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Technology and democracy are at a crossroads. Technology can potentially empower people and make our democracies more responsive. Or technology can be used to manipulate and divide us. Welcome to Impossible Tradeoffs. I’m Katie Harbath. In this weekly podcast, we’ll talk about and analyze the most fascinating headlines. We’ll make predictions about where things are going. And we’ll talk to experts about the challenges we face and how we might look for solutions. anchorchange.substack.com
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Tradeoffs

Tradeoffs

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Tradeoffs is an award-winning nonprofit news organization on a mission to help the folks on Main Street, Wall Street and Capitol Hill have smarter, more honest conversations about health policy. Founded in 2019 by former Senior Health Care Reporter at Marketplace, Dan Gorenstein, Tradeoffs’ journalism combines data, evidence and storytelling to help people better understand the complicated, costly and often counterintuitive world of health care. Learn more about us and find transcripts for e ...
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Kate Dommett, a professor of digital politics, discusses her book “Data-Driven Campaigning and Political Parties” and her research on how political parties use data in election campaigns. She explores the prevailing narratives around data-driven campaigning and how they often do not match reality. Dommett also discusses the role of regulation in da…
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While stories of private equity firms running amok in health care are easy to find, new research paints a more nuanced picture. Guests: Ambar La Forgia, PhD, Professor of Management of Organizations, Berkeley Haas School of Business Rachel Werner, MD, PhD, Executive Director, Leonard Davis Institute of Health Economics, University of Pennsylvania Y…
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Sorry for the slight delay today. The tech gods were not being kind. Watch this on YouTube! NOTE: A lot of this summary and show notes were generated via a new AI tool by Riverside.fmIn this episode, Brian Fishman, co-founder and chief strategy officer at Cinder, discusses his background in studying terrorism and his work at Facebook. He shares ins…
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A major new study throws cold water on a popular approach to relieving medical debt, but leading experts say the research also reveals a promising path forward. Guests: Henry Harrell, MD, Physician Neale Mahoney, PhD, Professor of Economics, Stanford University Allison Sesso, President and CEO, Undue Medical Debt Learn more and read a full transcri…
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Watch this episode on YouTube. As most of you know, I started working full-time as the Global Affairs Officer of Duco Experts in January. One of the things I like about the job is getting to work across the industry and seeing how companies tackle similar problems differently. Thus, I thought it would be fun to bring the leadership team on the podc…
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One advocate’s vision for the crucial role patients must play in the future of health care AI. Andrea Downing, President and Co-Founder, The Light Collective Learn more and read a full transcript on our website. Subscribe to our weekly newsletter. Follow us on X, LinkedIn and Youtube. Email us at info@tradeoffs.org. Hosted on Acast. See acast.com/p…
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I’m trying something different for this week’s podcast. I originally hoped I would have a webinar to repurpose, but we ended up rescheduling it, so rather than not doing a podcast this week, I thought I would record the answers to questions I get quite often. In this discussion, I go into seven different areas of interest. Topics and time stamps ar…
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Some patients’ lives are so complicated by trauma, poverty and other social problems that routine conditions like diabetes and asthma regularly turn into $10,000 hospital visits. America’s health care leaders have spent years trying to help this small but costly group of patients. What have they learned? Guests: Jeff Brenner, MD, CEO, The Jewish Bo…
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Watch the video of our conversation on YouTube! This week, I welcome Professor Kate Klonick to the podcast. The name of this episode comes from some amazing swag Kate made for a conference she put on last year on the history of the Trust and Safety profession. (You know how much I love swag.) Kate is among the foremost experts on many things, inclu…
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One doctor debates whether to work for the nation's largest insurance company after it purchased the independent practice she worked for in Oregon. Guest: Gwen O'Keefe, MD, Assistant Professor of Medicine, Department of Anesthesiology & Perioperative Medicine, OHSU Learn more and read a full transcript on our website. Subscribe to our weekly newsle…
