Nurse Talk

This time on Code WACK! As of spring 2026, enhanced Affordable Care Act (ACA) subsidies have not been extended. Without congressional action, millions of Americans could face significantly higher premiums—or lose coverage altogether. Around 22 million people receive ACA premium subsidies, many of whom benefited from pandemic-era enhancements. If those aren’t restored, affordability for individuals buying their own coverage will take a major hit. Meanwhile, health care costs are rising across the board. Employer-sponsored insurance premiums have seen some of the largest increases in over a decade, shifting more costs to workers through higher premiums, deductibles, and out-of-pocket expenses. Medicare premiums are also climbing, adding pressure on older adults. As coverage becomes less affordable, many people delay care, skip medications, or make tough financial tradeoffs just to get by. So what options do people have? Today, we revisit a timely 2025 conversation with Rachel Madley, executive director at the Center for Health and Democracy and former advisor to Congresswoman Pramila Jayapal. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on CodeWACK! What if the rising cost of health care - the surprise bills, the shrinking choices, the long waits — weren’t random at all, but largely the result of quiet, strategic consolidation happening behind the scenes? The Center for Health & Democracy has been working to reveal just this. Founded by former insurance executive-turned-whistleblower Wendell Potter, the organization shines a light on how corporate power shapes the American health care system — and what it means for patients and families. Joining us today is Rachel Madley, the Center’s Executive Director. A scientist by training and a federal health policy expert, Rachel also brings lived experience navigating the health system with Type 1 diabetes — giving her unique insight into how policy decisions ripple into real lives. Today, we’re talking about the Center’s recent Sunlight Report, a first-of-its-kind investigation into the corporate structure and expansion of UnitedHealth Group, the largest healthcare company in the world. The report pulls back the curtain on health care consolidation and reveals how deeply corporate expansion is reshaping who delivers care, how much it costs, and who ultimately benefits. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on CodeWACK! Imagine two patients … same diagnosis, same medication, same country. Each one needs the same prescription. One gets their care through the Department of Veterans Affairs, the other gets it through Medicare. The price of the exact same drug could be half as much for one patient as for the other. That's not a glitch. It's how the system is designed. Our guest is Bob Coleman, a retired healthcare professional who spent more than 40 years serving veterans through the U.S. Department of Veterans Affairs—as a clinical pharmacist, medical informaticist, and researcher. His latest ebook is called "Hostile Takeover: How Wall Street and Congress Hijacked American Healthcare and How We Can Take it Back." This is the second of a two-part series. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on CodeWACK! Today, we’re talking about insurance denials, hidden incentives… and why getting care can feel like navigating a system designed to stop you. Our guest is Bob Coleman, a retired healthcare professional who spent more than 40 years serving veterans through the U.S. Department of Veterans Affairs—as a clinical pharmacist, medical informaticist, and researcher. His latest ebook is called "Hostile Takeover: How Wall Street and Congress Hijacked American Healthcare and How We Can Take it Back." This is the first of a two-part series. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on CodeWACK! Most employers don’t actually know what they’re paying for healthcare - and employees are paying the price. In this episode of Code WACK!, discover why companies are “flying blind” on healthcare costs, how opaque pricing drives higher premiums, and what this means for your coverage, care, and financial security. To learn more, we spoke with Chuck Melendi, who has more than three decades of experience in healthcare leadership, advocacy, and industry strategy. He spent 25 years at Johnson & Johnson, where he tackled issues including drug pricing, payer negotiations, policy, and commercial strategy. Chuck retired from Johnson & Johnson in early 2025 and went on to launch Disruptive Dialogue, a podcast and consulting platform where he shares insights from inside the U.S. healthcare system – while exploring ideas for reform. This is the second of a two-part series. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on CodeWACK! What challenges do employers face when providing health coverage to their employees? And what role do health insurers and Pharmacy Benefit Managers—prescription drug middlemen known as PBMs—play in shaping costs, coverage, and access to care? To find out, we spoke with Chuck Melendi, who has more than three decades of experience in healthcare leadership, advocacy, and industry strategy. He spent 25 years at Johnson & Johnson, where he tackled issues including drug pricing, payer negotiations, policy, and commercial strategy. Chuck retired from Johnson & Johnson in early 2025 and went on to launch Disruptive Dialogue, a podcast and consulting platform where he shares insights from inside the U.S. healthcare system – while exploring ideas for reform. This is the first of a two-part series. Check out the Transcript and Show Notes for more!

