26 Burst results for "David Intra"

"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

05:35 min | 7 months ago

"david intra" Discussed on The Healthcare Policy Podcast

"To the healthcare policy. Podcast i'm the host. David intra cosso with me today to discuss the climate crisis related health. Costs is dr. vj lemay climate and health scientists at the national resources. Defense council center. Dr lemay welcome to the program. Thank you dr maze by is of course posted on the podcast website on background. Twenty twenty set another global warming record this past year tight twenty sixteen as the hottest record year and strikingly warmer than twenty nineteen. For example average temperatures in some parts of the arctic last year were more than six degrees celsius higher than the twenty one thousand nine hundred eighty one to two thousand ten baseline average per no at twenty twenty seven. Us record with twenty two one billion dollar plus climate disasters. The previous record was sixteen and twenty seventeen toiling in some ninety. Five billion dollars in damages are more than double the forty one year average of forty five billion seventy events were linked to hurricanes and tropical storms concerning wildfires california suffered over ten million acres burned more than double the previous record set in twenty eighteen at four million acres adverse health effects caused by climate crisis. Events are on bounce well known for example in two thousand sixteen. The government published the impacts of climate change on human health in the us. And i recently cited lance and twenty twenty countdown on health report that concluded in part quote the world has already warned by one point. Two degrees celsius resulting in profound immediate and worsening health effects close quote nevertheless response. By thorough policymakers. Along with the health care industry remains far beyond inadequate. The best the recent congress recently concluded congress can do as produce a five hundred fifty page climate crisis report that drew no connection between the climate crisis and related effects. Imposed on medicare medicaid beneficiaries. Do likely in part to the fact. That neither med pack or mac. Pack independent gresham commissions given broad authority to address issues affecting. These programs has never addressed much less mentioned the climate crisis with me again to discuss climate crisis related. Health costs is the national resource. Defense counsels dr. vj lemay so at that <hes>. As background vj. Let me begin by asking. If you can briefly describe the nrdc signed centers work shirt and. Thank you david for the invitation to speak with you and your listeners. I work at nbc. The natural resources defense council we are a profit organization working really to stay guard the earth. it's people plants animals and the natural systems on which we all rely. We combine the power of more than three million at rdc members across the country with the expertise of about seven hundred staffers that scientists like me but also lawyers policy advocates who are working together to protect clean air clean water and the natural systems on which we all depend so i work in the science center at entity see and science release the foundation of our work to protect people in the environment. We worked to understand environmental and human health problems working in interdisciplinary spaces in some of the work that we'll talk about today. In terms of connecting the dots between climate change in house is really the focus of my work. And i just have to say you know this period unprecedented on the scientific enterprise. It's more important than ever that we recognize the value that science brings to society and helping us to confront respond to some of these. Really urgent threats thank you. I appreciate that last point <hes>. As we are well aware. Let me go to you recently. Published an article <hes>. To your credit in health affairs <hes>. Last month last month december issue was a theme issue on the climate crisis. I should say a health affairs polishes. Nineteen eighty-three had never previously addressed. Or excuse me. Nineteen one had never previously addressed this subject <hes>. So again a -gratulations. Your article with your colleagues was titled estimating the cost of action and the economic benefits of addressing. The health harms of climate. Change <hes>. But i wanna ask you specifically about that because you wrote in this essay quote unquote. There is currently a knowledge gap that must be addressed for more complete understanding of climate change related exposure response relationship. So explain to me what this knowledge gap is. Sure you know in your setup remarks. You mentioned the huge toll that climate and weather disasters inflicted on the united states last year. About ninety five billion dollars by the federal governments fresh estimate and well that's a staggering number as a health scientist. I'm an epidemiologist. I look at that figure and i wonder what's not included and the truth is that when our federal government is tracking the damage the climate change in reports like the billion dollar disaster list. It's actually not accounting for tremendous profound and sometimes irreversible damage to human house so there is a huge missing component. We think about the continuing and mounting costs of inaction on the climate crisis

david congress twenty eighteen twenty twenty seven sixteen lemay Five billion dollars four million acres twenty seventeen forty one year twenty two one billion dollar last year forty five billion seventy eve today Twenty twenty more than three million one point Two degrees celsius two thousand sixteen five hundred
NRDC's Dr. Vijay Limaye Discusses Measuring the Health-Related Costs of the Climate Crisis

The Healthcare Policy Podcast

05:35 min | 7 months ago

NRDC's Dr. Vijay Limaye Discusses Measuring the Health-Related Costs of the Climate Crisis

"To the healthcare policy. Podcast i'm the host. David intra cosso with me today to discuss the climate crisis related health. Costs is dr. vj lemay climate and health scientists at the national resources. Defense council center. Dr lemay welcome to the program. Thank you dr maze by is of course posted on the podcast website on background. Twenty twenty set another global warming record this past year tight twenty sixteen as the hottest record year and strikingly warmer than twenty nineteen. For example average temperatures in some parts of the arctic last year were more than six degrees celsius higher than the twenty one thousand nine hundred eighty one to two thousand ten baseline average per no at twenty twenty seven. Us record with twenty two one billion dollar plus climate disasters. The previous record was sixteen and twenty seventeen toiling in some ninety. Five billion dollars in damages are more than double the forty one year average of forty five billion seventy events were linked to hurricanes and tropical storms concerning wildfires california suffered over ten million acres burned more than double the previous record set in twenty eighteen at four million acres adverse health effects caused by climate crisis. Events are on bounce well known for example in two thousand sixteen. The government published the impacts of climate change on human health in the us. And i recently cited lance and twenty twenty countdown on health report that concluded in part quote the world has already warned by one point. Two degrees celsius resulting in profound immediate and worsening health effects close quote nevertheless response. By thorough policymakers. Along with the health care industry remains far beyond inadequate. The best the recent congress recently concluded congress can do as produce a five hundred fifty page climate crisis report that drew no connection between the climate crisis and related effects. Imposed on medicare medicaid beneficiaries. Do likely in part to the fact. That neither med pack or mac. Pack independent gresham commissions given broad authority to address issues affecting. These programs has never addressed much less mentioned the climate crisis with me again to discuss climate crisis related. Health costs is the national resource. Defense counsels dr. vj lemay so at that As background vj. Let me begin by asking. If you can briefly describe the nrdc signed centers work shirt and. Thank you david for the invitation to speak with you and your listeners. I work at nbc. The natural resources defense council we are a profit organization working really to stay guard the earth. it's people plants animals and the natural systems on which we all rely. We combine the power of more than three million at rdc members across the country with the expertise of about seven hundred staffers that scientists like me but also lawyers policy advocates who are working together to protect clean air clean water and the natural systems on which we all depend so i work in the science center at entity see and science release the foundation of our work to protect people in the environment. We worked to understand environmental and human health problems working in interdisciplinary spaces in some of the work that we'll talk about today. In terms of connecting the dots between climate change in house is really the focus of my work. And i just have to say you know this period unprecedented on the scientific enterprise. It's more important than ever that we recognize the value that science brings to society and helping us to confront respond to some of these. Really urgent threats thank you. I appreciate that last point As we are well aware. Let me go to you recently. Published an article To your credit in health affairs Last month last month december issue was a theme issue on the climate crisis. I should say a health affairs polishes. Nineteen eighty-three had never previously addressed. Or excuse me. Nineteen one had never previously addressed this subject So again a -gratulations. Your article with your colleagues was titled estimating the cost of action and the economic benefits of addressing. The health harms of climate. Change But i wanna ask you specifically about that because you wrote in this essay quote unquote. There is currently a knowledge gap that must be addressed for more complete understanding of climate change related exposure response relationship. So explain to me what this knowledge gap is. Sure you know in your setup remarks. You mentioned the huge toll that climate and weather disasters inflicted on the united states last year. About ninety five billion dollars by the federal governments fresh estimate and well that's a staggering number as a health scientist. I'm an epidemiologist. I look at that figure and i wonder what's not included and the truth is that when our federal government is tracking the damage the climate change in reports like the billion dollar disaster list. It's actually not accounting for tremendous profound and sometimes irreversible damage to human house so there is a huge missing component. We think about the continuing and mounting costs of inaction on the climate crisis

Vj Lemay David Intra Defense Council Center Dr Lemay Dr Maze Natural Resources Defense Coun Gresham Commissions Given Broa Congress Arctic United States Lance RDC Medicare Drew
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

09:54 min | 8 months ago

"david intra" Discussed on The Healthcare Policy Podcast

"To the healthcare policy podcast on the host. David intra cosso during this podcast discussed with the union of concerned. Scientists climate energy programs policy director. Dr rachel cletus. What the biden administration needs to address mitigate the effects of the worsening climate crisis. dr cletus. welcome to the program. Hello david thank you so much for having me. dr cletus. bile is of course posted on the podcast website. This is my fifteenth climate crisis related interview on background. The climate catastrophe continues to accelerate hemispheric carbon concentrations are now measured at four hundred seventeen parts per million the greatest concentration of carbon in our species existence. Not surprisingly there's a ninety nine percent chance. Twenty twenty will be among the top five warmest years. Two thirds chance for sixty six percent chance that will be the warmest year on record. This year is also experiencing a record-breaking atlantic hurricane and with thirty named storms to date and record breaking wildfires in the arctic that is warming at upwards of three times the rate of the rest of the planet the albedo effect from the loss of summarized will be equal to the release of one tree tons of carbon equivalents in the atmosphere. This amount approximates forty percent of all human caused ghg emissions. Since seventeen fifty in addition northern permafrost that holds almost twice as much carbon dioxide is currently in the atmosphere his thawing seventy years earlier than previously predicted the plan is also experiencing unprecedented biological violation. Vector-borne diseases including covid nineteen continued to proliferate and the trump administration in denying scientific reality has rescinded approximately one hundred environmental regulations that i discussed with sabin centers. Michael burger last may and finally listeners are where he federal court ruled earlier. This year. that americans do not have a constitutional right to survivable climate. So with that welcome. Dr cletus again were here discuss climate policy under the vitamin station. So before diving into that. A doctor cletus <hes>. Regarding my brief assessment. Is there anything. You'd like to add or alternative. I can i alternatively i can ask the question. The union put out a document a few years ago called the title the world scientists warning to humanity. so if you prefer to answer <hes>. The ladder what was in that warning. I think you've just made out a very thorough set of reality that were tainted with respect to the climate crisis. Things that climatize this morning house project are now actually happening around a severe climate crisis. If you're now it's no longer about some distant problem and it's affecting us here in the united states and around the world you mentioned the record breaking hurricane season we've seen the cocaine season moby seem pretty extraordinary type wounds on the other side of her world with the teams being. Hit back to back. In the last few weeks we've seen extraordinary heatwaves around the world in europe in asia <hes> flooding <hes>. And see living wage which is inexhaustible <hes> continuing slow moving disaster that many low-lying things around the world are facing <hes>. Including as in the us <hes>. Especially in on that. He's been go goes. We're at a point. Now where we are rapidly running out of time to address very new classes and as you pointed out <hes> as well we actually earn a moment for our nation is facing colliding. Place the covid nineteen pandemic as you mentioned <hes> but we also have a rapidly worsening economic crisis. We have a crisis democrats in our country. That is being made there <hes>. In this moment so all of these colliding to creative patrician where underlying social economic disparities than discrimination being exacerbated and a climate crisis is holding a very inequitable way <hes>. Around the world and here in the us so what we do now what the biden administration does and what future us administration to is very very important. The most significant difference. We're going to see is that we now have an administration that recognizes the fines will be guided by the signs and how they respond to the climate crisis instead of an administration that basically lied relentless me about the existence of <hes>. Munchies the climate crisis that even the reality the cova christ who actually worked to make them more worse. So now we have a president who actually five <hes> instead of sidelining them and silence them yes. <hes> thank goodness. I will say <hes>. As had been speculated trump's legacy will probably be moreover his <hes>. Calling the crisis a hoax and of course <hes>. Rescinding these operas of hundred epa mostly epa regulations. Let's get into <hes>. What we might expect from the biden administration. We could start with. I did intend or ask you <hes>. What did the biden campaign pledge to address the climate crisis. But let's let's pass on. That says now he's been elected you wrote <hes>. In a union of concerned scientists blog post. I believe it was dated november seventh <hes>. What the by presi means <hes>. Relative to the climate crisis you identified <hes>. Various aspects are measures that the biden ministrations should take under the title wet. President biden's should do on climate. You could note a few of these relative to what you think would be most productive coming from a biden administration. What's most important for the vitamin that administration to extend a very clear strong and early signal. They're going to take this challenge seriously. They wanna aggressive with all of that. They have so. I know that maybe have pointed out that <hes>. In our democratic took them eighty the actions that the president together with the action congress that will really allow for full <hes>. Aggressing of problems like climate crisis. And no doubt congress. Must say it's hard if we're going to get your <hes>. They should have and comprehensive action. But there's a loss at the biden expiration can and should do on its own and much of that can be done fairly quickly <hes>. Within the first hundred days of the administration taking power one quick forward and simple thing that everyone has been talking about is of course are getting back in the remount of the trump administration on november. four <hes>. The final the us from the of women that is an action that puts us on the sidelines and uniquely isolated on the world stage where the only country that has actually stepped away from the therapy. We need to get back <hes>. An after the responsible major nation of the world i together with other nations to raise invasion around a dozen the global climate crisis. And i miss fans there's no different the covid nineteen pandemic. we can solve the global complex challenges only when the app in concerts that other nations. So that's pretty straightforward <hes>. It's not enough to just get back. In paris agreement we have to borrow <hes>. A with domestic action. That shows that you are gonna take this seriously. We have to set signs and gone goals cutting <hes>. He in mission here in the us. The ipc record and twenty eighteen all down some pretty cure now. Metrics are the growth of the global community would have to meet to stay below two degrees here. Aiming for one point five degrees celsius about pre industrial levels the temperature increase so. She do contribute. Its fair share to that. The us must be on a bad day to get to net zero emissions. No later than twenty for before. I'm have to be well on that. By twenty thirty having our mission show <hes>. By twenty thirty to do that we're going to need action across the economy. Has inspector the biden administration should be directing every federal agency <hes>. To make sure that they're incorporating climate science and their actions that they're looking for opportunities to go cut emissions as the bill climate billions <hes> to the climate impacts that are unfortunately already locked in <hes>. Their action that the administration can take to the deputy voters and regulatory action to cut heat trapping emissions cosby economy. They should do so <hes>. There are a number of very aggressive. Compensation decorative voter that <hes>. Should be giving both back and one thing that <hes> is the has not recognize the now taking these kinds of ambitious actions requires leadership not just from the president but from his gatherer competitive agency. You'll be watching me. What appointments look like we need to have people in charge of these agencies and appointed to cabinet positions that recognize how climate change touch with every aspect of our economy and our lives and there needs to be david into their world view.

