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The Fifth Branch: Keeping People Safe
How do you keep everyone safe? We look at HEART’s impact on the safety of Durham residents in crisis, the mental health workers responding, and the police.
Guests:
David Prater, Peer Support Specialist, Durham Department of Community Safety
Ryan Smith, Director, Durham Department of Community Safety
Yolanda, Durham resident
Sgt. Dan Leeder, Durham Police Department
Patrice Andrews, Police Chief, Durham Police Department
Christie Thompson, Staff Writer, The Marshall Project
EMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch.
Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness.
To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.
How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.
The Marshall Project's Christie Thompson reports on the state of alternative crisis response across the country.
Learn more about this series, which first ran in July, 2024 on our website.
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353. A New Kind of Primary Care Comes to America
26:08||Season 1, Ep. 353A 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.352. One Economist’s Plan to Blow Up America’s Health Insurance System
25:50||Season 1, Ep. 352Economist 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.351. Homeless Camp Sweeps Can Harm Health. Some Cities Are Trying a New Way.
25:47||Season 1, Ep. 351Several 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.350. Rising Costs, Fewer Choices: What’s Up with Medicare Drug Plans?
26:17||Season 1, Ep. 350Facing 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.349. The Quiet Cuts Making ACA Enrollment Harder
20:09||Season 1, Ep. 349Higher 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.348. Should I Trust AI to Diagnose Me?
25:12||Season 1, Ep. 348Physician 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 YorkerLearn 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.347. Will Trump’s Prescription Drug Deals Really Lower Prices?
24:23||Season 1, Ep. 347Facing unprecedented pressure from the Trump administration, some of the world’s top drugmakers promise to cut prices. But experts say the savings might not be what they seem.Guests:Michael Cannon, Director of Health Policy Studies, Cato InstituteStacie Dusetzina, Professor of Health Policy, Vanderbilt UniversityDarius Lakdawalla, Chief Scientific Officer, USC Schaeffer CenterPete Loftus, Reporter, Wall Street JournalBen Rome, Assistant Professor of Medicine, Harvard Medical SchoolLeslie Walker, Senior 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.346. How New York Times Columnist Paula Span Navigates ‘The New Old Age’
24:59||Season 1, Ep. 346Journalist Paula Span, who writes The New Old Age column for the New York Times, shares what she’s learned about how to age well.Guest:Paula Span, reporter and The New Old Age columnist for the New York TimesLearn 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.345. The Future of Health Care Research: 'Federal Funding Really Is Irreplaceable'
25:09||Season 1, Ep. 345What happens if President Trump cuts billions from research on how to make our health care system work better?Guest(s):Aaron Carroll, President and CEO, Academy HealthStuart Buck, Executive Director, Good Science ProjectLearn 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.