This time on CodeWACK! Today, most people on Medicaid get their care through private insurers called Managed Care Organizations, or MCOs—like Aetna and UnitedHealthcare. Critics say these companies add layers of bureaucracy that make it harder for patients—most of them low-income—to get care. They discourage physicians from accepting Medicaid patients by making them jump through hoops to get treatment pre-authorizations, or even to get paid. Are Managed Care companies making health care more expensive, not less? How are some states reacting? Are legislators starting to wake up and see through the hype? Some are. All this and more is discussed in a recent report from Physicians for a National Health Program, Removing the Middlemen from Medicaid. To unpack it, we spoke with Dr. Alankrita Olson, a public health physician and PNHP board member who advocates for a single-payer healthcare system. This is the 2nd of a two-part series. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on CodeWACK! Why are there middlemen in Medicaid—and what are they doing to our most vulnerable patients and physicians? How and why are private insurance intermediaries permitted to put profits ahead of patients? A recent report by Physicians for a National Health Program, titled Removing the Middlemen from Medicaid, pulls back the curtain on Managed Care Organizations (MCOs). To learn more, we spoke with Dr. Alankrita Olson, a public health physician and advocate for a universal single-payer system. She serves on the board of Physicians for a National Health Program and works to protect and expand healthcare access for all Americans. This is the first episode of a two-part series. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on Code WACK! We’re taking a closer look at what happens when private equity buys hospitals. Our guest is Dr. Renee Hsia (pronounced “Shaw”). An emergency physician at Zuckerberg San Francisco General Hospital, Dr. Hsia explains how patients can be harmed when Wall Street firms take over health care. A Professor of Emergency Medicine and Health Policy at the University of California, San Francisco, she is also Vice Chair of Health Services Research in the Department of Emergency Medicine, and a core faculty member of the Philip R. Lee Institute for Health Policy Studies. This is part two of our two-part series. Keep Code WACK! on the air with a tax-deductible donation.

This time on Code WACK! What happens to staff and patients when private investors buy hospitals to make them more profitable? And why should this concern us all? To break it down, we spoke to Dr. Renee Hsia ( pronounced “Shaw”) an attending physician at San Francisco General Hospital and Trauma Center and a Professor of Emergency Medicine and Health Policy at the University of California, San Francisco. She’s also Vice Chair of Health Services Research in the Department of Emergency Medicine, and a core faculty member of the Philip R. Lee Institute for Health Policy Studies. This is the first episode in a two-part series. Check out the Transcript and Show Notes for more! Keep Code WACK! on the air with a tax-deductible donation.

This time on Code WACK! Millions of Americans have health insurance, but still can’t afford to use it. So what happens when high deductibles and corporate profit pressures shape the care patients receive? To break it down, we spoke with Dr. Adam Gaffney — a pulmonary and critical care physician, public health researcher, and Assistant Professor of Medicine at Harvard Medical School. He’s also a former president of Physicians for a National Health Program, and his work focuses on health care financing and national reform. This is the second episode in a two-part series. Check out the Transcript and Show Notes for more! Keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on Code WACK! Why do Americans live about four years less, on average, than people in similar European countries, despite spending far more on health care? And why are so many dying from illnesses we already know how to prevent or treat? To help us unpack this, we spoke with Dr. Adam Gaffney — a pulmonary and critical care physician, public health researcher, and Assistant Professor of Medicine at Harvard Medical School. He’s a former president of Physicians for a National Health Program, and his research and advocacy focus on health care financing and national reform. He’s also the author of To Heal Humankind: The Right to Health in History. This is part one of a two-part series. Check out the Transcript and Show Notes for more! Keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on Code WACK! Why are people in America resorting to receiving medical care in animal stalls - even if they have health insurance? What would it take to make volunteer stopgap clinics unnecessary - and who stands in the way of real reform? To break it down, we spoke with leading healthcare reform advocate and New York Times bestselling author Wendell Potter. A former health insurance executive turned industry whistleblower, Wendell now serves as board president of the Center for Health and Democracy, which advocates for healthcare reform, and editor-in-chief of HEALTHCARE Un-covered, which investigates healthcare corporations and insurance conglomerates. This is part two of a two-part series. Check out the Transcript and Show Notes for more!

