Fixing Healthcare Podcast

In the final episode of season three, we welcome Dr. David Shulkin, the ninth U.S. Secretary of Veterans Affairs. For most of his career, David was a physician and then a private-sector leader who earned a reputation for turning around struggling hospitals. In 2015, President Obama asked him to help turn around the scandal-ridden Department of Veterans Affairs. Two years later, President Trump appointed him VA Secretary—making David the only Obama-administration holdover to serve in Trump’s cabinet. Lessons from his experiences in government fill the pages of his new book “It Shouldn’t Be This Hard to Serve Your Country: Our Broken Government and the Plight of Veterans” (Public Affairs). In this interview, David talks about the difference between serving President Obama and President Trump, the “wait time” crisis that lured him to the VA and how the culture of government is a good match for improving patient care. Here are some of the highlights from Episode 19: On the differences serving Trump vs. Obama I think most of the listeners understand that there’s a big difference in style between President Obama and President Trump. Interestingly, I experienced them in very different ways. Both cared very deeply about veterans and making sure that we are doing the right things, but they had different approaches. President Obama was very thoughtful, analytic and careful in policy making and decision making where President Trump was much more willing to move quickly and take risks. On politicizing the healthcare of veterans For me, the issue of veterans should be a bipartisan issue. It should be outside of the traditional political divisions that we see so much in this country. I was very proud that I worked both as Under Secretary and as Secretary in a bipartisan fashion. And in fact, most senators and congressmen that worked with me had no idea if was a Republican or Democrat and that was exactly the way I wanted it. When you’re dealing with improving the lives of veterans, that really should not be a Democratic or Republican issue. On dealing with scandal in the VA The reason why I came to government in the first place was because of the wait-time crisis that was receiving national attention, where veterans were being alleged to have been harmed, some of them dying because they weren’t able to get access to care. So, when I entered government, I had a mandate to fix that and I certainly was committed that-that was going to be my top priority to make sure that every veteran that needed healthcare was getting it in a timely fashion. On mental healthcare and suicide prevention for veterans The single top priority that I had as secretary that I established … for the Department of Veteran Affairs was to reduced veteran suicide. With 20 veterans a day taking their life, it was and still is an epidemic in the veteran population, as well as the greater American public health issue that we see today. I think that the Department of Veteran Affairs has really been a leader in trying to reintegrate physical care with behavioral health care. On the over-reach of Trump’s political appointees What we’re seeing is the power of political appointees throughout the administration to influence decisions that are really somewhat more political in nature rather than necessarily what is good public policy. And when it comes to the Department of Veteran Affairs, I experienced many of these political appointees trying to influence what I would call their ideology of how government should work rather than necessarily what was the right thing to do for the veterans that we served. READ: Full transcript of our discussion with David Shulkin * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 19: Former VA Sec. explains why it’s so hard to serve your country appeared first on Fixing Healthcare.

In this episode, we welcome Representative Eric Swalwell, from California’s 15th Congressional District. A former presidential candidate and a rising star in the democratic party, Eric serves on several House committees, including the high-profile Judiciary and Intelligence committees. He’s now in his fourth term and joins the Fixing Healthcare podcast to offer his thoughts on the role of government in advancing our nation’s healthcare agenda. Here are some of Eric Swalwell’s highlights from Episode 18: On his top 3 healthcare priorities for America First and foremost, I would make sure that every family in America has access to healthcare. And healthcare to me includes prescription drugs … The second, I think it’s really about the future of medicine, in that we need to be a country of curers again, and investing in cures in our lifetime … And then third would be to just make sure that our children, at the earliest of ages, are educated about diet and exercise. On getting bipartisan support to lower drug prices We recently passed prescription drug reform in the House (H.R.3) but … we’ve not seen enough bipartisan progress. I would like to see more Republicans, especially with a president who has talked about prescription drug reform, show more seriousness … The president has talked about it, and I’ll take him at his word that he wants to do something on prescription drugs, but we’re going to need leadership to get the prescription drug bill that we passed in the House to get a vote, or some sort of reform in the Senate … I think medicine has to be bipartisan, any legislation in that area, and that’s where I’ve tried to lead. On how we can become a ‘country of cures’ again I think when it comes to cures, the private sector, that’s where you find the ingenuity and the people, but it’s really going to take public funding to get there. On whether ‘Medicare for all’ is the best option I’m a big supporter of Medicare for anyone who wants it. Essentially, a hybrid system, where the Federal government would dramatically increase what it contributes to healthcare, to have a public option. Not to eliminate private insurance, but with a robust public option, to make private insurance more competitive, and frankly, more accountable on their costs, and who is covered. On the role of parents in promoting proper diet and exercise I think Michelle Obama was the biggest person to try and make strides on this, and she was ridiculed, and it was politicized, sadly. But I think really making sure that our kids, and what they eat at school, and their preschools, really set them on a course for a healthy lifestyle, so that you can head off some of the costlier issues that they would take on later in life. READ: Full transcript of our discussion with Eric Swalwell * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 18: Eric Swalwell on whether Congress can pass a bipartisan healthcare bill appeared first on Fixing Healthcare.

