2014 Topical Reporting, Large Newsroom winner

Paying Till It Hurts


About the Project

A simple stitch made with a dab of glue seals a gash in a toddler’s forehead and costs a family in Northern California almost $1,700. An amateur athlete in his 60s from Indiana, in need of a hip replacement, travels to Europe for the procedure after finding his insurance won’t cover it. He pays $13,660, saving over 75 percent of what he would have spent out of pocket in the United States. These and other stories of exorbitant medical costs, each originating from a reader who had commented on an earlier article, were the lead examples in “Paying Till It Hurts,” a series of articles by Elisabeth Rosenthal on the quickly rising price of medical treatment in the United States.

A suite of features, built by developers on the The Times’s Interactive News team in a collaboration with Ms. Rosenthal and editors from the social media team, provided a dual function for each of the reported stories: Readers could contribute to a conversation on themes related to the subject of the article — and away from the related hot button of the Affordable Care Act. The comments themselves provided the reporter with a rich database of new sources and an innovative way of using readers’ concerns as the foundation for her next pieces.

Prompts for comments focused on a specific theme within the narrative, resulting in comments that added significant first-person perspective. In reading through those comments, which numbered over 10,000, Ms. Rosenthal found new themes on which to focus subsequent articles. For example, a story on asthma and its treatment emerged as a common source of concern within the reactions to a story focused on the costs associated with pregnancy and childbirth. Additionally, potentially complex topics in health care involving economics and policy became more accessible and relatable through the thousands of short personal narratives within the curated set of reactions on each story.

In using comments as the basis for her report, Ms. Rosenthal noted a shift in her thinking about her role: “I think of myself as the reporter/writer, but also the conductor/collator of its many moving parts.” This continuing effort, with Ms. Rosenthal taking a thoughtful, responsive approach to what readers had to tell her and one another, turned the commenting public from respondents to active participants in the evolution of a series on a topic of critical importance in American life today.