5. Steven Brill. Mr. Brill — renowned journalist, Yale Law School grad and founder of CourtTV and American Lawyer magazine — has established himself as a fixture on the national healthcare debate. He first made his mark with a special report in Time magazine, for which he was the recipient of a National Magazine Award. Now, his new book “America’s Bitter Pill” explores the years of politicking that resulted in the Patient Protection and Affordable Care Act, the additional bureaucracy brought on by the legislation, numerous confusing regulations and the inefficiencies that lead to abundantly expensive medical bills and confusion for both patients and insurers. The book is also informed by Mr. Brill’s own experience as a patient. In spring 2014, Mr. Brill underwent surgery to repair an aortic aneurysm. His experience reinforced one of his major criticisms: how little leverage patients have in their own healthcare. “It drove home to me the reality that in addition to being a tough political issue because of all the money involved, healthcare is a toxic political issue because of all the fear and the emotion involved,” he told NPR. Mr. Brill, who says he has given hospital bosses the sweats by posting questions about their salaries, nonprofits’ profits, and chargemaster prices, is one of the most assertive journalists covering the industry and he does so in a painstaking manner. Mr. Brill said he interviewed 243 people, many multiple times, over 27 years to inform his latest book.
6. The Wall Street Journal and Dow Jones. The prominent newspaper and its publisher have been a major force behind the movement to expose the truth on how much taxpayer money individual physicians receive from Medicare. In January 2011, Dow Jones filed a motion to overturn a court injunction won by the American Medical Association in 1979 that blocks public access to records containing evidence of Medicare fraud and the physicians behind it. In 2010, the Wall Street Journal published a series of articles called “Secrets of the System” documenting its investigation, highlighting suspicious billing, potential abuses of the system and the government’s role in patrolling Medicare payments. However, the WSJ and other news organizations were barred from a full investigation because the injunction limited its access to just a subset of the data. The government also prohibited the WSJ from revealing the identities of individual physicians in the databases. In April 2014, Dow Jones won its motion and the injunction was lifted, making public the Medicare billing data by physicians for the first time in 35 years, according to Bloomberg. U.S. newspapers and other media outlets have the WSJ to thank for what is now publicly available information. In fact, when the New York Times reported on the Medicare payment findings, it did not refer to the WSJ. Margaret Sullivan, NYT’s public editor, later devoted an op-ed to this oversight and called out credit where it was due: “What’s missing in that story is any reference to The Wall Street Journal, whose persistent legal efforts over several years helped result in a trove of Medicare data being made public,” she wrote. While many journalists have and will continue to make use of this data, it was the WSJ and Dow Jones that acted “rebelliously” by acting litigiously and challenging the opaque nature of the payment system.
7. Douglas McMillon. Mr. McMillon, president and CEO of Wal-Mart, is shaking up the healthcare market and introducing a whole new force for hospitals and health systems to compete with. The global retail giant had been eyeing the healthcare industry for years. It started opening primary care clinics in Texas and South Carolina stores operated by nurse practitioners in a partnership with QuadMed, according to Forbes. These sites for primary care are in addition to the retail giant’s acute-care clinics leased by hospital operators at stores across the country, according to The New York Times. Walk-in check-ups cost $40 for customers plus additional fees for lab tests, and just $4 for Wal-Mart employees and dependents on the company’s health plan. Wal-Mart’s convenient locations and promise to always drive down costs and offer comprehensive services, such as chronic disease management, should worry providers. Rob Lazerow, a practice manager with The Advisory Board, told Forbes Wal-Mart clinics threaten hospitals with competition and the risk of losing patient volumes.
8. Elizabeth Holmes, CEO of Theranos. Ms. Holmes’ seemingly unfettered sense of ingenuity has continued to surpass the expectations of her peers and mentors since the day in 2003 she sat in front of her chemical engineering professor at Stanford and said, “Let’s start a company.” Soon after that conversation, the sophomore Ms. Holmes dropped out of college to work full-time on her newly founded Palo Alto, Calif.-based blood test company, Theranos, according to Fortune. Today, Theranos performs nearly 10 billion tests a year and is estimated to provide the foundation for approximately 70 percent of physicians’ medical decisions. Medicare and Medicaid each pay about $10 billion to the company each year in reimbursement. Theranos is licensed to operate in nearly every state and currently offers more than 200 of the most commonly ordered blood diagnostics tests, each of which can be performed on just a few drops of blood — up to one thousandth of the amount typically required. The company is preparing to offer more than 1,000 of such tests in the future. Ms. Holmes has built the force behind her growing company by assembling what may be “the single most accomplished board in U.S. history,” including former U.S. Secretary of State, Treasury and Labor, George Shultz; former Secretary of Defense, Bill Perry; former Secretary of State and National Security Adviser Henry Kissinger; and former U.S. Senators Sam Nunn and Bill Frist, among others, according to Fortune.
Editor’s note: This story was updated Feb. 18 to with revisions to the information for Douglas McMillon’s profile. An earlier version of this story stated Wal-Mart had “hundreds” of primary care clinics across the country, whereas the primary clinics stand at 17 total across South Carolina and Texas. The acute-care clinics, in partnership with healthcare providers, total 100 or more.
