Tradeoffs

12/13/2025

Nabarun Dasgupta has spent two decades studying and trying to turn the tide on America’s drug addiction and overdose crises.

His work was recognized this fall with a MacArthur Fellowship, often known as a “Genius Grant.”

Listen to the latest episode or read the transcript to hear about the very personal reasons that drive Dasgupta’s work.

A leading addiction expert explains how he’s driven by the memory of a friend who died, and why he believes giving data on the drug supply to people on the street is more important than using it to inform national drug policy.

12/12/2025

This year has been one of the most fast-paced, unpredictable stretches in health policy we’ve seen in years. From sweeping shifts in the Trump administration’s health agenda to the ripple effects of AI in medicine, change has been constant, and the stakes have been high.

At Tradeoffs, our job is to help you make sense of it all. Week after week, we’ve broken down the headlines, sorted fact from speculation, and delivered clear, evidence-based explanations of what these changes actually mean for patients, providers, and policymakers.

We’ll continue doing that in 2026 but we need your help to keep this nonprofit newsroom strong.

As we kick off our year-end campaign, we’re aiming to bring 200 new donors into the Tradeoffs community. If we hit that goal before December 31, we unlock a $5,000 match from NewsMatch and our Audience Match Fund. Your gift — whether it’s $10 or $100 — gets us one step closer.

Donate now: http://tradeoffs.org/donate

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12/11/2025

Nabarun Dasgupta has spent two decades studying and trying to turn the tide on America’s drug addiction and overdose crises.

The University of North Carolina at Chapel Hill epidemiologist explained why he thinks regulating street drugs will save lives, and how memories of the friends he’s lost drive him to continue this work.

https://tradeoffs.org/2025/07/31/scientists-mission-change-prevent-overdoses/

A leading addiction expert explains how he’s driven by the memory of a friend who died, and why he believes giving data on the drug supply to people on the street is more important than using it to inform national drug policy.

12/10/2025

Amid all the speculation and political noise this year, Tradeoffs cut through with rigorous reporting grounded in data and research.

But here’s the thing: less than 1% of our audience donates each year, and heading into 2026 — with just as many unknowns ahead — we need more people to step up.

Donate today to keep our independent newsroom going: tradeoffs.org/donate

12/08/2025

A group of nurses in East Baltimore piloted a bold plan to bring basic primary care to everybody no matter their age, income or insurance.

Could this idea from abroad take root in the United States?

A group of nurses in East Baltimore is piloting a bold plan to bring basic primary care to everybody no matter their age, income or insurance. Can this idea from abroad take root in the United States?

12/05/2025

Tradeoffs exists because people like you believe health policy reporting should be clear, independent and deeply reported.

If our work helps you understand the system and the paths to fixing it, donate today to keep it going.

Tradeoffs is supported by people like you. Support Tradeoffs today.

12/04/2025

Sometimes the best ideas come from the unlikeliest places, like the tiny, faraway country of Costa Rica. That's where a group of Baltimore-based nurses found their inspiration for overhauling primary care in America.

They call their program Neighborhood Nursing and it’s pioneering a kind of universal primary care. Their goal: Visit every person in a given neighborhood at least once a year, whether they are sick or healthy, rich or poor, young or old, and no matter if they have private insurance, Medicare, Medicaid, or no insurance at all.

“What's revolutionary,” Sarah Szanton, dean of the Johns Hopkins University School of Nursing and leader of the project, told Tradeoffs back in 2024 when we first profiled this initiative, “is that it’s for everybody.”

Szanton was inspired by a similar effort in Costa Rica, which has for roughly three decades deployed health care teams nationwide to homes to check on residents’ medical and social needs.

The question: Can this model take root in a country as different as the U.S., with a health care system as entrenched and fragmented as ours? Listen to the episode or read the transcript for some innovative and ambitious food for thought.

A group of nurses in East Baltimore is piloting a bold plan to bring basic primary care to everybody no matter their age, income or insurance. Can this idea from abroad take root in the United States?

12/02/2025

All year long, Tradeoffs has worked to bring clarity to a fast-changing health policy landscape — from shifting priorities in the Trump administration, to real-world impacts of AI in medicine.

If our reporting has helped you cut through the noise, we hope you’ll consider supporting our nonprofit newsroom today.

We’re working to bring 200 new donors into the Tradeoffs community by December 31. Hitting that goal will unlock a $5,000 match from NewsMatch and our Audience Match Fund — a meaningful boost for our small team.

If you’re able, even $5 makes a difference.

🔗 Donate: https://tradeoffs.fundjournalism.org/donate/

11/29/2025

Amy Finkelstein has studied America’s health insurance system for more than 20 years — and she’s come to one very simple conclusion.

"It’s just not a system that can work." Listen why one of the country’s leading economists says it’s time for a total overhaul — and what she believes we should build in its place.

Economist Amy Finkelstein has studied America’s patchwork of health insurance policies for more than 20 years. She’s finally concluded that it’s time to tear the whole system down.

11/28/2025

Local governments across the U.S. have turned to sweeps and arrests as the number of people living on the nation’s streets exploded by nearly 60% between 2015 and 2024.

But evidence shows forcing people to move can harm their health.

Several cities and counties are addressing street homelessness with a new approach, which experts say can clear encampments while protecting the health of people who are forced to move.

11/27/2025

Amid the strain and deep cracks in the American health care system, Tradeoffs is always on the hunt for solutions — the people who shine a light on a problem, then do the hard work of trying to fix it.

As we enter the season of gratitude, our next few episodes highlight those folks: the provocative thinkers and the doers, the doctors and the nurses, all striving in their own ways to make our health care better, cheaper and more equitable.

This week, we’re looking back at our conversation with MIT health economist Amy Finkelstein.

As health insurance costs continue to rise, learn about Amy’s big plan to finally fix health insurance, once and for all.

Give the episode a read or listen for a quick dose of out-of-the-box brainstorming.

Economist Amy Finkelstein has studied America’s patchwork of health insurance policies for more than 20 years. She’s finally concluded that it’s time to tear the whole system down.

11/25/2025

Concern for the well-being of unhoused people, along with the challenges posed by encampments — elected officials point to excessive trash, open drug use, or parks no longer available to neighborhood kids — have put pressure on cities to clear people from the streets.

A 2024 Supreme Court decision gave cities the green light to disperse folks without offering them shelter. This summer, President Donald Trump upped the pressure by threatening to pull federal funding from any city that didn’t make it harder for people to sleep outside.

Advocates have long said that these “sweeps” of people living on the street harm health and rarely result in getting anyone into permanent housing. But sweeps are unlikely to go away anytime soon. Is there such a thing as a “good sweep?” Could a city clear encampments in a way that addresses concerns of the surrounding community, but avoids damaging the health of the people being displaced?

The latest episode of Tradeoffs, published in partnership with The Marshall Project, explores that question. Listen to hear from researchers, advocates, clinicians, local government officials and people who have been uprooted in this way while living on the streets.

https://tradeoffs.org/2025/11/20/homeless-camp-sweeps-can-harm-health-some-cities-are-trying-a-new-way/