The Dose

Earlier this week, President Biden declared the pandemic over. This tracks with public opinion: most Americans have long abandoned their masks, and federal funds may soon dry up for testing, treatment, and even vaccines. Of course, this doesn't mean the virus has disappeared. In fact, hundreds of Americans are still dying each day from COVID-19, and thousands more are suffering from long COVID, a host of protracted symptoms that could lead to severe health complications down the line. On the latest episode of The Dose, host Shanoor Seervai talks to Dr. Bob Wachter about what it's like to live with COVID in 2022. Dr. Wachter, professor and chair of the Department of Medicine at the University of California, San Francisco, is one of the nation's foremost experts on the pandemic.

Among other things, the Inflation Reduction Act is being hailed as a potential breakthrough in making health care more affordable. But what does this landmark legislation, enacted last month, really mean for Americans – now and in the future? To open the new season of The Dose, host Shanoor Seervai interviews Stacie Dusetzina, an associate professor in health policy and cancer research at Vanderbilt University. Dusetzina breaks down the key health provisions of the new law, from drug price negotiation in Medicare to the redesign of Part D coverage. We've "repeatedly been burned by the health care system… [so] we're all suspicious when something sounds really too good to be true," she says. "The changes here for people who have very expensive drugs are almost too good to be true."

Social programs like Medicaid are supposed to help people, but often they reproduce racial inequities — and sometimes actually create them. That's because even well-intentioned policymakers can't always see the disproportionate impact their decisions have on people of color. But what if there were a tool to help legislators and government officials identify when and how they should be thinking about racism? Well, Jamila Michener has developed one. And on this encore episode of The Dose podcast, she explains how it can be applied to Medicaid's transportation benefit specifically and to health policy more broadly. Michener, an associate professor in Cornell University's Department of Government, speaks about how her research on, and personal experiences with, Medicaid has highlighted the importance of hearing from people impacted by policy choices. "You can't really address the ways that racism manifests… unless you have people who experience it directly at the table, not only having voice, but also having some power," she says. This encore episode was originally released on 2/11/2022.

Climate change can have a devastating impact on our health. When people are injured or exposed to disease related to floods or fires, it's up to health systems to pick up the pieces. But health care itself is one of the world's most carbon-intensive industries, responsible for 4.5 percent of all greenhouse gas emissions. What can health systems do to address climate change? In the United Kingdom, the National Health Service (NHS) has set some ambitious goals to reduce its carbon footprint. On this encore episode of The Dose, Nick Watts, the NHS's chief sustainability officer, talks about how the health service is meeting these goals, and whether its efforts could be replicated in countries like the United States. A low-carbon health care system, he says, is actually just a good health care system. This encore episode was originally released on 1/28/2022.

The Dose will be taking a short summer break while our team works on brand-new episodes for the next season. Listen to our season finale, in which we highlight some of the accomplishments of our guests. Join us in the fall, for new conversations with health policy experts as they share ideas about how the U.S. can improve health care for everyone. Episodes Mentioned: Priti Krishtel on "For Global Vaccine Access, Overhaul the Patent System" Kevin Simon on "Closing the Mental Health Care Gap for Black Teens" Rachel Hardeman on "The Quest for Equity in Reproductive Health"

A well-functioning public health system is vital to keeping individuals, and the population at large, safe and healthy. Except that success is often invisible when it comes to public health—we don't notice it until the system breaks down. The U.S. public health system has taken a drubbing from COVID-19. But the pandemic has also driven home just how critical it is to invest in this key component of national infrastructure. On the latest episode of The Dose, Dr. Dave Chokshi, who led New York's pandemic response as the city's health commissioner, talks about how we can apply the lessons of the past two years in rebuilding the U.S. public health system. "If we take the opportunity to build [a] community-based public health infrastructure, to embrace a mission of health equity as fundamental to health, then that's what will help to protect… our community as a whole," he says.

Racial bias in medical care extends all the way to the prescription pad. Research shows that people of color are less likely to receive the most effective treatments for life-threatening conditions, including cancer and heart disease. One way to address this is by aiming for "pharmacoequity" — where all patients, regardless of race, socioeconomic status, disability, or other characteristics, have access to the highest-quality evidence-based medical therapies that meet their health needs. On the latest episode of The Dose, the man who coined this term, Utibe Essien, M.D., an assistant professor of medicine at the University of Pittsburgh, explains what it will take to achieve pharmacoequity. "The data are not lying about how we're prescribing medications," Essien says. To eliminate such biases, he believes we must be honest about the data and develop strategies to ensure greater equity.

Nurses in the United States are experiencing burnout at unprecedented rates. More than two years into the pandemic, they are still processing the trauma of what they witnessed in the early days. Staffing shortages, meanwhile, are creating unmanageable workloads. On the latest episode of The Dose podcast, host Shanoor Seervai interviews Rebecca Love, a nurse and president of SONSIEL, the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders, a nonprofit dedicated to creating new opportunities for nurses in health care innovation. Love talks about what it would take to fix the nursing crisis, from changes in nursing reimbursement to new ways of training and empowering nurses to provide the best possible patient care.

When a federal judge lifted the national mask mandate on airplanes, trains, and other public transportation, some Americans broke out the champagne. Others wrung their hands, dreading the removal of a relatively simple public health tool at a time when COVID-19 cases are rising across the U.S. On the latest The Dose podcast, Celine Gounder, M.D., Senior Fellow and Editor-at-Large for Public Health at the Kaiser Family Foundation and Kaiser Health News, talks about why people without privilege — like those who are poor or uninsured and many people of color — will be hit the hardest if we rush to return to normal. "Having safety nets becomes really important," she says. Measures like improved indoor air quality, paid sick and family medical leave, and better access to health insurance would help control the health, social, and economic impacts of the pandemic.

Access to health care is a constitutional right for the 2 million Americans in our criminal justice system. For some of those incarcerated – overwhelmingly people with low income and people of color – the first time they receive care is behind bars. But when individuals transition back into their communities, this care often vanishes. On the latest episode of The Dose, Emily Wang, M.D., director of the SEICHE Center for Health and Justice at Yale University, explains why we need to ensure continuity of care for people cycling in and out of the criminal justice system. The first few weeks after release are critical, she says. "You want people to return home to reintegrate… to reestablish a life, get a house, get a job, contribute meaningfully as a member of our community."