The Healthcare Policy Podcast ® Produced by David Introcaso

• Director Don Lieber Discusses the "First Do No Harm" Campaign

  Despite the fact US healthcare has $7.6 trillion market cap and is beyond capital intensive, industry executives have been loathe to divest in fossil fuels. For example, per “The Lancet’s” 2023 and 2024 annual “Countdown on Health and Climate” reports, between 2008 and 2023 of the 1,613 institutions committed to divesting in fossil fuels, only 28 were healthcare institutions and since 2018 only one has committed to doing so. Among numerous other reasons why this is, to be polite, disturbing, if not evil, is because: fossil fuel investments substantially explain healthcare’s massive carbon footprint at over 600 MMT of CO2e annually; anthropocentric warming poses the greatest threat to human health; failure to divest make a mockery of the Hippocratic Oath; and, among other ironies of the 12 S&P 500 economic sectors the energy sector was the worst performer by far since 2010. Information regarding the First Do No Harm campaign, including their sign-on letter, is at: https://firstdonoharm.earth/. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• Johns Hopkins' Economics Prof. Melinda Buntin Discusses Slowing Healthcare Spending Growth Over the Past Two Decades

  US healthcare costs and spending are extreme made evident by the fact healthcare at a $5 trillion annually accounts for roughly half the global healthcare market. This reality led Princeton’s Nobel Prize Economist Angus Deaton to conclude in 2020, “the industry is a cancer at the heart of the economy.” Though healthcare costs are projected to rise 7 to 8%, this year, cost growth over the past 15 plus years plus has not on average exceeded GDP growth - made evident by the fact that while the 2020 Medicare Trustee report concluded the Medicare hospital trust fund would be bankrupt by 2026, the most recent report concluded 2036. Prof. Buntin’s recent writing on the topic, “The Value Zeitgeist, Considering the Slowdown in Healthcare Spending Growth,” coauthored by Harvard’s Ellen Meara and Dartmouth’s Carrie Colla, was published in “The New England Journal of Medicine” on April 12th. Prof Buntin’s recent publications are at: https://hbhi.jhu.edu/expert/melinda-buntin. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• CUNY's Dr. Lyndon Haviland Discusses the Government's Response to the Measles Outbreak

  At present, measles, one of the most contagious communicable diseases for which there is no treatment, disproportionately sickens - and kills - preschoolers. The outbreak is present today in 21 states ranging from Alaska to Vermont. As of last Friday, this year has already seen 607 confirmed cases, 72% of cases were among those age 5 to 19 and 97% of those infected were either unvaccinated or their vaccination status is unknown. For comparison, for five-year period ending in 2024 the average number of annual measles cases equaled 105.The measles, mumps, and rubella (MMR) vaccine is exceptionally effective and when immunization is greater than 95%, herd immunity is achieved. Having previously attained this percent measles was considered officially eliminated in the US in 2000. Achieving measles elimination was considered an historic public health achievement. Today however approximately 40 of states have vaccination rates below 95%. As a result, public health officials, for example in West Texas, expect the outbreak to continue for the remainder of this year, if not beyond.Concerning the federal government’s response this past Sunday when asked about the outbreak , President Trump stated, “It’s so far a fairly small number of people relative to what we’re talking about,” adding, “this is not something new.” Beyond cutting CDC staff and state funding to monitor infection/disease transmission, the White House is withdrawing the US from the World Health Organization (WHO) that in part managed a networks of labs, entirely funded by the US, to track measles cases around the world. HHS Secretary Robert Kennedy, a man with an anti-vaccination history, recently stated the measles vaccine is the “most effective way to prevent the spread” of the disease, however, he continues to frame vaccination as a personal choice and suggest the vaccine can cause just as much harm as the disease itself. Hours after making his “most effective” comment, the Secretary highlighted the work of doctors treating infected children with steroids and an antibiotic. The Secretary has also noted cod liver oil and Vitamin A as treatments. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• Healthcare Policy Attorney Alissa Smith Discusses What To Know If/When ICE Knocks

  The Trump administration has made no secret it intends to aggressively enforce immigration laws, made evident by the recent arrest of a Columbia University grad student and green card holder on Columbia’s campus. Since the White House has repeatedly stated it intends to deport roughly all 12 million undocumented immigrants, this presents an immediate problem for healthcare providers who, in part, have legal and ethical obligations to all their patients. This is particularly true ironically for HHS-regulated Federal Qualified Health Centers (FQHCs) who serve 32 million largely racial/ethnic minorities who, because they are largely poor and medically disenfranchised, are disproportionately in need of healthcare. One day after assuming office in January the acting Department of Homeland Security rescinded decades of prior policy that essentially stated the federal government would not take immigration enforcement action in “protected areas” that included healthcare facilities - and schools like Columbia University. Ms. Smith’s most recent writing on the topic, “ICE in your Healthcare Facility? No Need to Freeze,” is at: https://www.dorseyhealthlaw.com/ice-in-your-healthcare-facility-no-need-to-freeze/. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• Alexander Howard Discusses HHS Secretary Kennedy's Richardson Waiver Recission

  Two weeks after being sworn in, last Friday HHS Secretary Robert Kennedy announced, “effectively immediately, the [1971] Richardson Waiver is rescinded and is no longer policy of the Department.” He explained his decision by stating “the extra-statutory obligations of the Richardson Waiver impose costs on the Department and the public, are contrary to the efficient operation of the Department, and impede the Department’s flexibility to adapt quickly to legal and policy mandates. “ The waiver, issued by President Nixon’s HEW Secretary, Elliot Richardson, effectively meant HHS would use the 1946 Administrative Procedure Act’s “notice of proposed rule making” (NPRM) process broadly and its “good cause” exception sparingly. (The APA essentially governs the process by which federal agencies develop and issue regulatory rules.) Secretary Kennedy rescinded the waiver citing APA language that exempts rule making, effectively public input, from matters “relating to agency management or personnel or to public policy, loans, grants, benefits or contracts” and permits departments to forgo public comment for “good cause” or when the procedure is “impracticable, unnecessary or contrary to the public interest.” Though Secretary Kennedy’s decision will almost certainly be challenged in court, in the near term HHS can make significant, and now unquestioned, regulatory changes to, for example, the Medicare and Medicaid programs. Sec. Kennedy’s one page, March 3 Federal Register notice is at: https://www.govinfo.gov/content/pkg/FR-2025-03-03/pdf/2025-03300.pdf. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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