The Healthcare Policy Podcast ® Produced by David Introcaso

During this podcast I read part two of a draft, yet-to-be-published essay titled, “Institutional Betrayal: HHS and the National Academy of Medicine’s Failure to Decarbonize the US healthcare Industry.” That the window formally closed in January 2025 means healthcare will not approach reducing its greenhouse gas emissions by 50% in 2030. HHS will continue to intentionally fund the industry’s harm-t...

During this podcast I read part one of a draft, yet-to-be-published essay titled, “Institutional Betrayal: HHS and the National Academy of Medicine’s Failure to Decarbonize the US healthcare Industry.” That the window formally closed in January 2025 means healthcare will not approach reducing its greenhouse gas emissions by 50% in 2030. HHS will continue to intentionally fund the industry’s harm-t...

This is the first of a two-part reading of a yet-to-be-published essay presently titled, “Institutional Failure: HHS and the National Academy of Medicine’s Failure to Decarbonize Healthcare.” Comments are of course welcomed. Thank you. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Unlike most rich countries or advanced economies the US does not define healthcare, including long term care, as a universal social risk – despite the fact we all get sick, no one knows their health status tomorrow, approximately 85% of Medicare beneficiaries have at least one chronic condition and life expectancy at birth is approximately 79 years. Medicare does not provide long term care, Social...

To state the obvious nutrition is considered the cornerstone of public health, a, if not the, primary preventative measure against chronic disease. Nevertheless, the OBBBA cut SNAP funding by an estimated $187 billion; since the start of the pandemic food prices have increased by roughly 30%; and, going forward are at risk due to uncertain trade policy, global shocks including the ongoing war in I...

Not surprisingly healthcare affordability has risen to the top or #1 mid-term election campaign issue. Largely due to pricing failure, that costs Americans about $250 billion annually, pricing power is the consequence of an increasingly concentrated healthcare market. Think: Herfindahl-Hirschman Index scores. Hospital pricing/prices are particularly noteworthy or moreover surgical procedures and p...

Per my May 2025 interview with Stanford’s Chris Callahan regarding his April 2025 “Nature” article titled, “Carbon Majors and the Scientific Case for Climate Liability,” we know that among the 90 companies responsible for 63% of industrial GHG emissions over the past 200 years, 83 are fossil fuel companies . Two weeks ago Senator Cruz (R-TX) and four other Republican senators dropped their “Stop C...

Listeners are all well aware US healthcare is increasingly unaffordable. Among other stats nearly 50% of Americas are either uninsured, at 8% or 27 million, or underinsured, at 41% or 120 million. Upwards of 4.8 million Americans are expected to drop their ACA coverage; the average commercial family plan comes w/a $6,800 annual premium and 42% of Americans are now enrolled in high-deductible comme...

Over the past 12 years the Affordable Care Act (ACA) has reduced the total number of uninsured Americans and low-income individuals more specifically by over 50% and by over 66% for young adults. In 2025 the ACA insured a record breaking 45 million Americans: 24 million through the federal and state exchanges; and, 21 million via the ACA’s expansion of the Medicaid program. Having been under nearl...

Podcast listeners are aware US healthcare, the largest industry in the world’s largest economy, consumes- and wastes a massive amount of carbon-based energy made painfully evident by the fact annual greenhouse gas emissions account for over 600 million metric tons of carbon dioxide equivalents. Healthcare’s extraordinary or excessive energy consumption means it is a high entropy producer, one that...

Listeners may recall I interviewed Ms. Smith early last March because the Trump administration immediately abandoned a decades old policy that forbade immigration enforcement at “protected [or sensitive] areas” that include healthcare facilities. Now a year later, ICE contingents have been sent to over 15 cities including of course Minneapolis. Beyond ICE arrest operations resulting in gunshot wou...

Over the past few weeks the Trump administration has significantly upped its game to eliminate greenhouse gas regulations that protect human and global health. The Sabin Center on Climate Change Law’s “Climate Backtracker” database presently identifies over 320-related administrative and regulatory actions that in sum undermine the EPA’s mission to protect human health and the environment. Most re...

