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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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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

Nate Padgett, Chris Rill

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Nate Padgett and Chris Rill go hands-on exploring the world of hardware startups. Each month they interview founders, early team members, and industry leaders to uncover the secrets behind building successful products. From the best practices of product design, to the ins and outs of manufacturing, they leave no stone unturned in their mission to help budding entrepreneurs succeed. Join them on their journey and get the inside scoop on all the exciting and innovative developments in the hard ...
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Twenty-six states have passed bans on gender-affirming care for transgender minors, and the Supreme Court is set to hear arguments in December about Tennessee's ban. We take a closer look at gender-affirming care and the legal arguments that could influence how accessible that care is. Meredithe McNamara, MD, Assistant Professor of Pediatrics, Yale…
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In this episode of TradeOffs we connect with Tom George, former Head of Pebble at Sidewalk Labs, and now a Product Team Lead at Google focusing on Sustainable Cities. We’ll hear about Tom’s journey from working on speech compression technology for BlackBerry accessories to developing satellite communication systems for ships, and eventually leading…
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Image created by ChatGPT If I’m honest, I’m still processing everything. I’m giving myself and others the space to process everything. But, I still wanted to do a podcast. I have this deep fear that if I don’t stick to a schedule, I’ll fall off the wagon of creating content. It's probably not true, but I like to keep doing things to move forward. S…
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It’s Medicare open enrollment season, and in this episode first aired in 2021, we explain why shopping for a new plan is often tougher than it seems. Guests: Lilyan Grossman, Medicare beneficiary Tricia Neuman, ScD, Senior Vice President and Executive Director of the Program on Medicare Policy, Kaiser Family Foundation Amal Trivedi, MD, Professor o…
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In this episode, I welcome Maria Giannopoulos who shares her unique journey at the intersection of politics and technology, particularly her role in the 2024 Republican National Convention. She discusses the extensive planning involved in organizing such a large-scale event, developing a digital strategy to engage both on-site attendees and online …
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In this episode, Nicole Schneidman discusses the critical processes involved in the electoral system, emphasizing the importance of understanding what happens after voting. She outlines key dates in the election cycle, changes in election laws since 2020, and the journey of a ballot from submission to certification. The discussion also highlights t…
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One of the nation’s leading experts on the Affordable Care Act breaks down its track record and weighs in on the stakes the historic health care law faces in the lead-up to the election. Guest: Larry Levitt, Executive Vice President for Health Policy, KFF Learn more and read a full transcript on our website. Want more Tradeoffs? Sign up for our fre…
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Twenty years ago, Wired editor Chris Anderson wrote “The Long Tail” - a story about how “the future of entertainment is in the millions of niche markets at the shallow end of the bitstream.” Also, twenty years ago, the term “podcasting” was coined thanks to the introduction of the iPod and RSS feeds that could carry audio files. Today, in these fin…
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We have another bonus podcast episode for you. One perspective I wanted to get for this season of the podcast is what people outside of the United States think about the election and this country’s overall approach to tech. There’s no one better to ask that question of than Mark Scott. Mark has covered tech as a journalist and now works at the Atla…
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In this episode, Tim Harper discusses his extensive background in election administration and technology, focusing on the intersection of democracy and technology. He elaborates on his work with the Bipartisan Policy Center's task force aimed at improving election processes, as well as his current role at the Center for Democracy and Technology (CD…
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The next U.S. president will have to make consequential choices about the Affordable Care Act, prescription drug prices and abortion. We compare the positions of candidates Kamala Harris and Donald Trump on these major health policy issues. (NOTE: This episode has been updated to clarify the number of people who would lose health coverage if Afford…
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I’ve been so lucky to have some great conversations for the podcast this Fall, but with Election Day rapidly approaching in the United States, I will do two bonus Monday episodes on top of the usual ones on Thursdays to get all of this content out. First, we have Betsy Hoover and Eric Wilson discuss with me the evolving landscape of campaign techno…
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I’m excited to welcome Allie Funk, Grant Baker, and Kian Vesteinsson of Freedom House’s technology and democracy team to the podcast, who released their 2024 Freedom on the Net report this week. Our conversation revolves around the latest Freedom on the Net report, highlighting the ongoing decline of global internet freedom for the 14th consecutive…
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Journalist Paula Span, who writes The New Old Age column for the New York Times, shares what she’s learned about how to age well. Guest: Paula Span, reporter and The New Old Age columnist for the New York Times Learn more and read a full transcript on our website. Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest heal…
