An Arm and a Leg - podcast cover

An Arm and a Leg

An Arm and a Legarmandalegshow.com

An Arm and a Leg is a podcast about why health care costs so freaking much and what we can (maybe) do about it.

If you’ve ever been surprised by a medical bill, you’re in good company. But as our team of seasoned journalists has learned from years of reporting — you’re not always helpless. We don’t have all the answers, but we’ll offer you tools and big picture insights with plenty of humor and heart. 

An Arm and a Leg is co-produced with KFF Health News and distributed in partnership with KUOW.

You can support An Arm and a Leg by donating at armandalegshow.com/support/

Show Credits: Created, hosted, and produced by Dan Weissmann with senior producer Emily Pisacreta and engagement producer Claire Davenport, edited by Ellen Weiss. Audio wizard: Adam Raymonda. Music is by Dave Weiner and Blue Dot Sessions. Bea Bosco is our consulting director of operations. Lynne Johnson is our operations manager.

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Episodes

Watch Your Back: Outwitting the Back-Pain Industry

Cathryn Jakobson Ramin, an investigative reporter with a bad back, spent years researching the $100-billion back-pain industry. She found that the most commonly-prescribed treatments, including surgery, frequently do not work — and often leave people a lot worse off. She also learned what does work. Whenever someone I know says their back is killing them, I send them a link to Ramin's 2017 book, Crooked: Outwitting the Back Pain Industry . In this episode, we hit the highlights of Ramin's findin...

Jan 02, 202029 minSeason 3Ep. 8

Christmas in July

How one family's tragedy became, decades later, a $1 million gift to their neighbors. This story has everything: Laughter. Tears. Family. Community. Generosity. Softball. AND: Punk rock. John Oliver. A taco bar. See omnystudio.com/listener for privacy information.

Dec 26, 201926 minSeason 3Ep. 7

This hospital sued thousands of patients — until a reporter called them out.

They say the problem with relying on journalists to embarrass providers into caving on crazy bills is, there aren’t enough journalists to go around. Fair. But sometimes journalists can scale up. In Memphis, reporter Wendi Thomas found that the city’s biggest hospital routinely sued its patients over unpaid bills, despite making tidy profits. The hospital even sued its own badly-paid employees — a fact Thomas said was immediately visible just by visiting the court house. “You saw them, there, in ...

Dec 19, 201923 minSeason 3Ep. 6

Can they freaking DO that?!?

A woman got a bill from a medical testing lab she’s never heard of, for $35. Then, a follow-up bill said if she didn’t pay up right away, that price was going up — WAY up: to $1,287. Which raises a question that comes up a LOT with medical billing: Can they freaking DO that?!? Can some random lab hit you up for money — and then threaten you with a late fee of more than $1,000?? On this episode, we go find out. This was fun. We'll do it again. Next time you want to know, Can They Freaking DO That...

Dec 12, 201928 minSeason 3Ep. 5

Why can't they tell you the price upfront?

Sarah Macsalka has seen the stories about how expensive an emergency room visit can be, even for a minor complaint . So when her seven year-old son Cameron gashed his knee on a weekend morning in June, the ER was NOT where her family headed first. In fact, Macsalka did just about everything she could to avoid paying a big, fat bill to get Cameron’s knee stitched up — and ultimately failed. For instance, she took Cameron first to a local urgent-care clinic, but was told they didn't have anestheti...

Dec 05, 201926 minSeason 3Ep. 4

Health Care: The Musical

It would sound a LOT like Explanation of Benefits , which is a musical revue that actually played in New York City in 2019. ... so it would feature a parody of "Bills, Bills, Bills" — the 1999 Destiny's Child hit —rewritten for the age of GoFundMe. And it would have smart, funny musical numbers tracing the long, sad history of the U.S. health care industry. Welcome to our musical episode! And thank you to the young NYC troupe Heck No Techno for creating Explanation of Benefits . Our episode isn'...

Nov 27, 201922 minSeason 3Ep. 3

My Neighbor the Health-Care Ninja

Meredith Balogh has spent years learning to navigate the financial side of the health-care system. She’s a type-one diabetic, she’s never had a lot of money, and for years she didn’t have health insurance. It hasn’t been easy, but she’s become a master. “There's only three things that you're fighting,” she says. “Problems with competence, problems with greed and problems with maliciousness. And luckily most things are incompetence.” She has saved herself and her family many thousands of dollars,...

