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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

Revisiting ‘Christmas In July’

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, 202427 minSeason 12Ep. 9

New lessons from the fight for charity care

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, 202428 minSeason 12Ep. 8

Fight health insurance — with help from AI

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, 202422 minSeason 12Ep. 7

Can racism make you sick?

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, 202425 minSeason 12Ep. 6

Special Feature: A Beloved Nursing Home, from “To See Each Other”

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, 202432 minSeason 12Ep. 5

“Baby steps” in the fight against facility fees

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, 202424 minSeason 12Ep. 5

Anatomy of a Fall: One rural hospital’s ransomware story (from Click Here)

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, 202427 minSeason 12Ep. 4

Don’t get “bullied” into paying what you don’t owe

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, 202424 minSeason 12Ep. 3

We want to see your hospital bills

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, 20243 minSeason 12Ep. 2

The woman who beat an $8,000 hospital fee

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, 202426 minSeason 12Ep. 1

Coming soon: your stories on facility fees

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, 20242 min

Meet the Middleman’s Middleman

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, 202425 minSeason 11Ep. 8

Staying on Medicaid seems tougher than it should be

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, 202423 min

We’re digging into “facility fees.” We need your help.

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, 202410 minSeason 11Ep. 6

The Hack

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, 202422 minSeason 11Ep. 5

Son of Medicare: Attack of the Machines

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, 202430 minSeason 11Ep. 4

The Medicare Episode

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, 202429 minSeason 11Ep. 3

Wait, is insulin cheaper now?

A listener wrote to us at the beginning of the year with a query, “I was just reading the news about the price of insulin going down to $35! Is that for everyone?” It turns out, there is a lot of good news about the so-called “poster child” for the high cost of prescription drugs. But to say it costs $35 now is an oversimplification – and diabetes activists don’t think this fight is over. Senior producer and self-proclaimed “insulin correspondent” Emily Pisacreta took a hard look at the recent d...

Feb 08, 202425 minSeason 11Ep. 2

Self defense 101: Keeping your cool while you fight

Dealing with the American health care system as a patient means lots of tough moments – unexpected bills, meds not covered, insurance and hospitals making you go back and forth without a clear answer, endless hold times and phone trees… the list goes on. So listeners ask us all the time: How do I stay strong and fight for my rights without totally losing my s---? We’re bringing back one of our most useful episodes ever: How to keep your cool in a tough moment, according to a self defense expert....

Jan 18, 202425 minSeason 11Ep. 1

One last tip before 2024

Real quick: Now's the best time to support this show! Thanks to a few super-star Arm and a Leg listener/donors, your donation is matched two for one right now. Here's the link to donate . Ok, now: We’ve got a mini-episode for you today, a four-minute coda to the epic story we brought you in December. It features a last tip for anyone who might want to ask a hospital about charity care — which, as we learned from these recent stories, is most of us. And it comes with my big thanks for being part ...

Dec 28, 20234 minSeason 10Ep. 9

When hospitals sue patients (part 2)

Hey! The BEST time to support this show with a donation just got even better. Right now, any gift you make, up to $1,000, will be matched TWO for ONE, thanks to a few super-generous Arm and a Leg fans who’ve pooled their dough. . It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it ! And… are you ready for our most-ambitious story yet? We’ve been working on this investigation all year, with our partners at Scripps News and the Baltimore Banner . With ...

Dec 21, 202337 minSeason 10Ep. 8

When hospitals sue patients (part 1)

Hey, it’s the BEST time to support this show with a donation . Thanks to NewsMatch, any gift you make, up to $1,000, will be doubled. It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it ! We’ve been working on this investigation all year, with our partners at Scripps News and the Baltimore Banner . For years, we’ve been hearing about hospitals suing patients over unpaid medical bills – sometimes even in bulk, by the hundreds or thousands at a time. M...

