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Tradeoffs

Tradeoffs explores the toughest choices in health care, diving into issues like the cost of care, health equity, insurance, mental health and artificial intelligence. We connect policy to practice, uncovering the data and personal stories that help audiences understand the stakes — and the potential solutions.

Learn more about us, find transcripts for each episode and additional reporting at https://tradeoffs.org.

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S1 · E394
Thursday · 21 min
As SNAP Shrinks, What's the Future of Food Aid in America?
Cash-strapped states and struggling families are wrestling with the consequences of major reforms to the SNAP program passed as part of Republicans’ Big Beautiful Bill. Guests: Romina Boccia, Director of Budget and Entitlement Policy, Cato Institute Chloe East, Associate Professor of Economics, University of Colorado Boulder Joël McClurg, former SNAP compliance officer Leslie Walker, senior reporter, Tradeoffs John Waxler, SNAP applicant Lori Ventura, operations director, Free Senior Health Clinic This episode was reported and produced by Leslie Walker, edited by Ryan Levi and Dan Gorenstein, and mixed by Andrew Parrella. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Special thanks to Jossie Barroso, Jack Cardinal, Cindy Huddleston, Acadia Jacob, Joseph Llobrera and Kenny Palmer. Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E393
September 3 · 57 min
Beyond Finger Pointing: The Fight to Lower Health Care Costs
In a live conversation recorded at Aspen Ideas: Health, executives from a hospital, insurer and pharmacy join a top Trump administration official and leading health economist to discuss how to collectively bring down health care costs. Guests: Stephanie Carlton, Deputy Administrator, Centers for Medicare & Medicaid Services Brendan Carr, CEO, Mount Sinai Health System David Cutler, Professor of Applied Economics, Harvard University Katerina Guerraz, Chief Operating Officer, Aetna; President, Aetna Medicaid John Love, Vice President, Amazon Pharmacy Watch a video of this conversation at Aspen Ideas: Health, along with another conversation about medical uncertainty moderated by our host Dan Gorenstein. This episode was produced by Ryan Levi and mixed by Andrew Parrella. The Tradeoffs theme song was composed by Ty Citerman. Special thanks to Ifrah Asmat, Eric Baker, Tonya Bauer, Katie Taylor and Ryan Zynger. Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E392
August 27 · 22 min
The Cost of Cutting NIH Research: Voices from the Frontlines
A candid conversation between a professor and a Ph.D. candidate about potential funding cuts from the National Institutes of Health and their impact on the future of medical research. Guests: Yvonne Commodore-Mensah, Associate Professor, Associate Dean of Research, Johns Hopkins School of Nursing Laura Mata López, PhD Candidate, Johns Hopkins School of Nursing This episode was produced by Ryan Levi, edited by Dan Gorenstein and mixed by Andrew Parrella and Cedric Wilson. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Additional thanks to Rachel Bender Ignacio, Jeremy Berg, Otis Brawley, Aaron Carroll, Dan Cooper, Elena Fuentes-Afflick, Robert Kelchen, Daniel Martinez, Raphe Reggie, Sarah Spreitzer and Sarah Szanton. Reporting for this episode was supported in part by Arnold Ventures. Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E391
August 20 · 21 min
Trump's Pick to Quiet HHS Chaos Heads to the Senate
President Trump has nominated former health care executive Chris Klomp to help RFK Jr. get his health agenda back on track. Guest: Dan Diamond, White House Reporter, Washington Post This episode was produced by Ryan Levi, edited by Dan Gorenstein and Leslie Walker, and mixed by Andrew Parrella and Cedric Wilson. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E390
August 13 · 16 min
‘I Feel Unsafe Almost Everywhere’: How Trump Has Changed Life for One Transgender Teen
A conversation with an 18-year-old and her dad about how anti-trans policies have impacted their lives during the second Trump administration. Guests: Harleigh Walker Jeff Walker Learn more: Read the full reporting and explore additional resources on our website. This episode was produced by Ryan Levi, edited by Dan Gorenstein and mixed by Cedric Wilson and Andrew Parrella. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E389
August 6 · 25 min
Should I Trust AI to Diagnose Me?
