Tradeoffs
@tradeoffs.org
Journalism that explores the complicated, costly, and often counterintuitive world of health care.
New podcast episodes every Thursday, hosted by Dan Gorenstein.
Subscribe to our weekly newsletter: tradeoffs.org/subscribe
New podcast episodes every Thursday, hosted by Dan Gorenstein.
Subscribe to our weekly newsletter: tradeoffs.org/subscribe
Nationwide, people with serious mental illness are jailed 2 million times a year. California families hoped CARE Court could compel their loved ones into treatment instead of jail.
Now, many who initially cheered CARE Court have now become disillusioned.
Now, many who initially cheered CARE Court have now become disillusioned.
Mental Illness Left Their Loved Ones on the Streets. California’s Big Fix Hasn’t Helped.
How Gov. Gavin Newsom’s ambitious plan to force more people into mental health treatment left many families still searching for help.
tradeoffs.org
February 9, 2026 at 5:01 PM
Nationwide, people with serious mental illness are jailed 2 million times a year. California families hoped CARE Court could compel their loved ones into treatment instead of jail.
Now, many who initially cheered CARE Court have now become disillusioned.
Now, many who initially cheered CARE Court have now become disillusioned.
How do you help someone who doesn’t want help?
June Dudas turned to California's CARE Court after 40 years of trying to help her schizophrenic cousin. Her hopes and heartbreaks are shared by many families who try to get treatment for their loved ones.
June Dudas turned to California's CARE Court after 40 years of trying to help her schizophrenic cousin. Her hopes and heartbreaks are shared by many families who try to get treatment for their loved ones.
Mental Illness Left Their Loved Ones on the Streets. California’s Big Fix Hasn’t Helped.
How Gov. Gavin Newsom’s ambitious plan to force more people into mental health treatment left many families still searching for help.
tradeoffs.org
February 7, 2026 at 3:02 PM
How do you help someone who doesn’t want help?
June Dudas turned to California's CARE Court after 40 years of trying to help her schizophrenic cousin. Her hopes and heartbreaks are shared by many families who try to get treatment for their loved ones.
June Dudas turned to California's CARE Court after 40 years of trying to help her schizophrenic cousin. Her hopes and heartbreaks are shared by many families who try to get treatment for their loved ones.
Last November, every state in the nation pitched the Trump administration for how to spend $50 billion to transform rural health care.
The ideas the White House liked best would get more money. It was a competition.
How did Maryland fare?
Listen: tradeoffs.org/2026/01/29/o...
The ideas the White House liked best would get more money. It was a competition.
How did Maryland fare?
Listen: tradeoffs.org/2026/01/29/o...
One State's Sprint for its Share of $50 Billion for Rural Health: Part 2
Maryland finds out how much the state will get from a nationwide competition for federal rural health investment.
tradeoffs.org
February 6, 2026 at 3:03 PM
Last November, every state in the nation pitched the Trump administration for how to spend $50 billion to transform rural health care.
The ideas the White House liked best would get more money. It was a competition.
How did Maryland fare?
Listen: tradeoffs.org/2026/01/29/o...
The ideas the White House liked best would get more money. It was a competition.
How did Maryland fare?
Listen: tradeoffs.org/2026/01/29/o...
In today's episode of Tradeoffs, hear how California's bold new program to help people with serious mental illness failed to meet expectations... and what it means for the families left searching for help.
Listen:
Listen:
Mental Illness Left Their Loved Ones on the Streets. California’s Big Fix Hasn’t Helped.
How Gov. Gavin Newsom’s ambitious plan to force more people into mental health treatment left many families still searching for help.
tradeoffs.org
February 5, 2026 at 3:01 PM
In today's episode of Tradeoffs, hear how California's bold new program to help people with serious mental illness failed to meet expectations... and what it means for the families left searching for help.
Listen:
Listen:
Elizabeth Kromm spent the end of last year locked in a $50 billion competition.
The prize: a windfall to make progress on longstanding barriers to health that lead rural Americans to live sicker and die younger than their metropolitan counterparts.
