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01/20/2019

Upcoming Podcast: Remote Area Medical Discusses Its Mobile Medical Clinic Work

In early February Remote Area Medical (RAM), founded in 1985,  will conduct its 1,000 "expedition," opening a temporary mobile medical clinic in Knoxville, Tennessee providing free dental, vision and medical care.  (The poverty rate in Knoxville is 27 percent, twice that of the national average.  Area residents suffer disproportionately high rates of diabetes, COPD and hypertension.)   RAM's mission is to provide free dental, vision and medical services to the underserved and uninsured.  RAM's volunteers have numbered over 100,000 and have provided an estimated $134 million in free care to an estimated three-quarters of a million Americans in AL, CA, FL, GA, KT, LA NM, NV, OH, OK, SD, TX, VA, WVA and overseas. 

01/18/2019

The Current Ebola Outbreak in the Congo: A Conversation with Joseph Lafave (January 17th)

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This past summer the the Democratic Republic of the Congo (DRC) began experiencing its 10th Ebola outbreak.  (The virus, with a mean mortality rate of 50 percent, is endemic in that country.)  To date, the current outbreak has claimed approximately 400 lives.  The World Health Organization (WHO) expects the outbreak to persist for another six months, in part, because current political turmoil in the DRC is effecting the ability of health officials to contain the spread of the disease to neighboring Rwanda, the South Sudan and Uganda.  Listeners may recall the last Ebola outbreak in 2014-2016 in West Africa infected over 28,000 and killing over 11,000.  While vaccines are in development and currently in use in the Congo there is currently no approved or licensed vaccine.

During this 21 minute conversation Joseph Lafave discusses the status of the current outbreak, the role political instability resulting from a disputed December 30th DRC presidential election is playing in containing the outbreak, what support the US is currently providing, how the US's current response compares to its 2014-2016 efforts, what related actions the Congress has taken, progress in developing an Ebola vaccine and the difficulty in fighting a major public health problem in context of political unrest.

Joseph Lafave is a journalist with NewRep and covers infectious disease outbreaks along with military and finance issues.  LafavePrior to is journalism work that included work at the Shreveport News, Mr. Lafave worked as an Environmental Safety and Health Engineer for Lockheed Martin as a Emergency Medical Technician in Leon County, Florida, and as a Safety Administrator for University Health Shreveport.  Mr. Lafave holds a Masters of Science in Healthcare Management from the University of Southern New Hampshire and an undergraduate degree in criminology from Florida State University.      

For more information on Ebola go to, e.g., https://www.cdc.gov/vhf/ebola/index.html.   

 

01/14/2019

After Conceding Health Care Market Consolidation, What's Left is Exploiting Pricing Power (January 14, 2019)

The Trump administration published a lengthy report in December outlining its solutions for creating higher quality health care at more affordable prices.   

This editorial, titled, "The Necessity of Exploiting Pricing Power in a Post-Consolidated Health Care World," by myself and my colleague, John Rother,  is essentially a rebuttal.  It appears today in "The Morning Consult" and is at: https://morningconsult.com/opinions/necessity-exploiting-pricing-power-post-consolidated-health-care-world/

The Trump administration's report, "Reforming America's Healthcare System Through Choice and Competition," is at: https://www.hhs.gov/sites/default/files/Reforming-Americas-Healthcare-System-Through-Choice-and-Competition.pdf.

 

12/19/2018

Essay: "Climate Change Is the Greatest Threat to Human Health in History" (December 19th)

Listeners may be aware this has been a long standing interest/concern of mine, e.g., over the past few months I've posted several related podcast interviews and another essay.  Today, Health Affairs published my essay titled, "Climate Change Is the Greatest Threat to Human Health in History."  Since this simply is a summary of existing report findings, it's largely or only noteworthy in that it is, sadly, the first discussion on this topic by the journal in its 37 year history.  The essay is at: https://www.healthaffairs.org/do/10.1377/hblog20181218.278288/full/.

 

 

12/14/2018

Dr. Jeremy Hess Discusses Lancet's "Countdown: Tracking Progress on Health and Climate Change" (December 13th)

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In late November, Lancet published its 2018 "Countdown: Tracking Progress on Health and Climate Change."  The 36-page report (link below), authored by nearly 70 scientists, including Dr. Jeremy Hess, provides an assessment of health and economic effects of climate change and global warming as well as provides an assessment of the world's green house gas emissions and current global efforts to reduce our carbon footprint all via 41 data indicators reported under five domains.  Among other sobering conclusions, the report states, "Carbon intensity remains broadly unchanged," i.e., "climate change is moving faster than we are."  This leads to the report states, "unacceptable high level of risk for the current and future health of populations of the world," that have the report states further, "dire implications for every aspect of human life."

