13 episodes

What's your life worth? Healthcare in the United States can bankrupt you, demoralize you—or actually kill you. Healthcare economist David Smith grew up in a Mormon community in Utah, and lost his father, sister, and brother to the same deadly epidemic. He’s spent his career exploring whether their deaths were preventable and how we can make health a priority for everyone. On The Cost of Care, David and his guests – patients, medical experts, and policy makers – reveal how the wealthiest nation on earth ended up with one of the most expensive, worst-performing health care systems in the world and provide solutions to fix it, together.

The Cost of Care Lemonada Media

    • Health & Fitness
    • 4.1 • 353 Ratings

Listen on Apple Podcasts
Requires subscription and macOS 11.4 or higher

What's your life worth? Healthcare in the United States can bankrupt you, demoralize you—or actually kill you. Healthcare economist David Smith grew up in a Mormon community in Utah, and lost his father, sister, and brother to the same deadly epidemic. He’s spent his career exploring whether their deaths were preventable and how we can make health a priority for everyone. On The Cost of Care, David and his guests – patients, medical experts, and policy makers – reveal how the wealthiest nation on earth ended up with one of the most expensive, worst-performing health care systems in the world and provide solutions to fix it, together.

Listen on Apple Podcasts
Requires subscription and macOS 11.4 or higher

    David Smith Revisits Last Day S1 Ep 3: And Now, We Rewind the Tape

    David Smith Revisits Last Day S1 Ep 3: And Now, We Rewind the Tape

    Opioids are killing more people than ever. In 2020, overdose deaths in the U.S. spiked nearly 30% to a record high -- the sharpest annual increase in 30 years. Fentanyl sold on the street and the ongoing toll of the pandemic are the primary drivers. With so many of us affected, there’s a dire need for solutions. That’s why we’re re-releasing episodes 2-12 from season one with new updates from previous guests and fans of the show. Last Day Revisited: The Opioid Crisis is a binge listen that offers essential knowledge, support, and answers for people directly impacted by addiction. PLUS, we reveal what topic we’ll be covering in Last Day Season 3, dropping early 2022. Together, we can reduce stigma and save lives.  On Last Day, we talk about what’s killing us, the stuff that’s hard to comprehend and getting worse every day. Join host Stephanie Wittels Wachs, as she confronts massive epidemics with humanity, wit, and a quest for progress. While Season 1 chronicled the opioid crisis in the US, Season 2 delves into the growing suicide rate, telling real stories, talking to experts, and asking everyone along the way, "How did we get here, and what could we have done differently?"

     

    On this episode, Stefano Cordova Jr.’s family tries to make sense of Stefano’s overdose death and how they all got here. Then, Dr. Sam Snodgrass, a behavioral pharmacologist with a doctorate in biopsychology, explains how his own addiction to opioids is a disease and why understanding that is key to helping people with substance use disorders.

     

    To hear more of Last Day, search for Last Day wherever you are listening right now.

    See omnystudio.com/listener for privacy information.

    • 46 min
    10. Pro Tips on Fighting the System

    10. Pro Tips on Fighting the System

    In the final episode of the season, David highlights pro tips from the experts themselves: patient advocates Linda Michelson and AnnMarie McIlwain. Dr. David Blumenthal of The Commonwealth Fund joins to shine the light on tangible solutions on how to restructure our national health care system.

     

    Resources from the episode:
    Check out Marshall Allen's book, Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win: https://www.marshallallen.com/ 
    Contact Linda Michelson: https://medicalbillproblems.com/ 
    Contact AnnMarie McIlwain and her team: http://www.patientadvocators.com/?gclid=Cj0KCQjwnueFBhChARIsAPu3YkR5dzaS6o-jIY8ZJUoJZUlRku1bWMVgVYfnn5wQ4F-c1YwmDUbMihIaAnb9EALw_wcB  
    Keep up with the Commonwealth Fund: https://www.commonwealthfund.org/ 
    AdvoConnection’s patient advocates directory: https://profile.advoconnection.com/ 
    AdvoConnection’s comprehensive overview of patient advocacy: https://www.aphadvocates.org/profession-overview/ 
    National Patient Advocate Foundation’s resources on choosing the best health care plan for you: https://www.npaf.org/patients-and-caregivers/how-to-choose-a-plan/ 
    CoPatient’s resources for making sure your bills are fair and accurate: https://www.copatient.com/ 

     

    Keep up with David on twitter @CHIDavidSmith. 