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Don’t forget you can watch all of these on YouTube! This week, we are discussing all things online influence operations with one of the foremost experts - Olga Belogolva. We’re talking about Russians, Chinese, Iranians, and other actors who want to influence the online information environment. The title of this episode comes from one of her classes…
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As lawmakers around the country take aim at transgender rights, we dig into findings from the largest survey ever of trans Americans. Guest: Sandy E. James, JD, PhD, Lead Researcher, 2022 U.S. Transgender Survey Learn more and read a full transcript on our website. Subscribe to our weekly newsletter. Follow us on X, LinkedIn and Youtube. Email us a…
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Don’t forget you can also watch this on YouTube! This week, we are talking to Michael Bąk. Michael brings more than two decades of experience across international development, peacebuilding, diplomacy, and tech policy. Throughout his career, he has sustained a strong commitment to democratic governance, human rights, and information integrity. He i…
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Girls in the U.S. are in the midst of a growing mental health crisis, and schools are on the front line of finding solutions. But will Black and Latina girls get left behind? Guests: Monica Bhatt, PhD, Senior Research Director, University of Chicago Education Lab Sheretta Butler-Barnes, PhD, Professor, Washington University Kathleen Ethier, PhD, Di…
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Don’t forget you can also watch these on YouTube! This week we welcome Stanford Law Professor Nate Persily to the podcast. I’ve known Nate since 2013/2014 when he held a gathering at Stanford with folks in the tech/digital industry and the Federal Elections Commission. Nate has been a thought leader his entire career with experiences across technol…
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Patients are now mostly protected from surprise bills, but doctors and insurers are still fighting about the prices. Guest: Benjamin Chartock, PhD, Assistant Professor of Economics, Bentley University Learn more and read a full transcript on our website. Subscribe to our weekly newsletter. Follow us on X, LinkedIn and Youtube. Email us at info@trad…
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Don’t forget you can now also watch these conversations on YouTube! This week, we are diving deep into elections and specifically where people go to get information on the election. Rachel Orey is the Bipartisan Policy Center’s Senior Associate Director where they are responsible for the organization’s election administration policy development, st…
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As adults with intellectual and developmental disabilities strive to live more freely and fully than ever before, many of America’s doctors, hospitals and insurers are getting in the way. We get an inside look at one doctor’s quest to improve health care for people with conditions like Down Syndrome, cerebral palsy and autism. Guests: Alison Barkof…
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This week on the podcast, we are taking you to SXSW and discussing a conversation I had with Sasha Issenberg about his new book, Lie Detectives: How Political Campaigns Fight Disinformation. You might remember him from his popular book Victory Lab, which was published after Obama won. Sasha’s book looks at people in the U.S. and Brazil who were at …
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A bipartisan bill takes aim at a $500 billion health care problem that few people have ever heard of. Will it make care better for some of the country’s sickest, poorest patients? Guests: U.S. Senator Bill Cassidy (R-LA) Saleema Render-Hornsby, Dually eligible patient Allison Rizer, MBA, Executive Vice President, ATI Advisory Eric Roberts, PhD, Ass…
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We’re back! I didn’t intend to take two full months off from the podcast, but as many of you know, I started a new job in January as the Chief Global Affairs Officer of Duco Experts - a technology consulting firm. It has been overwhelming, in a good way, but it took me a bit to get started again with the podcast. I’ve got some exciting guests lined…
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There are a lot of concerns about the dangers artificial intelligence could pose to your health privacy. AI expert Nicholson Price explains why he thinks too much concern over privacy could make health care AI worse. Guest: Nicholson Price, JD, PhD, Professor of Law, University of Michigan Learn more and read a full transcript on our website. Subsc…
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With high health bills drowning patients in debt, some lawmakers want nonprofit hospitals to give away more free care. But experts warn that could wind up being worse for patients. Guests: Ge Bai, PhD, CPA, Professor of Accounting at Carey Business School, Professor of Health Policy at Bloomberg School of Public Health at Johns Hopkins University J…
