The Healthcare Policy Podcast ® Produced by David Introcaso

Patricia Goldsmith Discusses CancerCare (October 5th)

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After heart disease cancer is the leading cause of mortality in the US at over 600,000 deaths annually.  Not surprisingly cancer care costs are considerable at approximately $210 billion of which approximately 10% is paid out of pocket.  This explains why in part up to 30% of Medicare beneficiaries without subsidies do not fill their anticancer prescriptions.  To make matters worse, the COVID pandemic has significantly compromised cancer diagnosis and treatment that are expected to produce negative ripple effects.  While  President Biden’s “Cancer Moonshot,” aims to cut cancer death rates by 50% over the next 25 years, last year the CDC projected that because of the growth and aging of the population the annual number of cancer cases will increase nearly 50% between 2015 and 2050.  

During this 33 minute interview Ms. Goldsmith discusses the CancerCare's work, in sum, the organization provides free professional support services and information for cancer patients.  We move on to discuss the relationship between CancerCare's work and the Medicare hospice benefit, problems with employer based coverage for cancer diagnoses, complications associated with timely cancer screenings, work CancerCare does to help their patients/clients afford their medications.  Ms. Goldsmith comments on President Biden's Cancer Moonshot initiative, drug pricing policies recently passed under the IRA, challenges her organization faces in raising financial assistance funding and the increasing demands on the organization's workforce.            

Patricia J. Goldsmith joined CancerCare in 2014 as Chief Executive Officer.  Ms. Goldsmith previously served as Executive Vice President and Chief
Operating Officer at the National Comprehensive Cancer Network (NCCN).  Previously still,  Ms. formerly served as Vice President for Institutional Development, Public Affairs and Marketing at the Moffitt Cancer Center in Tampa, Florida – an NCCN Member Institution.  Before joining Moffitt, she developed and directed all managed care activities for the University of South Florida College of Medicine.  A frequent national meetings and symposia, Ms. Goldsmith has also served on Congressional panels.  Ms. Goldsmith has studied at the Pennsylvania State University, the University of Missouri Bloch School of Business and the Harvard School of Public Health.  She was a winner of the 1999 Distinguished Women in Business Award sponsored by the Business Journal of Tampa Bay and also was named the 1999 Leukemia Society Woman of the Year.  Most recently, Ms. Goldsmith was named to Forbes 50 Over 50 Vision List which was established in partnership with Mika Brzezinski’s “Know Your Value,” and highlights women over the age of 50 who have achieved significant success.

Information on CancerCare is at: https://www.cancercare.org/.

Dr. Jeni Miller Discusses a Fossil Fuel Non-Proliferation Treaty (October 4th)

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This summer the planet once again experienced record temperatures, droughts, wildfires and extreme weather events.  Nevertheless, according to a recent report by the International Energy Agency and OECD, global public subsidies of fossil fuel subsidies nearly doubled from 2020 to $700b in 2021.  The US economy still remains significantly dependent on coal use; it generates approx. 20% of the country’s power or almost twice as much as the electricity generated by wind and solar.  (To compare in the UK, 1.5% of power production is coal-fired.)  Though the planet is currently projected to warm to well over 2.5C this century, per a recent report by United in Science global warming has already reached the lower end of five end game negative climate tipping points.  (Think, for example, a collapsing Greenland ice sheet.)  This finding led the UN Secretary General, Antonio Guterres, to state, “the report shows climate impacts heading into uncharted territory of destruction,” what he termed climate carnage.    

During this 33-minute interview Dr. Miller begins by discussing the work of the Global Climate and Health Alliance.  She goes on to discuss the impetus for a fossil fuel non-proliferation treaty, identifies organizations that have signed on including the World Health Organization, analogizes the treaty to the WHO Framework Convention on Tobacco Control, discusses what role the UN may play in forwarding a non-proliferation treaty, and what we currently know about what if any interest the White House and HHS are receptive to a non-proliferation treat.  We conclude with Dr. Miller's interpretation of why only a trivial fraction, as low as 1%, of Americans believe the climate crisis is the most important problem facing the country.     

Dr. Jeni Miller is Executive Director of the Global Climate and Health Alliance, where she coordinates the joint efforts of national, regional and international health organizations addressing climate change.  The Alliance works to minimize the health impacts of climate change and to maximize the health benefits of climate solutions, through leadership, advocacy, policy, research, and engagement.  On behalf of the Alliance, Dr. Miller co-chairs the WHO-Civil Society Working Group on Climate and Health.  In addition to her work at GCHA, Dr. Miller currently serves as Immediate-Past-Chair of the Environment Section of the American Public Health Association.  She has two decades’ experience working on policy- and systems-change strategies to improve community environments for health, in leading initiatives addressing childhood asthma, childhood obesity, climate change, health equity, and healthy community redevelopment.  Dr. Miller received her doctorate from the University of California, Berkeley.

The Global Climate and Health Alliance's related article is at: https://climateandhealthalliance.org/press-releases/international-health-organizations-call-for-fossil-fuel-non-proliferation-treaty-to-protect-lives-of-current-and-future-generations/. 

The fossil fuel non-proliferation treaty website is at: https://fossilfueltreaty.org/.  

Substack Post #7: "The Inflation Reduction Act Can Help Decarbonize the Health Care Industry" (October 3rd)

This week's post is my September 30 STAT published essay under this title. 

It opens with:

"The climate crisis — the greatest threat to human health in history — is often framed “in ways that pay little attention to its health dimensions,” as the authors of The Lancet’s annual “Countdown: Tracking Progress on Health and Climate Change” report were forced to remind us.

This tragic reality was on display in Health Affairs, JAMA, Kaiser Health News, and The Lancet itself, among others, when they limited their reporting on the recently passed Inflation Reduction Act to its enhanced Affordable Care Act subsidies and drug cost reforms. They failed to highlight for the health care industry that the IRA’s tax credit provisions for renewable energy, formally called energy security, are for the first time refundable for tax-exempt entities. This means that the largest greenhouse gas polluters in the health care industry — the vast majority of hospitals that are nonprofit or tax exempt — can take advantage of these economic subsidies to reduce greenhouse gas emissions." 

At: https://www.statnews.com/2022/09/30/inflation-reduction-act-reduce-health-care-industry-greenhouse-gas-emissions/.