In Dobbs v. Jackson Women’s Health Organization, the Supreme Court in June 2022 reversed the court’s previous 1973 Roe v Wade decision, and 20 related cases, wiping out a half century of constitutional protections for women’s reproductive rights.  In Dobbs, the court found the Constitution now excludes a woman’s control over her body as well as the possible continuation of her life.  Compelled pregnancy, involuntary childbirth and forced parenthood is not, the court ruled, an essential part...

Over the past 12 years this podcast has discussed increasing corporate dominance of healthcare delivery, made evident in part by the fact the healthcare market is highly concentrated and highly leveraged, e.g., over the past decade private equity has spent roughly $1 trillion to acquire physician practices.  The corporate practice of medicine (CPOM) is problematic because allowing for corporate medicine can compromise a physicians’ independence and/or creates a conflict between physicians’...

Research published last month in Advances in Atmospheric Sciences by Prof. Abraham and his colleagues once again show ocean temperatures, more specifically ocean heat content (OHC), once again dramatically increased in 2023.  (As I noted last year, many believe OHC is the best way of measuring anthropocentric warming because it is comparatively less variable on a year-to-year basis.)  Oceans, that cover over 70% of the earth’s surface, absorb roughly 90% of the sun’s heat trapped by an...

In his soon-to-be-published book, Dr. Chaudhary argues the climate crisis or the Anthropocene era is the political product of rightwing climate realism - what he terms the “Rex Tillerson Position.”  Listeners should be aware politics, not technology or economics, explains why the US continues to emit an enormous amount of CO2e pollution. (The US healthcare industry contributes approximately 550 MT CO2e annually or roughly 9% of the nation’s total.) The politics of functional climate...

Sepsis presents an enormous public health threat. There are for approximately 1.7 million hospital cases and 270,000 deaths per year. Sepsis is consistently in the top five for hospital case volumes and is the most expensive and resource intensive medical inpatient condition, representing approximately 15% of total hospital costs despite accounting for less than 4% of hospital stays.  Various studies estimate sepsis is present in 30% to 50% of hospitalizations that culminate in death....

In part because there are over 10,000 known human diseases and symptoms thereof may have numerous possible explanations, frequently diagnostic tests can be in-determinative or less informative than observing (termed: watchful waiting) a suspected disease’s clinical course over time.  Because of diagnostic complexities population level diagnostic errors represent a significant public health problem.  Nevertheless, despite the progress made in treating cancer - as Ropeik writes in his...

According to the non-profit Mapping Police Violence, since 2013 when experts first starting tracking police shootings, last year was the deadliest year on record with 1,176 law enforcement gun deaths, or more than three people per day and nearly 100 per month.  In 2022 Blacks were three three times more likely to be killed by police than Whites.  However in, for example, MPLS and Chicago, Black shooting deaths were respectively 28 and 25 times more likely than White.   In her recently...

US healthcare emits a massive amount of carbon pollution at approximately 600 million tons annually or roughly 9% of total US greenhouse gasses.  Because of the rapid increase in climate crisis-related harms projected economic losses worldwide over the next few years are estimated in the trillions.  Consequently, the US is beginning to follow Brazil, Canada, France, Japan, Switzerland and the UK in mandating GHG emission and climate-risk disclosures.  Most noteworthy, in April 2022 the...

US healthcare spending is extreme currently at approximately $4.3 trillion.  The single largest payer of healthcare services is Medicare at roughly $900 billion annually or 21% of total healthcare spending.   In this edited volume, recently published by Johns Hopkins University Press, Dr. Moffit along with eleven other contributors including Joe Antos, Douglas Holtz-Eakin, Brian Miller, Mark Pauly and Gail Wilensky, lay out the conservative version of Medicare reform.  In sum, the authors...

Over the past several decades healthcare has increasingly defined patients as medical consumers.  For example, healthcare advertising is today a $22 billion annual business; federal policymakers have over the past few years instituted regulations requiring both hospitals and commercial health plans to make pricing information public; and, provider quality performance information is increasingly publicly reported.   The question begged is to what extent have efforts to define patients as...

Professors Albritton Jonsson and Wennerlind’s recently published book, “Scarcity” by Harvard University Press, offers interpretations of a key concept in economic theory: scarcity, or the belief we live in a world of limited resources and therefore must master the natural world to meet desired needs.   The authors state, “the book does not offer a critique of the usefulness of the neoclassical concept of scarcity, instead, the problem we highlight is that it has been far too successful,” that...

