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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These docs are trying to kick private equity out of their ER

A show about why health care costs so freaking much, and what we can (maybe) do about it. Hosted by award-winning reporter Dan Weissmann (Marketplace, 99 Percent Invisible, Planet Money, Reveal). Hosted on Acast. See acast.com/privacy for more information.

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When a subsidiary of the giant UnitedHealth Group got hit by a cyberattack recently, a big chunk of the country’s doctors, pharmacists, hospitals and therapists just stopped getting paid. 
It’s been a huge disruption, with some providers wondering if they can keep their doors open.
But thanks to their huge size and reach, the situation may have had a silver lining — for United.
Which seems like a big problem, and got us wondering: What can we maybe do about it?
The answer turns out to be: Maybe more than we think, via antitrust enforcers at the Federal Trade Commission and the U.S. Department of Justice.
Strap in for a wild ride — and then maybe check out FTC Chair Lina Khan’s talk with Jon Stewart on The Daily Show. We include some short excerpts, but the whole thing is worth a watch.
Thanks to reporters Brittany Trang (STAT News) and Maureen Tkacik (The American Prospect) for guiding us through their reporting.
And to the novelist/journalist/activist Cory Doctorow, who has been writing about antitrust enforcement for years. Here are a couple of his columns about Lina Khan and what she and other antitrust enforcers are up to.
If you want a deeper dive on the new antitrust movement: It’s summed up in a terrific (and short) book by Tim Wu, a Columbia University law professor and former White House adviser: The Curse of Bigness: Antitrust in the New Gilded Age. 
And you may be able to get it for free! If your local library uses a system called Hoopla, you can borrow it as either an audiobook or an ebook.
Super-fun tangent: Cory Doctorow and Tim Wu went to elementary school together — and apparently played a lot of Dungeons and Dragons — when they were kids in Toronto. 
Here’s a transcript of this episode. 
Send your stories and questions. Or call 724 ARM-N-LEG.
And of course we’d love for you to support this show. Hosted on Acast. See acast.com/privacy for more information.

The Hack

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. 
Send your stories and questions. Or call 724 ARM-N-LEG.
And of course we’d love for you to support this show. Hosted on Acast. See acast.com/privacy for more information.

Son of Medicare: Attack of the Machines

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. 
Send your stories and questions. Or call 724 ARM-N-LEG.
And of course we’d love for you to support this show. Hosted on Acast. See acast.com/privacy for more information.

The Medicare Episode

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. 
Send your stories and questions. Or call 724 ARM-N-LEG.
And of course we’d love for you to support this show. Hosted on Acast. See acast.com/privacy for more information.

Wait, is insulin cheaper now?

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. 
Send your stories and questions. Or call 724 ARM-N-LEG.
And of course we’d love for you to support this show. Hosted on Acast. See acast.com/privacy for more information.

These docs are trying to kick private equity out of their ER

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