Episódios

  • It’s Medicare open enrollment season, and in this episode first aired in 2021, we explain why shopping for a new plan is often tougher than it seems.


    Guests:

    Lilyan Grossman, Medicare beneficiary

    Tricia Neuman, ScD, Senior Vice President and Executive Director of the Program on Medicare Policy, Kaiser Family Foundation

    Amal Trivedi, MD, Professor of Medicine and Health Services, Policy, and Practice, Brown University


    Learn more and read a full transcript on our website.


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  • One of the nation’s leading experts on the Affordable Care Act breaks down its track record and weighs in on the stakes the historic health care law faces in the lead-up to the election.


    Guest:

    Larry Levitt, Executive Vice President for Health Policy, KFF


    Learn more and read a full transcript on our website.


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  • The next U.S. president will have to make consequential choices about the Affordable Care Act, prescription drug prices and abortion. We compare the positions of candidates Kamala Harris and Donald Trump on these major health policy issues. (NOTE: This episode has been updated to clarify the number of people who would lose health coverage if Affordable Care Act enhanced subsidies expired.)


    Guests:

    Michael Cannon, Director of Health Policy Studies, Cato Institute

    Ederlina Co, JD, Associate Professor of Law, University of the Pacific

    Cynthia Cox, Vice President and Director of Program on the ACA, KFF

    Stacie Dusetzina, PhD, Professor of Health Policy, Vanderbilt University Medical Center

    Benedic Ippolito, PhD, Senior Fellow, American Enterprise Institute

    Ryan Levi, Reporter/Producer, Tradeoffs


    Learn more and read a full transcript on our website.


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  • Journalist Paula Span, who writes The New Old Age column for the New York Times, shares what she’s learned about how to age well.


    Guest:

    Paula Span, reporter and The New Old Age columnist for the New York Times


    Learn more and read a full transcript on our website.


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  • U.S. companies spend more than $1 trillion annually on health care for their employees. To get this budget-busting figure under control, some companies are experimenting with cutting out insurers, and investing in primary care clinics at the office. 


    Guests:

    Amy Cooper, NP, Vera Whole Health

    Bob Galvin, MD, former Chief Medical Officer, General Electric and Board Chairman, Catalyst for Payment Reform

    Dan Mendelson, CEO, Morgan Health

    Ann O’Malley, MD, MPH, Senior Fellow, Mathematica

    Matt Ohrt, Co-founder, Self Fund Health

    Lee Sagraves, Employee, JPMorganChase

    Gwen Sagraves


    Learn more and read a full transcript on our website.


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  • For decades, the most effective treatment for addiction to methamphetamine or cocaine has been mired in stigma and mostly limited to small research studies. But with deaths involving meth and cocaine on the rise, policymakers across the country are turning to gift cards to fight drug use.


    This story has been updated to clarify the research on long-term effects of contingency management and the eligibility requirements to deliver contingency management through CalAIM.


    Credits:

    Stephen Higgins, PhD, Professor of Psychology and Psychiatry, University of Vermont

    Richard Rawson, PhD, Professor Emeritus, UCLA Department of Psychology

    Andrew Dertien, Contingency Management Coordinator, HealthRIGHT 360

    Bernard Groves

    Ayesha Appa, MD, Assistant Professor of Medicine, UCSF and San Francisco General Hospital

    Tyler Sadwith, Medicaid Director, California Department of Health Care Services


    Learn more and read a full transcript on our website.


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  • Many potent new medicines pose a host of challenges for drug companies trying to copy and sell similar versions on the cheap. Can those companies find a sustainable path forward, or will patients get left stuck paying exorbitant prices?


    Guests:

    Christine Baeder, MBA, President, Apotex USA

    Alfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical Industry Association

    Jeremy Greene, MD, PhD, Professor of Medicine and the History of Medicine, Johns Hopkins University

    Candy Meyer, Patient

    Bhaven Sampat, PhD, Professor, Arizona State University School for the Future of Innovation in Society

    Marta Wosińska, PhD, Senior Fellow, Brookings Institution

    Leslie Walker, Senior Reporter/Producer, Tradeoffs


    Learn more and read a full transcript on our website.