In this episode, we welcome James Carville, one of the most recognizable figures in American politics. Carville came to fame as the lead strategist on Bill Clinton’s 1992 presidential campaign run, coining the now-ubiquitous phrase, “It’s the economy, stupid.” He has worked as a political commentator for both CNN and Fox News, and remains a powerful voice in politics today. Carville hosts now the “2020 Politics War Room” podcast alongside political insider Al Hunt. He joins us now, in season three of the “Fixing Healthcare” podcast, to talk about the 2020 elections, the possibility of legislating major healthcare changes and the effects of climate change on public health. Here are some James Carville highlights from Episode 17: On the dangers of trying to reform healthcare as president Traditionally, politically, anybody that moves on this issue tends to lose. So, we moved on it in ‘93, didn’t get it through. We lost politically. President Obama moved on it in 2009, was able to get it through and suffered politically. On drug prices and research funding I think it’s a terrible thing in a country of this enormous wealth where we have people that are priced out of getting the kind of pharmaceutical help they need … One of the things that the pharmaceuticals say, “Well, we need this [funding] because we need to do ongoing research.” I think there’s a compelling case to make, a public case to make, is let the federal government fund the research. You apply for grants like you do for anything else and you have a board of physicians that determine what’s meritorious research or not. And then you say, “Okay, we’ll pick up the research costs for you.” If that’s what standing between people living and dying, the amount of money, like I said, they can do the research. On hospital consolidation and monopolistic pricing I live in New Orleans and maybe there’s something here that Ochsner [Health System] hadn’t bought, but it’s kind of hard to find. And I just have to believe, based on just everyday experience, that the reason that they’re gobbling all the people up, becoming consolidated, is because they want some price power … As you have consolidation, you have increased political might. So, they’re going to be more formidable now than they were five years ago. That’s just a fact.” On the political unlikelihood of ‘Medicare for all’ Look if we were going to start from scratch, we’d do a lot of stuff different. All right, I wish I could start from scratch. I’m 75 … You going to tell an Alameda County firefighter in California that you don’t have your health insurance anymore? That you’re in Medicare? I don’t think that’s going to work … The problem with Medicare for all is you have to un-ring a bell. On climate change and public health I mean the public health ramifications of climate change are beyond comprehension. And of course, as you would expect, as always the case, is disproportionately going to affect poor people. And this, I can tell you, we have so much water and it’s coming our way in Louisiana. It’s horrific. And I am very depressed and skeptical about the ability of the world to deal with this issue. On what a democratic Congress and president could achieve in four years First of all, you would have real strengthening, deep strengthening of Obamacare. You’d have a pretty significant expansion of the number of people that actually had health insurance … And I don’t think there’s any doubt, they would have a hard time not dealing with the prescription drug issue. READ: Full transcript of our discussion with James Carville * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 17: Talking healthcare politics with James Carville appeared first on Fixing Healthcare.

