In February, we asked you, our listeners, to share the tips, tricks, and tactics you’ve learned for getting the medicine you need at prices you can manage. And of course some of you work in health care and have insider knowledge. Which we’re passing along in this second episode of The Prescription Drug Playbook. We’ll hear from a listener who works to help seniors find healthcare, a pharma sales rep, an employee benefits advisor, and a battle-worn hospital caseworker – all bringing something a l...
Jun 30, 2025•28 min•Season 13Ep. 10
Too many of us get sticker shock when we go to pick up our meds. We asked our listeners how they get by in this situation, and we learned dozens of tips. And in this two-part series, we’re sharing those strategies — including some advice from experts. The next episode drops June 30. See omnystudio.com/listener for privacy information.
Jun 24, 2025•1 min
In surveys, one in four Americans report having to skip their medications due to cost. We asked our listeners: what strategies have you used when you’ve been hit with pharmacy sticker shock? We heard from a ton of you – with stories, strategies and workarounds that surprised and encouraged us. None of them will work for everybody. This is a set of patches and bandaids for a broken system. But if there’s one that’ll work for you, we want to help you find it. So we’re bringing you the most-complet...
Jun 12, 2025•26 min•Season 13Ep. 9
What do the KGB and the former CEO of Cincinnati Children's Hospital have in common? At different times, they’ve each looked to a guy named Eugene Litvak for help. He only said yes to Cincinnati — but he saved that hospital more than a hundred million dollars a year. For the last few decades, Litvak – a Soviet émigré with a PhD in math – has been on a mission: save U.S. hospitals from financial ruin, and improve the lives of doctors, nurses, and patients. He says he has just the formula to do it...
May 22, 2025•32 min•Season 13Ep. 8
With news blasting from Washington like a firehose, it feels impossible to take it all in — to stay on top of all the changes the Trump administration has been trying to make. But for health care, one person is probably closer to anyone than to understanding the full picture: KFF Heath News Chief Washington Correspondent Julie Rover. In this episode, Julie helps us see that picture, by telling us two stories: The first concerns a teeny part of the health care system — an obscure federal agency, ...
May 01, 2025•26 min•Season 13Ep. 7
People who work in real-life emergency rooms have raved about how accurately the new drama The Pitt (Max) captures the dynamics and the medical details of their workplaces. Here at An Arm and a Leg , we’ve been nerding out about how the show depicts the financial forces that shape the ER’s day-to-day problems like crowding, eternal wait times, and scary bills. For this episode, we got Dr. Alex Janke, an emergency medicine doctor and health policy researcher to nerd out with us. Here’s a transcri...
Apr 10, 2025•23 min•Season 13Ep. 6
A few months ago, we got a note from a listener named Meagan, who wanted to thank us. She said the stories she heard on this show had given her the advice and encouragement she needed to finally win a fight against a medical bill she didn’t owe — a battle she’d been waging for more than two years. As Meagan tells us, those two years were filled with wild twists and turns and a lot of disappointment. We hear what kept her motivated and encouraged despite all the setbacks – and after an insurance ...
Mar 20, 2025•24 min•Season 13Ep. 5
A federal agency called the Consumer Financial Protection Bureau — CFPB for short — has taken big steps to help people with medical debt. In early February, the Trump administration moved to effectively shutter the agency. We talked with credit counselor Lara Ceccarelli about how the CFPB has helped clients at the nonprofit where she works, and how she’s navigating the sudden change. And consumer-rights advocate Chi Chi Wu — an attorney with the National Consumer Law Center — describes the court...
Feb 27, 2025•20 min•Season 13Ep. 4
Hey – real quick: some big news from the team at An Arm and a Leg . Our First Aid Kit newsletter is going weekly! First Aid Kit brings you advice from our show and more on how to survive and navigate America’s health care system. And allow us to introduce First Aid Kit’s new writer, Claire Davenport. When she was our intern last summer, she reviewed An Arm and a Leg’s entire catalog of episodes, and took notes along the way. Now she’s bringing the practical lessons from all that reporting straig...
Feb 24, 2025•5 min•Season 13Ep. 3
We’re kicking off a new reporting project about how much we pay for our medicine — and what we can maybe do about it — and we want to hear your stories. Because: Getting a case of sticker shock with a prescription happens all the time. So we’re asking: What have you done — or tried to do — to get the medicines you need at prices you can afford? And what did you learn that might be useful for other people to know? Maybe you learned a strategy that actually WORKED for you. Like using a coupon or o...
