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

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.

There’s a bit more in this write-up I did for our pals at Kaiser Health News.

But first!  How about taking our listener survey?

It just takes a few minutes, and you’ll be helping us out a TON: https://armandalegshow.com/survey/

Thank you! You’ll be helping us get Season 3 made.

 

An actor walks into a doctor’s office…

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). 

In today’s episode, 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/

Thank you!

Whoa, this medical device is spying on me. In my sleep. So my insurer can deny me coverage.

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 two of them together, in this episode, are hilarious and enlightening.

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.

Extra fun: One of those examples features a 16 year-old Marshall Allen.

Marshall Allen, age 16, in his 1988 yearbook photo. (Photo courtesy Marshall Allen.)

Note: Eric curses a couple of times. We left it in.

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

The price of insulin is iconic — doubling, tripling, multiplying 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.

Charles Best and Frederick Banting on the roof of the University of Toronto medical building, petting a dog they probably picked up from some shady character on the street … and whom they would soon sacrifice in the name of science. (Photo courtesy University of Toronto.)

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.

Anthony Di Franco holds a 3-D printed model of an insulin molecule at Counter Culture Labs in Oakland. (Photo courtesy Anthony Di Franco.)

If it sounds crazy — well, we talked with a listener who has hacked together an artificial pancreas from outdated equipment, raw computer parts, and open-source software, all with the help of her fellow “rogue, cowboy hackers,” who are growing in number. So, you never know.

Terri Flynn of Arizona shows off the home-made rig that regulates her blood-sugar and insulin levels according to her specifications. (Photo courtesy Terri Flynn.)
Terri Lyman of Arizona shows off the home-made rig that regulates her blood-sugar and insulin levels according to her specifications. (Photo courtesy Terri Flynn.)

Meanwhile, activists with T1 International — an advocacy group run by Type 1 diabetics — are lobbying Congress, like the woman who leads off our story.

Adeline Umubyeyi, a T1 International activist, models a t-shirt from the group’s Washington, DC chapter president.
Adeline Umubyeyi, a T1 International activist, models a t-shirt from the group’s Washington, DC chapter president. (Photo courtesy Adeline Umubyeyi.)

They’re also organizing “caravans to Canada” (as our colleagues at Kaiser Health News recently documented with PBS News Hour

You will find a TON of details, links and resources in our newsletter. We’ve been told that even the sign-up process is pretty entertaining. 

Coming next week: The price of insulin

As we started working on season two of this podcast, there was one topic that seemed like we just had to look at: insulin.

… and I wondered:  There are stories about insulin prices everywhere.  Would we really have something to add? Something that wasn’t just more of the same? (Enraging, terrifying, depressing.)

Turns out: OH YES WE DO.

And some of it is… hopeful.

We are holding it back a week, so you can take a break for the holiday, come back fresh, and be ready for something epic.  See you then.

(If you’re new here, welcome! All our episodes so far are on our home page, or wherever you get podcasts.  You can sign up for our newsletter , share a story, or check us out on Facebook and Twitter @armandalegshow.)