Kaiser Health News, An Arm and A Leg Podcast

California plans to make its own insulin and sell it super-cheap. Really.

4 days 8 hours ago

This year, the state of California put up $100 million to produce its own insulin, and sell it for cheap. How’s it going to work? (Is it going to work?)  


The price of insulin could be the starkest example of our out-of-control health care system: More than 7 million Americans need it to survive, and some die because they can’t afford it— medicine that’s been around for 100 years, medicine its discoverers didn’t want to patent. 


We look at how California’s plan came to be, and what might stand in the state’s way. 


Further listening:


Also, we mention our recent coverage of the legal and lobbying power of the pharmaceutical industry. That’s in our last episode, here:  https://armandalegshow.com/episode/congress-fixed-a-piece-of-medicare/ 


Here’s a transcript of this episode.


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Congress fixed (a piece of) Medicare. It only took a few decades.

3 weeks 4 days ago

Lots of seniors have to pay thousands of dollars for drugs—even tens of thousands—or do without life-saving medicine. That’s finally going to change. 


The new Inflation Reduction Act will set a $2,000 cap on out-of-pocket drug costs for seniors. (Yes, it’ll do a bunch of other stuff too.) 


It took a long time. Folks like researcher Stacie Dusetzina spent years building evidence about how Medicare prescription drug policy was failing people with cancer and other conditions. 


The pharmaceutical industry fought this change tooth and nail — for decades. Julie Rovner, Chief National Correspondent for Kaiser Health News, takes us on a journey back to the late 1980’s, when Congress learned the cost of messing with Big Pharma. 


  • Transcript
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The Medical-bill "Negotiation Lab"

1 month 2 weeks ago


It’s often possible to negotiate medical bills. It sounds hard — and it can be — but what if we got it down to a science? Mapped out all the moves ahead of time? Jared Walker and his team at the nonprofit Dollar For are running a big experiment to see if they can do just that. And we got to visit the lab. 


The folks at Dollar For caught our attention — and lots of other people’s—when they went super-viral on TikTok with a 60-second recipe for crushing medical debt by accessing charity care, financial assistance that most US hospitals are legally required to offer. That was early 2021. 


Next, a group of whip-smart volunteers helped Dollar For develop a user-friendly system to help folks apply for that assistance. Dollar For also started holding open trainings on Zoom, teaching people the ins and outs of applying for charity care—and helping others to do so. They say their work to date has helped erase more than $18 million in medical debt. 


But lots of people who can’t afford their medical bills don’t qualify for charity care. So Dollar For is trying something new: what they’re calling a “negotiation lab” for gaming out the best way to negotiate with hospitals and debt collectors. 


We listen-in on one of Dollar For’s real-life negotiations with a debt collector and take notes. 



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The Genetic Testing ‘Bait-and-Switch’

2 months ago

Is it possible for a health care company to make enough people mad about their billing practices that it hurts their business? For one genetic testing company, maybe so. 


An Arm and a Leg listener Jessica got a test that’s become routine in early pregnancy: non-invasive prenatal testing. It was supposed to be $99. But then — after she took the test — that turned into $250. And when she asked questions, she was told it could go up to $800 if she didn’t pay up quick. , Jessica looked up the testing company, and found out that lots of people experienced what she called “the genetic testing bait-and-switch.”


And she’s not the only one who noticed.


When some guys on Wall Street, plus New York Times reporter Sarah Kliff, started hearing about those bills, the company found itself in some hot water. 

Here’s a transcript of the episode


Bonus reading:


Send your stories and questions: https://armandalegshow.com/contact/ or call 724 ARM-N-LEG


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One ER Doc’s Journey Through the Pandemic — and the Health Care System

2 months 3 weeks ago

Thomas Fisher is an emergency room doc in Chicago. His book, The Emergency, is an up-close chronicle of the COVID pandemic’s first year in his South Side ER. 


It also zooms out to tell the story of his journey as a doctor: How his upbringing on the South Side fueled his desire to become a doctor. And how the realities and inequities of American health care limited his ability to help. 


He details how the failures of the American health care system — and the racial inequities it perpetuates — leave health care workers with a profound sense of moral injury. 


“Over time, when you have this conflict between what you can do and what you're supposed to do—what you wish you could do, what you're trained to do—that creates a moral conundrum….It also leads a lot of people to leave the profession ” 


For a time, Fisher himself stepped away from practicing medicine. The journey took him to the executive suite but ultimately landed him back in the ER where he started.


On the street outside the hospital where Fisher works, he sits down with host Dan Weissmann to discuss the book and his search for meaning in the daily sprint of life in the ER. 



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These docs are trying to kick private equity out of their ER

3 months 2 weeks ago

About a third of ER doctors now work for companies backed by private equity. A lot of those docs do not like the arrangement, which they say puts profits ahead of patients. Now, a group of ER docs are suing to kick one of those private-equity owned companies out of their hospital-- and all of California. They see it as the first step in a long, long fight. 


The suit cites California’s ban on the “corporate practice of medicine” — which is supposed to outlaw situations where non-doctors tell doctors what to do, for profit. 


Which raises a question: How did it get left to a group of doctors to get that law enforced? 


We break it down, with help from:



And while you're here, why not:


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1 hour 51 minutes ago
Kaiser Health News, An Arm and A Leg Podcast
A show about why health care costs so freaking much, and what we can (maybe) do about it. Hosted by award-winning reporter Dan Weissmann (Marketplace, 99 Percent Invisible, Planet Money, Reveal).

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