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A handful of states allow terminally ill people to take life-ending medications prescribed by a doctor instead of waiting for death. This week, we talk with journalist Steven Petrow about his sister’s choice to use medical aid in dying. Guest: Steven Petrow, Journalist and author Learn more and read a full transcript on our website. Subscribe to ou…
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Companies claim they can catch cancer sooner with new blood tests and full-body MRI scans. What are the risks and benefits? Guest: Ishani Ganguli, MD, MPH, Assistant Professor of Medicine, Harvard Medical School; primary care physician, Brigham and Women's Hospital Learn more and read a full transcript on our website. Subscribe to our weekly newsle…
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A live conversation between a top federal health official and a health care executive about how they must work together to keep AI from exacerbating racial bias in health care. Guests: Micky Tripathi, PhD, MPP, National Coordinator for Health Information Technology, U.S. Department of Health and Human Services James Ellzy, MD, Chief Health Officer,…
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In this special episode of Impossible Tradeoffs, I sit down with Latika Bourke - a journalist who I first met in Sydney ten years ago - who now has her own Substack at . In celebration of Facebook’s 20th birthday we sat down to take a look back at the role the platform has played in politics and elections and what we might expect going forward. Get…
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Key court decisions in 2024 about prescription drug prices, abortion bans, gender affirming care and the Affordable Care Act could change the way health care is delivered in America. Guests: Zach Baron, Co-director of Health Policy and the Law Initiative, O’Neill Institute for National and Global Health at Georgetown University Law Center Katie Eye…
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Fentanyl killed 75,000 people in 2022. Now it’s making one of the few treatments for opioid addiction harder to use. Guests: Eric Ezzi, Certified Recovery Specialist, Penn Medicine Ashish Thakrar, MD, Assistant Professor of Medicine, University of Pennsylvania Leslie Suen, MD, Assistant Professor of Medicine, University of California San Francisco …
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We've got a lot to share with you in 2024! We're looking into how fentanyl and other synthetic opioids are upending long established treatments for opioid addiction, and what clinicians and policymakers are doing to adapt. There are a bunch of cases in the courts this year that have the potential to change Americans' access to care, and restrict th…
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Last fall, the federal government named its first 10 targets for historic drug price negotiations with big pharma. Those negotiations are expected to heat up this February when federal officials make their opening price offers. This week, we offer a refresher on how this negotiation process will work and the impact it could have. Guests: Anton Avan…
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More than 130 hospitals have closed in rural America over the last decade. Reporter Sarah Jane Tribble spent a year embedded in one small Kansas town as they dealt with their own hospital closure. Guest: Sarah Jane Tribble, Senior Correspondent, Kaiser Health News Read a transcript of this conversation: https://tradeoffs.org/2020/10/08/losing-a-hos…
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It’s our last podcast of the year! Thank you all for joining my journey in starting this podcast. As a reminder, I’ll take some time off before restarting episodes in 2024. Don't forget to fill out this short form if you have ideas for what you’d like to see. This week’s fun trade-off is: For our last guest of 2023, I’m welcoming Sarah Oh to the po…
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From where medical students are choosing to train to how doctors are caring for women in reproductive health crises, the Supreme Court's decision to overturn Roe has had major ripple effects on the field of medicine. In this conversation from our friends at STAT's First Opinion podcast, host Torie Bosch talks with two abortion providers about what …
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You all like your guacamole! In last week's poll, 64% of you voted for it over queso. I have friends who have strong feelings on either side of this debate. Maybe someday I’ll expand this podcast beyond just impossible tradeoffs in tech. By the way, I’m on team queso. This week’s fun tradeoff question is: This week, we are traveling to Mexico. They…
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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, MI…
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There are only a few more episodes of Impossible Tradeoffs for 2023! Today’s fun tradeoff question is a real challenge: From past tradeoff questions, most of you who took the polls prefer to live in the city (81%) rather than the country (19%). An equal number of you like to travel by plane and automobile (38%), and 25% of you like to take the trai…
