The Healthcare Policy Podcast ® Produced by David Introcaso

Listen Now Increasing social isolation and loneliness have been recognized for several decades.  The issues was the topic of Harvard’s Robert Putnam’s much publicized research three decades ago, i.e., his 2000 publication "Bowling Alone."   More recently, the Pope has observed “radical loneliness,” caused by a consumer culture is subverting social relationships.  In Japan, loneliness deaths among...

Listen Now Despite the fact the US is a net food exporter, the country suffers a significant food security problem (defined as uncertain of having or unable to acquire enough food).  Per the USDA, over 11% of Americans, or over 37 million(including 12 million children), are food insecure or worse.   In addition, the US ranks first among OECD countries in obesity, a primary indicator of a poor or l...

Listen Now CMS' efforts, via the Centers for Medicare and Medicaid Innovation (CMMI),  to develop episode-based bundled payment models in Medicare is now it its eight year.  This work is currently being pursued under the 2018-initiated Bundled Payments for Care Improvement (BPCI) Advanced (that succeeded the BPCI demo, begun in 2013, now concluded) and the Comprehensive Care for Joint Replacement...

Listen Now This past January 17 the 9th Circuit Court of Appeals ruled in Juliana v the US.   Filed in 2015 by 21 children and others, the plaintiffs argued health harm caused by the federal government’s long support or promotion of the fossil fuel industry violates their Constitutional right to life and liberty, i.e., their right to a survivable climate.  The plaintiffs argued further the court s...

Listen Now Considering the frequent favorable assessment of Canadian health care of late, by, for example, several presidential candidates and (surprisingly) the Trump administration via its recent decision to propose a regulatory pathway for US entities to import drugs from Canada, the question is begged how or how well do the Canadians deliver universal health care and at what expense. During th...

Listen Now Professor Andrea Freeman's recently published, Skimmed: Breastfeeding, Race and Injustice, explains how and why Non-Hispanic Black women are significantly less likely to breastfeed their newborn than White, Non-Hispanics and Hispanics.  Black, Non Hispanics are, instead, significantly more likely to feed their newborns formula milk.  That formula, manufactured by Pet, Mead Johnson, Abbo...

Listen Now The 2019 Lancet Countdown on Health and Climate Change (subtitled, Ensuring That the Health of a Child Born Today is not Defined by a Changing Climate), released in mid-November, identifies 41 indicators in five domains: climate change impacts, exposures and vulnerability; adaption, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and...

Listen Now Twenty years ago last month the National Academy of Sciences published the landmark report, “To Err Is Human, Building a Safer Health System.”  The report found upwards of 98,000 people die each year in hospitals alone as a result of medical errors.  One specific medical error, diagnostic error, was, and remains today, a substantial contributor.  Defined as a wrong, delayed or missed di...

Listen Now On October 31st, the FDA released the agency's Congressionally-mandated report titled, “Drug Shortages: Root Causes and Potential Solutions.”  The 124-pg report found drug shortages are increasing, persistent, i.e., the duration longer, with both the intensity and public health impact high.  These shortages can, the FDA found, “have a devastating effect,” by prolonging patient suffering...

Listen Now As has been widely reported the US spends upwards of twice what other OCED countries on medical care however with worse or similar outcomes.  What explains this is in part the fact the US spends about one-third of what other OECD countries spend on social services such as food aid, housing assistance and transportation.  This despite knowing research shows basic measures of health are m...

Listen Now On November 1st, the Centers for Medicare and Medicaid Services (CMS) published the agency's final 2020 Quality Payment Program (QPP) rule that announced beginning in 2021 CMS will begin instituting MVPs, or Merit-based Incentive Payment System Value Pathways.  These value pathways will be created to financially incent and reward, as CMS states, “high value clinicians.”  This means CMS...

Listen Now Dr. Azra Raza's recently published book, The First Cell and the Human Costs of Pursing Cancer to the Last, has been described as a "searing account of how both medicine and our society (mis)treat cancer, how we can do better, and why we must."  It has been termed "a clarion call . . . [that] repudiates the approach . . . that biomedical science has taken to attempt to find new treatment...