Physician and New Yorker writer Dhruv Khullar says artificial intelligence is a powerful tool to get quicker and more accurate diagnoses. But it can also be dangerous. Guest: Dhruv Khullar, Physician, Weill Cornell Medical College; Contributing Writer, The New Yorker Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E388
July 30 · 26 min
Meet the Man Launching Trump's Medicaid Work Requirements Months Early
Nebraska Medicaid Director Drew Gonshorowski says the state’s data capabilities put it in a strong position to quickly implement the historic changes. Advocates and researchers warn that eligible people may still fall through the cracks. Guest(s): Drew Gonshorowski, Director of Medicaid and Long Term Care, Nebraska Department of Health and Human Services Benjamin Sommers, Huntley Quelch Professor of Health Care Economics, Harvard T.H. Chan School of Public Health Amy Behnke, CEO, Health Center Association of Nebraska Learn more: Read the full reporting and explore additional resources on our website. This episode was produced by Julie Wernau, edited by Dan Gorenstein and Ryan Levi, and mixed by Andrew Parrella. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Special thanks to Adrianna McIntyre, Rebecca Myerson, Kinda Serafi and Andrea Skolkin. Tradeoffs reporting for this story was supported, in part, by Arnold Ventures. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E387
July 23 · 23 min
A Wyoming Doctor’s Fight to Keep Abortion Legal in Her Deep Red State
Four years after the Supreme Court overturned Roe v. Wade, the fight over abortion access continues to rage. In Wyoming, where abortion is still legal but under constant legal challenge, OB-GYN and abortion provider Giovannina Anthony is helping lead the fight to keep it that way. In this episode of Tradeoffs, Dr. Anthony shares what it's like to provide abortion care in a time of so much legal uncertainty, and how the ongoing battles over abortion laws, reproductive health and medication abortion are affecting physicians and patients in one of the nation's most conservative states. Guest: Giovannina Anthony, OB-GYN, GMA Health Learn more: Read the full reporting and explore additional resources on our website. This episode was produced by Christine Herman, edited by Ryan Levi and Dan Gorenstein, and mixed by Cedric Wilson and Andrew Parrella. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E386
July 16 · 54 min
Call to Mind: Immigration and the Challenge to Belong
A deep dive on the unique mental health challenges faced by immigrants in America, produced by Call to Mind from American Public Media. Learn more and read a full transcript on our website. This episode was produced by Call to Mind, American Public Media's initiative to foster new conversations about mental health. The program was produced and written by senior producer Jessica Bari, edited by Stephen Smith and hosted by Angela Davis. It featured reporting by Jessica Bari, Cari Spencer and Kristi Marohn. The technical director is Josh Savageau, and Hans Buetow scored the show. Additional thanks to Mohammad Ebrahim for his translation. This episode was produced and mixed for Tradeoffs by Ryan Levi. The Tradeoffs theme song was composed by Ty Citerman. 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. Want more Tradeoffs? Sign up for our free weekly newsletter featuring our latest reporting on health care's toughest choices. Donate to support our work. Tradeoffs is a nonprofit, powered by listeners. Hosted on Acast. See acast.com/privacy for more information.
S1 · E385
July 9 · 22 min
As Drama at Trump's FDA Subsides, Doubts and Damage Linger
We talk with STAT News reporter Lizzy Lawrence about the agency’s recent turmoil and its hunt for a new leader. Guest: Lizzy Lawrence, FDA Reporter, STAT News Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. This episode was produced by Leslie Walker, edited by Ryan Levi and Dan Gorenstein, and mixed by Cedric Wilson. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Special thanks to Alex Hogan. Tradeoffs reporting for this story was supported, in part, by Arnold Ventures. Hosted on Acast. See acast.com/privacy for more information.
S1 · E384
July 2 · 52 min
Making Medical Decisions with Uncertain Science
Two physicians and an ethicist discuss how to make the best decisions in areas like artificial intelligence and gender-affirming care when there is limited evidence in a live conversation recorded at Aspen Ideas: Health. Guests: Ishani Ganguli, Primary Care Physician, Associate Professor of Medicine; Harvard Medical School and Brigham and Women’s Hospital Christine Yu Moutier, Chief Medical Officer, American Foundation for Suicide Prevention Vardit Ravitsky, President, Hastings Center for Bioethics Watch a video of this conversation at Aspen Ideas: Health, along with another conversation about health care costs moderated by our host Dan Gorenstein. Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. This episode was produced by Ryan Levi and mixed by Andrew Parrella. The Tradeoffs theme song was composed by Ty Citerman. Special thanks to Ifrah Asmat, Eric Baker, Tonya Bauer, Katie Taylor and Ryan Zynger [zinger]. Hosted on Acast. See acast.com/privacy for more information.
