The Healthcare Policy Podcast ® Produced by David Introcaso

Listen NowConsidering 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 risks and enjoy far fewer legal protections. During this 33-minute conversation, Prof Friedman discusses his motivation or intent in writing the book, what in theory is intended in calculating a monetary value for a life, how value is calculated or the "Value of a Statistical Life," why valuations vary widely, examples of why and when they're employed, for example, the 9/11 Victims Compensation Fund (VCF), the infamous Ford Pinto example and others including employer insurance policies on employees (commonly termed "dead peasants" insurance") and lives threatened by the climate crisis and relevance today in context of the COVID-19 pandemic.Professor Howard Friedman teaches at the Columbia University Mailman School of Public Health and Columbia's Data Science Institute. He also provides statistical analysis for the United Nations Populations Fund.  Previously, Dr. Friedman served as a Director at Capital One where he led teams of statisticians, analysts and programmers in various areas of operations.  He has authored and co-authored over 70 scientific articles and book chapters in areas of applied statistics, health economics and politics.  His recent publications have appeared in the American Journal of Gastroenterology, Current Medical Research & Opinion, Clinical Therapeutics, Inflammatory Bowel Disease, Journal of Managed Care Pharmacy, Clinical Drug Investigation, American Journal of Cardiovascular Drugs and Value in Health. Professor Friedman is also the author of the 2012 work, Measure of a Nation and the 2013 work, A Modest Proposal for America.  Professor Friedman Friedman received his Bachelor’s degree from Binghamton University in Applied Physics, earned a Masters in Statistics and Ph.D. in Biomedical Engineering from Johns Hopkins. Information on Ultimate Price is at: https://www.ucpress.edu/book/9780520343221/ultimate-price.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowListeners 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% of annual Medicare spending.  With the onset of the COVID-19 pandemic, the Congress and CMS regulators, recognizing the emergency or dire need to maintain a Medicare beneficiary's ability to access to clinical care in a timely manner, markedly expanded telehealth coverage.  Both the Congress's March 27th CARES Act and CMS' April 6 interim final rule made sweeping reforms to Medicare telehealth policy.   During this 22 minute conversation Ms. Drobac begins by explaining why the Medicare program significantly restricted use of telehealth.  Moreover, she outlines telehealth policy reforms noted in recent COVID-19-related legislation, moreover the CARES Act, and in CMS' interim final rule.  She discusses take-up or utilization by the provider community subsequent to these reforms, related Stark law issues, the need or persistence of integrity guard rails, and whether telehealth reforms will persist beyond the COVID-19 public health emergency.Ms. Krista Drobac is the Executive Director of the Alliance for Connected Care, an organization that advocates for telehealth policy reform.  She is also a Partner at the DC-based Sirona Strategies, a health policy consulting firm.  Previously, Ms. Drobac  was Director of the Health Division at the National Governors Association’s Center for Best Practices.  Prior to NGA, Ms.Drobac spent five years on Capitol Hill as a health advisor.  Prior still, she was a Senior Advisor at the Center for Medicare & Medicaid Services (CMS) working in Medicaid and private insurance regulation and also served as Deputy Director of the Illinois Department of Healthcare and Family Services.    Ms. Drobac holds a BA from the University of Michigan and an MPP from the Harvard University Kennedy School of Government.The Alliance for Connected Care is at: http://connectwithcare.org/.Telehealth reform policies detailed in CMS' April 6th interim final rule  are at: https://www.govinfo.gov/content/pkg/FR-2020-04-06/pdf/2020-06990.pdfThe CARES Act is at: https://www.congress.gov/bill/116th-congress/senate-bill/3548/text.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowNow, 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 worldwide deaths, more than 22,000 (a number that is substantially underestimated), or more than any other country.   Comparatively, Germany has suffered far fewer infections and deaths per capita due in part to early and widespread testing, a capable health care model (Germany has even been accepting COVID-19 patients from Italy, Spain and elsewhere), a population that has uniformly observed social distancing guidelines (and is advantaged by having a chancellor with a Ph.D. in chemistry).   Among other failures, the federal government has not taken leadership in acquiring necessary Personal Protective Equipment (PPE) and medical supplies forcing states to competitively bid, i.e., pay inflated prices, for the them.  Still fewer than 1% of the US population has been tested, in part because the president failed to deliver on  his March 13th promise to establish drive-through testing sites, causing former CMS Administrator, Dr. Don Berwick, to conclude, “we’re in a lot more trouble than we need to be" because "we are flying blind unless we find a way to find the people who are infected.”  