An Arm and a Leg
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Podcast Overview
<p>An Arm and a Leg is a podcast about why health care costs so freaking much and what we can (maybe) do about it.</p> <p>If you’ve ever been surprised by a medical bill, you’re in good company. But as our team of seasoned journalists has learned from years of reporting — you’re not always helpless. We don’t have all the answers, but we’ll offer you tools and big picture insights with plenty of humor and heart. </p> <p>An Arm and a Leg is co-produced with <a href="https://kffhealthnews.org/">KFF Health News</a> and distributed in partnership with <a href="https://www.kuow.org/">KUOW</a>.</p> <p>You can support An Arm and a Leg by donating at <a href="https://armandalegshow.com/support/">armandalegshow.com/support/</a></p> <hr> <p><strong>Show Credits: </strong>Created, hosted, and produced by Dan Weissmann with senior producer Emily Pisacreta and engagement producer Claire Davenport, edited by Ellen Weiss. Audio wizard: Adam Raymonda. Music is by Dave Weiner and Blue Dot Sessions. Bea Bosco is our consulting director of operations. Lynne Johnson is our operations manager.</p>
Language
🇺🇲
Publishing Since
10/11/2018
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Recent Episodes
May 21, 2026
The Chatbot Will See You Now: Big Tech In Therapy (from Organized Money)
Host Dan Kois interviews psychologist Linda Michaels about tech companies recording therapy sessions and how Illinois's new law offers a path to better mental healthcare access.
April 27, 2026
The Supreme Court case that could slow generic drugs
<p>It’s a case you’ve (probably) never heard of: This week, the Supreme Court is hearing <a href="https://www.supremecourt.gov/oral_arguments/argument_audio/2025">oral arguments</a> in Hikma v. Amarin — a legal battle that could impact how much you ultimately pay for prescription drugs. </p> <p>Here’s why the case matters: As soon as a generic version of a brand-name drug comes to market, its price typically drops by half. Within 10 years, by more than 75%. Meaning: the sooner we have access to generics, the less we pay at the pharmacy counter. </p> <p>But one of the fastest legal pathways for generic companies to get their drugs to market may be about to get a lot narrower – depending on how the court rules later this year.</p> <p>Amarin, a brand-name drugmaker, has accused Hikma, a generic company, of encouraging doctors to infringe on their patent for a drug called Vascepa. </p> <p>The case revolves around the legal concept of skinny labels: a carveout in drug patent law that allows generic companies to bring drugs to market when one of the brand-name drug’s patents has expired, but others haven’t.</p> <p>And it raises the (unexpected) question of whether it’s OK for a generic drug company to call their product the generic version of something. </p> <p>Legal experts help us unpack the nerdy details – including how this case came to be, and what’s at stake for both generic drug companies and anyone looking forward to one day paying less for an expensive brand-name drug. </p> <p>Want to learn how these drug monopolies work – and came to be in the first place? Check out our previous episode: <a href="https://armandalegshow.com/episode/medicine-monopolies-101/">Why drugs cost so much, 101: Medicine monopolies</a></p> <p><a href="https://armandalegshow.com/episode/the-supreme-court-generic-drugs/#transcript">Here's a copy of this episode's transcript</a>. </p> <p><a href="https://armandalegshow.com/contact/">Send your stories and questions.</a> Or call 724 ARM-N-LEG.</p> <p>And of course we’d love for you to<a href="https://armandalegshow.com/support/"> support this show</a>.</p><p>See <a href="https://omnystudio.com/listener">omnystudio.com/listener</a> for privacy information.</p>
April 9, 2026
Why drugs cost so much, 101: Medicine monopolies
<p>We’re always asking: Why do drugs cost so freaking much? </p> <p>And it’s a complicated question. There are a bunch of reasons — <a href="https://armandalegshow.com/episode/pbms-2023/">to</a> <a href="https://armandalegshow.com/first-aid-kit/why-drugs-cost-so-much-and-can-be-hard-to-even-find/">be</a> <a href="https://armandalegshow.com/episode/swimming-with-sharks/">sure</a>. But in our reporting over the years, like our stories on <a href="https://armandalegshow.com/episode/the-insane-surprising-history-behind-insulins-crazy-price-and-some-hopeful-signs-in-the-wild/">insulin</a> and <a href="https://armandalegshow.com/episode/john-green-part-1/">tuberculosis drugs</a>, experts cited one big reason over and over again: </p> <p>The pharmaceutical industry wages sophisticated legal battles to keep monopoly control over their best selling, most lucrative drugs — blocking generic competition, and increasing their prices along the way. </p> <p>How did it come to be this way? </p> <p>In this first episode of a new series – what we’re calling An Arm and a Leg 101 – we’re doing a crash course in the history of the drug patent system.