Tradeoffs

We've got a lot to share with you in 2024! We're looking into how fentanyl and other synthetic opioids are upending long established treatments for opioid addiction, and what clinicians and policymakers are doing to adapt. There are a bunch of cases in the courts this year that have the potential to change Americans' access to care, and restrict the power of federal health agencies. And nearly 25...

Last fall, the federal government named its first 10 targets for historic drug price negotiations with big pharma. Those negotiations are expected to heat up this February when federal officials make their opening price offers. This week, we offer a refresher on how this negotiation process will work and the impact it could have. Guests: Anton Avanceña , PhD, Assistant Professor of Health Outcomes...

More than 130 hospitals have closed in rural America over the last decade. Reporter Sarah Jane Tribble spent a year embedded in one small Kansas town as they dealt with their own hospital closure. Guest: Sarah Jane Tribble , Senior Correspondent, Kaiser Health News Read a transcript of this conversation: https://tradeoffs.org/2020/10/08/losing-a-hospital/ Hear more of Sarah Jane's reporting about...

From where medical students are choosing to train to how doctors are caring for women in reproductive health crises, the Supreme Court's decision to overturn Roe has had major ripple effects on the field of medicine. In this conversation from our friends at STAT's First Opinion podcast, host Torie Bosch talks with two abortion providers about what it's like to practice medicine in post-Roe America...

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...

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...

In this special episode we reflect on a few of our favorite stories of 2023 and hear how they’re making a difference for patients and policymakers.  Guests: Hannah Neprash , PhD, Assistant Professor, University of Minnesota School of Public Health Jami Snyder, MA, president and chief executive officer of consulting firm JSN Strategies Learn more and read a full transcript on our website . And...

One out of every four Medicare patients in the hospital is the victim of a medical error. Over the past 20 years, a growing number of hospitals have adopted practices that discuss medical mistakes and offer support to the people who must cope with the often tragic consequences. We examine why experts are calling on the Biden Administration to make patient safety a national priority. &nbs...

Congress banned most surprise medical bills back in 2020, with one major exception: ambulance rides. Most people agree that patients should be shielded from these unexpected charges. But who should pick up the tab instead? As state and federal policymakers grapple with that question, we delve into why finding a fair solution is harder than you’d think. Guests: Tara Bannow , Reporter, STAT Precious...

Health care leaders are spending more time and money trying to improve the way doctors and nurses talk with their patients, to build more trust. Are those efforts working? We eavesdrop on some difficult conversations between patients and providers, and meet researchers who are measuring the power of using just the right words.  This episode first aired in 2019 and remains as relevant as ever....

California’s Medicaid program is two years into the nation’s most ambitious effort yet to cover non-traditional health care services like housing and food for some of the state’s sickest and most vulnerable residents. Everyone expected this transformation — known as CalAIM — to take some time to hit its stride. We dig into CalAIM’s early challenges and what’s being done to right the ship. Guests:...

A wave of new research is showing the promise of psychedelics to help with mental health conditions — like depression and post traumatic stress disorder. The federal government continues to say it’s illegal to use these substances for treatment, but states like Oregon and Colorado are attempting to roll out regulated use. We talk with Mason Marks about the latest research, regulation, and leg...

Every fall, an avalanche of advertising bombards the phones, televisions and mailboxes of the country’s 65 million Medicare beneficiaries. Private insurance companies and brokers unleash this flurry of marketing in hopes of persuading as many people as possible to switch plans during Medicare’s open enrollment period. This week, we explore how too many choices, too little help and an alarming amou...

In 2021, University of Minnesota health economist Hannah Neprash listened to a Tradeoffs story on ransomware in health care and was inspired to study whether cyberattacks actually harm patients. This week, she shares her striking findings, and we revisit the inside story of a ransomware negotiation that sparked her work. Guests: Karen Sprenger , CISSP, GCFE, Chief Operating Officer and Chief Ranso...

Employers are facing a big dilemma: how do they pay for the new highly effective and popular obesity medications without breaking the bank? This week, the questions are forcing companies to re-examine their attitudes on obesity as the understanding of the disease deepens. Guests: Sean Scanlon , Connecticut Comptroller Jeff Levin-Scherz , WTW population health leader Mike Thompson , President of th...

Many of America’s poorest and sickest patients are stuck navigating two separate insurance programs — Medicare and Medicaid — to get the care they need. Guests: Jose Figueroa , MD, MPH, Assistant Professor of Health Policy and Management, Harvard T.H. Chan School of Public Health Jean Minkel , PT, ATP, Senior Vice President of Rehab and Mobility Services, Independence Care System Rochelle Render,...

Girls in the U.S. are in the midst of a growing mental health crisis, and schools are on the front line of finding solutions. But will Black and Latina girls get left behind? Guests: Monica Bhatt , PhD, Senior Research Director, University of Chicago Education Lab Sheretta Butler-Barnes , PhD, Professor, Washington University Kathleen Ethier , PhD, Director, CDC Division of Adolescent and School H...

This summer, our research reporter Soleil Shah added a new role to his resume: first-year medical resident. Now he spends his days alternating between making the rounds on hospital patients and reading up on the latest health policy research for the Tradeoffs newsletter.  Guest: Soleil Shah, MD, MSc, Research Reporter, Tradeoffs; Resident Physician, Brigham and Women's Hospital Learn more and...

Nearly two decades ago, Dr. Jeff Brenner hypothesized that nurses and social workers could guide the country's most complicated patients toward better health ... and cut expensive hospital admissions along the way. Was he right? Jeff Brenner, Camden Coalition of Health Care Providers Amy Finkelstein, Economist, MIT Kathleen Noonan, Camden Coalition of Health Care Providers Allison Hamblin, Center...

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...

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...

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...

Black Americans report higher levels of mistrust in the health care system than white Americans and suffer worse outcomes in everything from maternal mortality to life expectancy. What if improving health literacy and demystifying health information could be the part of the solution? This week, one doctor’s crusade to help more people understand their own health care and why insurers are starting...

The Inflation Reduction Act gave Medicare historic new power to directly negotiate the prices of some of the costliest prescription drugs. Now the federal agency must grapple with a difficult question: What makes a drug price fair? This week, we explain how this negotiation process will work and the impact it could have. Guests: Anton Avanceña , PhD, Assistant Professor of Health Outcomes, Univers...