Dan: Hey there. I want to introduce you to a few folks– some of the people who make this show with me. Because I use the word “I” a lot here, but I DO NOT do this by myself. Which is why sometimes I use the word “we.” As we wrap up a big year around here, I want you to hear some of the voices that I’m listening to all the time, that guide the making of this show.

We got together a couple of weeks ago, on Zoom.

I’ve got with me, our consulting, managing producer, Daisy Rosario.

Daisy: Hello. Thanks for having me, Dan.

Dan: Thank you so much for being here. Thank you for being part of this team,, our editor, Marion Wang,

Marian: Hello.

Dan: and Emily Pisacreta who joined as our intern.

Really this year is now our associate producer. Meaning you make the show with me. Hey, Emily.

Emily: Hey, Dan.

Dan: I’m not gonna play you ALL of our conversation. It turns out, hosting a conversation like that for a podcast is a WHOLE skill, one that I could still use some work on. I just want to give you a few highlights, to give you a clearer sense of how we make the show.

This is An Arm and a Leg, a show about why health care costs so freaking much, and what we can maybe do about it. I’m Dan Weissmann. I’m a reporter, and I like a challenge, so my job here is to take on one of the most enraging, terrifying, depressing parts of American life and bring you a show that’s entertaining, empowering, and useful.

And to do that I need a LOT of help and guidance. Daisy Rosario has been with this show from the beginning. Her title is Consulting Managing Producer. Which is a title we made up. Here’s what it means:

I was looking for an editor– I come from newsrooms. Having an editor as a partner to bounce story ideas off of, and drafts, and just everything– that’s a must.

And I started thinking that if I were to make a show like this at, say, a public radio station, not only would I have an editor– a boss– but my editor would have a boss.

Somebody we’d both meet with to get big-picture guidance. Like, beyond story-to-story, what are we trying to achieve as a project, and how will we do it?

I was like: I should definitely have somebody in that role.

Daisy: And it was me. Yeah. I mean,. It felt great from our first conversation. Like we were put in touch by a mutual friend, AC Valdez, new father, welcome to the world. Cute baby. And I remember we were talking and I was talking about how I had studied experimental theater.

And you were like theater stuff. Yeah. And we were just connecting on these multiple levels. And, you know, my background was in reporting and producing as well. Audio specifically, I’d had a healthcare focus for awhile. It was what I studied in journalism school. And I remember that in our early conversations, I would always be like, it’s not a healthcare system.

It’s just a bunch of stuff. Like even saying system was really frustrating to me because I was like, it’s not, And so I was really excited about your desire to try and make it more clear and accessible for people because

it just feels like one of those things that is so clear that people need help and guidance and we’re just not getting enough of it.

Dan: Yeah. I feel like I don’t have enough of it. Like I’m still

Daisy: Right.

Dan: But, Doing what we are doing feels so much better than not doing it.

And Daisy, you like our whole rockstar, like you’re, you were like running a major. Public radio show before you and I met. And we’re then taking over podcast operations at a major, public radio station and while we’ve been working together have taken over, running a whole bunch of shows for a big podcast network, if I’m looking for guidance, about strategy, like. see it all and you have this depth of understanding of the non-system that we are in and, and so much else. just, I couldn’t be luckier.

Daisy: So thank you.

Dan: Speaking of rockstars, marrying you came in a year and a half ago. I was like, wait, I get to work with you. This is fantastic.

Daisy: We were very excited about Marion. You guys very much.

Marian: You, guys. I was excited too.

Dan: You wrote to me, and said that you’re a listener to the show and that it reminded you of what you do , and your day job as a producer for John Oliver.

Yeah! And, side note: Marian’s job before that was as an investigative reporter for ProPublica.

And I was like, well, holy crap, we should talk. And you know, I think Daisy and I both agreed like, I’ve never been more impressed with, with anybody’s introduction of themselves. Just immediately it was clear that you were someone I would really like to work with

Daisy: Marian is going to listen back and be like, you have to cut out all these compliments to me.

Marian: no for sure.

Dan: Yeah, not gonna happen. Because in addition to her incredible credentials, Marian is the most amazing colleague, and I cannot begin to tell you what a great editor she is. Except, if you’ve been listening to the show, if you like it, then you know: it’s good because of Marian’s guidance and patience and smarts.