Concerning Congressional efforts, this past Friday HHS Secretary Alex Azar announced he was awarding $30 billion of the $100 billion in grant moneys authorized under the March 27th CARES Act to support provider response to the COVID-19 pandemic.  Despite noting in his press press release theses monies were being distributed in a “fair” manner, Kentucky, the home of Senate Majority Leader Republican Mitch McConnell, received $311,000 per COVID-19 case, while New York, the home state of Senate Minority Leader Democrat Chuck Schumer, received $11,800 per case. During this 27 minute conversation Dr. Rishi Desai discusses where we are on the infection curve, mortality projections, success to date in practicing social distancing, uniquenesses associated with COVID-19, the development of a vaccine and antibody tests, supply and demand of PPE, the pandemic's disproportionate effects on minority communities and the poor, mental health effects, what lessons have we or will we learn as a result of the public health emergency and what these lessons suggest for necessary health care policy reforms going forward. Dr. Rishi Desai (MD, MPH) is a pediatric infectious disease physician with a public health background who currently serves as the Chief Medical Officer at Osmosis, an online medical learning platform developer.  He also recently led Khan Academy Medicine.  Dr. Desai had an accelerated education, completing high school and receiving his BS in Microbiology and Molecular Genetics from UCLA by the age of 18.  He completed his medical training at UCSF and went on to work at medical centers including Boston Children's Hospital, Boston Medical Center, Children's Hospital Los Angeles, and Stanford University.  He earned his MPH in epidemiology at UCLA and then spent two years at the Centers for Disease Control and Prevention as an Epidemic Intelligence Service Officer investigating disease outbreaks before beginning his work in online medical education.  Otherwise, Dr. Rishi spends his time taking his 3-year-old son to the park - when allowed, eating raspberries and learning Mandarin.For information on Osmosis go to: https://www.osmosis.org/. The CARES Act is at: https://www.congress.gov/bill/116th-congress/senate-bill/3548/text. CDC information on COVID-19 is available via the agency's home page at: https://www.cdc.gov/. Stay well.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowIt 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 among groups whose members were mostly likely uninsured before the reforms,” i.e., racial and ethnic minority groups.   We would do well to remember the 19th century German physician Rudolph Virchow whom argued, we should think of medicine as a social science - meaning medical care requires collective action to address social inequality’s contribution to ill health.  (Concerning social inequities, I encourage listeners will to listen to my March 10th conversation with the Center for Budget and Policy Priorities' Mr. Joseph Llobrera regarding the administration's treatment of SNAP.)During this 33 minute conversation, Daniel Dawes begins by providing historical context, i.e., early efforts in our nation's history to address population health and health inequities, e.g., creation of the (short lived) Freeman's Bureau in 1864.  He identifies and discusses three over-arching political determinants of health, possible reasons why the ACA (and again its health inequity provisions) have been so polarizing and current progress in political determinants addressing inequities, e.g., as related to the climate crisis.      Mr. Daniel Dawes is the Director of the Morehouse School of Medicine’s Satcher Health Leadership Institute and Associate Lead for Government Relations.   Among previous positions he founded and chaired the advocacy group, the National Working Group on Health Disparities and Health Reform and was the co-founder of the Health Equity Leadership and Exchange Network (HELEN).  He has worked to shape federal health equity policies including the Mental Health Parity Act, the Americans with Disabilities Act Amendments Act, the Genetic Information Nondiscrimination Act and the Affordable Care Act.  He is the author of the 2017 work, 150 Years of Obamacare.  He is an elected fellow of the New York Academy of Medicine and has served on several boards, commissions, and councils focused on improving health outcomes and elevating health equity in the United States.  He is an adviser to international, national, regional, state, and municipal policymakers, as well as think tanks, associations, foundations, corporations, and nonprofit organizations.  Mr. Dawes obtained his Juris Doctorate from the University of Nebraska. For more information on The Political Determinants of Health go to: https://jhupbooks.press.jhu.edu/title/political-determinants-health.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowIncreasing 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 the elderly have become so common the Japanese have named the phenomenon, kodokushi (lonely death).  In the UK, former Prime Minister Theresa May in 2018 created the new cabinet position, Minister of Loneliness.   In the US, former US Surgeon General Vivek Murthy called loneliness a “growing health epidemic.”  During this 32-minute conversation, Dr. Blazer begins by defining social isolation and loneliness or collectively social connections.  He then discusses the numerous associated adverse health effects including cardiovascular disease and dementia.  