Tradeoffs

Ashish Jha shifted from the role of academic theorizing about health policy into a calm, reassuring voice leading the White House’s COVID response. Now, he’s back in the world of studies and scholarship leading Brown University's School of Public Health. This week, what he learned from his time in Washington. Guest: Ashish Jha, Dean of Brown University’s School of Public Health and former White Ho...

It’s been one year since 988, the country’s new mental health crisis line, went live with hopes of transforming crisis services in America. So far, call volumes are up, wait times are down, and reviews are mixed. This week, we check in on what’s working, what’s not, and what’s next for 988. Content warning:  This episode includes mentions of suicide. If you or someone you know is in crisis, p...

Economist Amy Finkelstein has studied America’s patchwork of health insurance policies for more than 20 years. In a forthcoming book she concludes it’s time tear the whole system down. This week, Dan talks with Amy about how she came to that conclusion and what a better system could look like.  Guest: Amy Finkelstein , PhD, Professor of Economics, MIT Learn more and read a full transcript on...

More than 1.5 million people have lost Medicaid coverage since April 1 as states start purging people from the rolls for the first time in three years. This week, we check in on the “Medicaid unwinding” with a leading researcher, and get an up- close look at what it’s like to fall through the unwinding cracks. Guests: Adrianna McIntyre , PhD, MPP, MPH, Assistant Professor of Health Policy and Poli...

One year after the Supreme Court overturned Roe v. Wade, 15 states have effectively banned abortion. Dozens of clinics in those states have shut their doors or moved to states where abortion is still legal. This week, Politico’s Alice Miranda Ollstein takes us to an Alabama clinic that stayed put. She wanted to learn what happens when an abortion clinic can no longer provide abortions. Guest: Alic...

Medicare is in the midst of a pretty dramatic transformation. Before long, two out of every three enrollees will likely have a private Medicare Advantage plan.     This week, we look at what’s gained and what’s lost when private insurers manage so much of the nation’s Medicare program — and where we go from here. Guests: Carol Berman, Medicare Advantage enrollee Rick Gilfillan , MD,...

Next week many of the country’s health economists will gather in St. Louis to share new research at the annual meeting of the American Society of Health Economists. This week health economist Sayeh Nikpay gives us a sneak peek at some of the most exciting papers coming out of this conference. Guest: Sayeh Nikpay, PhD, MPH, Tradeoffs Senior Research Advisor; Associate Professor, University of Minne...

There’s growing excitement that artificial intelligence can make health care better by speeding up care, improving diagnoses and easing the burden on a burned out workforce. But there are also concerns that these powerful new tools will perpetuate biases and inequities long baked into our health care system. In Part 2 of our special series on racial bias in health care AI, we dig into what the Bid...

There’s growing excitement that artificial intelligence can make health care better by speeding up care, improving diagnoses and easing the burden on a burned out workforce. But there are also concerns that these powerful new tools will perpetuate biases and inequities long baked into our health care system. In the first of two back-to-back episodes on racial bias in health care AI, we explore the...

Black Americans are at higher risk for many serious illnesses like dementia and kidney failure. But data show they are less likely to have their pain treated and less likely to access services like hospice and palliative care that can reduce suffering, especially at the end of life. This week, we explore what stops seriously ill Black patients and their families from getting the care they want in...

Every year, 100,000 Americans — mostly teens and young adults — experience their first psychotic episode. Research shows getting specialized, holistic treatment early can help, but most people don’t get that care. KQED’s April Dembosky shares her reporting on why early treatment for psychosis can be so hard to get. Guest April Dembosky , Health Correspondent, KQED News Learn more and read a f...

Medicare could soon pay hospitals much less for common outpatient services like x-rays and checkups. This week , we explain an old policy gathering new steam in Washington, how it could save Medicare and patients billions of dollars a year, and why it has hospitals worried. Guests:  Loren Adler , MS, Fellow and Associate Director, USC-Brookings Schaeffer Initiative for Health Policy Joe Antos...

Just like the rest of us, when clinicians are short on time and overwhelmed by complex decisions, their brains look for corners to cut, numbers to round, patterns to repeat. This week, Dan talks with Harvard physician and economist Bapu Jena about the surprising impact these mental shortcuts can have on our health care. Guest: Bapu Jena , MD, PhD, Professor of Health Care Policy, Harvard Medical S...