Stephen Bergman, who goes by the pseudonym Samuel Shem, took the medical and literary worlds by storm in 1978 when he published his provocative satire “The House of God,” based on his clinical internship at the Beth Israel Hospital, a teaching facility associated with Harvard Medical School in Boston. The cult novel, which the New York Times described as “raunchy, troubling and hilarious,” sold over 2 million copies and served as the backdrop for Shem’s latest work “Man’s Fourth Best Hospital.” Set in a nearby institution, Massachusetts General Hospital, now 40 years later, Shem pulls us into the present, taking a critical look at the failures of American medicine today. In this episode of Fixing Healthcare with Dr. Robert Pearl and Jeremy Corr, Shem reflects on why “The House of God” remains relevant, why the doctor-patient relationship is faltering and what can be done to combat the “abuse” of doctors. Here are some interview highlights from Episode 16: On what’s different about medicine today The biggest difference that has caused all the trouble … are the computer screens that are linked, that link data to payment, that link code to cash. As you know but the public doesn’t know, it’s mainly, in a lot of ways, a billing machine or a cash register (and) that we doctors are at these machines from 60 to 70, 80% a day because we are tasked with the job of fighting for the highest payment of our diagnosis that we’re putting down. On the other side of the war of the screens, the insurance drones are trying to pay the least for each of the codes we click. Like all wars, it’s about money. On what’s still the same Well, at best, the same is the same. I’m a writer of resistance to injustice, and the injustice, both in “The House of God” and in “Man’s Fourth Best Hospital,” is the doctor-patient relationship. The injustice of being forced in a system where you can’t really do what you want to do and, as you know, what we docs came into it for, which was to help people, to make contact and guide them through their suffering, and be there at the worst times in their life to help them through. On the high hopes of treating patients Well, “The House of God” is a story sort of one step off real of my internship where it’s really going through the internship with five other interns as major characters. This character called the Fat Man, who is their resident that teaches them, who’s the hero of the book, of both books, and who is this marvelous kind of huge-in-every-way, wise, foolish-in-a-way, expert teacher and doctor. The book is about how the sort of innocent interns, including the narrator, Roy Bash, enter this system with all high hopes of being humane doctors and treating patients well, and, alas, this big hierarchal system does not allow them to do what they think is in the best interest of their patients. On the treatment of women in his books There were criticisms, valid criticisms, by nurses especially, who are mostly women, that oh, the way you portray women in this book, this is really not very good, blah, blah, blah. I plead that that’s the way it was. That’s the only defense I had. I write not only real, I wrote one step off real, my editor said, which brings out the humor. I write from real. What I’ve done consciously in “Man’s Fourth Best Hospital,” because it’s such a different era, that you will be pleased to hear, and everybody will be pleased to hear, that when the Fat Man founds this clinic leaning up against man’s fourth best hospital, this public clinic, by the end of the novel, we have achieved parity with women. There’s as many women as men, which really makes me feel good because that’s the way it is now. On physician suicide and burnout Yeah, the thing that the students are most riveted by in the book is when we come to the chapter with the suicide. That’s because, here’s linking it to your question, that’s because there is an increased rate of suicide not just in doctors, which is big now. That’s because of “burnout,” which I would much rather call abuse because burnout makes it feel like we’re not up to it. Abuse makes it, I think, clearer. Anyway, there are suicides, and suicides are up in medical schools, too, which I find incredibly moving. These kids who have just worked and worked and worked to get into medical school and then, often, on the edge of leaving medical school or first-year, that’s when suicides happen, the transition. It’s because they get isolated. READ: Full transcript of our discussion with Samuel Shem * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 16: ‘The House of God’ author Samuel Shem appeared first on Fixing Healthcare.