He discusses the current state of play regarding the extent to which the health care sector is addressing, social isolation in context of the ongoing COVID-19 pandemic, he notes several recommendations the report makes, discusses programming, and the scientific evidence for, that attempt to address these issues and potential problems associated with some of these interventions moreover use of technology.        Dan G. Blazer II, M.D., M.P.H., Ph.D., is the J. P. Gibbons Professor of Psychiatry Emeritus and a professor of community and family medicine at Duke University as well as adjunct professor in the Department of Epidemiology, School of Public Health, University of North Carolina.  He is the author or co-author of more than 180 books chapters, more than 220 published abstracts, and nearly 500 peer-reviewed articles.  He is also the editor or author of 40 books.  Many of the book chapters and scientific articles are on the topics of late life depression, epidemiology, consultation liaison psychiatry, the interface between religion and psychiatry, and the epidemiology of substance use disorders.  Most of his research projects have focused on the prevalence of physical and mental illness in the elderly.  He has served as the principal investigator (PI) of the Duke University Established Populations for Epidemiologic Studies of the Elderly, the Piedmont Health Survey of the Elderly, and the MacArthur Field Studies of Successful Aging.  He also was the original PI of the Duke Clinical Research Center for the Study of Depression in Late Life.  Dr. Blazer is an elected member of the National Academy of Medicine from which he received the Walsh McDermott Award for Distinguished Lifetime Service to the Academy.The NAS report is at: https://www.nationalacademies.org/our-work/the-health-and-medical-dimensions-of-social-isolation-and-loneliness-in-older-adults. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowDespite 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 low nutritional diet.  (Many Americans also suffer from "hidden hunger" or micro-nutrient deficiency.)  What explains this includes the fact 42% of American workers are paid $15 an hour or less – causing the US to have one of the highest poverty rates among developed/wealthy countries.   The US, unlike 158 other countries, is not a signatory to the 1966 International Covenant on Economic, Social and Cultural Rights which recognizes “the fundamental right of everyone to be free from hunger.”  In addition, health care ironically contributes to hunger in America.  If health care cost what it does, for example in Switzerland or 30% less per capita, median income growth over the past 30 years would have grown to twice what it is.  Phrased another way, medical expenses push millions of Americans below the poverty line, including 7 million who earn 150% of the poverty level.  (Devoted listeners may vaguely recall I interviewed the CBPP's Dr. Paul Van de Water in January 2013 regarding Medicare and Social Security reform.) During this 32-minute conversation Dr. Llobrera begins by providing an overview of the SNAP program and its benefits.  He then explains the Trump administration's proposed FY 2021 SNAP budget that would, like the administration's previously proposed budgets, cut SNAP spending by $182 billion over ten years, or by over 25%, he discusses administration regulatory reforms currently being implemented that will cut SNAP by $50 billion and remove approximately 4 million from the program, how or what rationale the administration uses to explain these budget cuts/program changes, the Congress's response to these policies and what the health care industry/health care providers are doing programmatically to address the reality that food is medicine.     Dr. Joseph Llobrera is the Director of Research for the Food Assistance team at the Center on Budget and Policy Priorities (CBPP).   Previously, Dr. Llobrera served as Research Associate at the Center between 2002 and 2007.   Before returning to the Center, he served as an Associate Director of Learning and Improvement at Insight Policy Research, providing technical assistance and training to federal, state, and local human service agencies that administer the Supplemental Nutrition Assistance Program and the Temporary Assistance for Needy Families program.  He also also employed as a researcher at IMPAQ International and the Urban Institute, focusing on food assistance policy, workforce development, and health policy.  Dr. Llobrera received his Ph.D. in Nutrition from the Friedman School of Nutrition Science and Policy at Tufts University, his master’s degree from the University of Washington (Seattle), and a bachelor’s degree in Mathematics and Urban Studies from Brown University.The CBPP's February 18 memo providing an overview of the president's proposed 2021 SNAP budget is at: https://www.cbpp.org/research/food-assistance/presidents-2021-budget-would-cut-food-assistance-for-millions-and-radicallyCBPP's November 2019 SNAP Chartbook is at: https://www.cbpp.org/research/food-assistance/chart-book-snap-helps-struggling-families-put-food-on-the-table This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowCMS' 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 (CJR) and the Oncology Care Model demonstrations, both began in 2016.   These models are designed to pay a specified or target price for a discrete episode of care, in CJR for a hip or knee replacement.   