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Welcome to fellow newsletter writer, Bruce Mehlman who has long been a fixture in DC for his smart graphs and quarterly reports on where the trends are going, not just in politics but also in the economy, tech, national security, and more. I highly recommend you sign up for his newsletter, Bruce Mehlman's Age of Disruption. In our conversation, Bru…
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U.S. companies spend more than $1 trillion annually on health care for their employees. To get this budget-busting figure under control, some companies are experimenting with cutting out insurers, and investing in primary care clinics at the office. Guests: Amy Cooper, NP, Vera Whole Health Bob Galvin, MD, former Chief Medical Officer, General Elec…
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In this episode of TradeOffs we connect with Christina Perla, co-founder and CEO of Makelab, an on-demand 3D printing service. Christina discusses her journey from working in corporate design at Converse to co-founding Makelab, emphasizing the challenges and successes of running a hardware startup. She highlights Makelab's growth strategy, includin…
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We’re back! Thanks again to everyone for your understanding of my gap week. In this episode, Amanda Elliott and Kyle Tharp, both newsletter writers focused on digital politics, discuss their experiences and insights into the evolving landscape of political campaigning. They explore the impact of digital strategies, fundraising, and the role of soci…
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For decades, the most effective treatment for addiction to methamphetamine or cocaine has been mired in stigma and mostly limited to small research studies. But with deaths involving meth and cocaine on the rise, policymakers across the country are turning to gift cards to fight drug use. This story has been updated to clarify the research on long-…
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In this episode of TradeOffs, we sit down with Kevin Lavelle, founder of Mizzen and Main and Harbor, to discuss the challenges of building and scaling two very different companies—one in apparel and the other in pediatric telemedicine. Lavelle shares candid insights on navigating U.S. manufacturing hurdles, the importance of strategic networking, a…
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Good morning. Due to some scheduling changes, I don’t have a podcast for this week. Thank you for understanding. If you are new to the pod, I recommend you check out the archives. Some of the more popular episodes include: * A conversation with Renee DiResta about her book Invisible Rulers * Dave Willner on the evolution of trust and safety in tech…
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Many potent new medicines pose a host of challenges for drug companies trying to copy and sell similar versions on the cheap. Can those companies find a sustainable path forward, or will patients get left stuck paying exorbitant prices? Guests: Christine Baeder, MBA, President, Apotex USA Alfred Engelberg, JD, retired attorney and former counsel to…
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We’re back! Welcome to season three of Impossible Tradeoffs. This season will focus mainly on the U.S. election, how the campaigns use tech, how tech companies respond, and what people outside the United States are watching. First up is Paolo Carozza, a member of the Meta Oversight Board and law professor at Notre Dame. Earlier this week, the Overs…
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America pays less, on average, than any other major country for our generic drugs. But selling essential drugs at such low prices comes with hidden costs — from quality problems to frequent shortages. This is the second episode of Race to the Bottom, a three-part series by Tradeoffs on the problems plaguing the generic drugs we all rely on — and ho…
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Generic drugs are, in many ways, the unsung hero of America’s health care system, bringing powerful medical innovations within the reach of millions more people. These cheaper copies of brand-name drugs — from pills that stop heart attacks to antibiotics that cure life-threatening infections — save America hundreds of billions of dollars a year. Bu…
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One organization turns to a game to get employees to debate and decide together what health care they most value. Guests: Paul Fronstin, Ph.D., Director, Health Benefits Research, Employee Benefits Research Institute Jeanette Janota, Senior Research Associate, American Speech-Language-Hearing Association Tavril Saint Jean, Senior Research Associate…
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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. Want more Trade…
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In The Fifth Branch, Tradeoffs explored new ways to respond to people in a mental health crisis, this week we have look at another area of the mental health crisis the country is grappling with. 'Lost Patients', a new podcast from KUOW and The Seattle Times, dives into why so many people with mental illness live on the streets, and lack long-term c…
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The Inflation Reduction Act gave Medicare historic new power to directly negotiate the prices of some of the costliest prescription drugs. Now the federal agency must grapple with a difficult question: What makes a drug price fair? This week, we revisit our 2023 episode explaining how this negotiation process works and the impact it could have. Gue…
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I’ve got another special episode of the Summer Spectacular podcast for you with my good friend Emi Kolawole. Emi has 10 years of experience in communications, design, and tech. In our conversation, she shares her insights from attending the Aspen Ideas Festival and the Socrates program. She highlights the importance of including diverse voices, par…
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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. Want more Tradeoffs? Sign up f…
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Alternative response teams are being asked to tackle vexing problems: mental illness, homelessness, addiction. How much can they actually do? We explore how Durham grapples with connecting people to long-term care and support, and where the city draws the line between crisis response and social services. Guests: Ryan Smith, Director, Durham Communi…
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How do you keep everyone safe? We look at HEART’s impact on the safety of Durham residents in crisis, the mental health workers responding, and the police. Guests: David Prater, Peer Support Specialist, Durham Department of Community Safety Ryan Smith, Director, Durham Department of Community Safety Yolanda, Durham resident Sgt. Dan Leeder, Durham …
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Ahead of TrustCon next week, I wanted to bring you a conversation I’ve been trying to set up since Duco released the Trust and Safety Market Research Report in March. Guests, investors Lauren Wagner and Shu Dar Yao, join me to discuss their involvement in the report and the reasons behind it. They highlight key takeaways from the report, such as th…
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How do you convince police officers that it makes sense to send unarmed mental health workers to some 911 calls? Guests: Patrice Andrews, Police Chief, Durham Police Department Ryan Smith, Director, Durham Department of Community Safety Sgt. Dan Leeder, Durham Police Department Abena Bediako, Clinical Manager, Durham Department of Community Safety …
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EMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. Nearly half of the country’s 50 largest cities - including San Francisco, New York, Hou…
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In this special bonus episode, we break down the Supreme Court’s recent abortion rulings with help from health reporter Shefali Luthra. Guest: Shefali Luthra, Health Reporter, The 19th Learn more and read a full transcript on our website. Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and new…
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Medicare is betting that taking care of the caregiver will help dementia patients stay at home longer. Patients and their caregivers are often left to navigate the confusing world of dementia by themselves, but Medicare is launching a new program to change that. Guests: Malaz Boustani, MD, PhD, Founding Director, Sandra Eskenazi Center for Brain Ca…
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I’ll admit, I wasn’t expecting to do my first Summer Spectacular episode quite this quickly. However, when Saurabh Shukla with NewsMobile pinged me on WhatsApp to offer to talk about what had happened in the Indian election, I jumped at the chance. I then saw former Integrity Institute resident fellow Alexis Crews post about her work in the EU, and…
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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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Don’t forget to follow us on YouTube! This is the last episode of season 2! Thank you all for listening. I’ll be taking a break over the summer and returning with season 3 in the Fall. Between now and then, I might be planning a few summer spectacular episodes, so keep your eyes out. I couldn’t have asked for a better person to end the season with.…
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Employers are facing a big dilemma: how do they pay for the new highly effective and popular obesity medications without breaking the bank? This week, the questions are forcing companies to re-examine their attitudes on obesity as the understanding of the disease deepens. Guests: Sean Scanlon, Connecticut Comptroller Jeff Levin-Scherz, WTW populati…
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Don’t forget to follow us on YouTube! This week Claire Wardle and Daniel Bramatti discuss their work in creating fact-checking coalitions around elections as a follow up to the guide we published back in April. They highlight the importance of collaboration and trust-building among news organizations and social media platforms. They also discuss th…
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A group of nurses in Baltimore wants to bring basic care to every person in a neighborhood regardless of age, health, income or insurance. Can this idea from abroad take root in the United States? Guests: Dawn Alley, PhD, Head of Scale, IMPaCT Care Asaf Bitton, MD, MPH, Executive Director, Ariadne Labs Regina Hammond, Founder, Rebuild Johnston Squa…
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As Congress figures out the future of telehealth, we get a reality check from a top researcher about what this care has and has not delivered. Guest: Ateev Mehrotra, MD, MPH, Professor, Brown University School of Public Health Learn more and read a full transcript on our website. Want more Tradeoffs? Sign up for our free weekly newsletter featuring…
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Don’t forget to follow us on YouTube! I’m so honored to have my good friend and expert extraordinaire Kat Duffy as my guest this week. I have no words other than you should listen to everything she says. Summary Kat Duffy, a senior fellow for digital and cyberspace policy at the Council on Foreign Relations, discusses her work in the trust and safe…
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ACK! I totally forgot to schedule this last night. So sorry for my delay. Don’t forget to follow us on YouTube! This week we welcome Nina Jankowicz to the podcast. She talks about the importance of recognizing Russia's use of disinformation as a geopolitical strategy and the need for more vocal online presence in countering disinformation. Nina als…
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Just like the rest of us, when clinicians are short on time and overwhelmed by complex decisions, their brains look for corners to cut, numbers to round, patterns to repeat. This week, Dan talks with Harvard physician and economist Bapu Jena about the surprising impact these mental shortcuts can have on our health care. Guest: Bapu Jena, MD, PhD, P…
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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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