Nov 21, 201930 minSeason 3Ep. 2

Mom vs. Texas

Stephanie Wittels Wachs has a daughter born with hearing loss, which is how she found out insurance didn't cover hearing aids for kids. Those start at $6,000 and only last a few years. Stephanie teamed up with a few other moms to change Texas law... and won. Stephanie is a terrific storyteller. She's the author of Everything Is Horrible and Wonderful , a memoir about grieving her brother, Harris Wittels , a writer for TV comedies like Parks and Recreation , who died of a heroin overdose. ... and...

Nov 14, 201929 minSeason 3Ep. 1

Hey there! Season 3 is coming November 14. Here’s a preview.

It’s going to be REALLY fun. Also, maybe useful. Catch you here soon! Also, here’s a little video preview . Bonus news: Did you know we're nominated for an award as a TRUE CRIME show? Almost too perfect. Everything on this show is legal, and that's the true crime. Here's a link — please pass it around! Wanna share it with folks? Be our guest! Here it is on Twitter , Facebook , Instagram , and Vimeo . See omnystudio.com/listener for privacy information....

Oct 31, 20192 min

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. James Gingerich stands in front of shelves holding books that Maple City Health Care Center distributes to families with young children. He’s not a modest guy, and two of his brags stand out — as a study in contrasts. One is a quote from a board member that makes him sound like a big dreamer: “Peo...

Jul 31, 201923 minSeason 2Ep. 8

An actor walks into a doctor’s office…

Dr. Saul Weiner is a physician and researcher at Jesse Brown VA Medical Center and the University of Illinois at Chicago. (Photo: Roberta Dupuis-Devlin) Researcher Saul Weiner 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. He’s tallied up what doctors miss (a lot), and how much it costs (ditto). In today’s episode, we hear what actually happened in one of th...

Jul 24, 201918 minSeason 2Ep. 7

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. He got mad. And he got even, in a way: Eric is an editor at the non-profit newsroom ProPublica, and he tipped a colleague —Marshall Allen, who covers health care there. The two of them together, in this episode, are hilarious and enlightening. T he story Marshall wrote opened up bigger issues about how insurance companies are collecting all kinds of dat...

Jul 17, 201917 minSeason 2Ep. 6

The surprising history behind insulin’s absurd 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. To understand it, we went back almost 100 years and dug up a story of sweaty Canadian researchers — swatting away flies and doing business with probable dog-nappers, on the way to a Nobel Prize… and a deal with corporate pharma. Charles Best and Frederick Banting on the roof of the University of Toronto medical building, petting a dog they probably picked up from some...

Jul 10, 201927 minSeason 2Ep. 5

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....

Jul 03, 20192 min

Why are drug prices so random? Meet Mr. PBM

I filled a prescription recently, and the drugstore said they wanted more than 700 bucks… for 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. Luckily, I got help. Both from some experts, and from the classic Christmas movie It’s a Wonderful Life (source of the pictures above and below, of course). I mean, what I actually learned was not a hundred percent cheerful. We get these unpredictable prices thanks to comp...

Jun 26, 201918 minSeason 2Ep. 4

How much for an MRI? Well, that depends…

This week, we look at three MRIs with four different price tags, and an enormous range. Liz Salmi and a view of her brain. (Photo: Kaiser Health News) The first two price tags come from listener Liz Salmi, who has been living with brain cancer for more than a decade. Liz gets MRI scans twice a year, to make sure the cancer isn’t growing. A couple years ago, Liz changed insurance, changed providers… and got serious sticker-shock when she saw the bill for a scan: $1,600 — AFTER insurance. So when ...

Jun 19, 201922 minSeason 2Ep. 3

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. Photo courtesy James Crannell We start with Chicago woodworker James Crannell, who — and there’s no non-scary way to say this — stuck his finger in a table saw. Even more scary: He d...

Jun 12, 201916 minSeason 2Ep. 2

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. As it turned out, they’d made a couple of small mistakes, which they were eager to fix. But their insurer was definitely not interested. Caitlin and Corey spent fruitless weeks on the phone. And then, Caitlin’s pregnancy — more than six months along — ran into complications. They scrambled for months to get covered, while rac...