The prize: a windfall to make progress on longstanding barriers to health that lead rural Americans to live sicker and die younger than their metropolitan counterparts.
Inside Maryland’s High-Stakes Bid for Trump’s $50 Billion Rural Health Fund
The White House asked states to compete for a rare pot of new money dedicated to transforming health care across rural America.
tradeoffs.org
February 4, 2026 at 3:01 PM
Elizabeth Kromm spent the end of last year locked in a $50 billion competition.
The prize: a windfall to make progress on longstanding barriers to health that lead rural Americans to live sicker and die younger than their metropolitan counterparts.
The prize: a windfall to make progress on longstanding barriers to health that lead rural Americans to live sicker and die younger than their metropolitan counterparts.
As part of the Medicaid Insights Colloquium, @dgorenstein.bsky.social will speak on how he helps researchers and experts distill complex concepts into clear, compelling narratives.
🗓️ Wednesday, Feb. 25, 2026 11 a.m. to noon, PST
Register: www.medicaidinsightscolloquium.com
🗓️ Wednesday, Feb. 25, 2026 11 a.m. to noon, PST
Register: www.medicaidinsightscolloquium.com
February 3, 2026 at 3:02 PM
As part of the Medicaid Insights Colloquium, @dgorenstein.bsky.social will speak on how he helps researchers and experts distill complex concepts into clear, compelling narratives.
🗓️ Wednesday, Feb. 25, 2026 11 a.m. to noon, PST
Register: www.medicaidinsightscolloquium.com
🗓️ Wednesday, Feb. 25, 2026 11 a.m. to noon, PST
Register: www.medicaidinsightscolloquium.com
In part two of our look at a huge, one-time investment in rural health, we explored how a top health official in Maryland looked to make the most of it.
One State's Sprint for its Share of $50 Billion for Rural Health: Part 2
Maryland finds out how much the state will get from a nationwide competition for federal rural health investment.
tradeoffs.org
February 2, 2026 at 6:01 PM
In part two of our look at a huge, one-time investment in rural health, we explored how a top health official in Maryland looked to make the most of it.
The White House asked states to compete for a rare pot of new money dedicated to transforming health care across rural America.
We got a look inside Maryland’s bid in a $50 billion competition for rural health funding.
tradeoffs.org/2026/01/29/i...
We got a look inside Maryland’s bid in a $50 billion competition for rural health funding.
tradeoffs.org/2026/01/29/i...
Inside Maryland’s High-Stakes Bid for Trump’s $50 Billion Rural Health Fund
The White House asked states to compete for a rare pot of new money dedicated to transforming health care across rural America.
tradeoffs.org
February 1, 2026 at 6:32 PM
The White House asked states to compete for a rare pot of new money dedicated to transforming health care across rural America.
We got a look inside Maryland’s bid in a $50 billion competition for rural health funding.
tradeoffs.org/2026/01/29/i...
We got a look inside Maryland’s bid in a $50 billion competition for rural health funding.
tradeoffs.org/2026/01/29/i...
In this week's episode of Tradeoffs, Maryland learns how much it will get from a nationwide competition for federal rural health investment — and more hard choices arise.
Listen or read the transcript:
Listen or read the transcript:
One State's Sprint for its Share of $50 Billion for Rural Health: Part 2
Maryland finds out how much the state will get from a nationwide competition for federal rural health investment.
tradeoffs.org
January 29, 2026 at 3:01 PM
In this week's episode of Tradeoffs, Maryland learns how much it will get from a nationwide competition for federal rural health investment — and more hard choices arise.
Listen or read the transcript:
Listen or read the transcript:
The federal government gave states 52 days to apply for new rural health funding.
“We can build on the work that we’ve already been doing to serve rural communities, and we don’t want to miss out on that," said Maryland health official Elizabeth Kromm.
“We can build on the work that we’ve already been doing to serve rural communities, and we don’t want to miss out on that," said Maryland health official Elizabeth Kromm.
