Listen here for the latest updates on medical procedures, health insurance and managed care. Aired on audio broadcasts from leading radio shows and premium podcasts.
Hacking Our Way to Innovation with Rebecca Love, RN, MSN
"So here. The woman we really love to dig into wine. Nurses decided on that sealed in particular. So what made you want to be nurse so nursing was a second career choice for me? I had gone for Undergrad in a degree in international relations and a minor in Spanish and I thought that I was going to be a lawyer to be honest and I was working on a presidential campaign at the time when healthcare was a big issue. I remember being these rallies and everybody was talking about healthcare and there were no nurses in the audience or a lot of Ernie's or a lot of lobbyists or a whole bunch of people that know nurses and I don't know about you Daniel but my mom's nurse. Do you have any family members who are nurses in your family? My Grandmother was okay and so that was my piddle movement. My mom came out and we went to dinner and she said we really think you should be a nurse and I remember her. It was an interesting time the politics going on and I remember thinking you know what? How can you be a member of? How can you speak to the choir if you're not a member of it and if everybody's talking about healthcare but nobody a nurse here? How do we really know what needs to change? And what the problem. Yeah and that was where my life turns recognizing that to really impact change in healthcare. I probably had join healthcare Do that and that's where my journey began. That's amazing it's topic. I've talked to a couple of friends about we've talked about on here to how there isn't representation in Congress in government of nurses like what we're actually going through what we face on a daily basis. I think that's fascinating at that. Made you change your career path. That's amazing well. It's funny that you say that because the statement that made me change my career path was at my I want you know. I said I wanted to be a lawyer and my mom said to me she said you know there's plenty of strong lawyers out there in the world and she said but I can tell you is being a nurse. There's not enough strong nurses out there. I need more strong nurses on there to change. What nursing looks like to the world and and you to become a nurse and at that time? I didn't know what that meant. I I remember. It felt really importance. But it's now ten fifteen years later that I look back and I recognize those words shaped everything that I've done in nursing every step of the way and I know your own story about how hard times it was for you to be a nurse and how it's challenges we faced how you didn't always feel like you fit in are you also didn't feel like you had a voice and that was hard for me and I'm and how to learn how to navigate. What sometimes feels like a very disempowered profession to become more voicemail and more recognized but more importantly that necessarily placated she but really just given a seat at the table is. Hey you got this. You know what you're talking about and I respect your opinion as much as I respect. Everybody else is around the table. Not so much. Hey I'm just giving it placeholder for a nurse to have at the table. It's really sit there and say we want them here. Because we we get that you guys have value add. That's been really interesting place to come from and I don't know you know in your own personal With your conversation if you guys have felt the same kind of challenges at times yes One hundred percent. And that's something that I think just Added onto years of being like repressed as a nurse that led to ultimately me burning out at the bedside. And that's something that you've been really trying to champion a lot for to in that you know there's this fear like aren't nurses are burning out after two years we're reporting out all these new grads but they're burning out so quickly yeah two hundred fifty thousand nurses. We graduate a year in this country and we lose over fifty percent of them by the bedside within spheres a practice the largest exodus of a profession that nobody talks about and I like you left the bedside as a as an rn. Within two years. I went back to Grad. School became a nurse practitioner for that exact feeling of feeling so like I didn't have that voice and every time I stepped in and I felt like there were so many near misses where I begged you know for changes to happen or orders to be changed or medications to begin our interventions to happen literally knowing that things were going wrong but not having the ability to make those decisions to change. There's outcomes depending on other people to make those decisions and only be given. The toolbox is a nurse to sit there and say well I really think I really believe are really feel that we got to make this big this change or get medication and not giving the tools to actually effectively voice. Why I had the you know the knowledge in the expertise to make those decisions at everything I always did had to be signed off by somebody else because as I was considered for lack of a better world credible enough or had the license or the intelligence to be able to recognize that what we were seeing. Mary made sense it. We should be able to take initiatives to save patient's lives because that was always really hard place for me to citizens to sit there and beg other people and then sometimes it literally and I'm sure you face it if you felt like you were burnt out so often begging to make the changes that we did an often being told. Hey stay in your lane like if you see problems but your job is to be a nurse and to do those things. Your job is not to challenge the way that things are being done and under mentally. That always sat wrong with me Fundamentally because you probably nursing school told hey you're you're the advocate of the patient where you really get on but when we got out in practice man it was tough
How a Top NLP Startup is Growing, with Caitlyn Brooksby, Executive Director of PR/Communications at Canary Speech
"Is the executive director of PR and communications at Canary Speech Walking Caitlin. Thanks for being here for having so Canary. Speech was named one of the most promising. Nlp STARTUPS TWO THOUSAND. Nineteen and the company describes itself as being at the intersection of healthcare and technology. Can you tell us a little bit more about what Canary Speech does? And why it is seen as one of the most promising and I'LL BE STARTUPS. Not a great question. You know what I think about. That really takes me back to origin story right. How do we start so five years ago? Our founders Jess Adams in Henry Call. They had been friends for over nearly three decades. Honestly and you know they had lived their careers and they got together and what they wanted to do was set auguste standard in a speech and language industry. They were poised to do it right both. Jeff and Henry. They have a clear the experience in Ashley had the excitement to do it and it really well doctors one question and why light you mentioned because normally talk about speech language industry it really can get techy if you don't really deep which is exciting that fun but what we started with nearest started with was this is how is was humans understand the raw motion in the words that someone speaks. You know when you're talking to your sister or your best friends and you ask how their duty say no good but not you know. There's something different right it's off. And how can we do that as humans? And how you use and what we've done is use machine guided machine learning and to really understand identify conditions. So that really is us so now. Today were six. Hatton's later boss. Us An international. And we've just taken this to a whole new level of redefining speaking language in the healthcare industry and so we talk about healthcare in No the intersection there. That that's really what we're setting out to utilize each language in the healthcare industry and bringing it just that step further so about you know. That's exciting because it does take voice to another level like you said you're not only hearing the words but your understanding you know they should behind what's being said and especially in the healthcare space. That's really important. How are you able to do that? I mean if you can talk about that a little bit. Is there a lot of testing research? They're able to kind us to understand the emotions. Someone's voice yes so really I like to Don frears and so what we've done is we've identified two thousand four hundred fifty eight biomarkers in speech. Okay what is a biomarker? What we're talking about here is like tonal. Quality these aspects of speech but mo up. It's what our body creates. And so we're gonNA find these biomarkers and then we developed bottles that are Z. Specific so they're not person's right cake a rich history of somebody's entire healthcare data and compare it but really what we're duty is a disease that he used mass in really scaled and just be utilized healthcare industry and then he used these models as our speech data so we started out here siege. Five years ago we really were focused on farm street. We were in FDA. Hire me cynical. Trials to this is very controlled environment right and we did this. Because we wanted to be able to cruise our technology and energy to get s right wide able to really tune in for router market or the playstation of it and so we really spent a solid three years of just focusing on these controlled. Studies REALLY AMAZING COPIES. Who wanted to get their to market or just simply to help with a civic disease and so that was really exciting to be a part of that and then we really moved into studies where we from the one hundred group right that were testing to really like in the thousand. Just last month we were able to reach a project that had heard ten thousand over dissipate and that was just exciting me. Mary siege his coming to blow background. Like how is this talk about area of science but what we realized early on was that we need full sets to go into a steadier going for project so what we do is hatcher tissue speech on a person's smart device so we use iphones IPADS android. We use these devices to captures fees. We also talk about the intersection of healthcare technology. What's really exciting is. We decided again early. On though he needed to create that bridge. What we were doing in the healthcare street was connected to what we were going to rate so reduce we include the gold standard Or are the panels which used to go to your doctor if you're dealing with stress I e Rd typically piece of paper that you're asked to allow the pen and paper and rate yourself on Howard layer urge years weeks ago and that's what your position uses to solve. You treats the symptoms that you're dealing with when you work with your physician that you say you could just read their seconds of across cheer South Kearns for the doctors I and made from that based on her stress near Zion Unions. And now we're there which brothels really exciting as a company you've made strides that that's a society scalable. That's Donbass it and resilient school that your physician to news you can use these tests. Don't have to be administrated within the hospital space or in the administrative is like family real and that's a place where is comfortable and you think about what's gone on over the last three or by months with coded ninety it really brings tall houses centerstage in funny. I was seven or eight years ago. I was on one of the committees to bring telehealth mount healthcare in your mouth. Nearly ten years ago I started my career there and is now. I'm embarrassed to say but I used to work for the very first time three months ago. I got a cold sore. I mean I knew it wasn't over ninety but I knew I needed some kind of policy packer. Someone is able to use tell homey bonus. I think that's really going to become the nor so. Yeah that's simple bit of our coaching kind of how I see it. How we see ED signing into healthcare. I agree. I mean we've definitely been using. How much more than we have over time and like I said I love that you all are kind of focusing on this emotional piece. You had mentioned earlier that your company also has multiple patents. Can you share with us? What they are. And why was it important for the company to have patents and do you think that something other voice technology companies should be doing for sure so that we pride ourselves? Moore is coming non-negotiable or Henry Projects. They knew that they wanted language. And in order to do that we had to prove that our technology was novel. And it's really exciting. Because just two weeks ago he had are six patents in the EU and so total right so acid time is for the EU. We were awarded one hundred of our planes which is now is not Donald Law. We were in a meeting with one of our clients. Actually find that I met last lie. Voice show guys and they astor pat they. So what do you think about these pens and looked around set rock-solid on that was exciting? I was excited be in for CEO. So I'll break down. Three strategic areas are Hatton's first one is that selection of the twenty four hundred biomarkers show and that had is called is slipping speech germs for building models for detecting medical conditions. So that patent is discharge behind. It is how we go about these biomarkers and using them within our guy and then the second is the. Pat Huddle is medical assessment based on voice. So there's really strategies around this particular the versus we use these selected biographers to identify. Disease are hunger stations. Each right. We're not to read this verbatim Hans. That's awkward not natural right. We're saying hey is our technology on conversational speech. Something that you and I are right now. And then. The third kind of strategy area is use of this artificial speech on vices in zone patented utilize the techniques together on smart devices. And what would that be your watch or your phone right? In an dots really were strategies are
Longterm Care in Denmark vs the United States
