About a third of ER doctors now work for companies backed by private equity. A lot of those docs do not like the arrangement, which they say puts profits ahead of patients. Now, a group of ER docs are suing to kick one of those private-equity owned companies out of their hospital-- and all of California. They see it as the first step in a long, long fight. 

The suit cites California’s ban on the “corporate practice of medicine” — which is supposed to outlaw situations where non-doctors tell doctors what to do, for profit. 

Which raises a question: How did it get left to a group of doctors to get that law enforced? 

We break it down, with help from:

• Dr. Lisa Moreno, immediate past president of the American Academy of Emergency Medicine which filed the lawsuit.
• Law professor Erin Fuse Brown, who has written about private equity’s growing role in medicine.
• Legendary financial reporter Gretchen Morgenson, now at NBC News, who has been reporting on private equity’s role in medicine since 2020, and whose reporting tipped us off to this lawsuit. 

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Credit reporting bureaus announced in April that they would start taking most medical debt off of people’s credit reports. At first, we weren’t sure that would be such a huge deal. After all, the medical debt would still exist, people would still get harassed by debt collectors, or even sued over it.

But it turns out, there’s a bunch of reasons why these changes could be life-changing, and we want to give credit (the good kind) where it’s due. 

The changes include:

• Paid-off medical debt disappears from credit reports on July 1, 2022
• Debts under $500 (even if you haven’t paid them) come off reports in March 2023
• Medical bills under $500 that you received after March 1, 2022 should will never be counted on your credit report
• No medical bills – of any size– will appear on your credit report until they’re at least a year old, starting July 1, 2022

Plus, some an end to some games debt collectors can play with your credit score. 

Here’s a transcript of this episode.

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A new golden age is dawning, and it starts where the sun don’t shine.

A listener got a pricey quote for her colonoscopy, but the medical practice behind it seems like “the only game in town.” We scope it out and learn the surprising reason why: Investors have decided your butt is a goldmine. 

Private equity investors have made their way into many areas of our lives. Now, they’re at the gastroenterologist’s —and lots of other medical specialists, too. We learned why these doctors are selling their practices to private equity, and what it could mean for your health care and your bills. 

Correction notice: The original version of this story mis-identified the organization where Claire McAndrew worked when we spoke to her in 2019. Whoops. We've updated the audio file, so it's correct now.

Here's a transcript for this episode.

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Dan’s COVID has hung on there for a while, kept him SUPER tired. Yoinks. Back in a couple weeks!

Meanwhile, as always, we'd love for you to:

• Get in touch to share a story or your thoughts.
• Subscribe to First Aid Kit, our newsletter about how to survive the health-care system
• Support us: Your donations are this show's biggest source of income.

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Hey there — I got COVID a little before we were scheduled to tape this week's episode. Whoops!

I'm fine now, but kinda tired. Just to be on the safe side — some people stay tired for a while — let's give me two weeks before we come back with a full episode.

Meanwhile, I'll share this: I think one reason I got better quick was, I was able to get anti-viral meds. (Paxlovid, in my case.)

And I mention this because: There's a new variant going around, BA.2, which looks like it's going to bring on a new wave; we don't know how big it'll be yet, but the New York Times had some good tips recently for how to be prepared.

One was: Have a plan for getting antiviral treatment, in case you do get sick. Some docs don't like to prescribe them, and some folks shouldn't take them because of things like drug interactions. It's worth knowing your best options ahead of time.

I'm here to co-sign that advice. The rest was good too. Here's the link: https://www.nytimes.com/2022/03/30/well/live/ba2-omicron-covid.html

Finally: Even this two-minute sick note has a highly-entertaining moment, thanks to a listener who wrote a surprising response to a recent First Aid Kit newsletter... then recorded that note as a voice memo.

So, I'll catch you in a couple weeks. Till then: Take care of yourself, for real.

And as always:

• Our First Aid Kit newsletter collects the practical lessons I've learned about how to fight the awful cost of health care. You might want to subscribe.
• We love it when you send your stories and questions: https://armandalegshow.com/contact/ or call 724 ARM-N-LEG
• And of course we’d love for you to support this show.

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It’s illegal to advise someone who’s being sued for medical debt, unless you're a lawyer. Yep, really. Even in its most basic form (like helping people fill out a checklist) it’s considered the “unlicensed practice of law.” And it’s a crime. As in, you could go to jail.

So some New Yorkers are suing to get that changed. 

The non-profit Upsolve wants to help people represent themselves in court when they’re being sued over debt. Their plan is to train people like pastors, social workers, and librarians and others to help people others know their rights. And iIn the Bronx, Reverend John Udo-Okon is one of those volunteers, ready to help. 

We meet the CEO of Upsolve and Reverend John to talk about their work – and why they’re suing the state of New York. 

