To get paid, hospitals get creative

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.

Photo courtesy James Crannell

We start with Chicago woodworker James Crannell, who — and there’s no non-scary way to say  this — stuck his finger in a table saw.

Even more scary: He didn’t have insurance. “I don’t know which was worse. The pain in my hand, or the fear of: What is this going to cost me?”

Spoiler alert: The emergency-room didn’t charge him full price.

This episode kicks off a series where we start asking: How did prices get so high to begin with?

 

We thought we had adulted properly

Caitlin and Corey Gaffer got a surprise letter from their insurance company — saying they were being dumped for non-payment. Except, as far as they 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. Caitlin and Corey spent fruitless weeks on the phone.

And then, Caitlin’s pregnancy — more than six months along — ran into complications.

They scrambled for months to get covered, while racking up about $30,000 in hospital bills.

There’s a happy ending. Two, in fact.

First, their baby was born healthy (and insured) in January. She’s in the episode too, and she’s adorable.

Maggie, Corey, and Caitlin Gaffer, with Luna the dog. (Photo by Lauren Cutshall.)

Second: In March their old insurer offered an apology — and offered to reinstate them. (This was the day after a reporter called to ask the insurer for their side of the story.)

… but the whole journey was harrowing, and opens up questions about what kinds of safeguards consumers have — or should have — against getting dropped.

Welcome to Season Two!

This story — like a lot of this season — came straight from my inbox. A few days after the show launched, I got an email with the subject line “Pregnant woman and her husband in Minnesota need help.”

We’ve got new friends!

We’ve got co-producers for Season Two, Kaiser Health News. Three things to know:

First: Kaiser Health News is not affiliated with the giant health care provider Kaiser Permanente. They share an ancestor — which is a fun story I’ve written all about here.

Second: They ARE a great non-profit newsroom covering health care in America, an editorially independent project of the Kaiser Family Foundation. (There’s that name again. And again, here’s the story.)

Third: Their editor-in-chief is one of the people who inspired this show.

YEP. The whole story is worth reading. I am so pleased and proud to be working with these folks.

Catch you next time. Till then, how about…

We’re back! Check out the Season 2 trailer (and our amazing new friends)

The new season launches June 4! I’m so excited to share the trailer with you. 

This season is full of stories from listeners — and every single one of them opens up vital, maddening questions about the cost of health care… which I get to run down.

In fact, we spend about half the season starting to wrap our minds around what may be the biggest question of all: HOW THE HECK DID PRICES GET SO HIGH?

We’ll look at three examples: an MRI, a routine prescription drug, and insulin, which was discovered almost 100 years ago and still keeps getting more expensive. (We go back to the very beginning for that one. The origin story is wild, and super-revealing.)

And… I have been looking forward to making this introduction for a while:  Please meet our partner for Season Two: Kaiser Health News.

Three things to know about them:

First, what they’re not: Kaiser Health News is not affiliated with the giant health care provider Kaiser Permanente. They share an ancestor — which is a fun story I’ll get to in a little bit.

Second, what they are: A GREAT non-profit newsroom covering health care in America, an editorially independent project of the Kaiser Family Foundation. (There’s that name again. Hang in there, the story’s coming.)

Third: Their editor-in-chief is one of the people who inspired this show.

When I first started working on this project — like, before it even had a name —  people told me: There’s this book you have to read, called An American Sickness: How Healthcare Became Big Business, and How You Can Take It Back.

I got the book, and they were 100% right.

The author, Elisabeth Rosenthal, was a New York Times reporter for more than 20 years, and spent her last few years at the paper covering the cost of health care. Oh, also: She’s an M.D.

A few years ago, she left the Times, published the book, and became editor-in-chief at Kaiser Health News.

The book is a map of everything this show is looking at. And the daily email that Kaiser Health News puts out features a ton of amazing reporting, every day.

So, I wanted to get in touch with Elizabeth Rosenthal, but it took me a while to work up my nerve.

Like: Until midway through Season One, when one of her reporters, Jenny Gold, was featured as one of the main voices in our episode about Why Health Insurance Actually Sucks.  

The morning before we posted that episode, I wrote Elisabeth Rosenthal a note that said, essentially: Hi there. Big fan. Interviewed one of your reporters, posting the episode tonight, hope you like it, would love to talk sometime.

She wrote back, a few hours later, with a note that started: Hi Dan, Good to hear from you – actually, I was going to reach out to you.

And here we are.

It took us a while to work out the details of how we’d work together. Here’s what we decided:

Kaiser Health News is our co-producer for the season, which means they’re providing some financial support — not our whole budget, by a long shot, but a big help — and editorial support too. So far, that’s meant:

  • KHN’s national editor for broadcast, Diane Webber, has been consulting on edits. She’s amazing. Also, super-nice.
  • A Kaiser Health News reporter is following up on one of this season’s stories, digging deeper into some things we found out.
  • Elisabeth Rosenthal herself shows up in Episode 3, to explain some really puzzling stuff.

And we’re just at the beginning.

Meanwhile, An Arm and a Leg remains very much an editorially independent project:  Whitney Henry-Lester is still the show’s editor, and she and our consulting managing producer Daisy Rosario are still the show’s guiding voices — and they hold the final word.

It’s just that we’ve got some incredibly awesome new friends and allies.  

So, you may be asking: 

Where did Kaiser Health News come from, and why are they so great?

Glad you asked! Please strap in. 

Henry J. Kaiser was what you might call an “industrialist.”

He built a lot of U.S. cargo ships for World War II, and he helped build the Hoover Dam. He got into smelting aluminum, making steel, all kinds of stuff. (He also started a health-care program for his shipyard workers that became Kaiser Permanente, so that’s that deal.)

Along the way, Henry Kaiser started a family foundation, and when he died in the 1960s, he left the foundation half his money. It gave away money like a regular foundation until 1990, when Drew Altman became their CEO.

At that point, the Kaiser Family Foundation — also known as KFF — turned itself into a different kind of organization: It stopped giving money away, and instead hired a bunch of health policy experts, and had them do their thing. The idea was to become a place where reporters and policy-makers could get solid, non-ideological information about the U.S. health care system.

(As a reporter in earlier jobs, I’d called them as sources. Editors and colleagues said they were solid, and the information definitely seemed super-straight-up. But nobody’d ever told me this story, and I always wondered: Honestly, what’s the deal? When they invited me to work together, I made sure to find out. OK, back to the story…)

By 2009, the Foundation noticed: It wasn’t getting as many calls from reporters — because newsrooms were shrinking, and journalists were getting laid off.

So Altman created Kaiser Health News —  an editorially-independent program within KFF — that aims to fill that gap: a newsroom putting out the kinds of stories that commercial newsrooms just … weren’t doing as much, or as well, as they used to.

They hired a bunch of amazing reporters and editors — the word “award” appears dozens of times on the staff-bios page — and had them start putting out stories.

To get those stories out there, Kaiser Health News makes its reporting available for free, under Creative Commons licenses, and it partners with news organizations like NPR, the New York Times, CNN, the Chicago Tribune, the Tampa Bay Times— really anywhere — to put those stories out.

That’s who they are, and that’s why I couldn’t be pleased-er that they are co-producing this season of An Arm and a Leg.

One more thing:  Have you checked out the trailer yet? It’s pretty good.

See you in just-under-two-weeks, with episode one!  

Can’t wait.

Till then, take care of yourself.

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

Bari Tessler is a little famous as 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!

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