Tradeoffs

U.S. companies are rethinking their healthcare strategies as costs soar, with many opting to invest in on-site primary care clinics. This trend emphasizes cutting out insurers and bridging access gaps for employees like Lee Sagraves. Personal stories highlight the challenges of managing chronic conditions within a fragmented system. With a proactive approach to employee health, businesses hope to streamline care and reduce expenses, sparking discussions about equity and the future of workplace healthcare.

For decades, the most effective treatment for addiction to methamphetamine or cocaine has been mired in stigma and mostly limited to small research studies. But with deaths involving meth and cocaine on the rise, policymakers across the country are turning to gift cards to fight drug use.This story has been updated to clarify the research on long-term effects of contingency management and the eligibility requirements to deliver contingency management through CalAIM.Credits:Stephen Higgins, PhD, Professor of Psychology and Psychiatry, University of VermontRichard Rawson, PhD, Professor Emeritus, UCLA Department of PsychologyAndrew Dertien, Contingency Management Coordinator, HealthRIGHT 360Bernard GrovesAyesha Appa, MD, Assistant Professor of Medicine, UCSF and San Francisco General HospitalTyler Sadwith, Medicaid Director, California Department of Health Care ServicesLearn 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.

Christine Baeder, President of Apotex USA, Alfred Engelberg, a retired attorney with a focus on the generic pharmaceutical industry, and Jeremy Greene, a professor at Johns Hopkins, dive into the rising costs of life-saving medications. They discuss the emotional toll on patients facing exorbitant prices and the struggles generics face against patent-holding brand companies. The conversation also covers the implications of recent reforms like the Inflation Reduction Act and the ongoing challenges of ensuring affordable medication access for all.

Christine Baeder, President of Apotex USA, Laura Bray, Founder of Angels for Change, and Craig Burton, Senior VP at the Association for Accessible Medicines, delve into the complexities of America's generic drug market. They discuss the hidden costs of low-priced drugs, including quality issues and shortages. A poignant story about the Bray family's struggle with the life-saving drug Vincristine highlights systemic failures and the emotional toll on patients. The conversation stresses the urgent need for reform to ensure drug availability while balancing affordability and quality.

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.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.

In this discussion, Alex Olgin, a reporter known for her insights on health policy, features guests from the American Speech-Language-Hearing Association who introduce an innovative gamified approach to health insurance. They delve into how the 'Benefit Builder' game encourages employees to collaboratively navigate healthcare priorities, revealing diverse values and ethical dilemmas. The conversation also touches on the rising costs of weight-loss medications and the overarching challenges in the generic drug market. Tune in for a fresh perspective on engaging employees in health benefit decisions!

A handful of states allow terminally ill people to take life-ending medications prescribed by a doctor instead of waiting for death. This week, we talk with journalist Steven Petrow about his sister’s choice to use medical aid in dying.Guest:Steven Petrow, Journalist and authorLearn 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.

In The Fifth Branch, Tradeoffs explored new ways to respond to people in a mental health crisis, this week we have look at another area of the mental health crisis the country is grappling with. 'Lost Patients', a new podcast from KUOW and The Seattle Times, dives into why so many people with mental illness live on the streets, and lack long-term care.Heidi Aurand has watched her son Adam spiral from one psychiatric crisis to the next for about eight years, bouncing between emergency rooms, jails, and homelessness. Now, after treatment at the state's largest psychiatric hospital, Adam was just released back onto the streets of downtown Seattle. A mother asks: How could her son pass through so many institutions and none are able to stop his decline?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.

The Inflation Reduction Act gave Medicare historic new power to directly negotiate the prices of some of the costliest prescription drugs. Now the federal agency must grapple with a difficult question: What makes a drug price fair?This week, we revisit our 2023 episode explaining how this negotiation process works and the impact it could have.Guests:Anton Avanceña, PhD, Assistant Professor of Health Outcomes, University of Texas Darius Lakdawalla, PhD, Professor of Pharmaceutical Economics and Public Policy, University of Southern California Lauren Neves, JD, Deputy Vice President, PhRMASteve Pearson, MD, MSc, Founder and President, Institute for Clinical and Economic Review (ICER)Ben Rome, MD, MPH, physician and researcher, Harvard Medical SchoolMeena Seshamani, MD, PhD, Deputy Administrator, Centers for Medicare and Medicaid ServicesLeslie Walker, Senior Producer/Reporter, TradeoffsLearn 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.

Ishani Ganguli, MD, MPH, is an assistant professor of medicine at Harvard Medical School and primary care physician at Brigham and Women's Hospital. She discusses the latest in cancer screening technologies like blood tests and full-body MRIs, weighing their potential benefits against psychological impacts and risks. The conversation also highlights the emotional toll on patients and doctors when navigating cancer diagnoses. Ganguli emphasizes the need for clearer doctor-patient communication to enhance understanding and accessibility in cancer care.