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With the election just days away, Larry Levitt joins me to discuss where Harris and Trump stand on key health issues: reproductive health, affordability and Medicaid. While health has not taken center stage (as it has in the past), the outcome of this election will have profound impacts on every aspect of health in the years ahead.
We discuss:
Why the ACA is no longer a political battlefieldThe shifting dynamics of abortion as a single-issue voteWhy medical debt and drug prices are key affordability issues to watchWhether we could see bipartisan progress on AI governance, long term care or PBM reform over the next four yearsLarry reminds us that health IS an economic issue:
“People think of the economy and health care being separate issues, but they're In fact, not separate issues at all. I mean, we spend an enormous amount on health care. A lot of people's household budgets go to health care. So, you know, when you talk about an economic issue, health is an economic issue, issue for people.”
Relevant Links
KFF panel: What the 2024 election could mean for health coverage, affordability and the budget
KFF election 2024 page
How medical debt is the canary in the coal mine for health affordability [article]
Project 2025
Abortion-related state ballot measures
About Our Guest
Larry Levitt is the executive vice president for health policy, overseeing KFF’s policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women’s health, and global health. He previously was editor-in-chief of kaisernetwork.org, which was KFF’s online health policy news and information service and directed KFF’s communications.
Prior to joining KFF, Levitt served as a senior health policy adviser to the White House and the Department of Health and Human Services, working on the development of the Clinton Administration’s Health Security Act and other health policy initiatives. Earlier, he was the special assistant for health policy with California Insurance Commissioner John Garamendi, a medical economist with Kaiser Permanente, and served in a number of positions in the Massachusetts state government.
Levitt holds a bachelor’s degree in economics from the University of California, Berkeley, and a master’s degree in public policy from the Kennedy School of Government at Harvard University.
Source: https://www.kff.org/person/larry-levitt/
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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and...
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How do you create a healthier city? As the climate shifts, screens dominate our lives and cities continue to grow - urban areas are grappling with how to put themselves on a better track to health. New York City Health Commissioner Dr. Ashwin Vasan joins The Other 80 to talk about his ambitious plan to increase health in the Big Apple, with the goal of increasing life expectancy from 78 to 83 years.
We discuss:
What Paul Farmer taught him about rejecting a scarcity mindset and reaching for bold goalsThe three cross-cutting challenges addressed in the Healthy NYC agenda: access to primary care, mental health and climate changeWhy NY issued a public health advisory on teen social media use and is suing Meta, Tik Tok YouTube and SnapChatAshwin shares why youth social media use is such a major public health priority:
“ Our kids are hurting … Fifty percent of teens are saying that they are either moderately or severely depressed …It's hard to ignore the role that digital media and social media is playing … And what we found was pretty troubling …The more time you're spending on social media, the worse your self -reported mental health is. Whether it's symptoms of depression, anxiety, hopelessness, fear for the future.”
Relevant Links
Article: “Using Law to Advance Population Health Management”
The City of New York’s Advisory on Social Media
More information on Healthy NYC
Viral Video of “Dancing Guy”
About Our Guest
Dr. Ashwin Vasan is the 44th Health Commissioner of New York City. He is a practicing primary care physician, epidemiologist and public health expert with nearly 20 years of experience working to improve physical and mental health, social welfare and public policy outcomes for marginalized populations in New York City, nationally and globally. Throughout his career, he has brought in a unique, unparalleled focus to combating the mental health crisis, releasing a comprehensive citywide mental health plan addressing the second pandemic – a crisis of mental health plaguing youth, vulnerable New Yorkers with severe mental illness, and those impacted by the overdose epidemic. Having begun his career in global health working at Partners in Health and the HIV Department of the World Health Organization, he most recently served as the President and CEO of Fountain House, a US-based mental health nonprofit. He currently serves as faculty at the Columbia University Mailman School of Public Health and Vagelos College of Physicians and Surgeons.
Stay Informed
Sign up for The Other 80 Newsletter to receive a monthly update with reflections, news, events, jobs and funding curated for you by Claudia. Click here to sign up.
Connect With Us
For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and
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In July, US Surgeon General Dr. Vivek Murthy issued a landmark advisory declaring firearm violence a national public health crisis. The advisory builds on decades of work from Dr. Megan Ranney and other researchers who advocate taking a public health approach to reducing firearm violence. She joined us at Aspen Ideas: Health to discuss what this means: namely moving from a focus on law and order to centering harm reduction and prevention. Now, as the Dean of the Yale School of Public Health, Megan is applying the same systems thinking approach to focus on the big changes we need to drive health in the US.
