The Healthcare Policy Podcast ® Produced by David Introcaso

Having posted over 25 related climate and health-related interviews over the past several years, podcast listeners are aware that the healthcare industry effectively exists in a harm-treat-harm cycle where providers cause patients harm via their greenhouse gas (GHG) pollution - that requires treatment causing providers to emit more harmful GHG pollution added - that leads to more patent harm - tha...

After heart disease cancer is the leading cause of mortality in the US at over 600,000 deaths annually.  Not surprisingly cancer care costs are considerable at approximately $210 billion of which approximately 10% is paid out of pocket.  This explains why in part up to 30% of Medicare beneficiaries without subsidies do not fill their anticancer prescriptions.  To make matters worse, the COVID pand...

This summer the planet once again experienced record temperatures, droughts, wildfires and extreme weather events.  Nevertheless, according to a recent report by the International Energy Agency and OECD, global public subsidies of fossil fuel subsidies nearly doubled from 2020 to $700b in 2021.  The US economy still remains significantly dependent on coal use; it generates approx. 20% of the count...

Is at: https://substack.com/inbox/post/75107864 .  It opens with: In summarizing Professor Jedediah Purdy’s recent book, Two Cheers for Politics, The New Yorker’s Adam Gopnik recently wrote, “He [Purdy] is angry at the elites who supervise the bureaucratic capitalist state on behalf of their overlords while keeping up an elaborate masquerade of equality of opportunity.”   “Keeping up the masquerad...

Over the past few years federal policymakers have instituted healthcare price transparency.  Until last year, healthcare prices were largely, if not altogether, unknown to patients.   As of this past July 1 most group health plans and issuers of group or individual health insurance are required to publicly disclose pricing information.  As of this past January 1, providers were no longer able to s...

During its recent August 3rd hearing titled, “A System in Need of Repair: Addressing Organizational Failures of the U.S.’s Organ Procurement and Transplantation Network," Senate Finance Committee Chairman, Ron Wyden (D-OR), characterized efforts by the federally-contracted not for profit, UNOS (United Network for Organ Sharing) regarding organ procurement and transplant as grossly mismanaged and i...

Two weeks ago Senate Majority Leader, Chuck Schumer, announced the $739 billion Inflation Reduction (IRA) Act of 2022, compromise legislation agreed upon by Senator Manchin.  The bill includes just a few of the healthcare policy reform provisions House Democrats included in House legislation passed late last year, moreover extending expanded ACA marketplace insurance subsidies and allowing the Med...

Toxic Debt, An Environmental History Justice History of Detroit, just published by North Carolina University Press in its Justice, Power and Politics series, is largely a history of failure by federal, state and local government officials to regulate the auto industry’s extremely harmful environmental and consequential human health effects.  This failure is substantially explained by the replaceme...

In mid-June Columbia's Professor Frederica Perera and Stanford's Dr. Kari Nadeau published a review article in The New England Journal of Medicine titled, "Climate Change, Fossil-Fuel Pollution, and Children's Health."  The article provides an overview of the numerous health harms inflicted on children around the world resulting from fossil fuel combustion's released of massive amounts of airborne...

(P)Luck moreover details the nine year collaboration between identical twins, Dr. Alfred Sadler and Blair Sadler, an attorney, via their work at NIH,  Yale, the Robert Wood Johnson Foundation and the Hastings Center on Bioethics to advance national organ donation and transplantation policy, create the Physician Assistant profession, advance national emergency medical care and address related bioet...

Listeners are certainly aware of never ending US gun violence.  For example, since 37, moreover 4th grade children, were shot with 19 killed in Uvalde, Texas on May 24th, there have subsequently been at least 14 subsequent mass shootings killing at least 10 and wounding another 61.   Over the past ten years, or since the Sandy Hook , there have been 950 subsequent school shootings.   Concerning fe...

Coincident to the United Nations' 1992 creation of the Framework Convention on Climate Change (UNFCCC) agreement that governs international efforts to address the climate crisis/reduce Anthropocene warming, the UN also created the Convention on Biological Diversity (CBD) that attempts to address or maintain biodiversity or mitigate declining biodiversity worldwide.  The CBD has been ratified by ev...

