Tradeoffs

Tradeoffs
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Jan 1, 2026 • 29min

Race to the Bottom: Boom Times

Generic drugs are, in many ways, the unsung hero of America’s health care system, bringing powerful medical innovations within the reach of millions more people. These cheaper copies of brand-name drugs — from pills that stop heart attacks to antibiotics that cure life-threatening infections — save America hundreds of billions of dollars a year. But will affordable, high-quality generic drugs continue to be there when we need them?Some players are abandoning this business while others slash costs by cutting dangerous corners. Shortages of older generic drugs have become the norm, sending doctors scrambling. At the same time, crucial new medicines are proving tougher to copy on the cheap, saddling patients with brand-name prices.Over the course of “Race to the Bottom,” our new three-part podcast series, we’ll explore why this industry that’s so essential to our health is in trouble — and what could change that.In part one, we examine the history of this industry. Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug market. Lawmakers made choices back then that help explain the wild success and also the troubles we see today with generic medicines.Guests:Christine Baeder, MBA, President, Apotex USAAlfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical AssociationLeslie Walker, Senior Reporter/Producer, TradeoffsLearn more and read a full transcript on our website.Al Engelberg’s recently published memoir, “Breaking the Medicine Monopolies”, digs into the history of generic drugs. 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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Dec 25, 2025 • 25min

One Doctor’s Crusade to Improve Health Literacy

The discussion dives into the significant mistrust Black Americans have towards the health care system and its consequences. One doctor makes a bold move to enhance health literacy, aiming to bridge knowledge gaps. Grapevine Health is spotlighted for simplifying medical info and fostering trust within communities. Real-life success stories reveal how relatable advice transforms health outcomes. Insurers are starting to recognize the value of this approach, seeking better engagement with vulnerable populations.
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Dec 18, 2025 • 28min

How Treating Teens’ Trauma Is Stopping Violence in Chicago

A Chicago violence prevention program is pairing cognitive behavioral therapy with intensive mentoring and wraparound support to help high-risk teens avoid incarceration.Guests:Nour Abdul-Razzak, Research Associate, University of Chicago Harris School of Public Policy; Research Director, University of Chicago Inclusive Economy LabCharles Branas, Professor and Chair, Department of Epidemiology, Columbia University Mailman School of Public HealthToni Copeland, Director of Student Supports and Violence Prevention Programs, Chicago Public SchoolsJennifer Doleac, Executive Vice President of Criminal Justice, Arnold VenturesJasper Guilbault, Therapist, BrightpointGary Ivory, President and CEO, Youth Advocate ProgramsJulie Noobler, Director of Mental Health and Wellness, BrightpointT-ManLearn more and read a full transcript on our website.Help us unlock a $5,000 match by becoming one of 200 new donors at tradeoffs.org/donate.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Hosted on Acast. See acast.com/privacy for more information.
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Dec 11, 2025 • 27min

One Scientist's Mission to Change How We Prevent Overdoses

A leading addiction expert explains how he’s driven by the memory of a friend who died, and why he believes giving data on the drug supply to people on the street is more important than using it to inform national drug policy.Guest:Nabarun Dasgupta, Epidemiologist, University of North Carolina Street Drug Analysis Lab and Opioid Data LabLearn more and read a full transcript on our website.Help us unlock a $5,000 match by becoming one of 200 new donors at tradeoffs.org/donate.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Hosted on Acast. See acast.com/privacy for more information.
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Dec 4, 2025 • 26min

A New Kind of Primary Care Comes to America

A group of nurses in Baltimore wants to bring basic care to every person in a neighborhood regardless of age, health, income or insurance.Can this idea from abroad take root in the United States?Guests:Dawn Alley, PhD, Head of Scale, IMPaCT CareAsaf Bitton, MD, MPH, Executive Director, Ariadne LabsRegina Hammond, Founder, Rebuild Johnston Square Neighborhood OrganizationChris Koller, President, Milbank Memorial FundTerry Lindsay, Community Health Worker, Sisters Together and Reaching, Inc. (STAR)Sarah Szanton, PhD, RN, FAAN, Dean, Johns Hopkins School of Nursing; Founder, Neighborhood NursingLearn more and read a full transcript on our website.Help us unlock a $5,000 match by becoming one of 200 new donors at tradeoffs.org/donate.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Hosted on Acast. See acast.com/privacy for more information.
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Nov 27, 2025 • 26min

One Economist’s Plan to Blow Up America’s Health Insurance System

In this engaging conversation, Amy Finkelstein, a Professor of Economics at MIT and MacArthur Fellow, shares her radical vision for America's health insurance. With over 20 years of research, she argues for a complete system overhaul, proposing universal free basic coverage. Finkelstein highlights the instability of current insurance, revealing that 25% of Americans experience coverage gaps. She discusses the harmful effects of co-pays on access to essential medications and suggests automatic enrollment to simplify access and reduce inequalities in health care.
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Nov 20, 2025 • 26min

Homeless Camp Sweeps Can Harm Health. Some Cities Are Trying a New Way.

Several cities and counties are addressing street homelessness with a new approach, which experts say can clear encampments while protecting the health of people who are forced to move.Guests:Josh Barocas, Associate Professor, University of Colorado Anschutz School of MedicineMarc Dones, Policy Director, Benioff Homelessness and Housing Initiative, University of California San FranciscoRyan Levi, Managing Editor, TradeoffsMatt Mahan, Mayor, City of San JoseJazmine MapesPeter Radu, Neighborhood Services Manager, City of BerkeleyLearn more and read a full transcript on our website.Help us unlock a $5,000 match by becoming one of 200 new donors at tradeoffs.org/donate.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news. Hosted on Acast. See acast.com/privacy for more information.
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Nov 13, 2025 • 26min

Rising Costs, Fewer Choices: What’s Up with Medicare Drug Plans?

Facing mounting financial pressures, insurance companies are changing the prescription drug coverage available to many consumers in Medicare Part D.Guests:Stacie Dusetzina, Professor of Health Policy, Vanderbilt UniversitySteven Hadfield, Medicare beneficiaryMark Newsom, Managing Director, Avalere HealthErin Trish, Co-Director, USC Schaeffer CenterCindy Trish, Medicare beneficiaryLeslie Walker, Senior Reporter, TradeoffsLearn more and read a full transcript on our website. If you know someone on Medicare, please encourage them to give their coverage a closer look before open enrollment ends on Dec. 7! People can find unbiased enrollment counseling through the federal SHIP program or review their options on Medicare.gov.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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Nov 6, 2025 • 20min

The Quiet Cuts Making ACA Enrollment Harder

Higher premiums and penalties have made shopping for Obamacare plans more confusing this year. Federal funding cuts have left consumers in many states with fewer guides to help them navigate their options. “I don’t want people to just feel ghosted,” a West Virginia navigator told Tradeoffs.Guest:Jeremy Smith, director, West Virginia navigator program, First Choice Services.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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Oct 30, 2025 • 25min

Should I Trust AI to Diagnose Me?

Join physician and New Yorker writer Dhruv Khullar as he navigates the promising yet perilous world of AI in healthcare. He explores how AI can expedite diagnostics but warns of potential dangers, such as cognitive de-skilling and reliance on faulty chatbot advice. Khullar emphasizes using AI as a tool for guidance rather than a definitive source, while highlighting its ability to enhance communication for non-English speakers. He discusses the balance of human judgment with technology's capabilities, urging caution and accountability in AI integration.

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