"I'm Benjamin Day I'm Stephanie. Nakajima this is Medicare for all the PODCAST for everybody who needs healthcare except for the corona virus freedom fighters. They are really stand out to American values and God and so And this is actually related to the top. We're GONNA TALK ABOUT TODAY. because You know one of the one of the most shocking things in the US is that Somewhere between probably fifty and sixty percent of virus related deaths are happening in long term. Care facilities So these are you know. Nursing homes assisted living facilities. These are really wear. The hot spots and outbreaks are taking place and Part of this is related to the really terrible horrible. No good very bad. Long-term CARE system we have in the United States Well one of the two of us Stephanie. You have actually managed to escape Our our system and you're getting like an incredible window on the Danish long-term care system. Do you want to talk a little bit about it? Sure so last time I mentioned in the podcast that I was in Denmark. And the reason I'm here is not the best under the best of conditions. My husband who is Dane. His father who lives here in Copenhagen is really quite ill And he's been in the hospital for many days and you know with Karoon virus happening and everything it was. It's the exact wrong timing for him. Be Ill And so we sort of rushed over here. writes about the beginning of the corona virus pandemic And we've been here sort of helping him transition from the hospital into Rehab and then finally Land to an assisted living facility as living facility. So I've been sort of like a firsthand experience with the Danish long-term Healthcare System And I've been so impressed really just with how well everything is. Coordinated how How many resources there are for people and also just quality of the facilities the quality of the flat. He is going to be in and the the cost. It's only going to be seven thousand per month. Which is like just over a thousand dollars for This beautiful seventy meters flats with greenspace on the front of the back and then also in addition to that he'll be getting home help however many hours it is determined. He is needed as well for free. He's not bankrupting. The family for long term care it. There is a time where we were. We were looking at each other making on. I would just like tears in our eyes like I can't believe this is all you know working out for us and everything so so yes so. We a special guest Here today this is the first ever so exciting who is an expert on? Denmark's long-term healthcare system to give us sort of this personal experience and I want to hear more about it from the structural standpoint so I'm going to welcome our guest John Vista. He's professor at the Institute of Society and Globalization at Roskilde University here in Copenhagen Denmark and request has published on the long term healthcare system in Denmark as well as other areas of Danish social policy. So welcome professor crest very much happy to be nice to meet him so we have a lot of questions and we'll talk a little bit also about the US experienced but could you just kind of For folks who are not familiar with what long-term care is and what it covers Could you just give a very basic definition? Yes so so long. Term Care is about take off people who cannot take care of themselves so we would be frail people and what we're talking about. Today are people who are elderly. Who are frail so people who are unable to take care of themselves? They would get various types of support or so in the case so some of it will be homes like. Stephanie mentioned that her father in law moving into a home that is for made for elderly and I think it was together with staff associated with the home and he will have to pay rent so he would pay about a thousand dollars per month for this flat but we all pay money for our housing. So it's not like it's not like long term care is fine is actually not means. Tested needs tested. So you get long term care if you are needed independently of your financial situation then some of it you have to pay for like the red for the flat and for some practical help with laundry and shopping and food services so beside the home home care as a homes like institutional care and practical care. It can also be rehabilitated. Let's imagine that you elderly person at you have fallen then you will get a rehabilitation helping you to get back on your feet and to undertake daily activities Again vacuum. At what have you so we have been attention. Physical training assisting daily living activities. That sort of thing and the final thing is that you will also get a visit. A seventy five year will get once a year by a person who would come and ask you how you're doing and if you need any help to get paid life well that is such a contrast with what we have in the US. So I don't know if it's the same in Denmark but in the US also People with disabilities regardless of their age are in need of the long term. Care support except And so here in the US. A lot of people think that Medicare which is are sort of universal system for seniors sixty five and over would cover long-term care but it actually does not Medicaid. Which is our program for low income. People covers long-term care so if you Are in desperate need of long term. Care if you're just really not able to carry out daily activities like bathing and a shopping and going about the house You cannot get support. You don't qualify for nursing home or help in your own home unless you become poor. Enough to qualify for Medicaid. So it often happens and these are some of the most horrifying stories we see in the. Us is that Someone becomes disabled or they get older and have chronic disabilities and they they spend down all of their money on long-term care until they become poor and then they qualify for Medicaid and they get public coverage. But I'm assuming this is not how it works in Denmark. That's not the case. We have a so-called universal system which means basically everybody who I need so if it's locked so the elderly you have to be above sixty five years of age and then you go food at each test where they've seen. How can you such your toes Can you make your own food? These sort of issues. That would be crucial. Perry to it is once name is to increase the quality of life and the second goal is to increase your ability to take care of yourself because we know that Elderly other people. They liked to be independent and autonomous and not have other people to rely on in order to do whatever it is that they wanted to particularly
Until a Vaccine Arrives...
"Brian resnick senior science reporter at Vox. There's a lot of uncertainty about how the future of the pandemic is going to play out. But what do we know for sure? The one thing we know for sure. And that's always in my mind when I'm seeing stories about states opening up and people going out again. Is that this virus still such a high pandemic potential that just like hasn't been spent pandemic potential. What do you mean by that? So I've been asking researchers a question along the lines of what's really different now than like when I went into lockdowns March and the answer is well few more people relatively speaking have been infected but a lot of the conditions that were really scary then are still scary now and this is a hard thing to think they're like we've seen an enormity of pain of death of horrible horrible things like this is already in my mind like just one of the worst things to happen in modern history but yet so much more can happen and that's like a really at this point in time like after we've seen so much to realize that nationally only a handful of percentage points of people in the United States have been infected by this and so so many more could be in the future potentially. It's it's a really tough moment. So when the epidemiologists that you spoke to look into the future what exactly are thinking about. Yeah so like. Let's say the summer it's not that bad we've opened up. People are still behaving as though there's a pandemic going on. And we generally keep social distancing up generally keep the pandemic from not destroying our health. Care system you can imagine people becoming complacent and anxious to start life again so you can imagine in the fall. There's all these calendar dates that could bring people together again so schools in September can decide to open up shortly thereafter like Halloween which you know brings a lot of if you're ever been on a college campus than on Halloween. You know you see people mingling together. there's election day. There's Thanksgiving these are all days on the calendar where people can start to really collect together again And increasingly indoors. We know this is becoming like we know. This is a clear risks like this virus three doors when people are breathing the same air. We're breathing each other's breath so you can just look at the calendar and like anticipate a potential situation where if there is still a huge susceptible population to get this infection and then suddenly we release all the restrictions and we declare you know. This is behind us. Summer wasn't as bad as those nasty scientists were predicting and warned us about the mets setting up a situation for just like a huge explosion in cases right so people get to go outside right now. A lot of people have not been infected and then in the winter we get bored of this whole thing. The holidays are coming and then all of a sudden. We're all squishing together. Which makes us far more likely to become infected and again as we said people have not been infected and so they were likely to get sick. Yeah and I've had so many conversations with epidemiologists who you know. They're worried about the fall. They're worried about those calendar dates in those family. Get togethers but they're also worried about the summer. They're worried about states opening up too quickly without adequate plans for testing and contact tracing place and we could see a big second wave of the summer to like. That's not out of the question you know. There's just so many possible futures and you don't have to like point to one over the other as being scary like they're hall scary. What are some of the other scenarios for how this pandemic could end up playing out? The first thing to know. Is that in all these scenarios? The virus will likely remain around for years without a vaccine years years. Yeah but there are few different paths. Like what's going to happen over these next two years or more. You know before. There's a vaccine. Let's imagine three scenarios and these are drawn from histories of flu pandemics The first is what we discussed like a huge fall. Wave where you know you keep people safe during the summer and then you create the perfect conditions for this virus to just explode in the fall and winter and then viruses already seated itself throughout the United States so you have like all these like igniter fuzes in all sorts of parts of the country and it could just like you know a powder keg and the fall you know where the fuel another scenario just like we just keep seeing peaks and valleys good just hits different cities a heads different regions at a time and so the second scenario. It's a little chaotic. Okay and what's the third scenario? The third scenario is like a slow burn. It's the plateau where we get to place where cases you know. They're not really destroying our health system. They're not creating crises for different parts of our country. But it's just like not going away. There will be continued infections continued deaths and we manage it perhaps with contact tracing and testing perhaps with learning about more about how this virus is transmitted and avoiding the worst places for transmission. But even in the case where this is the slow burn keeping it under control where we're keeping it from Nick Knight. A huge powderkeg like that. Pandemic potential is still there. It's still gonNA find people this virus sneaky as a long incubation period. People can spread it without symptoms like the bottom line. Here of this scenario is like we're going to need vigilance. Until there's a vaccine we're GONNA need more than fifty percent of the population immune for there to be like a natural slowdown of this pandemic. So until then like more infections are possible in are not going to get down to zero.
Wearables as Early Detection Health Systems
"And so you know to frame this discussion Obviously with the whole pandemic going on right now Were in the midst of I. Think a whole lot of different trends that are being accelerated in. You know for me personally. I've been writing. Blogging about biometric sensors. And the idea of wearables serving the role of preventative health tools really since the onset of future in so now it's becoming clear as ever that there's this is a really important role particularly during pandemics in health crisis that I think these body weren't computers can play and so I think to kick things off I WanNa to go to you Ryan about just the idea of the different types of metrics that sensors like the ones that Alan cell produces can capture I would love to hear from you know particularly around metrics respiration rate but oxidation You know these different metrics that on the surface. You hear them okay. These you know. A body worn sensor can now capture a respiration rate. What does that actually mean and input it? In the context of why that would be an important metric to know Particularly with you know something that is a respiratory illness like Ovid In how we might be able to be a little bit more proactive with our approach. Here you know in terms of understanding what's actually going on with our bodies and maybe using these tools as part of a early diagnostic system in in just a better way to diagnose and detect anomalies in the data that there might be something going on even before you might be showing symptoms so Ryan. Why don't you start with maybe just a a an overview of some of these different metrics? How we've even gotten to the point to be able to capture these and then what we can glean from those types of metrics. It's a really interesting topic because the One of the silver linings if you will in this In this pandemic or and now is really highlighting the capability the current capabilities of existing Wearable sensor technology that in many cases has been around for years if not long if not decades or longer in the case of something like the pg sensor technology that we make that has been around and finger clips and your lobe clips that measure vital hind in hospitals and healthcare facilities for for decades Those things so the ability to measure things like heart rate and heart rate variability and bought oxygenation in wearable devices has been around for decades. What what this current environment is is really putting focus and and really highlighting is the capabilities of those devices and And also the the ability and the importance of Wanda to data Capture across those different metrics. So it's one thing to to look at