Episodes of An Arm and a Leg

This is Water, and it sucks. Let’s talk. (Season One, episode 1)

Scared Goldfish The cost of health care is like water. We’re all surrounded by it. We don’t even see it anymore.

The spiraling cost of medical care shapes people’s lives: The jobs we’re afraid to leave because of insurance, the risk that a trip to the doc could end in bankruptcy. It’s not healthy.

This is my story too, and that’s why I’m making this podcast.

(There’s more at the permanent link to this episode.)


All the Marbles: One woman’s epic quest for health insurance (Season One, episode 2)

marbles-2614142_640Laura Derrick takes a drug that costs more than $500,000 a year.

So when her family was going to lose their insurance, she made crazy sacrifices… and changed the course of history.

I was so determined,” she told me. “I was not going to go through all of this, for nothing.”

Here’s a permanent link to this episode.


How one drug got its $500,000 price tag. (Season One, episode 3, with 99 Percent Invisible)

popcorn-via-99piThe answer involves a suburban housewife, a 1970s TV star, and a Las Vegas maker of popcorn and nacho cheese sauce. Also: Wall Street.

Produced with our friends at 99 Percent Invisible.

Many thanks to Abbey Meyers, Joshua Schein, and Nora Guthrie.

Here’s a permanent link to this story.


Why you (and I) will likely pick the wrong health insurance. (Season One, episode 4)

sad-dogBecause (as smart economists recently proved) it is super-confusing, and most of us can’t do the math.

But! We found glimmers of hope. So don’t be scared.

Also, we’ve got some resources here guides from some smart, friendly folks — to help you get smarter and avoid some worst-case outcomes.

Find those resources at the permanent link to this episode.


So, Robin Hood’s got an approach to medical bills (Season One, episode 5)

RobinHoodFullThe health-care system — especially the financial side — can feel like a Medieval torture device. So maybe it fits that workers from Renaissance fairs have come up with a work-around.

In this episode I meet Robin Hood and a woman who has made more than $2 million in medical bills… disappear.

Also, you’ve started sending us stories as voice memos. And they are awesome.

(There’s more at the permanent link to this episode)


Why health insurance actually sucks (Season One, episode 6)

Pissed Off Sick Boy
Credit: Liza (via Flickr/CC 2.0 License)

Turns out, insurance companies allow — even encourage — crazy price-gouging by hospitals. For example, the leg brace Blake needed was available for $150 on Amazon. But thanks to his insurance, he paid more than $500.

Investigative reporter Jenny Gold’s work helps us understand how that kind of thing happens. She compares health care to shopping for a gallon of milk.

“We can look at the cost of a gallon of milk at lots of different stores and decide which one is the best,” she says.At the store, there’s maybe there’s a couple different brands, with the prices on the shelf. We pick the one we want, pay on the way out.

“Now with healthcare,” she says, “the analogy would be, you go to the store for a gallon of milk. You have no idea what it costs. You don’t know what it costs at that store compared to other stores. You walk into a random store, pick out a gallon of milk, go through check-out. You still don’t know what it costs. You give them your credit card information and then a few weeks later you get a bill telling you how much they charged you.”

Super-crazy. Jenny’s reporting shows how insurance companies help to keep those prices hidden, and keep them high.

(More at the permanent link to this episode.)


Why are ER bills so crazy? (Season one, episode 7, with Sarah Kliff)

Emergency rooms often bill you a “cover charge” just for walking in the door, and it can be thousands of dollars.

That’s in addition to the huge markup on everything that happens there: seven bucks for a band-aid. Twenty dollars for a couple of pills.healthcare costs, medical bills, hospital bills

Reporter Sarah Kliff has collected more than a thousand ER bills from her readers at Vox.

She was an expert on health care before starting this project — she covered it for years at the Washington Post before moving to Vox — but even she found plenty of surprises.

More at the permanent link to this episode.


Is it ever appropriate to fudge a little? (Season one, episode 8)

Bari Tessler is a financial therapist, but even she gets rattled by the price of health care.

Also: What my family is doing for health insurance next year.

This is our Season One finale. Maybe you’d like to subscribe to our newsletter, so we can keep you posted as we prepare Season Two.

Also this week: A taste from one of the most painfully-hilarious things to hit the Internet for a long time. Welcome to Our Modern Hospital, Where if You Want to Know a Price, You Can Go F*** Yourself, published by McSweeney’s.

There’s a longer excerpt, and an interview with the author, Alex Baia — that’s on our Patreon.  Thanks to Alex for permission to record excerpts, and to ttsreader for dramatizing the text for us!

Here’s a permanent link to this episode.


We thought we had adulted properly…  Season 2, episode 1!

Last fall, Caitlin and Corey got a surprise letter from their insurance company — saying they were being dumped for non-payment.
 
Except, as far as Caitlin and Corey knew, they were paid up.  As it turned out, they’d made a couple of small mistakes, which they were eager to fix. But their insurer was definitely not interested.
 
And then, Caitlin’s pregnancy — more than six months along — ran into complications.
 
Don’t worry! There’s a happy ending. But it’s a roller-coaster, and it raises a BUNCH of questions. Like: Was this even legal?  
 
Here’s a permanent link to this episode.

To get paid, hospitals get creative.  (Season 2, episode 2)

Hospital bills are too high, and insurance doesn’t cover enough. Turns out, that’s a crisis for hospitals too: more and more of us aren’t paying those bills, because we can’t. So, they’re getting creative about collecting — and offering discounts. Which raises questions about why the bills are so high to begin with. 

