Six years in, and almost 1,800 Mayhew Anderson on Insurance posts written. Another anniversary and another exploration of the odd esoterica of the US healthcare system completed as I begin writing for a seventh year at Balloon Juice. I need to say the same thing that I said last year:
Writing here at Balloon Juice has been and continues to be an amazing experience. I get to play with ideas that fascinate me, and John gives me the keys to write to an audience…..
One of the big changes since I’ve come to Duke, beyond saying good bye to the persona of Richard Mayhew, is that I’ve changed my writing targets. When I was Richard Mayhew, I had to write at Balloon Juice…. Now, the audience is sometimes all jackals. Other days, the intended audience is a few score of geeks and policy professionals who need to know about some esoteric corner case. I apologize when I take over the blog for those purposes as I feel like I am hijacking your attention to pay the cost of entry into conversations that I want to be in….
But mainly, I just want to thank all of the jackals, the front-pagers and John for a community where I can nerd out on something that I find fascinating. I’ll figure out what Year Six SEVEN looks like, but the first five six have been wonderful.
My writing has become even more narrowly focused over the past year. Part of that has been that I set a goal for myself to play in the peer review space this year. And the very nature of that space requires far more targeting. At this point last year I had a single peer reviewed research project that was almost to the point of acceptance at the Journal of Health, Politics, Policy and Law and a letter to the editor for Health Affairs where I made the point that 2018 is an analytically weird year.
This summer I had a cluster of original research come out and an invited commentary already published. I have an article forthcoming in two weeks where a co-author and I will be looking at one of two topics which will dominate the 2021 rule making process for the ACA exchanges. The two of us have another paper accepted last night which engages on the other major topic of the 2021 rule making process. We, along with a third collaborator, are again looking at that question from a different angle with a paper that is likely to come out this fall. I had a moment of quasi-maniacal super-villain laughter this summer when I looked at a revised version of Exhibit 3 for that manuscript and realized it will be entered as evidence in future litigation.
This afternoon, I am expecting to get back a second round of co-author edits for a manuscript that uses public use files to show something bloody obvious but not recorded. Insurance is complicated and this project shows some additional forms of complications in a way that no one else has even thought about. We’re using public, downloadable data, and part of our analytical data set has less than fifty downloads (and I am responsible for 6 of them as I lost track of the file a few times). Over the weekend, I need to make edits to the discussion section of a methods paper on matching for a small and unusual population (TLDR: It is really tough to do with reasonable assumptions). We hope to get that manuscript submitted for the first time next week. Another half dozen projects are in various stages of review, revision, and rewriting even as I’m building my 2020 project pipeline that builds on what I did in 2018 and 2019. Under the most pessimistic assumptions I anticipate having six accepted manuscripts this year, median assumptions are eight or nine acceptances while wildly optimistic assumptions have a bakers dozen acceptances. I will have four first or solo authorships from this current tranche of papers.
From an academic point of view, that is a wildly productive year especially as a good number of those manuscripts will be landing at very good journals.
But there are trade-offs. I have narrowed my thinking a lot and it shows that a lot of my Balloon-Juice writing is technocratic tinkering. Beyond that, my non-Balloon Juice public writing has crashed. I have only published three blogs at Health Affairs this year. I have not written an op-ed although I am in the process of prepping one around a topic that will be relevant around Thanksgiving. I became very narrow this year.
I needed a year to demonstrate that I can work well within the peer review paradigm. I think I achieved that. I enjoyed myself as I would like to think that I have added some unique value to the conversation and the knowledge that my co-authors, collaborators, colleagues and I are sharing will be meaningful and important in policy development. Next year will also be a productive but hopefully at a slightly less insane pace of production in the peer review universe. I hope I can grab some of those thoughts back from the ultra-specific to slightly broader questions that are more important that describing a particular form of financial plumbing.
I still get tremendous energy writing here. I would like to de-geekify and make some of my writing more pragmatic over the next year. I would really appreciate help on that and suggestions as to how to be more responsive to the needs of Jackals instead of merely paying the cost of entry to other conversations. But that is a thought for another day and another post, so onto year seven.