     

    Share your feedback!  Email us at costofcare@lemonadamedia.com or leave us a voicemail at 833-453-6662. 

     

    Support for this episode of The Cost of Care comes from Healthline.com, America’s leading digital health brand. Visit healthline.com/costofcare now, and stay connected by following @healthline on Instagram, Facebook and Twitter. Healthline: Powering healthy actions and supporting you on your journey to well-being.

     

    Support for this podcast comes from The Commonwealth Fund, a health care research foundation working to improve the U.S. health system. Visit commonwealthfund.org/costofcare, and stay connected by following us on Twitter, LinkedIn, and Instagram. Commonwealth Fund: Affordable, quality health care. For everyone.

     

    You can click this link for a full list of current sponsors and discount codes for this show and all Lemonada shows.

     

    To follow along with a transcript and/or take notes for friends and family, go to https://www.lemonadamedia.com/show/thecostofcare/ shortly after the air date.

     

    Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.

    See omnystudio.com/listener for privacy information.

    • 36 min
    9. We Asked, You Replied: Listener Submissions Special

    9. We Asked, You Replied: Listener Submissions Special

    From the start of our show, we’ve asked listeners to share stories about navigating the American health care system. Today, David talks with those of you who have had to fight for health care in order to manage chronic illnesses, secure gender-affirming surgeries, and help children receive developmental therapies for Down Syndrome.

     

    Resources from the episode:
    Planned Parenthood transgender identity terms and labels: https://www.plannedparenthood.org/learn/gender-identity/transgender/transgender-identity-terms-and-labels 
    GLAAD transgender glossary of terms: https://www.glaad.org/reference/transgender 
    JAMA article on the association between gender-affirming surgery and mental health: https://jamanetwork.com/journals/jamasurgery/article-abstract/2779429 
    National Down Syndrome Society resources for finding support: https://www.ndss.org/lifespan/finding-support/ 
    National Down Syndrome Congress local and national support networks: https://www.ndsccenter.org/programs-resources/affiliate-organizations/local-and-national-support-networks/ 
    American College of Obstetricians and Gynecologists endometriosis resources: https://www.acog.org/womens-health/faqs/endometriosis 
    Johns Hopkins Crohn’s resources: https://www.hopkinsmedicine.org/gastroenterology_hepatology/diseases_conditions/faqs/crohns_disease.html 
    Cancer Care breast cancer resources: https://www.cancercare.org/diagnosis/breast_cancer 

     

    Keep up with David on twitter @CHIDavidSmith. 

     

    Share your feedback!  Email us at costofcare@lemonadamedia.com or leave us a voicemail at 833-453-6662. 

     

    Support for this episode of The Cost of Care comes from Healthline.com, America’s leading digital health brand. Visit healthline.com/costofcare now, and stay connected by following @healthline on Instagram, Facebook and Twitter. Healthline: Powering healthy actions and supporting you on your journey to well-being.

     

    Support for this podcast comes from The Commonwealth Fund, a health care research foundation working to improve the U.S. health system. Visit commonwealthfund.org/costofcare, and stay connected by following us on Twitter, LinkedIn, and Instagram. Commonwealth Fund: Affordable, quality health care. For everyone.

     

    You can click this link for a full list of current sponsors and discount codes for this show and all Lemonada shows.

     

    To follow along with a transcript and/or take notes for friends and family, go to https://www.lemonadamedia.com/show/thecostofcare/ shortly after the air date.

     

    Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.

