The Healthcare Policy Podcast ® Produced by David Introcaso

Listen Now (As noted below on the podcast website this discussion is the first of eight interviews concerning federal healthcare policy reform.  This discussion with Dr. Woolf was conducted in early November.  As you will hear this podcast, and all seven others, are introduced by ProMedica's CEO, Randy Oostra.  This series was produced in an effort to interest or persuade federal healthcare offici...

Listen Now 2020 was yet another record setting temperature year tying 2016 as the warmest on record.  2020 was strikingly warmer than 2019, by about .75 degrees Fahrenheit, and some parts of Arctic were warmer by more than 10 degrees Fahrenheit.   2020 also set a US record for $1 billion climate disasters numbering 22 and totaling $95 billion damages (the previous records were 16 in 2017 and more...

Listen Now Listeners are aware social determinants significantly explain one's health, as much as 80%.  Principally among these is economic status.  Wealth positively correlates with health.   As listeners are, or should be, well aware 250 fifty years of slavery and a century and a half of institutionalized racism has resulted in median black household net worth equal to one-tenth that of median w...

Listen Now Catastrophic climate crisis effects continue to accelerate.  Atmospheric carbon concentrations are now measured at 417 ppm, the greatest concentration of atmospheric carbon in our  existence.  This year will again prove to be one of warmest on record.  This year is also a record-breaking Atlantic hurricane season, with 30 named storms to date, and a record breaking year for wildfires. ...

Listen Now Computer or cybercrimes against health care providers, moreover hospitals, disenable computer networks holding them for ransom, frequently for a bitcoin fee.  Though these attacks date back at least 30 years they have become increasingly prevalent since 2010.   Last month, Universal Health Services, with 400 locations moreover in the US, suffered a cyberattack.  Recently too, the first...

Listen Now The ongoing COVID-19 pandemic has placed a spotlight on the social determinants of health (SDOH) - generally defined as health access and quality, education, economic circumstances, food security, social conditions and environmental factors.  It is estimated SDOH determine as much as 60% of one's health status, whereas formal medical care accounts for just 10%.  Concerning economic circ...

Listen Now Collectively termed subnationals, numerous academic institutions, states, cities and other local governments, companies, NGOS and other entities across the country have independently pledged to go green or become climate neutral.  Ironically, the industry most lagging in this effort is health care despite the fact that, after the food industry, health care is the largest emitter of carb...

Listen Now Patient safety, or preventable patient harm, remains a significant threat to patients, particularly seniors, now over 20 years after publication of the landmark IOM report, “To Err is Human."  The country’s failure to contain COVID-19 (SARS-CoV-2) stands in marked contrast to successful containment of SAR-COV-1 (and MERS and H1N1).  This failure has assuredly increased incidences of pat...

Listen Now In testimony before the House Energy and Commerce Committee in 2007, the FDA's Dr. David Graham stated, "15,000 elderly people in nursing homes [are] dying each year from the off-label use of antipsychotic medications for an indication that the FDA knows the drug doesn't work.  The problem has been known to the FDA for years and years.”  Eleven years later, Human Rights Watch published...

Listen Now From an ethical perspective our nation's response to the COVID-19 pandemic has been disastrous.  For example, as has been widely reported, our nation has failed to protect the most vulnerable among us, for example, nursing home residents have suffered approximately one-third of all COVID-19-related deaths.  As for other disenfranchised, African Americans have been were more than twice a...

Listen Now Because the economy and the Medicaid program run counter cyclically or are negative correlated (when the economy falters, Medicaid enrollment increases ), to no one's surprise the COVID-19 pandemic's effect on the economy has put the Medicaid program in jeopardy.  The US is experiencing the worst unemployment rate since the Great Depression causing state budgets, heavily reliant and inc...

Listen Now Federal policymakers have struggled unsuccessfully since at least the 1980s to create a national long term care (LTC) policy.  LTC coverage is available however it can only be obtained by pursing a complicated asset depletion process to qualify for coverage under the Medicaid program.  (Medicare is frequently assumed to provide LTC.  It does not.)  The 2010 Affordable Care Act's CLASS A...