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There’s growing excitement that artificial intelligence can make health care better by speeding up care, improving diagnoses and easing the burden on a burned out workforce. But there are also concerns that these powerful new tools will perpetuate biases and inequities long baked into our health care system. In Part 2 of our special series on racia…
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Welcome to this week’s podcast. The fun question to kick things off with is … For this week’s podcast, we are heading to India. I’ve been following Indian politics since late 2013 and find it absolutely fascinating. Their elections are unlike any anywhere else in the world. To help us navigate all of that, Shoaib Daniyal joins me from the news webs…
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There’s growing excitement that artificial intelligence can make health care better by speeding up care, improving diagnoses and easing the burden on a burned out workforce. But there are also concerns that these powerful new tools will perpetuate biases and inequities long baked into our health care system. In the first of two back-to-back episode…
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Hi all, we are back after a week break for Thanksgiving with a new episode! This week, I recorded three more interviews, which, along with the ones I already have in the hopper, will take us through December 28th. After that, I plan on taking a short break - no more than a few weeks - to think about how I can make the podcast better. I’ve enjoyed p…
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In this special episode we reflect on a few of our favorite stories of 2023 and hear how they’re making a difference for patients and policymakers. Guests: Hannah Neprash, PhD, Assistant Professor, University of Minnesota School of Public Health Jami Snyder, MA, president and chief executive officer of consulting firm JSN Strategies Learn more and …
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Hey all, since I’m off elk hunting, there’s no fun question or intro interview for this episode. Instead, we’re going to jump right into the main discussion. This week, I chatted with Phumzile Van Damme, a fellow at Harvard and a long-time expert at the intersection of technology and human rights. She was kind enough to walk me through all things e…
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One out of every four Medicare patients in the hospital is the victim of a medical error. Over the past 20 years, a growing number of hospitals have adopted practices that discuss medical mistakes and offer support to the people who must cope with the often tragic consequences. We examine why experts are calling on the Biden Administration to make …
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From last week's poll, most of you prefer physical books to digital ones. Physical books won 73 percent to 27 percent. This week’s question is: This week, we are nerding out on all things digital campaigning and the platforms’ approach to elections. First up is my interview with Henri Makembe who is the CEO of Do Big Things - a creative services fi…
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Congress banned most surprise medical bills back in 2020, with one major exception: ambulance rides. Most people agree that patients should be shielded from these unexpected charges. But who should pick up the tab instead? As state and federal policymakers grapple with that question, we delve into why finding a fair solution is harder than you’d th…
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Welcome to another episode of Impossible Tradeoffs! Thank you all for bearing with me as I get used to being a podcast host. Listening to this latest episode, I realize I use some phrases a lot - like I’m always very excited for my guest. I'm going to work on standardizing some of these things. But this is another interesting episode — first, the f…
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Health care leaders are spending more time and money trying to improve the way doctors and nurses talk with their patients, to build more trust. Are those efforts working? We eavesdrop on some difficult conversations between patients and providers, and meet researchers who are measuring the power of using just the right words. This episode first ai…
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I have to apologize to you all. I forgot to put a poll in last week’s podcast notes about our fun tradeoff, which was how you would want to unwind. I won’t make that same mistake this week! The hard question for you today is: This week, we are joined by a bunch of exciting guests. First up is Diane Chang. Diane is a journalist-turned-product manage…
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California’s Medicaid program is two years into the nation’s most ambitious effort yet to cover non-traditional health care services like housing and food for some of the state’s sickest and most vulnerable residents. Everyone expected this transformation — known as CalAIM — to take some time to hit its stride. We dig into CalAIM’s early challenges…
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