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4 posts from August 2022


Substack Post: "Environmental Justice is - Still - Unrelated to the Climate Crisis" (August 29th)

Dear Listeners:

Today, I posted my latest Substack writing under this title.  It largely makes note of the fact the CDC's recently-announced Environmental Justice Index (EJI), the topic of my first or last Substack writing, fails to recognize or moreover account for climate crisis-related health harms - fossil fuel combustion and resulting anthropogenic greenhouse gas warming are of course the leading cause of environmental injustice.  

The post is at: https://davidintrocasophd.substack.com/p/environmental-justice-is-still-unrelated?utm_source=email

Thank you.



First Substack Newsletter Post: "HHS's Environmental Justice Index Constitutes Redlining" (August 22nd)

Dear Listeners:

Today, I posted my first Substack newsletter item.  The newsletter is titled, "Health Care Policy Analysis from DC."  This first post argues HHS' August 10th announced Environmental Justice Index (EJI), defacto, amounts to redlining, or the discriminatory practice that compromises minority populations' ability to access numerous financial and related services including healthcare insurance.  

The post is at: https://davidintrocasophd.substack.com/p/the-department-of-health-and-human?utm_source=%2Finbox&utm_medium=reader2

Feel free to comment.

Thank you.


Greg Segal Discusses Organ Procurement and Transplantation Policy Reform (August 16th)

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During its recent August 3rd hearing titled, “A System in Need of Repair: Addressing Organizational Failures of the U.S.’s Organ Procurement and Transplantation Network," Senate Finance Committee Chairman, Ron Wyden (D-OR), characterized efforts by the federally-contracted not for profit, UNOS (United Network for Organ Sharing) regarding organ procurement and transplant as grossly mismanaged and incompetent.  After a two plus year investigation that included reviewing over a half million pages of documents, the committee found efforts by UNOS and nation's over 55 Organ Procurement Organizations (OPOs), rife with inefficiencies, medical errors and poor leadership, that combined helps to explain why, conservatively estimated, over 6,000 Americans, disproportionately minorities, die annually awaiting an organ.  Listeners will recall I interviewed Alfred and Blair Sadler in early June.  They, in part, discussed their work at NIH in the late 1960s drafting the Uniform Anatomical Gift Act.

During this 37-minute interview Mr. Segal begins by describing Organize's mission.  He next provides an overview of how the process of human organs are procured and transplanted, largely the work by UNOS and OPOs, identifies and discusses more substantive problems associated with the transplant process including the lack of financial, performance, transparency and regulatory pressures placed on OPOs.  These leads to Mr. Segal defining policy reform opportunities including requiring OPO's to report standardized process data and what action Senate Finance and the Congress should take, moreover, the Organ Procurement and Transplantation Network (OPTN) contract, under which UNOS is contracted, be significantly revised.                   

Mr. Greg Segal is the Founder and CEO of patient advocacy group, Organize.  The non-profit advocates for structural reforms to increase the supply Unnamed of lifesaving organ transplants every year.   Mr. Segal started Organize after his father waited five years for a heart transplant.  Organize served as Innovator in Residence in the Office of the Secretary of the U.S. Department of Health and Human Services from 2015-2016.  The group's research has been heavily cited by the ongoing Congressional investigations from the Senate Finance Committee and the House Oversight Committee into the U.S. organ donation system.  Mr. Segal's writings regarding the need for data-driven reforms to organ monopolies have appeared in MedPage, Health Affairs, CNN, STAT and JAMA.   

Information on Organize is at: www.organize.org.

Documents related to the Senate Finance Committee's August 3rd hearing is at: https://www.finance.senate.gov/hearings/a-system-in-need-of-repair-addressing-organizational-failures-of-the-uss-organ-procurement-and-transplantation-network.  



NACHC's Jeremy Crandall Discusses Inflation Reduction Act-Related Policy Reforms (August 4th)

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Two weeks ago Senate Majority Leader, Chuck Schumer, announced the $739 billion Inflation Reduction (IRA) Act of 2022, compromise legislation agreed upon by Senator Manchin.  The bill includes just a few of the healthcare policy reform provisions House Democrats included in House legislation passed late last year, moreover extending expanded ACA marketplace insurance subsidies and allowing the Medicare program to negotiate drug prices.  The IRA also includes, as has been widely reported, $369 billion in tax credits over ten years intended to accelerate the adoption of renewal energy.   (Some have suggested the bill should be more appropriately titled The Temperature Reduction Act.)   The legislation likely, if not in fact, represents the last chance Congressional Democrats and the Biden Administration have to pass health and healthcare related policy reforms this Congress under reconciliation rules - that expire September 30th.  

During this 40 minute interview Jeremy begins by describing NACHC's mission.  He goes on to discuss extending ACA insurance subsidies in context of the patients his community community health, or Federally Qualified Health Centers (FQHCs), serve, how might the Medicaid funding cliff be addressed, i.e., approximately 16 million current enrolls would lose their coverage at the end of the current public health emergency, and provides comments on extending telehealth coverage expansion, workforce shortages and the climate crisis.        

Jeremy Crandall is the Director of Federal and State Policy for the National Association of Community Health Centers, where he works to address Download policy issues concerning Medicaid funding, 340B prescription drugs, FQHC payment and delivery reforms, behavioral and telehealth policies and primary care workforce issues.  Jeremy previously spent six years working on state-based issues at the Blue Cross Blue Shield Association and at the Pew Charitable Trusts.  For eight years prior still he worked in Maryland state politics with Attorney General Brian Frosh and State Delegate Heather Mizeur.

Information on NACHC is at: https://www.nachc.org/.