What do the KGB and the former CEO of Cincinnati Children's Hospital have in common?

At different times, they’ve each looked to a guy named Eugene Litvak for help. He only said yes to Cincinnati — but he saved that hospital more than a hundred million dollars a year.

For the last few decades, Litvak – a Soviet émigré with a PhD in math – has been on a mission: save U.S. hospitals from financial ruin, and improve the lives of doctors, nurses, and patients.

He says he has just the formula to do it, lots of prominent experts agree, and he’s documented impressive results so far: Financial savings, fewer hospital-related deaths, lower staff turnover, and shorter wait times.

But Litvak and his allies are still struggling to convince more hospital CEOs to try his method.  

We talk with Litvak about his wild life story and how he found the fix that he says could revolutionize American hospitals. And we speak with experts to determine why more hospitals don’t try it. 

Here’s a transcript of this episode. 

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With news blasting from Washington like a firehose, it feels impossible to take it all in — to stay on top of all the changes the Trump administration has been trying to make. 

But for health care, one person is probably closer to anyone than to understanding the full picture: KFF Heath News Chief Washington Correspondent Julie Rover.    

In this episode, Julie helps us see that picture, by telling us two stories:

The first concerns a teeny part of the health care system — an obscure federal agency, one of many that the Trump administration has taken a chainsaw to.

The other is anything but obscure: Possible cuts to Medicaid —which Julie thinks Republicans will actually find very difficult to make.

Plus, reporting from Julie’s KFF Health News colleague Arthur Allen. And a cameo from one of Julie’s beloved corgis.

Check out Julie’s weekly health policy news podcast: What the Health? 

Read more from Arthur Allen on cuts to AHRQ in KFF Health News:

What’s Lost: Trump Whacks Tiny Agency That Works To Make the Nation’s Health Care Safer

Trump HHS Eliminates Office That Sets Poverty Levels Tied to Benefits for at Least 80 Million People

Here’s a transcript of this episode. 

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People who work in real-life emergency rooms have raved about how accurately the new drama The Pitt (Max) captures the dynamics and the medical details of their workplaces.

Here at An Arm and a Leg, we’ve been nerding out about how the show depicts the financial forces that shape the ER’s day-to-day problems like crowding, eternal wait times, and scary bills. 

For this episode, we got Dr. Alex Janke, an emergency medicine doctor and health policy researcher to nerd out with us. 

Here’s a transcript of this episode. 

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Of course we’d love for you to support this show.

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A few months ago, we got a note from a listener named Meagan, who wanted to thank us. 

She said the stories she heard on this show had given her the advice and encouragement she needed to finally win a fight against a medical bill she didn’t owe — a battle she’d been waging for more than two years.

As Meagan tells us, those two years were filled with wild twists and turns and a lot of disappointment.

We hear what kept her motivated and encouraged despite all the setbacks – and after an insurance rep pointed her to a free legal resource — the tactic that finally led to a breakthrough. 

Here’s a resource we mention — with a spoiler alert: It’s the sample cease-and-desist letter that a lawyer shared with Meagan. 

We’ll break down the details — how a letter like this could work, in certain situations — in a future First Aid Kit newsletter.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

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A federal agency called the Consumer Financial Protection Bureau — CFPB for short — has taken big steps to help people with medical debt. In early February, the Trump administration moved to effectively shutter the agency. 

We talked with credit counselor Lara Ceccarelli about how the CFPB has helped clients at the nonprofit where she works, and how she’s navigating the sudden change. 

And consumer-rights advocate Chi Chi Wu — an attorney with the National Consumer Law Center — describes the court battle she and her colleagues are mounting to slow down the agency’s dismantling — and where things could go from here. 

We’ll track this developing story in next week’s First Aid Kit newsletter, so if you’re not signed up, this is a great time to start: www.armandalegshow.com/firstaidkit.

Here's a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

See omnystudio.com/listener for privacy information.

Hey – real quick: some big news from the team at An Arm and a Leg. Our First Aid Kit newsletter is going weekly! First Aid Kit brings you advice from our show and more on how to survive and navigate America’s health care system. 

And allow us to introduce First Aid Kit’s new writer, Claire Davenport. 

When she was our intern last summer, she reviewed An Arm and a Leg’s entire catalog of episodes, and took notes along the way. Now she’s bringing the practical lessons from all that reporting straight to your inbox, every week. 

Get it while it’s hot: sign up for First Aid Kit here. 

See omnystudio.com/listener for privacy information.

We’re kicking off a new reporting project about how much we pay for our medicine — and what we can maybe do about it — and we want to hear your stories.

Because: Getting a case of sticker shock with a prescription happens all the time. 

So we’re asking: What have you done — or tried to do — to get the medicines you need at prices you can afford? And what did you learn that might be useful for other people to know?

Maybe you learned a strategy that actually WORKED for you. Like using a coupon or ordering drugs from online pharmacies — even pharmacies in other countries.

Maybe it was, “Man, I learned about a new way I’m getting screwed.” 

However things went, tell us about it here: armandalegshow.com/drugs

Your story can be short or long, scary or uplifting – whatever you’ve gone through to get your meds, whether it worked or not, we want to hear about it.

The more we learn about these strategies, and about new ways we’re getting beat up, the more we can work together to do something about it. 

And over the next couple of months, we’ll dig into everything you bring us, call up some experts, and start bringing you what we’re learning.

Meanwhile, if you could use some tips right now for getting a better price for your prescription, we’ve just posted a batch to our First Aid Kit newsletter – check it out here.

Fair warning: It’s a collection of band-aids — that’s what you find in a first aid kit — but it’s a start.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

See omnystudio.com/listener for privacy information.

You remember a guy named Martin Shkreli? If his name rings a bell, it’s probably because back in 2015, he jacked up the price of an old drug — from around $13 a pill to $750. The media dubbed him “the pharma bro,” and he became a symbol of brazen pharmaceutical greed. 

Now, he’s the namesake for the Shkreli Awards — a kind of Oscars for the most outrageous examples of greed, fraud, and general brokenness in American health care. 

Every year, a health care think tank called the Lown Institute ranks the top ten worst stories and holds an award ceremony to “honor” the winners. 

We’re bringing you highlights from this year’s ceremony – featuring things like human bones for sale without the consent of the deceased or their families, phantom urinary catheters, and so much more – and some reflections from the Lown Institute’s president, Dr. Vikas Saini. 

“Showing all these stories together paints a picture of a health care system in desperate need of transformation,” Saini said at the ceremony. “Not just because the stories are shocking, but because often what they're depicting, like Martin Shkreli's infamous price hike, is perfectly legal.” 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

See omnystudio.com/listener for privacy information.

See omnystudio.com/listener for privacy information.

A few weeks ago, a listener sent us a note with a link to a news article about a new resolution that had recently been adopted by the American Medical Association – the largest group representing doctors in the US. 

The resolution said: hospitals need to do more to guarantee charity care to patients who qualify. Legislators and regulators should make them. 

Our listener was the author of that resolution, and he told us he first learned about charity care through this podcast. 

His name is Joey Ballard and he’s an internal medicine resident at the University of Illinois-Chicago (UIC).

We talked with him about his early organizing as a medical student, bringing the resolution to the AMA, and the optimism he feels bringing the fight for charity care to the hospital he works at now.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

And again... we’d love for you to support this show.

See omnystudio.com/listener for privacy information.