podcast

This time on Code WACK! Privatized Medicare now covers more than half of older adults nationwide. But how do Medicare Advantage plans’ lower star ratings, narrow networks, and “paper benefits” hit seniors of color hardest-and why are hospitals dropping these plans, leaving patients scrambling for care? Our guest is Dr. Belinda McIntosh, an Atlanta-based psychiatrist with more than 20 years of experience, Physicians for a National Health Program board member, and co-author of the PNHP report No Real Choices: How Medicare Advantage Fails Seniors of Color. This is part two of a two-part series. Check out the Transcript and Show Notes for more! Keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on Code WACK! How does Medicare Advantage - also known as privatized Medicare - fail seniors … especially seniors of color? Why do many seniors find they actually have no other choice than an Advantage plan? What’s the consequence of that lack of choice? And how do Medicare Advantage insurance plans actually deepen racial and income disparities? To find out, we spoke with Dr. Belinda McIntosh — an Atlanta-based psychiatrist with more than 20 years of experience, a board member of Physicians for a National Health Program, and co-author of a new PNHP report titled “No Real Choices: How Medicare Advantage Fails Seniors of Color.” This is the first episode in a two-part series. Check out the Transcript and Show Notes for more! Keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on Code WACK! This time on Code WACK! In celebration of Dr. Martin Luther King Jr. Day, we’re rebroadcasting this episode examining how desegregation shaped the experiences of Black patients in America – and what still hasn’t changed. What does racism in medicine look like today? To break it down, we spoke to Dr. Barbara Berney, project creator and producer of the documentary “Power to Heal: Medicare and the Civil Rights Revolution.” She’s also an emeritus professor at City University of New York School of Public Health and a distinguished scholar in public health, environmental justice, and the U.S. healthcare system. This is the second of two episodes with Dr. Berney. It originally aired in March of 2025. Check out the Transcript and Show Notes for more! Keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on Code WACK! In honor of Dr. Martin Luther King, Jr. Day, we’re rebroadcasting our Anthem Award–winning episode on one of the most overlooked civil rights battles in American history: the desegregation of hospitals. The episode features Dr. Barbara Berney, a distinguished public health scholar and the creator of the award-winning documentary Power to Heal: Medicare and the Civil Rights Revolution. Together, we explore how federal Medicare dollars were used as a powerful tool to force hospitals to integrate in the 1960s. We’re uplifting this groundbreaking story to educate a new generation about the critical role health care played in the civil rights movement - and to confront how racism still shapes access to care and health outcomes today. This is part one of a two-part series. Check out the Transcript and Show Notes for more! And keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

This time on Code WACK! As healthcare costs skyrocket and Americans face new coverage threats, California advocates are pushing for something bigger than simple fixes around the edges. We’re joined by longtime healthcare organizer Michael Lighty, who breaks down the fight for single payer, what’s at stake in 2026, and why unity may be the key to winning guaranteed healthcare for all. Michael is the president of Healthy California Now and has organized, advocated and developed policy for single payer Medicare for All nationally and in California for more than 30 years. This is the second episode in a two-part series with Michael Lighty. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation.

This time on Code WACK! Today we’re talking about rising healthcare costs and the renewed momentum behind Medicare for All. Recent polling shows majority support for the idea-across Democrats, independents, and even a notable share of Republicans-even when voters are told it would replace most private insurance and require higher taxes. As premiums, deductibles, and out-of-pocket costs continue to climb, healthcare affordability is once again front and center in the political debate. To help us unpack what’s driving this support-and whether it represents a real political opportunity-we’re joined by longtime healthcare advocate and policy strategist Michael Lighty, president of Healthy California Now and former healthcare constituency director for the Bernie 2020 campaign. This is the first of two episodes with Michael Lighty. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation.