An Arm and a Leg

If you need medical care, it's like you've entered a casino, playing for your financial life, with the deck stacked against you. Lucky for us, we get insight — and tips the dealer WON'T tell you— from ace reporter Celia Llopis-Jepsen. To start with, she got an executive from a health-care company to talk honestly — maybe more honestly than he realized — about how his company and others are playing the game, when they send patients bills for huge amounts. Here's what else she found, when she investigated an $80,000 bill one man got: For many COVID patients, including the guy in her story, lots of providers just aren't allowed to bill for more than insurance pays them. Those are providers who took some of the $175 billion in bailout funds that Congress passed out in March. Don't expect your provider to just tell you. (That $80,000 bill did not include a footnote saying, "Once insurance pays us, you can forget all about this.") But if you get a bill for COVID treatment, you can make your own luck and look up the provider yourself. Because Celia found a government database where you can SEE if your provider took those funds. We also like Celia's Expert tip sheet for pushing back against your medical bills. ... and her first big medical-bill story— A Kansan's $50k Medical Bill Shows That You Don't Always Owe What You're Charged— is packed with insight too. Note: When this episode was first posted, our host mis-pronounced the first name of a man who received an $80,000 bill. He is Anil Garmalkar. The audio has been corrected. We are bringing you these self-defense lessons every two weeks from here on out. That's thanks to direct support from listeners. We'd love for you to support us too: https://armandalegshow.com/support/ 
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There's no time like a pandemic to (a) learn to fight back against the awful cost of health care. And (b) have a good time doing it. Yep. Let’s go. 
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We wrap up our COVID-19 popup season with stories from three folks with very different takes on what we've learned so far about what the pandemic is costing us: A doctor and advocate in Brooklyn looks back on the wave of black and brown patients that filled her clinic in March. A nurse-practitioner in Texas looks at how new tech is—and isn't—helping the older patients she cares for. And: One of the country's top insurance nerds says her first policy ideas to keep people from getting stuck with high bills for COVID tests ... were wrong. Get ready for the hug shortage, the new abnormal, and the $7,000 COVID test. And: Help guide the next steps for this show! Take five minutes for our listener survey. We so appreciate it. https://armandalegshow.com/survey/ Thanks to everyone who supports the show on Patreon. You can join 'em here: https://www.patreon.com/armandalegshow 
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In early April, Katelyn was in a financial bind: Home sick with COVID, she hadn't been paid in weeks. And bills were due. "My landlord is kinda beating down my door right now," she said in a voicemail to our hotline. Weeks later, Katelyn got back in touch: She had made it through, thanks to a combination of playing hardball with one company and knowing how to play nice with others. Because of her job, she had an insider's understanding of the playing-nice process: Katelyn works in collections for a financial institution, so she knew how to ask for help. Even so, she didn't find the process easy. She came out of the ordeal with a heck of a story, and hard-won tips for all of us. In addition, here are a couple of resources mentioned in this story: A collection of tips on dealing with medical bills and collection agencies, from one of our favorite teachers: TikTok mom Shaunna Burns. https://armandalegshow.com/medical-bill-tips-from-a-mom-who-knows-some-things Hello Landlord is a free online tool that automatically generates letters you can send to your landlord, asserting your legal rights. (Right now, those rights may include some federal protections avainst evictions.) https://hellolandlord.org/ You can call and leave us a message too: (724) 267-6534 — that's 724 ARM N LEG Or share stories at https://armandalegshow.com/contact/ Thanks to everybody who supports our work! Join 'em here: https://www.patreon.com/armandalegshow 
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A listener, who has worked in health insurance for decades, wrote in. "I have listened to all the episodes in this podcast, and there are times I come away feeling bad working for the insurance company." We talked. Along with angst, she shared advice we all can use. 