S1 · E383
June 25 · 22 min
With Millions Expected to Lose Coverage, States Look for New Ways to Prevent Medical Debt
As millions of Americans are expected to lose health insurance coverage following federal cuts to Medicaid and the Affordable Care Act, states are searching for new ways to prevent medical debt before it starts. In this episode of Tradeoffs, economist Neale Mahoney explains the research into strategies for relief from high healthcare costs and evaluates policy fixes to protect consumers. Guest(s): Neale Mahoney, professor of economics, Trione Director of Stanford Institute for Economic Policy Research, Stanford University. Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. This episode was produced by Melanie Evans, edited by Ryan Levi and Dan Gorenstein, and mixed by Andrew Parrella. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Tradeoffs reporting for this story was supported, in part, by Arnold Ventures. Hosted on Acast. See acast.com/privacy for more information.
S1 · E382
June 18 · 28 min
Medicaid Overhaul Complicates States’ Plans to Bring Care Into Jails and Prisons
Washington is one of 19 states that have received federal approval to enroll people in Medicaid before they leave jail or prison — a radical change in Medicaid policy that health care and law enforcement leaders believe will save lives. But this experiment in bringing Medicaid behind bars is now colliding with H.R. 1, the sweeping federal law that is forcing states to make major changes to Medicaid. Guest(s): Autumn Boylan, Deputy director, California Department of Health Care Services Lauren Brinkley-Rubinstein, Professor, Population Health Sciences, Duke University School of Medicine Cody Coughenour Pete Croughan, Deputy secretary, Louisiana Department of Health Bruce Greenstein, Secretary, Louisiana Department of Health Tyron Nixon, Medicaid Reentry Transformation Implementation Manager, Washington State Health Care Authority Emma Sandoe, Medicaid director, Oregon Penelope Sapp, Chief of corrections, Kitsap County Sheriff’s Office Marc Stern, Former assistant secretary for health care at the Washington Department of Corrections Tamara Vanover, Mental health specialist, Clallam County Sheriff’s Office Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. This episode was reported by Julie Wernau, edited by Dan Gorenstein and Ryan Levi, and mixed by Andrew Parrella and Cedric Wilson. The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound. Special thanks to Gabrielle de la Gueronniere, Jody Rich and Kinda Serafi. Tradeoffs reporting for this story was supported, in part, by Arnold Ventures. Hosted on Acast. See acast.com/privacy for more information.
S1 · E381
June 11 · 52 min
Where Did the No Surprises Act Go Wrong? And Can It Be Fixed?
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 Learn more: Read the full reporting and explore additional resources on our website. Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter. Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today. Hosted on Acast. See acast.com/privacy for more information.
S1 · E380
June 4 · 26 min
Mental Health Courts Offer People Facing Prison an Imperfect Alternative
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 Learn more on our website. Check out our 2025 Impact Report: https://tradeoffs.org/2025-impact-report/. Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Support this type of journalism today, with a gift. Hosted on Acast. See acast.com/privacy for more information.
S1 · E379
May 28 · 28 min
A Closer Look at a Widely Despised Health Insurance Policy
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 Learn more on our website. Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Support this type of journalism today, with a gift. Hosted on Acast. See acast.com/privacy for more information.
S1 · E378
May 21 · 26 min
Republicans Want to Change How You Buy Health Care
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. Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Support this type of journalism today, with a gift. Hosted on Acast. See acast.com/privacy for more information.
S1 · E377
May 14 · 19 min
The U.S. Saved $1 Trillion on Health Care. Why Doesn't It Feel Like It?
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 Learn more and read a full transcript on our website. Want more Tradeoffs? Sign up for our free weekly newsletter featuring our latest reporting on health care's toughest choices. Donate to support our work. Tradeoffs is a nonprofit, powered by listeners. Hosted on Acast. See acast.com/privacy for more information.
S1 · E376
May 7 · 54 min
Call to Mind: The Fifth Branch
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. Want more Tradeoffs? Sign up for our free weekly newsletter featuring our latest reporting on health care's toughest choices. Donate to support our work. Tradeoffs is a nonprofit, powered by listeners. Hosted on Acast. See acast.com/privacy for more information.
S1 · E375
April 30 · 23 min
Doctors Hated the No Surprises Act. Now Some Are Getting Rich Off of It.
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 Learn more and read a full transcript on our website. Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Support this type of journalism today, with a gift. Hosted on Acast. See acast.com/privacy for more information.

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