\n\t\t\t\t@danweissmann.bsky.social\t\t\t<\/a><\/p>\n\t\t\tHost and producer of “An Arm and a Leg.” Previously, Dan was a staff reporter for Marketplace and Chicago’s WBEZ. His work also appears on “All Things Considered,” the BBC, “99% Invisible,” and “Reveal,” from the Center for Investigative Reporting.\t\t<\/p>\n
\n\t\tCredits\t<\/h3>\n
\tEmily Pisacreta
\n\tProducer<\/p>\n
\tClaire Davenport
\n\tProducer<\/p>\n
\tAdam Raymonda
\n\tAudio wizard<\/p>\n
\tEllen Weiss
\n\tEditor<\/p>\n
\t\t\t\t\tClick to open the Transcript\t\t\t\t<\/p>\n
\t\t\t\t\t\tTranscript<\/strong>: NYT\u2019s Ron Lieber: \u2018These people are not going to win.\u2019<\/strong>\t\t\t\t<\/p>\nNote: \u201cAn Arm and a Leg\u201d uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.<\/em><\/p>\nDan:<\/strong>\u00a0Hey there.\u00a0Let\u2019s meet somebody.\u00a0<\/p>\nRon Lieber:\u00a0<\/strong>I\u2019m Ron Lieber. I write the \u201cYour Money\u201d column for the New York Times. I write all sorts of books, and I live in Brooklyn, New York.<\/strong><\/p>\nDan:<\/strong>\u00a0 Ron\u2019s specialty is beating the system: How to not pay more than you really need to. His most recent book \u2014 about paying for college \u2014 we\u2019ve practically worn out our copy around my house.\u00a0<\/p>\nNow, it\u2019s possible Ron\u2019s not the\u00a0most<\/em>\u00a0prominent journalist in his household. A major Hollywood movie a few years ago had Zoe Kazan starring as Ron\u2019s wife, Jodi Kantor.\u00a0<\/p>\nZoe Kazan as Jodi Kantor:<\/strong>\u00a0Hi. We\u2019re from the New York Times. I believe you used to work for Harvey Weinstein.<\/strong><\/p>\nDan:<\/strong>\u00a0She was one of the reporters who exposed the movie producer Harvey Weinstein\u2019s history of sexual assault, and helped kick start the Me Too movement. I mean, that\u2019s hard to beat.\u00a0<\/p>\nIn 2024, Jodi was diagnosed with breast cancer, and she got scheduled for surgery at Memorial Sloan Kettering on a Monday morning in December.<\/p>\n
Ron Lieber:<\/strong>\u00a0And she was doing all the things you\u2019re supposed to do to get ready for surgery. She did the meditation for a week and, you know, she wound down everything at work she went away for a couple days with friends.<\/strong><\/p>\nDan:<\/strong>\u00a0So on Saturday, two days before surgery, Jodi is on that trip with friends. Ron spends the day with their 9-year-old, just the two of them.<\/p>\nRon Lieber:<\/strong>\u00a0And we get home and there\u2019s a pile of mail and I put the 9-year-old to bed and I start going through the mail and there is a fat envelope from United Healthcare.<\/strong><\/p>\nDan:<\/strong>\u00a0Ron says he suspects right away that it\u2019s bad news about the surgery.<\/p>\nRon Lieber:<\/strong>\u00a0And sure enough it\u2019s, you know, kind of pages of gobbledygook, but it\u2019s clear from the cover page, that they\u2019re issuing a partial denial, in effect, and we have, flunked partially, our prior authorization test.<\/strong><\/p>\nDan:<\/strong>\u00a0Prior authorization. It rings a bell. He does a quick search to get his bearings\u2013 and quickly realizes: This is a HUGE phenomenon. It hasn\u2019t hit him personally before, but it hits millions of people every year.<\/p>\nRon Lieber:<\/strong>\u00a0So at this point, a whole bunch of stuff goes through my head.<\/strong><\/p>\nDan:<\/strong>\u00a0First, professional embarrassment. Ron\u2019s a personal finance columnist at the New York Times. And he\u2019s thinking: how could he have missed something that causes so much personal financial distress to so many people?\u00a0<\/p>\nRon Lieber:<\/strong>\u00a0I had that same feeling that I did in 2008.<\/strong><\/p>\nDan:<\/strong>\u00a0When the financial crisis hit and he hadn\u2019t seen it coming.\u00a0<\/p>\nRon Lieber:<\/strong>\u00a0Back in 2008. It was, you know, Ron, why did you not become an expert on mortgage securitization before now?<\/strong><\/p>\nDan:<\/strong>\u00a0This time, it\u2019s prior authorization.\u00a0Ron manages to forgive himself pretty quickly on that score\u2013 and move on to more pressing concerns.<\/p>\nRon Lieber:<\/strong>\u00a0The first thing I gotta figure out is: What am I gonna say to Jodi?<\/strong><\/p>\nDan:<\/strong>\u00a0Is he gonna crash her pre-op mellow she\u2019s worked so hard for?\u00a0<\/p>\nAnd second: How worried should they be?<\/p>\n