After eight months of working at his first job out of college, Tyler Shultz was at a crossroads. He realized the device that he was hired to engineer was a total flop. After a bit of soul searching, Shultz made a life-altering choice. He blew the whistle to federal regulators. Not long after, Theranos’ billion-dollar valuation imploded, creating the biggest bust in Silicon Valley history. “A good lesson learned is to be wary of a charismatic leader,” Shultz said of Theranos founder Elizabeth Holmes. Today, Tyler is a biotech entrepreneur and a leading voice on the topics of corporate governance, business ethics and the role of government in regulating healthcare. In this episode of Fixing Healthcare with Dr. Robert Pearl and Jeremy Corr, Tyler opens up about what went wrong at Theranos and what could be done to prevent the next billion-dollar hoax. Here are some interview highlights from Episode 15: On Theranos founder Elizabeth Holmes “Elizabeth was amazing at being able to flip me on my head. I would be working in the lab thinking, oh my God, this thing is never going to work. It’s giving us terrible results. And then, I would go and I would have one conversation with Elizabeth and I would leave thinking, wow, I’m going to change the world working at this company for the rest of my career.” “Elizabeth raised $900 million and not a single investor ever saw an audited financial statement, which is mindboggling. It’s totally mindboggling. I started my company, I’ve had investors ask me for an audited financial statement and I’m trying to raise a $1 million seed round, not $1 billion. That point really astounded me that the investors just really didn’t seem to do even the most basic type of due diligence.” “The last conversation I ever had with her was actually a Thanksgiving dinner after I had quit … She actually came to our family’s Thanksgiving. It was a very intimate setting. It was just me, my parents, my brother, Elizabeth, her parents and my grandparents. It’s not like there were 100 people at this Thanksgiving dinner. It was a small dinner, and at the table, Elizabeth raised her glass and gave a toast and said, ‘I just want to say that I love and appreciate every member of the Shultz family.’ I remember lifting my glass and my hand was literally shaking because of all of the emotions I was feeling at the time. That’s the last time I talked to her. Other than that, it’s all been through the lawyers.” On the red flags at Theranos The first time that I saw (inside a Theranos device) was the first time that actually a high-level senior scientist was seeing it. In retrospect, that should have been a red flag that there were high-level scientists who have been working there for years who hadn’t seen a Theranos device. “Theranos had a very, very intense culture of secrecy. The labs weren’t supposed to talk to each other. There were barricades up all over the place or locked doors. And then, you had bulletproof glass, bulletproof windows.” On the lessons learned “What I’ve learned is that there’s actually much safer ways to blow the whistle. I think part of the problem was that I actually didn’t even recognize that I was really in a whistle-blowing situation. I was really just reacting to situations and doing the best I could with the information that I had … For example, if I were to have just taken everything that I had seen, any data that I had and I just went directly to the SEC, then I would have been protected and Theranos wouldn’t have been even able to threaten to sue me over things that I had just told the SEC. So, the government will protect you. But I didn’t even know about that.” On the role of government and regulation “When the CMS (Centers for Medicare and Medicaid Services) inspectors came through to give Theranos their CLIA certification, they actually weren’t even shown the lab that had the Theranos devices. They were only shown the lab that had the third-party equipment, because … almost all of the tests were run on third-party equipment and not on Theranos equipment … They knew that Theranos was this highly lauded company who had supposedly come up with this revolutionary technology to do blood testing and then they go and do the inspection, but they don’t even look at that piece of technology. It just seems very strange to me.” On what it was like to blow the whistle “I was extremely stressed. I was almost debilitatingly stressed during that period of time, where I would wake up in the morning and just think that today is going to be the worst day of my life. I wish I didn’t have to get out of bed, but somehow I’d pulled myself out of bed and I would charge forward. “There were instances where I would hear a rustling outside of my window at night and my heart rate would go up to like 180, and I would wonder if tonight’s the night that Sunny (Balwani) whacks me. I would really peer out my window trying to cautiously see what was making the noise. Eventually, I’d see like a deer raccoon or something, but I did sleep with a knife next to my bed and I carried pepper spray with me pretty much anywhere I went. Not that that would really do anything, but it was something of a pacifier.” READ: Full transcript of our discussion with Tyler Shultz * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 15: Theranos whistleblower Tyler Shultz appeared first on Fixing Healthcare.