someone's heart rate or let's say their body temperature or their respiration rate at a given point in time but what Where these are really adding additional value? And that's really getting highlighted in. This environment is understanding at an individual level. What that data looks like over time. And in a longitudinal sense where you can get an individual baseline on a person and understand how they're different Let's say they're different resting heart rate or heart rate variability changes in an individual Those may be different between Me and you an Andy and Chris All all of us are going to have different baselines at an individual level but the ability to see. Not just what what's going on when someone goes to visit a doctor or in this case where we are discouraged from going into into hospitals and healthcare facilities what that looks like a longitudinal basis for an individual and that gives In many cases much better insights into how individual is responding to whatever. They're whatever they're currently doing or whatever their current environment Maybe doing to them so That gives unique insights and the capability has been there for many years. What this current environment is really putting a highlight on is what are the what those capabilities and mean on longitudinal basis and also in a in a remote monitoring scenario where an individual doesn't have to come into A hospital or a health care facility to see to see a healthcare provider. That can all be done remotely today and we're really seeing The acceleration of telemedicine telehealth and the And the use of wearable sensor data in those contexts to be able to get that data and and I see how an individual's baseline is changing over time. Yeah no I think that makes a Lotta sense and Chris I want to go to you. Now you know. Kinda going off of what Ryan just described with how we can capture all this information before recording. You had mentioned a study that you had just conducted with Va. That I would love for you to expand upon a little bit here and share with the audience About what we can then actually gleaned from this information and in how you worked with. Va To make some pretty meaningful insights based on this type of information that were now being able to gather from these different sensors so you're just to build them what Ryan sharing these. The sensors themselves have indeed been around for for decades the EKG writer DC. G HAS BEEN AROUND FOR I think. Essentially now And while traditionally these types of sensors have been used in impatient environment. Where you have somebody who's lying in a hospital bed where you know it does it does make sense to use something like resting heart rate When you introduce these types of technologies in the real world where people are moving around Going to the mailbox or walking upstairs. They're they're they're sleeping they're awake. How do you capture these? These data sets in that environment in a way that you can actually make sense of what's going on. So the big leap is in the artificial intelligence that the neural nets and machine learning that we can now apply to these data streams to do what Ryan ascribed Annette is build a personalized baseline for an individual from which then you can detect very subtle anomalies in so If his IQ our first FDA clearance was in an algorithm that did exactly that and that was invalidated in this. This va sponsor. Study that you just referenced. In so with that Algorithm. What we're doing is a platform is ingested continuous vital signs specifically cartwright respiration rate in activity. And doing that from a wearable biosensor and it builds a personalized model of their cardiopulmonary physiology as relationship between these different vital signs to detect subtle changes that are are indicative of compensatory behavior within their physiology that can be predictive of
Providing PPE and Getting It Right
"This is the biggest ever ramp-up of volume I've ever seen in wickedness. So simple again the right stuff to the right place to the conditions on the front line. We've never seen anything like it. We've redeemed with huge volumes requirements. That rapidly ramped up at the same time. Pp's required all over the world. Which is all you know. Hundreds of other challenges and this is where a local supply base is really helped his. Estan moving along with the same time we've seen tremendous innovation ready for the while supply base. We've got people come into US offering to offer new solutions. You know some of these items would used in great volumes to follow so the way in which we've done in the past we try to encourage business but this has this has made things have been more fine bit more than this shown supplies wildly. You can't do business with us. Is just how to do how to do more quickly to get a foot in the door. So the the opportunities of that full Famo- business ongoing I think the challenges is currently a salads markets. We're experiencing higher prices that we've paid before where we're having to go. Nutri globally to get some of the stuff we need. While industry stepped up to the plate on the number of items but when the dust settles and business becomes more business as usual will come back into the normal game of competition and what we want to try and find his way of help in while supplies maintain the photo. That you've got will be other people out there who businesses. Well these all of us you know government legislators acumen and the whole of the the public sector eighty two the by to agree why is required in by Welsh on Ford P Phillips. I'm the director of the surgical materials testing laboratory. We based in Princess of Wales Hospital in Regent. We've been around for forty years in one form or another. We provide testing of medical devices to wash. Nhs UNTO particularly twelve procurement. All the gloves that we you've let us in ways if you're an each workup will would have come through all the Bodry to make sure that they comply with European standards and we provide technical advice to procurement on what of Standards and regulations. They should be applying. We've been I would say Cinderella Service Fall of almost Mike Korea. We've sort of come to prominence in the in the last four six weeks because everybody's looking test data and regulation of devices and P. P. E. We rapidly together a team from within. Sm T. L. who are good about five or six. I work in every day and we put an extra people in as required on are not just from ourselves. By the way from health technology ways in seed and some consultancies as well and we are screening all the certification that comes through to Graham's team so the life sciences had screen the the the initial a trench teen than deal with those who seem a promising and then we actually look in detail at the tickets that they've applied in the test ripples so we talked in broad terms about the demands on Industry. What about the role of Life Scientists Have Wales Shutting Matthew in the head of industry? Engagement at the hub explains now role is to support the acceleration on the development and adoption of innovative solutions for better health and well being of our nation sent more recently we during the Kovac nineteen outbreak. We've held a slightly different role. This road has certainly demonstrated to us the breadth of support that is out there across the nation of people wanting to to help in this very very difficult and challenging time. It's demonstrated in over fifteen hundred responses through the portal of organizations and people wanting to support this very difficult time and help the deliver the right products at the right time. Companies thought have fulfilled. The criteria are informed that they have been referred from the life sciences onto the various buying partners of which they're all a number so industry. Whales plays a an excellent part in this We've managed to forward offers people wanting to help with producing gowns so textile -tunities people have come forward offering manufacturing space. An all of those referrals have been sent on to the appropriate people. Those that have not fulfilled the criteria. Have all been sent a message explaining why they haven't fulfilled the criteria and given the opportunity to reconsider their application and then if they then are able to fulfill the criteria then they're referred back to the appropriate person. Fifteen hundred sounds a lot. So how do we get from an inquiry that looks promising to position of an individual being able to make a valuable contribution to the NHS? He is Greg Davis take A fluid resistant gowns. That we've been we've been buying. We've got a couple of enquiries one came to interact one came through the life sciences portal. We've got help from whilst governments. You Know Industry Wales Economy Industry. A to this applies to products the prototype. You need to get him. Certified and tested and peach symbol. Do the the checks on the patient. Testing eight mentioned it without doubt. We are using them more than we have before at too rapid pace. And they've done a great job. You know trump health but trying to help while supply base direct people to ask them. And then who would this lots of questions year round having certification? Should you have said indication what to see me mocking me? So just explain exactly what the requirements should be able to ultimately clegson old if a p any just wells some of the things that people think was p p such as the surgical face masks which are commonly known as type. Two all masks are actually medical devices other types of mosques are PPI respirate the mosques f. f. p. threes and then hand Gel Bigly using a commander and the sites so we have three sets of regulations. Medical device regulations P. personal protective equipment regulations and by your side regulations. And it depends what you're trying to sell to the NHS which set of regulations you need to comply with alongside the regulations. We have standards the type to our master mentioned. It's a medical device in the NHL. If you WANNA sell us a mosque like that you have to comply with the European standard. Which is one four six eight three? And if you sell respirator. That has to comply with E. N. One four nine two. So you have to have two things sorted. You have to have standards compliance which shows the performance of your device and you need to make sure it complies with regulations. That's where the C. E. Mark comes in so medical devices AC- earmarked under the medical device directive or medical device regulations and. It is basically the authority that you're given to sit when you put the C. E. Mark on your product. It means you comply with the essential requirements of that directive.
Dr. Varinder Singh: Coronavirus At Ground Zero
"I contracted cove in the middle of March. I had it For two weeks you know I have to tell you that Two things work with this disease. They really do relation. Works Right. Stay isolated the other thing that works to speak to eat We're looking at our conversion rates for our doctors and our frontline workers a appropriate use of PD. Well used we have less than six percent conversion rate but we still have the six percent conversion rate and I think. I'm pretty sure that's probably what happened to me on the front lines and I kind of look at my Cova. Domus all COVADONGA MRS as either. You're really sick or you're not that right it's like a define line And and if you survive it Categorized you in the you weren't that sick 'cause I've seen enough and I think Steve is probably seen enough to know that people that really do get sick with this. Don't where were you one of the guys that just had Hardly anything as far as symptoms are concerned or did you have some serious symptoms. I woke up on Tuesday a Tuesday night. I felt a little headache. And that's one of the known presenting symptoms of it again. I didn't think anything of it I just was like. Are you been working a lot doing a lot of the frontline ships on strange physical and emotional and I woke up? The next morning was Wednesday morning and I felt viral right. My eyes were puffy. They were watery And I had congestion and I knew enough that I should not go to work. I assumed I was awesome. I went and got tested. Did a chest x-ray the blood work and all emergency rooms right now and this is something that the public should know you know we are Cova contained and are pathways for evaluation in American healthcare. Right now are done scientifically. They're done through epidemiology so that you are actually at a low risk of getting Cova seeking medical care and that is very very important because I think a lot of people believe. Oh my God. All those patients are in that building. And if I walk in there that's where I'm actually GonNa get it and that's not true so I did. What everybody should be doing is I went to the emergency room. They had a whole pathway. The screen me before I even got really in the building a pathway which was the viral evaluation pathway Got Tested got chest. Xrays saturation's You know positive and we felt like I could manage myself at home. I can tell you that about four or five days into it. I could not remember what I had done five minutes ago. So this is important because we clearly know that the five to eight day window from the original diagnosis is a critical period of time. Steve Seen this. I've seen this people doing much better much better. They Crash Bang the inflammatory response. And so I actually got into an argument one week into it with my employees health director from the from my home self-isolated saying I'm ready to come back to work. And she was like no. You're not I'm not clearing and I. It's been a week. I have seventy two hours. No fever no cough. I WANNA come back to work. It was like no way. She was great and our after that phone call. It came back on and it came back on me much much worse than it did. The first time and a wound up in the next day. severely dehydrated. I've never been dehydrated in my life. The gave me fluid bag after bag and I just was like I need another one. You know what my own body was saying to me. You need more of this Listen you always become a better doctor when your patient you learn more empathy? You learn what's going on in somebody's head that sphere its anxiety. It's the same questions. I had the same off of like. Wow I still got a big run left in the. I'm not ready to go yet. I mean all the things that every one of us thinks about ourselves they think about and it makes you more empathetic incompassion. Tell us a little of how it makes you feel as doctors in the middle of this thing