Ron Lieber:<\/strong>\u00a0Should we show up on Monday? What\u2019s the worst thing that can happen? And so I\u2019m starting to do mental math, like what\u2019s the rack rate for this procedure anyway, and I\u2019m thinking, eh, probably 150- $200,000. Right?<\/strong><\/p>\nDan:<\/strong>\u00a0Yeah, like real money. This is the point when a lot of people would decide to reschedule surgery. But Ron digs into the paperwork, and he can see this denial is a mistake. United isn\u2019t even denying the reconstructive part of Jodi\u2019s surgery \u2014 the part a plastic surgeon does. They\u2019re denying the mastectomy itself.<\/p>\nThat\u2019s gotta be wrong. And Ron decides that is not going to stick.<\/p>\n
Ron Lieber:<\/strong>\u00a0These people are not going to win. I am going to win, because I\u2019m Ron Lieber.<\/strong><\/p>\nDan:<\/strong>\u00a0He\u2019s a professional at beating the system.\u00a0<\/p>\nRon Lieber:<\/strong>\u00a0I\u2019m gonna stand up for my wife.<\/strong><\/p>\nDan:<\/strong>\u00a0And he\u2019s not in this alone.<\/p>\nRon Lieber:<\/strong>\u00a0I work for a big company. We have excellent HR people.\u00a0<\/strong><\/p>\nDan:<\/strong>\u00a0And he figures the hospital will hold up their end in this fight.<\/p>\nRon Lieber:<\/strong>\u00a0I imagine that there are 10, 15, 20 people at Memorial Sloan Kettering who do nothing but deal with nonsense, all day long. So one way or another, we\u2019re gonna win.<\/strong><\/p>\nDan:<\/strong>\u00a0One thing he says knows he WON\u2019T do in this fight: Let on to anybody at the hospital or the insurance company that they should give him special treatment because he, you know, works for the New York Times.<\/p>\nRon Lieber:<\/strong>\u00a0We have the strictest ethics code, probably on the planet, right? We get fired for throwing our weight around. The moment you open your mouth at 1-800 United Healthcare and say, I work for the New York Times, stop messing around with me, you lose your job. There\u2019s no second chances.<\/strong><\/p>\nDan:<\/strong>\u00a0He DOES plan on taking notes. Because eventually, this could be a good story.<\/p>\nAnd I\u2019ll just tell you right now. It was. Ron eventually put his family\u2019s story in the New York Times, looking to help other people avoid \u2014 at the least \u2014 getting a scary notice that there\u2019s some problem with their insurance with no time to do anything about it.<\/p>\n
Hundreds of readers wrote back with their own stories, with suggestions, with complaints.<\/p>\n
And Ron responded by coming back to the story with a tool he hoped people \u2014 actually people\u2019s doctors \u2014 could use to prevent these kind of scary situations, at least some of them.<\/p>\n
I freaking love it.<\/p>\n
This is An Arm and a Leg \u2014 a show about why health care costs so freaking much, and what we can maybe do about it. I\u2019m Dan Weissmann. I\u2019m a reporter, and I like a challenge. So the job we\u2019ve chosen on this show is to take one of the most terrifying, enraging, depressing parts of American life, and bring you something entertaining, empowering, and useful.<\/p>\n
Jodi comes home from her trip with friends on Sunday. Surgery is scheduled for the next morning, first thing. Ron tells her the news. She hits the roof.<\/p>\n
