The Cost Of Healthcare in America

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Creation Date March 17th, 2020
Updated Date Updated May 7th, 2020
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Why is healthcare in America so expensive? These episodes dive into the reasons why, look at how other countries control their costs & explore how the U.S. might follow suit.
  1. The battle over Republican Senators' most recent attempt at repealing and replacing the Affordable Care Act dominated the media this week, and seemingly at all hours of the day. We take a look at a few players in the saga, from the putative maverick who brought the process to a halt with a quick thumbs-down, to a reporter trying to follow a process somewhat devoid of transparency, to the war of words that could determine the future of the American health care system. Plus, a retrospective view on the media's role in Charlie Gard's life.  1. The Atlantic's James Fallows explores Senator John McCain's long history in the media spotlight — a story of dualities, cozy jokes, and the occasional, genuine maverick choice.  2. Kaiser Health News's Julie Rovner describes the opaque and convoluted experience of covering the GOP process to repeal and replace Obamacare.  3. The Daily Beast's Sam Stein examines the new anti-Obamacare propaganda coming from within the Trump Administration.  4. Florida State University's Jill Quadagno leads us through the hundred-year messaging war over universal healthcare in the U.S., including a recent rise in public support for a single-payer system.  5. The Times of London's Melanie Phillips discusses the role the American right-wing media played in the media storm surrounding Charlie Gard's tragic, short life.  Support On the Media by becoming a member today at    
  2. How could an ER visit in which a patient receives nothing more than a Band-Aid cost $629? Sarah Kliff, a health policy reporter for 'Vox,' spent over a year reading ER bills and investigating the reasons behind the high costs. Emergency rooms have a facility fee, which can range from the low hundreds to the high thousands, where the patient pays essentially for just walking through the door. Kliff will also talk about the GOP's latest attempts to cut back Obamacare, and what a Medicare-for-all plan would entail. Also, Maureen Corrigan reviews two books about forgotten stories from Hollywood's past, 'The Lady from the Black Lagoon' and 'Giraffes on Horseback Salad.'
  3. Why are medical bills so hard to read? How is the consolidation of hospitals affecting the price of care? Why is it that more competition in the pharmaceutical industry drives prices up rather than down? Journalist (and former physician) Elisabeth Rosenthal investigates the dysfunction of the American health care system in her new book 'An American Sickness.' Also, TV critic David Bianculli reviews the new season of AMC's 'Better Call Saul.'
  4. Americans spend more on healthcare than people in other high-income countries, and it's not because we use more of it.
  5. Dylan Scott and special guest Sarah Kliff join Matt for a close look at health care in Taiwan, Australia, and the Netherlands.Recommended reading:"Everybody Covered" by Dylan Scott, Ezra Klein, and Tara Golshan, Vox"Taiwan’s single-payer success story — and its lessons for America" by Dylan Scott, Vox"Two sisters. Two different journeys through Australia’s health care system." by Dylan Scott, Vox"The Netherlands has universal health insurance — and it’s all private" by Dylan Scott, VoxHosts:Matthew Yglesias (@mattyglesias), Senior correspondent, VoxDylan Scott (@dylanlscott), National security reporter, VoxSarah Kliff (@sarahkliff), Investigations and health policy, New York TimesMore to explore:Subscribe to Impeachment, Explained on Apple Podcasts, Spotify, Stitcher, Overcast, Pocket Casts, or your favorite podcast app to get stay updated on this story every week.About VoxVox is a news network that helps you cut through the noise and understand what's really driving the events in the headlines.Follow Us: Vox.comFacebook group: The WeedsOur project, Everybody Covered, was made possible by a grant from The Commonwealth Fund. Learn more about your ad choices. Visit
  6. 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 companies that — surprise! — make a big profit from driving prices up. (They’re called “pharmacy benefit managers” — PBM for short.)Theoretically, they work for insurance companies and employers who pay the premiums, and they’re supposed to keep drug prices down.Economist Geoffrey Joyce used to think they did OK at that, but he’s changed his mind.One thing that turned him around:They got sued in several states, saying, ‘Hey, you should be acting in the best interest of your clients.’ And they’ve won in court saying, ‘No, we have no obligation to do what’s best for our clients. We do what’s best for us.’So, not all sunshine. But: Feeling a little smarter about the whole thing? It’s a victory. Also kinda fun.  See for privacy and opt-out information.
  7. We chronicle the epic struggle to get drugs that treat very rare diseases on the market, and the unintended consequence of that fight, which affected the cost of all kinds of drugs. This is a strange story that involves a hit 70s TV show, a fake march on Washington, a courageous advocate, a carnival concessions wholesaler, and a new drug law that helped a lot of people, made drug companies billions of dollars, and opened a whole can of worms. Adapted from the new podcast An Arm and a Leg by Dan Weissmann Orphan Drugs
  8. 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 shady character on the street … and whom they would soon sacrifice in the name of science. (Photo courtesy University of Toronto.)We also found hopeful signs out there today, including the folks at the Open Insulin Project in Oakland, California, who are working on their own recipe for insulin, which they hope to share as widely as possible.Anthony Di Franco holds a 3-D printed model of an insulin molecule at Counter Culture Labs in Oakland. (Photo courtesy Anthony Di Franco.)If it sounds crazy — well, we talked with a listener who has hacked together an artificial pancreas from outdated equipment, raw computer parts, and open-source software, all with the help of her fellow “rogue, cowboy hackers,” who are growing in number. So, you never know.Terri Lyman of Arizona shows off the home-made rig that regulates her blood-sugar and insulin levels according to her specifications. (Photo courtesy Terri Flynn.)Meanwhile, activists with T1 International — an advocacy group run by Type 1 diabetics — are lobbying Congress, like the woman who leads off our story.Adeline Umubyeyi, a T1 International activist, models a t-shirt from the group’s Washington, DC chapter president. (Photo courtesy Adeline Umubyeyi.)They’re also organizing “caravans to Canada” (as our colleagues at Kaiser Health News recently documented with PBS News Hour) You will find a TON of details, links and resources in our newsletter. We’ve been told that even the sign-up process is pretty entertaining.   See for privacy and opt-out information.

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