Listen Now Psychedelic agents or drugs, for example Lysergic Acid Diethylamide or LSD (a cereal fungus and first synthesized in 1938), were widely researched for their therapeutic potential through the 1950s.   Among other noted users of these agents was the actor, Cary Grant.  However, when these drugs escaped the research lab in the 1960s, moral panic set in.  America's youth would, it was feare...

Listen Now Though difficult to accurately calculate for obvious reasons, the Department of Housing and Urban Development's (HUD's) 2018 point-in-time survey identified over 550,000 individuals living in emergency shelters, transitional housing or were unsheltered.  One-third were families, a disproportionate number were African American and/or veterans and a growing number were victims of wildfire...

Listen Now Largely with the exception of the 2010 passage of the ACA, federal legislative (and regulatory) efforts to reform health care over the past few decades has lagged.   This is the result of an increasingly dysfunctional Congress.  For example, Congressional productivity, measured by the number of enacted laws, has decreased every decade since 1990 by over 20 percent.  For this reason and...

Listen Now In CMS' proposed hospital outpatient rule published in the Federal Register in early August, the agency proposed requiring hospitals to make public a list of its negotiated rates for common items and services.   The proposed rule is based on two White House executive orders and is an expansion of a related regulatory rule that went into effect this past January 1st that requires hospita...

Listen Now Medical aid in dying is now legal in nine states and the District of Columbia or is available to approximately one-fifth of the US population.  State medical societies allow physicians to provide treatment that comports with their conscience, survey data shows the practice enjoys substantial public support and the option is available in numerous foreign countries including the Netherlan...

Listen Now In late June, Professor Philip Alston, the UN's Special Rapporteur on Extreme Poverty and Human Rights, published "Climate Change and Poverty."  The 20-page report is unsparing in its criticism of the response, or lack thereof, by corporations, governments, NGOs and the human rights community to the climate crisis, moreover their response concerning the effect the crisis will have on th...

Listen Now The news is grim.  Our planet has just experienced its hottest June in recorded history and likely the hottest July.  This year will likely join ten others since 2000 as the warmest ever recorded.  Several studies just published in Nature and Nature Geoscience have concluded there has never been a period over the past 2,000 years when temperatures have changed as fast and extensive as i...

Listen Now One way to increase the value of insurance coverage is to eliminate or lower a patient's out of pocket costs (OOP), i.e., their co-pays and/or deductables, for health care services that are of high value, for example, vaccines and/or alternatively increase OOP costs for low value service, for example, certain imaging tests.  The concept is based on the straight forward rationale that, b...

Listen Now Nine in 10 prescriptions are today filled using a generic drug saving Americans tens of billions annually.   A significant amount of generic drugs, along with active ingredients in all drugs, are manufactured overseas.  However, how safely or to what quality standards are these ingredients and generics produced?   Bottle of Lies, published in May, tells the story of appalling practices...

Listen Now US gun violence is, in one word, obscene.  It is widely considered an epidemic, even the always cautious AMA termed it a "public health crisis" in 2016.  Through the first five months of this year there were 148 mass shootings that killed or wounded nearly 750 individuals.   It is worth repeating comments I made in April 2018 to introduce Dr. Al-Abga (whom treated victims of the 1999 Co...

Listen Now This past June 4th the 9th Circuit Court heard oral arguments concerning Juliana v. the US , a case filed in 2015 by 21 children seeking a jury verdict on whether the US government, by failing to address the climate crisis, is protecting the plaintiff’s rights to life, liberty and the pursuit of happiness.  In its defense the US is arguing these children, now young adults, have “no fund...

Listen Now Americans spend over $3.5 trillion or 6% of the GDP annually on health care.  One third, or over $1 trillion, of that spending is considered waste, i.e., health care that does not improve our health status.  Despite substantial efforts to improve health care value or spending efficiency via so called pay for value, performance based and alternative payment models, for example ACOs and b...

Listen Now It should go without stating "nature's contribution to people are vital to human existence."  Nevertheless, this was the third line in the May 6th report by the UN Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES).  As the report notes, "70% of drugs used for cancer are natural or are synthetic products inspired by nature, four billion people reply...