An Arm and a Leg

We’re always asking: Why do drugs cost so freaking much? 

And it’s a complicated question. There are a bunch of reasons — to be sure. But in our reporting over the years, like our stories on insulin and tuberculosis drugs, experts cited one big reason over and over again: 

The pharmaceutical industry wages sophisticated legal battles to keep monopoly control over their best selling, most lucrative d...

This year, the price of health insurance increased dramatically for millions of people. Tens of millions. Obamacare subsidies shrunk, and premiums skyrocketed. 

People asked themselves: how on earth am I supposed to make this work? 

Two of those folks — attorney Nicole Wipp and skate-shop owner Noah Hulsman — tell the story of how they chose among lousy options.

Nicole chose to dump health insurance altogether...

Hey, first! We’re looking for your help. Can you take a couple minutes and fill out our Audience Survey? 

We’re dying to know more about the community that’s using this show — and about what’s working for you and what you’d like to see. Let us know!

Today we’re switching it up. We’re sharing an episode from the new podcast Drug Story. In each episode, science journalist...

Thirty-six hours before his wife was scheduled for a major surgery, New York Times personal finance columnist Ron Lieber got a letter in the mail that sent him reeling. 

Insurance was denying prior authorization for the surgery. The only way forward would be to appeal the decision. But it was Saturday night, and the surgery was Monday morning. There wouldn’t be any time. Should they even go to the hospital?

They decided ...

For five years, we’ve been following the work of Dollar For and its founder Jared Walker, watching them quickly scale up their efforts to help people crush medical debt by tapping into “charity care” — the financial assistance that hospitals are legally required to offer some patients. 

Their work represents what a small, scrappy, thoughtful group of people can do. Last year, their tiny staff helped wip...

Hey, first!  If you value what we do, we need your support to keep it going in 2026. 

We have SO much work ahead, and we can’t do it without you.  

Every little bit counts. Here’s where you can chip in. Thank you SO much!

Our listeners have been teaming up on an incredible project – kicked off earlier this year by a med student named Thomas Sanford. 

The idea: create a list of re...

Hey, first!  If you value what we do, this is the best-ever time to support our work.

We have SO much work ahead in 2026. Donate here.

We’re back for another look at things that – believe it or not – did NOT suck in 2025. 

Specifically: new state laws from around the country aimed at protecting people from things like medical debt, insurance delays and denials, and corporate profiteering.  ...

Hey, first!  If you value what we do, this is the best-ever time to support our work:  This month, every donation gets matched two-for-one.  

We have SO much work ahead in 2026. Donate here — and get your money matched two-for-one.

It’s probably fair to say: this is the worst year ever for picking health insurance. Premiums are skyrocketing – whether you get insurance through work or from ...

Hey, first!  If you value what we do, this is the best-ever time to support our work:  This month, every donation gets matched two-for-one.  

We have SO much work ahead in 2026. Head to https://armandalegshow.com/support/ to donate — and get your money matched two-for-one.

This statement might shock you: some actual good things happened in 2025. Or, at least things that did not totally suck. 

Stu...

Economist Vivian Ho has been researching the US health care system for four decades. These days she focuses on what she describes as the biggest burden on the average American: runaway hospital prices and rising health insurance premiums. (You know, Arm and a Leg stuff.) 

And she’s developed a strategy for addressing high insurance premiums – one based on a real-life success story.

So when she asked us to help her ...

A listener named Thomas Sanford wrote to us earlier this year, asking for help with a little DIY project. And it’s turned into the most encouraging thing we’ve seen all year.

With input from the Arm and a Leg community — specifically folks who get our First Aid Kit newsletter — Thomas has drafted a one-page handout, packed with resources for anyone who needs help with medical bills.

It’s ready for you ...

For the first time, our senior producer, Emily, has to sign up for Obamacare. And it turns out, it’s one heck of a year to do that. 

A recent headline from KFF Health News reads: “Insurers and customers brace for double whammy to Obamacare premiums.”

We break down what those “whammies” might mean in dollars and cents for Emily and the millions of others signing up for Obamacare in 2026.  ...

Hey first! We need your help: Financial help. Donations from listeners power this show, and we’ve got a goal: 100 people making their first-ever gift, this week. 

If you haven’t chipped in before, this is a great time — just click here.

OK, onwards…

Sharing a favorite from our archive – with lessons that are as relevant as ever. 

Laurie Todd calls herself The Insurance Warrior. She fights he...

When a New York couple purchased a health insurance plan from a telemarketer, everything sounded legit. Meds, doctors, tests?  All covered.

But it didn't take long for them to realize they'd been “hustled” – ending up with bills for thousands of dollars, and leaving them no choice but to skip important medical care. 

In their series “Health Care Hustlers,” Bloomberg reporters Zach Mider and Z...

As a follow-up to our series The Prescription Drug Playbook — all about how you can get the meds you need at a price you can (maybe) afford — we’re stepping back to look at the big picture. 

From the start of this podcast, we’ve been trying to answer a major question: Why do my meds cost so freaking much? And we’ve highlighted the profit-seeking games that insurance, pharma, and middlemen play all...

In February, we asked you, our listeners, to share the tips, tricks, and tactics you’ve learned for getting the medicine you need at prices you can manage. 

And of course some of you work in health care and have insider knowledge. Which we’re passing along in this second episode of The Prescription Drug Playbook.

We’ll hear from a listener who works to help seniors find healthcare, a pharma sales rep, an empl...

In surveys, one in four Americans report having to skip their medications due to cost. We asked our listeners: what strategies have you used when you’ve been hit with pharmacy sticker shock? 

We heard from a ton of you – with stories, strategies and workarounds that surprised and encouraged us.

None of them will work for everybody. This is a set of patches and bandaids for a broken system. But if there’s one ...

What do the KGB and the former CEO of Cincinnati Children's Hospital have in common?

At different times, they’ve each looked to a guy named Eugene Litvak for help. He only said yes to Cincinnati — but he saved that hospital more than a hundred million dollars a year.

For the last few decades, Litvak – a Soviet émigré with a PhD in math – has been on a mission: save U.S. hospitals from financial...