I asked everybody about stories they thought they’d remember from this year. And Marian brought up the episode we did in November about picking insurance. Because it ended up being useful to HER. Which she hadn’t expected.

She already had an insurance plan, through her main job, that she’d been with for five years. She just expected to stick with it.

Marian: . And then two weeks after we published that episode completely unexpectedly, my employer decided to tell us that they had switched. Insurance providers. So I now had seven different plans to choose from. And I was like, I guess I’m going to be using what we shared in our episode. All the advice about all the things to check in our episode I was checking myself and knew to check now because of our episode.

Dan: And then there was the all-staff zoom call with the insurance rep. Where they gave a canned presentations, and took questions.

Marian: And I was just in the zoom call, like in the comments spamming with questions like where do I see the provider directory? Where do I see the formulary? You know, do any of these plans have deductibles for pharmaceuticals, you know, bam, bam, bam, like constantly asking all these questions.

But a lot of that was because I knew what questions to ask from our segment,

Dan: Marian said she also referred back to our First Aid Kit newsletters from November that went over all the same stuff, plus a little more.

Marian: because it’s in some ways an easier reference than, then a segment or an episode. Yeah.

So I, sent that link first aid kit to like a number of my colleagues too. Cause everyone was just sorta like, there are seven plans. How do we decide between them?

Daisy: I mean, so many of us, we’ve probably all learned things like through the making of the show that we do really use. I think that’s, that’s part of, what’s so special about it to me. I mean, everyone is impacted by health care. And it’s just so overwhelming, I think for the average person .

Emily: Not just the average person

Dan: Yeah, I was going to say that too.

Emily: I think of Marianne and all her colleagues, like really, really smart people, still need help with this.

Marian: well, it’s like needlessly confusing, right? It’s like alphabet soup of like HDHP plans. HMO’s PPO is like, even someone who considers themselves like an expert at. Untangling complex things can use a hand, which, you know, I consider myself pretty good at synthesizing information and like understanding really dense stuff, but I still needed a quick reference in our stuff.

Definitely came in handy. So I I’m pretty confident that like, it will come in handy for others. Cause it did for me.

So that’s one of Marian’s highlights. For me, it’s been Emily Pisacreta joining our team– starting as an intern and pretty quickly becoming our associate producer.

Especially Emily’s first story for us, when she covered a training offered by Jared Walker and the folks at Dollar For.

It was a capstone to what’s probably our key story for the year, and the happiest: The way Jared has been educating people–including me– about the fact that non-profit hospitals are legally required to provide charity care, and you can hold them to it.

In September, Jared started holding open trainings on zoom for anyone to become a resource, to help people leverage charity care laws. Emily covered that training for us. She did an amazing job– suddenly, this show has another reporter!

… and she wrote up the information from that training: Her tip sheet for using charity care to crush medical bills may be the single most useful thing we’ve ever published on our site.

Especially because our pals at Kaiser Health News published a version of Emily’s story, with her byline, translated it into other languages, and shared it with a network of other news outlets that carry their stuff. So LOTS of people saw it.

Emily: Yeah. I mean, you say that out. One of the highlights of your year? It definitely was for me too. I feel, so much pessimism sometimes about the country and our healthcare system. And, you know, I don’t really want to have this healthcare system for the rest of my life. In the meantime, to log into that zoom meeting and there’s just like people from all over the country just gathered, just out of the goodness of their hearts to like help people deal with medical bills that are outrageous. It was incredible. And it was, you know, definitely it’s something I probably won’t forget for a really long time.

Dan: Me either. And there’s another project Emily’s been working on that you haven’t heard– yet. She’s been keeping on top of our show’s inbox in a way I never could have done on my own. She’s following up on some of your emails for stories that I can’t wait for you to hear.

And thanks to Emily, we’re able to respond to so many more of the stories and questions you send us. Which is a whole big chunk of work. Because, one: there’s a lot. [Which is great, please keep them coming] And two: So many of them open up such big questions.

Emily: Yeah. You know, my old job, I worked for many years at Planned Parenthood and part of my job was sort of taking submissions from the inbox and putting our responses online to sort of use it as a place to educate people about their bodies. A lot of those questions were about this happened and then this happened and then this happened and could I be pregnant?

