Nurse Talk

This time on CodeWACK! Today, we’re talking about insurance denials, hidden incentives… and why getting care can feel like navigating a system designed to stop you. Our guest is Bob Coleman, a retired healthcare professional who spent more than 40 years serving veterans through the U.S. Department of Veterans Affairs—as a clinical pharmacist, medical informaticist, and researcher. His latest ebook...

This time on CodeWACK! Most employers don’t actually know what they’re paying for healthcare - and employees are paying the price. In this episode of Code WACK!, discover why companies are “flying blind” on healthcare costs, how opaque pricing drives higher premiums, and what this means for your coverage, care, and financial security. To learn more, we spoke with Chuck Melendi, who has more than t...

This time on CodeWACK! What challenges do employers face when providing health coverage to their employees? And what role do health insurers and Pharmacy Benefit Managers—prescription drug middlemen known as PBMs—play in shaping costs, coverage, and access to care? To find out, we spoke with Chuck Melendi, who has more than three decades of experience in healthcare leadership, advocacy, and indust...

This time on CodeWACK! Today, most people on Medicaid get their care through private insurers called Managed Care Organizations, or MCOs—like Aetna and UnitedHealthcare. Critics say these companies add layers of bureaucracy that make it harder for patients—most of them low-income—to get care. They discourage physicians from accepting Medicaid patients by making them jump through hoops to get treat...

This time on CodeWACK! Why are there middlemen in Medicaid—and what are they doing to our most vulnerable patients and physicians? How and why are private insurance intermediaries permitted to put profits ahead of patients? A recent report by Physicians for a National Health Program, titled Removing the Middlemen from Medicaid, pulls back the curtain on Managed Care Organizations (MCOs). To learn...

This time on Code WACK! We’re taking a closer look at what happens when private equity buys hospitals. Our guest is Dr. Renee Hsia (pronounced “Shaw”). An emergency physician at Zuckerberg San Francisco General Hospital, Dr. Hsia explains how patients can be harmed when Wall Street firms take over health care. A Professor of Emergency Medicine and Health Policy at the University of California, San...

This time on Code WACK! What happens to staff and patients when private investors buy hospitals to make them more profitable? And why should this concern us all? To break it down, we spoke to Dr. Renee Hsia ( pronounced “Shaw”) an attending physician at San Francisco General Hospital and Trauma Center and a Professor of Emergency Medicine and Health Policy at the University of California, San Fran...

This time on Code WACK! Millions of Americans have health insurance, but still can’t afford to use it. So what happens when high deductibles and corporate profit pressures shape the care patients receive? To break it down, we spoke with Dr. Adam Gaffney — a pulmonary and critical care physician, public health researcher, and Assistant Professor of Medicine at Harvard Medical School. He’s also a fo...

This time on Code WACK! Why do Americans live about four years less, on average, than people in similar European countries, despite spending far more on health care? And why are so many dying from illnesses we already know how to prevent or treat? To help us unpack this, we spoke with Dr. Adam Gaffney — a pulmonary and critical care physician, public health researcher, and Assistant Professor of M...

This time on Code WACK! Why are people in America resorting to receiving medical care in animal stalls - even if they have health insurance? What would it take to make volunteer stopgap clinics unnecessary - and who stands in the way of real reform? To break it down, we spoke with leading healthcare reform advocate and New York Times bestselling author Wendell Potter. A former health insurance exe...

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This time on Code WACK! Privatized Medicare now covers more than half of older adults nationwide. But how do Medicare Advantage plans’ lower star ratings, narrow networks, and “paper benefits” hit seniors of color hardest-and why are hospitals dropping these plans, leaving patients scrambling for care? Our guest is Dr. Belinda McIntosh, an Atlanta-based psychiatrist with more than 20 years of expe...

This time on Code WACK! How does Medicare Advantage - also known as privatized Medicare - fail seniors … especially seniors of color? Why do many seniors find they actually have no other choice than an Advantage plan? What’s the consequence of that lack of choice? And how do Medicare Advantage insurance plans actually deepen racial and income disparities? To find out, we spoke with Dr. Belinda McI...