Jun 04, 201924 minSeason 2Ep. 1

A “deal” on health insurance comes with troubling strings

Bari Tessler is a little famous as a “financial therapist,” but even she gets rattled by the price of health care. Her story is complicated. And very relatable. Bari chose to use a Christian "health share" instead of regular insurance. It's cheaper, but it comes with strings: Things the group doesn’t cover, limits on their obligations to you… and a religious vision that not everybody is comfortable with. Including Bari. She sees it, for now, as the least terrible of a bunch of terrible options —...

Dec 19, 201822 minSeason 1Ep. 8

Why are ER bills so horrible? Sarah Kliff spent a year finding out. (Season One, episode 7)

Emergency rooms often bill you a “cover charge” just for walking in the door, and it can be thousands of dollars. That’s in addition to the huge markup on everything that happens there: seven bucks for a band-aid. Twenty dollars for a couple of pills. Reporter Sarah Kliff has collected more than a thousand ER bills from her readers at Vox. She was an expert on health care before starting this project — she covered it for years at the Washington Post before moving to Vox — but even she found plen...

Dec 12, 201819 minSeason 1Ep. 7

Why Health Insurance Actually Sucks (Season One, episode 6)

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. Investigative reporter Jenny Gold ’s work helps us understand how that kind of thing happens. She compares health care to shopping for a gallon of milk. “We can look at the cost of a gallon of milk at lots of different stores and decide which one is the best,” she says.At the store,...

Dec 05, 201817 minSeason 1Ep. 6

So, Robin Hood’s got an approach to medical bills. (Season One, episode 5)

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. In this episode I meet Robin Hood and a woman who has made more than $2 million in medical bills… disappear. Also, you’ve started sending us stories as voice memos. And they are awesome . Send more! [email protected]. Regular emails are nice too. You’ve sent some powerful stories that way. We are listening...

Nov 27, 201816 minSeason 1Ep. 5

Why you (and I) will likely pick the wrong health-insurance plan (Season One, episode 4)

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. We’d like to hear how you’re choosing your health insurance for next year — or are you going to do without? — and what you’ve learned from past mistakes. You can scroll down and just start typing, or hit us up at insurance [[at]] arm and a leg show [[dot]] [[com]] EXTRA CREDIT: We’d love it if you send us a voice memo! Finally, we’ve got some ...

Nov 21, 201819 min

How one drug got its $500,000 price tag. (With 99 Percent Invisible– Season One, episode 3)

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 . Many thanks to Abbey Meyers, Joshua Schein, and Nora Guthrie. Find Us Online Website: http://armandalegshow.com Twitter: http://twitter.com/armandalegshow Instagram: http://instagram.com/armandalegshow Facebook: http://facebook.com/armandalegshow About Us Host: Dan Weissman ( www.danweissmann.com ) Editor: Whitn...

Nov 14, 201825 minSeason 1Ep. 3

All the Marbles: One woman’s epic quest for health insurance (Season One, episode 2)

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 sacrifices… and changed the course of history. Find Us Online Website: http://armandalegshow.com Twitter: http://twitter.com/armandalegshow Instagram: http://instagram.com/armandalegshow Facebook: http://facebook.com/armandalegshow About Us Host: Dan Weissman ( www.danweissmann.com ) Editor: Whitney Henry-Lester ( thedarlingkiller.com ) Consulting Producer: Daisy ...

Nov 14, 201819 min

This is Water, and it sucks. Let’s talk. (Season One, episode 1)

When I first started talking about doing a show about the cost of health care… everybody had a story. Including me. It’s like that famous speech by the writer David Foster Wallace called This is Water . It starts with a joke about two young fish swimming along. An older fish passes by and says, “Morning boys. How’s the water?” He goes, then one young fish turns to the other and says, “What the hell is water?” Sound familiar? The cost of health care is like water. We’re all surrounded by it. We d...

Nov 14, 201820 minSeason 1Ep. 1

A podcast about the cost of health care, coming November 2018

The spiraling cost of medical care shapes people’s lives: The jobs we’re afraid to leave because of insurance, the risk that a trip to the doc could end in bankruptcy. It’s not healthy. This is my story too, and that’s why I’m making this podcast. Here’s what I’ve got in mind. An Arm and a Leg will be entertaining, empowering— even useful. As a reporter , I’ll bring my skill at finding and telling revealing, surprising stories. But the project’s big focus— since I’m in this mess too—is connectin...

Oct 11, 20184 min
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