biden administration biden David intra cosso Dr rachel cletus united states president policy analyst Twenty twenty Michael burger dc dr cletus. bile trump dr cletus. epa cocaine director europe
Union of Concerned Scientists' Dr. Rachel Cleetus Discusses What the Biden Administration Needs to Do to Address the Climate Catastrophe

The Healthcare Policy Podcast

09:54 min | 8 months ago

Union of Concerned Scientists' Dr. Rachel Cleetus Discusses What the Biden Administration Needs to Do to Address the Climate Catastrophe

"To the healthcare policy podcast on the host. David intra cosso during this podcast discussed with the union of concerned. Scientists climate energy programs policy director. Dr rachel cletus. What the biden administration needs to address mitigate the effects of the worsening climate crisis. dr cletus. welcome to the program. Hello david thank you so much for having me. dr cletus. bile is of course posted on the podcast website. This is my fifteenth climate crisis related interview on background. The climate catastrophe continues to accelerate hemispheric carbon concentrations are now measured at four hundred seventeen parts per million the greatest concentration of carbon in our species existence. Not surprisingly there's a ninety nine percent chance. Twenty twenty will be among the top five warmest years. Two thirds chance for sixty six percent chance that will be the warmest year on record. This year is also experiencing a record-breaking atlantic hurricane and with thirty named storms to date and record breaking wildfires in the arctic that is warming at upwards of three times the rate of the rest of the planet the albedo effect from the loss of summarized will be equal to the release of one tree tons of carbon equivalents in the atmosphere. This amount approximates forty percent of all human caused ghg emissions. Since seventeen fifty in addition northern permafrost that holds almost twice as much carbon dioxide is currently in the atmosphere his thawing seventy years earlier than previously predicted the plan is also experiencing unprecedented biological violation. Vector-borne diseases including covid nineteen continued to proliferate and the trump administration in denying scientific reality has rescinded approximately one hundred environmental regulations that i discussed with sabin centers. Michael burger last may and finally listeners are where he federal court ruled earlier. This year. that americans do not have a constitutional right to survivable climate. So with that welcome. Dr cletus again were here discuss climate policy under the vitamin station. So before diving into that. A doctor cletus Regarding my brief assessment. Is there anything. You'd like to add or alternative. I can i alternatively i can ask the question. The union put out a document a few years ago called the title the world scientists warning to humanity. so if you prefer to answer The ladder what was in that warning. I think you've just made out a very thorough set of reality that were tainted with respect to the climate crisis. Things that climatize this morning house project are now actually happening around a severe climate crisis. If you're now it's no longer about some distant problem and it's affecting us here in the united states and around the world you mentioned the record breaking hurricane season we've seen the cocaine season moby seem pretty extraordinary type wounds on the other side of her world with the teams being. Hit back to back. In the last few weeks we've seen extraordinary heatwaves around the world in europe in asia flooding And see living wage which is inexhaustible continuing slow moving disaster that many low-lying things around the world are facing Including as in the us Especially in on that. He's been go goes. We're at a point. Now where we are rapidly running out of time to address very new classes and as you pointed out as well we actually earn a moment for our nation is facing colliding. Place the covid nineteen pandemic as you mentioned but we also have a rapidly worsening economic crisis. We have a crisis democrats in our country. That is being made there In this moment so all of these colliding to creative patrician where underlying social economic disparities than discrimination being exacerbated and a climate crisis is holding a very inequitable way Around the world and here in the us so what we do now what the biden administration does and what future us administration to is very very important. The most significant difference. We're going to see is that we now have an administration that recognizes the fines will be guided by the signs and how they respond to the climate crisis instead of an administration that basically lied relentless me about the existence of Munchies the climate crisis that even the reality the cova christ who actually worked to make them more worse. So now we have a president who actually five instead of sidelining them and silence them yes. thank goodness. I will say As had been speculated trump's legacy will probably be moreover his Calling the crisis a hoax and of course Rescinding these operas of hundred epa mostly epa regulations. Let's get into What we might expect from the biden administration. We could start with. I did intend or ask you What did the biden campaign pledge to address the climate crisis. But let's let's pass on. That says now he's been elected you wrote In a union of concerned scientists blog post. I believe it was dated november seventh What the by presi means Relative to the climate crisis you identified Various aspects are measures that the biden ministrations should take under the title wet. President biden's should do on climate. You could note a few of these relative to what you think would be most productive coming from a biden administration. What's most important for the vitamin that administration to extend a very clear strong and early signal. They're going to take this challenge seriously. They wanna aggressive with all of that. They have so. I know that maybe have pointed out that In our democratic took them eighty the actions that the president together with the action congress that will really allow for full Aggressing of problems like climate crisis. And no doubt congress. Must say it's hard if we're going to get your They should have and comprehensive action. But there's a loss at the biden expiration can and should do on its own and much of that can be done fairly quickly Within the first hundred days of the administration taking power one quick forward and simple thing that everyone has been talking about is of course are getting back in the remount of the trump administration on november. four The final the us from the of women that is an action that puts us on the sidelines and uniquely isolated on the world stage where the only country that has actually stepped away from the therapy. We need to get back An after the responsible major nation of the world i together with other nations to raise invasion around a dozen the global climate crisis. And i miss fans there's no different the covid nineteen pandemic. we can solve the global complex challenges only when the app in concerts that other nations. So that's pretty straightforward It's not enough to just get back. In paris agreement we have to borrow A with domestic action. That shows that you are gonna take this seriously. We have to set signs and gone goals cutting He in mission here in the us. The ipc record and twenty eighteen all down some pretty cure now. Metrics are the growth of the global community would have to meet to stay below two degrees here. Aiming for one point five degrees celsius about pre industrial levels the temperature increase so. She do contribute. Its fair share to that. The us must be on a bad day to get to net zero emissions. No later than twenty for before. I'm have to be well on that. By twenty thirty having our mission show By twenty thirty to do that we're going to need action across the economy. Has inspector the biden administration should be directing every federal agency To make sure that they're incorporating climate science and their actions that they're looking for opportunities to go cut emissions as the bill climate billions to the climate impacts that are unfortunately already locked in Their action that the administration can take to the deputy voters and regulatory action to cut heat trapping emissions cosby economy. They should do so There are a number of very aggressive. Compensation decorative voter that Should be giving both back and one thing that is the has not recognize the now taking these kinds of ambitious actions requires leadership not just from the president but from his gatherer competitive agency. You'll be watching me. What appointments look like we need to have people in charge of these agencies and appointed to cabinet positions that recognize how climate change touch with every aspect of our economy and our lives and there needs to be david into their world view.

Biden Administration Dr Cletus Trump Administration David Intra Union Of Concerned Dr Rachel Cletus Biden Atlantic Hurricane Michael Burger Us Administration Cletus United States Sabin Arctic EPA
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

06:36 min | 9 months ago

"david intra" Discussed on The Healthcare Policy Podcast

"Welcome to the healthcare policy podcast on the host David Intra Cosso. . This podcast discussed cybercrime or ransomware attacks against hospitals and other healthcare providers with Collab- Barlow CEO Synergistic Tech this barlow welcome to the program. . Hey pleasure to be here. . David. . Mr Biles vile is, , of course, , posted on the podcast website. . On background computer or cybercrimes against healthcare providers, , more of a hospitals, , disabled computer networks holding them for ransom. . Frequently for Bitcoin fee, , the tax have been prevalent since at least two, , thousand and ten. . This past month however, , universal health services with over four hundred locations. . Over in the US suffered a cyber attack disabling it's company wide computer network causing some it's hospitals to revert to pen and paper recordkeeping also last month the first known death. . Resulted from a ransomware attack in Germany when a patient did not survive transferred to another hospital. . Though a twenty nineteen hhs report found between twenty, , twelve and sixteen. . Hospital deaths increased after ransomware attacks. . Earlier this month covid nineteen VACs. . A covid nineteen vaccine trial was delayed by more attack or at least one. . Likely. . The most costly ransomware attack was to the UK's national health service in seventeen that amounted to an estimated one, , hundred, , twenty, , million in it costs and lost productivity. . ransomware attacks are on the increase especially amongst small hospitals, , particularly vulnerable to phishing attacks, , lasting upwards of tumor weeks because of their lean or inadequate security support. . As Josephine Wolf noted in October Seventeen New York Times editorial quote Unquote cybersecurity shortcomings in the healthcare sector needs to be addressed now. . More than ever when medical care is increasingly being offered via remote online formats. . In twenty twenty states introduced more than two hundred and eighty cybersecurity related bills enacting several related to task forces or commissions training. . Cybersecurity insurance in criminal. . Penalties. . The US Senate and House passed seven cybersecurity bills whoever not specifically addressed the healthcare industry and none became law. . With me again and discuss healthcare cybersecurity is synergise texts, , CEO. . COLLAB- Barlow so <hes> club with that. . As background LET'S START WITH A. . Primer Info. . I've read these ransomware products. . <hes> in part are. . Titled or named Wannacry Laki Win Plock encrypt locker. . <hes>. . Are some these known ransomware product. . So my question is, , how do these encrypt clinical data and to what effect? ? So. So . basically, , what happening if you look at ransomware incident is a you know a narrow will gets access to a network and that could be as simple as grabbing somebody's credentials. . You know maybe you were on a retail site, , use the same credentials you used at work that retail site was compromised and <hes>. . There are many locations on the dark web that will. . Sell compromised credentials or could have been through a phishing attack once the bad guy is into the network then there's two primary things that they're looking to do first is to move laterally. . They WANNA get as much access across the networks they can, , and there are a variety of tools that they'll deploy. . They will actually help them harvest additional credentials once they've got a beachhead. . On, , the network in addition to harvesting new credentials and kind of moving lateral or what we call lateral movement. . The other thing that are going to do is to try to elevate their privilege. . So going from maybe an administrator or you know a nurse and triage and maybe getting access to their credentials, , they're going to try to work their way up to a network. . Administrator or someone that controls access to the whole domain once they've been able to get in and move their tentacles around the organization, , then they're going to deploy their payroll, , which is one of several of the tools that you mentioned will allow them to then lock things up effectively what these tools, , our cryptographic tools, , and they basically take the entire hard drive at the device. . Scramble it and lock it up with a cryptographic key. . What we've seen of late is the bad guys oftentimes insert a new step just before scrambling data, , locking it all up in that the exfiltrated lot of it, , and they're using that to increase their chances of getting paid by potentially threatening to. . The organization by releasing that data if they don't pay ransom. . Okay. . Thank you so. . I in my reading. . It's uncertain Saul. Asked . you this question? ? What's your understanding? ? How frequently? ? Is this occurring in the healthcare sector? ? Oh, , it's every day I mean literally every single day because you got to remember what you read about in the news is only a very small fraction of what's actually going on even though technically speaking ransomware incident is as far as I'm concerned reportable incident <hes> because you gotta remember if the bad guy had enough access to walk up your data, , they had the same level of access needed to read the data and they actually in many cases had the same level access needed to change the data. . So the problem is you've actually lost control of that system when you've had a ransomware incident. . I. . So that was that was a question I did have. . Other than. . Possibly, , making this data public and you know healthcare data's is is is confidential proprietary, of , course. . What do they typically do this data other than hold it hostage? ? Well remember, this , is a organized crime. . It is a volume organization you're dealing with a human on the other end and that human is organized right. . You're not the only target, , their targeting dozens of organizations at the same time in many cases are teams of thirty individuals and you know there's a breakdown on that team there's a project manager of a boss. . There's people that are responsible for getting access. . There's people that are responsible for moving laterally people responsible for elevating credentials and people are responsible for negotiating. . Once walked up system

Collab- Barlow CEO Synergistic David Cosso David David Intra Cosso policy analyst US Senate Mr Biles CEO US Josephine Wolf New York Times UK Germany House
Caleb Barlow Discusses Healthcare Industry Ransomware Attacks and Measures to Prevent Cybercrimes

The Healthcare Policy Podcast

06:36 min | 9 months ago

Caleb Barlow Discusses Healthcare Industry Ransomware Attacks and Measures to Prevent Cybercrimes

"Welcome to the healthcare policy podcast on the host David Intra Cosso. This podcast discussed cybercrime or ransomware attacks against hospitals and other healthcare providers with Collab- Barlow CEO Synergistic Tech this barlow welcome to the program. Hey pleasure to be here. David. Mr Biles vile is, of course, posted on the podcast website. On background computer or cybercrimes against healthcare providers, more of a hospitals, disabled computer networks holding them for ransom. Frequently for Bitcoin fee, the tax have been prevalent since at least two, thousand and ten. This past month however, universal health services with over four hundred locations. Over in the US suffered a cyber attack disabling it's company wide computer network causing some it's hospitals to revert to pen and paper recordkeeping also last month the first known death. Resulted from a ransomware attack in Germany when a patient did not survive transferred to another hospital. Though a twenty nineteen hhs report found between twenty, twelve and sixteen. Hospital deaths increased after ransomware attacks. Earlier this month covid nineteen VACs. A covid nineteen vaccine trial was delayed by more attack or at least one. Likely. The most costly ransomware attack was to the UK's national health service in seventeen that amounted to an estimated one, hundred, twenty, million in it costs and lost productivity. ransomware attacks are on the increase especially amongst small hospitals, particularly vulnerable to phishing attacks, lasting upwards of tumor weeks because of their lean or inadequate security support. As Josephine Wolf noted in October Seventeen New York Times editorial quote Unquote cybersecurity shortcomings in the healthcare sector needs to be addressed now. More than ever when medical care is increasingly being offered via remote online formats. In twenty twenty states introduced more than two hundred and eighty cybersecurity related bills enacting several related to task forces or commissions training. Cybersecurity insurance in criminal. Penalties. The US Senate and House passed seven cybersecurity bills whoever not specifically addressed the healthcare industry and none became law. With me again and discuss healthcare cybersecurity is synergise texts, CEO. COLLAB- Barlow so club with that. As background LET'S START WITH A. Primer Info. I've read these ransomware products. in part are. Titled or named Wannacry Laki Win Plock encrypt locker. Are some these known ransomware product. So my question is, how do these encrypt clinical data and to what effect? So. So basically, what happening if you look at ransomware incident is a you know a narrow will gets access to a network and that could be as simple as grabbing somebody's credentials. You know maybe you were on a retail site, use the same credentials you used at work that retail site was compromised and There are many locations on the dark web that will. Sell compromised credentials or could have been through a phishing attack once the bad guy is into the network then there's two primary things that they're looking to do first is to move laterally. They WANNA get as much access across the networks they can, and there are a variety of tools that they'll deploy. They will actually help them harvest additional credentials once they've got a beachhead. On, the network in addition to harvesting new credentials and kind of moving lateral or what we call lateral movement. The other thing that are going to do is to try to elevate their privilege. So going from maybe an administrator or you know a nurse and triage and maybe getting access to their credentials, they're going to try to work their way up to a network. Administrator or someone that controls access to the whole domain once they've been able to get in and move their tentacles around the organization, then they're going to deploy their payroll, which is one of several of the tools that you mentioned will allow them to then lock things up effectively what these tools, our cryptographic tools, and they basically take the entire hard drive at the device. Scramble it and lock it up with a cryptographic key. What we've seen of late is the bad guys oftentimes insert a new step just before scrambling data, locking it all up in that the exfiltrated lot of it, and they're using that to increase their chances of getting paid by potentially threatening to. The organization by releasing that data if they don't pay ransom. Okay. Thank you so. I in my reading. It's uncertain Saul. Asked you this question? What's your understanding? How frequently? Is this occurring in the healthcare sector? Oh, it's every day I mean literally every single day because you got to remember what you read about in the news is only a very small fraction of what's actually going on even though technically speaking ransomware incident is as far as I'm concerned reportable incident because you gotta remember if the bad guy had enough access to walk up your data, they had the same level of access needed to read the data and they actually in many cases had the same level access needed to change the data. So the problem is you've actually lost control of that system when you've had a ransomware incident. I. So that was that was a question I did have. Other than. Possibly, making this data public and you know healthcare data's is is is confidential proprietary, of course. What do they typically do this data other than hold it hostage? Well remember, this is a organized crime. It is a volume organization you're dealing with a human on the other end and that human is organized right. You're not the only target, their targeting dozens of organizations at the same time in many cases are teams of thirty individuals and you know there's a breakdown on that team there's a project manager of a boss. There's people that are responsible for getting access. There's people that are responsible for moving laterally people responsible for elevating credentials and people are responsible for negotiating. Once walked up system