There are currently approximately 15,500 Skilled Nursing Facilities (SNFs) in the US providing care to approximately 1.5 million Americans at an annual cost of approximately $175 billion.  Research has for decades demonstrated SNF care quality lags - made tragically evident by the ongoing COVID pandemic.  As MedPAC termed in its recent March report, the pandemic's effects on SNF patients have been...

This interview relates to numerous previous podcasts, however, to date I have not specifically discussed economic neoliberalism.  The effects of economic neoliberal theory (and its related political movement) underlies recent interviews with, for example, Dr. Steven Woolf and Prof. Kathleen Mullan Harris regarding declining US life expectancy, with Prof. Carol Graham regarding diseases and deaths...

Johns Hopkins is generally cited as the first to pilot the Hospital at Home care model over 20 years ago.   The model has been subsequently adopted by the VA and overseas in Australia, Canada, Israel and the UK among other countries.   CMS first tested the model in 2014 when it awarded Mount Sinai a grant to test the model, however, the model was not expanded having failed to the meet statutory cr...

In her just published Johns Hopkins University Press book, "Ethically Challenged, Private Equity Storms US Health Care," Professor Olson’s describes how and why Private Equity (PE) firms over the past forty years have purchased an ever-increasing number of acute and post-acute providers, physician groups, dental practices and a long list of health care ancillary services and what impacts PE firms...

This discussion intends to bring listeners more up to date regarding declining life expectancy in the US via discussion of the National Academy of Sciences' 2021 consensus report, "High and Rising Mortality Rates Among Working-Age Adults."  This interview builds upon previous related discussions including my 2013 interview with Dr. Steven Woolf regarding the IOM’s related report, “Shorter Lives, P...

In a survey published late last year in The Lancet Planetary Health, coauthored by Dr. van Susteren, 10,000, 16-25 year olds across 10 countries including the US were surveyed to assess their level of climate anxiety and the beliefs about government responses to the climate crisis.  The survey found: 75% thought the climate crisis posed a frightening future; 66% were left afraid, anxious or sad; 6...

Listeners of this podcast are aware the US suffers from extreme wealth and income inequality.  (E.g., see my “The Unrecognized Tragedy of Working Class Immiseration” STAT News essay posted here on December 31st.)  Concerning CEO compensation in the health care industry, the highest ten paid CEO’s in 2020 were paid an average of $20 million.  By comparison, according to 2020 data from the Bureau of...

Our economy is frequently defined as one of unpaid costs.  (Think: Garret Hardin and the tragedy of the commons.)  Nature or natural resources are considered either inexhaustible and/or the byproducts of their use, such as polluted air and degraded water quality, are externalized costs borne by society, i.e., no one.   Our economic model perfectly well explains the climate crisis.  Treating our at...

Over the past several years the earth's oceans, that cover 70% of the planet's surface, have dramatically warmed.  In a paper published last week in Advances in Atmospheric Sciences researchers concluded for the sixth consecutive year ocean temperatures in 2021 reached record levels.  Compared to 2020, 2021 ocean temperatures were 14 zettajoules (14 followed by 21 zeros) warmer.  This amount of en...

The climate crisis threatens human health in innumerable ways including injury from extreme weather events, respiratory illness, zoonoses, water-borne, vector borne, and non-communicable diseases, malnutrition, behavioral health and psychosocial problems and finally heat related illnesses and death. Climate crisis-related health effects are and will be particularly be hard felt by the elderly and...

Concerning the recent United Nation’s COP 26 meeting in Glasgow, again unverifiable pledges were made moreover to cut methane gas emissions by 30% by 2030, limit deforestation and adequately finance converting to a green economy.  The US continued to exhibit intransience and/or fecklessness moreover by refusing to sign a pledge to phase out coal despite the fact it is the single biggest source of...

Last November 9th I discussed declining life expectancy in the US with Dr. Steven Woolf, i.e., US life expectancy stopped increasing in 2010 and had been decreasing since 2014.  This is significantly due to increasing mortality rates among men, disproportionately white men aged 25-64, for approximately 30 disease conditions ranging from cancer, cerebrovascular, circulatory, genitourinary, infectio...

Greenwashing is generally defined as a public relations or marketing practice used to deceptively persuade the public an organization is environmentally responsible.  In recent related news, after an Exxon lobbyist was caught on tape admitting efforts to undermine the Biden administration's efforts to address the climate crisis, last week the House Government and Oversight Committee requested docu...