An Arm and a Leg

Latest Episodes:

A doctor’s love letter to ‘the People’s Hospital’ Mar 23, 2023

Show notes

What if we had a decent, publicly-funded health system — available to everybody, with or without insurance? We’ve got one, says Dr. Ricardo Nuila. It’s where he works.

And it could be a model for the whole country. Yes, really.

That’s the pitch he makes in his new book, The People’s Hospital: Hope and Peril in American Medicine. It’s a love letter to Houston’s Ben Taub hospital, and an argument for bringing Ben Taub’s model — efficient, innovative, and cheap —to the rest of the country.

And if that seems unlikely in today’s political climate, well: Ben Taub’s wild origin story was plenty unlikely too.

That story takes us to the 1960’s, when Dutch novelist and playwright Jan de Hartog moved to Houston. He fell in love with the bustling, futuristic home of NASA and the Astrodome.

But he also discovered the city’s dreadful underside: a neglected charity hospital where largely African-American patients are left to seek health care in unsanitary and unsafe — hellish — conditions.

De Hartog and a group of Quaker volunteers waged a campaign to change that, and eventually found an unlikely ally who brought it over the finish line.

The People's Hospital is a heck of a book. We might want to start a book group someday, just to talk about it. If you want to grab a copy, here’s a link. (Or: Audiobook, or ebook.)

Here’s a transcript of the episode.

Send your stories and questions. Or call 724 ARM-N-LEG.

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

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Lessons from “wrestling with a giant” Mar 02, 2023

Show notes

The ER visit was quick and uneventful. The bill was $1,300. Our listener decided to push back. He didn't win, but he learned a lot — and so did we.

We had help, from an expert we met by visiting a Renaissance Fair — which we did in this very fun early episode. Kaelyn Globig, head of advocacy for the Rescu Foundation, is a medical-bill wizard, and no one has taught us more.

In this story, she teaches us how to find out what Medicare pays for a given procedure — here’s the guide she shared with us — and how to use that information.

We also got advice on dealing with debt collectors — when it makes sense to file a dispute — from April Kuenhoff, an attorney with the National Consumer Law Center.

She shared resources too. Here are sample letters — templates you can edit:

To tell a debt collector that you are disputing a charge.
To demand verification of a debt they say you owe
To limit their legal right to harass you.

Here’s a transcript of the episode.

Send your stories and questions. Or call 724 ARM-N-LEG.

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

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

The bill looked like BS. So she took it to small claims court. Feb 09, 2023

Show notes

“I sued a hospital in small claims court and lost — here’s what I learned.” That was the subject line for an email we got from listener Lauren Slemenda.

She wrote: “I feel like I won” — and we knew we needed to talk with her.

She wants to encourage more people to try taking providers to court over unfair bills.

“If everybody that they screw stands up,” she says, “They can't afford to pay a lawyer to defend against all of those [cases].”

It’s an interesting idea for sure — What if more people use small claims court to fight messed-up medical bills? Like, a lot more people? — and we’ll be exploring it in the coming months.

Meanwhile, Lauren’s story has lessons for all of us. For instance, even though she lost her case, she doesn’t expect to pay a cent.

Here’s a transcript of the episode.

More helpful resources

Want to try some of Lauren’s tactics?

Looking up billing codes: The latest First Aid Kit newsletter is all about fact-checking medical bills and includes a section about examining billing codes. We'll go deeper on those codes in the next installment.

Dealing with debt collectors: We discussed knowing your rights when dealing with debt collectors with a couple of experts in this very-fun episode.

Lauren got her dealing-with-debt-collectors playbook from journalist and friend-of-the-show Marshall Allen. His book, Never Pay the First Bill, includes a template of a letter you can send to a debt collector, challenging them to document their claim.

Exploring small claims court: We first got tipped off to this aggressive approach in a story we re-played recently: Can They Freaking Do That?!?

... and followed up with the story of Jeffrey Fox, who successfully used small claims court to force a big hospital to refund a $2,000 charge. David vs. Goliath.

Send your stories and questions. Or call 724 ARM-N-LEG.

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

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Can They Freaking Do That?!? (2023 Edition) Jan 19, 2023

Show notes

We’re kicking off the year with a throwback. We revisit a 2019 episode that opened up new possibilities for fighting back against outrageous medical bills — a theme we’ll spend a lot more time exploring this year

A listener named Miriam got a bill from a medical testing lab she’s never heard of, for $35. Then, a follow-up bill said if she didn’t pay up right away, that price was going up — WAY up: to $1,287.

Which raises the kind of question that comes up a LOT with medical billing: Can some random lab hit you up for money — and then threaten you with a late fee of more than $1,000??

We went to find out.

The answer: They can try. And a lot of the time, they’ll get away with it. But we found experts who explain how, sometimes, we can fight back— by threatening to take them to court.

If you’ve got the time and the moxie, these experts say you’re on solid legal ground, and you really can make the other side accept a fair offer.

We’ll come back to this idea next time. Meanwhile, here’s a 2020 episode with the story of a guy who took his local hospital to court, and won.

The original version of this story, from 2019, found us learning about a couple topics we went on to explored in more depth later: Surprise bills — which we got new legal protections from in 2022— and the role of private equity in health care, both how it’s been expanding, and how some doctors are trying to fight back.

Here's a transcript of this 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.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

2022 in Review Dec 29, 2022

Show notes

The Arm and a Leg editorial team gathered to talk about the moments from 2022 that we’ll never forget — including when work collided with real life.

We’re so lucky we get to do this work, and we couldn’t do it without our community. From sending us your stories and questions, to supporting the show financially, our listeners and subscribers are what this show runs on. Thank you.