To begin my 14th year of podcasting, my 335th interview is with John Abraham, Professor of Thermal Science and Fluid Mechanics at the University of St. Thomas. Prof. Abraham joins me for a fifth time or for a fifth consecutive year to discuss ocean warming in 2025 and the increasingly frightening consequences thereof. Last Friday, Prof Abraham along with 54 research colleagues published in “Advanc...

At least one in four girls suffers childhood sexual abuse. For example, the Department of Justice (DoJ) concluded Jeffery Epstein trafficked over 1,000 girls, some as young as 14. Nevertheless, six years after Epstein’s reported suicide, the Trump Administration’s 2026 budget proposes to entirely delete a subsection of federal law that requires DoJ’s Office of Violence Against Women to be “a separ...

The US has effectively always suffered a physician shortage. Last year the AMA estimated a shortage of 86,000 by 2035. US policymakers have since 1965 addressed this problem by recruiting foreign born physicians (termed Foreign Medical Graduates or FMGs), mostly from Southeast Asia, largely India. Today FMEs, that account for 25-30% of the physician workforce, are disproportionately employed in He...

Over roughly the past year Prof. Blumberg and her Georgetown Center for Health Insurance Reform (CHIR) colleagues have been researching healthcare providers and payers increasing use of third-party entities they collectively termed “middlemen” with whom providers and payers contract to provide various supportive administrative or financial services. For example, payers frequently use of Third Part...

Even though PC is the only component of healthcare shown to increase life expectancy and is crucial to achieving healthcare equity, outcomes, quality and value PC remains on life support. For example, an August National Academy of Medicine report concluded, “despite PC’s essential value for the health of the nation, more than 100 million people across rural and urban communities in the US are expe...

Because healthcare today can be increasingly defined as commodified, expedient, financialized, myopic, reductionist and failing to transcend politics, the question of healthcare’s ethics or the roll ethics plays should play is increasingly begged. For example, last October Health Affairs launched an “Ethics and Health Systems Change” series that to date has simply complained about private equity a...

This past summer CMS, more specifically CMMI, announced a six-year Medicare Part A demonstration that would require hospitals in six states to submit claims for prior authorization (PA) approval by non-medical, CMS-contracted, 3rd party entities using enhanced technologies, i.e., AI, for 17 medical items and services. Private/commercial Medicare or Part C Medicare Advantage plans have for years ex...

The World Health Organization (WHO) defines patient safety as “a framework of organized activities to reduce risks, lower the occurrence of avoidable harm, make errors less likely, and minimize their impact when they occur.” Over this past summer the HHS Office of the Inspector General (OIG) published three patient-safety reports. (Since 2008 the OIG has published at least 24 related studies.) One...

Recently published research by Prof. Wrigley-Field and her colleagues found that between 1980 and 2023 the total number of US excess deaths equaled 14.7 million. Between 2010 and 2023 excess deaths ranged between 120% and 130% higher compared to other HIC (High Income Countries). Possibly more disturbing the authors found US excess deaths were moreover among working-age adults, for example, in 202...

The greatest threat to human health is us. Humans are the only species capable of self-annihilation. For at least the past 30 years it has been acknowledged that the earth is presently experiencing its sixth mass extinction entirely caused by anthropogenic GHG emissions. Per research published in 2023, current generic extinction rates are 35 times higher than expected background rates prevailing i...

On July 23rd the United Nations’ International Court of Justice (ICJ) announced its highly-anticipated climate advisory opinion. The opinion represents a watershed moment because the court ruled states or countries are accountable for contributing to anthropogenic warming or for their GHG emissions. Consequently, the ICJ concluded countries are legally obligated to ensure the climate is protected...

The climate crisis is not a tragedy. It’s a crime. The July 4 signing of HR1, is the latest if not the greatest climate crime considering the current state of the earth’s energy imbalance or the ever-increasing amount of atmospheric GHG emissions that trap infrared radiation (heat) causing planetary warming. It’s estimated the OBBBA will over just the next five years add an extra seven billion ton...

Last week’s signing of the OBBBA serves as federal policymakers’ latest reverse Robin Hood effort, or to redistribute wealth from the poor to the rich. Per a February RAND report, over the past 50 years $79 trillion in wealth has been redistributed from the bottom 90% of Americans to the top 1%. The 2017 Trump tax cult left billionaires $6 trillion richer and the OBBBA, otherwise termed the Bill f...