Ron Lieber:<\/strong>\u00a0She\u2019s not angry, she\u2019s just sad and she\u2019s stressed all the things that should not happen, right, when you\u2019re going into major surgery.\u00a0<\/strong><\/p>\nDan:<\/strong>\u00a0Meanwhile, Ron does what he can to get the insurance thing resolved. Which, on a Sunday, isn\u2019t much.\u00a0<\/p>\nRon Lieber:<\/strong>\u00a0There\u2019s this stupid appeal form that you can send to a supposed emergency fax line. So, you know, I download E-fax for the first time in 19 years, um, and send the fax off into the ether. Nothing happens.<\/strong><\/p>\nDan:<\/strong>\u00a0Next morning, they show up for surgery, and once Jodi\u2019s under anesthesia, Ron figures he\u2019s got 6 hours to kill, maybe eight.<\/p>\nSo he starts roaming the hospital campus, looking for someone who could explain what was up, and what to do.<\/p>\n
Ron Lieber:<\/strong>\u00a0So I was just showing up at desks saying, Hey, check out this love letter I got from UnitedHealthcare.<\/strong><\/p>\nDan:<\/strong>\u00a0And the people at those desks are like, Oh wow\u2013 we got one of these TODAY?\u00a0<\/p>\nBecause Ron and Jodi\u2019s story was playing out against the backdrop of a much bigger story, one that had started just a few days before.<\/p>\n
Jessica Tisch: In Midtown Manhattan, early this morning, 50-year-old Brian Thompson, the CEO of UnitedHealthcare was shot and killed in what appears at this early stage of our investigation to be a brazen, targeted attack.<\/strong><\/p>\nNews announcer:<\/strong>\u00a0Protestors have targeted United Healthcare, which reportedly denies one of every three claims.\u00a0<\/strong><\/p>\nNews reporter:<\/strong>\u00a0CBS news also confirms law enforcement found shell casings at the crime scene with the words deny, defend, and depose written on them.<\/strong><\/p>\nDan:<\/strong>\u00a0Those words \u2013 \u201cdeny, defend, depose\u201d\u2013 they suggested to lots of people that issues like prior authorization played a role in the killer\u2019s motivation.\u00a0<\/p>\nAnd: Police were chasing the suspected shooter\u2013 later identified as Luigi Mangione\u2013 that very morning. So when Ron shows up at the billing office with his UnitedHealthcare denial\u2026<\/p>\n
Ron Lieber:<\/strong>\u00a0People are like, oh, is he still on the loose? They just, just couldn\u2019t believe that like this thing, you know, that Luigi was clearly upset about, right, was presenting itself in real time while he was still being chased.\u00a0<\/strong><\/p>\nDan:<\/strong>\u00a0They also quickly reassured Ron about his immediate situation.<\/p>\nRon Lieber:<\/strong>\u00a0The nice woman in the billing office, you know, clicks a bunch of keys on her keyboard and she pulls it up and she said, oh yeah. She said, this isn\u2019t gonna be a problem. She said, it may take a while. But don\u2019t worry about it.<\/strong><\/p>\nDan:<\/strong>\u00a0And she said something else that gets Ron\u2019s wheels spinning.<\/p>\nRon Lieber:<\/strong>\u00a0She said, we got notice of this, you know, seven or eight days ago. If we had thought that there was gonna be a problem, we would\u2019ve called you right away and told you not to come.<\/strong><\/p>\nDan:<\/strong>\u00a0Ron was thinking: I sure wish you\u2019d have given us a heads-up \u2014 and this kind of reassurance \u2014 before now.<\/p>\nRon Lieber:<\/strong>\u00a0I\u2019m mad because we didn\u2019t find out about it until 36 hours ahead of time when it was too late to do anything \u2019cause it was Saturday night and the surgery was Monday morning. So why didn\u2019t you just tell me?<\/strong><\/p>\nDan:<\/strong>\u00a0And he\u2019s thinking: Ok, what\u2019s my next move?