Dec 07, 202328 minSeason 10Ep. 7

To get health insurance, this couple made a movie

Last fall, actor-writers Ellen Haun and Dru Johnston were hustling to get their health insurance sorted out for 2023. To qualify for insurance through the actor’s union, SAG-AFTRA, Ellen would have to book a little more work — doable, but not a sure bet. So they came up with a plan: crowdfund a bunch of money to make a short film, starring Ellen … called “Ellen Needs Insurance,” of course. It worked! And the movie, a 13-minute comedy , is terrific. Ellen and Dru sat down with us to go over how t...

Nov 16, 202319 minSeason 10Ep. 6

“Your Money or Your Life”: Dr. Luke Messac’s book on the history of medical debt

In 2019, Dr. Luke Messac was a medical resident who found himself spending his day off in a courthouse archive. He’d heard about hospitals suing their own patients over unpaid medical bills. He wanted to know if the hospitals he worked in were doing the same. They were. Trained as a historian, Messac then set out to trace the history of this phenomenon, and the story of medical debt in the U.S. His new book, Your Money or Your Life is the result of that research. Luke Messac sat down with us for...

Nov 02, 202326 minSeason 10Ep. 5

Paging Dr. Glaucomflecken: Presenting “The Nocturnists - Conversations: Will & Kristin Flanary (The Glaucomfleckens)”

First: an update on our recent two-parter with the writer John Green, about the global, decades-long fight to make an important tuberculosis drug more widely available. Just two days after we posted part 2, the activists waging that battle scored a major victory. John Green was kvelling on YouTube , of course. We’ll get you up to speed. And for the meat of this episode, we’ve got a guest a lot of you have been asking for: Physician/comedian Will Flanary, AKA Dr. Glaucomflecken. His punchy videos...

Oct 19, 20231 hr 4 minSeason 10Ep. 4

John Green vs. Johnson & Johnson (part 2)

This is part two of our globe-spanning story about drugs, patents, and YouTube megastar John Green. Quick recap: In our last episode, we learned how writer and YouTube star John Green kicked up a fight with Johnson & Johnson over a medicine called bedaquiline. And appeared to score a victory. Here, we dig into the backstory: How everything John Green and his fans won was built on activism going back 20 years, and spanning multiple continents. All of it illustrates how pharma companies work t...

Sep 28, 202326 minSeason 10Ep. 3

John Green vs. Johnson & Johnson (part 1)

This episode is special. When we heard that widely-beloved writer John Green was rallying his online community around a fight over drug prices — and apparently making a difference — we were pumped. And this story took us in so many different directions: Literally around the world, and then straight back home. The drug in question is bedaquiline, made by Johnson & Johnson. It treats drug-resistant tuberculosis, and its price has been a huge obstacle to getting it to places it’s needed most — ...

Sep 07, 202323 minSeason 10Ep. 2

Something's coming, something good.

Hey there— our next story is gonna take a little more time to cook, but it is going to be SO worth it. It involves John Green , author of The Fault in Our Stars — and yes, we've got an interview with him — and a global fight against multi-drug resistant tuberculosis. ... which turns out to be directly related to fights over the prices of drugs like insulin and humira in this country. Meanwhile, let me recommend a story from ProPublica that's related to a story we did here a few months ago. You m...

Aug 17, 20234 min

How to Get a Surprise Bill on Your Way to the Hospital

For a year and a half now, the No Surprises Act has protected patients from some of the most outrageous out-of-network medical bills. But Congress left something pretty crucial out of the law — bills from ground ambulances. We look at just how wild ambulance bills can be, with a story about three siblings who took identical ambulance rides — from the same car wreck to the same hospital — and got completely different bills. (Thanks to Bram Sable-Smith who reported the story for the Bill of the Mo...

Jul 27, 202320 minSeason 10Ep. 1

Wait, what’s a PBM (and how do they work)?

If you’ve been told your insurance won’t cover your meds — or that you’re gonna have to pay an arm and a leg for them — you’ve met a PBM: a pharmacy benefits manager. And: Experts say they play a big role in jacking up drug prices overall. But how, exactly? We took a deep dive. This episode first went out in 2019. We’re bringing it back because PBMs are in the news these days: Congress is targeting them, in an effort to to be seen doing something about prescription drug prices. And PBMs’ sometim...

Jul 06, 202322 minSeason 9Ep. 9
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