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Dan Weissmann left public radio in 2017. Dan Weissmann was heartbroken and terrified.

The thing he was most concerned over, Weissmann says in the premiere episode of his show The Arm and A Leg, is “freaking about health insurance.” That is, how he would be able to pay for the coverage of his family members now that his job was not available.

“For decades, our career choices as well as our family’s choices — a lot of them were influenced by the thought, ‘Okay, what’s your health plan? We’re going to have to get it and that’s the way it is,'” Weissmann says.

Then it hit him. There are other people also in this boat who could need some help.

With over 20 years of experience in the media, Weissmann says health care is often discussed with three different, sometimes unhelpful lenses: The politics of the horserace, personal tragedy, or even as an enterprise.

He was looking to change the way he did things through his podcast.

Weissmann’s current study focuses on how the American healthcare system discreetly influences our daily decisions: The unexpected $500 bills that threaten to bankrupt us, the soul-crushing decision to stay at a bad job just to keep our insurance, and the is-this-heartburn-or-do-I-need-to-go-to-urgent-care decisions that so many of us weigh carefully against our wallets.

This is a very personal issue for Weissmann, who has a congenital disability in the heart. His condition made him a hurdle in obtaining insurance coverage before the Affordable Care Act took full effect in 2014. Before that, insurers could deny coverage to individuals like Weissmann who suffered from pre-existing health conditions or even charge them outrageous costs. Since then, there has been a lot of change, but the systems remain a bit shaky, Weissmann says.

More than three years since its first episode Three years after its debut, the show has been running for more than three years. Arm and a Leg is sixty-plus episodes long and packed with stories to aid listeners in navigating our complicated health system.

The month of November was when Weissmann launched a new newsletter titled the First Aid Kit with small-sized advice on paying for medical care.

Then I have to inquire. Why is health care so expensive, “an arm and a leg” in America?

There are many books about this topic. I’m unable to provide a professional answer. It’s because there’s a chance for many people to earn lots of money.

Some shady participants in the business include pharmaceutical firms, insurance companies, and significant health providers. When we come across them, it’s as if we’re being escorted to a casino and then taken to the table at the World Series of Poker. It’s a highly complex and intricate variant of the game. We’re also playing against big companies that are aware of all the rules and create the rules.

There’s no way anyone goes to this casino to win. It’s a matter of the amount we’ll lose.

Have been the Affordable Care Act changed this way of life? Did it live up to its name?

The health care and political issues are highly polarizing. I try to stay clear of politics.

I believe that the Affordable Care Act provides some enhancements. I am no longer denied health insurance due to a birth heart defect. However, the ACA didn’t solve our issues. It’s because these considerable players in the business are highly proficient at doing what they’re good at.

Even if you’re an administrator of a hospital at a non-profit institution — where you consider your job very rigorously and where your primary goal is to offer the best possible service to the most significant number of people while doing the least amount of financial damage you’re limited by the fact that you’re in essence at the poker table and playing against the other health care providers. Not just the other health providers. There’s also competition with all other pharmaceutical companies. You’re competing against them for market share, but you’re also in competition with them for capital access.

There’s every reason for you to be at the very least the size of a shark everyone else.

In the course of the numerous interviews you’ve conducted in the series, what’s the most beneficial or practical guidance you’ve received?

There’s no one-size-fits-all advice available because health professionals have myriad ways to sabotage us. The variety of unique terrible, absurd, and ridiculous issues and even the costly or annoying problems that may occur are really inexplicably endless. That’s a bummer.

But there are some points that every person should know. One of them is that we have rights. One of these rights is that we can receive an itemized invoice of all hospital charges. The non-profit hospital also must provide the “charity healthcare” policy and specify under what conditions they can reduce the amount you pay.

If they are not wealthy, you shouldn’t believe that you’re not qualified.

A third option is a right to a copy of the insurance contract. It’s not a summary of benefits two pages in length and is tentative. It’s a legally binding document that’s on about 100 pages. It lays out precisely what the legal requirements of your insurance company are. It is possible to obtain a copy. It’s probably a matter of finding a copy of it and gaining the concept. But it’s also frustrating to sit in a hold for so long and talk to millions of people who’re not responding to your queries.

How can you convince people to be aware of and protect these rights?

It’s a bit stressful. One of the most helpful tips I’ve ever sought was by a self-defense expert who explained how to stay calm when dealing with health professionals, insurance companies, and insurance companies. The type of self-defense she and her coworkers teach is known as “empowerment defense.” It’s more than simply kicking and punching. It’s more about responding to all types of threats to our security and dignity.

It’s about staying calm, setting boundaries, and standing up for yourself without creating more tension than is needed. It doesn’t do any good to become enraged at the person on the phone with you, who’s just a member of the call center, with a task to finish and perhaps a family to return home to.

What else do people need to know about navigating the health system in 2022?

A timely tip for the start of the new Year was provided by someone who listened to the show. If you’re having annual health screenings, make sure to plan them in the early part of the year. In case God maybe, uncovers something expensive and painful to treat, such as cancer, At least you’re in an upcoming year of health insurance.

A reader told me she had cancer in August. This meant the treatment began in October. Also, she had paid all of her deductibles and reached her maximum out-of-pocket. However, in January, the treatment was not completed. So the clock started once more. As she continued her treatment, she was paying the money repeatedly.

For me, it’s an excellent, terrible lesson. I’m planning this lesson for January and February for me personally.

Beginning in 2022, there’s another right worth knowing about: A brand new law in the federal government called”the No Surprises Act will take effect in the coming year and will address some of the more irritating nightmare problems that many of us have had to deal with. You visit a hospital — perhaps to the ER, give birth, or for surgery. You select a place that’s in the network and accepts your insurance. However, there’s a chance that one or more doctors who are part of the team aren’t in the network and won’t accept your insurance. Then, surprise! You receive a massive bill from your doctor entirely independent of your hospital bill. Your insurance won’t pay for much of it. You’re paying the remainder.

This is very common among ER doctors, anesthesiologists, and radiologists. In essence, all the specialists are ones you rarely choose from and, in some cases, aren’t even able to meet. Some estimates say one in five people who visit ERs or undergo surgery are charged unexpected bills, which, honestly, I believe could be a bit overstating things.

The No Surprises Act says that it’s not your fault if this occurs. For the bill. The insurance company must deal with the person trying to invoice you.

However, there are many exceptions right off the bat that include areas where it isn’t applicable for the regular ambulances and birthing centers and some urgent-care facilities. As with every other right that we enjoy in these circumstances, it will take some effort to ensure this one is enforced.

Another suggestion I have for the year ahead is to start the habit of looking over your insurance contract If you can locate it. Be aware of the doctors and services that are included in your network. Make sure you are very familiar with the places you can go to receive the care your insurance company would be most helpful.

If God forbid, if you suffer from a health emergency that requires treatment, then you’re going to be able to prepare for this.

Robert M. Brown