Presidential hopeful John Delaney joined the Fixing Healthcare podcast to spell out his plan for the future of American healthcare policy. In this, the second episode of season three, physician and healthcare leader Robert Pearl quizzed Delaney on the specifics of his universal healthcare platform, which he dubs BetterCare. Fixing Healthcare cohost Jeremy Corr asked questions that are no doubt on the minds of patients, many of whom are finding healthcare increasingly unaffordable. Delaney is an American attorney, businessman and Maryland politician who is running for President of the United States in 2020. In 2017, he became the first Democrat to announce his run for president in 2020. Delaney co-founded two companies that were publicly traded on the New York Stock Exchange, including Health Care Financial Partners (HCFP), to loans available to smaller-sized healthcare service providers. Delaney is the author of a 2018 titled, The Right Answer: How We Can Unify Our Divided Nation. In this interview, John Delaney explains his history as a healthcare businessman, outlines his innovative platform “BetterCare,” and tells voters why both Sanders and Trump are dead wrong about healthcare financing. Download the complete transcript or check out some of the highlights from the interview here: On Delaney’s healthcare objectives I think we have to think of three things: that is access, quality and costs, because healthcare is really all of those things. When we think about reforming our healthcare system, which I do believe is broken, our goal should be to create a system of universal access so that everyone has access to healthcare. What I would do initially as president in my first 100 days is what I call “fix the Affordable Care Act,” because I think the Affordable Care Act was a very important step forward and it was a good law. But there are some things that need to be fixed. Principally, a mechanism needs to be created to take some of the higher-risk patients out of the various exchanges that have been established or could be established around the country, because some of these patients really do skew the economics of exchanges. The second thing I would try to do with my first 100 days is put in place a public option, which I think would significantly improve the American people’s ability to get healthcare. I would likely model the public option around something that uses the Medicare provider network, which I think is the most trusted provider network in the country, and creating a low-cost, very efficient public option that everyone would have the opportunity to buy into. I think it would significantly improve healthcare in this country. But then, thirdly, I’d want to work towards a form of universal healthcare because I think healthcare is a basic human right and I also think it’s smart economic policy. On creating universal coverage I think if every American had a basic healthcare package as part of citizenship, they would be able to be more economically mobile either as entrepreneurs or just in pursuing economic opportunities, because, unfortunately, I think a lot of Americans are shackled to their job because it’s the way they get their healthcare. The way I would create a universal healthcare system is along the lines of the proposal I rolled out, which is called BetterCare. Under BetterCare, we leave Medicare alone because it works. While it’s not perfect, it’s probably the best part of our healthcare system. I wouldn’t make any changes to Medicare. But what I would do is I would create a new program that everyone gets from when they’re born to they’re 65 and then when they’re over 65 they go into Medicare. I would roll Medicaid into this new federal program because Medicaid is really a broken program around this country. The way the new federal healthcare plan would work under Bettercare is even though you get a basic government healthcare package as a right, you don’t have to take it if you don’t want to. So, I would give the American people choice, and the way that would work is everyone would get their basic healthcare, they could take it or not. On Delaney’s healthcare credentials After college and law school, I became an entrepreneur. My first business with two partners was a home healthcare business where we provided healthcare into people’s homes. Fairly traditional home care services, but this was in the late ‘80s, early ‘90s. It was somewhat of a new service at the time. The second company of mine was called Health Care Financial Partners and what it did is it focused on financing small to midsize healthcare companies all over the country. Things like rural hospitals, long-term care providers, home health care, large physician practices, diagnostic companies. During the time I ran the business, we made loans to a thousand healthcare companies all around the country. I think I’d be the only president who ever has any experience in the healthcare business, which is maybe one of the reasons why we’ve had such a broken healthcare system, historically. On competing health policy plans The fundamental problem with the single-payer proposal that a lot of politicians put forth is … we have no evidence to suggest that the government ever pays the cost of healthcare. I think Medicare is a great example of that because Medicare only covers about 90% of healthcare costs. Medicaid I think covers 80% and commercial insurance pays 120%. So, I’d like to get Medicare rates up to, more approximate, the cost of healthcare because I think that would create a healthier healthcare marketplace. Bernie Sanders … says, well, the hospitals have a lot of bad debt and, if you had Medicare for all, then