The Healthcare Policy Podcast ® Produced by David Introcaso

Over the past four decades the US has, per a 2019 JAMA-published study, made a “clear lack of progress on health equity.” Health equity or disparities have almost certainly worsened over the past five years due to COVID and accelerating climate breakdown.  For example, air pollution in 2021 killed over 8 million globally including 2,000 children under age five daily. Foul air, nearly entirely the...

Mr. Burger joins me to discuss climate crisis-related litigation here and abroad and its effectiveness in curbing greenhouse gas emissions. Dedicated listeners may recall I interviewed Mr. Burger in May 2020 regarding the Trump administration’s unwinding of numerous environmental regulations.  Michael Burger  is the Executive Director of the Sabin Center for Climate Change Law at Columbia Universi...

Climate-related health effects are typically defined or limited to those resulting from extreme weather events, exacerbations of chronic disease and increases in vector borne diseases. Unfortunately, very little attention or even recognition is afforded the effects the climate crisis has on brain health largely via climate-fueled neurotoxin exposure. Mr. Aldern’s valuable if not indispensable work...

In Dobbs v. Jackson Women’s Health Organization, the Supreme Court in June 2022 reversed the court’s previous 1973 Roe v Wade decision, and 20 related cases, wiping out a half century of constitutional protections for women’s reproductive rights.  In Dobbs, the court found the Constitution now excludes a woman’s control over her body as well as the possible continuation of her life.  Compelled pre...

Over the past 12 years this podcast has discussed increasing corporate dominance of healthcare delivery, made evident in part by the fact the healthcare market is highly concentrated and highly leveraged, e.g., over the past decade private equity has spent roughly $1 trillion to acquire physician practices.  The corporate practice of medicine (CPOM) is problematic because allowing for corporate me...

Research published last month in Advances in Atmospheric Sciences by Prof. Abraham and his colleagues once again show ocean temperatures, more specifically ocean heat content (OHC), once again dramatically increased in 2023.  (As I noted last year, many believe OHC is the best way of measuring anthropocentric warming because it is comparatively less variable on a year-to-year basis.)  Oceans, that...

In his soon-to-be-published book, Dr. Chaudhary argues the climate crisis or the Anthropocene era is the political product of rightwing climate realism - what he terms the “Rex Tillerson Position.”  Listeners should be aware politics, not technology or economics, explains why the US continues to emit an enormous amount of CO2e pollution. (The US healthcare industry contributes approximately 550 MT...

Sepsis presents an enormous public health threat. There are for approximately 1.7 million hospital cases and 270,000 deaths per year. Sepsis is consistently in the top five for hospital case volumes and is the most expensive and resource intensive medical inpatient condition, representing approximately 15% of total hospital costs despite accounting for less than 4% of hospital stays.  Various stud...

In part because there are over 10,000 known human diseases and symptoms thereof may have numerous possible explanations, frequently diagnostic tests can be in-determinative or less informative than observing (termed: watchful waiting) a suspected disease’s clinical course over time.  Because of diagnostic complexities population level diagnostic errors represent a significant public health problem...

According to the non-profit Mapping Police Violence, since 2013 when experts first starting tracking police shootings, last year was the deadliest year on record with 1,176 law enforcement gun deaths, or more than three people per day and nearly 100 per month.  In 2022 Blacks were three three times more likely to be killed by police than Whites.  However in, for example, MPLS and Chicago, Black sh...

US healthcare emits a massive amount of carbon pollution at approximately 600 million tons annually or roughly 9% of total US greenhouse gasses.  Because of the rapid increase in climate crisis-related harms projected economic losses worldwide over the next few years are estimated in the trillions.  Consequently, the US is beginning to follow Brazil, Canada, France, Japan, Switzerland and the UK i...

US healthcare spending is extreme currently at approximately $4.3 trillion.  The single largest payer of healthcare services is Medicare at roughly $900 billion annually or 21% of total healthcare spending.   In this edited volume, recently published by Johns Hopkins University Press, Dr. Moffit along with eleven other contributors including Joe Antos, Douglas Holtz-Eakin, Brian Miller, Mark Pauly...

Over the past several decades healthcare has increasingly defined patients as medical consumers.  For example, healthcare advertising is today a $22 billion annual business; federal policymakers have over the past few years instituted regulations requiring both hospitals and commercial health plans to make pricing information public; and, provider quality performance information is increasingly pu...

