Jun 23, 2021 • 35M

240th Podcast: Brian Alexander Discusses His Recently Published, "The Hospital: Life, Death and Dollars in a Small American Town" (June 22nd)

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Appears in this episode

David Introcaso, Ph.D.
Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues are typically complex, clear, reasoned, dispassionate discussion is required. These podcasts will attempt to fill this void. Among other topics this podcast will address: •Implementation of the Affordable Care Act •Other federal Medicare and state Medicaid health care issues •Federal health care regulatory oversight, moreover CMS and the FDA •Healthcare research •Private sector healthcare delivery reforms including access, reimbursement and quality issues •Public health issues including the social determinates of health Listeners are welcomed to share their program comments and suggest programming ideas. Comments made by the interviewees are strictly their own and do not represent those of their affiliated organization/s.
Episode details

In The Hospital, Mr. Alexander provides an account of Bryan, Ohio's Community Hospitals and Wellness Centers (or CHWCs) hospital’s efforts to stay solvent between 2018 and 2020.  The work, in many ways is a companion to Nick Freudenberg's "At What Cost, Modern Capitalism and the Future of Health (I interviewed Prof. Freudenberg on May 20th), is particularly timely because rural hospitals, that serve roughly one in five Americans, are closing at a record rate.  For example, 136 have closed since 2010 and currently over 500 are at risk of closing.   The demise of rural hospitals is largely due to decades of poor-to-dire economic circumstances, largely zero wage growth for non-degreed workers, particularly in Ohio and the five other Rust Belt states.  The consequence thereof has been approximately 100,000 annual "deaths of despair."  (See Case and Deaton's 2020 volume by the same title.)  The demise of rural hospitals generally and the threat to CHWC is the health care marketplace that Mr. Alexander terms, "cut throat."  Not surprisingly therefore, in “The Hospital” Mr. Alexander also profiles the health status and economic circumstances of several CHWC patients and their peers and describes healthcare marketplace realities and their effects on CHWC.      

During this 34 minute interview Mr. Alexander begins by explaining how and why he chose CHWC to profile.  He moves move on to discuss moreover the health status of CHWC patients' health and their economic circumstances (i.e., the role social determinants play), discusses CHWC's struggle to succeed in a health care market dominated by two large regional provider organizations, why the CHWC's CEO and board refused to merge with a large provider entity and discusses what he concludes from his two year study.     

Brian Alexander is a contributing writer to The AtlanticHis most previous work is the Glass House, The 1% Economy and the Shattering of the All American Town, winner of the Ohioana Book Awards.  He’s also written for The New York TimesLos Angeles  Times and Esquire, among others.  He’s presented at The Obama Foundation Summit and in Washington, D. C. to members of the Senate and House of Representatives.  Mr. Alexander lives in San Diego. 

Information on The Hospital is at: https://us.macmillan.com/books/9781250237361.

Information on Glass House, The 1% Economy and the Shattering of the All American Town is at: https://us.macmillan.com/books/9781250085801.