March 2013 | Hillman Foundation

Clear It With Sidney

Notes on journalism for the common good, by Lindsay Beyerstein

March 2013

Kidnapping Rings Strong-arm Eritrean Immigrants

Imagine getting a voicemail from a teenage cousin you’ve never met telling you that you must pay a $25,000 ransom or her kidnappers will torture her to death and sell her organs on the black market. You know she’s telling the truth because you can hear another victim screaming in agony in the background as his captors pour molten plastic on his back.

Refugees have been streaming out of Eritrea since the country gained independence from Ethiopia two decades ago. Highly organized gangs capture the refugees as they try to cross the border and extort their relatives who have already established themselves in the United States. Thousands of Eritrean refugees have been kidnapped by these syndicates.

Joel Millman reports on the operations of the gangs in the lawless Sinai Peninsula and the desperate attempts of Eritrean Americans to raise money to free their relatives.

Steven Brill Wins March Sidney for Explaining the High Cost of Medical Bills

Steven Brill has won the March Sidney Award for his explanatory reporting on the high cost of medical bills. Brill’s prize-winning story, entitled “Bitter Pill: Why Medical Bills are Killing Us” was published as a special feature in Timethe longest in the magazine’s history.

Many of Brill’s core concepts, like the bargaining power of Medicare to secure low rates, and the higher prices charged to uninsured patients, will be familiar to health care policy wonks. What makes Brill’s piece stand out is they way he weaves the stories of real patients into a multi-faceted, systemic analysis of the high cost of medical care.

Brill spent seven months combing through medical bills in an attempt to discover what Americans will get for the estimated $2.8 trillion we will spend this year on health care. What he found blew away his preconceptions about why hospital bills cost so much. The culprits weren’t greedy health care unions or overly-entitled patients. The problem turned out to be the structure of the marketplace itself.

Brill describes the medical marketplace as a kind of Through the Looking Glass parody of the free market where uninsured patients are charged whatever the hospital sees fit, for whatever services they are deemed to need. Unlike public and private insurers, who negotiate fees for services in advance, and use their bargaining power to secure lower prices, the average uninsured patient is completely at the mercy of the system. If a hospital wants to charge $1.50 for a single generic Tylenol, or $6 for a paper cup, the patient has no way of knowing in advance and little standing to complain after the fact.

One 64-year-old woman was charged over $20,000 for a single ER visit. She thought she was having a heart attack, but it turned out to be indigestion. If the woman had been a year older, and enrolled in Medicare, the same care would have cost a fraction of what the woman was forced to pay.

Many investigative journalists have documented how non-profit hospitals are raking in even larger profits than their for-profit counterparts. Brill extends that analysis to see what non-profit insurers do with all this money, given that they can’t redistribute it to shareholders, like for-profit hospitals do. Instead of devoting the surplus to charity care, as one might expect from non-profit hospital, these institutions reinvest in ever larger buildings and ever more elaborate testing machines. Many also pay their top administrators exorbitant salaries.

Studies show that the more machines there are, the more tests doctors tend to order. Brill notes that there’s an even bigger conflict of interest when the hospital or the doctor owns the machine and sets the price for using it. Hospitals that own their own diagnostic machines and testing facilities have a vested interest in charging high fees for these tests, and testing a lot of people who may or may not need them. The end result is a vicious cycle of overcharging and over-treatment.

Brill shies away from sweeping policy recommendations, and he has said in interviews that he thinks single-payer health care is not a realistic option of the United States, but the implications of his argument are difficult to escape. Lone patients are the worst off when it comes to medical gouging. Private insurers fare significantly better, but their bargaining power pales compares to that of Medicare. If Medicare can secure such dramatically lower rates because of its immense bargaining power, why not put everybody on Medicare?

The depth and scope of Brill’s reporting makes Bitter Pill an important contribution to the national debate on health care costs and its prominent placement in Time will familiarize a broad cross-section of the public with critical concepts that policy wonks have been laboring to disseminate for years.

FDIC: Ignore the Multi-Billion-Dollar Bank Settlement Behind the Curtain

Shorter FDIC: Move along, nothing to see here, folks.


[Photo credit: Thomas Fisher Rare Book Library, Creative Commons.]

#Sidney's Picks: Pink Slime (Still Pink, Still Slime), James O'Keefe, Robot Surgery

  • Reuters asks: “Did ABC News Create the Pink Slime Scandal?” and definitively answers its own question. No: pink slime created the pink slime scandal. The litigious Beef Products, Inc. just doesn’t like you using the word “slime” to describe its viscous protein product.
  • Dirty trickster James O’Keefe agreed to pay $100,000 to compensate a former ACORN employee who lost his job because of O’Keefe’s misleading video sting of ACORN.
  • Rolling Stone takes us inside the military’s culture of rape denial and victim-blaming with this harrowing account of one officer’s desperate bid to clear her own name and save her career after a brutal attack: “The Rape of Petty Officer Blumer.”


