. I’ve been checking prices on various procedures for some time and am always surprised at how much they vary. “
“I have a ton of EOB’s that I would have to print and black out info and scan back in in order to put them in the database. But I am SO glad you guys are starting this, maybe it will make the prices come down. I am truly lucky to have good insurance coverage and I can’t imagine if I didn’t. I’m a teacher and he is a truck driver, so there isn’t a lot of money hanging around. Thank you!”
“As a Medicare member, I am subject to providers in my providers handbook. Does your investigation affect this situation? I follow ch. 8 religiously and your investigations are an important reason. “
“To Whom it May Concern,
“Please find attached some Explanation of Benefits that I was able to find. I hope it helps and I hope to be part of the solution. Thanks for all you do.”
“The costs and transparency by the hospitals and the whole system is outrageous. I commend you all for this very important initiative and would like to offer my help whatever way I can.”
To discuss a potential partnership, email firstname.lastname@example.org.