all that uncompensated care would get paid, and he’s right about that. That would add revenues to hospitals, there’s no question about it. But if you look at the 30 to 40 percent of their business that’s commercial insurance, and you were to cut that in half, the additional revenues from uncompensated care would not cover the lost revenues from everyone getting paid at Medicare rates. Trump made this kind of dumb statement at one point, but he was right when he said healthcare is complicated. It’s such an incredibly complicated system. I mean it’s almost 1/5th of our economy. It’s really thousands of systems layered upon themselves. Medicare for all absolutely achieves universal access, just like my plan BetterCare does. But it will undoubtedly lead to a reduction in quality and increasing cost, in my opinion. I think the reduction of quality could get so significant that it actually starts leading to limited access. I don’t think there’s any chance Medicare for all ever becomes law in this country because it’s fundamentally bad healthcare policy. If you reimburse the U.S. healthcare system at Medicare rates, hospitals all this country would close. That’s never going to happen politically. Medicare is not a single-payer program. You get basic Medicare when you’re over 65, but then you have choices. You can get a supplemental plan, but you can opt-out and buy Medicare Advantage. Under Medicare for all, you can’t do either of those things. So, I just think it’s bad healthcare policy, it’s terrible politics, it’s never going to happen. But we should have universal healthcare. We just need a smarter plan than that. On lowering drug prices I think the biggest opportunity is with pharmaceutical pricing because that’s where the American people are just like out-of-control mad. I would describe the American people’s attitudes towards the pharmaceutical companies is they’re really close to grabbing their pitchforks. There (are) two issues with pharmaceutical prices in this country, which are really out of control. There’s the easy issue that all the Democrats running for president talk about, which is that the government should negotiate Medicare rates, which of course we should … But the deeper problem in many ways, and the problem that’s a little harder to get your head around, is the fact that the U.S. is really subsidizing the whole industry. What I mean by that is if you break the world down into two types of countries, poor countries and wealthy countries, I think we all agree that poor countries ought to be able to buy drugs really inexpensively, because if we don’t provide them drugs at a low cost, they won’t have access to them. I think we should also all agree that the wealthy countries should largely pay about the same for drugs. What I mean by that is folks in Germany should pay the same as U.S. citizens for their drugs. That’s not what’s happening. Folks in Germany may be paying a third of what we’re paying and the reason for that is they have one person who negotiates the prices no matter where you buy the drugs. In many ways, those people negotiate the prices down below costs. To some extent, pharmaceutical companies don’t even care that much because they can just keep raising the prices here. So, in reality, the entire profit of the pharmaceutical industry is made in the United States of America. That’s just not fair. On rural healthcare Just go to any rural hospital in this country, ask them how it would be if, in the prior year, all their bills were paid at the Medicare rate. Pretty much everyone I’ve ever walked into told me they would close. We’ve got to be more creative about telemedicine. We got to be more creative about getting flexible, high-quality healthcare delivered into these communities. I think we have a crisis of rural health in this country, and I think it’s based on Medicaid because Medicaid has become a much bigger part of rural health, because rural health’s populations are shrinking, they’re aging, and they’re getting more poor. It’s just at a crisis level, and I think it’s got to be at the top of healthcare reform in supporting rural health through supporting these Medicaid programs. On empowered patients The only way out of our healthcare situation is to have a more empowered patient. Our healthcare system has really taken the patient out of it. There are very few rewards for patients to be healthier in our healthcare system right now because the bulk of healthcare that they receive is paid for by someone else. Even though they have in some ways crushing co-payments and out-of-pockets, they don’t see how those things go up or down based on how healthy they are. It’s a situation where the consumer is really disconnected from the cost of healthcare and they don’t shop for healthcare the way they shop for other things. So, there hasn’t been the ability to rein in cost that I think we really need to do. On requiring vaccinations I think the government’s role as it relates to vaccines is requiring vaccines. That doesn’t mean we should require a vaccine for everything. If certain diseases can be vaccinated against, but they can only be transmitted based on certain behavior … I don’t think those should be mandated vaccines. But for diseases that are readily transferable and can lead to public health outcomes, and your behavior doesn’t really change whether you would get them or not, then I think the government should require vaccinations. READ: Full transcript of our discussion with John Delaney * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 14: John Delaney wants to be first president with ‘any experience’ in healthcare appeared first on Fixing Healthcare.