Dr. Young’s novel, “2060” tells the story of Willis Smith, a data analyst employed by IntegraHealth Pharmaceuticals. Mr. Smith is assigned to identify a surviving meta-quad, a patient that has survived four naturally occurring cancers.  In his search Willis meets the owners of Mekong Gardens Senior Care Center who offer a distinctly different healthcare formula.   The story arc peaks when the owners of Mekong Gardens’ care model is exposed and its owners are required to explain their...

On background, listeners are aware that the US healthcare industry emits an enormous amount of GHG pollution, that hospitals are the largest contributor to industry emissions, that they are substantially energy in-efficient and that the industry’s emissions alone cause innumerable and unrelenting health harm - disproportionately impacting are Medicare seniors and Medicaid children.  Despite these facts the healthcare industry on balance remains solidly uncommitted to decarbonizing. Finally,...

Professor Larry R. Churchill, Emeritus Professor of Medical Ethics at Vanderbilt, discusses “Biotethics Reenvisioned,” a just-published book he co-authored with Wake Forest Professor Nancy M. P. King and UNC Professor Gail E. Henderson. The authors, appropriately, argue “bioethics needs an expanded vision” or beyond one that has predominately focused on patient autonomy, beneficence and nonmaleficence.  The field needs to take “a more robust role” they write and begin to address upstream...

As this hour-long documentary explains US hospital care, and healthcare in sum, is largely volume-driven that over-emphasizes expensive specialty versus spending-efficient primary care.  There exist few constraints on commercial healthcare pricing despite the fact hospital prices have little correlation to care quality or value, defined as outcomes achieved relative to spending.  Prices also vary significantly - even within the same city.  Healthcare today can be largely defined as a...

More than likely the most important legislation the Congress will pass this year or this session is the multi-year fam bill that is projected to cost $1.5t over the next 10 years.  A significant component of farm bill leg is Title IV that addresses nutrition assistance, namely the Supplemental Nutrition and Assistance Program (SNAP) that serves 42 million Americans, including one in every four children.  SNAP benefits were expanded during the COVID pandemic.  As of two months ago however...

In February the CDC released its latest Youth Risk Behavior Survey findings.  Somewhat needless to say the data is discouraging.  For example, in 2021 40% of high school students, 60% of high school female students and 70% of high school LGBQ students reported feeling sad or hopeless. Among other findings, 22% of high school students had seriously considering suicide, 18% made a suicide plan and 10% had attempted suicide - these percentages are the highest reported since the first Youth Risk...

Listen Now This past March 20th the United Nation's Intergovernmental Panel on Climate Change (IPCC) published its fourth and last...

This past March 20th the United Nation's Intergovernmental Panel on Climate Change (IPCC) published its fourth and last sixth assessment cycle (AR6) report.  This last report integrates the main findings of the IPCC's three, sixth assessment working group reports published over the past 18 months.  The report has been informally termed the “last warning” since the IPCC 7th assessment work will likely not be published until after 2030 - at which time we’ll know whether we have succeeded or not...

Listen Now In June 2021 I argued in STAT News that HHS require healthcare providers to publicly disclose their GHG...

In June 2021 I argued in STAT News that HHS require healthcare providers to publicly disclose their GHG emissions that in turn would help enable the healthcare industry to decarbonize.  In order to do this, I argued the the Environmental Protection Agency's (EPA’s) Energy Star Portfolio Manager tool be exploited.  Already well over 50% of hospitals use Energy Star to better manger their energy consumption, i.e., improve their energy efficiency.  Energy Star, an online energy benchmarking tool...

Listen Now The US government is frequently defined generally as an army with an insurance company. Regarding the latter, podcast...

The US government is frequently defined generally as an army with an insurance company.  Regarding the latter, podcast listeners are well aware federal healthcare policymakers have essentially done nothing to address the healthcare industry's annual 500 million ton carbon footprint, 9% of total annual US GHG emissions, despite the fact that at $1.5 trillion the federal government is far and away the largest purchaser of healthcare services.  What about the army?  The army, or the Department...

Listen Now Dr. Paul Farmer unexpectedly passed away on February 21, 2022. He was 62. Trained as physician and medical...