Feb 03, 2025•10 min•Season 13Ep. 2
You remember a guy named Martin Shkreli? If his name rings a bell, it’s probably because back in 2015, he jacked up the price of an old drug — from around $13 a pill to $750. The media dubbed him “the pharma bro,” and he became a symbol of brazen pharmaceutical greed. Now, he’s the namesake for the Shkreli Awards — a kind of Oscars for the most outrageous examples of greed, fraud, and general brokenness in American health care. Every year, a health care think tank called the Lown Institute ranks...
Jan 16, 2025•25 min•Season 13Ep. 1
An Arm and a Leg is a show about why health care costs so freaking much, and what we can (maybe) do about it. New episodes every three weeks. See omnystudio.com/listener for privacy information.
Jan 06, 2025•57 sec
A few weeks ago, a listener sent us a note with a link to a news article about a new resolution that had recently been adopted by the American Medical Association – the largest group representing doctors in the US. The resolution said: hospitals need to do more to guarantee charity care to patients who qualify. Legislators and regulators should make them. Our listener was the author of that resolution, and he told us he first learned about charity care through this podcast. His name is Joey Ball...
Dec 30, 2024•12 min•Season 12Ep. 10
Today we’re revisiting one of our favorite episodes from the archive – a story about giving – and bringing you an update. In 1980, a young father named Denny Buehler was battling leukemia and needed to travel from Cincinnati to Seattle for treatment. To raise the money, his friends and family threw a softball tournament. Denny passed away a few months later. But his friends and family turned the softball tournament into a beloved tradition, and a chance to give back. For more than 40 years, they...
Dec 12, 2024•27 min•Season 12Ep. 9
Longtime listeners to this show know we’ve been talking about something called “charity care” for years. Federal law requires that all nonprofit hospitals have charity care policies – that is, financial assistance policies — to reduce or remove people’s medical bills. The problem: people don’t know about it, and hospitals don’t always make it easy to access. New research suggests that the scale of this problem is huge: hospitals are failing to provide more than 14 billion dollars worth of charit...
Nov 22, 2024•28 min•Season 12Ep. 8
Several listeners sent us an article with the headline Make your health insurance cry , about a new AI tool to fight health insurance. We had to learn more. Meet Holden Karau: a Bay Area software engineer who says she’s “trying to make health insurance suck a little bit less.” So she’s created an AI tool to appeal insurance denials. Her project, Fight Health Insurance , is a labor of love (she’s not earning money from it) and fueled by hatred (of insurance companies). It draws on her tech expert...
Nov 01, 2024•22 min•Season 12Ep. 7
Something different: We talk with journalist Cara Anthony about topics that don’t always come up in conversations about the cost of health care. For the last four years, she’s been reporting on the public health effects of racism, violence, and intergenerational trauma in a small Missouri town.. The result: A new documentary and podcast series called Silence in Sikeston . She sat down with us to talk about the value of breaking silences and the possibility for healing. Here’s a transcript of thi...
Oct 17, 2024•25 min•Season 12Ep. 6
We're sharing an episode of “To See Each Other,” about a question that’s SUPER-relevant to this show: How do we pay for long-term care, like nursing homes? To See Each Other aims to complicate the narrative about small-town Americans. In this new season, host George Goehl heads to Lincoln County, Wisconsin — population, 28,000-and-some. And home to a publicly-run nursing home with a 5-star quality rating from the feds. A conservative county board plans to sell the home to a private operator, but...
Oct 01, 2024•32 min•Season 12Ep. 5
An $88 “observation room” fee for a check-up didn’t sit right with Kari Greene, a listener from Oregon. When the price went up to $99 the next year, Kari complained to her benefits rep; they thought it was weird, too — but couldn’t do anything about it. In states like Connecticut and Indiana, legislators are trying to do something about fees like these – often called “facility fees.” In this episode, we go deep on Kari’s bill, one of dozens that listeners have shared with us over the past few mo...
Sep 26, 2024•24 min•Season 12Ep. 5
What happens when a hospital gets hit by a ransomware attack? We’re sharing an episode from a podcast called Click Here that takes us inside the aftermath of a cyber attack on a rural hospital in Oregon. The story starts the minute the hospital’s IT director finds out they’ve been hacked, and follows him and his colleagues as they scramble to keep the place running while they try to get it back online. It’s a fascinating adventure, and it gives us a window into the growing problem of cyberattack...
