#38 Why Obamacare Might Collapse: Megan McArdle: How Do We Fix It?

For its opponents, Obamacare is a disaster - a classic example of over-reach by an Administration that wants to expand the size and scope of the Federal government.

Supporters say The Affordable Care Act is a triumph, benefiting countless millions of Americans, while reducing the threat of personal bankruptcies in medical emergencies crippling healthcare costs.

"We have decreased the rate of the uninsured by about a third," says our guest Megan McArdle, a columnist at Bloomberg View. But Obamacare poses a potentially fatal threat.

"What people are doing is they're gaming the system." Some with health emergencies, who have inadequate medical insurance are "signing up for a few months, using a ton of services and then dropping it again."

Several large insurance companies say they are losing money on the government-run exchanges. UnitedHealth, the nation's largest health insurance firm, warned it would have to pull out if market conditions didn't improve. Exchange enrollments are lower than the government had forecast. 

Is Obamacare the victim of "an adverse death spiral"?  Are costs rising faster than expected?  Do Americans have unrealistic expectations that would doom any attempt to provide better coverage?

We debate the arguments from different points of view and suggest a fix that could involve consumers more directly in cost decisions, while putting a ceiling on heath care costs for each household.

Megan McArdle is the author of "The Upside of Down: Why Failing Well Is The Key To Success."

#37 Breast Cancer: Lessons from a life-threatening journey. Debbie Galant.

With love, humor and compassion,  Debbie Galant talks about what it's like to live with breast cancer.  What she learned along the way amount to solutions for what can be a desperate, lonely experience.

From the first shock of her first diagnosis to sometimes wrenching, sometimes funny conversations with her doctors and family, Debbie gives us valuable lessons about how to survive and recover, physically and emotionally.

"You are pitched into this world of fear... this incredible world of fear," she tells us. "You're making a lot of decisions in that period, but you're really in a primal place."

Her journey includes how to "de-code" her oncologist, and learn from a nurse-navigator to dealing with her own emotional roller-coaster ride.  She also talks about a vital ingredient: humor.

"Going into a doctor's appointment with a sense of humor, as opposed to a sense of dread, really helped."

Debbie, her husband Warren Levinson, and son Noah tell their story in the podcast, "Chemo Files" - is a deeply personal account of her months of dealing with cancer. She is Associate Director of New Media Initiatives and runs NJ News Commons at Montclair State University, New Jersey.

If you would like more information about understanding breast cancer and learning more about communities that can help, these websites may be helpful: 

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#27 America's Sleep Crisis: Jeff Koyen. How Do We Fix It?

If you have at least seven hours of interrupted sleep each night, consider yourself very lucky indeed.  Problems with sleep are remarkably widespread. 

Many millions of adults and children either don't spend enough time in bed or suffer from sleep disorders, resulting in illness, obesity, depression, mood swings and loss of creativity.

Our guest is Jeff Koyen, Editor-in-Chief of Van Winkle's, a new website "obsessed with sleeping, waking and everything in between.  He shares the stories of scientists, artists, travel writers, child-care experts and many others who have a great deal to tell us about how we do - and don't - sleep.

"Sleep is a very complicated issue that touches probably everyone you know. It's not just adults," says Jeff. "We're talking about teenagers have sleep issues, even children."

Smartphones, tablets and other devices have made the problem even worse. "Ten years ago, five years ago you were not taking your phone with you to bed."

We look at fixes and what science tells us about how to get a better night's sleep.