This time on Code WACK! This time on Code WACK! In celebration of Dr. Martin Luther King Jr. Day, we’re rebroadcasting this episode examining how desegregation shaped the experiences of Black patients in America – and what still hasn’t changed. What does racism in medicine look like today? To break it down, we spoke to Dr. Barbara Berney, project creator and producer of the documentary “Power to H...

This time on Code WACK! In honor of Dr. Martin Luther King, Jr. Day, we’re rebroadcasting our Anthem Award–winning episode on one of the most overlooked civil rights battles in American history: the desegregation of hospitals. The episode features Dr. Barbara Berney, a distinguished public health scholar and the creator of the award-winning documentary Power to Heal: Medicare and the Civil Rights...

This time on Code WACK! As healthcare costs skyrocket and Americans face new coverage threats, California advocates are pushing for something bigger than simple fixes around the edges. We’re joined by longtime healthcare organizer Michael Lighty, who breaks down the fight for single payer, what’s at stake in 2026, and why unity may be the key to winning guaranteed healthcare for all. Michael is th...

This time on Code WACK! Today we’re talking about rising healthcare costs and the renewed momentum behind Medicare for All. Recent polling shows majority support for the idea-across Democrats, independents, and even a notable share of Republicans-even when voters are told it would replace most private insurance and require higher taxes. As premiums, deductibles, and out-of-pocket costs continue to...

This time on Code WACK! America is facing a looming crisis in caregiving with an aging population and scarce in-home care resources . Could neighborhood-based care networks offer answers? What becomes possible when they’re in place? To find out, we spoke with Dr. Mary-Elizabeth Harmon, a scientist-turned-storyteller, caregiver and founder of a business helping neighbors build caring communities an...

This time on Code WACK! Suddenly, with little notice, you may find yourself having to step into a caregiving role for a friend or family member. Maybe you already have. It could be an aging parent, an ailing partner or an injured child. What does it really cost—emotionally, physically, and financially—to care for someone you love? To find out, we recently spoke with Dr. Mary-Elizabeth Harmon, a sc...

This time on Code WACK! Join us on a deep dive into the hidden forces behind soaring out-of-pocket costs, from rising medical costs to pandemic aftershocks and corporate profit pressures. Our guest, health insurance agent Sherry Davis Johnson, shares eye-opening stories from the front lines. We’ll also explore how the Affordable Care Act has saved lives, what protections still matter most, and wha...

This time on Code WACK! We’re digging into big questions: Are reduced health insurance subsidies leaving Americans with a bad case of sticker shock? If you’re shopping on the ACA marketplace, what should you watch out for before picking a plan? And what happens if you're pre-authorized for treatment in 2025, but can't afford to renew with the same plan in 2026? (It's not pretty). For these answers...

This time on Code WACK! Will Humana and UnitedHealth Group be found by the courts to have prematurely denied or cut off physician-ordered post-acute care for Medicare Advantage members using AI models with error rates as high as 90%? And could these same AI tools, which over 60% of doctors allege systematically deny patients necessary care, be used in Traditional Medicare as well? The answer is YE...

This time on Code WACK! Imagine watching your mom suffer a stroke and two seizures that left her unable to use her right side… and then having her Medicare Advantage health insurer deny coverage for the nursing home care she desperately needs. Now imagine learning that the decision to deny her coverage may have been based on artificial intelligence (AI) instead of clinical observation by a qualifi...

This time on Code WACK! How do health insurance hassles like denials and preauthorizations exacerbate inequities in our broken healthcare system? How do they rob physicians of precious time caring for patients and even jeopardize their practices? And why are some big insurance companies buying up physician practices? To find out, we recently spoke with Dr. Erica Rowe Urquhart, a private practice o...

This time on Code WACK! Why can working as a doctor in America feel like being on a battleground? What questionable tactics are insurance companies using? How are they affecting patients and physicians alike? And when coverage is denied, what can patients do? (See Helpful Links below for tips on appeals.) To find out, we recently spoke with Dr. Erica Rowe Urquhart, a private practice orthopedic su...