We discuss:
What it means to be a great public health communicatorHow public health approaches were used to dramatically reduce automobile deaths over the last 50 years, and how the same strategies should be used now to tackle firearm deathsHer take on bridging the gap between medical care and public healthMegan says this is the moment for public health reinvention:
“This is a moment where we get to reinvent how we study, teach, and most of all, practice public health, not just locally, but also globally, as we come out of the COVID pandemic, and I think there's a real moral clarity, but also a moral imperative for us, as public health professionals, to seize this moment, to take this kind of pivot point that we're at as a field, and to move it forward in a direction that we will be proud of.”
Relevant Links
Megan Ranney testimony on gun violence as a public health issue
Gun violence panel at Aspen Ideas: Health
Surgeon General advisory on firearm violence
Yale Q&A with Dean Megan Ranney
Common health coalition
Bipartisan Safer Communities Act
UC Berkeley School of Public Health course on urban gun violence prevention
More on Rahimi case
About Our Guest
Dr. Megan L. Ranney is an emergency physician, researcher, and national advocate for innovative approaches to public health. In July 2023, she joined Yale University as Dean of the Yale School of Public Health, where she is also the C.-E. A. Winslow Professor of Public Health. Her research focuses on developing, testing, and disseminating digital health interventions to prevent violence and related behavioral health problems, and on COVID-related risk reduction. She has held multiple national leadership roles, including as co-founder of...
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Deena Shakir is an investor who is obsessed with expanding access to the basic health services people need and often can’t access: pediatric care, community health and women’s services. Her journey to investing passed through policymaking, journalism and big tech and her early techno optimism has given way to a much more nuanced and pragmatic view. She is able to see the big opportunities for impact hiding in plain sight.
We discuss:
The two obvious megatrends hitting healthcare: GLP1s and AIAnd the not so obvious opportunity: doing basic things betterHow Dobbs was an accelerant, not a deterrent, for investments in women’s healthWhy Public Health is great training for healthcare foundersDeena is excited about “asset light” investments that combine new care models – like community health workers – and technology:
“There are some things that won't change. And there are things that hopefully tech can help to navigate. And so these asset light models, these models that are leveraging under leveraged care workers – like community health workers that are providing culturally competent care – and at the end of the day, that are improving metrics and outcomes, are the ones that get me excited.”
Relevant Links
Lux Capital
Jonathan Haidt article in The Atlantic titled “Why the past 10 years of American Life have been uniquely stupid”
President Obama’s Cairo speech
ARPA-H Sprint for Women’s Health
Health companies Deena mentions that she invests in:
Waymark
Summer health
Maven Clinic
About Our Guest
Deena's investments span stages and sectors, and include women's health, digital health infrastructure, health equity, foodtech, and fintech. Above all, she seeks out extraordinary, often underdog, founders on a mission. Prior to Lux, Deena was a Partner at GV (formerly Google Ventures), led product partnerships at Google for health, search, and AI/ML, and directed social impact investments at Google.org. Deena also served as a Presidential Management Fellow at The U.S. Department of State under Secretary Clinton, where she helped launch President Obama’s first Global Entrepreneurship...
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Government systems often take a lot of flack for their (sometimes) built-in inability to take risks and make big bets. So, what would it take to encourage the government to take those big, risky moonshots? For Health, that’s the role of ARPA-H – to fund new ways of improving health by investing in people with big ideas. We sat down with ARPA-H Director Renee Wegrzyn at Aspen Ideas Health to talk about how it’s going and what comes next.
We discuss:
Why ARPA-H is personal for President Biden.How ARPA-H’s special authorities – from flexible hiring to novel contracting – are its secret weapons for speed and scale.The critical role of Program Managers – single decision maker driving the vision and execution of each $50-$200 million initiative.Renee says ARPA-H gives her the ability to direct funds into areas that are sometimes left off the list of “must haves” for innovation:
“...one of the only top down things I've done as a director is said, ‘Why aren't we funding more in women's health? We don't have any program managers in the pipeline that want to exclusively focus on this’. But I think we all inherently understand that women are underrepresented in almost every aspect of health. So I asked our [Program Managers].. who wants to raise [a] hand and pick a topic that is really either unique to women, or is disproportionately affecting women that we can do a sprint and invest around. And so I got six Program Managers to come up with topics, everything from Women's Health at home, to brain health, to understanding and quantifying pain – and through the Investor Catalyst Hub we have worked with investors to understand what kind of convincing scale do we need to get to for you to be the second investor. And we competed this across the country.”
