Tradeoffs

The No Surprises Act was designed to protect patients from unexpected medical bills, but nearly four years after the law took effect, many experts say parts of its implementation aren't working as intended. Insurers, hospitals, physician groups and federal regulators continue to battle over the law's payment dispute process, raising questions about whether one of the nation's most significant health care consumer protection laws is achieving its goals.

In this special live episode of Tradeoffs, host Dan Gorenstein moderates a conversation with three leading experts on surprise medical billing, health insurance regulation and federal health policy. They explain how the No Surprises Act was implemented, how litigation has shaped the arbitration process, why providers have won a disproportionate share of payment disputes and what policymakers could do to improve the law.

Guests:

• Zack Cooper, Associate Professor of Public Health and of Economics, Yale University; Director of Health Policy, Tobin Center for Economic Policy; Director, Health Care Affordability Lab at Yale
• Benjamin Chartock, Assistant Professor of Economics, Bentley University
• Lindsey Murtagh, Senior Fellow in Health Services, Policy and Practice, Brown University School of Public Health
• Rachel Werner, Executive Director, Leonard Davis Institute of Health Economics; Professor of Medicine, Perelman School of Medicine, University of Pennsylvania

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Hundreds of U.S. courts offer treatment over prison for some defendants with mental illness. But critics say mental health courts have outpaced research on their effectiveness.

Guest(s):

• Grace Hauck, Investigative reporter, Illinois Answers Project 
• Debra Pinals, Adjunct Clinical Professor of Psychiatry, University of Michigan Medical School and Law School

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Every year, millions of people’s medical care runs into the roadblock known as prior authorization, which requires an insurer to sign off before chemotherapy, surgery or countless other services can proceed. Who does this often onerous process help, who does it hurt and how could it work better for everyone?

Guests:

Tom Roberts, Oncologist, Mass General Cancer Center

Aaron Schwartz, Assistant Professor, Department of Medical Ethics and Health Policy and Department of Medicine, University of Pennsylvania

Kathleen, Caregiver

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President Trump and other leading conservatives are pushing policies they hope will empower patients to shop more wisely for the health care they need.

Guests:

• Brian Blase, President, Paragon Health Institute
• Sherry Glied, Professor of Public Service, New York University
• Adam Leive, Assistant Professor of Public Policy, UC Berkeley
• Jason Levitis, Senior Fellow, Urban Institute
• Tony Lo Sasso, Professor of Public Affairs, University of Wisconsin–Madison
• Avik Roy , Co-founder and Chairman, Foundation for Research on Equal Opportunity

Learn more and read a full transcript on our website.

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New research from leading health economist David Cutler explores what’s behind a historic slowdown in health spending, even as millions of Americans struggle to afford their care.

Guest:

• David M. Cutler, Dean of Social Science, Professor of Economics, Harvard University

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A collaboration with American Public Media’s Call to Mind, highlighting how Durham, North Carolina, has reimagined its mental health crisis response system — and what it has learned.

Find more reporting on mental health from Call to Mind on their website, on your local public radio station, or by subscribing to the Call to Mind podcast.

Guests:

• Patrice Andrews, Police Chief, Durham Police Department
• Ryan Smith, Director, Durham Community Safety Department
• Sgt. Dan Leeder, Durham Police Department
• Abena Bediako, Clinical Manager, Durham Community Safety Department
• David Prater, Peer Support Specialist, Durham Community Safety Department
• Yolanda, Durham resident
• John Warasila, Real estate developer and architect, Alliance Architecture
• Bo Ferguson, City Manager, Durham

Learn more and read a full transcript on our website.

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Doctors are flocking to arbitration under the 2020 consumer protection law to settle pricing disputes with insurers. They’re winning, often securing high prices. 

Guest:

• Margot Sanger-Katz, reporter, The New York Times

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The state’s Medicaid director Amir Bassiri shares his plans for blunting the effects of Republican health reforms — starting with work requirements.

Guest:

• Amir Bassiri, Medicaid Director, New York State Department of Health

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As demand for new weight loss drugs soars, some employers are making workers track their diet and exercise in hopes of limiting use and keeping costs down.

Guests:

• Nick Miller
• Ann Lewandowski, founder, Healthcare Rebel Alliance
• Sean Scanlon, Connecticut Comptroller
• Dr. Katherine Saunders, executive vice president and cofounder, Flyte Health
• Christopher Whaley, associate director of the Center for Advancing Health Policy through Research, Brown University

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The White House wants states to drop certificate of need laws in hopes of lowering health care costs. Researchers and state leaders are split.

Guests:

• Nate Adler, founder, Gertie
• Matthew Mitchell, senior fellow, Fraser Institute; senior affiliated scholar, Mercatus Center at George Mason University
• Jill Horwitz, professor, Northwestern University Pritzker School of Law and Feinberg School of Medicine
• Bo Watson, Tennessee state senator
• Alyssa Black, Vermont state representative
• Amy Cooper, founder, board president Green Mountain Surgery Center

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