    See omnystudio.com/listener for privacy information.

    • 43 min
    8. Medical Jargon is Killing Us

    8. Medical Jargon is Killing Us

    Medical jargon is a thing of the past and health literacy is now en vogue – and can actually save patients’ lives according to our guest, Dr. Lisa Fitzpatrick. We're also joined by Dr. Venice Haynes and Natalie Davis who talk to us about the anxiety, confusion, and fears people across the country have about asking those life-saving health care questions and booking a doctor’s appointment in the first place.

     

    Resources from the episode:
    Dr. Lisa’s interview with The Atlantic on the upside of health care plainspeak: https://www.theatlantic.com/ideas/archive/2020/12/public-health-value-speaking-plainly/617352/ 
    Dr. Lisa on the Street YouTube series: https://www.grapevinehealth.com/media 
    Dr. Lisa’s Washington Post op-ed on how zip codes can determine health outcomes: https://www.washingtonpost.com/opinions/local-opinions/my-southeast-dc-zip-code-shouldnt-be-my-health-destiny/2020/11/17/156a989c-1931-11eb-befb-8864259bd2d8_story.html 
    US of Care Voices of Real Life storytelling project: https://unitedstatesofcare.org/who-we-are/voices/ 
    US of Care Voices of Real Life YouTube series: https://www.youtube.com/playlist?list=PLchtNczPer_8g7icvpiu2gmVNPr9XPENQ 
    US of Care listening project 2020 findings: https://unitedstatesofcare.org/findings-from-deep-listening-and-national-public-opinion-research/ 
    Keep up with US of Care on twitter: https://twitter.com/USofCare 
    Follow Grapevine Health on twitter: https://twitter.com/HealthGrapevine?s=20 

     

    Keep up with David on twitter @CHIDavidSmith. 

     

    Share your feedback!  Email us at costofcare@lemonadamedia.com or leave us a voicemail at 833-453-6662. 

     

    Support for this episode of The Cost of Care comes from Healthline.com, America’s leading digital health brand. Visit healthline.com/costofcare now, and stay connected by following @healthline on Instagram, Facebook and Twitter. Healthline: Powering healthy actions and supporting you on your journey to well-being.

     

    Support for this podcast comes from The Commonwealth Fund, a health care research foundation working to improve the U.S. health system. Visit commonwealthfund.org/costofcare, and stay connected by following us on Twitter, LinkedIn, and Instagram. Commonwealth Fund: Affordable, quality health care. For everyone.

     

    You can click this link for a full list of current sponsors and discount codes for this show and all Lemonada shows.

     

    To follow along with a transcript and/or take notes for friends and family, go to https://www.lemonadamedia.com/show/thecostofcare/ shortly after the air date.

     

    Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.

    See omnystudio.com/listener for privacy information.

    • 41 min
    Bonus Episode: Incentivizing Health Outcomes with Gov. Mike Leavitt

    Bonus Episode: Incentivizing Health Outcomes with Gov. Mike Leavitt

    Former Utah Governor, Mike Leavitt, helped to implement the Medicare Part D Prescription Drug Program under former President George W. Bush. He joins David to talk about moving away from a profit-driven model to one that incentivizes better health outcomes.

    7. Why Kidney Failure Pays

    7. Why Kidney Failure Pays

    America’s relationship with Dialysis is out of control. Roughly 1% of the entire federal budget is spent treating people with kidney failure. That’s billions of dollars devoted to treating one preventable illness. How did we end up with so many people on dialysis? And who’s getting rich from it? This week, we connect the dots from Richard Nixon to Dr. Evil and talk with disruptors who have some new ideas for how to fix the system. Bobby Sepucha, Will Stokes and nephrologist Dr. Natasha Dave join us to talk about how these kidney care disruptors are prioritizing patients and their overall health.