as you see us opening up with a higher base of infected people then we had even when we locked down in the first place. I don't think we've been hit nearly as hard as New York has. I'm actually very concerned embracing for major impact and very frustrated with the concept that people feel that it's okay to start opening businesses and re assimilate into society the higher density of the virus. I think may much more dangerous than it was in February. The fact that people have basically had enough with social distancing and masking and their frustration which will cause them to be even more lax than maybe they were before I think creates a potentially very dangerous set of circumstances and I think our hospitals will have a huge surge like we had initially but now with a base of patients who already have the disease but enough. You're going to add a sudden peak to that. We're going to feel that pressure. Healthcare professionals be at risk in patients will not be able to get the services that they need and that's at our level in Los Angeles. So how do you feel doctor saying? I can't imagine the pressure that you guys are under right now. At one point we had over four hundred forty patients in the hospital. We would like to think that what we learned early on and disseminated nationally and internationally helped you of you know we. I know that I was on multiple track groups that first week with physicians all over the East Coast positions of Midwest positions on the West Coast. And we still kept those going. Those first six weeks of this awful will you subject to some of the shortages that we all saw on the CUOMO press conference. We knew we were at just enough levels. And so every day you would wake up and you come in and you'd say how many people are under investigation. The merchants from how many people came in and it was just every day more and more and more and then we were scrambling to get stuff. We had People Donating de we had people Donating whatever they could do to to help us get what we needed to get through. It was overwhelming and it still remains overwhelming. You know a Steve. You've seen this when they first started coming in the people that we were discharging by because we were filled so we were trying to triage people to stay at home and call them to see how they were doing. And we all talk about it. You know some fifty five year old guy who comes with a bilateral pneumonia and has a PO to set of ninety four in the pre co era hundred percent would have gotten admitted right just for his own medical health and just because we were scrambling did an amazing job of like built making beds every night every night every day we make more bets but we would try and manage a lot of those patients at home call them and follow them and make sure that they were doing okay Just doing that early on was you realized that we were into something that we've never done before. Can I ask you how many ventilators you have it at Lenox Hill? I don't know the exact number but I can get it for you. Know it's interesting. Everyone talks about. Do you have an ventilators? We have capacity of one hundred ventilators but it always say and who is going to run one hundred ventilators. Did the the rate limiting step on that is not the number ventilators at least in our institutions. We have an ICU. Team of seven people. We could expand that ever so slightly are then going to say seven. Doctors are going to be running hundred ventilators not to mention all the other consoles on the
Alexa Healthcare Skills with Dr. Bob Kolock
"I'm curious because like you said you've you've you've designed now eighteen skills. Did you teach yourself how to code along the way or how did you get these skills to do that? I you know I have to compliment Amazon. Who's still have a lot of good documentation all along the way There were opportunities to learn for free or minimal between what they provided in. What are some of the Code Academy a? There's there's a couple ones that are out there that really minimal charge. I so I learn Java script books on it but a lot of trial and error. And it's gotten to yet so I never knew Java scrip- I worked the website. I mentioned I use coal fusion probably burdette. I've heard of it but that's about it. That's not so use co fused. I haven't Do Some Aung. Php I'm sorry. But I learned along the way again. There are a lot of times I built the skills. I probably built fifty steals but majority of those were learning skills. Like okay gotcha. Well it's really impressive. I it's very inspiring to know that you can. If you really WanNa do this and get involved you I mean the resources are there to go and learn it and start to create these things that have real value so I think that's that's wonderful. What can you share any thing that you're working on next top secret or any other plan coming up? Well I'm the one I start. I started working on this over the weekend And I think I might submitted later today or tomorrow so really so I'll tell you I'll tell you what it is. It's the concept is again trying to focus on the good things in our lives so the draft name of this is gratitude law. Yeah it's very simple. What it asks you to do. There are real functions. You will tell lack Alexa three things that you're grateful for. Okay and you do that as many times as you like in then you could ask subsequently tell me my blessings and it will ran the Maya through your list and tell you three random things and yet it's not the track my doses a lot more conflicts and pop located those functional. This is more. Let's focus on the good things like kindness counts and the things we should be thankful for. We're seeing a lot of that and social media. I think you know one of the big things. Thank our first responders doctors and the nurses who are in the front line. Those kind of things by so. I'm hoping people again. It's ready to be out there. I'm not sure we're going to keep that name gratitude blog but anyway I'll let you know change but now but again it's that purpose in mind. I'm I'm also like working with one or two Companies that are trying to do some like an adviser yet works Ireland. You know I guess just to finish off. I'd love for you to just share how people can contact you and how they can get in touch with you if they want to chat with you about maybe working on some of these projects with you or otherwise just getting touch and having a chat with you about your thoughts and ideas on the stuff. Well my email is probably the best way is our a Kato Nello. Ck One and she mail dot com. That's probably the bass have linked in Robert A CO lock. Md The official. May I yeah and I would love to hear from people while Bob? I really appreciate you taking some of your time to chat with us and chat with listeners and myself It's a real pleasure to be able to connect with you like this and I certainly look forward to stay in touch it and seeing what your next projects are Following along with all these great skills
New Sanders/Jayapal bill: the Healthcare Emergency Guarantee Act
"The the next biggest thing obviously in healthcare is going to be this phase. Four relief bill which they're calling the cares to act which is likely to start moving through congress in the next week or two and the big question for us at least is. Is there going to be any healthcare relief for the millions and millions of people who are losing their jobs and losing their health insurance coverage right in the middle of massive healthcare crisis and there are now three bills that Democrats have different? Democrats have proposed in the house side And there's one on the Senate side It's not entirely clear whether anything will go through the Senate at all democratic leadership on the Senate side has not really made much noise about this But let's let's go back to the we've already talked about two of the house bills. We talked about A bill that Senator Sanders and reptile Paul are going to introduced. Actually not yet filed. This is called the Healthcare Emergency Guarantee Act. But what it really is it would cover everyone with Medicare It would have no co no deductibles and even if you have private or public insurance already than this bill would Medicare would cover all of your co pays and deductibles so basically it would achieve all of the access goals of a Medicare for all system. It would just temporarily believing in the private insurers and kind of providing wraparound and then but it is the like it is the Medicare Gateway Bill. Oh no doubt no doubt. Yeah I think so. We're going to be getting behind this bill. Most of the Medicare for movement is going to be supporting this bill. I think our feeling is that you know if you can get the experience of Medicare for all even if you don't get all the financing and limiting the health insurance company that it'll create real momentum to just do the full thing and because really leaving the health insurance companies in there. It just makes it much more expensive to do. It's hard to afford universal health. Care if you don't kick them out And you have to deal with them continuing to deny coverage and using the system just for their own profits so the other two bills. We already talked about this shitty bill that a democratic leadership is pushing the well the Worker Health Coverage Protection Act And this would obviously be good for some folks it expand. It basically subsidizes Cobra. So this is if you happen to have good health insurance in the job that you left. Then it would subsidize you staying on your previous employer's plan but a lot of people would not qualify for that Especially you know if you work at a small business. This is only Kober only works if you were working at a place that has twenty or more employees and it only works if your health. Your previous employer still exists and if their their health plan still exists. It doesn't work if your previous employer just went under or if they closed down their healthcare plan and obviously for many people who didn't have health care coverage previously. It would do nothing so just to give some numbers to illustrate the differences between these two bills the giant Paul Sanders Bill. The Healthcare Emergency Guarantee. Act THAT BILL WOULD COVER EVERYBODY. Who's currently uninsured? And that number is between thirty and forty million and rising as people are kicked off their their jobs and then kicked off their health insurance and then of course it would also because it would provide that wrap around coverage Basically it would basically affect everybody in the United States hundred plus million three hundred million whereas the Cobra Bell the Cobra for some ish. Bill that Nancy Pelosi is pushing would cover at most four to five million people so the scope is really different. Yeah I hadn't even seen that projection but that is shockingly inadequate for sort of what's facing us and we now have a third bill if you weren't confused already this is This is a bill introduced this past week by Reps. Chhaya Paul and Reps Kennedy who are both Medicare for all supporters in called the Medicare Crisis Program Act? We we might need to rename all these bills down and their bill would Instead of I mean the other thing about the bill is that it's just throwing public tax dollars at private health insurance companies but this plan that Kennedy introducing would expand Medicare extend Medicare to the recently unemployed so basically people who have become unemployed due to You know in the period of Corona virus would be allow- allowed to enroll in the Medicare program But the thing that makes this it's not nearly as good as the sanders giant. Paul Bill Because it leaves all of almost all of the cost sharing and copays and deductibles Under Medicare would still be there They did eliminate some like the premiums that you have to pay but you'd still have A part A. Part B. deductibles. You'd still have to buy a drug plan if you want to have any drug coverage you'd have the donut hole all that all those limitations that Medicare unfortunately comes with And then if you did not become recently unemployed then you also wouldn't qualify for the program So in my opinion it's it's better than the Cobra Bill. it would cover more people But it's still. I think totally inadequate for what's needed in this crisis and it makes kind of arbitrary distinctions about who gets in and who doesn't so I don't know our current system Yeah but yeah it would be better. It's like a gateway light right so we have like the the sanders dry. Paul Act which is like improved Medicare for all ish improved Medicare for all gateway drug. We have this the Reps Scott. Dingle Pelosi Bill which is like Cobra for some ish like you should have been a Republican bill right. They may be actually and I mean this. This is what I thought. The Republicans were going to push would be like. Let's subsidize private insurance but it turns out. There's been some like trading places going on over the decades so and then we have this new job. Kennedy Bill Medicare for the recently unemployed. So now we've got these three bills but none of it is really important. The distinctions between the bills. If nobody's actually going to fight for any of these bills and Pelosi for example they introduce this bill but she hasn't really been talking that much about it. I'm not sure if there's been a lot of discussion about whether it's actually going to be in the next phase of relief and and I think that there's a reason that the Democrats haven't really tackled the UN insurance problem. Which is there's no good solution for them. I mean insurers want them to expand Cobra which would be massively expensive and then as we were talking about cover only a fraction of the newly insured newly uninsured. The other option is of course you either expand private or public insurance and so the other option is to temporarily expand public insurance which would cover more people and of course be far less expensive but would also piss off the industry. Not only because they aren't going to be receiving those subsidies Cobra but because it would just be difficult to claw back you know expansion of public insurance and it would also demonstrate a way for us to transition away from employer based insurance so democratic leaders are just Kinda stuck between these two forces I think and I think that maybe they're just hoping that all these people who had insurance these are the ones they sort of have to worry about the the people that they think make up their base they. They hope that maybe they'll get their jobs back soon. And then they won't have to deal with this whole problem.