Mr Biles Josephine Wolf Seventeen New York Times Wannacry Laki Bitcoin Barlow National Health Service HHS Collab Us Senate Tumor Germany David UK United States House Saul
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

04:28 min | 9 months ago

"david intra" Discussed on The Healthcare Policy Podcast

"On background computer or cybercrimes against healthcare providers, , more of a hospitals, , disabled computer networks holding them for ransom. . Frequently for Bitcoin fee, , the tax have been prevalent since at least two, , thousand and ten. . This past month however, , universal health services with over four hundred locations. . Over in the US suffered a cyber attack disabling it's company wide computer network causing some it's hospitals to revert to pen and paper recordkeeping also last month the first known death. . Resulted from a ransomware attack in Germany when a patient did not survive transferred to another hospital. . Though a twenty nineteen hhs report found between twenty, , twelve and sixteen. . Hospital deaths increased after ransomware attacks. . Earlier this month covid nineteen VACs. . A covid nineteen vaccine trial was delayed by more attack or at least one. . Likely. . The most costly ransomware attack was to the UK's national health service in seventeen that amounted to an estimated one, , hundred, , twenty, , million in it costs and lost productivity. . ransomware attacks are on the increase especially amongst small hospitals, , particularly vulnerable to phishing attacks, , lasting upwards of tumor weeks because of their lean or inadequate security support. . As Josephine Wolf noted in October Seventeen New York Times editorial quote Unquote cybersecurity shortcomings in the healthcare sector needs to be addressed now. . More than ever when medical care is increasingly being offered via remote online formats. . In twenty twenty states introduced more than two hundred and eighty cybersecurity related bills enacting several related to task forces or commissions training. . Cybersecurity insurance in criminal. . Penalties. . The US Senate and House passed seven cybersecurity bills whoever not specifically addressed the healthcare industry and none became law. . With me again and discuss healthcare cybersecurity is synergise texts, , CEO. . COLLAB- Barlow so <hes> club with that. . As background LET'S START WITH A. . Primer Info. . I've read these ransomware products. . <hes> in part are. . Titled or named Wannacry Laki Win Plock encrypt locker. . <hes>. . Are some these known ransomware product. . So my question is, , how do these encrypt clinical data and to what effect? ? So. So . basically, , what happening if you look at ransomware incident is a you know a narrow will gets access to a network and that could be as simple as grabbing somebody's credentials. . You know maybe you were on a retail site, , use the same credentials you used at work that retail site was compromised and <hes>. . There are many locations on the dark web that will. . Sell compromised credentials or could have been through a phishing attack once the bad guy is into the network then there's two primary things that they're looking to do first is to move laterally. . They WANNA get as much access across the networks they can, , and there are a variety of tools that they'll deploy. . They will actually help them harvest additional credentials once they've got a beachhead. . On, , the network in addition to harvesting new credentials and kind of moving lateral or what we call lateral movement. . The other thing that are going to do is to try to elevate their privilege. . So going from maybe an administrator or you know a nurse and triage and maybe getting access to their credentials, , they're going to try to work their way up to a network. . Administrator or someone that controls access to the whole domain once they've been able to get in and move their tentacles around the organization, , then they're going to deploy their payroll, , which is one of several of the tools that you mentioned will allow them to then lock things up effectively what these tools, , our cryptographic tools, , and they basically take the entire hard drive at the device. . Scramble it and lock it up with a cryptographic key. . What we've seen of late is the bad guys oftentimes insert a new step just before scrambling data, , locking it all up in that the exfiltrated lot of it, , and they're using that to increase their chances of getting paid by potentially threatening to. . The organization by releasing that data if they don't pay ransom. .

Collab- Barlow CEO Synergistic David Cosso David David Intra Cosso policy analyst US Senate Mr Biles CEO US Josephine Wolf New York Times UK Germany House
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

07:29 min | 9 months ago

"david intra" Discussed on The Healthcare Policy Podcast

"To the healthcare policy podcast on the host. . David. . Intra Cosso. . During this podcast saw discussed efforts to address social determinants of health with John Gorman chairman of the nightingale partners and founder and former Executive Chairman of Gorman Health Group. . John Welcome to the program. . Thanks David. . Great to be here. . especially with another native DC guy here most welcome John's by is, , of course, , posted on the podcast website. . Briefly on background, , the ongoing covid nineteen pandemic has exposed. . The country's failed to adequately address the social determinants of health. . Generally defining health access and quality education, , economic circumstances, , food security, , social conditions, , and environmental factors. . It is estimated that where people live work and socialize determines as much as sixty percent of their health status. . Whereas formal medical care accounts for just ten percent. . For example concerning. . Circumstances forty years of wage stagnation among lower income earners has left forty five percent of working age Americans. . With either no health care insurance for insurance without a pocket expenses so high. . They avoid sinking care went for example, , they developed covid nineteen related symptoms. . Healthcare policy makers have slowly begun to take an interest in addressing sto ages as a way to improve health delivery by increasing increasing appropriate utilization and reducing costs. . For example, , Medicare, , advantage plans which enroll more than one third of all Medicare beneficiaries have recently been given regulatory authority to offer Ma benificiary supplemental benefits beyond medical care such as mail deliveries, , home modifications, , and Personal Care Services. . With beginning, discuss, , , addressing, , social determine, , specifically use of what are termed opportunities zones. . Again. . John Gorman. . So Jon with that as background. . Louis. . Begin by asking if you could provide a brief overview of nightingale. . Sure David Nangle partners is one of these weird opportunities zone funds that came out of trump's big tax giveaway bill <hes>. . It was actually <hes> Cory Booker's program that was designed to <hes> encourage investment in real estate and disadvantaged communities and <hes> I was sitting on my ass retired last spring and <hes> got a notification that the irs had just completely revamped the rags to allow opportunities own capital to be used not just for real estate investment. . But also for leases one portly for working capital or for meeting the business requirements of a new company inside one of the nine thousand roughly nine thousand opportunities zones around the country and those opportunities owns David are all. . Severely, , economically disadvantaged and more importantly medically underserved, , and because the irs allowed now opportunities own capital to be used for working capital for meeting business requirements. . That's what opened the door to allow us to use opportunities on Capitol to make large scale investments in social determinants of health intervention. . So <hes> nightingale partners with insurers with health systems with large medical groups to finance design <hes> launch, , and where necessary <hes> execute on our goals to improve. . The quality of care for vulnerable populations. In . this country, , a lot of people <hes> like to say and I love it that we packed a Republican billionaire tax shelter in order to improve care for black drought people on that gets me up every morning. . Sir Thank you. . So this as you noted, , this was a provision in the December seventeen tax bill. . Specifically <hes> page one, , hundred, , and thirty. . This was picked up this previous legislation as you noted, , <hes> that as you mentioned <hes> senator from New Jersey Cory Booker but also the South Carolina African American Republican, , the only one Tim Scott. . So <hes> <hes> this is picked up in the tax bill previous legislation and you mentioned the nine thousand. . So these are census tracts that meet this low income community criteria wrote <hes>, , and then explain to me. . Governors than have to select a discrete number. . That could benefit from this. . Tax Advantage program is that correct doubts correct and there was a little bit of mischief but some of the governors in the designation of some of those areas and there's been, , you know some gamesmanship with this story like you know Chris Christie, , the former governor of New Jersey is. . Used an opportunity zone fund open up frigging LAUNDROMAT. . In Asbury, , Park with Bruce, , springsteen cats not the kind of stuff that we do. . I'm not surprised to hear that I guess <hes> the former governor is a is obsessed with. . <hes> Mr Asbury Park <hes> and again just so on. . Understand better more clearly, , this is the tax advantage here is that by investing the capital gains on your investment, , you can avoid paying the. . Twenty three percent the capital gains tax and that basically. . Sure go ahead, , go ahead. . Well, basically, , , the way it works is that if you invest money or capital gains in and opportunities zone and you leave it in for at least ten years, , not only is the initial investment completely tax free but then all of the proceeds that you make on that investment are completely tax free. . So high net worth individuals. . And family offices large corporations the generate large amounts of capital gains love this program, , and indeed it opened up about six point two trillion dollars in available capital <hes> based on the amount of capital gains that we generate in our economy. So . <hes> of that amount, , David Roughly <hes> a hundred billion dollars has been invested thus far <hes> into opportunities zones off. . The roughly eight months programs operate. . And again, , the idea is the long leave the money and means completely tax free for ten years out of step seven years you pay are you're eighty five percent excuse but I know that that number surprises me would you say this this this one, , hundred, , billion, , his far more than was estimated when the legislation was passed. . No I think it's probably rolling out slower than <hes>. . A lot of folks had hoped <hes>, , and as you can imagine, the , vast majority of those deals that have been done thus far has been around real estate and real estate redevelopment <hes> certainly in the healthcare sector I think we're still the only firm out here. . That's a healthcare focus opportunities on fund <hes> it. . You know it we've been the only ones to my knowledge. . So we're you know we're granted here, , but we have yet even break a billion, , but we're that's our goal. .

John Gorman David David Cosso Gorman Health Group policy analyst David Nangle Cory Booker chairman Medicare Louis Personal Care Services Executive Chairman trump Jon irs
John Gorman Discusses the Use of Opportunity Zones to Address Social Determinants

The Healthcare Policy Podcast

07:29 min | 9 months ago

John Gorman Discusses the Use of Opportunity Zones to Address Social Determinants

"To the healthcare policy podcast on the host. David. Intra Cosso. During this podcast saw discussed efforts to address social determinants of health with John Gorman chairman of the nightingale partners and founder and former Executive Chairman of Gorman Health Group. John Welcome to the program. Thanks David. Great to be here. especially with another native DC guy here most welcome John's by is, of course, posted on the podcast website. Briefly on background, the ongoing covid nineteen pandemic has exposed. The country's failed to adequately address the social determinants of health. Generally defining health access and quality education, economic circumstances, food security, social conditions, and environmental factors. It is estimated that where people live work and socialize determines as much as sixty percent of their health status. Whereas formal medical care accounts for just ten percent. For example concerning. Circumstances forty years of wage stagnation among lower income earners has left forty five percent of working age Americans. With either no health care insurance for insurance without a pocket expenses so high. They avoid sinking care went for example, they developed covid nineteen related symptoms. Healthcare policy makers have slowly begun to take an interest in addressing sto ages as a way to improve health delivery by increasing increasing appropriate utilization and reducing costs. For example, Medicare, advantage plans which enroll more than one third of all Medicare beneficiaries have recently been given regulatory authority to offer Ma benificiary supplemental benefits beyond medical care such as mail deliveries, home modifications, and Personal Care Services. With beginning, discuss, addressing, social determine, specifically use of what are termed opportunities zones. Again. John Gorman. So Jon with that as background. Louis. Begin by asking if you could provide a brief overview of nightingale. Sure David Nangle partners is one of these weird opportunities zone funds that came out of trump's big tax giveaway bill It was actually Cory Booker's program that was designed to encourage investment in real estate and disadvantaged communities and I was sitting on my ass retired last spring and got a notification that the irs had just completely revamped the rags to allow opportunities own capital to be used not just for real estate investment. But also for leases one portly for working capital or for meeting the business requirements of a new company inside one of the nine thousand roughly nine thousand opportunities zones around the country and those opportunities owns David are all. Severely, economically disadvantaged and more importantly medically underserved, and because the irs allowed now opportunities own capital to be used for working capital for meeting business requirements. That's what opened the door to allow us to use opportunities on Capitol to make large scale investments in social determinants of health intervention. So nightingale partners with insurers with health systems with large medical groups to finance design launch, and where necessary execute on our goals to improve. The quality of care for vulnerable populations. In this country, a lot of people like to say and I love it that we packed a Republican billionaire tax shelter in order to improve care for black drought people on that gets me up every morning. Sir Thank you. So this as you noted, this was a provision in the December seventeen tax bill. Specifically page one, hundred, and thirty. This was picked up this previous legislation as you noted, that as you mentioned senator from New Jersey Cory Booker but also the South Carolina African American Republican, the only one Tim Scott. So this is picked up in the tax bill previous legislation and you mentioned the nine thousand. So these are census tracts that meet this low income community criteria wrote and then explain to me. Governors than have to select a discrete number. That could benefit from this. Tax Advantage program is that correct doubts correct and there was a little bit of mischief but some of the governors in the designation of some of those areas and there's been, you know some gamesmanship with this story like you know Chris Christie, the former governor of New Jersey is. Used an opportunity zone fund open up frigging LAUNDROMAT. In Asbury, Park with Bruce, springsteen cats not the kind of stuff that we do. I'm not surprised to hear that I guess the former governor is a is obsessed with. Mr Asbury Park and again just so on. Understand better more clearly, this is the tax advantage here is that by investing the capital gains on your investment, you can avoid paying the. Twenty three percent the capital gains tax and that basically. Sure go ahead, go ahead. Well, basically, the way it works is that if you invest money or capital gains in and opportunities zone and you leave it in for at least ten years, not only is the initial investment completely tax free but then all of the proceeds that you make on that investment are completely tax free. So high net worth individuals. And family offices large corporations the generate large amounts of capital gains love this program, and indeed it opened up about six point two trillion dollars in available capital based on the amount of capital gains that we generate in our economy. So of that amount, David Roughly a hundred billion dollars has been invested thus far into opportunities zones off. The roughly eight months programs operate. And again, the idea is the long leave the money and means completely tax free for ten years out of step seven years you pay are you're eighty five percent excuse but I know that that number surprises me would you say this this this one, hundred, billion, his far more than was estimated when the legislation was passed. No I think it's probably rolling out slower than A lot of folks had hoped and as you can imagine, the vast majority of those deals that have been done thus far has been around real estate and real estate redevelopment certainly in the healthcare sector I think we're still the only firm out here. That's a healthcare focus opportunities on fund it. You know it we've been the only ones to my knowledge. So we're you know we're granted here, but we have yet even break a billion, but we're that's our goal.

