An Arm and a Leg

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 findings. For information regarding your data privacy, visit acast.com/privacy

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. For information regarding your data privacy, visit acast.com/privacy

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 their scrubs,” she said. “I could see their [hospital] badge clipped to the front of their uniforms.” The injustices were stark. “The defendants are just outmatched,” Thomas said. “They don't have the resources of a billion dollar hospital with its own collection agency and attorneys.” Thomas did such a good job making a stink about it that after a couple of months, the hospital dropped more than 6,500 lawsuits, and erased the debts. “Shame is a powerful motivator,” said Thomas. “It just is. And the hospital didn't look good, so they had to address it.” For information regarding your data privacy, visit acast.com/privacy

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?!? ... get in touch. Also: We get into a whole story in this episode about "surprise billing" — and as we were publishing this episode, news was breaking. We've got an update at https://www.patreon.com/armandalegshow For information regarding your data privacy, visit acast.com/privacy

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 anesthetic. So it was off to the ER. Before signing anything, Sarah asked what it might cost and pressed hard — but got only squishy answers. She ended up liable for $3,000 in charges. If only she had known. “I would've said thank you very much. And walked out and gone back to our lovely urgent care and been like, 'Cameron, bite on this stick.'” Her adventures make an entertaining parable, and they raise a big question: In a health care system where consumers are told to "shop" for the best deal, why is it so hard for us to get the information we need? On this episode, we get some answers, thanks to a super-insider and straight shooter: Lisa Bielamowicz, a doctor who now runs Gist Healthcare, a consultancy firm where hospitals are the clients, gives us the dirt. We'd love it if you support this show on Patreon. https://www.patreon.com/armandalegshow For information regarding your data privacy, visit acast.com/privacy

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't sung all the way through — it's more like the PBS documentary on Hamilton than an actual musical of its own. But that is still. Pretty. Darn. Cool. AND: In keeping with our theme this season of self-defense against the cost of health care, Explanation of Benefits wraps with a set of short vignettes demonstrating ways patients can work to protect themselves from excessive charges. So we have included here an email-by-email breakdown of songwriter Emily Lowinger's successful battle to fight off a surprise medical bill. ... and we've set it off with music — timing and cues lovingly adjusted by our audio wizard, Adam — and it is a TREAT. Go enjoy. Have a great Thanksgiving! ... and speaking of thanks: I recently spent a weekend afternoon sending thank-you cards to folks who support this show on Patreon. I'd love it if you became one: https://www.patreon.com/armandalegshow For information regarding your data privacy, visit acast.com/privacy

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, and made a habit — even a hobby — out of helping others: Fellow diabetics, co-workers, and strangers on the Internet. She's a health-care ninja. And she happens to be my neighbor. Also in this episode: Our show's chief investor (and my spouse) applies some ninja-level negotiating skills to save our family more than $700 on a lost medical device. Around here, that's what we call romantic. Thanks to our supporters on Patreon! We'd love it if you became one: https://www.patreon.com/armandalegshow For information regarding your data privacy, visit acast.com/privacy

Stephanie Wittels Wachs has a daughter born hearing impaired, 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 she is the host of the new podcast Last Day, which uses her brother's story as a starting point for a deep and smart and very-human look at the opioid crisis. Highly recommend: https://www.lemonadamedia.com/show/last-day P.S. This podcast, An Arm and a Leg, is a finalist for a very-strange, very-approriate award: Best True Crime show of 2019. Because not all crimes are against the law. Let 'em know: Go vote for us right now — voting closes November 18: https://awards.discoverpods.com/finalists/ Also: We'd love it if you support this show on Patreon: https://www.patreon.com/armandalegshow Thanks! For information regarding your data privacy, visit acast.com/privacy

It’s going to be REALLY fun. Also, maybe useful. Catch you here soon! Also, here’s a little video preview. Wanna share it with folks? Be our guest! Here it is on Twitter, Facebook, Instagram, and Vimeo. For information regarding your data privacy, visit acast.com/privacy

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: “People think of us as a medical organization. We’re not. We are fundamentally a peace and justice organization that happens to be engaged in our community through medical care.” The other is the way he stands at his desk and nerds out on stats that show his clinic beating the pants off the competition, on preventive-care measures like screenings for cervical cancer, vaccination rates for two-year-olds, etc.. “OK, next: diabetes control,” he says. “Are you getting the idea here?” At the heart of it, he says, is listening to people’s stories. The rest he calls “housekeeping.” It’s not a fix for our whole broken system — you can’t just copy-and-paste what’s happening here — but it’s definitely pretty inspiring. There’s a bit more in this write-up I did for our pals at Kaiser Health News. But first! How about taking our listener survey? It just takes a few minutes, and you’ll be helping us out a TON: https://armandalegshow.com/survey/ Thank you! You’ll be helping us get Season 3 made. For information regarding your data privacy, visit acast.com/privacy