Listen Now Our planet is currently experiencing its sixth mass extinction.  Over the past 450 million years the planet has experienced five previous mass extinctions.  Each of which destroyed or extinguished between 70% and 95% of all plants, animals and micro-organisms.  While these five previous extinctions were moreover the result of volcanization, the current extinction crisis is human caused....

Listen Now The Trump administration has strongly supported alternative insurance plans in the individual market or those that do not meeting regulatory requirements, for example providing what are defined as "essential health benefits," under the Affordable Care Act.  (While the administration claims the ACA reforms are responsible for higher premiums, research shows price increases are largely du...

Listen Now Being endemic in the US, racism is pervasive in health care.  It explains everything from the fact that the black to white infant mortality ratio has never dipped below to 2:1, to more generally, disproportionate un- and under-insured rates, compromised access, non-referrals, accelerated aging and and excess deaths.  More pernicious than interpersonal racism, structural or systemic raci...

Listen Now The current public health emergency brings into stark relief US health care’s ineffectiveness.  As previously noted, with 4.25% of the world’s population, the US currently accounts for 26% of worldwide COVID-19 infections and deaths.  Concerning our response to date, Harvard's Ashish Jha recently stated, "we may end up being the worst of any country in the world in terms of our response...

Listen Now Since I've received and answered questions via email concerning podcast interviews and related health care policy questions over the past eight years, I thought it might be it might be useful to attempt answering listeners via a podcast program.  This podcast addresses questions I received via my solicitation a few months ago.  Joe DiLauro, the gentleman whom introduces the podcast and...

Listen Now The COVID-19 pandemic has had particularly fatal effect on seniors or the frail elderly residing in Long Term Care (LTC) facilities, e.g., in a Skilled Nursing Facility (SNF_ or in assisted living.  As of last week approximately four in ten COVID-related deaths had occurred in these residences.  For example, in Virginia, as of mid-May approx. 60% of all COVID 19 related deaths have occu...

Listen Now Since the federal government's response to the COVID-19 pandemic remains, as the The New England Journal of Medicine termed last week, laconic, the US response continues to be best understood at the state level.  California immediately comes to mind for obvious reasons.  Among others, it has a population of 40 million or 12% of the nation’s total (and if it was its own nation, would con...

Listen Now It should go without saying that we interact with the environment constantly.   It should also go without saying a degraded environment compromises our health and leaves us less resilient.  This explains why Black Americans, disproportionately suffering from chronic conditions resulting from, e.g., poor air quality, are suffering COVID-19 mortality rates upwards of three time that of Wh...

Listen Now Since I've received and answered questions via email concerning podcast interviews and related health care policy questions over the past eight years, I thought it might be it might be useful to attempt answering listeners via a podcast program.  This podcast addresses questions I received via my solicitation a few months ago.  Joe DiLauro, the gentleman whom introduces the podcast and...

Listen Now Considering how the COVID-19 pandemic has been addressed by federal policy makers, e.g., the US, with 4.25% of the world's population, accounts for approximately 30% of worldwide deaths, the question arises to what extent do we value life - literally.  As Professor Friedman notes in his work, lives undervalued are lives unprotected since they are exposed to greater health and safety ris...

Listen Now Listeners may be aware that up until recently the Medicare program strictly limited provider use of telehealth services via originating site and other numerous other regulatory rules despite its much wider adoption by other payers and the VA.  (E.g., see my previous interview/discussion with Ms. Drobac.)  Annual Medicare reimbursement for telehealth services equaled approximately 0.003%...

Listen Now Now, exactly one month after President Trump declared a national emergency, the federal government's response to the COVID-19 pandemic has been largely inept.  As of April 12th, the pandemic has infected over 560,000 Americans constituting slightly more than 30% of the world’s total number of infections. The US accounts for 5% of the world’s population, however, it has suffered 20% of w...

Listen Now It is altogether appropriate to discuss the political determinants of health since this past Monday we marked the ten year anniversary of the Affordable Care Act (ACA).   The law was intended, in part, to reduce health inequities.  Research published earlier this month in Health Affairs concluded, “the ACA produced broad gains in insurance coverage,” and “that coverage increased most am...