An Arm and a Leg is a podcast and reporting project with a clear mission: to inform and empower individuals as they navigate the often-treacherous terrain of healthcare costs in the United States. The show pairs big-picture insight into our broken system with actionable information: tools, strategies, and legal rights that many people are unaware of.
The podcast matches journalistic rigor and ambition with compelling storytelling, an eye for the often-dark humor inherent in its topic, and a strong sense of community. Listeners respond with an ongoing stream of stories, tips, and feedback.
These elements come together in an episode that caps an investigation into “facility fees.” Essentially “cover charges” for simply walking into a hospital-owned facility—which can include a stand-alone physician’s office—these fees can add thousands of dollars to a patient’s bill with little justification. They’d been on our radar for years, and to dig deeper, we asked listeners to share their experiences.
Dozens responded, including Kari Greene, from Portland, Oregon. To manage her autoimmune disorders, Kari visits a rheumatologist regularly—and was shocked when an $88 “observation room fee” appeared on her bill. The next year, the fee jumped to $99. Despite calling her insurer, she got no answers until a national expert helped the show’s reporting team dig into her policy documents, finding she likely never should have been charged the facility fee at all.
From Kari’s story, our episode zooms out to look at bipartisan efforts by policymakers in multiple states to limit facility fees—and the obstacles those efforts face.
In another episode, telling the story of tech worker Holden Karau, who developed an AI-powered tool to help people fight health insurance claim denials, the show strikes a balance: It illustrates the potential for technology to empower patients while also exploring the obstacles and dilemmas involved in bringing a tech project to scale without ethical compromise. This episode takes advantage of a pair of charming characters—Karau and her wife—to walk listeners through an often-technical story. And it gives listeners tips—and caveats—for taking advantage of this potentially game-changing tool.
Furthermore, An Arm and a Leg doesn’t shy away from examining the role of institutions and policy in shaping the healthcare landscape. In the third episode here, we report on the impact of the Trump administration’s moves to shutter the Consumer Financial Protection Bureau (CFPB), a federal agency that shields consumers from predatory practices, particularly in regards to medical debt. By featuring experts and those directly affected, the show underscores the importance of both individual action and systemic change. This story also aired on NPR’s All Things Considered.
At its core, An Arm and a Leg fosters a sense of solidarity, promoting the idea that collective knowledge and mutual support are essential tools in the fight for a more just and affordable healthcare system.
