Categories: Newsletter Issue 2020:2

Frequent Tradeoffs: An Interview with Dan Gorenstein, Host of the Podcast Tradeoffs

By: David Slusky

How was the decision made to drastically increase the frequency of Tradeoffs episodes?

Dan Gorenstein: In the middle of March, we called an unscheduled editorial meeting. We looked at our calendar. The episode on deck – a look at the funding of residency programs – didn’t seem to match the moment. Italian doctors were facing terrible choices. Social distancing was taking hold. Public health officials were scrambling.

By the end of that week (and a few dozen phone calls) it was clear that the coronavirus was going to have a sweeping effect on the U.S. health care system in profound and potentially terrible ways. It was scary. As a health policy show, we know health policy. And we felt a duty to cover as much of this story as we could. And honestly, it gave us purpose during the crisis.

Until then, Tradeoffs had produced two episodes a month. But the story was moving way too fast to work at that pace. The last thing you want to do in the news/information business is produce stale stories. So, the clip of the pandemic kicked us into gear.

What were you hoping to achieve by doing this?

Dan Gorenstein: Our operating hypothesis: the experiences of today will inform the policy choices of tomorrow. At a broad level, our goal was to document the economic and human fallout from the crisis.

Here’s how we’re trying to do that:

  • We are identifying what we consider to be some of the most relevant topics, including the economic crisis in primary care, a Congressional bill to fund COBRA plans for laid off workers, and whether COVID+ patients should be discharged to Skilled Nursing Inpatient Facilities (SNIFs).
  • We also want to let our audience know there are folks out there struggling with hard choices. (Right now, lots of us are stepping into the unknown and there’s comfort in knowing you aren’t alone)
  • We’ve produced a profile of Mayra Jimenez, a 35-year old server with a chronic condition who just lost her job. We talked with Professor Alison Buttenheim, who battles with her impulse to ignore her own social distancing coda. Finally, Antonio Matthews, walks us through his thinking as he must decide if he’s willing to potentially risk his life to make a critical doctor’s appointment.

Do you think you’ve achieved that, so far?

Dan Gorenstein: Wouldn’t it be nice to answer this question definitively!

The truth is its hard to gauge with much precision. Anecdotally, we’ve gotten some nice feedback. We’ve also heard from a few folks who prefer our pre-COVID work. But since this is a newsletter for people who live and die on numbers, let’s check the stats.

At a time when total podcast listening in the U.S. dropped, our numbers improved.  We saw a 30 percent jump in March listens over February. And what’s really exciting is that our audience is sticking with us!

Overall, yes we think we are capturing tough policy choices and the economic and human fallout from the pandemic.

What’s the most unexpected / surprising thing you’ve learned making these recent episodes?

Dan Gorenstein: We’ve increased production four-fold without increasing staff and people still keep showing up for work! It’s been pretty great to see how nimble we are and finding a new speed.

The show has also taken on a slightly different texture. Until COVID, we felt like every story had to be wonky AND human. Now there’s a greater variety of episodes. There are 5-minute check-ins with folks like Dr. Bob Wachter. There are newsier stories like a quick Q&A with Larry Leavitt about the SCOTUS risk corridor ruling. This leaves us feeling like Tradeoffs is becoming a more diverse show.

Lately, we’ve been thinking of the podcast a bit like a neighborhood bar where health policy folks hang out. Every time you walk in, it may be a little different, but you can count on high quality reporting that’s accessible and has a bit of heart.

What was one of your goals with these episodes that you didn’t achieve?

Dan Gorenstein: Like every podcast on the planet, you’d always like to see a bigger audience. We exist to help people have smarter health policy conversations. The more people who listen, the bigger our influence. So, it would have been nice to have a bigger boost.

At the same time, every major media organization is now – to some extent – covering health policy. A bunch of coronavirus-themed podcasts have also popped up, a few hosted by big names like Andy Slavitt and Zeke Emanuel. So breaking through has gotten tougher.

But while the space is crowded, we think we are finding our voice and remain confident growing our audience is just a matter of time and continuing to work with other media partners like NPR and Kaiser Health News.

What’s next for Tradeoffs?

Dan Gorenstein: In the short-term, we expect to keep cranking out multiple episodes each week. That may change as the pandemic evolves. No one can say how this pandemic will play out in the coming months. We’ve learned that the show can adapt and produce relevant, smart and engaging shows.

At the same time, the team is hungry to get back to producing longer-form stories built around great academic research. Like we did with the Camden Coalition RCT. That’s our bread and butter. To do that, we want to develop a better pipeline of upcoming research so we can stay on top of these great papers. (Looking at you ASCHEcon members! Let us know what you’re working on.)

Finally, the team is looking forward to a much needed few weeks off this summer!

Dan Gorenstein is the Host & Executive Producer of Tradeoffs.

David Slusky is an Associate Professor of Economics at the University of Kansas and the Editor of the ASHEcon Newsletter.