Welcome to a new season of the Fixing Healthcare podcast. As co-hosts Robert Pearl and Jeremy Corr turn their attention to the politics of American healthcare, they were eager to greet the first guest of season three, David Blumenthal. David is a healthcare policy expert and president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social policy issues. He’s a former primary care physician, director of the Institute for Health Policy, and professor of medicine and health policy at Harvard Medical School. Under the Obama administration, David served as the National Coordinator for Health Information Technology, in charge of building a nationwide health information system and supporting the “meaningful use” of health IT. In this episode, David tackles health policy topics that range from Medicare for all to cyber security to his role in the computerization of medicine under the Obama administration. Here are some of David’s most memorable quotes: On government in promoting research and innovation I think government is uniquely suited to do research and development and to lead the implementation of innovative ways of improving the delivery of healthcare services and in doing so, to find ways to stimulate and promote innovation in the private sector while also providing leadership. On lowering drug prices We need to find ways to make [medications] affordable, and I think that means moving away from some outdated protections of intellectual property—some, for example, associated with the Orphan Drug Act and also some of the abuses of patent law that have arisen as pharmaceutical companies try to protect their intellectual property. On educating lawmakers about healthcare Senators and congressmen are pretty representative of the people that elected them. They’re lay people. They are not sophisticated in their understanding of technical issues whether it’s transportation or energy or health, and that to convince them of a policy, you have to reduce it to understandable lay terms. On the goal of electronic health records If we prioritized quality and cost control as the most important priorities for our healthcare system, electronic health records (a) would have been adopted without government incentives and (b) would be different than they currently are. They would have been developed with those goals in mind rather than as they were, with the goal of recapitulating the paper record and assuring in the process that revenues for organizations were maximized. On the role of The Commonwealth Fund We believe that facts still matter. We believe there is such a thing as valid information. And we believe that it is the responsibility of those who develop such information to communicate it effectively to decision makers. It’s not enough to do the research or do the analysis, throw it out into the stratosphere and hope for the best. So, we try to produce the right information at the right time in the right way for the right people. On government’s role in regulating healthy choices I would like to see much, much more advertising like anti-cigarette ads; much, much more advertising about the risks of sugared beverages, about the risks of high-sugared foods in general, about the risks of obesity, about the need to wear seatbelts, about the risks of vaping, about the risks of medications that are so heavily advertised on television. So, I’d like to see a balanced information environment before I jumped to aggressive regulations. On enacting Medicare For All policy I don’t think it’s politically realistic and I say that having been involved in multiple efforts over my career to enact comprehensive national health insurance. I don’t think that the American congress in the business of putting industries out of business. I don’t think they’re going to force the insurance industry to close shop. And I think the prospect of ripping insurance away from 160 to 180 million Americans is an insuperable political obstacle to Medicare For All. That says nothing about the merits of the idea, it’s simply a political judgment. I think there is zero chance that it will be enacted in my lifetime. READ: Full transcript of our discussion with David Blumenthal * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 13: David Blumenthal gives Medicare-for-all ‘zero chance’ appeared first on Fixing Healthcare.

In this “bonus episode,” co-hosts Dr. Robert Pearl and Jeremy Corr offer their take on the best ideas and most promising solutions from seasons one and two of the Fixing Healthcare podcast. During season one, which kicked off a year ago this month, Robert and Jeremy put our nation’s foremost healthcare practitioners, leaders and thinkers on the hot seat—each guest vying for the highly coveted (and totally fictitious) role of “Leader of American Healthcare.” To earn the title, guests needed to provide a detailed road map for achieving major (nationwide) improvements across five key measures. At the end of season one, listeners were asked to vote on the best of the best ideas in the first-ever “Survey To Fix American Healthcare” while also sharing their own solutions, which were featured on air throughout season two. During season two, Robert and Jeremy sought to address the next big set of challenges: how to implement meaningful change and bring bold ideas to life. For answers, they invited unconventional leaders from outside the medical mainstream to join the show. As part of this bonus episode, the listening audience is asked to vote on the most valuable ideas from the second season, and provide their own thoughts on how to improve American healthcare in the future. Voting is now live … Take the NEW “Survey To Fix American Healthcare” To get detailed insights on the top solutions from season two before voting, listen to the full bonus episode or check out the show’s transcript for more details. And just like in the inaugural survey, Robert and Jeremy will ask listeners to write-in their own suggestions for solving healthcare’s biggest issues. The best solutions will be featured on future episodes of Fixing Healthcare. Rounding out this bonus episode, Robert and Jeremy give listeners a preview of season three of Fixing Healthcare, which kicks off September 10. The coming season will focus on the role of politics and policy in American medicine, which lines up perfectly with what should be a loud and raucous year of presidential debate. Read: The full transcript from this bonus episode * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Bonus episode: The best of ‘Fixing Healthcare’ so far appeared first on Fixing Healthcare.