Relevant Links
About ARPA-H ARPA-H Health Equity Factsheet The Minor Consult Podcast EpisodeARPA - H TimelineYoutube Conversation with New Yorker writerWhite House FAQ Sheet on ARPA-HAbout Our Guest
Dr. Renee Wegrzyn is the first director of the Advanced Research Projects Agency for Health (ARPA-H), appointed by President Biden on October 11, 2022. Previously, she was the Vice President of Business Development at Ginkgo Bioworks and Head of Innovation at Concentric by Ginkgo, where she focused on synthetic biology for combating infectious diseases like COVID-19.
Wegrzyn has experience with DARPA and IARPA, the models for ARPA-H. At DARPA, she used synthetic biology and gene editing to enhance biosecurity and the bioeconomy, managing programs like Living Foundries, Safe Genes, PREPARE, and DIGET. She received the Superior Public Service Medal for her DARPA work. Her career includes leading biosecurity and gene therapy teams in private industry, developing immunoassays and diagnostics. Wegrzyn has served on various scientific advisory boards, including those for the National Academies and the Air Force Research Labs. She holds a Ph.D. and a bachelor's degree in applied biology from the Georgia Institute of Technology and completed...
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The US is living through an affordable housing crisis - in fact, we are short millions and millions of affordable housing units. During the pandemic, homelessness flattened with an influx of resources to help keep people housed. But, those resources have long expired and now we are seeing an uptick in homelessness across the country. Jeff Olivet, the director of USICH (United States Interagency Council on Homelessness), says the problem is complex – but the math isn’t. We need more affordable housing.
We discuss:
Biden’s proposed budget, which includes guaranteed vouchers for every low income veteran and person aging out of foster careThe new frontier; pairing emergency response such as shelters with robust prevention strategiesHow prevention starts with helping families through periods of financial crisisWhat happens when heat crises turn deadly for people who are homelessJeff reminds us that the people affected most by the affordable housing crisis are those who have experienced trauma and domestic violence:
“50 years ago, we still had domestic violence, we still had addiction, we still had mental illness, and we didn't have perfect systems to address that – but we had enough housing for everybody, and we did not see homelessness on the scale we see it today. So when we're responding to homelessness, it's critical to individualize support for people to make sure they have access to the care they need in terms of health and mental health and recovery and all of those important things. But if we don't solve the underlying structural stuff, the lack of affordable housing, the ongoing discrimination that people of color and LGBTQ people face in jobs and trying to buy a home or rent a home in the criminal legal system, in education, if we don't solve that underlying stuff, we're gonna keep seeing homelessness for a very long time to come.”
Relevant Links
Jeff Olivet testimony to Congress on strategies to reduce Veteran homelessness
Federal actions to increase housing supply and lower housing costs
HUD-VASH vouchers to support homeless veterans
USICH guidance document for healthcare
Article about the SCOTUS ruling
About Our Guest
Jeff Olivet is the executive director of USICH. He has worked to prevent and end homelessness for more than 25 years as a street outreach worker, case manager, coalition builder, researcher, and trainer. He is the founder of jo consulting, co-founder of Racial Equity Partners, and from 2010 to 2018, he served as CEO of C4 Innovations. He has worked extensively in the areas of homelessness and housing, health and behavioral health, HIV, education, and organizational development. Jeff has been principal investigator on multiple research studies funded by private foundations and the National Institutes of Health. Jeff is deeply committed to...
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California is the latest state to address healthcare affordability through cost growth targets. Elizabeth Mitchell – President and CEO of Purchaser Business Group on Health – Joins us to discuss the nuts and bolts of the 3% cost growth target recently adopted by the state. Healthcare affordability is a big issue across the country. More than half of us skip or postpone care due to cost and medical bills are a leading cause of bankruptcy. Reining in medical costs is also how we’ll free up resources for what we know works to build health in America: prevention, addressing the social drivers and fostering health in communities.
We discuss:
Two proven strategies to reduce healthcare costs: advanced primary care and effective specialty referralsWhy better consumer “shopping” is not the path to healthcare affordability How price transparency gives employers new tools to negotiate, and reveals troubling facts about purchasing intermediariesElizabeth reminds us how troubling it is that we don’t have clear prices in a sector that makes up 20% of the economy:
“The idea that you can't find out what something is going to cost before you agree to it is outrageous. Name any other industry that refuses to show you a price. It is incredible to me that we are still fighting about transparency when it is 20 % of the US economy. I mean, this is a multi-trillion-dollar industry who feels no accountability to show pricing. So, I just think it is incredible that we do not have meaningful transparency yet.”
