Tradeoffs

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.

Black Americans report higher levels of mistrust in the health care system than white Americans and suffer worse outcomes in everything from maternal mortality to life expectancy. What if improving health literacy and demystifying health information could be the part of the solution?This week, one doctor’s crusade to help more people understand their own health care and why insurers are starting to buy in.Guests:Lisa Fitzpatrick, MD, MPH, MPA, Founder and CEO, Grapevine HealthKeith Maccannon, Director of Marketing, Outreach and Community Relations, AmeriHealth Caritas District of ColumbiaYvonne Smith, Grapevine ClientKaren Dale, RN, MSN, Market President, AmeriHealth Caritas District of ColumbiaLearn 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.

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.

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.

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.

Economist Amy Finkelstein has studied America’s patchwork of health insurance policies for more than 20 years. In a forthcoming book she concludes it’s time tear the whole system down.This week, Dan talks with Amy about how she came to that conclusion and what a better system could look like. Guest:Amy Finkelstein, PhD, Professor of Economics, MITLearn 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.

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.

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.

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.