Assuming quality performance is met, if spending is below the target price the provider recoups the savings, if above the target they owe the difference.   Recent evaluations, discussed here, show these programs are on balance demonstrating savings, though modest, to the Medicare program.  Listeners may recall I interviewed Archway's Founder and CEO, Dave Terry two years ago this  month.     During this 37 minute interview (lengthy but worth it), Ms. Macmillan begins by providing an overview of Archway Health.  She then discusses Archway's results to date regarding participation in BPCI Advanced relative to financial performance, quality and utilization - that she unpacks by discussing what accounts for savings, what quality is being measured and how measuring quality can be improved and steps CMS is taking to more accurately target price episode payments via peer groupings.  We discuss CMS' latest evaluation of the agency's CJR demonstration and other evaluation findings, participation by MA and commercial plans in episode based bundled payment arrangements, how best these demonstrations or models can be evolved, i.e., how better episode and population-based models can be better integrated, the inclusion of Part D spending, whether bundled payments should be made mandatory and what explains Archway's success in participating in these payment  models.      Ms. Keely Macmillan is currently Senior Vice President of Policy and Solutions management at Archway Health where she oversees all aspects of Archway’s involvement CMS' Bundled Payments for Care Improvement (BPCI) Advanced demonstration.   She is an expert in alternative payment models including bundled payments and ACOs, value-based purchasing, and MACRA’s Quality Payment Program.  Previously, Ms. Macmillan was manager of government payment policy at Partners HealthCare, the largest health system in Massachusetts, where she managed public payer financial forecasting and led the government payment policy team in the analysis of performance-based reimbursement models.   Ms. Macmillan earned her master’s degree in Health Policy and Management from the Harvard T.H. Chan School of Public Health and a Bachelor of Science from Yale University.Information on Archway Health is at: https://www.archwayhealth.com/.Mentioned during this discussion:CMS' January 2020 8-page overview of episode based bundled payment results to date is at: https://innovation.cms.gov/Files/reports/episode-payment-models-wp.pdf. The Lewin Group's second CJR evaluation published last June is at: https://innovation.cms.gov/Files/reports/cjr-secondannrpt.pdf.Evaluations of BPCI published in the January issue of Health Affairs are by Amol Navathe, et al. and Rajender Agarwal, et al., are at: https://www.healthaffairs.org/toc/hlthaff/39/1 (subscription is required). This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowThis 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 should redress this harm by issuing an injunction requiring the federal government  to prepare a plan for judicial review and approval that would draw down green house gas emissions.  In its defense the federal government argued there is no fundamental constitutional right to a stable climate system, or that the state of the climate has no connection to personal life and liberty.  The court ruled 2-1 in favor of the US government, arguing the plaintiffs complaint was not redressable or was nonjusticiable, despite admitting "climate change was occurring at an increasingly rapid pace," "will wreak havoc on the Earth if left unchecked" and "may hasten an environmental apocalypse."  The dissent argued the Constitution's perpetuity principle, that life and liberty is secured for both ourselves and posterity, does not "condone the Nation's willful destruction."  During this 30 minute discussion, Ms. Rodgers begins by describing the physical and mental health harm experienced by the Juliana plaintiffs.  She notes organizations that contributed amicus briefs.  She explains the majority opinion's reasoning (authored by Justice Andrew Hurwitz) that ruled in favor of the defense and the minority opinion authored by Justice Josephine Staton.  She discusses media coverage of the case, related cases, moreover the December Urgenda decision by the Supreme Court of the Netherlands that ruled in favor of the plaintiffs, and the Juliana plaintiffs intent to appeal the January decision or petition the 9th Circuit Court for a rehearing en banc.   Ms. Andrea Rodgers is Senior Litigator Attorney at Our Children’s Trust, an Oregon-based public interest law firm, that represents the Juliana plaintiffs.  In her role at Our Children's Trust she also is lead counsel on the constitutional youth climate lawsuits against the state of Washington, Aji v. State of Washington, and the state of Florida, Reynolds v. State of Florida.  Previously, Ms. Rodgers served as an Honors Attorney for the U.S. Department of Transportation, In-House Legal Counsel for the Snoqualmie Indian Tribe, and Staff Attorney for the Western Environmental Law Center.  After graduation from the University of California, Santa Barbara in 1998 and the Arizona State University School of Law in 2001, where she served as co-executive editor of Jurimetrics: The Journal of Law, Science and Technology, she clerked for the Hon. John C. Gemmill on the Arizona Court of Appeals.  