A new class of drugs can help people lose up to one-fifth of their body weight and manage serious health conditions associated with obesity. But they’re also raising difficult questions. This week, we talk with STAT reporter Elaine Chen about how these breakthrough treatments are changing how we view and treat obesity.  Guest: Elaine Chen , Cardiovascular Disease Reporter, STAT Learn more and...

About half of people on Medicare use hospice care before they die, but as the popular benefit turns 40 this year, it is struggling with waste, access and inequity issues.  This week, we look at a federal experiment revamping Medicare's hospice policy, and how it could ultimately change the way millions of people die. Guests: Vince Mor , PhD, Professor of Health Services, Policy & Practice...

The Affordable Care Act faces yet another in a long string of legal challenges. Last Thursday's ruling, by a conservative federal judge who has targeted the ACA before, jeopardizes a provision in the law that gives 150 million Americans access to free preventive care for conditions like HIV and cancer. Guest: Nicholas Bagley , JD, Professor of Law, University of Michigan Learn more and read a full...

We dig into three research papers to make sense of what will happen to 15 million people set to lose their Medicaid over the next year. Guests: Sayeh Nikpay , PhD, Tradeoffs Senior Research Advisor; Associate Professor of Health Policy and Management, University of Minnesota Learn more and read a full transcript on our website . Want more Tradeoffs? Sign up for our free weekly newsletter featuring...

The pandemic pushed Medicare to start paying for “hospital-at-home” care for the first time, launching the largest test ever of home-based hospital care. This week, we look at what we’ve learned from the hospital-at-home explosion and questions about home-based care remain unanswered. Guests:  Bruce Leff , MD, Director, The Center for Transformative Geriatric Research, Johns Hopkins David and...

Even though more Americans than ever have health insurance, medical debt is a pervasive problem in the United States. Guests:  Noam Levey , Senior Correspondent, Kaiser Health News Wesley Yin , PhD, Associate Professor of Economics, UCLA Learn more and read a full transcript on our website . Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy researc...

Less than a year after the Supreme Court overturned Roe v. Wade, some states are rethinking their abortion bans. This week, reporter Alice Miranda Ollstein introduces us to a Republican lawmaker pushing to add exceptions to the ban he helped pass, and we consider how well exceptions work - or don't - in practice.  Guests: Alice Miranda Ollstein , Health Care Reporter, Politico State Sen. Rich...

Meet the man behind our revamped research newsletter bringing you the latest health policy studies, original analysis, interviews with leading researchers and more every Tuesday. Subscribe at tradeoffs.org/research Guest: Soleil Shah, Research Reporter, Tradeoffs Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Support this type of j...

Later this year the Supreme Court is set to decide whether to close a legal pathway that Medicaid recipients have used for more than 50 years. This week, we talk with Farah Yousry about the potential consequences of this decision. Guests: Farah Yousry, Health Equity Reporter, Side Effects Public Media Susie Talevski, patient Chris Schandevel , Senior Counsel, Alliance Defending Freedom Jane Perkin...

People leaving jail and prison are at extremely high risk of hospitalization and death. This week , why policymakers from deep blue California to solidly red Utah think bringing Medicaid behind bars could help. Guests: Lee Reed Shira Shavit , MD, Professor of Family and Community Medicine, University of California San Francisco; Executive Director, Transitions Clinic Network Jacey Cooper , Directo...

Medicare’s historic plan to slow prescription drug spending is taking shape. Last Thursday federal health officials began detailing how one of two major drug price reforms contained in the Inflation Reduction Act will work and who it will affect.  This week, we talk with Medicare director Meena Seshamani about the “opportunity of a lifetime” to put these unprecedented policies into action. Gu...

One year of health insurance premiums for a family of four now costs as much as a car. Nine states are trying to lower those costs in an aggressive way - by holding hospitals and insurance companies accountable for high spending. In this episode we look to see if any of those efforts have bent the cost curve. Guests:  Leemore Dafny, PhD, Harvard University economist Michael Bailit , MBA Presi...