Professors Albritton Jonsson and Wennerlind’s recently published book, “Scarcity” by Harvard University Press, offers interpretations of a key concept in economic theory: scarcity, or the belief we live in a world of limited resources and therefore must master the natural world to meet desired needs.   The authors state, “the book does not offer a critique of the usefulness of the neoclassical con...

Dr. Young’s novel, “2060” tells the story of Willis Smith, a data analyst employed by IntegraHealth Pharmaceuticals. Mr. Smith is assigned to identify a surviving meta-quad, a patient that has survived four naturally occurring cancers.  In his search Willis meets the owners of Mekong Gardens Senior Care Center who offer a distinctly different healthcare formula.   The story arc peaks when the owne...

On background, listeners are aware that the US healthcare industry emits an enormous amount of GHG pollution, that hospitals are the largest contributor to industry emissions, that they are substantially energy in-efficient and that the industry’s emissions alone cause innumerable and unrelenting health harm - disproportionately impacting are Medicare seniors and Medicaid children.  Despite these...

Professor Larry R. Churchill, Emeritus Professor of Medical Ethics at Vanderbilt, discusses “Biotethics Reenvisioned,” a just-published book he co-authored with Wake Forest Professor Nancy M. P. King and UNC Professor Gail E. Henderson. The authors, appropriately, argue “bioethics needs an expanded vision” or beyond one that has predominately focused on patient autonomy, beneficence and nonmalefic...

As this hour-long documentary explains US hospital care, and healthcare in sum, is largely volume-driven that over-emphasizes expensive specialty versus spending-efficient primary care.  There exist few constraints on commercial healthcare pricing despite the fact hospital prices have little correlation to care quality or value, defined as outcomes achieved relative to spending.  Prices also vary...

More than likely the most important legislation the Congress will pass this year or this session is the multi-year fam bill that is projected to cost $1.5t over the next 10 years.  A significant component of farm bill leg is Title IV that addresses nutrition assistance, namely the Supplemental Nutrition and Assistance Program (SNAP) that serves 42 million Americans, including one in every four chi...

In February the CDC released its latest Youth Risk Behavior Survey findings.  Somewhat needless to say the data is discouraging.  For example, in 2021 40% of high school students, 60% of high school female students and 70% of high school LGBQ students reported feeling sad or hopeless. Among other findings, 22% of high school students had seriously considering suicide, 18% made a suicide plan and 1...

This past March 20th the United Nation's Intergovernmental Panel on Climate Change (IPCC) published its fourth and last sixth assessment cycle (AR6) report.  This last report integrates the main findings of the IPCC's three, sixth assessment working group reports published over the past 18 months.  The report has been informally termed the “last warning” since the IPCC 7th assessment work will lik...

In June 2021 I argued in STAT News that HHS require healthcare providers to publicly disclose their GHG emissions that in turn would help enable the healthcare industry to decarbonize.  In order to do this, I argued the the Environmental Protection Agency's (EPA’s) Energy Star Portfolio Manager tool be exploited.  Already well over 50% of hospitals use Energy Star to better manger their energy con...

The US government is frequently defined generally as an army with an insurance company.  Regarding the latter, podcast listeners are well aware federal healthcare policymakers have essentially done nothing to address the healthcare industry's annual 500 million ton carbon footprint, 9% of total annual US GHG emissions, despite the fact that at $1.5 trillion the federal government is far and away t...

Dr. Paul Farmer unexpectedly passed away on February 21, 2022.   He was 62.  Trained as physician and medical anthropologist, Dr. Farmer was known moreover for his healthcare work in Haiti that he more formally forwarded via Partners in Health (PIH), an organization he cofounded in 1987.   Over the subsequent years Dr. Farmer and PIH expanded their work around the world in Africa, Russia, South Am...

Listeners may recall two years ago this past month I interviewed Professor Jacobson regarding his text “100% Clean Renewable Energy and Storage for Everything.”  I noted in my introduction to that 2021 interview Prof. Jacobson argued since 2009 100% of the world’s energy supply could be produced via solar, wind and water power within 20 to 30 years.  The barriers to a 100% conversion to renewables...