The Healthcare Policy Podcast ® Produced by David Introcaso

In a world of unbridled self-interest or where self-interest becomes the basis for reason, where integrity is abandoned, where there exists a striking absence of and/or contempt for moral analysis, virtue and empathy and where cynicism becomes inevitable, power compromises the law and evil no longer needs to be justified. These realities, for example, help explain a projected 14+ million deaths by...

On July 30 Senate Finance Committee Democrats issued an 86-page Request for Information (RFI) titled, “Health Coverage That Works for Everyone.” As Ranking Democratic Member Ron Wyden explained, much like the Finance Committee’s 2008 white papers that laid the groundwork for the ACA, this RFI constitutes an essential blueprint for necessary and immediate federal healthcare reform. Surprisingly - o...

Beginning in the 1970s and 1980s (think, e.g., Hayek, Friedman, Reagan, Stockman and Clinton), US policymakers decided healthcare should be defined like any other commercial or market commodity. It’s not, think: Ken Arrow. Therefore, national policymakers under the mantra of the financialization of everything or privatization included healthcare (think: Medicare Advantage); largely per Robert Bork...

With the Congress adjourned for summer recess and the mid-terms now 83 days away, August is a good time to discuss substantive or systematic HC reform. Listeners, and/or anyone paying attention to mid-term campaigns and primaries (think: Dr. Abdul El-Sayed) are well aware healthcare is again on life-support largely due to increasing unaffordability and political acquiescence. In “Beyond Medicare f...

As everyone is well aware, healthcare, particularly acute care (think: hospitals) has become increasingly more unaffordable. For the four-year period ending next year ERISA or employer-sponsored health insurance plans will increase employee premiums by ~25%; this year the average employee family premium is ~$27,000; by the end of this year six million are expected to lose ACA coverage; and, to rea...

In May 2024, Vermont enacted entirely unprecedented legislation that attempts to mitigate climate-charged disaster events and associated financial fallout inflicted on Vermont residents. Vermont climate superfund legislation, followed seven months later by New York (and presently pursued by at least ten other states), is in response to climate-charged disaster events that over the ten- yr period e...

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...