Welcome to the final episode of season two. This season has welcomed guests from outside of the medical mainstream. Season two’s final guest is Dr. Kevin Pho, a primary care physician, author, public speaker and media consultant. He’s best known for his platform KevinMD, which generates over 3 million monthly page views and communicates with more than 250,000 followers on Twitter and Facebook. He is a leading expert on how social and digital media can connect doctors with each other and their patients to improve medical care. Here are just some of Kevin’s thought-provoking comments from the show: On doctors helping patients navigate health info online “Doctors and patients should be partners… A lot of doctors I talk to don’t want their patients online. But I always tell them that it’s going to happen anyway whether we like it or not, so we might as well partner with patients and help guide them to reputable sources of health information, educate them in terms of what kind of websites are accurate, what kind of websites are legitimate, what are some of the tip-offs that they should look for whenever they’re online.” On why clinicians should be on social media “Clinicians need to use social media to make our voices heard. Our healthcare world is changing by the day. There’s going to be some seismic changes in the coming years. I think it’s important for practicing clinicians to share their story and have a voice in that conversation.” Advice for doctors joining social media “I always say you’ve got to start with your goals first. Why do you want to use social media? Do you want to use it to educate patients? Do you want to use it to guide patients to a better source of health information? Do you want to use it to connect and learn from your colleagues? Do you want to use it to debate healthcare reform? Do you want to use it to advocate for a cause? … On Kevin’s biggest social media fears “Instead of bringing people together, social media is making people more tribal. I think that’s really shutting down the discourse. We’re obviously seeing that in the political world. My biggest fear is that some of that’s going to seep into the healthcare world, as well, where you have patients who may just shut out the medical world and only listen to opinions and stories that they already agree with.” On censuring health misinformation online “To their credit, (Facebook and YouTube) are altering their algorithms. They’re suppressing information that’s clearly false. But I certainly don’t think they go far enough. I think that when it comes to health misinformation, it has the potential, of course, to cost lives. I do think that they need to be more accountable for the health misinformation out there and I think they need to do more than they’re currently doing.” READ: Full transcript of our discussion with Kevin Pho * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 12: Kevin Pho, social media’s No. 1 physician voice appeared first on Fixing Healthcare.

Consistent with the theme of Season 2, in which we look outside of traditional walls for medicine for ideas to fix healthcare, our guest this month comes to the Fixing Healthcare podcast from an unusual background. Dr. Lindsey Fitzharris is one of the world’s leading scholars on medical history, having earned her doctorate from the University of Oxford. She wrote the bestselling book, “The Butchering Art: Joseph Lister’s Quest to Transform the Grizzly World of Victorian Medicine,” created the popular blog, the Chirurgeon’s Apprentice, and hosts the YouTube series, Under the Knife, which takes a humorous look back at our medical past. Listen as healthcare leader Robert Pearl, MD, and his co-host Jeremy Corr, tap into Lindsey’s vast historical knowledge and extract relevant insights about healthcare today. In this episode, you’ll learn why: Doctors used to smell (and even taste) their patient’s urine, and why that’s not as crazy as it sounds. Patients of the past preferred their doctor’s apron to be covered in dried blood and guts. It takes, on average, 17 years for a medical innovation to become standard clinical practice. Surgery became more (not less) dangerous immediately after the advent of anesthesia. Historians of the future will shake their heads at American medical practice today. The anti-vaccination movement actually dates back as far as the 18th century. Lindsey Fitzharris is hesitant to use the word “quack,” considering its origins. READ: Full transcript of our discussion with Lindsey Fitzharris * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post Episode 11: Modern lessons from medicine’s grisly past with Dr. Fitzharris appeared first on Fixing Healthcare.