During this 32-minute conversation Dr. Hess discusses his contribution to the report, moreover his contribution to the "adaptation, planning and resilience for health" domain and he comments on numerous other aspects of the report including resulting vector borne diseases, moreover Dengue, the effect greenhouse gas emissions have on air quality and health, effects on agricultural production and the media's coverage of climate change. 

Dr. Hess is Associate Professor of Emergency Medicine and Associate Professor of Environmental and Occupational Health Hess2017smSciences at the University of Washington, Seattle.  He is as well a member of the Center for Health and the Global Environment (CHanGE) at UW and is a consultant for the Climate and Health Program at the Centers for Disease Control and Prevention.  He is also the principal investigator of an NIH-funded grant supporting work in India on the epidemiology of extreme heat and strategies for developing, implementing and evaluating heat early warning systems and is currently section editor at the Western Journal of Emergency Medicine.  Among other awards Dr. Hess is a recipient of the Presidential GreenGov award.  Dr. Hess earned his MD and MPH in global environmental health at Emory University. 

The "Countdown" report is at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32594-7/fulltext#

12/10/2018

Rosemary Gibson Discusses Her Recent Work, "China Rx" (December 7th)

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During this 31 minute discussion Rosemary Gibson unpacks her latest work, co-authored with Janardan Prasad Singh, titled, China, Rx, "Exposing the Risks of America's Dependence on China For Medicine.  As the title suggests the authors discuss the problems with relying on China for the production of essential ingredients for thousands of medicines, or the implications of relying on China regarding the quality and availability of essential drugs.  

Rosemary Gibson is Senior Adviser at The Hastings Center.  She is also board chair of the Altarum Institute, a non-profit health Rosemary_gibson[1]system research organization, she is a board member of the Accreditation Council for Graduate Medical Education, she serves on the MedStar Health System Institute for Quality and Patient Safety advisory board, is faculty for the Academy for Emerging Health Care Leaders and for the Dartmouth Summer Symposium on Quality Improvement.  While at the Robert Wood Johnson Foundation, Rosemary was the chief architect for it's $250 million, decade-long national strategy to establish inpatient palliative care programs that now number over 1,600.  She is also author of Medicare Meltdown (2013), Battle Over Health Care (2012), Treatment Trap (2010) and Wall of Silence (2003).  Among other awards, Rosemary is the recipient of highest honors from the American Medical Writers Association for her contributions to the field of medical communication. 

Information on China Rx is at: https://www.penguinrandomhouse.com/books/566043/china-rx-by-rosemary-gibson-and-janardan-prasad-singh/9781633883819/

11/18/2018

Dave Chase Discusses His New Work, "The Opioid Crisis Wake-Up Call: Health Care is Stealing the American Dream” (November 16th)

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Listeners may recall, I have previously discussed the opioid epidemic this past February 2 with Dr. Steve Passik concerning abuse deterrent formulations and on November 16, 2016 with Dr. Ann Lembke regarding her work, "Drug Deal MD."  Tragically, the opioid epidemic continues unabated.  In 2017 there were 72,000 drug overdose deaths, among these 29,000 were from synthetic opioids, predominately fentanyl.  While Mr Chase's work examines the cause of the opioid epidemic and what could be done to reduce fatalities, it is moreover a study that attempts to explain what accounts for massive dysfunction in health care delivery that causes, as I note in the podcast's introduction, Americans to spend $1 trillion annually on health care coverage and services that do not improve their health.

During this 30 minute conversation Mr. Chase explains what prompted his writing this work and what explains, in his view, the opioid crisis.  Moreover, he explains the problem with health care as one moreover one of pricing failure, how payers, moreover self-insured employers, can more competently purchase more affordable coverage for their employers and provides examples or organizations that have lowered their health care spending.  He also discusses direct primary care, ERISA, insurance risk pool size, medical loss ratios (MLRs) and his efforts at credentialing use of The Health Rosetta blueprint. 

Mr. Dave Chase is the co-founder of The Health Rosetta, described as an open source blueprint for the next generation's Dave chase headshothealth ecosystem.   Mr. Chase's first book, "The CEO's Guide to Restoring the American Dream: How to Delivery World Class Healthcare to Your Employers at Half the Cost," became a Kindle #1 best seller.  Mr. Chase and The Health Care Rosetta focus on replicating health economies that rebuild hope and community through improved outcomes, lower spending and higher performing models.   

Information on Mr. Chase's book is at: https://healthrosetta.org/friends/

For more on The Health Rosetta, go to: https://healthrosetta.org/

 

11/15/2018

Professor Kristie Ebi Discusses the IPCC Report's Findings Related to Global Warming on Human Systems (November 14th)

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The below November 7th podcast post provides a link to an essay that, in part, provides an overview of the United Nation's International Panel on Climate Change's (IPCC's) recent report titled, "Global Warming of 1.5°C."  As noted in the essay, what is particularly noteworthy about the IPCC's report is its conclusion that keeping or holding temperature increases to below 2°C, the goal of the Paris climate accord, would not avoid the more serious effects of global warming.  For example, at 1.5°C of warming a significant percent of vertebrates, insects and plants would lose half of their climatically-determined geographic range and 70 to 90 percent of coral reefs would be lost.   

