Reporter Bob Herman from STAT News unpacks his blockbuster investigation about the country’s biggest health care company.   

Covering the American health care system means we tell some scary stories. But this episode is almost like a horror movie. 

It’s got some of Hollywood’s favorite tropes: Machines taking over. Monsters from separate franchises meeting face to face in a new movie, like Godzilla and King Kong, or Jason and Freddy. And a couple perceptive folks warning everyone, ”Hey, look, something really bad is happening!” 

Those folks are Bob and his STAT News colleague Casey Ross. The monsters are United HealthGroup — a “behemoth” as one expert called them in an episode from last year — and Medicare Advantage, which we looked at in our last episode. And the “machines” belong to United.

Bob describes what some of United’s own employees said about the result: “For some of us, it's creating this moral crisis. Like we know that we are having to listen to an algorithm to essentially kick someone out of a nursing home, even though we know that they can barely walk 20 feet.” 

Scary stuff. But Bob and Casey’s reporting has caught the eye of some powerful people in government, and right now, Medicare Advantage plans are on notice from the federal Centers for Medicare and Medicaid Services, the U.S. Senate is holding hearings, and the Department of Justice reportedly has an anti-trust investigation in the works. 

Here’s a transcript of this episode. 

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Health insurance sucks. Which leaves lots of us counting down the days until we turn 65 and can get on Medicare – the federal government’s health insurance program for seniors. 

But Medicare is a lot more complicated – and costs more money – than a lot of us realize. (Also, it involves insurance companies.) And:t There will be huge, complicated decisions to make when you turn 65, that can have huge consequences. 

The biggest, and most consequential: Choosing between original Medicare and Medicare Advantage – the privatized version sold by health insurance companies that’s advertised everywhere seniors look. 

Some folks who pick Medicare Advantage later regret it — but find there are no do-overs. 

We get the scoop from Reporter Sarah Jane Tribble, who’s been covering the story for KFF Health News and the Washington Post. 

And we get a preview: What do we all need to know before we hit 65 about the choices we’ll face? There are a lot of options, and a lot of price tags. Sarah Murdoch from the Medicare Right Center gives us an outline of those choices and their consequences — and supplies both tips and resources. 

The biggest: When it’s time for you -- or anyone you care about -- to make choices around Medicare, every state has a free source of unbiased advice and information: Here’s a link to find your State Health Insurance Assistance Program (or SHIP).

Here’s a transcript of this episode. 

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A listener wrote to us at the beginning of the year with a query, “I was just reading the news about the price of insulin going down to $35! Is that for everyone?”

It turns out, there is a lot of good news about the so-called “poster child” for the high cost of prescription drugs. But to say it costs $35 now is an oversimplification – and diabetes activists don’t think this fight is over.

Senior producer and self-proclaimed “insulin correspondent” Emily Pisacreta took a hard look at the recent developments. 

Plus, what does the explosion of drugs like Ozempic and Wegovy have to do with the price of insulin? We break it down. 

Here’s a transcript of this episode. 

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Dealing with the American health care system as a patient means lots of tough moments – unexpected bills, meds not covered, insurance and hospitals making you go back and forth without a clear answer, endless hold times and phone trees… the list goes on. 

So listeners ask us all the time: How do I stay strong and fight for my rights without totally losing my s---? 

We’re bringing back one of our most useful episodes ever: How to keep your cool in a tough moment, according to a self defense expert. 

In late 2020, Dan hit up self defense expert Lauren Taylor to get strategies for standing up for yourself, and hear how she’s applied her approach in her own fight for health care coverage. 

Since then, she’s published a book! It’s called Get Empowered: A Practical Guide to Thrive, Heal, and Embrace Your Confidence in a Sexist World. 

Extra tip: At the moment, the site bookshop.org, which supports independent bookstores, has the best price.

Here’s a transcript of this episode. 

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Real quick: Now's the best time to support this show! Thanks to a few super-star Arm and a Leg listener/donors, your donation is matched two for one right now. Here's the link to donate.

Ok, now: We’ve got a mini-episode for you today, a four-minute coda to the epic story we brought you in December.

It features a last tip for anyone who might want to ask a hospital about charity care — which, as we learned from these recent stories, is most of us.

And it comes with my big thanks for being part of this show’s community this year. You’re our reason for being, and our best sources.  

You’re also our biggest source of financial support, so I will ask one more time to pitch in now if you can. 

Thank you so much! We'll catch you in 2024.

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Hey! The BEST time to support this show with a donation just got even better. Right now, any gift you make, up to $1,000, will be matched TWO for ONE, thanks to a few super-generous Arm and a Leg fans who’ve pooled their dough. . It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it!

And… are you ready for our most-ambitious story yet? We’ve been working on this investigation all year, with our partners at Scripps News and the Baltimore Banner. 

With those partners, we’ve dug up some surprising (and possibly uplifting) news about lawsuits in three states – Maryland, New York and Wisconsin — and what that news might mean for the rest of the country.  