<\/p>\nRon Lieber:<\/strong>\u00a0There are three voices played simultaneously in my head at a minimum. Number one is I\u2019ve got a personal situation on my hand that I gotta solve, you know, as cheaply as possible. Number two, this is a story and I ought to be taking really careful notes, not just for my own purposes, but to make sure that I\u2019ve documented things correctly and so that I can, you know, make the best case to the reader and, and the best case to the entities involved when it comes time to ask them some questions. And then number three. Try to avoid as best as I can, compromising the story in any way. Right? So like, don\u2019t lose your temper, don\u2019t lose your patience. Try not to even utter the words the New York Times\u2026<\/strong><\/p>\nDan:<\/strong>\u00a0How do you not blow your cover?\u00a0<\/strong><\/p>\nRon Lieber:<\/strong>\u00a0Exactly. Right.<\/strong><\/p>\nDan:<\/strong>\u00a0And there\u2019s another thought: UnitedHealthcare is like the day\u2019s top story. It\u2019s coming out that this issue \u2014 pre-authorization \u2014 seems to be one of the alleged killer\u2019s big issues.<\/p>\nRon Lieber:<\/strong>\u00a0So then I have a conversation with my editors while Jodi is still under anesthesia saying, I think I wanna write about this right now. Right? So this is like an hour before they catch Luigi. We\u2019re right on the news here and I think this is the thing that he was upset about and we should just go with it. And my editor correctly said \u201cno.\u201d In order this for this to be, um, a useful story for the reader and to make sure we are 182% in compliance, you know, with our ethical responsibilities, we gotta let this thing play out to its conclusion on its own.<\/strong><\/p>\nDan:<\/strong>\u00a0Ron went back to focusing on what really mattered to him right then. Which was not getting a scoop.\u00a0<\/p>\nRon Lieber:<\/strong>\u00a0I was not the main character here. My wife was the main character, right? She was sick. We were trying to fix her. It was a big deal. and I was sort of relieved, you know, at two in the afternoon when my editor was basically like, hit the pause button on this thing.<\/strong><\/p>\nDan:<\/strong>\u00a0And there was more relief coming right up.<\/p>\nRon Lieber:<\/strong>\u00a0Jodi does great. The surgery\u2019s successful. The surgeons did an amazing job.They were happy. Recovery was perfect. And we feel real good and so I\u2019m sort of watching the mail.<\/strong><\/p>\nDan:<\/strong>\u00a0Waiting for a super-high bill from the hospital. Or some word from United. Weeks go by. Nothing.<\/p>\nRon does something that I wouldn\u2019t expect \u2014 or necessarily advise \u2014 any normal person to do, any civilian: He keeps waiting.\u00a0<\/p>\n
Partly \u2018cause he\u2019s super-confident that this will work out, and as a reporter, he\u2019s gathering data: What would the system do, just left to its own devices?<\/p>\n
Finally, on March 1st \u2014 more than two and a half months after Jodi\u2019s surgery \u2014 Ron calls United. He says, \u2018Hey, you said in early December that you were denying us, and I faxed you an appeal. I was just wondering: any news?\u2019<\/p>\n
Ron Lieber:<\/strong>\u00a0And they took a look and they said, oh yeah. Um, the appeal on this one just went today to the physician, uh, who\u2019s going to review the appeal. And I said, you guys waited like two and a half months to do that. And they said, yep. Um, uh, and I thought, well, okay.<\/strong><\/p>\nDan:<\/strong>\u00a0Ron gets off the phone. Waits another few weeks before he finally calls again and hears from a United rep: Yep, this seems to be resolved.<\/p>\nEventually, Ron gets a bill. It\u2019s reasonable. He pays it. And switches to reporter mode.<\/p>\n
So Ron the Reporter gets to ask the same questions Ron the Civilian has been asking all along.<\/p>\n
Couldn\u2019t someone have given him and Jodi a heads-up earlier?<\/p>\n