Here’s a permanent link to this episode.


How much for an MRI? Well, that depends… (Season 2, episode 3)

We look at three MRIs with four different price tags, and an enormous range.  Like, from under $1,000 to about $26,000. 

Yep. And we got some answers about how that happens.

This is the first of a three-part series where we look at where health-care prices come from. So, this week it’s MRIs. Next time: Prescription drugs. 

Here’s a permanent link to this episode.


Why are drug prices so random? Meet Mr. PBM (Season 2, Episode 4)

When I filled a prescription recently, the drugstore said they wanted more than 700 bucks… for an old-line generic drug. My insurance ended up knocking that down, but it was WEIRD.  And it meant a big homework assignment for me.

Luckily, I got help. Both from some experts, and from the classic Christmas movie It’s a Wonderful Life. 

Here’s a permanent link to this episode.


 

The insane, surprising history behind insulin’s crazy price (and some hopeful signs in the wild) Season 2, Episode 5

The price of insulin is iconic — doublingtriplingmultiplying like crazy, for medicine Type 1 diabetics can’t live without.

To understand it, we went back almost 100 years and dug up a story of sweaty Canadian researchers — swatting away flies and doing business with probable dog-nappers, on the way to a Nobel Prize… and a deal with corporate pharma.

We also found hopeful signs out there today, including the folks at the Open Insulin Project in Oakland, California, who are working on their own recipe for insulin, which they hope to share as widely as possible.

Here’s a permanent link to this episode.

 


Whoa, this medical device is spying on me. In my sleep. So my insurer can deny me coverage. (Season 2, Episode 6)

That’s the rude awakening Eric Umansky got when he called the company that provided his CPAP machine — a device that helps him breathe at night.

He got mad. And he got even, in a way: Eric is an editor at the non-profit newsroom ProPublica, and he tipped a colleague —Marshall Allen, who covers health care there.

The story Marshall wrote opened up bigger issues about how insurance companies are collecting all kinds of data to use against us. And it included at least one example of how the “little guy” can fight back sometimes, and win.

Here’s a permanent link to this episode.


So, an actor walks into a doctor’s office… (Season 2, Episode 7)

Dr. Saul Weiner is a physician and researcher at Jesse Brown VA Medical Center and the University of Illinois at Chicago. (Photo: Roberta Dupuis-Devlin)

Researcher Saul Weiner has been sending fake patients — actors, wired for sound — into real doctors’ offices, to learn about what actually happens, especially: How well doctors really listen to their patients.

He’s tallied up what doctors miss (a lot), and how much it costs (ditto). 

We hear what actually happened in one of those “secret shopper” doctor visits — with the doctor and the actor who played his patient reading from the transcript of their visit, and then unpacking what went wrong.

Also:  We are doing a listener survey! Please take a couple minutes to fill it out. You will be helping us out a TON:  https://armandalegshow.com/survey/

Thanks! Here’s a permanent link to this episode


A place where they do health care more cheaply and effectively. (And yes, it’s in the U.S.) Season 2, Episode 8

For our Season 2 finale, time for some inspiration.

For 30 years, James Gingerich has run a super-effective clinic in Indiana, delivering great results at low cost — to high-need, low-income patients.

James Gingerich, founder of Maple City Health Care Center.
James Gingerich stands in front of shelves holding books that Maple City Health Care Center distributes to families with young children.

He’s not a modest guy, and two of his brags stand out — as a study in contrasts.

One is a quote from a board member that makes him sound like a big dreamer:

“People think of us as a medical organization. We’re not. We are fundamentally a peace and justice organization that happens to be engaged in our community through medical care.”

The other is the way he stands at his desk and nerds out on stats that show his clinic beating the pants off the competition, on preventive-care measures like screenings for cervical cancer, vaccination rates for two-year-olds, etc..

“OK, next: diabetes control,” he says. “Are you getting the idea here?”

At the heart of it, he says, is listening to people’s stories. The rest he calls “housekeeping.”

It’s not a fix for our whole broken system — you can’t just copy-and-paste what’s happening here — but it’s definitely pretty inspiring.

Here’s a permanent link to this episode.


DEEP CUTS: Our trailers.

Our first-ever trailer. Introducing An Arm and a Leg

The spiraling cost of medical care shapes people’s lives: The jobs we’re afraid to leave because of insurance, the risk that a trip to the doc could end in bankruptcy. It’s not healthy.

This is my story too, and that’s why I’m making this podcast. Here’s what I’ve got in mind.

An Arm and a Leg will be entertaining, empowering— even useful. As a reporter, I’ll bring my skill at finding and telling revealing, surprising stories. But the project’s big focus— since I’m in this mess too—is connecting and problem-solving, together. (One segment I’m excited to try out: Car Talk for Health Care.)

You are not alone. We may be screwed, but we’re together. And if we want to get even a little bit less-screwed, we need each other. If nothing else, we can be good company to each other. (more…)

Season Two trailer, summer 2019

Hey there! We’ve been working hard on season 2. We hope you enjoy this preview — there’s so much good (and frightening) stuff ahead. It all starts June 4.

We’ve got more to tell about the season — and the amazing new partner that’s helping make it happen.

You can keep up by following the show on Facebook and Twitter — and in our newsletter.

… and you can catch up on Season One, right here. Just scroll down and hit play. Or subscribe (for free) on Apple Podcasts, Spotify, or any other place you get podcasts.