One State's Sprint for its Share of $50 Billion for Rural Health
We follow Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.
tradeoffs.org
January 27, 2026 at 3:00 PM
The federal government gave states 52 days to apply for new rural health funding.
“We can build on the work that we’ve already been doing to serve rural communities, and we don’t want to miss out on that," said Maryland health official Elizabeth Kromm.
“We can build on the work that we’ve already been doing to serve rural communities, and we don’t want to miss out on that," said Maryland health official Elizabeth Kromm.
This month marks the start of a nationwide experiment to give health care in rural America a $50 billion makeover.
Here’s what you need to know about the Rural Health Transformation Program:
Here’s what you need to know about the Rural Health Transformation Program:
What You Need to Know About the New $50 Billion Rural Health Fund
The Trump administration recently announced how much money each state will receive under an ambitious 5-year initiative known as the Rural Health Transformation Program.
tradeoffs.org
January 26, 2026 at 10:46 PM
This month marks the start of a nationwide experiment to give health care in rural America a $50 billion makeover.
Here’s what you need to know about the Rural Health Transformation Program:
Here’s what you need to know about the Rural Health Transformation Program:
For seven weeks late last year, Elizabeth Kromm had one job: figure out how to ask the White House for $1 billion for rural health care in Maryland.
"There’s a game to be played, and we have to figure out how to play it and then how to win it."
tradeoffs.org/2026/01/22/o...
"There’s a game to be played, and we have to figure out how to play it and then how to win it."
tradeoffs.org/2026/01/22/o...
One State's Sprint for its Share of $50 Billion for Rural Health
We follow Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.
tradeoffs.org
January 24, 2026 at 8:55 PM
For seven weeks late last year, Elizabeth Kromm had one job: figure out how to ask the White House for $1 billion for rural health care in Maryland.
"There’s a game to be played, and we have to figure out how to play it and then how to win it."
tradeoffs.org/2026/01/22/o...
"There’s a game to be played, and we have to figure out how to play it and then how to win it."
tradeoffs.org/2026/01/22/o...
The Trump administration announced how much money each state will receive under an ambitious 5-year initiative known as the Rural Health Transformation Program.
We broke down the key takeaways of the program and the first round of state awards.
tradeoffs.org/2026/01/22/w...
We broke down the key takeaways of the program and the first round of state awards.
tradeoffs.org/2026/01/22/w...
What You Need to Know About the New $50 Billion Rural Health Fund
The Trump administration recently announced how much money each state will receive under an ambitious 5-year initiative known as the Rural Health Transformation Program.
tradeoffs.org
January 23, 2026 at 4:28 PM
The Trump administration announced how much money each state will receive under an ambitious 5-year initiative known as the Rural Health Transformation Program.
We broke down the key takeaways of the program and the first round of state awards.
tradeoffs.org/2026/01/22/w...
We broke down the key takeaways of the program and the first round of state awards.
tradeoffs.org/2026/01/22/w...
States will soon get their first payout from a new $50 billion fund that Congress created to bolster rural health care.
We followed Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.
tradeoffs.org/2026/01/22/o...
We followed Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.
tradeoffs.org/2026/01/22/o...
One State's Sprint for its Share of $50 Billion for Rural Health
We follow Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.
tradeoffs.org
January 22, 2026 at 11:48 PM
States will soon get their first payout from a new $50 billion fund that Congress created to bolster rural health care.
We followed Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.
tradeoffs.org/2026/01/22/o...
We followed Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.
tradeoffs.org/2026/01/22/o...
A 2024 Supreme Court decision gave cities the greenlight to forcibly remove people from the streets.
What are the health consequences of forcing people to leave their homes on the streets and how can cities minimize risks while still clearing encampments?
tradeoffs.org/2025/11/20/h...
What are the health consequences of forcing people to leave their homes on the streets and how can cities minimize risks while still clearing encampments?
tradeoffs.org/2025/11/20/h...
January 20, 2026 at 10:00 PM
A 2024 Supreme Court decision gave cities the greenlight to forcibly remove people from the streets.