Ron:<\/strong>\u00a0Why did you not just tell us immediately, not through the United States Mail, you know, which some people don\u2019t even open and some people don\u2019t get. Why did you not send up some kind of flare? Send us a text. Call us on her phone, send an email, um, do all three at once. Like fly a freaking, you know, banner over Prospect Park saying, \u2018Ron and Jodi call UnitedHealthcare right now. You have a problem.\u2019\u00a0<\/strong><\/p>\nDan:\u00a0<\/strong>There\u2019s a whole HUGE set of questions to ask about prior authorization itself \u2014 like, why on EARTH would you deny a mastectomy for breast cancer??<\/p>\nBut for this story, Ron\u2019s keeping a narrow focus.<\/p>\n
Ron Lieber:<\/strong>\u00a0The conversation I wanna have with UnitedHealthcare is not, you\u2019re terrible. The system is terrible. Prior authorization is terrible. All I wanted to know was, given that we have to live within this system for now, why didn\u2019t you call us?<\/strong><\/p>\nDan:<\/strong>\u00a0The first words of that question\u2013 GIVEN THAT WE HAVE TO LIVE WITHIN THIS SYSTEM FOR NOW \u2014 rang out so loud for me. Because, God help us,\u00a0we do.<\/p>\nAnd it is such a reasonable question: Isn\u2019t giving people a heads-up the LEAST you could do? So, Ron asked. On the record.<\/p>\n
Ron Lieber:<\/strong>\u00a0And here\u2019s what they said. Um, they said, yeah, you know, we know more needs to be done here about prior auth, you know, blabbity, blah, blah. And then they said this: \u2018We continue to make our own changes to help members navigate through these types of situations, including by offering the opt-in paperless communications.\u2019<\/strong><\/p>\nDan:<\/strong>\u00a0Opt-in. Like \u2014 oh, well. You COULDA opted in. Ron was like: Grr. You trying to say it\u2019s my fault, because I didn\u2019t opt in? He says he kept arguing to the United spokesperson \u2014 who he says was a total gentleman \u2014 you really should just go ahead and give people notice. He says it didn\u2019t take.\u00a0<\/p>\nRon Lieber:<\/strong>\u00a0So I thought to myself, okay, UnitedHealthcare doesn\u2019t seem that excited to change their processes 180 degrees and do what I\u2019m telling them to do.\u00a0<\/strong><\/p>\nDan:<\/strong>\u00a0And by the way, Ron says he has one idea about why they wouldn\u2019t.<\/p>\nRon Lieber:<\/strong>\u00a0 If they sent out the kind of notices that I am suggesting, they would need twice as many phone reps and it would cost them a ton of money. And they actually do not want people calling about this. But then I had another idea about how to work around them.<\/strong><\/p>\nDan:<\/strong>\u00a0And that is coming right up.<\/p>\nThis episode of An Arm and a Leg is a co-production between Public Road Productions and KFF Health News. KFF Health News is a nonprofit newsroom covering health issues in America. Their journalists win all kinds of awards, every year. We are honored to work with them.<\/p>\n
So Ron has another idea about how \u2014 if we have to live in a system where insurance companies issue stupefying, horrifying denials of care to millions of people \u2014 we don\u2019t have to get the news at the last possible minute.<\/p>\n
And it\u2019s this: Maybe our PROVIDERS could help us out here. I mean, they want to treat us. They want to get paid. We\u2019re a natural team.<\/p>\n
So there was an obvious question to ask the folks at Memorial Sloan Kettering: the question he\u2019d held back from pressing on the day of Jodi\u2019s surgery.<\/p>\n
That\u2019s when the lady from the billing department told him they\u2019d known about United\u2019s denial for seven or eight days. Why didn\u2019t you give us a heads up?<\/p>\n
Ron Lieber:<\/strong>\u00a0And, um, basically their response went like this, well, we just don\u2019t wanna bother patients with this. We only wanna bother them with, uh, what they described as clinically necessary information. But here\u2019s my response to that, right? Pre-surgery, mental health ought to be part of the institution\u2019s concern, right? You want people walking in there with their heads clear, without too much worry, without too much fear.<\/strong><\/p>\nDan:<\/strong>\u00a0And again: Ron didn\u2019t find himself persuading Memorial Sloan Kettering to change their policy.<\/p>\nSo when he wrote all this up in a column \u2014 in August, more than eight months after Jodi\u2019s surgery \u2014 he basically had a couple pieces of advice for readers.\u00a0<\/p>\n