[Photo credit: Wander Mule, Creative Commons.]

When Forest Whitaker Gets Frisked at the Deli

Judging by the traffic, you guys just can’t get enough of Ta-Nehisi Coates. We aim to please at Clear it With Sidney, so here’s your next dose of Coates: Ta-Nehisi’s op/ed on the insidious, ingrained racism that leads an otherwise “nice” person to frisk Forest Whitaker in an upscale neighborhood deli.

The Observer Profiles Hillman Prize-Winner Ta-Nehisi Coates

Ta-Nehisi Coates, the winner of a 2012 Hillman Prize for analysis and opinion journalism, is profiled in the New York Observer, and the Hillman Foundation gets a shout out:

At 37, Mr. Coates is the single best writer on the subject of race in the United States. His Atlantic essays, guest columns for The New York Times and blog posts are defined by a distinct blend of eloquence, authenticity and nuance. And he has been picking up fans in very high places.

Fans like Rachel Maddow, who tweeted: “Don’t know, if in US commentary, there is a more beautiful writer than Ta-Nehisi Coates.” The New Yorker’s Hendrik Hertzberg described him as “one of the most elegant and sharp observers of race in America,” when announcing that Mr. Coates had won the 2012 prize for commentary from The Sidney Hillman Foundation. MSNBC’s Chris Hayes, who recently hosted a book reading at MIT with Mr. Coates, a visiting professor at the school, said that “he is as fine a nonfiction writer as anyone working today.”

You might be surprised to learn that Coates turned down the New York Times’ offer of a regular column:

“I won’t go so far as to say I’d fail,” he wrote. “But I strongly suspect that the same people who were convinced this would be a perfect marriage, would—inside of a year—be tweeting, ‘Remember when that dude could actually write?’” Of course, that humility is exactly what makes readers want to see Mr. Coates on the op-ed page twice a week. The fact is, wherever he writes next, the man has arrived.

Coates has indeed arrived, and we at Hillman look forward to seeing him go from strength to strength.

Herbalife Pays Big Bucks to Docs at UCLA Med School

Proponents of alternative medicine often complain, justifiably, about Big Pharma’s propensity to secure the good will of influential doctors with cash and perks. But as the Los Angeles Times reports, Big Placebo can play that game, too. Herbalife, a billion-dollar natural products firm often accused of being a pyramid scheme, has effectively annexed large swathes of UCLA’s medical school for a relative pittance:

One of Ackman’s accusations against [Herbalife] is that it exaggerates the scientific research behind its powders and pills. That’s where UCLA comes in, because Herbalife has exploited its “strong affiliation” with the medical school to give its products scientific credibility.

Those words were uttered by Herbalife CEO Michael Johnson during a 2007 conference call. In fact, Johnson seldom lets an investor event pass without mentioning UCLA, specifically the Mark Hughes Cellular and Molecular Nutrition Lab at the medical school’s Center for Human Nutrition. Herbalife says it has contributed $1.5 million in cash, equipment and software to the lab since 2002. (The lab is named after Herbalife’s founder, who died in 2000 after a four-day drinking binge — not the greatest advertisement for healthful, active living.) [LAT]

One UCLA professor collects an astonishing $300,000 a year from Herbalife according to company disclosures.

[Photo credit: Mint chip and kale protein smoothie by elana’s pantry.]

NYC Screening, Mar 20: "Brothers on the Line"

Brothers on the Line, and award-winning documentary about the rise of Walter Reuther and his brothers from shop-floor organizers to transformative leaders of the United Auto Workers will be screened on March 20 at 9:30pm at The Anthology Film Archives, 32 2nd Ave, in Manhattan. General admission is $10. Click here for more details.

Directed by Victor Reuther’s grandson Sasha and narrated by Martin Sheen, Brothers features powerful archival footage and interviews with key historical figures in the rise of the United Auto Workers.

#Sidney's Picks: Signature Strikes, Domestic Violence, and a Canine Murder Mystery

The best of the week’s news:

  • “Signature strikes” sounds like a brand of cigarettes, but it’s actually a little-known facet of the U.S.’s drone war, the part that involves killing unidentified people who seem to be up to no good.
  • While profiling an ex-convict, photojournalist Sara Naomi Lewkowicz captured harrowing images of her subject beating his girlfriend. Her photo essay is a terrifying depiction of an all-too-common problem, one that is rarely glimpsed and only dimly understood by outsiders.


[Photo credit: Wander Mule, Creative Commons.]