1003 - The U.S.'s Insurance-Based Health Care System

About this episode: The U.S. takes a unique approach to health care by tying coverage to employment. This has led to high rates of uninsured Americans, the creation of the Affordable Care Act, and ongoing fights about health care spending culminating in a government shutdown late last year. In this episode: Jonathan Cohn details the health care debate happening in Washington right now, the nuances of universal coverage in other countries, and what might come next for health insurance in the U.S. Guests: Jonathan Cohn is a writer for The Bulwark and the author of "The Ten Year War: Obamacare and the Unfinished Crusade for Universal Coverage". Host: Stephanie Desmon, MA, is a former journalist, author, and the director of public relations and communications for the Johns Hopkins Center for Communication Programs. Show links and related content: Lawmakers reached a surprise bipartisan health deal. Now they have to keep it.—POLITICO Oregon Health Insurance Experiment—National Bureau of Economic Research Defenders of Medicaid cuts are misunderstanding a study I worked on—STAT Inside Rising Health Insurance Costs—Public Health On Call (November 2025) Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌PublicHealthPod on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed Note: These podcasts are a conversation between the participants, and do not represent the position of Johns Hopkins University.