During this 28 minute conversation Professor Kirstie Ebi begins by briefly explaining the IPCC's work, she then discusses several of the findings in chapter 3, that she co-authored and is titled, "Impacts of 1.5°C Global Warming on Natural and Human Systems.," Professor Ebi makes note of the international climate change research communities' upcoming meeting in Poland, next issue of the US's Climate Science Special Report, anticipated in December, and comments on the health care industry's responsibility and opportunity to contribute to solving the climate crisis. 

Professor Kristie L. Ebi, is the Director of the Center for Health and Global Environment (CHanGE) and the Rohm and Haas EbiEndowed Professor in Public Health Sciences at the University of Washington.  She is the author of multiple national and international climate change assessments, including the IPCC's recently published Report on Global Warming of 1.5C.  Professor Ebi co-chairs the International Committee on New Integrated Climate change assessment Scenarios (ICONICS) that created five scenarios of socioeconomic development over this century.  Professor Ebi's scientific training includes a MS in toxicology and a Ph.D. and a Masters of Public Health in epidemiology and two years of post-graduate research at the London School of Hygiene and Tropical Medicine  She has edited four books on aspects of climate change and over 200 publications.

The IPCC report is at: http://www.ipcc.ch/report/sr15/ 

Though not noted during this discussion, it's worth noting here the much discussed essay by Will Steffen and colleagues published this past August in the Proceedings of the National Academy of Sciences (PNAS) regarding "hothouse earth."  The essay, "Trajectories of the Earth System in the Anthropocene," is at: http://www.pnas.org/content/115/33/8252

 

11/07/2018

Essay, "The IPCC Confirms Life As We Know It Will Soon Cease to Exist" (November 7th)

Listeners of this podcast may recall I've written several essays concerning global warming over the past three years that I've posted links to via this website.  This is my latest, posted yesterday at THCB.  It is at: https://thehealthcareblog.com/blog/2018/11/06/the-ipcc-confirms-life-as-we-know-it-will-soon-cease-to-exist/.    

10/30/2018

Status of the 9/11 Victim Compensation Fund, Will It Run Out of Funds, A Conversation with Michael Barasch (October 29th)

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Soon after the 9/11 attacks the Congress created the Victim Compensation Fund (VCF).  Initially, the VCF was created to award moneys to 9/11 victims or their families.   Awards were made through 2004.  In 201o1 the Congress passed the James Zadroga 9/11 Health and Compensation Act, named after a 34-year old NYC policeman who died in 2006 of 9/11 related illness, was created to compensate first responders and individuals who later developed 9/11-related health problems including numerous forms of cancer and PTSD.   The fund was re-authorized in 2015 by President Obama for five years (it will will sunset in December 2020).  Because of the ever-increasing number of 9/11-related illnesses the VCF Special Master, Rupa Bhattacharyya, recently noted the fund could run out of moneys before all claims are resolved.  Ms. Bhattacharyya recently posted a Federal Register notice soliciting comments asking the public how the remaining funds should be allocated.  

During this 28 minute interview, Mr. Barasch discusses his firms 9/11 experience.  Located at ground zero, half his employees have since succumbed to cancer or are currently battling the disease.  He provides an explanation why the EPA came to determine the air quality at ground zero was safe (it definitively was not), provides an overview of the VCF and the related World Trade Center Health Program, his firms work in representing 9/11 victims seeking VCF settlements, efforts to solicit the Congress to further fund the VCF and the prospects of a wrongful death civil suit filed against the Saudi Arabian government (15 of the 19 9/11 terrorists were Saudis).  

Michael Barasch is the Managing Partner of Barasch & McGarry, lawyers for the 9/11 community.  His firm has represented Michael Baraschover 11,000 victims of 9/11 in their pursuit of a VCF settlement.  Ms. Barasch is a graduate of Fordham Law School.  

For more on Barasch & McGarry go to: https://www.personalinjuryjustice.com/ 

Barasch and McGarry's VCF-related work can be found at: 911victimfund.com

The Department of Justice's VCF info is at: www.vcf.gov  & DOJ's VCF helpline is: 1.855.885.1555. 

Concerning the Federal Register notice "September 11th Victim Compensation Fund: Compensation of Claims" (comments due December 3), see:  https://www.federalregister.gov/documents/2018/10/03/2018-21490/september-11th-victim-compensation-fund-compensation-of-claims