If you want to help us take on 2023, now is a great time to contribute. This month, every dollar you donate is DOUBLED, thanks to NewsMatch and the Institute for Nonprofit News. Holy cow, what a deal. Here, go for it.

Here’s a transcript of this episode.

Send your stories and questions or call 724 ARM-N-LEG.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Like pulling teeth. Dec 19, 2022

Show notes

When a car hit Susan and knocked out a bunch of teeth, her health insurance was supposed to pay for her oral surgery, and she knew it. So why has she had to chase them for 18 months and counting?

Getting insurance to pay for anything dental is usually hard, but this had us asking ourselves… is it usually this hard?

We connected Susan with law professor Jacqueline Fox — who, when she was practicing law, fought insurers on behalf of patients. And who says Susan has “done everything right.”

We’ve started to wonder whether Susan’s troubles could be related to broader accusations against her insurer, Ambetter, the largest provider of plans on the Obamacare marketplace.

Here’s a transcript of this episode.

We’d love for you to support this show.

Now is a great time to do it. This month, every dollar you donate is DOUBLED, thanks to NewsMatch and the Institute for Nonprofit News.

Holy cow, what a deal. Here, go for it.

Send your stories and questions or call 724 ARM-N-LEG.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

The best video about health insurance, ever Dec 01, 2022

Show notes

A couple months ago, we started getting messages from listeners telling us: you gotta watch this video.

It’s a thirty minute YouTube video from a creator named Brian David Gilbert, and it’s probably the best video about health insurance we’ve ever seen.

Brian David Gilbert is best known for his highly-detailed, hilarious videos for Polygon, a media company about video games. But when he left that job to strike out on his own, he needed new health insurance. We talked with him about how that experience turned into one of the most difficult videos he’s ever made — and this is a guy whose old job had him tracing things like Zelda storylines across decades-long franchises.

You can watch the full video here.

Other delightful BDG creations discussed in this episode:

The two-minute video that launched his career.
His 15-minute dive into the Legend of Zelda
A cooking demo: “Welcome to my weird ice creams.” Yum.

Special thanks to Wil Williams, Sarah Ballema, Josh Rubino, and Bea Bosco for adding their voices to this episode!

AND: We’d love for you to support this show. Now is a great time to do it. This month, every dollar you donate is DOUBLED, thanks to NewsMatch and the Institute for Nonprofit News. Holy cow, what a deal. Here, go for it.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Health insurance post-Roe, and a grassroots network of abortion funds Nov 17, 2022

Show notes

Since the Supreme Court overturned Roe v. Wade, abortion has been banned in more than a dozen states. As you choose your insurance plan for next year, you might be wondering: How does that affect my insurance plan? We learned two big things.

First: There’s no one answer (and few answers are settled yet). A lot depends on where you live, and where you work.

But second: For lots of people, for a long time, insurance has rarely been a help in accessing abortion. Most people pay cash. And lots of people can’t afford to.

But there are organizations who have been tackling this issue for decades — abortion funds.

We’re big fans of when regular people find a way to help each other survive this messed-up, profit-driven health care system — and abortion funds are a huge example of that kind of effort. There’s a lot we can learn from them.

We talk with Oriaku Njoko, executive director of the National Network of Abortion Funds, and Tyler Barbarin, a board member with the New Orleans Abortion Fund, to learn from their experience.

Here's a transcript of this episode.

We’d love for you to support this show. Now is a great time to do it. This month, every dollar you donate is DOUBLED, thanks to NewsMatch and the Institute for Nonprofit News. Holy cow, what a deal. Here, go for it.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

A listener asks: Could NOT having insurance be a better deal? Nov 03, 2022

Show notes

It’s open enrollment for 2023 health insurance for lots of folks — a time when you might find yourself asking: what good is health insurance anyway?

One listener wrote to us about his son, a student with no income. Dad asks, If the son could get charity care (financial assistance) at his local hospital…. should he bother getting health insurance?

The big picture question: If you’re broke, and can’t get insurance from work, what are your best options?

The big picture answer: It totally depends!

Do you live in a state that expanded Medicaid?
What are the financial-assistance policies like at the hospitals around you?
What kind of health care do you know you’re going to need?

We had expert help here: Karen Pollitz, a senior fellow at the Kaiser Family Foundation, and . Jared Walker, founder of Dollar For, and a super-expert on charity care.

If you want to go deeper:

We did a three-part series on picking health insurance in our First Aid Kit newsletter. Start here.
An episode from last year explored some more dos and don’ts for picking health insurance.
In a 2018 episode, we talked with another listener — a “financial therapist” — who had her own deep questions about health insurance.

We’d love for you to support this show. Now is a great time to do it.

This month, every dollar you donate is DOUBLED, thanks to NewsMatch and the Institute for Nonprofit News. Holy cow, what a deal.

Here, go for it.

Here’s a transcript of this episode.
Send your stories and questions: https://armandalegshow.com/contact/ or call 724 ARM-N-LEG

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Quick update from Arm and a Leg HQ Oct 20, 2022

Show notes

Hey there,

You may have noticed, we've been keeping a slower pace for the last few months — publishing every three weeks instead of every two — since Dan recovered from COVID.

And every-three-weeks is gonna stay our default for now. Putting out the show more often was wrecking Dan's health, and some important behind-the-scenes work just wasn't getting done.

When we slowed down the podcast release schedule, we also suspended the First Aid Kit newsletter, which compiles our most-useful information for dealing with the out-of-control medical system.

Starting today, First Aid Kit is back — publishing monthly instead of every-other-week. (We're telling you, Dan was pushing too hard before.)

If you're already a subscriber, you should have a new issue in your inbox right now. If you're not a subscriber yet, why not sign up?

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.