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3 posts from December 2020


Podcast Series: Eight Interviews Concerning National Healthcare Policy Reform (January - March 2021)

Due to the holiday season, this series of eight interviews will now be posted beginning in of January.  Again, these interviews with nationally-recognized healthcare policy experts will discuss policy solutions that offer the potential to remedy significant healthcare delivery and financing problems. 

The series will begin with a discussion of population health with Virginia Commonwealth's Dr. Steven Woolf.   As I noted previously, Americans are significantly more disease burdened and experience shorter life spans than individuals in comparative countries.  Long-time listeners of this podcast may recall I interviewed Dr. Woolf in February 2013 regarding his work in chairing the Institute of Medicine (now National Academy of Sciences) panel that published in early 2013, US Health in International Perspective: Shorter Lives, Poorer Health (at: https://www.nationalacademies.org/our-work/understanding-cross-national-health-differences-among-high-income-countries). 

In subsequent interviews I will discuss with:

  1. Dr. Steven Woolf (Virginia Commonwealth University) population health (posted January 31)
  2. Dr. Bob Berenson (the Urban Institute) health care pricing (posted February 18) 
  3. Dr. Amol Navathe (U. of Penn) traditional Medicare or Medicare fee for service
  4. Prof. Michael Chernew (Harvard and MedPAC Chairman) Medicare Advantage
  5. Mark Miller, Ph.D. (Arnold Ventures) drug pricing
  6. Dr. Kate Goodrich (Humana) health care quality measurement and performance benchmarking
  7. Prof. Judy Feder (Georgetown) long term care policy
  8. Dr. Paula Braveman and Dr. Laura Gottlieb (U. of California, San Francisco) the social determinants of health  


Prof. William Darity and Ms. Kirsten Mullen Discuss Their Recent Book, "From Here to Equality, Reparations for Black Americans in the 21st Century" (December 9th)

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Listeners are aware social determinants significantly explain one's health, as much as 80%.  Principally among these is economic status.  Wealth positively correlates with health.   As listeners are, or should be, well aware 250 fifty years of slavery and a century and a half of institutionalized racism has resulted in median black household net worth equal to one-tenth that of median white household net worth - due, in part, to blacks having comparative lower rates of upward mobility and higher rates of downward mobility.   (Even white high school dropouts accumulate more wealth than Black college graduates.)  This past October, after 208 years of publication, the prestigious The New England Journal of Medicine finally recognized the reparations issue by publishing a "Prospective" essay by Mary Bassett and her colleagues at the Harvard Center on Health and Human Rights titled, "Reparations as a Public Health Priority."   The authors concluded, “It is left to those of us in medicine and public health to argue that now is the time to act," i.e., address reparations, because they stated further, “addressing the black-white wealth gap through reparations is about saving lives."

During this 40 minute conversation, Prof. Darity and Ms. Mullen discuss moreover reparation efforts or compensated emancipation by President Lincoln and the Radical Republicans during the 1860s.  They discuss related state level reparations efforts and their limitations.  They discuss state and federal policies that prohibited blacks from accumulating wealth, e.g., post Civil War black codes, Jim Crow, limitations under the Homestead Act and the GI Bill and among others numerous efforts to deny blacks credit worthiness.  The authors also respond or answer several of the more common criticisms levied against reparations and explain how reparations can be calculated.     

Prof. William A. (“Sandy”) Darity, Jr., is the Samuel DuBois Cook Professor of Public Policy, African and African American I1278462Studies, and Economics and the Director of the Samuel DuBois Cook Center on Social Equity at Duke University.  He was the Founding Director of the Research Network on Racial and Ethnic Inequality at Duke.  Previously, he served as Director of the Institute of African American Research and Director of Graduate Studies at the University of North Carolina at Chapel Hill.  Prof. Darity was a visiting scholar at the Russell Sage Foundation (2015-2016), a fellow at the Center for Advanced Study in the Behavioral Sciences (2011-2012) at Stanford, a fellow at the National Humanities Center (1989-90) and a visiting scholar at the Federal Reserve’s Board of Governors (1984).  He received the Samuel Z. Westerfield Award in 2012 from the National Economic Association, the organization's highest honor, Politico 50 recognition in 2017, and an award from Global Policy Solutions in 2017.  He is a past president of the National Economic Association and the Southern Economic Association.  Prof Darity has also taught at Grinnell College, the University of Maryland at College Park, the University of Texas at Austin, Simmons College and Claremont-McKenna College.  He has served as Editor in Chief of the latest edition of the International Encyclopedia of the Social Sciences and as an Associate Editor of the 2006 edition of the Encyclopedia of Race and Racism (2013).  He has published or edited 13 books and published more than 300 articles in professional outlets.  

Ms. Kirsten Mullen is a folklorist and the founder of Artefactual, an arts-consulting practice, and Carolina Circuit Writers, a Mullenliterary consortium that brings expressive writers of color to the Carolinas.  She was a member of the Freelon Adjaye Bond concept development team that was awarded the Smithsonian Institution’s commission to design the National Museum of African American History and Culture.  Under the auspices of the North Carolina Arts Council she worked to expand the Coastal Folklife Survey.  As a faculty member with the Community Folklife Documentation Institute, she trained students to research and document the state’s African American music heritage. Kirsten was a consultant on the North Carolina Museum of History’s “North Carolina Legends” and “Civil Rights” exhibition projects.  Her writing can be found in museum catalogs and journals, and in commercial media—and includes “Black Culture and History Matter” (The American Prospect), which examines the politics of funding black cultural institutions.  

For information on "From Here to Equality," go to: https://uncpress.org/book/9781469654973/from-here-to-equality/.

Mary Bassett and colleagues' The New England Journal of Medicine essay is at: https://www.nejm.org/doi/full/10.1056/NEJMp2026170.  


The 2020 Lancet Countdown Report Is Published & the UN's Secretary General Provides His "State of the Planet" Assessment (December 6th)

This past Thursday, Lancet published its annual "Countdown" report (its fifth).  Listeners are well aware I've interviewed contributing authors of this report over the past few years.  The 42-page report is at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32290-X/fulltext

Among other things the report finds, all health effect domains the report measures are worsening, e.g., "vulnerable populations were exposed to an additional 475 million heatwave events globally in 2019," "during the past 20 years there has been a 53.7% increase in heat-related mortality in people older than 65 years," "the global response to climate change has been muted and national efforts continue to fall short," "carbon intensity of the global energy system has remains almost flat over 30 years, with global coal use increasing by 74% during this time," (and has increased over the past two consecutive years) and "the world has already warmed by more than 1.2C compared to preindustrial levels, resulting in profound, immediate, and rapidly worsening health effects." 

Last Wednesday, the the UN Secretary General, Antonio Guterres, gave a candid "State of the Planet" assessment at Columbia University.  Among other things he stated, "the state of the planet is broken," "humanity is waging war on nature," "biodiversity is collapsing," and "ecosystems are disappearing."  The speech is at: https://www.un.org/sites/un2.un.org/files/sgspeech-the-state-of-planet.pdf.

Reading both is highly recommended.