Whistleblower complaint alleges virus warnings were ignored
"Remember Dr Rick Bright. He was the guy who would be in charge of the government's efforts to find a corona virus vaccine and two weeks ago. He was removed from this extremely important job with zero explanation. Then Dr Bright claimed he was fired for pushing back on President. Trump. President trump push for an unproven malaria drug to be essentially distributed on demand. Today he filed a really revealing and shocking whistleblower complaint charging among other things and abusive authority or gross mismanagement. He elaborated on a conference call reporters this afternoon two years however had been beyond challenging time. After time I was pressured to ignore or dismiss expert and scientific recommendations and instead to award lucrative contracts based on political connections in other words I was pressured to let politics and cronyism dry decisions over the opinions of the best scientists. We have in government Dr. Brian also described his concerns about the lack of government response to the growing outbreak. As far back as January after bright relayed concerns from domestic surgical mass produced that quote the mask supplies at imminent risk. Nothing happened for Week. Leading the mask producer. Email bright quote rick. I think we're in deep shit joining me now. Sam Stein politics editor of the daily beast reporter. Dr Rick Complaint today and Sam. It's it's a long and detailed document and it is quite revealing. What jumped out to you? Well two things. One is the stuff that happened prior to the corona virus outbreak. Which is he details. The systematically corrupt HHS process in which Huge contracts being awarded to people who are very close to top officials at the Agency. The more pressing thing obviously many detailed an administration that was basically had their heads in the sand. I with respect to the corner virus outbreak in China for weeks. Not Months you touched on a bunch of stuff early on but just warning for seeing that a shortage of n ninety five masks was going to be a huge problem and being unable to convince anyone up the chain that this is something they had to deal with also a or lack thereof around getting a vaccine in the developmental process which we now see the administration. The president has but he was talking with officials. January early February about the need to prioritize the stuff and of course got nowhere. But I think the larger thing I was it was interesting to hear. Kathleen civilians. Talk about this is that there's sort of a bigger picture here. Which is that. The careerist and the scientists in the administration were more or less ignored or pushed aside and have been since the onset of the administration's not just the disbanding of the pandemic units. But its people like Dr Bright who are dismissed as alarmist even though the scientist nistration and this is sort of common pattern that you see with his presidency where he goes more with his political guts and how he's thinking than actually doing any long term strategic planning and it's more than guts and there's an allegation of essentially corruption. Here right that that that you have career. Scientists and civil servants were making determinations based on the science and there's pressure from above from the trump administration to steer things in the direction of people that have a a monitor interest because they're buddies of the president like that. And that's one thing if you're talking about know a contract for buying pencils for a federal agency it's another we're talking about vaccines and lifesaving drugs right now. There's so there was this story which detailed the president's push for hydroxy chloroquine as therapy drug To be stockpiled against all sort of prevailing scientific evidence or lack thereof that it was effective in Dr Bright raise. Those concerns admitted that he brought to the attention or confirmed an inquiry from a journalist which ultimately led to his dismissal from his post. So that this is a case of someone saying this is really crazy. What we're doing is borderline not completely unethical. I mean stop and he took provocative steps to stop it. There was another story today. Involving a jared Kushner is Coronavirus tasks in which one of the complaints made against that was that Fox News personalities were able to jump to the front of the line in terms of getting people to hospitals that they deemed helpful. Or you know emotionally close to. So you're absolutely right. There's a horrific way to do this. In the trump administration is basically hitting every which is cronyism favoritism and dismissal. The science I want I want play. What a bride had to say about H- dismissal the of high hydrochloric being the kind of breaking point in terms of Administration take a listen. Americans need to have all the fax they need to know the truth about this pandemic need to be able to trust their government
Howard Friedman Discusses His Recently Published Book, "Ultimate Price, The Value We Place on Life"
"Air was originally guest motivated by thinking more and more about the September Eleventh Victims Compensation Fund and I was acutely aware of the fund. At the time I'm I'm a native New Yorker who was living in D. C. In that really started this whole thought process for me about how human lives valued and my professional career alive. It has involved health economics in research. We're we're constantly looking at questions of what is the value of particular procedure or drug. And how can that be measured? So I started really with the victim's compensation fund and then connecting the dots and building that four and ironically my Book structure followed by exact thought process in opens with the September Eleventh Victims Compensation Fund and then connects that thread over to the civil courts in which it was constrained by and then later to talk about criminal courts regulatory agencies in the for profit companies. Okay thank you. We'll get to that in a minute. Let's just go over some of the theory and application so before we get to another examples you provide. What in theory is intent is intended in placing monetary value on a life. Well it really depends on the purpose so I almost have a carve back and say you know as we look at. What is the purpose and perspective of the calculation? The valuable life plays a different role. But usually you have situations where you have limited resources and you're trying to allocate them in what would be deemed an optimal matter and what is optimal becomes almost a philosophical question. But if you're trying to let's say save the most lives you would make one choice. The most life years different choice The most quality adjusted life years a different choice. If we're talking about health if we're talking about doing this from the point of view of a for profit company they're trying to maximize their profits and they're worried about. What is the cost associated with making a product safer and the benefits in terms of? What would they have in terms of reduced regulatory fines losses in civil courts and damage to brant? Kay thank you. So let's get into the calculation. There are variables typically considered in attempting to sum total. You discuss formerly. What's charmed the concept of the of a statistical life so what are typically some of these variables that go into calculating Value on a life. So let me let me describe that value of statistical a little bit more because Some people may not be as familiar with it. This is a calculation that was developed by economists in a few different ways In some cases they look at people stated preferences doing surveys and asking people how much risk are they willing to take on for an additional amount of money. That's one way to do it. other calculations look at wages. They looked at people who are working riskier professions. And how much more would they get paid or looking at how much someone was willing to pay in real world dollars to reduce their risk by buying safety products so with all these different methods the result? Is that the regulatory agencies all use the same number for all lives. Call it roughly ten million dollars. There's a little variation by regulatory agency but it's a very large number and what the regulatory agencies would do is if they're considering for example a new regulation for less arsenic allowed in the water or less pollutants in the air then. They would look at the costs that implies to society usually Companies we have to pay more in order to keep the water cleaner or maybe it's the local municipality and in the benefits in terms of how many lives are saved how much less morbidity and to convert the lives saved two dollars they would use this value of statistical life. So that's where it appears usually in the conversation regulatory agencies and it's a large number large in the sense that far more than people would typically earn in a lifetime so in some senses it's a numerator denominator in that it's its value over costs for example So the way it's estimated is a dollar per risk. That's really how they come up with this value of statistical life It's it's it's not really an individual base but it's really very much about how much someone would pay to avoid. Let's say an extra one in ten thousand risk of dying of cancer for example you and it's all applied using from a regulatory perspective so they're looking at societies costs not individual costs right. Okay okay thank you. Let's get into a couple of examples that are arrested and you mentioned courses of Victims Compensation Fund relative to nine eleven. I thought this was a fascinating conversation So this was explained. Explain to me how why this came about. And then how is our? Our dollar amounts calculated four to pay families of those who died on nine eleven. Absolutely so this is It's an a unique situation. So there had been previous terrorist attacks in the United States and certainly a horrendous amount to murders in which the government did not set aside a fund but for September eleventh. A large pool of money was set. Aside and can the Feinberg was assigned as the special administrator of the fun he was giving some restrictions he was told he must consider economic impacts when he makes offers families and if the families of the victims accepted an offer they would receive money by also simultaneously signing a contract agreeing to not sue the airlines and other entities so he did have freedom he could create a calculation and he had a formula yet a in which the minimum value of life was two hundred and fifty thousand dollars. And it's important to note that in civil court there is no minimum so this is saying that he asserted because he he felt that it was necessary. That families would be offered something no matter how old the person was or what they were earning. He also incremented based on salary but he capped the salaries. He said no matter what you are earning. I'm only going to assume you. Earned a Max of a little over two hundred thousand a year and by capping it he. He also asserted something. Which is that. He wasn't going to allow for astronomical ratios. He added some extra factors. Like the number of dependents. A person hat. The net result is the range of payouts. To the families of the victims was from two hundred and fifty thousand to over seven million. That's a thirty times range of course heading up. Those caps in place had he not restricted the maximum income and had he not put a minimum value. It would have been massively more salary alone in the United States already. Minimum wage will only yield you about fifteen thousand a year while there are executives of some of the largest companies in America. Earning hundreds of millions of dollars so this was the calculation. Now it's important to note that it wasn't really loved by the public. It was actually quite controversial only a few years. After he completed he himself said that given the opportunity he would have paid the families of the victims the same amount of money and he said it would have been easier to implement it would have been fairer and it would have been more accepted by the public fast forward to the Boston Marathon bombing of just a few years ago. There was a victim compensation fund this time. It was private money. Some no constraints were placed on In this case again Kenneth Feinberg so he was administering that fund as well and in that case he did exactly what he said he thought was appropriate. He paid the families of the victims. The same amount regardless of age regardless of what they were earning regardless of any factors.
Krista Drobac Discusses Sweeping Changes in Federal Telehealth Policy In Response to the COVID-19 Pandemic
"Let me just for background asked why had the Congress or what's your understanding of why the congressman CMS head up into recent strictly limited Medicare telehealth. And I'll throw in of course we'll get to more patient monitoring or these benefits. The long term challenge has always been the congressional budget. Office really does not look favorably on telemedicine. They believed that. It increases costs overall rather than replacing in person visit their underlying. Thinking is that people use telemedicine and then also on top of that also go in person so Our challenge up until now has always been The cost and the perceived worries about fraud. The we find it very interesting that people at the Office of Inspector General or CMS Program Integrity Office. Think that it easier to commit fraud by telemedicine because really the fraud that takes place in Medicare's often making up fake patients and it's a lot harder to track that down than it is in telemedicine to see a trend quickly And also you have an actual. It addressed the IP address. And tell them so. It seems to us that. Be Easier to detect and root out fraud in the online environment than it would be in the In the in person environment. So we think we've got Good arguments on the fraud piece. And we're collecting data now on the Kospi's okay. The I heard it explained in part by the view. It's duplicative and not substitutive. That's one variation of ood acclimation. Yes thank you. So let's go to Let's go to were at so obviously The Congress house past four so called Kobe. Nineteen related Bills or sometimes referred to as supplemental bills The first The first supplemental and of course the third the Care Act had telehealth provisions in them and then of course in late March early April. Cms published in interim final rule and Proxima. I forty pages of that discussed Regulatory Waivers SMS would grant In relation to their health policy. Can you provide some more top of line? Where the Moore's substantive congressional legislative and regulatory changes to the policy yes. Congress started with authority in the first couple mental hugh allow for the waiver of the originating site in rural restrictions in Medicare and to see us followed through with that and lifted those restrictions The subsequent bills actually gave the authority to cms to lift the entirety of eighteen. Thirty four in any part of eighteen. Thirty four M so that they went ahead and also lifted the restrictions on Speech therapists physical therapists occupational therapists. So now pretty much All of the Practitioners who bill Medicare can practice telemedicine and the patient can be anywhere and the provider can be anywhere they clarified the use of technology. So you can use a art hall And when advocates asked for audio only cms did add some em codes. That are audio. Only there are some codes that you can use for Phone only telemedicine they also Added a a lot of new codes so Most of the primary care codes are now cover. Behavioral Health is covered They sort of assessed what you might need to do. During a a cove emergency and added those codes. So there's a lot more that he'd be reimbursed The Office of Civil Rights at HHS way the Hesse requirements in terms of what kind of platform? You can use the. You don't have to have a hippo compliant platform you can use facetime or skype The waved the Co pays on Telemedicine So that You know for both remote monitoring and telehealth which is really advantageous especially for by train because remote Copays has been a barrier or remote monitoring up They actually most Medicare advantage. Plans have now waved. The Co pays for both tele-medicine and remote monitoring On the state side there have been significant. Changes about forty nine states have weighed some part of their state. Licensure rules Medicaid has started covering things that weren't covered previously State medical boards have allowed for the waiver of existing relationship. Requirements face requirements There's been some scope of practice changes so that For example supervision of nurses can be done virtually Some some states that didn't specifically allow nurses and physical therapists and physicians assistant to practice telemedicine. are now allowing it so there have been changes at both the federal and the state level so quite a lot To say the Least Napoli let me ask as as follow up. There has been some Sweetie question realized relative to tell health as relates to a stark or Physician self referral a law What's what's the intersection there. You know the kinds that hit it has come up. The stark laws from me has been between the vendor and the providers so we weighed the telemedicine restrictions and medicare but most of the capacity in the marketplace telemedicine is through vendors because in the past medical offices haven't been reimbursed for them so they didn't invest in televised. So when you want it to go and get a visit visit your employer or insurer had generally Then did that out in order to make that happen. So you've got a lot of doctors in their homes Doing telemedicine visits all day long. But they're the they're the employee of an American well or an empty live. There are not a physician office. Therefore they're not an enrolled in Medicare so that means that those vendors can't actually provide telemedicine services directly to patient. 