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Tradeoffs
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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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.
344. How States Are Reckoning with Republican Health Reforms
21:00||Season 1, Ep. 344It's been 90 days since Congress passed Trump’s megabill slashing health care spending and reshaping the Medicaid program. States are already knee-deep in dealing with the fallout.Guests:Hemi Tewarson, Executive Director, National Academy for State Health PolicyLeslie Walker, Senior Producer, TradeoffsLearn 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.
343. BONUS: What Happens if Obamacare Subsidies Shrink?
16:08||Season 1, Ep. 343Excerpts of a live conversation with two top health economists about how extra federal support has helped millions of Americans access health insurance, and what would happen if that aid went away.Guests:Katherine Baicker, Provost and Emmett Dedmon Distinguished Service Professor, University of ChicagoJonathan Gruber, Ford Professor of Economics, MIT Learn more on our website, and watch the full conversation on Penn LDI's YouTube page.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.
342. A Closer Look at a Widely Despised Health Insurance Policy
27:10||Season 1, Ep. 342Every year, millions of people’s medical care runs into the roadblock known as prior authorization, which requires an insurer to sign off before chemotherapy, surgery or countless other services can proceed. Who does this often onerous process help, who does it hurt and how could it work better for everyone?Guests:Tom Roberts, Oncologist, Mass General Cancer CenterAaron Schwartz, Assistant Professor, Department of Medical Ethics and Health Policy and Department of Medicine, University of PennsylvaniaKathleen, CaregiverLearn 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.
341. Why Are People With Mental Illness Starving to Death in Jail?
24:06||Season 1, Ep. 341Pulitzer Prize winning journalist Sarah Stillman explains why so many people with mental illness are starving to death in U.S. jails, who is profiting, and what can be done to prevent it.Guest:Sarah Stillman, Staff Writer, New Yorker; Founder, Yale Investigative Reporting LabLearn 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.