The Impact

By Vox

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A Podcast Republic user
 Jul 9, 2018


In Washington, the story often ends when Congress passes a law. For The Impact, that’s where our story begins. We focus on the human consequences of policy-making, what happens in the real world after the government, non-profits, even academic institutions start doing something differently. The Impact looks at policies that work — and policies that need some work — as they make their way out into the real world, with many surprises along the way.

Episode Date
Bonus: The gender wage gap

The Impact team is hard at work on our second season! In the meantime, here's an episode of Vox’s newest podcast, Today, Explained. This episode is about the gender pay gap, and you’ll hear Sarah talking about the real reason working women earn about 82% as much as men.

We’ll talk more about the gender pay gap in the second season of The Impact too. But before our second season begins, tune in to Today, Explained, and, of course, you can always hear Sarah on The Weeds.


Apr 12, 2018
Help us make season 2!

We're making season 2, and we need your help! We want to know about local policy experiments from around the country. These can be at the state, county, or city level, and can cover any kind of policy—environmental or housing or criminal justice. 

Send us your suggestions at

Jan 08, 2018
How California saves moms from dying in childbirth

The United States has an astoundingly high maternal death rate. It is three times higher than the UK, eight times higher than Norway, and still climbing.

But California does way better than the rest of the country. Over the last decade, doctors in the state have banded together and worked to bring their maternal death rate down. Today on The Impact, we'll tell you the story of that effort, and show you how it helped save one woman's life.

One of our health care reporters, Julia Belluz, has done some amazing in-depth reporting on this issue. You can read her story here.

Music in this episode from Chris Zabriskie.

This is the last episode of this first season of The Impact. Please send us your thoughts, and your ideas for next season. We can be reached at

Dec 04, 2017
The black robe effect

What is the best way to care for patients with severe mental illness?

The United States has struggled with this question for decades. In 1963, President Kennedy signed a law that was supposed to transfer patients with severe mental illness out of hospitals and back into their communities -- into outpatient treatment.

That effort hasn't really worked. A lot these patients end up homeless. Many are in prison or jail. One recent study found that more than half of all inmates have some kind of mental illness.

Summit County, Ohio, thinks it has a solution: court-ordered outpatient treatment. It’s often called Assisted Outpatient Treatment, or AOT for short. That’s sort of what President Kennedy hoped for: treatment outside of the hospital, in the community. But the treatment is enforced by the courts -- and that’s what makes it so controversial.

We had music on this episode from Blue Dot Sessions, Chris Zabriske, Kevin MacLeod, and Poddington Bear.

Please email us your feedback to

Nov 27, 2017
This robotic pelvis reduces teen pregnancy

American women are changing up their birth control. The use of IUDs and implants has increased 6000% in the United States since 2002. 

That's the result of specific policy choices made in Washington and in state houses. These policies have reduced the teen pregnancy rate. They have cut the abortion rate. But they’re also at risk right now. 

In this episode, we’re going to tell you how those policies came to be, how they're helping women access birth control -- and why, at this very moment, they are facing serious threats.

Music in this episode by Podington Bear and Kevin MacLeod

Email us feedback! We're at

Nov 20, 2017
The controversial way doctors fight pain without opioids

On this episode of The Impact, we’re looking at a possible future for pain treatment. It’s an idea known as “pain acceptance,” and in the wake of the opioid epidemic, it is gaining traction among American doctors.

Music from Podington Bear, Kevin MacLeod and Chris Zabriskie.

Nov 13, 2017
The policies that created the opioid epidemic

There's a well-known narrative about the opioid epidemic: pharmaceutical companies and dirty doctors pushed misinformation and addictive drugs on patients.

But there's also a policy story here, about well-meaning doctors who tried to find the best solution for their patients in pain.

These doctors developed and spread new policies that urged their peers to treat pain as a vital sign and measure it at every visit. That policy change helped create the nationwide opioid epidemic we’re dealing with today. 

Please, subscribe and leave us a review! You can email us at, or send an ER bill at

Music in this episode by Podington Bear and Chris Zabriskie, with sound effects from Berlin Atmospheres.

Nov 06, 2017
It’s time to face the fax

Why are fax machines still such a staple of American health care?

We talk to a pair of policy makers who hatched a plan to replace paper files and fax machines with electronic medical records. We explain why that plan backfired. And we go into clinics to understand why the fax's continued use isn't just annoying, but also sometimes harmful for patients' health.

For even more fax facts, check out Sarah's text version of this story. You can send us feedback at

Oct 30, 2017
Car crash hospitals vs. plane crash hospitals

Central line infections can be deadly. And they used to be extremely common: just a decade ago, hundreds of thousands of patients got them every year. Now, that number is closer to 9,000 annually. That's still high, but it's a dramatic drop in just ten years.

So how did that happen? On this episode of the Impact, we talk to the doctor who discovered that central line infections are, in nearly all cases, completely preventable. Physicians just need to follow a checklist to make sure the line stays safe and sterile.

And we’ll explore why, if this infection is preventable, some hospitals still have several cases of them each year.

This episode includes content that might be upsetting for listeners, so please be aware.

Many thanks to Vox's Johnny Harris, who originally recorded footage for this story. For more on this topic, read Sarah’s story on central line infections from 2015.

Please subscribe, leave us a rating and a review, and email us your feedback at 

Oct 23, 2017
The curious case of the $629 Band-Aid

How does a Band-Aid wind up costing so much money? Why are American health care prices so incredibly high?

Vox’s new podcast, the Impact, explores how policy affects real lives. This season, we’re focusing on healthcare, and we wanted to begin with one of thorniest questions in the American healthcare system: prices.

In this episode, we look at how the American decision not to regulate health care prices leads to $629 Band Aids and $3,170 fees just for visiting the emergency room.

We talk to doctors who think these prices are totally justified – and a health economist who doesn’t buy it. And we take a trip to the drug store to find out how much a Band-Aid should really cost.

Email us your feedback to 

Oct 16, 2017
The Impact: Real people, and the policies that shape their lives

The Impact is a show about how policy affects people — policies that work and policies that need some work.

We are going to follow those policies after they leave Congress or statehouses, to see what happens when they wind their way out into the real world where all of us live.

Our first season focuses on health care and the many challenges consumers face in the American health care system.

We'll criss-cross the country to tell you about the people who have struggled with these challenges first-hand.

And we'll show you that these problems are the direct result of policy choices that the United States has made over the past century.

Thoughts? Questions? Email us:

Oct 09, 2017