In 2016, Seattle Met Magazine recognized her legal work representing youth in the Washington climate change case in King County Superior Court against the Washington Department of Ecology (Foster v. Ecology).  The 9th Circuit Court's January decision is at: http://cdn.ca9.uscourts.gov/datastore/opinions/2020/01/17/18-36082.pdf. For complete information on the Juliana case go to: https://www.ourchildrenstrust.org/juliana-v-us. Information on the Urgenda case decided this past December in the Netherlands is at: https://www.urgenda.nl/en/themas/climate-case/.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowConsidering 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 this 30-minute interview Dr. Cram begins by providing a general overview of population health in Canada.  He goes on to discuss moreover how care is organized and budgeted (or how spending is managed) in Canada, how care is designed (via an emphasis on primary care), the extent to which providers enjoy autonomy and patients suffer lengthy appointment/referral wait times and the prospects of Americans importing drugs from Canada.  Dr. Peter Cram, an American citizen (a Connecticut native), is currently the Director of General Internal Medicine and Geriatrics at Sinai Health System and the University Health Network and Professor of Internal Medicine at the University of Toronto.  Previously, he was on faculty at the University of Iowa from 2002 to 2013.  Dr. Cram has published more than 180 research papers and is the co-founder of the International Health System Research Collaborative (IHSRC).  He earned his medical degree at the Wake Forest School of Medicine and completed his medical training at the University of Michigan.  During this interview mention was made of Cram, et al., "Trade-Offs: Pros and Cons of Being a Doctor and Patient in Canada," it is at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400751/.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowProfessor 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, Abbott Labs, Nestle and others and consisting of corn syrup and among other ingredients enzymatically dydrolyzed soy protein isolate (Freeman terms junk food for babies) does not compare to breast milk (that consists of living human cells, active hormones, antibodies and hundreds of other unique components ideal for infant health) helps explains why Black infant (and maternal) mortality remains twice that of White, Non-Hispanics.  Why Black women use formula, Professor Freeman explains, is due to a myriad of reasons that include targeted Black marketing, Professor Freeman details Pet's use of the Fultz quadruplets (born in North Carolina in 1946), federal policies that support and endorse formula use by Black women and a web of other laws, polices and practices that obstruct the ability of Black women to initiate or sustain breastfeeding. During this 30 minute interview, Professor Freeman discusses Dr. Fred Klenner's contract with Pet to market the Fultz children and numerous other variables that explain why Black women are less likely to breastfeed.  Among others, she discusses the effect 350 years of slavery has played, stereotypes of Black women, formula milk industry motivations, federal policies that reinforce/subsidize these motivations, limited legislative and regulatory oversight and limited efforts by the medical profession to contain or prohibit marketing formula milk and encourage breastfeeding.Andrea Freeman is an Associate Professor at the University of Hawaii's William Richardson School of Law.  She has also taught as a visiting professor at the University of California, Berkeley, School of Law, at the University of Denver Strum College of Law and has a Distinguished Scholar of Sustainable Agriculture and Food Systems at Vermont Law School. Before joining the faculty at the University of Hawaii, she taught at Santa Clara University School of Law, University of San Francisco School of Law, and California Western School of Law.  Professor Freeman is an active community member serving on the Litigation Committee of the ACLU Hawaii chapter.  She volunteers with the Kokua Hawaii Foundation, makes legal presentations to the Hawaii Judiciary History Center and Hawaii State Judiciary, and writes op eds on topics including Hawaiian sovereignty and race and health.  In 2015, Professor Freeman received the Community Faculty of the Year award from Richardson's Advocates for Public Interest Law.  Professor Freeman is the Chair of the AALS Section on Agriculture and Food Law and Treasurer of the AALS Section on Constitutional Law.  She is co-chair of the Law and Society Collaborative Research Network for Critical Race and the Law and a Founding Member of the Academy of Food Law and Policy.  After graduating from UC Berkeley School of Law, she clerked for Judge Jon O. Newman of the U.S. Court of Appeals for the Second Circuit and former chief Judge José A. Fusté of the U.S. District Court for the District of Puerto Rico.  Prior to attending law school, she worked in Toronto as a counselor for women and children who experienced domestic violence and in New York as a production manager in the independent film industry.   Information on Skimmed is at: https://www.sup.org/books/title/?id=28151. The related CDC August 2019 Morbidity and Mortality Weekly Report (MMWR) report noted during this interview is at: https://www.cdc.gov/mmwr/volumes/68/wr/mm6834a3.htm.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com