And those. Questions do not hold a candle to the complexity of the kinds of questions that we get in the arm and the leg, inbox. A lot of people in our inbox, like me live with a chronic illness.

And they are the people who are telling us about prior authorizations taking several months there, the people telling us about, oh, my biologic drug costs, Five figures , sometimes even more than that, one person was like,

I take this biologic drug. Is it so expensive because it’s made from Chinese hamster ovary cells.

Marian: Wow.

Emily: So it’s, it teaches me a lot. And, You know, it, it gives me some satisfaction to be able to sometimes respond to people with information, even though, you know, I’m still somebody who’s trying to learn this stuff too.

So I just love being here.

Dan: Ah, I’m so happy that you were here.

Marian: seriously,

Dan: and journalism is, you know, it’s a team endeavor, it’s a team sport, and seeing your contribution to this show has made really clear. You’re like a key resource. It’s a reason that it’s easy for me to ask people for money for the show.

Yep! But we don’t ask just anybody. We get approached by companies– and certain non-profits– in the health care world who want to advertise, or even donate. And we generally tell them no: As journalists, we avoid conflicts of interest.

Here’s Daisy.

Daisy: I mean, you and I have had many conversations about like, Hey, this place wants to offer money. And it’s like, Nope, because if it’s even remotely, you know, doesn’t look like it could be fully on the up and up. We’re like, we’re just not gonna even bother. Even if it makes life harder, honestly. Right. And I think being part of something that is doing what it can to really live its values is really special.

Dan: And that is what you are making possible by supporting this show. You are giving me money to pay these awesome people.

And people you haven’t heard from here. People like Adam Raymonda, our audio wizard– a musician and sound designer who makes this show sound amazing. People like Gabrielle Healy, who edits the First Aid Kit newsletter.

People like Izz LaMagdeleine, who has come aboard to help us find ways to be more entertaining, empowering and useful on social media– and anyplace else people could use what we’re learning.

This episode is a kind of thank-you note to YOU. Thank you for making it possible for us to do this work. Thank you for sending your notes and emails, educating us, putting questions and stories in front of us that we need to see. Thank you for listening.

We’ve got a ton of work planned for 2022–stories I can’t wait to bring you, more of the First Aid Kit Newsletter. And it looks like this pandemic is not finished bringing us surprises. So we’ll have more work cut out for us.

You can help us do all of that with a year-end donation. You helped us meet a challenge from the Knight Foundation and earn a thousand dollar bonus from them. Now they’ve got one more for us. If we raise six thousand more dollars before January 1, they’ll add another thousand of their own.

I don’t know if we’ll hit that, but I know that every dollar you send us, we are going to put to excellent use.

The place to go is arm and a leg show dot com slash, support. That’s arm and a leg show dot com, slash support.

I will catch you in January.

This episode of An Arm and a Leg was produced by me, Dan Weissmann, with a lot of help from our producer, Emily Pisacreta, edited by Marian Wang and special guest editor, Luis Antonio Perez.

Daisy Rosario is our consulting managing producer. Adam Raymonda is our audio wizard. Gabrielle Healy is our managing editor for audience, and she edits the First Aid Kit newsletter.

Our music is from Dave Winer and Blue Dot Sessions.

This season of an arm and a leg is a co production with Kaiser Health News. That’s a nonprofit news service about healthcare in america, an editorially independent program of the Kaiser Family Foundation. Kaiser Health News is not affiliated with Kaiser Permanente, the big healthcare outfit. They share an ancestor. This guy, Henry J Kaiser. He had his hands in a lot of different stuff.

Really different. Built a big chunk of the U.S. cargo fleet for World War II. Made cars- including the Jeep. Poured concrete. Made aluminum foil.

When he died more than 50 years ago. He left half his money to the foundation that later created Kaiser Health News. You can learn more about him and kaiser health news at arm and a leg show dot com slash kaiser.

Diane Webber is national editor for broadcast and Taunya English is senior editor for broadcast innovation at Kaiser Health News. They are editorial liaisons to this show.

Thanks to Public Narrative — a chicago-based group that helps journalists and non-profits tell better stories– for serving as our fiscal sponsor, allowing us to accept tax-exempt donations. You can learn more about public narrative at www dot public narrative dot org.