David Nangle John Gorman Cory Booker Gorman Health Group IRS New Jersey Chairman Mr Asbury Park Chris Christie Executive Chairman Personal Care Services Medicare JON
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

06:36 min | 9 months ago

"david intra" Discussed on The Healthcare Policy Podcast

"Welcome to the healthcare policy podcast on the host. . David. . Intra Cosso. . During this podcast saw discussed efforts to address social determinants of health with John Gorman chairman of the nightingale partners and founder and former Executive Chairman of Gorman Health Group. . John Welcome to the program. . Thanks David. . Great to be here. . especially with another native DC guy here most welcome John's by is, , of course, , posted on the podcast website. . Briefly on background, , the ongoing covid nineteen pandemic has exposed. . The country's failed to adequately address the social determinants of health. . Generally defining health access and quality education, , economic circumstances, , food security, , social conditions, , and environmental factors. . It is estimated that where people live work and socialize determines as much as sixty percent of their health status. . Whereas formal medical care accounts for just ten percent. . For example concerning. . Circumstances forty years of wage stagnation among lower income earners has left forty five percent of working age Americans. . With either no health care insurance for insurance without a pocket expenses so high. . They avoid sinking care went for example, , they developed covid nineteen related symptoms. . Healthcare policy makers have slowly begun to take an interest in addressing sto ages as a way to improve health delivery by increasing increasing appropriate utilization and reducing costs. . For example, , Medicare, , advantage plans which enroll more than one third of all Medicare beneficiaries have recently been given regulatory authority to offer Ma benificiary supplemental benefits beyond medical care such as mail deliveries, , home modifications, , and Personal Care Services. . With beginning, discuss, , , addressing, , social determine, , specifically use of what are termed opportunities zones. . Again. . John Gorman. . So Jon with that as background. . Louis. . Begin by asking if you could provide a brief overview of nightingale. . Sure David Nangle partners is one of these weird opportunities zone funds that came out of trump's big tax giveaway bill <hes>. . It was actually <hes> Cory Booker's program that was designed to <hes> encourage investment in real estate and disadvantaged communities and <hes> I was sitting on my ass retired last spring and <hes> got a notification that the irs had just completely revamped the rags to allow opportunities own capital to be used not just for real estate investment. . But also for leases one portly for working capital or for meeting the business requirements of a new company inside one of the nine thousand roughly nine thousand opportunities zones around the country and those opportunities owns David are all. . Severely, , economically disadvantaged and more importantly medically underserved, , and because the irs allowed now opportunities own capital to be used for working capital for meeting business requirements. . That's what opened the door to allow us to use opportunities on Capitol to make large scale investments in social determinants of health intervention. . So <hes> nightingale partners with insurers with health systems with large medical groups to finance design <hes> launch, , and where necessary <hes> execute on our goals to improve. . The quality of care for vulnerable populations. In . this country, , a lot of people <hes> like to say and I love it that we packed a Republican billionaire tax shelter in order to improve care for black drought people on that gets me up every morning. . Sir Thank you. . So this as you noted, , this was a provision in the December seventeen tax bill. . Specifically <hes> page one, , hundred, , and thirty. . This was picked up this previous legislation as you noted, , <hes> that as you mentioned <hes> senator from New Jersey Cory Booker but also the South Carolina African American Republican, , the only one Tim Scott. . So <hes> <hes> this is picked up in the tax bill previous legislation and you mentioned the nine thousand. . So these are census tracts that meet this low income community criteria wrote <hes>, , and then explain to me. . Governors than have to select a discrete number. . That could benefit from this. . Tax Advantage program is that correct doubts correct and there was a little bit of mischief but some of the governors in the designation of some of those areas and there's been, , you know some gamesmanship with this story like you know Chris Christie, , the former governor of New Jersey is. . Used an opportunity zone fund open up frigging LAUNDROMAT. . In Asbury, , Park with Bruce, , springsteen cats not the kind of stuff that we do. . I'm not surprised to hear that I guess <hes> the former governor is a is obsessed with. . <hes> Mr Asbury Park <hes> and again just so on. . Understand better more clearly, , this is the tax advantage here is that by investing the capital gains on your investment, , you can avoid paying the. . Twenty three percent the capital gains tax and that basically. . Sure go ahead, , go ahead. . Well, basically, , , the way it works is that if you invest money or capital gains in and opportunities zone and you leave it in for at least ten years, , not only is the initial investment completely tax free but then all of the proceeds that you make on that investment are completely tax free. . So high net worth individuals. . And family offices large corporations the generate large amounts of capital gains love this program, , and indeed it opened up about six point two trillion dollars in available capital <hes> based on the amount of capital gains that we generate in our economy. So . <hes> of that amount, , David Roughly <hes> a hundred billion dollars has been invested thus far <hes> into opportunities zones off. . The roughly eight months programs operate. .

John Gorman David David Cosso Gorman Health Group policy analyst David Nangle Cory Booker chairman Medicare Louis Personal Care Services Executive Chairman trump Jon irs
John Gorman Discusses the Use of Opportunity Zones to Address Social Determinants

The Healthcare Policy Podcast

06:36 min | 9 months ago

John Gorman Discusses the Use of Opportunity Zones to Address Social Determinants

"Welcome to the healthcare policy podcast on the host. David. Intra Cosso. During this podcast saw discussed efforts to address social determinants of health with John Gorman chairman of the nightingale partners and founder and former Executive Chairman of Gorman Health Group. John Welcome to the program. Thanks David. Great to be here. especially with another native DC guy here most welcome John's by is, of course, posted on the podcast website. Briefly on background, the ongoing covid nineteen pandemic has exposed. The country's failed to adequately address the social determinants of health. Generally defining health access and quality education, economic circumstances, food security, social conditions, and environmental factors. It is estimated that where people live work and socialize determines as much as sixty percent of their health status. Whereas formal medical care accounts for just ten percent. For example concerning. Circumstances forty years of wage stagnation among lower income earners has left forty five percent of working age Americans. With either no health care insurance for insurance without a pocket expenses so high. They avoid sinking care went for example, they developed covid nineteen related symptoms. Healthcare policy makers have slowly begun to take an interest in addressing sto ages as a way to improve health delivery by increasing increasing appropriate utilization and reducing costs. For example, Medicare, advantage plans which enroll more than one third of all Medicare beneficiaries have recently been given regulatory authority to offer Ma benificiary supplemental benefits beyond medical care such as mail deliveries, home modifications, and Personal Care Services. With beginning, discuss, addressing, social determine, specifically use of what are termed opportunities zones. Again. John Gorman. So Jon with that as background. Louis. Begin by asking if you could provide a brief overview of nightingale. Sure David Nangle partners is one of these weird opportunities zone funds that came out of trump's big tax giveaway bill It was actually Cory Booker's program that was designed to encourage investment in real estate and disadvantaged communities and I was sitting on my ass retired last spring and got a notification that the irs had just completely revamped the rags to allow opportunities own capital to be used not just for real estate investment. But also for leases one portly for working capital or for meeting the business requirements of a new company inside one of the nine thousand roughly nine thousand opportunities zones around the country and those opportunities owns David are all. Severely, economically disadvantaged and more importantly medically underserved, and because the irs allowed now opportunities own capital to be used for working capital for meeting business requirements. That's what opened the door to allow us to use opportunities on Capitol to make large scale investments in social determinants of health intervention. So nightingale partners with insurers with health systems with large medical groups to finance design launch, and where necessary execute on our goals to improve. The quality of care for vulnerable populations. In this country, a lot of people like to say and I love it that we packed a Republican billionaire tax shelter in order to improve care for black drought people on that gets me up every morning. Sir Thank you. So this as you noted, this was a provision in the December seventeen tax bill. Specifically page one, hundred, and thirty. This was picked up this previous legislation as you noted, that as you mentioned senator from New Jersey Cory Booker but also the South Carolina African American Republican, the only one Tim Scott. So this is picked up in the tax bill previous legislation and you mentioned the nine thousand. So these are census tracts that meet this low income community criteria wrote and then explain to me. Governors than have to select a discrete number. That could benefit from this. Tax Advantage program is that correct doubts correct and there was a little bit of mischief but some of the governors in the designation of some of those areas and there's been, you know some gamesmanship with this story like you know Chris Christie, the former governor of New Jersey is. Used an opportunity zone fund open up frigging LAUNDROMAT. In Asbury, Park with Bruce, springsteen cats not the kind of stuff that we do. I'm not surprised to hear that I guess the former governor is a is obsessed with. Mr Asbury Park and again just so on. Understand better more clearly, this is the tax advantage here is that by investing the capital gains on your investment, you can avoid paying the. Twenty three percent the capital gains tax and that basically. Sure go ahead, go ahead. Well, basically, the way it works is that if you invest money or capital gains in and opportunities zone and you leave it in for at least ten years, not only is the initial investment completely tax free but then all of the proceeds that you make on that investment are completely tax free. So high net worth individuals. And family offices large corporations the generate large amounts of capital gains love this program, and indeed it opened up about six point two trillion dollars in available capital based on the amount of capital gains that we generate in our economy. So of that amount, David Roughly a hundred billion dollars has been invested thus far into opportunities zones off. The roughly eight months programs operate.

John Gorman Nightingale Partners Gorman Health Group David David Nangle Cory Booker Medicare John IRS Sir Thank JON Louis Tim Scott Asbury, Park New Jersey Mr Asbury Park
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

05:54 min | 11 months ago

"david intra" Discussed on The Healthcare Policy Podcast

"Welcome to the healthcare policy podcast on the host David Intra. . Kosovo. . With me today Dr Rachel Dolan the US House of Representatives ways and Means Committee majority staffer to discuss the majority staffs recently released report titled Under enforced and over prescribed. . ANTIPSYCHOTIC drug epidemic ravaging America's nursing homes. . Dr Dole and welcome to the program. . I David thanks so much for having me. . Please call me Rachel. . While this'll be the last time Dr Dolan's bio is posted on, , of course, , the podcast website. . In testimony before the House Energy and Commerce Committee two, , thousand seven, , the FDA's Dr David Graham stated quote. . Unquote. . Fifteen thousand adults elderly people in nursing homes are dying each year from the off label use of antipsychotic medications. . For an indication that the FDA knows the drug doesn't work the problem has been only FDA for years and years close quote. . Legal the FDA does provide a black box warning label. . Regarding off label use of these drugs, , eleven years later, , Human Rights Watch published a report titled They Want Docile. . How. . Nursing homes in the US overmedicated people with dementia. . The report found in two thousand, sixteen, , , seventeen quote unquote massive use or abuse of Anti Psychotics, , for example, , Sarah. . Quel. . Doll and Rispler doll that have serious side effects including sudden cardiac death. . The human rights report estimated in an average week over one hundred, , seventy, , nine, , thousand, , long-stay Nursing Home Facility patients who administered antipsychotic drugs. . Without a diagnosis which the drugs are indicated or approved rover, , polar disorder and schizophrenia in testimony the ways and means. . Committee. Heard . this past November Richard Mollet Executive Director of the Long Term Care Community coalition concluded quote the use of San Anti psychotics in skilled nursing facilities is so extensive that puts the US in violation of internal conventions and covenants on torture and cruel inhumane and degrading treatment or punishment. . Close quote. . This is my third related interview. . In December twenty twelve I discussed the topic with Diana Zuckerman. . And in February, , eighteen high interviewed Hannah Lamb who authored the above mentioned human rights report. . With me again to discuss the ways and means report just released titled Under enforced and over prescribed is Rachel Dolan the reports lead author. . So that Rachel as background let's get right into this or immediate <hes> neatly into the specifics of the report. . What did the report find regarding <hes> the extent to which? ? They're persists overuse or misuse of anti psychotics in skilled nursing. . David. . So the report showed what what you what we would expect from your introduction, , which is the use of antipsychotic does persist in nursing homes across the country and it remains quite high and not of course, , has implications for patient safety and and health <hes>. . We found in the fourth quarter of Twenty nineteen approximately twenty percent of all skilled nursing facility residents in the US. . So that's about two, , hundred, , Ninety, , eight, , thousand, , six, , hundred, , fifty people every week received some form of antipsychotic medication <hes>, , and most of that was without any psychosis diagnosis for which these drugs are indicated <hes>. . So specifically, , we actually looked at trends and surveyor citations for unnecessary medication use in nursing home. . So that's kind of the. . Part of this study and what we found was a clear change in citation rates for these facilities between the change in administrations from the Obama Administration to trump administration <hes>. . So we found citations for antipsychotic misuse in sniffs increased by two hundred percent between twenty, , fifteen, , twenty seventeen but then declined by twenty two percent from two thousand, , seventeen to twenty eighteen, , and importantly a ten percent of citations associated with actual harm or immediate jeopardy to a residence health or safety. . So those are some of the most severe citation surveyors ever capture resulted in no fine from twenty seventeen to twenty eighteen under the trump administration. . So you know. . I. . Would say even though this study in particular couldn't determine causation <hes> we we did see a clear association between the Trump Administration's regulatory rollback campaign twenty, , seventeen, , twenty eighteen and a reduction in citations for these particular drugs. . Okay thank you and we'll get into the trump administration's <hes> regulatory decisions in this regard in a minute let me just ask as a follow up or an aside question and I don't think I saw this new report. . So you may not have these numbers top of mind but worth asking, , can you give an approximation of the cost? ? To the Medicare program at least relative to the overuse I, , mean, , this is a massive amount of money in reimbursement for these medications. . I don't remember offhand. . Let's see I think in the in the actually in the report we got <hes>. . About one third of older adult Medicare part d enrolling with dementia who spent more than one hundred days in a nursing humber prescribed antipsychotic in two, , thousand, , twelve constituting roughly three, , hundred, , sixty, three, , , million part D plan payments that year <hes>, , and of course, , there's also cost associated with hospitalizations for inappropriate use of these drugs <hes>. . So I would expect you know that that that is obviously very under an understatement <hes> understated estimate that does not capture the full realm of payments. . So it's it's fairly substantial. .