'cause they're not medicare enrolled providers so the way that it's happening in the marketplace. Now is that a lot of telemedicine. It'd being done through. Hospitals and other Medicare enrolled providers but they have vendors helping them under a white label. So one of the questions that we've had about dark kickback. Is Can a vendor Provide a referral to a hospital. So that if they get a patient that set you know obviously needs being. Can they refer that patient to the hospital? Who is there a quiet and right and the answer? Yes they can because it's not a self referral Those are the types of scenarios where this is coming up Just because of the strange way That telemedicine his grown up over time and mainly as a response to the regulatory challenges Medicare so in some sense to follow up. It's it it. Turns out to be convenient. That the vendor is not under the Medicare program thereby being able and that's an accident history. Meaning the Medicare provider wasn't doing the service themselves they farmed it out and as a result of that. This referral is now allowed. Is that correct correct? Okay sort of accident of history. I
Using Telemedicine to Limit PPE Usage
"The other sort of interesting telemedicine effort that blended into the PD. You situation and actually using Video conferencing system von impatient inside Just in our own hospital to limit some of the in and out of patience rooms and utilization of supply. They have the video abilities for docs for nurses to be able to video conference with fish in our in hospital and technological aspect. That is interesting to watch it. Just the explosion diagnostic testing and ability both in drug testing for the virus and labs developing earn test. But also the hunt for. What did the antibody response look like? And what that means A fascinating things that are happening So we cover a wide swath of southeast Alabama as well as parts of Georgia and West Florida close to seven hundred thousand people so a lot of the things that you see from Alabama Department of public about the number of patients that are diagnosed in Houston County as kind of a misnomer in the sense that In the southeast health right now we've had ten cova deaths There's three in the county that are outside of what we've reported so our hospital right now is At Max Capacity and they are utilizing quite a bit a. p. p. e. and they're very concerned about Their supplies moving forward that actually utilize the Labor pool of people who've been furloughed from Outpatient surgeries etc to actually start fabricating gowns the reusable. They have a pattern and there are people sewing. They create a yesterday. Twenty two hundred gowns We have people making masks Out The from around a Area who are donating to the hospital for the patients. Just you know the usual cloth. Reusable mass and we have had three D. printing from a com to create fait shields. Necessity brings out the best in the ingenuity. And it's showing around here. What we actually started doing here is Evaluating patients out in the parking lot. We have been utilizing telly. Help To reach our patients the only issue we that we really run into is Internet service So some of our patients just can't do zoom they don't have they can't facetime on their iphones So we do have to go to telephone for the majority of our patients decrease PP usage by doing zoom into a room Mostly with consultants right now and the Er has done it where they the patient once. And then they leave Zoom capabilities in there to reassess the patient without having to go back in repeatedly waste p. p. e. so from our rural perspective. you know. I think our challenges are a lot socioeconomic an
Court rules insurers can collect $12B under health care law
"The U. S. Supreme Court ruled that insurance companies can collect twelve billion dollars from the federal government to cover their losses in the early years of the affordable Care Act otherwise known as obamacare the justices voted eight to one and holding that insurers are entitled to the money under a provision of the law the promise the company is a financial cushion for losses they might incur by selling coverage to people in the market place is created by the health care law the case is separate from an over arching challenge to the health care law that the court has agreed to hear in its term that begins in
Dr. Anantha Shekhar and Translating Research into Treatments
"Is translational research? Because we've mentioned a couple of times on the show before but you probably better than anyone else's prepared to actually explain What is it? Yeah so translational. Research really spans. A broad Sort of space of biomedical research. Would we realized in biomedical research is that people can do research at various levels of Biology so there could be for example. A cancer researcher who studies cancer cells at the cellular level war. There could be a cancer researcher. Who Studies Cancer prevention at a statewide Prevention Program. So you have this enormous breadth of Medical Research. Going on what is missing. Though is our was missing for a long time was people who can connect these different levels of research. That is going on so that you can take a discovery in the laboratory and bring a treatment to patients war if there is a successful treatment in patients that is shown to be very effective in a clinical setting and then taking it into policy and into populations so the people that do that kind of work in the interface of these different levels. So free search or what? I would call translational researchers. I find when I talked to the general public about this. That surprised that this isn't even an issue. Like why weren't we doing that always Why do you think it is that it took until say twelve years ago before? There were major initiatives to do that. Yeah I think. Part of it is just the way Researchers are trained and research as Walt Lord of the basic in discoveries and fundamental research occurs in what we would call the traditional scientific laboratories where people are working on cells or small animals or you know various different organisms that are not humans and then at the other end you have clinicians who are working with patients or trying to treat patients or trying to understand diseases and these two worlds were never fully integrated because the people who do clinical work usually are trained as physicians or nurses and have a very different professional background whereas people who do fundamental research or PhD's and really know their biology and their basic science so the training is different. Their culture is different and the types of Environment they work in Hospitals Verses University laboratories are quite different. So I think a lot of this was just the way. We had sort of organized biology science and medicine With I think was a big problem so little more than a decade ago the NIH decided. We needed to do better. And the major way. I think we decided to do that was through which is called. C. T. essays. Can you talk a bit about that? And what they're supposed to do. Yeah so in In the nearby about fifteen years ago then National Institute of Health Director decided that this this silo of basic discovery and clinical research Is is a problem and we. They needed to create a large program. That connects the two. So what they proposed was Something called clinical and translational science awards. That will be given to Sort of leading medical centers very similar to the cancer center concept that they would find major academic medical centers to create this platform that helps connect clinicians and clinical researchers to basic discovery research This started as a grant program. It's a very large program is congressionally mandated program There's you know significant dedicated funds And over the last ten years they've now funded about sixty or so medical centers and each of them. are now mandated just like Indiana clinical and translational science institute to really connect discovery to people's
R/x for Healthcare: Better UX Through Measurement and Deeper Engagement with Jay Erickson, Chief Innovation Officer at Modus
"Just got back from Argentina year over there Yeah that's right. We have an office down there and I was doing some work down there and Yet we just moved back last week. Interesting time to move back of course to be traveling around but love Argentina. Wow well welcome back to the States. And you are also very focused on the digital aspects within healthcare so tell us what inspires your work in the healthcare vertical In the core of my inspiration is a very personal so seven years ago. I was diagnosed with advanced metastatic to sicker cancer. I spent about a year and treatment at Sloan. Kettering forty five days in patient. Three months of Chemo for big surgery. So I was sort of a professional patient for a year and I learned law things. I'm six years. No evidence of disease now so I feel very much. Thank you thank you and as you can imagine I learned a lot of things and a lot of different levels but one thing I I learned in observed in that role was just in my opinion. How poorly a digital was being deployed in space for patients and for clinicians and this is not a knock on Sloan. They're amazing they saved my life. But it's something that's across the industry. As as soon as I came back and so before that I was the chief operating officer is really just focusing on running the business and when I came back I said this is something I really want to dive back into. Working more directly with clients focusing on as a problem to be solved doing what I can to put my shoulder to the wheel of making better more effective experiences for patients and for clinician. So that's my My touchstone of the passion that I bring to it. Well I think it's A powerful story Jay and I appreciate sharing that and congratulate you for for beating cancer and so great that you have taken this upon yourself. Having been there done that as a patient better and more efficient are two things that we could definitely get from from digital technologies. Tell us a little bit more about how you guys are. Adding value to the ecosystem through digital so our focus is really on creating experiences that are engaging in effective and this mostly for patients but also for clinicians and sometimes caregivers and bringing best practices to the industry that hasn't really been woven into the to the way that the digital products have been built outside. The industry and healthcare has has been data centric and rightfully so right. The legislation was passed. You know twenty plus years ago saying you need to get everything into the data and and that's been journey and now that we have all the data in we're starting to figure out ways to unlock the data and share the data and do more with the data. We need to stop being so data centric and start being more human centric and understanding that people are complex and their situations are often very unique and we need to build experiences that meet them where they are and make things easy for them and drives towards the outcomes that we want for them. So that's a long answer and I can be unpacked. Non Thought of different ways but how we sort of more tactically are coming into his kind of doing really running more design thinking processes That haven't been lacking so picking up on sort of clinical insight or a market research research site in farm industry for instance and building on that doing ethnographic research actually talking to patients in really understanding their sort of holistic view. Their Longitudinal journey that might touch a bunch of different things. A bunch of different providers a bunch of different mediums a bunch of different co morbidity or products understanding those longitudinal journeys doing rapid prototyping and. Co Design and collaboration ways. And then putting those back for early prototype validation before anything gets actually develop so that process of design thinking is something that has been lacking in the industry and has led to a lot of digital experiences that are either painful or hard to navigate or create unnecessary cognitive. Load especially in the case of clinicians. It's interesting you know. And I'm glad you mentioned clinicians as well because bad experience exists on on the patient side and on the clinician side. As well and to your point there's a lot that's going on that's great but there's an opportunity to do so much better and saw I'd love to hear from. Uja On on what your team has done. That's made either outcomes better or business models better within healthcare. Yeah so I think it's. It's applying that process that I described by lake. You know it's all in. The end is about outcomes right so you really are trying to make better Clinton experiences. They can spend more time to medicine less time on data entry or so. They're less burnt out. Say let's make less mistakes and in the patient case you're trying to keep them engaged. You're trying to get data to flow and to have the outcome of their experience in their disease journey or or or health journey. Have a better outcome. So it's not just about great experiences to create great experiences. I WanNa make that clear to but specifically applying those cases. I mean. We've done everything from working with. Pharmaceutical companies to develop a digital prototypes around using stress managed using behavioral change techniques around social support for stress management or behavioral scientists at pharmaceutical companies or working with healthcare providers to provide better pathways for patients to navigate their journeys. So it's a lot of simple stuff and it can be starting with schedule. An appointment and navigating to the in helping with with with transport access to the site of care. Just that doesn't require blockchain or a I or anything fancy but doing that in a way that is easy in as easy as Uber or another experience that we're used to in our normal life bringing that level of ease and utility to those experience that's table stakes right and then it's going from. They're moving more into actual medicine side of things and we do a lot of stuff around adherence and getting people know we know that that forty percent of outcomes is driven by behavior. And there's really nothing better at a scalable in evaluating level to help with behavior change them and digital devices mean there's a there's a shadow side to that too also right. Mike. We're all addicted to these things. But that same power can be used to drive behavior change whether it's adherence to medication or physical therapy or just a care plan so creating experiences for patients that help them with that. So that's we start to get into the closer to the medical side of things so that's some of the ways that we are bringing our skills that we've owned also in other industries like you've working in hospitality and retail and e commerce and all these other industries that have more are more mature digitally especially from human centric perspective bringing all those practices and tools to the space
Emergency room doctors facing pay cuts and understaffing
