Editor’s Memo

Our Intrepid Elucidators

Peter Wehrwein

Almost everything under the sun is complicated once you start to really look into it. A closer examination and a critical mind will peel off the top layers to reveal—Oh my!—a daunting mess underneath.

Perhaps this is self-justifying, but medical matters and health care—especially the unwieldy, makeshift, money-addled American version—seem especially prone to complication. Every topic, it seems, comes with labyrinths designed and engineered to fend off understanding. Explanation—the detangling of things so they are plain and intelligible—is possible, but it’s a long, hard slog for the explainer.

In this issue, Senior Contributing Editor Timothy Kelley and Contributing Editor Jan Greene are the intrepid elucidators, our Colin O’Bradys—although not unassisted as every journalistic enterprise depends on sources.

A couple of months ago, Tim and I decided that he would write a piece about Medicare Advantage payment. We both noticed a dearth of accessible explanations of the inner workings. Cathy Murphy-Barron at Milliman helped us get started by giving us an hour of her time. Thereafter, Tim hacked his way through the weeds and brambles. His story (“The Devils—and the Insights—Are in the Details,” page 22) is a standout effort. Benchmarking, bidding, rebates, bonuses—they all get delineated by Tim in way that should be helpful to both MA novices and boffins.

Hormone replacement therapy has been a fraught topic in women’s health for decades, but neither Jan nor I expected it to be quite so … well, complicated.

Jan’s story (“HRT Has an Uncertainty Problem. Does Compounding Make It Worse?” on page 32) untangles the current issues of bioidentical HRT and compounding. Differences of opinion remain, but if you read Jan’s story you’ll leave the labyrinth, thanks to Jan, with a much better understanding of what they’re about.