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  • America pays less, on average, than any other major country for our generic drugs. But selling essential drugs at such low prices comes with hidden costs — from quality problems to frequent shortages.


    This is the second episode of Race to the Bottom, a three-part series by Tradeoffs on the problems plaguing the generic drugs we all rely on — and how we could fix them.


    Guests:

    Christine Baeder, MBA, President, Apotex USA

    Laura Bray, MBA, Founder, Angels for Change

    Craig Burton, Senior Vice President of Policy and Strategic Alliances, Association for Accessible Medicines

    Iilun Murphy, MD, Director of the Office of Generic Drugs, FDA

    Leslie Walker, Senior Reporter/Producer, Tradeoffs

    Marta Wosińska, PhD, Senior Fellow, Brookings Institution


    Learn more and read a full transcript on our website.


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  • Generic drugs are, in many ways, the unsung hero of America’s health care system, bringing powerful medical innovations within the reach of millions more people. These cheaper copies of brand-name drugs — from pills that stop heart attacks to antibiotics that cure life-threatening infections — save America hundreds of billions of dollars a year. But will affordable, high-quality generic drugs continue to be there when we need them?


    Some players are abandoning this business while others slash costs by cutting dangerous corners. Shortages of older generic drugs have become the norm, sending doctors scrambling. At the same time, crucial new medicines are proving tougher to copy on the cheap, saddling patients with brand-name prices.


    Over the course of “Race to the Bottom,” our new three-part podcast series, we’ll explore why this industry that’s so essential to our health is in trouble — and what could change that.


    In part one, we examine the history of this industry. Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug market. Lawmakers made choices back then that help explain the wild success and also the troubles we see today with generic medicines.


    Guests:

    Christine Baeder, MBA, President, Apotex USA

    Alfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical Association

    Leslie Walker, Senior Reporter/Producer, Tradeoffs


    Learn more and read a full transcript on our website.


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  • One organization turns to a game to get employees to debate and decide together what health care they most value. 


    Guests:

    Paul Fronstin, Ph.D., Director, Health Benefits Research, Employee Benefits Research Institute 

    Jeanette Janota, Senior Research Associate, American Speech-Language-Hearing Association

    Tavril Saint Jean, Senior Research Associate, American Speech-Language-Hearing Association

    Janet McNichol, Chief Human Resources Officer, American Speech-Language-Hearing Association

    Evan Reid, Senior Director of Analytics, American Speech-Language-Hearing Association

    Julia Reilly-Edwards, Data Scientist, American Speech-Language-Hearing Association


    Learn more and read a full transcript on our website.


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  • A handful of states allow terminally ill people to take life-ending medications prescribed by a doctor instead of waiting for death. This week, we talk with journalist Steven Petrow about his sister’s choice to use medical aid in dying.


    Guest:

    Steven Petrow, Journalist and author


    Learn more and read a full transcript on our website.


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  • In The Fifth Branch, Tradeoffs explored new ways to respond to people in a mental health crisis, this week we have look at another area of the mental health crisis the country is grappling with. 'Lost Patients', a new podcast from KUOW and The Seattle Times, dives into why so many people with mental illness live on the streets, and lack long-term care.


    Heidi Aurand has watched her son Adam spiral from one psychiatric crisis to the next for about eight years, bouncing between emergency rooms, jails, and homelessness. Now, after treatment at the state's largest psychiatric hospital, Adam was just released back onto the streets of downtown Seattle. A mother asks: How could her son pass through so many institutions and none are able to stop his decline?


    Learn more and read a full transcript on our website.


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  • The Inflation Reduction Act gave Medicare historic new power to directly negotiate the prices of some of the costliest prescription drugs. Now the federal agency must grapple with a difficult question: What makes a drug price fair?


    This week, we revisit our 2023 episode explaining how this negotiation process works and the impact it could have.


    Guests:

    Anton Avanceña, PhD, Assistant Professor of Health Outcomes, University of Texas 

    Darius Lakdawalla, PhD, Professor of Pharmaceutical Economics and Public Policy, University of Southern California 

    Lauren Neves, JD, Deputy Vice President, PhRMA

    Steve Pearson, MD, MSc, Founder and President, Institute for Clinical and Economic Review (ICER)

    Ben Rome, MD, MPH, physician and researcher, Harvard Medical School

    Meena Seshamani, MD, PhD, Deputy Administrator, Centers for Medicare and Medicaid Services

    Leslie Walker, Senior Producer/Reporter, Tradeoffs


    Learn more and read a full transcript on our website.