What are the health consequences of forcing people to leave their homes on the streets and how can cities minimize risks while still clearing encampments?
tradeoffs.org/2025/11/20/h...
What are the health consequences of forcing people to leave their homes on the streets and how can cities minimize risks while still clearing encampments?
tradeoffs.org/2025/11/20/h...
Some of the most powerful 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?
tradeoffs.org/2024/09/26/r...
Can those companies find a sustainable path forward, or will patients get left stuck paying exorbitant prices?
tradeoffs.org/2024/09/26/r...
Race to the Bottom: Where’s the Cavalry?
Some of the most powerful 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...
tradeoffs.org
January 18, 2026 at 8:04 PM
Some of the most powerful 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?
tradeoffs.org/2024/09/26/r...
Can those companies find a sustainable path forward, or will patients get left stuck paying exorbitant prices?
tradeoffs.org/2024/09/26/r...
2025 was a consequential year. Our Founder and Executive Editor @dgorenstein.bsky.social shared a message about why he's proud of the work Tradeoffs has done.
Read the letter from the editor:
tradeoffs.org/2026/01/15/l...
Read the letter from the editor:
tradeoffs.org/2026/01/15/l...
Letter from the Editor: A Consequential Year
A message from Tradeoffs founder and executive editor Dan Gorenstein.
tradeoffs.org
January 17, 2026 at 9:10 PM
2025 was a consequential year. Our Founder and Executive Editor @dgorenstein.bsky.social shared a message about why he's proud of the work Tradeoffs has done.
Read the letter from the editor:
tradeoffs.org/2026/01/15/l...
Read the letter from the editor:
tradeoffs.org/2026/01/15/l...
In the final chapter of “Race to the Bottom,” we look to the future — why it's getting harder to copy new medicines and sell them on the cheap, and what that could mean for the prices we all pay for the drugs we need.
tradeoffs.org/2024/09/26/r...
tradeoffs.org/2024/09/26/r...
Race to the Bottom: Where’s the Cavalry?
Some of the most powerful 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...
tradeoffs.org
January 15, 2026 at 6:57 PM
In the final chapter of “Race to the Bottom,” we look to the future — why it's getting harder to copy new medicines and sell them on the cheap, and what that could mean for the prices we all pay for the drugs we need.
tradeoffs.org/2024/09/26/r...
tradeoffs.org/2024/09/26/r...
Tradeoffs reporter Julie Wernau is looking for people impacted by the Trump Administration's 1/13 letter wiping out addiction and mental health grants.
Share your story with Julie and the Tradeoffs team: tradeoffs.org/tips/
Share your story with Julie and the Tradeoffs team: tradeoffs.org/tips/
January 14, 2026 at 6:57 PM
Tradeoffs reporter Julie Wernau is looking for people impacted by the Trump Administration's 1/13 letter wiping out addiction and mental health grants.
Share your story with Julie and the Tradeoffs team: tradeoffs.org/tips/
Share your story with Julie and the Tradeoffs team: tradeoffs.org/tips/
Tradeoffs has added veteran journalist Julie Wernau as its newest reporter and producer.
Wernau joins after more than a decade at The Wall Street Journal. At Tradeoffs, she will focus on covering mental health and addiction.
Learn more: tradeoffs.org/2026/01/13/t...
Wernau joins after more than a decade at The Wall Street Journal. At Tradeoffs, she will focus on covering mental health and addiction.
Learn more: tradeoffs.org/2026/01/13/t...
Tradeoffs Adds Veteran Health Journalist Julie Wernau to Reporting Team
Tradeoffs has added veteran journalist Julie Wernau as its newest reporter and producer.
tradeoffs.org
January 13, 2026 at 2:34 PM
Tradeoffs has added veteran journalist Julie Wernau as its newest reporter and producer.
Wernau joins after more than a decade at The Wall Street Journal. At Tradeoffs, she will focus on covering mental health and addiction.
Learn more: tradeoffs.org/2026/01/13/t...
Wernau joins after more than a decade at The Wall Street Journal. At Tradeoffs, she will focus on covering mental health and addiction.