FDA Dr David Graham Rachel Dolan Dr Dole US Human Rights Watch Nursing Home Facility House Energy and Commerce Comm Diana Zuckerman Hannah Lamb Rispler Richard Mollet Sarah Executive Director Long Term Care Community
Dr. Rachel Dolan Discusses The Antipsychotic Drug Epidemic

The Healthcare Policy Podcast

05:54 min | 11 months ago

Dr. Rachel Dolan Discusses The Antipsychotic Drug Epidemic

"Welcome to the healthcare policy podcast on the host David Intra. Kosovo. With me today Dr Rachel Dolan the US House of Representatives ways and Means Committee majority staffer to discuss the majority staffs recently released report titled Under enforced and over prescribed. ANTIPSYCHOTIC drug epidemic ravaging America's nursing homes. Dr Dole and welcome to the program. I David thanks so much for having me. Please call me Rachel. While this'll be the last time Dr Dolan's bio is posted on, of course, the podcast website. In testimony before the House Energy and Commerce Committee two, thousand seven, the FDA's Dr David Graham stated quote. Unquote. Fifteen thousand adults elderly people in nursing homes are dying each year from the off label use of antipsychotic medications. For an indication that the FDA knows the drug doesn't work the problem has been only FDA for years and years close quote. Legal the FDA does provide a black box warning label. Regarding off label use of these drugs, eleven years later, Human Rights Watch published a report titled They Want Docile. How. Nursing homes in the US overmedicated people with dementia. The report found in two thousand, sixteen, seventeen quote unquote massive use or abuse of Anti Psychotics, for example, Sarah. Quel. Doll and Rispler doll that have serious side effects including sudden cardiac death. The human rights report estimated in an average week over one hundred, seventy, nine, thousand, long-stay Nursing Home Facility patients who administered antipsychotic drugs. Without a diagnosis which the drugs are indicated or approved rover, polar disorder and schizophrenia in testimony the ways and means. Committee. Heard this past November Richard Mollet Executive Director of the Long Term Care Community coalition concluded quote the use of San Anti psychotics in skilled nursing facilities is so extensive that puts the US in violation of internal conventions and covenants on torture and cruel inhumane and degrading treatment or punishment. Close quote. This is my third related interview. In December twenty twelve I discussed the topic with Diana Zuckerman. And in February, eighteen high interviewed Hannah Lamb who authored the above mentioned human rights report. With me again to discuss the ways and means report just released titled Under enforced and over prescribed is Rachel Dolan the reports lead author. So that Rachel as background let's get right into this or immediate neatly into the specifics of the report. What did the report find regarding the extent to which? They're persists overuse or misuse of anti psychotics in skilled nursing. David. So the report showed what what you what we would expect from your introduction, which is the use of antipsychotic does persist in nursing homes across the country and it remains quite high and not of course, has implications for patient safety and and health We found in the fourth quarter of Twenty nineteen approximately twenty percent of all skilled nursing facility residents in the US. So that's about two, hundred, Ninety, eight, thousand, six, hundred, fifty people every week received some form of antipsychotic medication and most of that was without any psychosis diagnosis for which these drugs are indicated So specifically, we actually looked at trends and surveyor citations for unnecessary medication use in nursing home. So that's kind of the. Part of this study and what we found was a clear change in citation rates for these facilities between the change in administrations from the Obama Administration to trump administration So we found citations for antipsychotic misuse in sniffs increased by two hundred percent between twenty, fifteen, twenty seventeen but then declined by twenty two percent from two thousand, seventeen to twenty eighteen, and importantly a ten percent of citations associated with actual harm or immediate jeopardy to a residence health or safety. So those are some of the most severe citation surveyors ever capture resulted in no fine from twenty seventeen to twenty eighteen under the trump administration. So you know. I. Would say even though this study in particular couldn't determine causation we we did see a clear association between the Trump Administration's regulatory rollback campaign twenty, seventeen, twenty eighteen and a reduction in citations for these particular drugs. Okay thank you and we'll get into the trump administration's regulatory decisions in this regard in a minute let me just ask as a follow up or an aside question and I don't think I saw this new report. So you may not have these numbers top of mind but worth asking, can you give an approximation of the cost? To the Medicare program at least relative to the overuse I, mean, this is a massive amount of money in reimbursement for these medications. I don't remember offhand. Let's see I think in the in the actually in the report we got About one third of older adult Medicare part d enrolling with dementia who spent more than one hundred days in a nursing humber prescribed antipsychotic in two, thousand, twelve constituting roughly three, hundred, sixty, three, million part D plan payments that year and of course, there's also cost associated with hospitalizations for inappropriate use of these drugs So I would expect you know that that that is obviously very under an understatement understated estimate that does not capture the full realm of payments. So it's it's fairly substantial.

Dr Rachel Dolan FDA David Intra United States Antipsychotic Trump Administration Nursing Home Facility Dr Dole Us House Of Representatives Dr David Graham Human Rights Watch Kosovo House Energy And Commerce Comm Means Committee Diana Zuckerman America Obama Administration Psychosis Rispler
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

05:55 min | 1 year ago

"david intra" Discussed on The Healthcare Policy Podcast

"Welcome to the healthcare policy podcast on the host. . David Intra. . Cosso with me today discussed the nation's response, , the ongoing Kobe nineteen, , pandemic and context of healthcare ethics. . Is Dr. . Charles, , Brinkley the director of bioethics at the Santa Clara University's or coolest center for Applied Ethics. . Dr Bank welcome to the program. . Thank you, , David. . It's really good to be with you today I have to say dark billy Bigley I particularly appreciate time since of course, , California's once again. . Experiencing another unprecedented wildfire season. . So thank you. . For making. . Absolutely it's a real privilege to be on the show Dr. Bentley's . vile is, , of course, , posted on the podcast website. . On background, , our nation's response to the ongoing covid nineteen pandemic has been I would characterize as disastrous. . For example, as , has been widely reported approximately one third of all Kobe. . Nineteen related deaths have been among Nursing Home Facility residents. . African Americans have been more than twice as likely as non Hispanic whites to die of covid nineteen complications. . Inadequately protected healthcare providers. . Now conveniently turned heroes in a war against Covid as if the virus will one day surrender. . Defeated, , have been required to work in lethal environments as for Service Workers Moreover, , minorities instead of recognizing their do a livable wage. . Health Insurance and or sick leave. . We term essential workers and give them a hand. . Clap. . Has for the federal government's response to the president's sensitivity apparently goes so far as his stating, , it is what it is. . That the dictionary defines a business phrase that can be literally translated as and pardon my French fuck it. . As for the Congress's response seventy, , five percent of direct and indirect cares act money's went to corporations any forthcoming or additional federal response must include for the Senate Majority Leader Mitch McConnell's prerequisite covid related legal immunity protection, , or legislation consistent with what over twenty states have adopted to date. . Are Spas the pandemic in some brings to light the chasm that continues to exist between medical ethics. . Requires provider to support the betterment of public health and a responsibility to seek positive forms that are in the best injures of patience. . And how we deliver health care that is substantially profit motive dominated. . I'll add in my nearly twenty five years doing healthcare policy work in DC. . I never wants to tenor meeting or participated in a conversation with the speaker disgust or made reference to, , for example, , John Rawls veil of big nurturance or tick him Olam. . With Megan discuss the woeful state of healthcare ethics in the time of Covid is again Dr Charles Bentley. . So with that as a somewhat lengthy introduction Dr Brinkley. . Limb in assuming, , you'd largely agree federal policymakers have to understated done a poor job of living up to their obligations and responding to the pandemic. . So my question is in your view what generally accounts for this. . David I. . Think from a public policy perspective. . Many of the issues have become overly politicized. . So for instance, , things like mask wearing school reopenings, , how to reopen the economy have not always been based solely on the best medical or scientific principles but they've been put us is to take, for , instance, , the initial recommendations from the Centers for Disease Control and Prevention about school reopening those were revised based on the administration's desire to somehow make them more applicable or to open up things more aggressively. . So science hasn't always. . been the most respected voice <hes> in the pandemic <hes> Dr. Falcone . has emerged as really a hero for what is truth, , and so you have to consider the perspective of physicians in making recommendations in a physician or a scientist in general is going to base recommendations on doing good and avoiding harm. . That's really the ethical principle of medicine, , and so for instance, , plan the American Academy of Pediatrics Recommendations for. . School reopening is a very child centric perspective as well. . You would expect the group of pediatricians to speak from the perspective of children and when you take the balance of school opening on the whole, , it's far more advantageous to children for schools to be reopened not only because of the intellectual benefit schools provide but all the other resources of schools provide for children besides the traditional reading writing and arithmetic. . Takes Her instance the number of hungry children who rely on schools for nourishment, , the number of children but medical problems who rely on schools For their care asthma screening vision dental care. . You look at children with disabilities who really are dependent on their schools, , not only for learning but also for occupational therapy physical therapy and those students not only are not progressing in minsters they're regressing during the pandemic when they're not in schools, , you can't substitute the services that they were offered in person with remote learning and must be heartbreaking to those parents to see their children regress in this time. . So really the perspective of the most vulnerable and some ways has come to light. . During the pandemic when I think globally about how ethics the affected the pandemic

Mitch McConnell Senate Majority president Congress DC
Dr. Charles Binkley Discusses Medical Ethics in the Time of COVID-19

The Healthcare Policy Podcast

05:55 min | 1 year ago

Dr. Charles Binkley Discusses Medical Ethics in the Time of COVID-19

"Welcome to the healthcare policy podcast on the host. David Intra. Cosso with me today discussed the nation's response, the ongoing Kobe nineteen, pandemic and context of healthcare ethics. Is Dr. Charles, Brinkley the director of bioethics at the Santa Clara University's or coolest center for Applied Ethics. Dr Bank welcome to the program. Thank you, David. It's really good to be with you today I have to say dark billy Bigley I particularly appreciate time since of course, California's once again. Experiencing another unprecedented wildfire season. So thank you. For making. Absolutely it's a real privilege to be on the show Dr. Bentley's vile is, of course, posted on the podcast website. On background, our nation's response to the ongoing covid nineteen pandemic has been I would characterize as disastrous. For example, as has been widely reported approximately one third of all Kobe. Nineteen related deaths have been among Nursing Home Facility residents. African Americans have been more than twice as likely as non Hispanic whites to die of covid nineteen complications. Inadequately protected healthcare providers. Now conveniently turned heroes in a war against Covid as if the virus will one day surrender. Defeated, have been required to work in lethal environments as for Service Workers Moreover, minorities instead of recognizing their do a livable wage. Health Insurance and or sick leave. We term essential workers and give them a hand. Clap. Has for the federal government's response to the president's sensitivity apparently goes so far as his stating, it is what it is. That the dictionary defines a business phrase that can be literally translated as and pardon my French fuck it. As for the Congress's response seventy, five percent of direct and indirect cares act money's went to corporations any forthcoming or additional federal response must include for the Senate Majority Leader Mitch McConnell's prerequisite covid related legal immunity protection, or legislation consistent with what over twenty states have adopted to date. Are Spas the pandemic in some brings to light the chasm that continues to exist between medical ethics. Requires provider to support the betterment of public health and a responsibility to seek positive forms that are in the best injures of patience. And how we deliver health care that is substantially profit motive dominated. I'll add in my nearly twenty five years doing healthcare policy work in DC. I never wants to tenor meeting or participated in a conversation with the speaker disgust or made reference to, for example, John Rawls veil of big nurturance or tick him Olam. With Megan discuss the woeful state of healthcare ethics in the time of Covid is again Dr Charles Bentley. So with that as a somewhat lengthy introduction Dr Brinkley. Limb in assuming, you'd largely agree federal policymakers have to understated done a poor job of living up to their obligations and responding to the pandemic. So my question is in your view what generally accounts for this. David I. Think from a public policy perspective. Many of the issues have become overly politicized. So for instance, things like mask wearing school reopenings, how to reopen the economy have not always been based solely on the best medical or scientific principles but they've been put us is to take, for instance, the initial recommendations from the Centers for Disease Control and Prevention about school reopening those were revised based on the administration's desire to somehow make them more applicable or to open up things more aggressively. So science hasn't always. been the most respected voice in the pandemic Dr. Falcone has emerged as really a hero for what is truth, and so you have to consider the perspective of physicians in making recommendations in a physician or a scientist in general is going to base recommendations on doing good and avoiding harm. That's really the ethical principle of medicine, and so for instance, plan the American Academy of Pediatrics Recommendations for. School reopening is a very child centric perspective as well. You would expect the group of pediatricians to speak from the perspective of children and when you take the balance of school opening on the whole, it's far more advantageous to children for schools to be reopened not only because of the intellectual benefit schools provide but all the other resources of schools provide for children besides the traditional reading writing and arithmetic. Takes Her instance the number of hungry children who rely on schools for nourishment, the number of children but medical problems who rely on schools For their care asthma screening vision dental care. You look at children with disabilities who really are dependent on their schools, not only for learning but also for occupational therapy physical therapy and those students not only are not progressing in minsters they're regressing during the pandemic when they're not in schools, you can't substitute the services that they were offered in person with remote learning and must be heartbreaking to those parents to see their children regress in this time. So really the perspective of the most vulnerable and some ways has come to light. During the pandemic when I think globally about how ethics the affected the pandemic

Dr Charles Bentley Covid Dr Brinkley David Intra Dr Bank Center For Applied Ethics Centers For Disease Control An Kobe Billy Bigley Santa Clara University John Rawls California Nursing Home Facility Mitch Mcconnell American Academy Of Pediatrics Congress Director
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

02:42 min | 1 year ago

"david intra" Discussed on The Healthcare Policy Podcast

"We're properly paying the people we count on to serve us. Thank you for that. I'll just note on the details, his proposal, which also includes a child care related childcare benefits, and that is this proposal, some estimated seven, hundred, seventy, five, billion over ten years and concerning home and community based services point while taken since the proposal notes that there eight hundred thousand people on the wait list in those states that have such a benefit. Under the Medicaid program so it is a substantial problem. Have the. Way. are used as an indicator, but we know that waiting with her dressed indicator people go on them. Awesome. How meaningful they are is is an open question although it's certainly reflects their many more people wanting service than they're getting it but I think the number who wanted are larger than you sing on a waiting list cause people don't apply if they're if they're not going to get benefits, right? Yes. The chilling effect. Yes absolutely. Great Point. There is one other mystery aspect to this proposal in it and I'll ask you just if you have any idea what this is, but it states that. If elected, the administration will establish a long term services and supports innovation. Fund. Do you have any idea what that That would amount to I I. I have seen no more than it is in that proposal and I believe what it signals is a commitment on the part of a what would be president. Biden to enhance service provisions more broadly in this area I'd like to think of it as signal his interest in expanding legislation or in developing legislation like that we've talked about. Okay Judy we're at our time. So I appreciate this worldwide overview of a complicated subject So very helpful. Let's see where we go in the next say ten to twelve months, and maybe we can revisit this a relative progress. May I pleasure David I? So appreciate your interest and I'm very hopeful that in coming months, we'll have an opportunity to talk about moving forward in this really necessary area service that we have ignored for so long. Thank you again. You have just heard another edition of the healthcare policy podcast hosted by David Intra Cosso to comment on this program or others to see information about upcoming interviews to suggest a program topic or here an archive program. Please visit our website the healthcare policy podcast dot com. Thank you for listening please listen again soon..