</p> <p>And the rags-to-riches story of one amazing guy is going to help us do it. </p> <p>Al Engelberg got schooled in the Art of the Hustle at a young age, collecting dimes at an illegal bingo game on the Atlantic City boardwalk. </p> <p>Later, he’d put those street smarts to use as he sat at the negotiation table in Washington D.C., hashing out the details of a law that would usher in the generic drug industry as we know it. Then made millions from the rules he helped write.</p> <p>And as he admits, his legacy is mixed. </p> <p>On the one hand: The rules Al Engelberg helped write — a grand bargain between generic drugmakers and patent-holding brand pharma companies— unleashed the power of generic drugs to save Americans money. </p> <p>Nine out of ten prescriptions written today get filled with a generic.</p> <p>On the other hand: In the process of making his fortune, Al Engelberg discovered loopholes, gaps, and perverse incentives in that grand bargain. </p> <p>Gaps that allowed brand and generic drugmakers to profit by keeping generics for many hit drugs off the market. </p> <p>So we now spend more than ever on medicine — and more than 20 percent of Americans report skipping their medication because they can’t afford it. </p> <p>Al Engelberg, now 86, has spent the last 30 years — and millions of his own dollars — trying to close those gaps. </p> <p>“I live in a world — a pharma world — where half the people think I’m dead, and the other half wish I was,” he tells us. </p> <p>You can read more of Al’s story — plus his prescription for fixing the crisis of high drug prices — in his book, <a href="https://www.simonandschuster.com/books/Breaking-the-Medicine-Monopolies/Alfred-Engelberg/9798888456729">Breaking the Medicine Monopolies: Reflections of a Generic Drug Pioneer</a>.</p> <p>And you can hear our earlier reporting on drug patents here:</p> <p><a href="https://armandalegshow.com/episode/john-green-part-1/">John Green vs. Johnson & Johnson (part 1)</a></p> <p><a href="https://armandalegshow.com/episode/john-green-vs-j-and-j-part-2/">John Green vs. Johnson & Johnson (part 2)</a></p> <p><a href="https://armandalegshow.com/episode/the-insane-surprising-history-behind-insulins-crazy-price-and-some-hopeful-signs-in-the-wild/">The surprising history behind insulin's absurd price (and some hopeful signs in the wild)</a></p> <p><a href="https://armandalegshow.com/episode/medicine-monopolies-101/#transcript">Here's a copy of this episode's transcript. </a></p> <p><a href="https://armandalegshow.com/contact/">Send your stories and questions.</a> Or call 724 ARM-N-LEG.</p> <p>And of course we’d love for you to<a href="https://armandalegshow.com/support/"> support this show</a>.</p> <p><strong>An Arm and a Leg 101 is made possible in part by support from Arnold Ventures.</strong></p><p>See <a href="https://omnystudio.com/listener">omnystudio.com/listener</a> for privacy information.</p>
165 total episodes available with 44 transcripts
Recent guests on An Arm and a Leg
Guests from recent episodes — sign up to see every guest that has ever appeared on this show.
Linda Michaels
Guest
Nicole Wipp
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Noah Hulsman
Guest
Renuka Rayasam
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Thomas Goetz
Guest
Zach Mider
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Zeke Faux
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David Dayen
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Matt Stoller
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Bob
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Eugene Litvak
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Julie Rovner
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Frequently asked questions
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- What is An Arm and a Leg?
<p>An Arm and a Leg is a podcast about why health care costs so freaking much and what we can (maybe) do about it.</p> <p>If you’ve ever been surprised by a medical bill, you’re in good company. But as our team of seasoned journalists has learned from years of reporting — you’re not always helpless. We don’t have all the answers, but we’ll offer you tools and big picture insights with plenty of humor and heart. </p> <p>An Arm and a Leg is co-produced with <a href="https://kffhealthnews.org/">KFF Health News</a> and distributed in partnership with <a href="https://www.kuow.org/">KUOW</a>.</p> <p>You can support An Arm and a Leg by donating at <a href="https://armandalegshow.com/support/">armandalegshow.com/support/</a></p> <hr> <p><strong>Show Credits: </strong>Created, hosted, and produced by Dan Weissmann with senior producer Emily Pisacreta and engagement producer Claire Davenport, edited by Ellen Weiss. Audio wizard: Adam Raymonda. Music is by Dave Weiner and Blue Dot Sessions. Bea Bosco is our consulting director of operations. Lynne Johnson is our operations manager.</p> - How often does this podcast release new episodes?
This podcast updates weekly.
- Where can I listen to this podcast?
This podcast is available on 9 platforms including Apple Podcasts, Spotify, and more. You can also use the RSS feed directly.
- Does this podcast accept guests?
Yes, this podcast regularly features guests.
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