One: Yeah, if your insurance requires you to OPT-IN to get a heads-up, then\u2026 OK, opt in.<\/p>\n
And two: If you need some kind of treatment, ask your doctor\u2019s office some questions: Is prior authorization gonna come into play here? Can you start requesting it ASAP, so we can avoid some last-minute scramble? And if you hit any roadblocks, can someone give me a heads-up right away? And if *I* find out about a problem, who in your office should I call?<\/p>\n
That column got people\u2019s attention. More than 500 people left comments. Ron says even for the New York Times, that\u2019s a lot. A lot of them were supportive. A lot were from people who\u2019d had much worse experiences than Jodi and Ron.<\/p>\n
Ron Lieber:<\/strong>\u00a0There were multiple notes from people who said, I was sent home the morning of surgery because they cannot work it out. And there was one person who had already had the anesthesia stuck in her arm and they yanked the needle out and had to send her away to come back and try another day.\u00a0<\/strong><\/p>\nDan: Oh my God.<\/strong><\/p>\nRon Lieber: And then there was like a small handful of readers that were basically like, you\u2019re an idiot, right? How did you not investigate the possibility of an insurance denial ahead of time?\u00a0<\/strong><\/p>\nDan:<\/strong>\u00a0He thought about giving that advice in a follow-up column: Never turn your back for a minute. Make multiple calls.<\/p>\nBut he decided to take a different approach.<\/p>\n
Ron Lieber:<\/strong>\u00a0And I thought, okay, well how could this have been avoided, um, in our situation? Oh, they could have just given us a very plain spoken piece of paper, you know, upon diagnosis or when we scheduled the surgery.<\/strong><\/p>\nDan:<\/strong>\u00a0Something to give them a heads-up that this kind of thing could happen. In his newsletter, he asked readers for suggestions about what that piece of paper should say.<\/p>\nHe says he got lots of responses \u2014 including from some angry physicians.\u00a0<\/p>\n
Ron Lieber:<\/strong>\u00a0Who said to me, who are you to tell me how to run my medical practice? And then, and this was the loudest one. This is not my fault. Why are you putting this on me? And there were just as many doctors who wrote in who said, hey, in case I miss the story, can you send this to me when it comes out?\u00a0<\/strong><\/p>\nDan:<\/strong>\u00a0And he got lots of good suggestions. So he published a column with a template for a note doctors could use.<\/p>\nRon Lieber:<\/strong>\u00a0It said: \u2018Hey, um, here\u2019s what prior authorization is, and here\u2019s how it works. Um, sometimes people run into problems, um, where the insurance company says that they\u2019re not gonna pay for stuff. We don\u2019t want you to worry about this. You can call us here or email us here if you run into these issues, and we will try to take care of it. If you have any questions about this form, please call our billing specialist. We understand that you don\u2019t want to take up valuable exam time talking about this with the doctor. Frankly, our doctors don\u2019t either, but we wanna make sure that you know about this ahead of time.\u2019<\/strong><\/p>\nDan:<\/strong>\u00a0Again, lots of responses.\u00a0Useful responses.<\/p>\nRon Lieber:<\/strong>\u00a0I got incredibly good critical feedback. And I realized that the note could get a lot better.<\/strong><\/p>\nDan:<\/strong>\u00a0For instance, Ron\u2019s initial memo included some grouching about insurance companies, from a doctor\u2019s point of view. For instance:<\/p>\n\u201cOften, a doctor will have to do what\u2019s known as a peer review with someone from the insurance company. We find this burdensome, since the \u201cpeer\u201d on the line with us may not have the same level of expertise as we do. That prolongs the call, adds to our overall operating expenses and keeps us from spending more time with you, the patient.\u201d<\/p>\n