David Intra Cosso Great Point Biden president Judy
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

05:10 min | 1 year ago

"david intra" Discussed on The Healthcare Policy Podcast

"Welcome to the healthcare policy podcast on the host David Intra Cosso. During. This podcast saw discussed with Mr. Randy ostrow, president and CEO Pro-meta and Ohio based nonprofit healthcare system. Efforts to create a congressionally mandated National Health Care Reform Commission. Miss Joe Stra. Welcome to the program. Missed oestrus bio is of course posted on the podcast website. On background. The current public health emergency brings into stark relief, US healthcare's ineffectiveness. I've noted previously with four point, two five percent of the world's population us currently accounts for twenty six percent of worldwide Kobe, nineteen infections and deaths. Black American Cova deaths and hospitalizations are respectively two point five and four times greater than American whites. Concerning our response to date harbor widely cited global health professor. A she's jaw was quoted yesterday stating we may end up being the worst of any country in the world in terms of our response. Despite outspending all other always OECD countries to to one currently at four trillion annually, the effects of the pandemic is having should not altogether unexpected. In, the first major attempt to rank performance in two thousand, the World Health, organization listed US healthcare thirty seven, the world immediately after the Czech Republic and Jamaica. More recently twenty seventeen Commonwealth Fund ranked US healthcare's performance last among eleven, comparatively wealthy countries. With a current projected toll over two hundred thousand by October one. The question begged is what will federal policymakers learn from this experience more specifically. What will they do to reform? How healthcare is defined delivered and financed. With me again to discuss efforts to create a congressionally mandated national health care reform. Commission is chromatic. CEO Randy Oestra. For purposes of full disclosure I've been working with Primerica in advocating before the Congress on this issue. So to begin Randall, let me ask you if you could provide a brief overview of pro-meta. Sure. <hes>. Was a traditional integrated delivery system regional and an integrated system. We had hospitals. and. Doctors had an insurance company and then <hes> so we were several billion dollars in revenue primarily. Ohio sawfish Michigan and then about ten years ago. <hes> through. A variety of of interactions <hes> became <hes> very focused on of the hunger in the health issues, good as security that really less in spending a decade Fox's on the social determinants of health and a lot of experience. A lot of stories could tell as we talked to organizations around the country that have that were forever covering. We were probably the first houses than they ever talk to them. They said you know. What are you doing here? And then the next special as we're in the of bed and really it's been quite a journey of. Over two years ago while we purchase <hes>. largest for profit, senior companies in the United States cold hr matter. And <hes> so today we would call ourselves the health and wellbeing company <hes>. We're around. You know just in broad terms of seven billion dollars innovation we, we work in twenty eight states, and really the whole idea is about that. How do you integrate? Things, we do clinically with the things that immediately drafts from a social economic standpoint. You ready records some of that code, and then hot that translate into healthy aging, and all the things that go with it, some of the inequities in healthcare from the inequities treatments, and so we set back from an looking for model <hes> in healthcare in realize that we're ought to relieve wrong, pat. We Really Kinda Organization. Try to embark. Do APP, and that's his house voting folks. Okay thank you. Let's go specific to of a national commission, so let me begin with the substantive question, and that is in your experience. What would you say are the three or so overriding structural problems or challenges? Confronting Health Care Delivery and financing today. Yeah I think it's actually a a US question while. You know the American healthcare mile was a mess. <hes> I. Think you know that's real clear and I think when you look at the statistics have to go too far whether it's you know the back that we're headed toward ninety percent of the gross domestic. Product by twenty twenty five the statistic. Thank you get already cited from the OECD. Ranked in the world

US David National Health Care Reform Co David Intra Cosso CEO Randy Oestra policy analyst Mr. Randy ostrow World Health Primerica Joe Stra president and CEO Randall OECD Commonwealth Fund Kobe Ohio professor
Why we need a Congressionally Created National Health Care Reform Commission

The Healthcare Policy Podcast

05:10 min | 1 year ago

Why we need a Congressionally Created National Health Care Reform Commission

"Welcome to the healthcare policy podcast on the host David Intra Cosso. During. This podcast saw discussed with Mr. Randy ostrow, president and CEO Pro-meta and Ohio based nonprofit healthcare system. Efforts to create a congressionally mandated National Health Care Reform Commission. Miss Joe Stra. Welcome to the program. Missed oestrus bio is of course posted on the podcast website. On background. The current public health emergency brings into stark relief, US healthcare's ineffectiveness. I've noted previously with four point, two five percent of the world's population us currently accounts for twenty six percent of worldwide Kobe, nineteen infections and deaths. Black American Cova deaths and hospitalizations are respectively two point five and four times greater than American whites. Concerning our response to date harbor widely cited global health professor. A she's jaw was quoted yesterday stating we may end up being the worst of any country in the world in terms of our response. Despite outspending all other always OECD countries to to one currently at four trillion annually, the effects of the pandemic is having should not altogether unexpected. In, the first major attempt to rank performance in two thousand, the World Health, organization listed US healthcare thirty seven, the world immediately after the Czech Republic and Jamaica. More recently twenty seventeen Commonwealth Fund ranked US healthcare's performance last among eleven, comparatively wealthy countries. With a current projected toll over two hundred thousand by October one. The question begged is what will federal policymakers learn from this experience more specifically. What will they do to reform? How healthcare is defined delivered and financed. With me again to discuss efforts to create a congressionally mandated national health care reform. Commission is chromatic. CEO Randy Oestra. For purposes of full disclosure I've been working with Primerica in advocating before the Congress on this issue. So to begin Randall, let me ask you if you could provide a brief overview of pro-meta. Sure. Was a traditional integrated delivery system regional and an integrated system. We had hospitals. and. Doctors had an insurance company and then so we were several billion dollars in revenue primarily. Ohio sawfish Michigan and then about ten years ago. through. A variety of of interactions became very focused on of the hunger in the health issues, good as security that really less in spending a decade Fox's on the social determinants of health and a lot of experience. A lot of stories could tell as we talked to organizations around the country that have that were forever covering. We were probably the first houses than they ever talk to them. They said you know. What are you doing here? And then the next special as we're in the of bed and really it's been quite a journey of. Over two years ago while we purchase largest for profit, senior companies in the United States cold hr matter. And so today we would call ourselves the health and wellbeing company We're around. You know just in broad terms of seven billion dollars innovation we, we work in twenty eight states, and really the whole idea is about that. How do you integrate? Things, we do clinically with the things that immediately drafts from a social economic standpoint. You ready records some of that code, and then hot that translate into healthy aging, and all the things that go with it, some of the inequities in healthcare from the inequities treatments, and so we set back from an looking for model in healthcare in realize that we're ought to relieve wrong, pat. We Really Kinda Organization. Try to embark. Do APP, and that's his house voting folks. Okay thank you. Let's go specific to of a national commission, so let me begin with the substantive question, and that is in your experience. What would you say are the three or so overriding structural problems or challenges? Confronting Health Care Delivery and financing today. Yeah I think it's actually a a US question while. You know the American healthcare mile was a mess. I. Think you know that's real clear and I think when you look at the statistics have to go too far whether it's you know the back that we're headed toward ninety percent of the gross domestic. Product by twenty twenty five the statistic. Thank you get already cited from the OECD. Ranked in the world

United States World Health National Health Care Reform Co Oecd Ohio President And Ceo David Intra Cosso Mr. Randy Ostrow Joe Stra Ceo Randy Oestra Commonwealth Fund Primerica Kobe Randall Professor Congress
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

02:40 min | 1 year ago

"david intra" Discussed on The Healthcare Policy Podcast

"Topics of substantial national importance. Your host for the program is David. Cosso a DC based healthcare policy analyst and We invite you to comment on the program by visiting the healthcare. Policy podcasts. Dot Com. Now, Here's David. Welcome to the healthcare policy podcast on the host David Intra Cosso. During. This podcast saw discussed with Mr. Randy ostrow, president and CEO Pro-meta and Ohio based nonprofit healthcare system. Efforts to create a congressionally mandated National Health Care Reform Commission. Miss Joe Stra. Welcome to the program. Missed oestrus bio is of course posted on the podcast website. On background. The current public health emergency brings into stark relief, US healthcare's ineffectiveness. I've noted previously with four point, two five percent of the world's population us currently accounts for twenty six percent of worldwide Kobe, nineteen infections and deaths. Black American Cova deaths and hospitalizations are respectively two point five and four times greater than American whites. Concerning our response to date harbor widely cited global health professor. A she's jaw was quoted yesterday stating we may end up being the worst of any country in the world in terms of our response. Despite outspending all other always OECD countries to to one currently at four trillion annually, the effects of the pandemic is having should not altogether unexpected. In, the first major attempt to rank performance in two thousand, the World Health, organization listed US healthcare thirty seven, the world immediately after the Czech Republic and Jamaica. More recently twenty seventeen Commonwealth Fund ranked US healthcare's performance last among eleven, comparatively wealthy countries. With a current projected toll over two hundred thousand by October one. The question begged is what will federal policymakers learn from this experience more specifically. What will they do to reform? How healthcare is defined delivered and financed. With me again to discuss efforts to create a congressionally mandated national health care reform. Commission is chromatic. CEO Randy Oestra. For purposes of full disclosure I've been working with Primerica in advocating before the Congress on this issue. So to begin Randall, let me ask you if you could provide a brief overview of pro-meta. Sure. Was a traditional integrated delivery system.

US David National Health Care Reform Co David Intra Cosso CEO Randy Oestra policy analyst Mr. Randy ostrow World Health Primerica Joe Stra president and CEO Randall OECD Commonwealth Fund Kobe Ohio professor
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

02:29 min | 1 year ago

"david intra" Discussed on The Healthcare Policy Podcast

"To maintain some fidelity to that reciprocal relationship. and do your job as you see best, which is say. Do Your job. Don't worry about keeping your job. I would say sometimes they come in conflict, if not more often than you like and I'd say always err on the side of doing your job if you should happen at fired. Or there's there's some downside to that. I'd say long term. This is about your own development, so keep that first and foremost or primary always. Err on the side of doing your job or is sight Martin Luther King and the time has always ripe to right. Right and I think clean DC certainly elsewhere. Really the bottom line is your reputation, so have you noticed an honest broker? You Demonstrate Fidelity to the research they sent. The research is clear out of your career will take care of itself. If you compromise your reputation over time, that almost becomes a problem. You can't get out from under, or you can't defeat, and lastly I would say it's cliche realized, but you know probably best to flick the comfortable and comfort the afflicted. Of course. This is a serious subject healthcare. This is about sickness disease illness death. Not something we should take lightly. Everyone in my view deserves optimal care or should have the ability to achieve optimal health or far from that, so she worked towards that goal. The extent of correlates to career success or not. Hide I put that far distant second. So that's what I would say generally. Thank you. David think that covers all the questions we have at this time. Thank you for having me on to ask them. And I WANNA. Remind everyone you mentioned in part one that listeners with any additional follow up. Questions should feel free to email them in. Yes, please. And thank you for taking your time and. And running me through this. Thanks a lot David I. really appreciate it. I had a Lotta Fun and have a good evening. Take Care Bye. You have just heard another edition of the healthcare policy podcast hosted by David. Intra Cosso to come on this program or others to see information about upcoming interviews to suggest a program topic or to here an archive program. Please visit our website. The healthcare policy PODCAST DOT com. Thank you for listening. Please listen again soon..

David I. Martin Luther King
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

03:42 min | 1 year ago

"david intra" Discussed on The Healthcare Policy Podcast

"We go full <Music> bore into <Speech_Music_Male> the <Speech_Male> Technologies <Speech_Male> beyond <Speech_Male> you know person <Speech_Telephony_Male> to person communication <Speech_Telephony_Male> <Speech_Telephony_Male> Thinking <Speech_Music_Male> that that could be <Speech_Male> an easy substitution <Speech_Male> for them. <Speech_Male> It it <Speech_Male> on one hand. It's it <Speech_Telephony_Male> seems like an easy <Speech_Male> way to to deal <Speech_Telephony_Male> with things <Speech_Music_Male> but I think <Speech_Telephony_Male> On the other <Speech_Music_Male> I think it is. There's <Speech_Telephony_Male> some there's <Speech_Telephony_Male> some real ethical issues <Speech_Telephony_Male> in terms of <Speech_Music_Male> you know <Speech_Music_Male> I can see <Speech_Telephony_Male> a family for example <Music> <hes> <Speech_Music_Male> Getting a robotic <Speech_Male> dog and <Speech_Male> and giving it to <Music> a parent and <Speech_Male> then thinking that solves <Speech_Music_Male> the problem and leaving <Speech_Male> in not <Speech_Male> with <Speech_Music_Male> the parent as much and <Speech_Male> that can be a real problematic <Speech_Male> <SpeakerChange> substitute <Speech_Male> right <Speech_Male> <Speech_Male> and let my last <Speech_Male> question <Speech_Male> So <Speech_Male> my understanding is this was <Speech_Male> largely funded by <Speech_Male> the AARP. <Speech_Male> Which explains <Speech_Male> why the emphasis <Speech_Male> is on <Speech_Male> Adult <SpeakerChange> or senior population <Speech_Male> <Speech_Male> <Speech_Male> or mentioned <Speech_Male> Aarp Foundation <Speech_Male> <Speech_Music_Male> <SpeakerChange> <Speech_Male> Aarp <Speech_Male> cracked <Speech_Male> <Speech_Male> So the question always <Speech_Male> here is what <Speech_Male> <Speech_Male> Other producing the report <Speech_Male> <Speech_Male> How would you understand <Speech_Male> how this'll <Speech_Male> be used? <Speech_Male> And try to <Speech_Male> move the <Speech_Male> Improve <Speech_Male> <SpeakerChange> healthcare <Speech_Male> delivery in this regard <Speech_Music_Male> <Speech_Music_Male> well. Aarp <Speech_Male> has a number of projects <Speech_Telephony_Male> right now <Speech_Male> and in the foundation <Speech_Male> is is supporting <Speech_Male> a number of projects <Speech_Male> to try to <Speech_Music_Male> do. With this <Speech_Male> problem of loneliness. <Speech_Male> Overall our <Speech_Male> goal <Speech_Male> was <Speech_Male> to <Speech_Music_Male> try to identify <Speech_Music_Male> what the overall <Speech_Music_Male> problem was <Speech_Telephony_Male> and specifically focusing <Speech_Male> on the health outcomes <Speech_Male> <Speech_Male> and then the goal <Speech_Telephony_Male> was to find <Speech_Music_Male> ways in which the <Speech_Male> healthcare profession <Speech_Telephony_Male> as I mentioned <Speech_Male> before <Music> wide <Music> Could <Speech_Male> intervene in <Speech_Male> ways that could <Speech_Male> alleviate <Speech_Male> this overall <Speech_Male> problem assist <Speech_Male> on this <Speech_Male> focus specifically <Speech_Male> on the elderly. <Speech_Telephony_Male> <Speech_Male> So this is a part <Speech_Male> of a larger <Speech_Male> project. <Speech_Male> I think it's a central <Speech_Male> part of it. But <Speech_Male> it is a part of <Speech_Male> the less <Speech_Music_Male> and so we need to keep <Speech_Music_Male> that in mind <Speech_Male> as we go <Speech_Male> forward. <Speech_Male> I think we're <Speech_Male> seeing people <Speech_Male> come out of the woodwork. <Speech_Male> Right now <Speech_Telephony_Male> in terms of studies <Speech_Male> in commentaries <Speech_Male> etc <Speech_Male> own loneliness <Speech_Telephony_Male> social isolation <Speech_Male> and. That's all <Speech_Music_Male> to the good <Speech_Male> I think <Speech_Male> we have to be careful <Speech_Male> with these. <Speech_Male> And I've seen <Speech_Telephony_Male> some of these that I <Speech_Male> actually do have <Speech_Male> some concerns about <Speech_Male> because <Speech_Male> what we <Speech_Male> might be seeing <Speech_Telephony_Male> or opinions <Speech_Male> and <Speech_Male> A lot of raw <Speech_Male> about the <Speech_Male> importance of this without <Speech_Male> a lot of evidence <Speech_Male> and so <Speech_Male> one thing about national <Speech_Male> academy <Speech_Music_Male> <Speech_Male> that they are evidenced <Speech_Male> based <Speech_Male> did not wander <Speech_Male> beyond the evidence <Speech_Male> as much as we possibly <Speech_Male> could do <Speech_Male> so. <Speech_Telephony_Male> I think we really <Speech_Male> need to be <Speech_Male> aggressive. <Speech_Male> But <Speech_Male> we also need to be cautious <Speech_Telephony_Male> about the types <Speech_Male> of things where we <Speech_Male> react <SpeakerChange> recommending <Speech_Male> <Speech_Male> right. It wasn't <Speech_Male> lost on me <Speech_Male> the phrase evidence-based <Speech_Male> used <Speech_Male> repeatedly as <Speech_Male> typical for these <Speech_Male> NASA <Speech_Male> documents. So <Speech_Male> with that <Speech_Male> a doctor Blazer. I <Speech_Male> WanNa thank you for <Speech_Male> <Speech_Male> this conversation. <Speech_Male> I. I'm feeling <Speech_Male> less lonely during <Speech_Male> the pandemic <Speech_Male> so I appreciate <Speech_Male> the opportunity to discuss <Speech_Male> <Speech_Male> This subject <Speech_Male> <Speech_Male> And I hope <Speech_Male> <Speech_Male> this does <Speech_Male> produce <Speech_Male> a positive effect in <Speech_Male> how we <Speech_Male> deliver <Speech_Male> care. So <SpeakerChange> thank you <Speech_Male> <Advertisement> again. <Speech_Male> You're welcome and thank <Speech_Telephony_Male> you for taking on <Speech_Telephony_Male> this topic. <Speech_Male> <Speech_Male> You have just heard <Speech_Male> another addition of <Speech_Male> the healthcare policy <Speech_Male> podcast hosted <Speech_Male> by David. Intra Cosso <Speech_Male> to comment <Speech_Male> on this program <Speech_Male> or others <Speech_Male> to see information about <Speech_Male> upcoming interviews <Speech_Male> to suggest <Speech_Male> a program topic <Speech_Male> or two here <Speech_Male> an archive program. <Speech_Male> Please visit our <Speech_Male> website the healthcare <Speech_Male> policy podcast <Silence> dot com. Thank you for listening. And please listen again soon.

"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

11:25 min | 1 year ago

"david intra" Discussed on The Healthcare Policy Podcast

"Here's David Welcome to the healthcare policy podcast on the host David Intra Cosso during this podcast will discuss the healthcare needs of the homeless when they reached the point of homelessness and David you mentioned earlier in your introduction the disparity of that rate reminded me that our healthcare delivery.

David Intra Cosso
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

17:04 min | 2 years ago

"david intra" Discussed on The Healthcare Policy Podcast

"Of substantial national importance. Your host for the program is david intraco a dc based healthcare policy analyst and researcher. We invite you to comment on a program by visiting the healthcare policy podcasts dot com now. Here's here's david welcome to healthcare policy podcast on the host david intra cosso during this podcast discuss with psychiatrist. Dr louis cohen one his recently published work a dignified ending taking control over how we die doctor cohen's bio is of course posted on the podcasts is website. Dr cohen welcome to the program david. Thank you so much and you can go with dr cohn. You could call me lou okay well. I think i'll devolve into lou. Thank you briefly on background. Assisted suicide or medical aid in dying is today legal in nine states and d._c. In order of passage oregon in one thousand nine hundred ninety four followed by washington montana vermont california colorado in d._c. Hawaii new jersey this year and it will be legal starting next year in the state of maine. The option is available to approximately one fifth of the u._s. Population in some related legislation has also been proposed in over twenty other or additional states ten state medical societies now allow physicians to default a course of treatment that comports with their conscience concerning public opinion he two thousand eighteen gallup poll found that three out of four american support laws allowing patients to seek the assistance of a physician in ending their life overseas medical aid and dying is legal in several countries including belgium canada luxembourg. The netherlands and switzerland listeners may be aware end of life has been the topic of several previous interviews last related was with the journalist and newman this past april fifteenth concerning a harper's article this past february on mercy killings clings with mcguinness gus latest work is dr louis cohen a dignified ending <hes> lou <hes> with that as a brief background introduction. Let me start by asking you particularly. Since you're a psychiatrist. How did suicide become defined as a mental illness well <hes> there was if you will evolution that has taken place is <hes> where if you want to <hes> <hes> start back in times in which there's maybe five or a half a dozen <hes> instances <hes> that are spelled out at people who took their lives who committed suicide <hes> one of the interesting things is that in the bible <hes> and i'm counting the new testament in this <hes> those acts those suicidal ex are not looked on on necessarily in a negative way <hes> if anything they are many of them are viewed with considerable admiration <hes> and as <hes> things that one might <hes> even aspired to <hes> <hes> <hes> so in christianity and judaism <hes> there was an evolution evolution and thinking <hes> the <hes> <hes> can be seen <hes> if you go back by the way to <hes> pretty can roman times <hes> there have been different periods in which again <hes> taking one's life <hes> was viewed as not necessarily a negative thing thing or <hes> an aberrant thing <hes> but a noble death was something that's the stoic <hes> <hes> put out there <hes> something that people <hes> should spouse and hope to achieve that people should be able to die in a way. That's consistent with how they lived. <hes> it's really <hes> comfortable augustine <hes> in the fifth century the suddenly there's a link made <hes> among the religious <hes> and which <hes> they point to the ten commandments and thou shalt not on kill or murder <hes> augustine suggested that applied also to killing oneself <hes> the suddenly suddenly <hes> suicide became sin suicide became not just a sin <hes> but <hes> something that was was prohibited something that had <hes> religious consequences <hes> <hes> in medieval times <hes> <hes> <hes> one was assured that one was going to go right to hell <hes> and suddenly laws were being passed. Civil laws were being passed <hes> mm-hmm at that time a big piece of it probably was a <hes> financially driven part of things <hes> which is that by killing yourself. You're depriving your liege lord of all the things that you could be producing <hes> for him <hes> and <hes> so <hes> <hes> suicide side was understood various ways including ones estate was taken over by the liege lord <hes> and <hes> the <hes> superstitions began to come into play and people would be intentionally buried if they kill themselves the crossroads of so full it could literally walk over their dead bodies. <hes> those bodies were sometimes <hes> <hes> steak was driven through the heart <hes> <hes> and and began to get <hes> criminal statutes placed <hes> where people who attempted tempted suicide <hes> we're also considered criminals <hes> and would be punished in various ways and it doesn't probably until the nineteenth nineteenth century and i'm sorry david. This is a long answer to short question. Please <hes> it's not until the really the nineteenth century entry <hes> <hes> twentieth century <hes> that <hes> <hes> there's a transformation from sin to crime to mental mental illness <hes> and <hes> <hes> the suicide. Um falls into the purview of psychiatric <hes> medicine and become come something that <hes> psychiatrists colleges conditions paver medicine clinicians <hes> are instructed structed to attend to and to prevent these things from happening. Okay thank you so <hes> as we'll get to suicide can be a symptom him of mental illness but not not in all cases which clearly you imply and your relative to going back. I did find it interesting. You start your volume by discussion of hercules and philip t._t.'s which you don't normally see in these work so i applaud you for that discussion impart. Just it doesn't aside. I'm curious to know if you know relative to insurance policies say say you're in one of these nine states. What's that i mentioned and say you're in oregon and you may be on the on the death. Certificate natural causes saves physician aid in dying how to insurance policies interpret that because typically if you commit suicide. There's no and you have a policy. There's the company won't pay although if you look little bit more carefully <hes> that is often. There's a time limit on that <hes> in which the clock begins ticking when people <hes> take out those policies <hes> and i don't i don't know if the six months or one year <hes> but beyond that if you committed suicide you would still be entitled to your life insurance back <hes> but that's an aside yes. Yes okay direct answer to your question. Is that every one of the <hes> legislators <hes> that have put together. The laws regarding assisted <hes> suicide. We'll call it and i and i should say by the way i'm perfectly comfortable in this book and i choose to use all the terms assisted suicide assisted dying <hes> medical assistance in dying and so on <hes> but <hes> the laws that have been passed in this country each one of them tackles exac- the question you've raised and each one makes makes it explicit <hes> the insurance companies cannot <hes> <hes> avoid wade payment of life insurance <hes> for people who make use of those laws okay. Thank you helpful. Let's get into the book there several themes in the volume <hes> let me start with a two i found particularly interesting and useful and those are your discussions of aden dying and contexts antics of patients with disabilities and those with alzheimer's or cognitive impairment on the former <hes> the disability community unity has been for good reason <hes> very concerned about this option. Can you explain what their concern has been and how this issue has been addressed for those patients with otherwise <hes> disabilities sure and you put your finger david on the two areas that when i started writing this book i had not anticipated would be of interest to me the orchestra as much of the book as they do <hes>. They just became things that i i couldn't get away from <hes> that i just you know needed to sink my teeth teeth into <hes>. The first thing is to recognize that the so called disability community is not any kind of uniform <hes> group of people with a particular stance but rather <hes> you know like the american population <hes> is filled with different opinions <hes> on every the issue <hes> and so <hes> i have certainly encountered many folks who identify as having disabilities <hes> <hes> who <hes> are ardent supporters <hes> of their right to be able to take advent to have and to be able to take advantage of sorts so it's a laws <hes> that you've enumerated <hes> <hes> and they often will become spokespersons when these <hes> <hes> laws are debated in state legislators legislatures <hes> you do profile profile the other end which is the the organization interestingly titled not dead yet from the monty python movie <hes> they are. They are more cautious. <hes> they are ardent <hes> activists who are strongly opposition to such laws and they come out regularly <hes> to any of the debates that take place or any of the opportunities to give depositions testimonies about these laws and they come out from me against it and i've been fascinated by them mnay try to follow what they have to say on this <hes> on the subject act <hes> john kelly <hes> is one of their leaders and <hes> he features prominently <hes> in the book <hes> i mean he's a man who i can relate to in terms of <hes> white educated <hes> interested interested in the world around him <hes> but someone who has now been <hes> restricted to a wheelchair <hes> for a number of years and who has become a avid spokesperson <hes> four point of view in massachusetts on his played a major part. I thank in preventing that our state the states that i live in <hes> from in fact <hes> passing <hes> a law to address this to become one of the <hes> <hes> communities that has passed and you know what i've learned from john what i've learned from listening to the other activists listen not not dead yet <hes> which sprung up by the way in reaction to jack kevorkian's <hes> public relations campaign ryan. We'll get it to him. Okay but what i've learned is <hes> that these are folk who are terrified <hes> and there's no other word four it at what these laws <hes> the harm that they can do to the disability community <hes> community that is was dependent on <hes> receiving accommodations <hes> receiving medical care and and support <hes> that allow them to maximally function in this world <hes> and what they've you laws like this as and again. I'm speaking for them and i apologize. If i don't get it quite right they would be quick to tell me. I'm not getting it quite right. <hes> you point that out talk. Yes yeah john one <hes> truly lamb best me and i don't hesitate about voting on it <hes> but you know what they believe is that <hes> the efforts should not be placed on helping people to die from their standpoint <hes> this this is a this is suicide <hes> and that's the term that they use all the time and that the society is being hypocritical when on one hand and it <hes> spouses all sorts of prevention and treatment <hes> to help people not commit suicide and then on the other hand when then folks come down with terminal illnesses <hes> we have these laws that say <hes> yes <hes> we will <hes> the and help you set up some rules that will allow you to end your life well. It's understandable that this is obviously a a population of very vulnerable people and i think the phrase using your book relative describing their concern is that <hes> aid in dying is a seductively inexpensive alternative to comprehensive palliative care so i did note that i thought that was a well phrase phrase routed to capturing <hes>. They're concerned you do relative vulnerability their unemployment and poverty rate which course contributes to this <hes> sadly early. Let's go to persons with cognitive impairment alzheimer's. You know the statistic one in eight older adults over five million million americans. <hes> you argue that under certain circumstances. It should be allowable. Can you explain how that what those circumstances circumstances are. What that circumstance is okay. <hes> i will be glad to but let me say that the story that we've through the touch on this most directly is that the young woman who comes down with dementia and who had stated did from her earliest time that she had no interest in going whole hog with it <hes> she wanted to have her life ended before it reached the point of being being severe <hes> and her husband was in agreement and the rest of her family was in agreement <hes> but people the human organism adapts and in her case <hes> time went on and she became more demented and she ends up dying <hes> after several years having been placed in the mount timers is a unit and i come out of this. You know i come out. Is it sort of feeling like <hes> there was a moment maybe when and things could've been done differently and she could have been helped to die but that moment passed and that the right thing was done in terms of <hes> both <hes> providing her with care so that she could maximally <hes> enjoy <hes> her life <hes>.

david Dr louis cohen oregon alzheimer john kelly lou Dr cohen dr cohn d._c david intra cosso david intraco doctor cohen augustine maine belgium policy analyst dc
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

