Prognosis: Misconception

From Pushkin Industries, introducing Deep Background with Noah Feldman.

Every story has a backstory, even in today's 24-hour news cycle. In Deep Background, Harvard Law School professor and Bloomberg Opinions columnist Noah Feldman will bring together a cross-section of expert guests to explore the historical, scientific, legal, and cultural context that help us understand what's really going on behind the biggest stories in the news.

This week, Richard Lazarus, a law professor at Harvard and a leading Supreme Court advocate, discusses where public health stops and our individual liberties begin. Plus, what does it mean that the Supreme Court has postponed oral arguments?

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We continue our look back at some of our favorite episodes from the podcast. Joel Grimwood was almost certainly going to die. The pump that kept his failing heart going had become infected, and surgery after surgery had scraped away parts of his chest. Drugs didn’t work because the bacteria were in a slime, impenetrable to antibiotics. What saved his life was a little-known treatment called phage therapy. Popular in the former Soviet Union, they’ve fallen out of favor in the West. The viruses are the natural predator of bacteria, and a small number of scientists are trying to turn them against the threat.

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We continue our look back at some of our favorite episodes from the podcast. Among those most vulnerable to superbug infections are cancer chemotherapy patients. In India, many are dying from bacteria poisoning their blood that even the most potent antibiotics available can't stop. This calamitous scenario portends a global crisis as superbugs spread through international travel and trade.

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We continue our look back at some of our favorite episodes from the podcast. Do exercise-tracking apps and gadgets like the Fitbit actually make us healthier? Or do they just create a high-tech, data-centric illusion of control over our weight, sleep and general well-being? Bloomberg's Naomi Kresge loaded up some popular apps to find the answer –- and to see if she could get a better night’s sleep than her husband.

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We're revisiting some of our favorite episodes, starting with our very first. More than a million Americans suffer from Type 1 diabetes. The disease occurs when the pancreas mysteriously stops producing insulin, the hormone that converts food into energy. Modern medicine has been able to recreate insulin, but not the finely calibrated delivery mechanism of the pancreas. Now a group of like-minded do-it-yourselfers have gotten together on the internet and—working outside the purview of organized medicine—have figured out how to link a pump, glucose monitor and smartphone to simulate a functioning pancreas. The results have been spectacularly successful.

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The average cost of having a baby in the United States is $11,000 for people on private health insurance. But the price tag can vary by tens of thousands of dollars, depending on what hospital you go to and what doctor you see. And high-price medical care isn’t necessarily better: In the U.S., regardless of how much they or their insurance company pays, women experience unexpected problems related to pregnancy and childbirth at alarming rates.

The problem, of course, isn’t limited to maternity costs. Across the health-care system, wide differences in price and quality for the same procedures have led many economists and policymakers to conclude that the marketplace for medical care is broken. This week on Prognosis, we look at one health plan’s attempt to make it work better. It’s pushing hospitals to improve maternity care while keeping costs in check. These efforts bring to light a lot about what’s wrong with American health care, and one ambitious attempt to fix it.

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In America, poverty is linked to shorter lifespans. The wealthiest 1% of Americans live more than a decade longer than the poorest 1%, and the longevity gap has expanded in recent years. The medical community is increasingly examining the role that poverty and difficult social circumstances play in illness. Some people are asking whether the health care system could do more to address the things that influence people’s health beyond their medical care.

This week on Prognosis, we look at one startup that’s trying to redesign care for some of the most vulnerable patients, taking into account the complex realities of their lives. The company is trying to improve care for people and communities the medical system often fails – and it believes that fixing those failures will not only make people healthier, it will also save money.

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Independent doctors are a vanishing breed. Hospitals have spent decades scooping up physician groups to build large, powerful health-care systems. The rationale was to increase efficiency and save money but often the opposite occurred. In fact, lots of evidence shows that consolidation in health care has driven prices higher. And both physicians and patients increasingly feel that big health systems and insurance companies have too much sway over what happens in the exam room. A few years ago, a group of doctors in Charlotte, North Carolina, decided they’d had enough. They split from the big hospital system that owned their practice to strike out on their own. They’re betting that they can be more competitive, and serve their patients better, independent of their former owners. In this episode of Prognosis, we tell the story of how one doctors’ group bucked the trend toward more concentrated health-care markets, and what it might mean for the future of the U.S. health-care system.

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In 2020, Americans will spend almost $4 trillion on health care. Yet for all that spending, Americans overall tend to be less healthy and die younger than citizens of other wealthy nations. The cost of health care has become so burdensome that people all across the United States are forced to make difficult choices every day: forgo urgently needed medicines or treatment for serious injuries out of fear the cost, even with insurance, could bankrupt them. How did the U.S. health-care system get this way? And what are some people trying to do to change it? This season’s Prognosis explores these questions. 

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Americans are paying more and getting less for their health care than ever before. On the new season of Prognosis, reporter John Tozzi explores what went wrong. 

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