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You've probably noticed: The U.S. economy is crashing. Something you may not have noticed, that may sound really weird: Almost half of that economic devastation comes from just one sector. And that sector? It's health care. If that sounds completely backwards, it is. Except in the world of how we pay for health care in this country. Because even though we as a society need health care workers like never before, to fight COVID... ... we-as-individuals are avoiding doctors' offices and hospitals for everything else, whenever we can.…Just like we're avoiding going out to eat. And this country runs health care kind of like the restaurant industry:…When people stop showing up for Sunday brunch— or for hip replacements, colonoscopies, etc. —the enterprise runs short of cash real fast. Even folks you'd think would be the most in-demand — ER docs fighting COVID—aren't immune. In this episode, we look at some of the extra weird details of this very-weird recession: how a couple pieces of it are working, and what they could mean. For our wallets. We draw in this story on stuff we covered in a Season 3 episode called "Can They Freaking DO That?!?" It's still fun and relevant, and you can catch it right here. https://armandalegshow.com/episode/can-they-freaking-do-that/ Thanks to everyone who supports this show on Patreon! Join 'em, and we'll shout you out at the end of an episode: https://www.patreon.com/armandalegshow 
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Anna's insurance company said it would pay 100 percent for COVID-related testing. And then they left her to pay a giant bill. She got help, thanks to a viral tweet, but... her story exposes big loopholes in consumer protections. (We learn how not to fall in.) And: The way people responded to her tweet was generous, moving, and... complicated. Uncomfortable. Weird. Even with everybody doing their absolute best. (And, we should say, with as happy an ending as any of us get these days.) Anna's story gets right to the heart of some of the really weird ways that dealing with the cost of health care — ESPECIALLY in the world of COVID-19 and the Internet and everything else — just messes with our minds, and our relationships as humans. Thanks to Carmen Heredia Rodriguez, who reported the story of Anna's bill for Kaiser Health News and kindly let me piggyback on her hard work! You can read her version at.https://khn.org/news/bill-of-the-month-covid19-tests-are-free-except-when-theyre-not/. Send your stories our way: https://armandalegshow.com/contact/ And support our work: https://www.patreon.com/armandalegshow 
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Ryan Gamlin spent a decade working on the financial side of health care, before going to medical school. Now, as an anesthesiologist in Los Angeles, he’s on the front lines fighting COVID-19, an experience he describes as “scary, in a way that I never expected to be scared, going to work.” He was scared one day last summer, too, when a California wildfire came within feet of the hospital where he was working.… And then a fleet of fire trucks showed up to protect the hospital. “City, county, park service, forest service, new trucks, old trucks, unmarked trucks.” “As I drove home later that day through the protective ring of equipment, I realized the fundamental difference between public safety and health care. Public safety is built on latent capacity. We pay for people and equipment to stand idle, over-prepared for emergencies.” These days, he’s been thinking back to that experience. “We’ve left no latent capacity in health care,” he wrote in a Twitter thread.… “And some part of the tragedy that’s now unfolding in this country is because of that. Because we let health care become a business. And because businesses don’t keep a hundred extra fire trucks around, their crews trained and ready, just in case.” We talked with Ryan about his experiences for this week’s episode. With protective equipment in short supply, he said, "It felt like a fire, with no one to call." We ALSO hear some good news, about folks who are stepping up to help — tapping their own latent capacity. That includes people making "ear savers" for health-care workers. Turns out, if you wear a mask all day, the elastic rubs the heck out of the skin behind your ears. Some people are 3-D printing connectors that go around the back of the head. And some people are taking a more low-tech approach. Here's a picture of my friend and neighbor Liz Feldman is the medical director at a local clinic. She's modeling ear-savers that are basically fabric headbands, with buttons sewn in to hold the masks in place, made by a retired colleague from old t-shirts and scavenged buttons. 
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Lots of people have insurance plans that only cover them with certain places —providers, certain hospitals. But: in a COVID pandemic surge, who knows if you'd end up one of those places? And if you end up someplace else... then what? That’s the question we got from a listener named Becky in Minnesota. She's got a Bronze plan — it only covers a limited "network" of providers— and she's got a $6,000+ deductible. With officials talking about converting sports arenas into makeshift hospitals, Becky says: "If you call an ambulance, you may not even go to a hospital, right? Let alone a hospital that is quote-unquote in your network." We put Becky's question to one of the country’s top health-insurance nerds: Sabrina Corlette, founder and co-director of Georgetown University’s Center on Health Insurance Reforms. Not all the answers were comforting. But they weren't all grim either. And Becky turns out to have some good advice for us all. And, per Sabrina Corlette's advice for anybody newly out of work — and suddenly without health insurance: Go apply for Medicaid. As promised in the episode, here's a map showing which states have expanded Medicaid so that pretty much anybody who suddenly has very little income is eligible: https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/ Please keep your questions and stories coming: https://armandalegshow.com/contact/ Or call (724) 276-6534 — that's (724) ARM N LEG And as always, we'd love you to join us by supporting the show on Patreon: https://www.patreon.com/armandalegshow 
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We kick off SEASON-19, about the cost of COVID, with a dose of hope — a story about an unlikely chain of people coming together to speed PPE to a COVID hospital in Brooklyn. NYC is a couple weeks ahead of the rest of the country, we think, so there are lessons here we can all get ready to use. Especially this: Don't be afraid that what you have to offer isn't enough. Take the step in front of you, even if it's a little one. Here's a couple ways to start 1. You can donate to that effort to get PPE to that Brooklyn hospital here: https://www.gofundme.com/f/artcube-army-ppe-supplies 2. There are stories like this all over, big and small. And we want as many as we can find for SEASON-19. Tell us about the ones you know at https://armandalegshow.com/contact/ ... or leave a message on our hotline: (724) 276-6534. That's (724) ARM N LEG. 
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