Sep 05, 2024•27 min•Season 12Ep. 4
Caitlyn Mai expected her share of a recent surgery bill to be about $2,000, with insurance covering the rest. Then she started getting alerts on her phone from the hospital that she owed $139,000 — the full cost of her surgery. But Caitlyn, a legal assistant in Oklahoma, instinctively knew a cardinal rule of the American healthcare system — “never pay the first bill.” It’s a lesson we first heard from the journalist Marshall Allen, whose 2021 book Never Pay the First Bill serves as a how-to guid...
Aug 15, 2024•24 min•Season 12Ep. 3
We’re starting a new investigation and need your help. We’re looking into something we’ve talked about a lot on this show: hospital financial assistance – also known as “charity care” — which most hospitals are legally required to offer. Something like 60 percent of people might qualify to have their hospital bills reduced or even forgiven through charity care — but of course nowhere close to 60 percent of people actually get that assistance. A lot of people just don’t know about it. (A survey o...
Jul 25, 2024•3 min•Season 12Ep. 2
Georgann Boatright's local hospital told her she'd need to pay an $8,000 "operating room" charge for a test she was pretty darn sure wouldn't involve an operating room. So she went elsewhere, even though it meant driving to another state. Avoiding that charge required more than just a willingness to go — literally — way out of her way. Georgann Boatright has knowledge, skills, and grit that most of us don't — although we can maybe learn a thing or two from her. More and more, people are noticing...
Jul 11, 2024•26 min•Season 12Ep. 1
For months now, you’ve been sharing stories with us about facility fees, those sneaky fees that keep showing up on your medical bills. Facility fees are kind of like a cover charge for visiting a health care facility, usually one owned by a hospital. And many of you have been blindsided by them. Some of you have been going to the same place for years, only to one day get a brand new charge, seemingly out of nowhere. Many of you only found out about a facility fee after the fact, while some of yo...
Jul 03, 2024•2 min
Folks who expected their health insurance to cover some out-of-network care have been getting stuck with enormous bills instead. Like one couple from Kansas City: Their insurance hung them out to dry for thousands of dollars, all while sending statements touting a “discount” the couple was supposedly getting. Turned out: A middleman was cutting their coverage — actually a middleman’s middleman — working with their insurance company. The couple’s insurer got the “discount,” and the middlemen got ...
Jun 13, 2024•25 min•Season 11Ep. 8
We take our first look at Medicaid— the big, federally-funded health insurance program for folks with lower incomes— for two reasons: First, it’s a huge part of our health-care system. Medicaid covers a quarter of all Americans, and four in ten children. Second, it’s timely: In the last year, more than 20 million people have lost Medicaid — even though there’s evidence to suggest a lot of those people probably still qualify. More than two-thirds have been dropped for “procedural reasons” — basic...
May 23, 2024•23 min
We’re launching a brand new project and need your help! We’re zooming in on charges that are becoming more and more common on your medical bills: facility fees. Facility fees are charges tacked onto your bill for visiting a doctor’s office or clinic related to a hospital or larger health care system… or even talking with a doctor who’s in one of those places on a telehealth visit. If you’ve ever seen a charge for a facility fee on your medical bill, we want to hear from you . ... and if you have...
May 02, 2024•10 min•Season 11Ep. 6
When a subsidiary of the giant UnitedHealth Group got hit by a cyberattack recently, a big chunk of the country’s doctors, pharmacists, hospitals and therapists just stopped getting paid. It’s been a huge disruption, with some providers wondering if they can keep their doors open. But thanks to their huge size and reach, the situation may have had a silver lining — for United. Which seems like a big problem, and got us wondering: What can we maybe do about it? The answer turns out to be: Maybe m...
Apr 11, 2024•22 min•Season 11Ep. 5
Reporter Bob Herman from STAT News unpacks his blockbuster investigation about the country’s biggest health care company . Covering the American health care system means we tell some scary stories. But this episode is almost like a horror movie . It’s got some of Hollywood’s favorite tropes: Machines taking over. Monsters from separate franchises meeting face to face in a new movie, like Godzilla and King Kong, or Jason and Freddy. And a couple perceptive folks warning everyone, ”Hey, look, some...
Mar 21, 2024•30 min•Season 11Ep. 4
Health insurance sucks. Which leaves lots of us counting down the days until we turn 65 and can get on Medicare – the federal government’s health insurance program for seniors. But Medicare is a lot more complicated – and costs more money – than a lot of us realize. (Also, it involves insurance companies.) And:t There will be huge, complicated decisions to make when you turn 65, that can have huge consequences. The biggest, and most consequential: Choosing between original Medicare and Medicare ...
Feb 29, 2024•29 min•Season 11Ep. 3