Here’s a transcript of the episode. 

Subscribe to our newsletter, First Aid Kit. 

Send your stories and questions: https://armandalegshow.com/contact/ or call 724 ARM-N-LEG

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

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Pharma and insurance companies play devious, clever games, competing for dollars. They’re sharks! It’d be fun to track, but they’re eating us alive.

If anyone could beat the sharks at this game, we’d pick Lillian Karabaic, who runs the personal finance show/community called Oh My Dollar! — and is SUPER on-top-of her stuff. 

But Lillian recently got socked with an unexpected $3,000 charge— and expects to lose her very-organized fight against it.

Understanding how Lillian got here — how pretty much any of us could, and how we can start to fight back, together — means understanding the games these big sharks are playing.

Which is exactly what we do in our latest episode, with Lillian’s expert — and often very-funny — guidance. 

This episode goes deep on a shark game called a “copay accumulator” policy. In short, they’re an invention by the insurance industry to make sure only YOUR money counts toward your yearly deductible — not any assistance you may receive from a drug company. 

One thing we learned: Finding out if your insurance plan even includes one of these policies can be extremely tough: Otherwise, Lillian — who did her extremely-good best to check for this very information — wouldn’t have gotten taken by surprise.

We’ve got a little bit of help to offer: Researchers from a nonprofit called The AIDS Institute also researched this question, looking at hundreds of plans across the country. And they developed a tip sheet a tip sheet to help guide their search: How to search online, what questions to ask if the information just isn’t online (which happens).  

More resources:

• For tips on how to avoid overpaying for drugs — when that’s possible — check out the latest edition of our First Aid Kit newsletter.
• There’s a third bunch of sharks involved in this drug-pricing game: Middleman companies called Pharmacy Benefit Managers. If you want to understand the role they play, here’s an Arm and a Leg episode about them.
• A dozen states have banned copay accumulators, and more are considering it. This short report includes a list of those dozen states. 

Here’s a transcript of the episode. 

Send your stories and questions: https://armandalegshow.com/contact/ or call 724 ARM-N-LEG

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Last year we brought you the story — part caper, part tragedy — of how Philadelphia tried to hand off its COVID vaccination program to a wannabe tech bro right out of college. We built on the work of reporter Nina Feldman and her colleagues at WHYY. Now, they've laid out the entire thing in a podcast of their own, called Half Vaxxed. It’s terrific. Funny in places, horrifying in others, and full of lessons.

We'll be back in a few weeks to start the next batch of Arm and a Leg episodes. Meanwhile, we hope you'll enjoy the first episode of Half Vaxxed.

Meanwhile, don't miss our First Aid Kit newsletter, where we're sharing practical tips on surviving the world's most-expensive health care system.

Catch all of Half Vaxxed here

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Stephanie Wittels Wachs has made the show about a topic that's actually too enraging, terrifying, and depressing for An Arm and a Leg: the opioid crisis. And it's as entertaining, empowering and useful as we could ever want. It's called Last Day. Here's episode 1. (In case you need convincing that it's entertaining, we'll tell you: In this episode, she interviews comedians Sarah Silverman and Aziz Ansari at length.)

Part of what makes Last Day so good is that Stephanie is a great storyteller — as well a truly tireless crusader, and a witty, real-as-they-come human being. We should know — we had her on An Arm and a Leg to talk about how she and a few other Texas moms got state laws changed to cover hearing aids for kids. (You can catch that episode here: https://armandalegshow.com/episode/mom-vs-texas/)

If you haven't already met her there, you're going to love her here.

• Stephanie Wittels Wachs, from Season 1, episode 1 of Last Day.

Last Day made a second season, about suicide and mental health, and its third season, about America's gun-violence epidemic, is coming this spring. You can listen to everything, and subscribe to get new episodes, here: https://lemonadamedia.com/show/lastday/

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The No Surprises Act — a new law that protects us from some outrageous out-of-network hospital bills — takes effect this month. That's great news, but (and there’s always a but) there are some important caveats to know about. 

Like, for instance: these protections only apply to care you get in a hospital. Then there’s the deceptively-named Surprise Billing Protection form they might ask you to sign. And there’s more. 

We break down what you need to know about your rights under this new law, what traps to look out for, and who to call if something smells fishy. 

Actually, here: The federal hotline for reporting No Surprises Act violations: 1-800-985-3059.

Big thanks to our guides: Patricia Kelmar, Health Care Campaigns Director at U.S. PIRG, and Julia Nigrelli from health care consulting firm Chi-Matic. 

The federal hotline for reporting No Surprises Act violations: 1-800-985-3059.

Here’s a transcript for the episode. 

Send your stories and questions: https://armandalegshow.com/contact/ or call 724 ARM-N-LEG

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

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