Learn more: tradeoffs.org/2026/01/13/t...
Listen to todays's bonus episode of Tradeoffs to hear rural health experts dig into the Trump administration’s effort to transform rural health care, from our virtual event with @pennldi.bsky.social
tradeoffs.org/2026/01/12/b...
tradeoffs.org/2026/01/12/b...
Breaking Down Trump's $50 Billion Rural Health Fund
Rural health experts dig into the Trump administration’s effort to transform rural health care.
tradeoffs.org
January 12, 2026 at 11:48 PM
Listen to todays's bonus episode of Tradeoffs to hear rural health experts dig into the Trump administration’s effort to transform rural health care, from our virtual event with @pennldi.bsky.social
tradeoffs.org/2026/01/12/b...
tradeoffs.org/2026/01/12/b...
The generic drug industry has saved patients and the U.S. health care system trillions of dollars.
In Part 2 of Race to the Bottom, we shine a light on the weaknesses in the system, shortages of cancer drugs, and companies cutting dangerous corners.
tradeoffs.org/2024/09/19/r...
In Part 2 of Race to the Bottom, we shine a light on the weaknesses in the system, shortages of cancer drugs, and companies cutting dangerous corners.
tradeoffs.org/2024/09/19/r...
Race to the Bottom: Hard Bargain
America pays less, on average, than any other major country for our generic drugs. But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shorta...
tradeoffs.org
January 11, 2026 at 10:48 PM
The generic drug industry has saved patients and the U.S. health care system trillions of dollars.
In Part 2 of Race to the Bottom, we shine a light on the weaknesses in the system, shortages of cancer drugs, and companies cutting dangerous corners.
tradeoffs.org/2024/09/19/r...
In Part 2 of Race to the Bottom, we shine a light on the weaknesses in the system, shortages of cancer drugs, and companies cutting dangerous corners.
tradeoffs.org/2024/09/19/r...
Generic drugs fill 9 out of every 10 prescriptions in the U.S.
Americans have saved trillions of dollars, paying less for these drugs, on average, than people in any other major country. But all these low prices have come with some hidden costs.
Americans have saved trillions of dollars, paying less for these drugs, on average, than people in any other major country. But all these low prices have come with some hidden costs.
Race to the Bottom: Hard Bargain
America pays less, on average, than any other major country for our generic drugs. But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shortages.
tradeoffs.org
January 9, 2026 at 5:50 PM
Generic drugs fill 9 out of every 10 prescriptions in the U.S.
Americans have saved trillions of dollars, paying less for these drugs, on average, than people in any other major country. But all these low prices have come with some hidden costs.
Americans have saved trillions of dollars, paying less for these drugs, on average, than people in any other major country. But all these low prices have come with some hidden costs.
America pays less, on average, than any other major country for the generic drugs that fill 90% of our prescriptions.
But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shortages.
But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shortages.
Race to the Bottom: Hard Bargain
America pays less, on average, than any other major country for our generic drugs. But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shortages.
tradeoffs.org
January 8, 2026 at 7:00 PM
America pays less, on average, than any other major country for the generic drugs that fill 90% of our prescriptions.
But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shortages.
But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shortages.
Generic drugs bring remarkable medical innovations within reach for millions of Americans — but will they continue to?
"This medication that was once $130,000 a year to, you know, nothing," one patient said. "It’s kind of hard to wrap your head around."
"This medication that was once $130,000 a year to, you know, nothing," one patient said. "It’s kind of hard to wrap your head around."
Race to the Bottom: Boom Times
Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug industry. In part one of Race to the Bottom, we get an inside look at the choices made back then that help explain the wild success and also the troubles we see today with generic medicines.
tradeoffs.org
January 7, 2026 at 7:00 PM
Generic drugs bring remarkable medical innovations within reach for millions of Americans — but will they continue to?
"This medication that was once $130,000 a year to, you know, nothing," one patient said. "It’s kind of hard to wrap your head around."
"This medication that was once $130,000 a year to, you know, nothing," one patient said. "It’s kind of hard to wrap your head around."