"This from CBS news ER doctors in at least six states said they're taking pay cuts of up to forty percent some emergency rooms might have to shut down did not see that coming but they say they've they've seen a thirty percent decline in emergency room visits because people are staying home rural hospitals to most reliant insurance reimbursements from elective surgeries and outpatient services like radiology and lab work simply to break
Spilling the Travel Tea with Sarah Gaines, MSN, RNC-OB
"What are your tips for doing it the right way because I feel like right? Now there's there's a lot of people offering eight ton of money get some travel. There says an extra help. I bill like the big craze right. Now are the crazy crisis rates that are related to Co vid and my biggest advice right now to any nurse. That's looking into specifically like the Kobe hotspot areas with a crisis rates. Is You want to be cautious in. You don't WanNa be fooled by the high numbers and this applies to not only ovid crisis rates right now but just travel nursing in general at big the first mistake that a lot of travel nurses make is they just chased the highest paying contract. They're like oh my gosh so much money. I'm jumping on it right now but one of the things that I really focus on is maximizing your income not just increasing your income. So that requires you to look into the offer From a different perspective so instead of just focusing on how much money you're making it's more important to focus on how much money you're saving though all US. New York as an example because that's where the high rates all right now So a couple weeks ago I saw a rate that was like almost ten thousand dollars a week for a nurse to go cal exactly. That's everyone's thoughts right. Yeah we're good. You're like oh my gosh. I'm going to jump on it. That ten grand a but me when I look at that number. There are certain things that I am going to consider As a travel nurse you can allocate your money in different ways. There's different portions of your income. Some of its tax free. The other parts of it are tax so depending on how you allocate your money and depending on what your hourly rate is you have to keep in mind that since who are getting paid a lot more money that could possibly bump you into a different tax bracket which means that you're going to be taxed a little bit more on top of that. You want to pay attention to the location that you're in. So depending on the location there may be a federal tax estate tax in a city tax So those are other things that you want to consider the next thing to consider. Is You individually like? Do you own a home. Do you have any kids 'cause or anything like me and you don't have either of those you're GonNa be taxed even more heavily all of those things especially in New York when I looking at it. According to my calculations in my unique situation it was going to be almost thirty. Five percent tax really. That ten thousand dollars is close to sixty five hundred. Plus you also have to think about once you get to New York the other things you had to consider. How much is housing going to be? How much is it going to cost Are you going to have to ship your car? If you need a car in New York you would need it but just assignments in general so long story short. You WanNa make sure that you are absolutely crunching the numbers and you know exactly how much you're going to be saving at the end of for me when I was comparing New York. That ten thousand dollars a week to other offers that have gotten in. California and this was just like a regular rate non-co patients regular nurse patient ratios I got a similar offer in California and it was three thousand dollars a week for just a regular contract now. Three thousand dollars a week compared to ten thousand dollars a week doesn't sound that like that much but when you look at it and you really break it down to how much you would be saving so in. California three thousand a week to make it. Simple is about a thousand dollars a day right yet in New York. After taxes we calculate the take home. And how much I'd actually be saving. It'd be about six thousand dollars a week. With that crisis rate you would have to work seven days in a row so that would mean that in seven days six thousand dollars a week. That's actually less than a thousand dollars. A day so it would be more lucrative. I would be saving more money to actually take the contracts in California. That is three thousand dollars a week. And if I want to pick up an extra day of overtime I
When Bad Policy = Bad Business Models = Bad Public Health
"Let's start with the business or the market side. What was the underlying problem on the market side? That got us here much. Like a virus attacks the weaknesses in the human body this pandemic spreads by effectively attacking her exploiting the weaknesses across the healthcare system. Writ Large in the United States healthcare is a fairly unique case in that. This is one industry one area. Where policy sets business models? And where you have bad policy. You have bad business models which can lead to market failures which can lead to public health failures. We've seen it happen in the vaccines industry. We've seen it happen in diagnostics. We've seen it happen in anti-infective antibiotics more broadly and so these are an isolated examples where the system fails at the system. Historically we've made very little investment into prevention in general really where the money has been made is in the treatment of patients who get sick. And so there's been really just an orientation around the incentives being aligned with waiting until those patients do get sick to then provide treatments and therapies and procedures that generate more revenue unfortunately and also higher margins for physicians and hospitals. And you're seeing a version of that here where again. There's been very little investment in preparedness for these kinds of pandemic disasters. So let's pull apart those threads in those three different areas so because vaccines are so top of mind. Let's dive into vaccines. Why does that not a successful market? Why think vaccines in general has been a difficult industry for a couple of reasons number one? If you're developing a vaccine for something that already affects humankind. Broadly those are considered pretty commodity products. Today right. You're mumps vaccines your the number of vaccines children. Getting their regular stables are relatively commodity product or not differentiated. You can't charge a lot for them because he's almost basic staples of public health and therefore you know relatively speaking out there. Yeah we need him there. Well covered and they're widely available. The trick comes when you have something that emerges quickly and has the potential to spread rapidly cova nineteenth out the first example of this that we've seen we've seen this happen numerous times whether it's with SARS or h one and one or West Nile or Zeka. Obviously Bala was was one that was wakeup call and made a lot of people nervous. And I think if you look at a lot of those historical examples. Generally speaking. What we saw happen was the companies that did have active vaccine programs. I'm we're asked essentially to stop doing everything they were doing. To develop programs against whatever specific emerging threat was and they responded to that call for Action. And what happens with vaccines is when the threat goes away you know. The urgency tends to go his way as well and once the urgency is gone. The market goes with that along with that these that were developing vaccines for these specific newly emerging threats in many cases they were left holding the bag. Where you know. In some cases order at governments had put in for them kind of went away when the threat went away and so the business model of saying well ramp production for an emerging threat. Where if you are successful the market for what? You're developing goes away so the public health efforts are successful in containing the disease. You don't need the vaccine and therefore there's no market for it and therefore you essentially wasted the effort. The other thing that's true that has been true in previous pandemics is. There's generally a call on the industry by governments to make sure that the vaccines become available at cost or at low cost and it's very hard to build a business around that where you're building four. You know an event like you called it a black swan event but at the moment of that Black Swan event. You're not able to recoup profits for valid reasons that you obviously have to make this widely available. It's a very difficult business model unless you're in a situation where it's the entire Globe and then it's all of a sudden. Well Yeah but then you need the ability to actually ramp up and be able to produce vaccines at that scale and at that speed to me. It's a silver lining in all of this is how rapidly some of these novel platforms have been at looking to develop vaccines candidates. But for that to work. As a business model you need to either be able to produce a vaccine for every oncoming pandemic. And you need to be able to have a business model that will enable you to essentially recoup and make a profit from the investments you've made in developing that platform and that goes back to policy and one interesting thing that comes to mind as you're talking about this is there's a lot of characteristics of vaccines that are somewhat similar to some of the more novel of gene. Therapy and cell therapy is that we've talked about where you essentially need the vaccine once or maybe a handful of times when it comes to things like booster shots for your entire life and therefore the opportunity to monetize that particular intervention is very rare in the context of anyone patients. You just have to wonder whether some of the dialogue that's happening around value based payments for different types of treatments. How would he applied here? Because you know to take the traditional fee-for-service way of thinking about getting paid a commodity price for a one time intervention just doesn't seem to match well with the paradigm of how vaccines actually administered to. I think the analogy is valid. By the way I think a lot of the proof is in the pudding because that kind of incentive structure that you just described hasn't existed historically there have been several calls for our policy put in place some of the key areas that have pioneered. This have been sort of the one and done therapies for very rare diseases and I think the reason why there was room to have that discussion was number one because the prevalence of those diseases is fairly well understood even though they are very rare. And so you can essentially run the actuarial calculation to say. Okay well if we charge two million dollars to treats matic muscular atrophy we're still benefiting this system a significant amount by extending life and reducing the need for supportive care and all those things and so you can actually model those out and it's a rare event that with high value. You can put a high price on here. It's a little bit trickier because it's hard to model out the actuarial on this because a pandemic is generally speaking unknown event. So unless you have a policy for pandemics broadly where you essentially provide some sort of incentive whether they're block grants or success fees etc. That would have to be really large for any institution that comes up with a effective vaccine against a newly emerging threat. You're sort of trying to solve for an unknown number. But I think we could learn a lot from what we're seeing with these new. Modalities like seeing gene therapies and cell therapies that have in many ways trailblazer novel business models to make them viable. I understand how for vaccines that model apart. When sort of a massive event like this happens really quickly. But how about antibiotics? That feels like something that everybody needs that we know. There's an increasing demand for the right kind of antibiotic. Where does the market policy healthcare public? Health failure come together there. We'll so they're similar situation with different circumstances right so in the case of antibiotics public health agencies and the medical practice. Broadly have been very focused. On how you prescribe antibiotics and in what order in order to prevent the emergence of resistance and so we have broad spectrum antibiotics and then we have narrow spectrum antibiotics and we have ones that are more potent than others and you know once bacteria become resistant to all things and we have the threat of superbugs where basically have no last line of treatment against a bacteria that has become resistant and so the conventional thinking around antibiotics has been just think of it as first line and second line and third line and so if you develop a novel antibiotic you might be addressing a very important unmet need. But by definition physicians are going to use these new antibiotics. As sort of last line of therapy I develop a new antibiotic. And it's good. It's only going to be used sparingly and if I'm charging per treatment or per use that's obviously not going to be a very effective model for me either right. You don't want to be having to use these unless everything else has failed. That's right and by the way we've seen the real world examples of this as well. Large pharmaceutical companies have also exited like with vaccines. They've also exited the antibiotics space. Nevada's exited Santa Fe has exited. It's very hard for them to find a way to make profitable business for other reasons. We've been talking about there. Was a startup called the kitchen. That was actually successful in developing a novel. Antibiotic against a nasty bug so they had public health success but what they found was that they didn't have a business model and so they went bankrupt. This is a really strange industry where you have to me. It's so successful that you cannot build a business on it. Scott Gottlieb the former head of the FDA who's of course been so vocal and helpful throughout this cove in nineteen pandemic. He'd floated the idea a year ago of similarly creating some sort of incentive structure. So people could develop new business models around novel. Antibiotics and these include things like motive with vaccine's success fees for developing novel therapy. He even floated the idea on something like subscriptions where you know. Institutions would subscribe to get access to antibiotics and they wouldn't pay per use. They would pay for access so it's almost like an all you can treat model versus a pay per pill model and you need to come from policy. Why wouldn't that just make good market sentence for the market to respond in that way? Well I think you're gonNA see a combination of those things so some of it needs to come from policy in the sense that you can require institutions to have a broad tool. Kit of antibiotics require them to carry all of them. And then if you require that the companies are developing novel antibiotics come up with new business models to make it viable for them and to make. Bible Hospital
Progressives propose Medicare for the Uninsured