12:01 min | 2 years ago

"david intra" Discussed on The Healthcare Policy Podcast

"Of substantial national importance, your host for the program is David in Chico a DC based healthcare policy, analyst and researcher, we invite you to comment on the program by visiting the healthcare policy podcasts dot com. Now, here's David, welcome to the healthcare, posse podcast on the host David intra Cusco during this podcast will discuss with Harvard and mass general's. Dr Renee, salis the health effects of the climate crisis on children. Dr south welcome to the program. Thank you so much for having me. It's an honor to be here. Dr cells is by his, of course, posted on the podcast website briefly on background two weeks ago today, the nights circuit, court heard oral arguments concerning the Juliana versus US case, a case filed in twenty fifteen by twenty one children seeking a jury verdict on whether the us government by failing to address the climate crisis is, protecting the plaintiff's rights to life, liberty and the pursuit of happiness in its defense. The US is argument these children. Now young adults have no fundamental constitutional, right? Quote, unquote to quote a climate system. Capable of sustaining human life, close quote the data supports the plaintiff's assertion despite a substantial increase in the use of renewable resources over the past few years. For example, in twenty eighteen coal accounted for thirty eight percent of the world's power generation coal accounted for the. Zac saying thirty eight percent twenty years ago. Quit Sonali the approximate age of many of these plaintiffs. As a comparative, aside, the UK curly operates, six coal plants, if the US with approximately five times, the UK's population had a commensurate, number, it would operate thirty coal plants the US currently operates over two hundred forty in a may, thirtieth essay published in the New England Journal of medicine doctor cells and two colleagues concluded, quote, as the Juliana plaintiffs argue and we agree climate change is the greatest public health emergency in our time, and is particularly harmful to fetuses, infants children and adolescence with meniscus. What particular health? Harms the climate crisis exacting on children, or the so called Z generation is, again, Dr Sallis finally listeners may be aware. This is my seventh climate crisis related interview since last October. So that is background, Dr sows, I do know beyond a your research and your work as an emerge. Mercy physician, you are also a contributing author to the Lancet countdown annual Lancet countdown report. And you also are have signed onto an Emeka spray f- filed by thirteen organizations, including the American cannery pediatrics and others. The American pediatric society, lung and heart association's than others. In support of the Juliana plaintiffs my question in mentoring, the amiga's brief, how satisfied are not with you with the number of people organizations that have signed on, I counted thirteen. Yes, correct. You know, the Emmett brief was led by Wendy Jacobs, at the environmental law and policy clinic at Harvard Law School. You know, the goal was really to outlined the current evidence in the US for how climate change is impacting, the health of children in many facets of that were highlighted in perspective. That's Wendy and pretty Kefir from Columbia wrote. So, yeah, there were nearly eighty signatories and that included very prominent organizations, as well. So including the American kademi pediatrics American Heart Association, and the American lung association. I didn't see though the American Medical Association or the American hospital sociation on the list. Yeah. So this process, which actually Regina laroque here at M, G H really helped lead internally proved to be quite, quite a fact process. The we really had about a month to get the brief written that included essentially doing a very extensive literature search to ensure that we represented and presented, you know, the most up to date health information. And so that actually left us a very little time to be able to engage a lot of organizations. We sort of did a very broad reach an attempted to get as many signatories as possible. Unfortunately, though some institutions organizations did require longer timelines in order to approve their signature on a brief such as this. And so, I'd like to be hopeful that, if we'd had a little bit longer timeline to get that, submitted that potentially we could. Have had increasing notorious, but that said, you know very thankful for all the signatories, Bhagat and think at truly supported the gravity of what we were stating. Great. Thank you. What other background question before we get into the substance here? There are numerous cases related to Juliana, pending between actually Norway, and New Zealand and specifically last October, maybe where the Hague in the Netherlands ruled in favor of nearly nine hundred plaintiffs in that case. The confirming the fact that the Dutch government need to accelerate is reduction in greenhouse gas emissions from seventeen twenty five percent against ninety levels by twenty twenty five. So the reason I mentioned that to your knowledge or understanding is the US medical profession involved in any of these other cases says, of course, greenhouse, gas emissions don't are worldwide in any that the US emits, of course, affect the lives of people around the world. Yeah. You, you highlighted really a fundamental issue to climate change, and why there is such a health equity and social Justice component to it. Because what we do here, obviously, affects individuals halfway around the globe, and often, though, to contributed the least actually suffered the greatest health burden, and that's especially true for children, for example, that Juliana plaintiff. And so to my knowledge, I'm not aware on if other healthcare professionals at least within the US are involved in those cases, I am encouraged by the fact that I think, the, the reframing of climate change is a public health emergency that it truly is, is increasingly becoming more prominent, and I would hope that health is a prominent feature of the health impacts to those plaintiffs are being highlighted. Okay. Thank you. Let's get into the specifics here. So, again, your perspective piece, as well as the brief presents the latest research findings as relates to the health. Effects on children. I've actually typed up probably twenty that you mentioned and others about which were, so I'll leave it to you. If you would just give an overall answering are probably some follow ups on these many health effects. Please start and of course, I guess maybe the prompt you the obvious you often hear almost first relevant children has asthma. Yeah. And, you know, I think just to kind of take one step back. It's the fact that, you know what I just highlighted previously in my statement that today's children again, or that perfect example, that disturbing truths that those who do not contribute to the greenhouse gases that are really driving climate changes. Catastrophic downstream effects, those that are suffering the most health impacts. And I think, you know, the perhaps one of the most startling statistics the World Health Organization is estimated that eighty eight percent of the global health burden of climate change now, fold on children less than five years of age. So the doctor, you know, I feel an ethical moral obligation to protect their health, and obviously, one of their ways to protect their health and save lives in the generation is to shift from possible to renewable energy. And I think that also highlights relieved the connection between climate change and fossil fuel combustion, which produces air pollution, especially particularly matters. I'm into, you know, you highlighted we can, you know, asthma's obviously. A very key initial outcome. And it's you know as the exposure to air pollutants, for example, have been linked to increase mortality, who'll absenteeism, asthma-related, ED visits and admissions in cognitive and behavioral effects. And in fact, it's even been shown that early life exposure to air. Pollutants increases the child's likelihood of developing asthma, and actually having diminished lung function as a teenager. And, you know, the combustion of cool at power plants produces other toxic factors as well, such as mercury, and that's unknown potent narrow toxin for fetuses, and that's been shown to lead to reduce cognitive ability and motor function, even when children are exposed to very low levels of exposure, another big one is heat. And, you know, I think he is that you BIC witness exposure that no matter where you live within the US, you know, it can be can be exposed to it because we're some of the other. Climate change exposures tend to have geographic predisposition. And so, you know, it's been shown that in your door exposure to heat increased risk pregnancy complications and birth defects infants, especially in their first week of life or especially susceptible to heat in one study, actually, showed there was a twenty five percent increase in mortality in infants but even those that you think are, you know, young and immune to climate change. So you think about teenage athletes, for example. I mean they've shown that e visits an injuries due to heat related injuries actually increased by about one hundred thirty four percent between nineteen ninety seven and two thousand and six just to kinda hit a few other highlights, you know, infectious disease. We know that vector-borne or. He's also a climate sensitive, and those are increasing and the Zeke of iris is one of those sensitive Jesus. And I think most people are aware of the, the link spur defects that have been shown to be associated with us with a twenty one percent increase happening in that outbreak in twenty fifteen and unfortunately lime disease which, you know, I see a lot here in the northeast and even see in my practice at in the city of Boston that children between the ages of five and nine, especially our behind incidence of Lyme disease. And again, that's being having increasing incidents and also has been shown to be present in areas where previously hadn't. And then I think, you know, one of the last ones all high highlight is, you know, the mental health impacts, and I think, you know, unfortunately, all of climate change health impact, by this is the way I describe it, and I recognized the hiring of my description, and that's that it's really an iceberg in the sense that. You know, right now, we, we understand the health impacts that are above the surface of the water. But there's, unfortunately, I believe in normal burden of disease that we have yet to really characterize and understand. And I think that includes mental health impacts, and, you know, as we know that extreme weather is becoming more powerful and intense because of climate change. We unfortunately, will face more of these infants and children will be exposed to it more. So, but just as an example on what extreme weather can do to children in Hurricane Katrina, they found out of about two hundred thousand children about half of those preschool age children about seventy percent of middle school age children met the criteria for post traumatic stress disorder. And, you know, they even now found that thing called 'toxic stress where you know, went when children are exposed to these types of stresses..

US asthma World Health Organization Dr Renee David Harvard David intra Cusco American Medical Association Dr Sallis American Heart Association UK New England Journal of medicin Wendy Jacobs Lyme disease Boston Sonali Zac
Harold Miller Discusses Improving Medicare's Alternative Payment Models

The Healthcare Policy Podcast

04:54 min | 2 years ago

Harold Miller Discusses Improving Medicare's Alternative Payment Models

"To the healthcare policy podcast again on the host, David intra Cosso during this podcast, discuss Medicare's, alternative payment, models, APM's or more. Specifically, how APM's can be improved with Munis gust? The topic is president and CEO of the center for healthcare quality and payment reform herald Miller herald, welcome back to the program. Thank you. David vigor listeners may recall, I spoke with Mr Miller in September twenty fifteen moreover about bundled payments. Mr Miller's bio is of course, posted on the podcast website on background that twenty fifteen. Macro law created Medicare's advanced payment models again APM's these are otherwise term pay for performance reimbursement models where the provider assumes financial risk based on historical on regional spending in quality measurement performance. There are currently a dozen APM's although this year Medicare Advantage could qualify almost all of these are demonstration and the flagship of APM's or the one of currency give against is the as Medicare should savings program. More commonly termed ACO's because the vast majority of EPSN beneficiaries are over ten million are assigned to it. Or again, ACO's the ACO program just to note is currently. In its eighth year is unclear to what extent ACO's have reduced Medicare spending growth largely because CMS does not formally evaluate the program. If Medicare program, however to remain financially saw build fee for service APM's must produce meaningful. Savings results since the Medicare Advantage program that currently enrolls over thirty three Medicare beneficiaries and his rapidly growing does not in federal financial accounting terms score savings with me again to discuss APM's the flaws in their current design. And moreover how they can be better designed or generate meaningful savings is Harold Miller. So that is back on her. Let me start by asking we just celebrated or some did the nine year anniversary of the Affordable Care Act. So if I could begin by asking what's your overall Sussman of efforts moreover under the ACA to reduce Medicare spending growth over almost now ah decades time. Well, I think it was called the Affordable Care Act, but most of the law and most of the attention has really been about improving access to insurance and the the law has clearly done that. But I think that the track record in terms of actually making healthcare more affordable as much weaker. There really were weren't that many provisions in the law designed to deal with that. And the few that were there have had pretty slow implementation. I would say one of the things is you wanted to talk about alternative payment models today. One of the hopes was that the center for Medicare and Medicaid innovation. That was created under the Affordable Care Act would really spark a lot of innovation in terms of the way Medicare, and then hopefully other payers would pay for healthcare, but it's been pretty disappointing in terms of how. Much or how little is done to to do that in those nine years. Yes. Correct. I was going to follow up with your view of the Medicare cheered savings program December final rule, but let's we'll get to that. So let's move onto. Generally, you've written now numerous detailed reports regarding Medicare payment reform over the last several years, let's focus on your latest work. That is your January report titled the prom with Medicare's alternative payment models and how to fix them. Let me start by asking what would an idealized APM generally, look like. Well, I think in my opinion, if it were ideal model, and I know that there's written there's no one ideal model, but the the the elements of it would need to address the problems that exist in fee for service payment without taking away the strength of fee for service payment, and would actually and able physicians hospitals. Other health care providers to be able to deliver care to patients in in ways that would be both better for the patient and lower spending for Medicare or other payers. There are many many opportunities in to reduce spending without hurting patients in

Medicare APM ACO Harold Miller Miller Herald President And Ceo David Intra Cosso Sussman David Vigor ACA Medicaid Nine Years Nine Year
"david intra" Discussed on The Healthcare Policy Podcast

The Healthcare Policy Podcast

05:22 min | 2 years ago

"david intra" Discussed on The Healthcare Policy Podcast

"This program features interviews with respected healthcare industry experts on current topics of substantial national importance, your host for the program is David and Trucco a DC based healthcare policy analyst and researcher. We invite you to comment on the program by visiting the healthcare policy podcasts dot com. Now, here's David welcome to the healthcare policy podcast again on the host, David intra Cosso doing this podcast. We'll discuss the author Rosemary Gibson her recent book, titled China are ex exposing the risks of America's dependence on China for medicine may welcome back to the program. David it's great to be with you. Thank you for having me. Rosemary is senior adviser at the Hastings center and his board chair of the L tournaments, the two-day nonprofit health systems research organization her full by of course, is posted on the podcast website listeners may recall, I discussed medical eras with Rosemary. In November twenty thirteen and in June. Twenty fifteen we discussed the question of whether or not we healthcare in this country or rather medical commerce or their phrased we used for that discussion the medical industrial complex today. We'll discuss Rosemary and her co author Girardin Persad sings latest work again, titled China Rx that details the extent to which the US is dependent on the manufacturing drugs, and their active ingredients and medical devices and the extent to which this dependence imperils, both our health status and our Nations Security so that as a very brief overview introduction. Let me ask more of a question since I noted we've discussed to a subject interests of yours in the past this book appears to be a product of those previous interests or your discussions on those topics in that imported a Chinese drugs continued. Beg or do beg patient safety questions and the rapid offshoring of drug manufacturing by US. Pharmaceuticals is not surprising largely or purely a prophet play. Would you agree with this assessment? Well, the outsourcing of medicines to China David are generic drugs, increasingly and the components to make them all for random drugs and generics. Certainly has been driven by price. China has a lot of very talented chemists. They have. Environmental laws that are not like the United States air, consumer product liability is not what we're used to in this country. So that many other factors make it have made it she per to do production in China, but recently, China ramping up enforcement of pollution controls, the current trade challenges, and all that brings is making it harder for western and American companies to do business there. So those transaction costs are increasing. But you're right. It's primarily a cost driver. It is driven production to China. Okay. Thank you. So throughout the book, you we've the story about a tragic certainly said story about Dr Bob Allen. And I think it was extent useful in making your points. So this is the issue of his experience relegated to receiving the drug heparin. Which of course, you may know, our listeners may know is so widely used a blood thinner medication. Can you just provide an overview of that experience because it's exemplary of the patient safety issue or how these drugs can be dangerous because then we'll get into this the extent to which has their import of the US the FDA or federal regulators are able to provide adequate regulatory oversight. So again, could you give us an overview of Dr Allen's tragic experience. Sure, you know, David, I wrote this book in the public interest, and it's always important to show the. Human face of safety in this case are medicines when we're globalizing production. So the book opens with a story of Dr Bob Allen who the forty five year old healthy physician trained at Johns Hopkins and he walked into a hospital in Arizona with his family late at night. He knew we had a bleeding stomach ulcer, but like many physicians he kinda postponed getting treatment. But finally it was time in so because it was late at night they decided to admit him overnight and do an endoscopy the next morning. He received heparin the following morning. Several doses and inexplicably. He started having a heart attack at about eleven AM just less than twelve hours after being admitted to the hospital. So he went into the cath lab and he received two large doses of heparin, and the doctors were deeply deeply concerned that he was going into heart failure, and is other organs were also starting

David intra Cosso China Rosemary Gibson Johns Hopkins US Dr Bob Allen heparin China David David Girardin Persad policy analyst America Hastings center senior adviser researcher FDA Arizona Nations Security forty five year