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  • Companies claim they can catch cancer sooner with new blood tests and full-body MRI scans. What are the risks and benefits?


    Guest:

    Ishani Ganguli, MD, MPH, Assistant Professor of Medicine, Harvard Medical School; primary care physician, Brigham and Women's Hospital


    Learn more and read a full transcript on our website.


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  • Alternative response teams are being asked to tackle vexing problems: mental illness, homelessness, addiction. How much can they actually do? We explore how Durham grapples with connecting people to long-term care and support, and where the city draws the line between crisis response and social services.


    Guests:

    Ryan Smith, Director, Durham Community Safety Department

    Sammetta Cutler, Peer Support Specialist, Durham Community Safety Department

    Sarah Hall, Durham resident

    David Prater, Peer Support Specialist, Durham Community Safety Department

    John Warasila, Real estate developer and architect, Alliance Architecture

    Bo Ferguson, Deputy City Manager, Durham

    Patrice Andrews, Police Chief, Durham Police Department

    Christie Thompson, Staff Writer, The Marshall Project

    Allison Casey, EMT, Durham Community Safety Department


    EMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. 


    Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness. 


    To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.


    How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.


    Learn more on our website.


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  • How do you keep everyone safe? We look at HEART’s impact on the safety of Durham residents in crisis, the mental health workers responding, and the police.


    Guests:

    David Prater, Peer Support Specialist, Durham Department of Community Safety

    Ryan Smith, Director, Durham Department of Community Safety

    Yolanda, Durham resident

    Sgt. Dan Leeder, Durham Police Department

    Patrice Andrews, Police Chief, Durham Police Department

    Christie Thompson, Staff Writer, The Marshall Project


    EMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. 


    Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness. 


    To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.


    How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.


    The Marshall Project's Christie Thompson reports on the state of alternative crisis response across the country.


    Learn more on our website.


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    Hosted on Acast. See acast.com/privacy for more information.

  • How do you convince police officers that it makes sense to send unarmed mental health workers to some 911 calls?


    Guests:


    Patrice Andrews, Police Chief, Durham Police Department

    Ryan Smith, Director, Durham Department of Community Safety

    Sgt. Dan Leeder, Durham Police Department

    Abena Bediako, Clinical Manager, Durham Department of Community Safety

    Christie Thompson, Staff Writer, The Marshall Project


    EMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. 


    Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness. 


    To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.


    How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.


    Learn more on our website.


    Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.


    Support this type of journalism today, with a gift.


    Hosted on Acast. See acast.com/privacy for more information.

  • EMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. 


    Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness. 


    To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.


    How did Durham pull off what so many cities have struggled to do? Join Tradeoffs and The Marshall Project for our new series The Fifth Branch as we examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country. Episodes drop July 18, July 25 and August 1.


    Learn more on our website.


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    Hosted on Acast. See acast.com/privacy for more information.

  • In this special bonus episode, we break down the Supreme Court’s recent abortion rulings with help from health reporter Shefali Luthra.


    Guest:

    Shefali Luthra, Health Reporter, The 19th


    Learn more and read a full transcript on our website.


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  • Medicare is betting that taking care of the caregiver will help dementia patients stay at home longer. Patients and their caregivers are often left to navigate the confusing world of dementia by themselves, but Medicare is launching a new program to change that.


    Guests:

    Malaz Boustani, MD, PhD, Founding Director, Sandra Eskenazi Center for Brain Care Innovation; Professor of Aging Research, Indiana University School of Medicine 

    Rosanne Corcoran, Caregiver 

    Liz Fowler, PhD, JD, Director of CMMI and Deputy Administrator, Centers for Medicare and Medicaid Services  

    Cindi Hart, Caregiver 

    Alex Olgin, Reporter/Producer, Tradeoffs 

    Lauren Sullivan, Care Coordinator, Eskenazi Health 


    Learn more and read a full transcript on our website.


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