"Let's talk about the news of the week. The fight for having a relief. Bill that actually addresses what is going to be a massive health insurance crisis on So we had a bill introduced by Representative John Paul and Bernie Sanders in the Senate and then just Today actually as we're recording this this'll be yesterday as you're listening. Nancy Pelosi and House Leadership Democrat leadership in the House came out with a different proposal. We haven't seen language yet but this is clearly going to be the two kind of competing visions for next relief bill from the Democratic side so far icy silence from the Republican side. We don't even know if they're going support another relief bill at all Although I think the pressure is just going to become a hard to avoid once all of this unemployment leads to lack of insurance soon So the basic overview. Let's let why don't we start with the Sanders? John Paul Bill since that came out. I What they've proposed these of course are the lead sponsors of the Medicare for all legislation in the House and the Senate And this is not a medicare for all proposal. But it's kind of a stopgap proposal during the credit crisis. So what they've said is that Medicare should cover everyone who does not have health insurance And that Medicare will cover all co payments deductibles and cost sharing for everyone else. That's where people who have private insurance who have public insurance Like Medicaid or the Veterans Administration Or Medicare for that matter And that that will Last in effect until a vaccine is widely available to the public And the thinking of course is that we literally just cannot address this pandemic without everyone having access to healthcare Otherwise everyone who slipped through. The cracks of the healthcare system is going to be Is going to be unable to access. Care avoiding care when they need it and more likely to spread The contagion so Stephanie. What do you think about proposal? That came out of Japan. Senator Sanders Office. Well when I first heard about this proposal I thought it was perfect because it gives us a way to sort of expand public health insurance and it also fulfils the moderate concerns about allowing people to stay on their health insurance and all the stupid rationales for supporting a public option versus Medicare for all and that has always been the moderate case against Medicare for all right it's too disruptive maybe amid Medicare for all is in theory better but people are just so happy with their private insurance. Who Am I? Who are we to argue with them? And maybe they need a chance to try it out. And that's the impetus behind the whole public option. And you know they always say that. The of course. The goal is universal healthcare. But what the pathway. How do we get there? You know the details matter well. Here's your chance you know. Millions kicked off their insurance by no fault of their own at a time. When it's not actually safe to go outside but as far as I know no other members of Congress besides Sanders and Paul have supported this plan. Yeah I don't even know if it's been you know. They've barely rolled it out. It just came off the shelf. So we're us. The movement are going to have to build support for this bill. And you know it's interesting because this plan is kind of like some of the competing plans that you know. The centrists who were running for president were running on This doesn't resemble like the Biden plan but it is kind of what like Baidoa Rourke was was backing. It's a little bit like will cover everyone with the public plan. But we'll keep somehow the private health insurance in the workplace health insurance And I think the reason it's important to acknowledge why this is not a replacement for Medicare for all it needs to be. Temporary is the cost right. The the downside of doing it this way is that you don't get most of the savings that you get from Medicare for all system which really comes from like simplifying the system and you're cutting out all this administrative waste hospitals and doctors only have to deal with one pair they don't have to deal with fifty different payers. And that's how Medicare for all works by creating although savings you can afford to cover everyone else afford to have no co payments and deductibles. It is much more expensive to do it. This way to keep the private insurance companies in their keep all this complication waste in the system and expand coverage to everyone But I think you can do it temporarily as a stopgap measure And so I think it would be a good stepping-stone and people we literally cannot address this crisis with more and more people losing access to health insurance so I think it'll be an interesting fight. Yeah and it could arguably be even less expensive than giving subsidies to private health. Insurers who who made just end up pocketing. Well obviously we'll end up pocketing the profits but also will not be actually giving out any care outside of probably a lot of corona virus care because people aren't actually going to the doctor for anything else right now that's a fact that's not arguably that's it would definitely be cheaper to cover people through expanding medicare than it would be through throwing money at private
Judge rules cities' Affordable Care Act lawsuit can proceed
"Three a federal judge in Maryland has ruled that a lawsuit by several cities alleging that the trump administration has sabotage the affordable Care Act can go forward the judge denied parts of the government's motion to dismiss the complaint the lawsuit asserts the administration is trying to discourage enrollment and reduced choices and will destabilize the health care industry market Columbus Ohio is the lead plaintiff joined by Baltimore Cincinnati Chicago Philadelphia and resident residents of Charlottesville
Bernie drops out, COVID-19 rages on
"In honor of Bernie dropping out of the race we thought we would play a short clip about What he has to say about Medicare for all as he exits during he gave like a little concession speech from home in Vermont even before this horrific pandemic we are now experiencing more own more. Americans understood that we must move to a Medicare for all single payer program. During the primary elections exit polls showed in state after state a strong majority of Democratic primary voters supported a Siegel government health insurance program to replace private insurance. That was true even in states. Where out campaign did not prevail in every single state all Democratic voters overwhelmingly support Medicare for all. But it's actually not news if you've been following polling for a while because in fact a majority of Americans for quite a long time. Now at least a decade have supported Medicare for all even before Bernie ran for president. And I think really what's happening is that Bernie Gave political legitimacy to Medicare for all he actually made it so that we could demand it from We can demand what we wanted. What we've always supported Medicare for all From our elected officials and I think that is really. Actually it's not that Bernie Sanders brought Medicare for all of the masses and created this huge Bump and support for Medicare for all but that he just gave people permission to ask for it. Yeah I think I mean there were some polls from a few years back where there was even way more support for Medicare for all and I think partly. That's because they've changed how they were these polls now pretty much universally all the polling firms. Now use more biased. They don't actually use the phrase Medicare for say no it pulls well but yeah I think before Bernie ran the first time in two thousand sixteen. There was just a massive gap between the Democratic Base and Democrats in Congress and running for for President and I think his biggest accomplishment is to have started to close that gap that we now have a majority a bare majority support in in Congress in the house. He got more than a dozen senators on board for the first time So to me that was like the real accomplishment was starting to close the democracy gap within the Democratic Party which is no minor thing. Actually I was so sad when I saw that text this morning saying like Bernie. Sanders has a special announcement to make. I was like ooh. Maybe he's going to quit his campaign to start an actual revolution but no it's it's demoralizing I think I mean he. He had no pathway anyway to to becoming the nominee. I don't think at this stage but it's demoralizing to see kind of No champion left on the stage for kind of the basic rights. That especially at this moment during the current crisis have become so obvious glaring. And I have this moment every four years it turns out so although as you were saying. I don't think Bernie himself had a huge impact on polling numbers at least for Medicare for all one thing that has had a major impact is growing virus. It turns out we got our very first kind of post corona virus. Pull from the morning consults and they showed just a massive jump. Almost ten percent increase in national support for Medicare for all just month over month between February and March for Medicare for all so corona virus. Did what Bernie? Sanders has been trying to do these past. Yeah well corona verse for President Late Popular. Move Yeah I think this is really sort of a turning point in terms of the conversation about Medicare for all. I'm seeing pollsters or like you know. Well this bump endure through the virus which is just such a terrible heartache. I mean will people forget that. They lost their jobs and their health insurance during the apocalypse. Like I don't think that that's just a blip on the radar of the trajectory of their lives. And I think that you know we're we're living there truly is generational defining moment and we're watching. You know watching our healthcare system buckle under the pressure of this crisis is really gonNA stick with people. It's definitely gonNA stick with me. Yeah and unfortunately I mean what has really been exposed exposed. The the employer based healthcare system. Hasn't been colonel virus per se but the economic crisis caused by krona virus. An even I think once we start getting the public health crisis a little bit under control. We are still going to have this economic crisis to deal with and it's unclear how long that's GonNa last but it is going to translate into healthcare crisis of epic proportions. I think if we don't fix the healthcare system yeah and I think that this is really an opportunity for us to institute fixes in our safety net for example. Spain is right now. Instituting permanent universal basic income. I you know it was precipitated by the virus but this is something that their party has wanted to do for a long time and this has given an option or giving them an opportunity to finally get the ball rolling on. That program is because Andrea has moved to Spain. No very big man history. Take Their Ben. Yeah I think you know in terms of this. How how enduring is the impact on people's opinion towards Medicare for all? I think the biggest thing this crisis has done I think people are always GonNa have some anxieties and worries about Medicare for all especially since so many people in the United States have zero experience with other countries and other countries and the ones that do have universal healthcare so attack ads and scaremongering are going to continue to work but what the crisis is really done. I think is exposed. All of the alternatives is just stupid and totally inadequate. I mean flash back to some of these debates we had within the Democratic Party with Butch Itch and Amy Klobuchar. I mean think about the phrase you can you know you should be able to keep your workplace health insurance if you like it today right. I mean I dare them the truth. Dare Joe Biden Mountain saying the phrase hasn't spilled out of anyone's mouth and there's a good reason for it. I mean it was a lie to start with right. They're playing when you maintain this employer based healthcare. You can't keep your health insurance. If you want it you can only keep it if your boss wants to continue to give it to you and if the economy wants to allow you to have have the job in the first place so it was a lie then but I think it is totally exposed. How stupid linking health insurance to the workplaces and I was actually thinking the other day about. What is what is now. The Republicans healthcare plan during the krone of crisis. I have not heard the words. Repeal obamacare come out of any Republicans lips since this crisis started and. I don't think it's an accident anymore. Because it would be political suicide. I think with forty million potentially unemployed tens of millions of new people uninsured to now like pull out the skimpy remaining safe at last that has left to
Ohio, Oklahoma courts rule abortions can continue amid virus
"News courts in two states now say abortions can continue even during restrictions imposed by the pandemic judges say abortions in Ohio in Oklahoma do not fall under nonessential elective surgeries the Associated Press reports the sixth circuit appeals court did not take up the argument from Ohio's Attorney General while in Oklahoma judge blocked a portion of governor Kevin states ordered to put off elective surgeries abortion opponents argue continuing with the procedures used as personal protective equipment now in short supply to fight coronavirus Oklahoma's Attorney General says he plans to challenge the decision to the tenth circuit court of
Obamacare Markets Will Not Reopen, Trump Decides
"Time president trump says he will not re open obamacare enrollment for those Americans who have lost their jobs their health insurance because of the outbreak the instead we're going to try and get a cash payment to the people and we're working out the mechanics of that with the legislature so we're going to try to get them a cash payment because just opening it up doesn't help as much A. B. C. news correspondent Karen Travers is with us again this morning from Washington DC because any further explanation as to why health care insurance would be denied to these people you know they really four two days Wednesday and Thursday were kind of dancing around the question about we opening exchanges in fact when the vice president of athletics on Wednesday spoke for several minutes the president complimented him on not even answering it he actually said you know wow that was an amazing night after their by the vice president but the bottom line is they're not going to reopen the obamacare exchanges the involvement period that ended in mid December in most parts of the country and you know how that works it's a couple weeks you have a chance if not that's it until the next year there's been a big push in recent days for them to re open this because now people might be rethinking not having insurance because of concerns about getting corona virus and what that cost of treatment could be like now there are a couple exceptions here so if you have lost your health insurance through your job because you lost your job right now you do have sixty days to enroll in obamacare if you never had health insurance and you lost your job you might qualify for Medicaid if you don't fit into one of those categories you could still get this through your state Washington state is one of the eleven plus defeat that are running their own exchanges and have made those exchanges open to enrollment right now so a couple ways you can still do it even if the old the trump administration says we're not reopen next at the federal level Karen are there any specifics yet on those direct payments to governments promising you know they're still saying that this is going to get out quickly the secretary of the treasury without in the briefing room and said you know we are going to do this as fast as possible they don't want to mail checks that they don't have to they want to do that quickly into checking account direct deposit because they know people need it so this should be coming in the next few days for most Americans and the Americans now the question of course is going to be is that enough and I think even after the president give the inquisitive and dry and the two trillion dollars aid relief package there is already talk about what round four is going to look like and that next batch of cash that Americans and small businesses are going to need very quickly yesterday's briefing was over two hours in length and I noticed that the the president's son in law Jared Kushner was brought out what's his role in all of this you know he had the unique position in the administration of the senior adviser and son in law and that kind of gives you the latitude to jump in on the issue I think when you would like to see not formally a member of the task force as it would pull it out through the White House order but he is now according to our sources playing a bigger role in the coordination and the federal and state effort on that working with states working with hospitals he went to great detail about trying to make phone calls yesterday to get things ready for New York and I'm get desperately needed medical supplies and equipment I think the bottom line at you know like present tense the charge of the task force Dr Bergsma the White House response coordinator on coronavirus your question has a very unique and special edition of the son in law but he can jump and like that all right Keren thanks have a great weekend ABC's Karen Travers with us from Washington
'Please come help us': New York begs for medical workers
"New York with hospitals flooded governor Cuomo also put out an urgent plea for medical volunteers from across the country to spell exhausted medical personnel here we need relief we need relief for nurses who are working twelve hour shifts one after the other after the other we need relief for doctors we need relief for attendance so if you're not busy come help us please and we will return