And although lots of doctors say exactly those things in lots of forums, they don\u2019t do it on hospital letterhead.\u00a0<\/p>\n
Ron Lieber:<\/strong>\u00a0There were some doctors who said, uh, There\u2019s no way I could ever get this by our lawyers. Um, you know, nice try, uh, wish I wish I could, but ain\u2019t gonna happen over here. To which I said, send it to your lawyer and have them call me and we can have a conversation about what would pass muster.<\/strong><\/p>\nDan:<\/strong>\u00a0Other readers told Ron the language just needed to be simpler. They\u2019d his note through software that analyzes a piece of text for reading difficulty.\u00a0<\/p>\nRon Lieber:<\/strong>\u00a0And then wrote me notes and said, this is written at a 12th grade level. And like, my patients don\u2019t speak English at a first language, or they\u2019re never gonna read this, and you need to write it at a fifth grade level. And so I, so I thought, okay, yeah, that\u2019s, that\u2019s pretty good advice<\/strong>.<\/p>\nDan:\u00a0<\/strong>Ron digested all the feedback on the memo he\u2019d published.<\/p>\nRon Lieber:<\/strong>\u00a0And then I published another one, which was better, right? It was shorter, the language was plainer. I took out the the commentary<\/strong>.<\/p>\nDan:<\/strong>\u00a0We\u2019ll have a link to that second version wherever you\u2019re listening to this. If you\u2019re a health care worker \u2014 or know some health care workers who might find it useful \u2014 please check it out, pass it around.<\/p>\nOf all the comments on Ron\u2019s stories, one that stuck with me was from a reader who made a wish that was actually like a lament\u2013 on behalf of anybody who needed major medical care. Anyone in that situation, they wrote, Quote: \u201cshould be enrolled in a certificate course for how to navigate the healthcare system.<\/p>\n
Ron Lieber:<\/strong>\u00a0So this is the thing, Dan, right? This is why I have a job and I\u2019m pretty sure this is why you have a job too. And I would love to be put out of business, right? But the way in which I would be put out of business. Is if there were mandatory certificate programs in 25 different categories of personal finance existence, right. And so that\u2019s how I would be put outta business. But because nobody\u2019s ever gonna require such a certificate in, in any of the areas of personal finance that we are forced, um, to wade through as human beings, I have a job and I\u2019m just trying to do a better job of it.<\/strong><\/p>\nDan:\u00a0<\/strong>?I hear that. There is so much I appreciate about having my job, but I wish it weren\u2019t so necessary. Lots of people end up in much worse circumstances than Ron Lieber and Jodi Kantor.\u00a0<\/p>\nIn a book called \u201cCoverage Denied,\u201d coming out this spring, University of Pittsburgh professor Miranda Yaver cites estimates ranging from 850 million to 3 billion denials a year.\u00a0<\/p>\n
She also cites data showing that appeals work more often than most of us think \u2014 about half the time.\u00a0<\/p>\n
But appealing is hard work. The less privilege you have \u2014 like, say if you don\u2019t have a flexible schedule to call and fax and everything else \u2014 the harder it is.<\/p>\n
She calls the result \u201cRationing by inconvenience.\u201d\u00a0\u00a0<\/p>\n
And we can all use all the help we can get making life less annoying and inconvenient. Which is why I\u2019m gonna leave you with Ron Lieber\u2019s answer to my last big question for him.\u00a0<\/p>\n