    Resources from the episode:
    Learn more about Strive Health’s Kidney Heros: https://www.strivehealth.com 
    Read up on Cricket Health’s kidney care model: https://www.crickethealth.com
    Listen to Dr. Dave’s podcast on life as a nephrologist: https://www.kidney.org/podcast 

     

    Keep up with David on twitter @CHIDavidSmith. 

     

    Share your feedback!  Email us at costofcare@lemonadamedia.com or leave us a voicemail at 833-453-6662. 

     

    Support for this episode of The Cost of Care comes from Healthline.com, America’s leading digital health brand. Visit healthline.com/costofcare now, and stay connected by following @healthline on Instagram, Facebook and Twitter. Healthline: Powering healthy actions and supporting you on your journey to well-being.

     

    Support for this podcast comes from The Commonwealth Fund, a health care research foundation working to improve the U.S. health system. Visit commonwealthfund.org/costofcare, and stay connected by following us on Twitter, LinkedIn, and Instagram. Commonwealth Fund: Affordable, quality health care. For everyone.

     

    You can click this link for a full list of current sponsors and discount codes for this show and all Lemonada shows.

     

    To follow along with a transcript and/or take notes for friends and family, go to https://www.lemonadamedia.com/show/thecostofcare/ shortly after the air date.

     

    Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.

    See omnystudio.com/listener for privacy information.

    • 38 min

Customer Reviews

4.1 out of 5
353 Ratings

353 Ratings

WhyBabyJesusWhy ,

Pandering to what is

Having experienced UK (NHS) and decades of for profit American health care for my chronic issues this is my take on this podcast.

Focus on anecdotal experiences and graphic tragic outcomes doesn’t illustrate the everyday mindset and relationship with health care of most Americans.

To illustrate:

There’s a billion dollar industrial complex of over the counter treatments, alternative care and health and wellness that Americans routinely access in lieu of standard western medical care because the health care system is problematic.

Everyday people self diagnose and practice frontier medicine on themselves because of the cost and well known inefficacy of the medical establishment in America.

My own chronic condition routinely gets prescribed a cocktail of drugs that are peer review researched to have about the same effect as a placebo and a slew of cumulative nasty side effects that include suicidal ideation. I opted out of those standard treatments. Go figure.

And mine is an average experience here in America. In general we don’t trust our health system. And the ramifications of millions of people who no longer use the established medical system (unless they absolutely have to) is the unnecessary death toll (Covid for example)and general unmitigated medical maiming of the population that’s not seen in other countries.

When I was living in the UK I was straight up told first day I arrived (apropos of nothing) and like I was a slow child that health care was a human right.

And in practice, observing my UK friends/colleagues receive health care and my own personal experiences with NHS made me realize that my experience with the monetization of American health care impacts me in every aspect in a negative way because humans are not disease widgets that need just in time attentions of a mechanized system of delivery that weaponized profit making over good health outcomes.

Moreover I learned that on all levels my ideas about health care and how I accessed it were grounded and lensed in the for profit model.

And so too is this podcast’s framework and lens intrinsically tied to the for profit model in its unexamined bias and editorial choices that rely on anecdotal evidence of “the cost of human suffering” to drive the narrative.

Until we as Americans examine “what is”... that we see basically everything as a marketplace to our own detriment- we’re gonna just have more of the same. And no matter how groundbreaking the discussion is- it will be rendered moot.

Health care is a commodity in America not a human right. Yes, medical care has a “price” and billions of other humans planet wide have figured out how to provide for each other because they do not see the overarching need to make profit from medicine.

kh3425 ,

Uninformed and wrong

Uninformed and wrong podcast. Never gets into personal responsibility. Admits that the problems with insurance only started because of government interference and socialist actions but thinks that more socialism is the answer!

brizdaishhh ,

Eye opening and informative

As a “healthcare provider” I have been shielded from the realities of how the system actually works. Exploiting us as pawns and as consumers of the very same system. not only is this podcast informative, it guides listeners on how to advocate for ourselves.. this system can’t continue to work as it is working… we’re all victims. Give it a listen. It’s worth it.

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