This is part two of a two-part series. In part one, we examined the phenomenon of hospitals suing patients in bulk – sometimes hundred or thousands at a time – over unpaid bills. 

We learned that in many cases, those patients are struggling financially, and that the lawsuits aren’t very lucrative for hospitals anyway. So why did they happen in the first place? As one former collections industry insider told us, those decisions are “philosophically based.” 

In this episode — before getting to those surprising/hopeful findings — we try to understand that “philosophy,” perhaps best described as: business-as-usual. We speak with a former hospital billing executive and a representative from the third-party collections industry. 

This series is produced in partnership with the McGraw Center for Business Journalism at the Craig Newmark Graduate School of Journalism at the City University of New York.

… and supported by the Fund for Investigative Journalism.

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Hey, it’s the BEST time to support this show with a donation. Thanks to NewsMatch, any gift you make, up to $1,000, will be doubled. It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it!

We’ve been working on this investigation all year, with our partners at Scripps News and the Baltimore Banner. 

For years, we’ve been hearing about hospitals suing patients over unpaid medical bills – sometimes even in bulk, by the hundreds or thousands at a time. 

Many of the patients getting sued are already facing financial hardship, or like one couple we interviewed, already in bankruptcy. 

Judgments against patients in these suits can be life changing. But according to experts, these lawsuits don’t recoup a ton of lost revenue for hospitals. So why do they happen? And what if hospitals stopped doing it completely? 

In this episode, we talk to a former sales rep for a medical-debt collections agency — who now steers hospitals away from efforts to collect money, via lawsuits or other means, from folks who just don’t have it.

He tells hospitals: This is better for your bottom line. 

Stay tuned for part two, coming in two weeks. 

… and to preview some of what’s in it — plus a whole lot more excellent reporting — check out the Baltimore Banner’s story: Maryland hospitals stopped suing patients with unpaid bills. Will they start again?

This series is produced in partnership with the McGraw Center for Business Journalism at the Craig Newmark Graduate School of Journalism at the City University of New York.

… and supported by the Fund for Investigative Journalism.

OOH: And don’t forget. It’s prime time to make a donation and support this show. 

Here’s a transcript of this episode.

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Last fall, actor-writers Ellen Haun and Dru Johnston were hustling to get their health insurance sorted out for 2023. To qualify for insurance through the actor’s union, SAG-AFTRA, Ellen would have to book a little more work — doable, but not a sure bet. 

So they came up with a plan: crowdfund a bunch of money to make a short film, starring Ellen … called “Ellen Needs Insurance,” of course.

It worked! And the movie, a 13-minute comedy, is terrific. 

Ellen and Dru sat down with us to go over how they made the whole thing happen, and how this year’s Hollywood strikes changed their perspectives. 

Here’s a transcript of this episode.

ALSO: Hey, it’s the BEST time to support this show with a donation. Thanks to NewsMatch, any gift you make, up to $1,000, will be doubled. It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it!

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In 2019, Dr. Luke Messac was a medical resident who found himself spending his day off in a courthouse archive. He’d heard about hospitals suing their own patients over unpaid medical bills. He wanted to know if the hospitals he worked in were doing the same. They were. 

Trained as a historian, Messac then set out to trace the history of this phenomenon, and the story of medical debt in the U.S.

His new book, Your Money or Your Life is the result of that research. 

Luke Messac sat down with us for a chat about how he got interested in medical debt, how medical debt became the massive problem it is today, and what he thinks people who work in health care can do to start to fix it.

ALSO: Hey, it’s the BEST time to support this show with a donation. Thanks to NewsMatch, any gift you make, up to $1,000, will be doubled. It’s a great deal, and it will set us up to kick maximum butt in 2024.

Here’s the link, go for it!

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First: an update on our recent two-parter with the writer John Green, about the global, decades-long fight to make an important tuberculosis drug more widely available. 

Just two days after we posted part 2, the activists waging that battle scored a major victory. John Green was kvelling on YouTube, of course. We’ll get you up to speed. 

And for the meat of this episode, we’ve got a guest a lot of you have been asking for: Physician/comedian Will Flanary, AKA Dr. Glaucomflecken. 

His punchy videos satirizing the absurdities and cruel complexities of the American health care system have been a fan favorite for years among An Arm and a Leg listeners (and us too).

We’re sharing a delightful and moving conversation with Dr. G and his wife, educator Kristin Flanary (AKA @LadyGlaucomflecken online), from our pals at The Nocturnists, a podcast about the experiences of health care workers. 

As the Glaucomfleckens tell Nocturnists host Dr. Emily Silverman, the inspiration behind Flanary’s most biting videos. came from the couple’s experience dealing with health insurance after he suffered a near-fatal heart attack.

Check out the Nocturnists here or wherever you get your podcasts, and Dr. Glaucomflecken’s videos on TikTok, Instagram, and YouTube. 

Send your stories and questions for An Arm and a Leg, or call 724 ARM-N-LEG.

And of course we'd love for you to support this show.

See omnystudio.com/listener for privacy information.