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1. This is Water, and it sucks. Let’s talk.

When I first started talking about doing a show about the cost of health care… everybody had a story. Including me.

It’s like that famous speech by the writer David Foster Wallace called This is Water. It starts with a joke about two young fish swimming along. An older fish passes by and says, “Morning boys. How’s the water?”

He goes, then one young fish turns to the other and says, “What the hell is water?”

Sound familiar? The cost of health care is like water. We’re all surrounded by it. We don’t even see it anymore.
Continue reading “1. This is Water, and it sucks. Let’s talk.”

Is it ever appropriate to fudge a little? (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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Why are ER bills so crazy? (with Sarah Kliff of Vox.com) Episode 7

ER Door with Danger Sign


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.

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.


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Image adapted from a drawing posted to flickr by Wellness Corporate Solutions.

Why Health Insurance Actually Sucks

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.

Jenny Gold works for Kaiser Health News — which, we should explain, is not part of Kaiser Permanente health care. It’s part of an independent foundation that basically runs on an endowment set up by Mr. Kaiser, more than 50 years ago.

RESOURCE ALERT:  Jenny’s boss, former New York Times reporter Elisabeth Rosenthal, published an amazing book in 2017: An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.  I have been studying it like a bible and a playbook since I started working on this show.  

If you want to really get mad — and learn a ton about how health care got so crazy in the U.S. — this is the book to read.

An audio version of Jenny’s story ran on the public-radio show Marketplace. Thanks to Kaiser Health News, and to Marketplace for the story and for the tape of Sarah Azad and Ken Weber.

Photo, above: by Liza, via Flickr. CC 2.0 license.

Thanks again to the great Mucca Pazza for the use of their tune War of Amusements at the close of this episode.

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Is the future of health care at the Renaissance fair?

The 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. Continue reading “Is the future of health care at the Renaissance fair?”

4. Why you (and I) will likely pick the wrong health-insurance plan

Because 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.

We’d like to hear how you’re choosing your health insurance for 2019 — or are you going to do without? — and what you’ve learned from past mistakes. You can scroll down and just start typing, or hit us up at insurance [[at]] arm and a leg show [[dot]] [[com]] 
EXTRA CREDIT: We’d love it if you send us a voice memo!

Finally, we’ve got some resources here — guides from some smart, friendly folks — to help you get smarter and avoid some worst-case outcomes.
Continue reading “4. Why you (and I) will likely pick the wrong health-insurance plan”