Responses to Listener Survey!

You’re helping us shape Season 3: Here’s some of what we’re learning

About 500 of you responded to our listener survey, and you are amazing. I mean, to start with: you are SO NICE.

Here’s a small selection of things you’re saying you get from the show:

  • My sense of hopeful outrage I guess
  • Because of you guys I was able to face a lingering hospital bill. I ended up talking to the billing department and they reduced my bill by 80%!
  • The system is bananas, makes it feel like I’m not the only one.
  • I love that you don’t shy away from the nuts and bolts or geeky stuff!
  • I feel like this could be part of a consumer movement.
  • Your show is very moving. Greetings from Norway.

One thing LOTS of you are saying you like about the show , and want more of: Useful information. (Noted!)

You’re also saying you find the show entertaining, and that you appreciate the combination of real-people stories and big-picture insight. (Thank you! So nice to hear.)

One thing comes through loud and clear: We are all in this together. People listening to this show represent all ages, all incomes, all levels of education.

That includes lots of folks who work in health care, like this ER nurse in Texas: Listening to your show makes me an advocate for change. Whenever I have the opportunity, my patients get your info!

I heard similar things from doctors, physician assistants, hospital administrators, pharmacists, medical students and med-school professors.

And then there’s this:

Keep doing what you’re doing! I’m a kindergarten teacher in a low-income neighborhood, the people who are screwed by this system the hardest are my students and their families. You give me hope that things will get better and my babies will get healthier.

YES. Let’s do this.

Episodes of An Arm and a Leg

Season 1: Fall/winter 2018

Episode 1: This is Water, and it sucks. Let’s talk. The cost of health care is like water. We’re all surrounded by it. We don’t even see it anymore. And why am I making this show?

Episode 2: All the Marbles: One woman’s epic quest for health insurance Laura 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 sacrificesand changed the course of history.

Episode 3: How one drug got its $500,000 price tag. The 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.

Episode 4: Why you (and I) will likely pick the wrong health insurance 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.

Episode 5: So, Robin Hood’s got an approach to medical bills 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.

Episode 6: 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.

Episode 7: Why are ER bills so crazy? Emergency rooms often bill you a “cover charge” just for walking in the door, and it can be thousands of dollars.

Episode 8: Is it ever appropriate to fudge a little? 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.

Season 2: Summer 2019

Episode 1: 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.

Episode 2: 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.

Episode 3: How much for an MRI? Well, that depends We look at three MRIs with four different price tags, and an enormous range. Like, from under $1,000 to about $26,000.

Episode 4: Why are drug prices so random? Meet Mr. PBM I filled a prescription recently, and the drugstore said they wanted more than 700 bucksfor 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. Drug pricing and PBMs.

Episode 5: 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. Some bizaare history…and a lot of dead dogs.

Episode 6: 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.

Episode 7: So, an actor walks into a doctor’s office Researcher Saul Weiner, MD  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.

Episode 8: 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.



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.)

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.)

AndI 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.