Because hearing\u00a0\u00a0one part of\u00a0his advice on how not to get blindsided by an insurance denial led to another question \u2014 one that seemed like a good one to ask an expert at beating the system.\u00a0<\/p>\n
I said:\u00a0 Hey, you recommend opting in to emails and texts from your insurance company so they might give you a quicker heads-up.\u00a0<\/p>\n
Let\u2019s say I do. How the heck am I supposed to find that in my inbox \u2014 which keeps getting harder to sort through every day with things I don\u2019t want and don\u2019t need to look at?\u00a0<\/p>\n
I asked him: How do you, Ron Lieber, manage the inbound?\u00a0 How do you identify what actually needs your attention?<\/p>\n
And he had a good answer:<\/p>\n
Ron Lieber:\u00a0<\/strong>?Yeah. So I have three email inboxes. I have, you know, work email, I have personal email that is only personal correspondence and the most vital other stuff, you know, kids\u2019 school, uh, college tuition payments. And then I have an old Yahoo email for everything else. And so, you know, I read the last 12 to 24 hours of the Yahoo email, you know, once a day or so. Uh, and then, you know, once a month, I\u2019ll open the inbox and I won\u2019t close it until I\u2019ve unsubscribed to 10 things. And, and so that keeps it more or less manageable.<\/strong><\/p>\nDan:\u00a0<\/strong>This is such good advice. I haven\u2019t had a chance to implement it since I talked with Ron \u2014 hey, I was on deadline for this episode! \u2014 but honest:\u00a0 I\u2019m going to.\u00a0<\/p>\nHere\u2019s one other thing I\u2019m going to do in the next few weeks:\u00a0 Have surgery myself. A hernia repair, it\u2019s gonna be fine, I\u2019m in great hands.\u00a0 But it\u2019s happening a few days before our next episode is scheduled to come out.<\/p>\n
So, as it happens, I\u2019ve got a great story from somebody ELSE to share with you then. We\u2019ll have another new episode of our own for you when I\u2019m back.<\/p>\n
And meanwhile, we\u2019ll keep the First Aid Kit newsletter coming. If you aren\u2019t subscribed, it\u2019s really good!\u00a0<\/p>\n
My colleagues Emily and Claire have been serving up need-to-know information:\u00a0 Like, when you get your annual checkup\u2026 what\u2019s actually covered?\u00a0 A lot of the time, it\u2019s less than you\u2019d think.<\/p>\n
Which sucks, but is SO important to know. If you\u2019re not signed up, check it out at arm and a leg show dot com, slash, newsletter.<\/p>\n
I\u2019ll catch you soon. Till then, take care of yourself.<\/p>\n
This episode of An Arm and a Leg was produced me, Dan Weissmann, with help from Emily Pisacreta \u2014 and edited by Ellen Weiss.\u00a0<\/p>\n
Adam Raymonda is our audio wizard.<\/p>\n
Our music is by Dave Weiner and Blue Dot Sessions.\u00a0<\/p>\n
Claire Davenport is our engagement producer.<\/p>\n
Sarah Ballema is our Operations Manager. Bea Bosco is our consulting director of operations.\u00a0<\/p>\n
An Arm and a Leg is produced in partnership with KFF Health News. That\u2019s a national newsroom producing in-depth journalism about health issues in America and a core program at KFF, an independent source of health policy research, polling, and journalism.<\/p>\n
\u00a0Zach Dyer is senior audio producer at KFF Health News. He\u2019s editorial liaison to this show.<\/p>\n
An Arm and a Leg is distributed by KUOW, Seattle\u2019s NPR news station.<\/p>\n
And thanks to the Institute for Nonprofit News for serving as our fiscal sponsor.<\/p>\n
They allow us to accept tax-exempt donations. You can learn more about INN at INN.org.<\/p>\n
Finally, thank you to everybody who supports this show financially.<\/p>\n
You can join in any time at arm and a leg show, dot com, slash: support.<\/p>\n
\u201cAn Arm and a Leg\u201d is a co-production of KFF Health News and Public Road Productions.<\/em><\/p>\n