Relevant Links
California’s Office of Health Care Affordability sets cost growth target
Federal hospital price transparency requirements
Purchaser Business Group on Health (PBGH) website
PBGH white paper on advanced primary care
US Department of Labor clarifies the fiduciary responsibilities of self-insured employers purchasing healthcare
About Our Guest
As President and CEO, Elizabeth Mitchell advances Purchaser Business Group on Health’s (PBGH’s) strategic focus areas of advanced primary care, functional markets and purchasing value. Mitchell leads PBGH in mobilizing health care purchasers, elevating the role and impact of primary care, and creating functional health care markets to support high-quality affordable care, achieving measurable impacts on outcomes and affordability.
At PBGH, Elizabeth leverages her extensive experience in working with health care purchasers, providers, policymakers and payers to improve health care quality and cost. She previously served as Senior Vice President for Healthcare and Community Health Transformation at Blue Shield of California, during which time she designed Blue Shield’s strategy for transforming practice, payment and community health. Mitchell also served as the President and CEO of the Network for Regional Healthcare Improvement (NRHI), a network...
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The scope, scale and timeline of what California is trying to do with CalAIM is truly breathtaking. Two years after the launch of the ambitious program, which offers integrated medical and social care for California's 15 million Medicaid members, Dr. Palav Babaria joins us to discuss how it’s going and what comes next. Dr. Babaria is a primary care physician who leads quality and population health management for California’s Medicaid program, Medi-Cal.
We discuss:
Which community supports are used most, or least? One of the big learnings from CalAIM: the enhanced care management models that work for adults dont work for childrenHow Medi-Cal is leveraging health plans as the organizers of social care because that’s where the members areThe soon-to-be-released population health management service will address two big issues: standardized and equitable approaches to identifying high risk members and integrating state level benefits data, like for WICPalav reminds us that CalAIM was built through listening:
“Not everyone may know this, but CalAIM was generated from a statewide listening tour. Our previous state Medicaid director went around the state and literally asked communities… rooms full of plans, members, providers, what do you need from Medi-Cal that isn't working today? [The] smorgasbord of recommendations is what turned into CalAIM … Listening to the community and responding to the community's needs is in the core DNA of this program.”
Relevant Links
Listen to our related episode “Reflecting on Year One of CalAIM with Jacey Cooper”CalAIM dashboard Population health management policy guide California and other states require managed care plans to reinvest in local communitiesNY waiver summaryAbout Our Guest
Dr. Palav Babaria was appointed Chief Quality Officer and Deputy Director of Quality and Population Health Management of the California Department of Health Care Services beginning in March 2021. She was formerly the Chief Administrative Officer of Ambulatory Services at Alameda Health System. In that capacity, she operationally and clinically oversaw 26 specialty clinics, four large primary care FQHCs, specialty and integrated behavioral health, and is responsible for all outpatient value-based payment programs. Prior to that role, she served as Medical Director of K6 Adult Medicine Clinic. She also has over a decade of global health experience and her work has been published in the New England Journal of Medicine, Academic Medicine, Social Science & Medicine, L.A. Times, and New York Times. Her areas of interest include ambulatory transformation in resource-limited settings, shifting to value-based care, and issues of gender in medicine. Babaria received her bachelor’s from Harvard College, as well as her MD and Masters in Health Science from Yale...
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To achieve whole person care, we can try layering new social services on top of medical care. But Dr. Rishi Manchanda believes we should move further upstream and ask, what will it take to actually improve health in communities? From founding Rx the Vote to HealthBegins, Rishi is committed to building community social capital in America.
We discuss:
Why he created HealthBegins, which is now halfway to its goal of transforming equity in 250 communities by 2025How California is making practice transformation a foundation of whole person careRx the Vote and the important role of health organizations in voter engagementKaiser Permanente's health, housing and justice initiativeRishi thinks all public health students should study and know how to shift the political determinants of health:
“I think we can recognize there's ways to… get the dollars out the door, get the services out the door, get the access that we need while [also building] local governance. And I think that's what I see as a really interesting opportunity for us in California… There are opportunities here for public health schools, including Berkeley, to [help] public health students… understand the political determinants of health and then understand their role [to]... address them and improve them.”
Relevant Links
HealthBegins website
Rishi’s book The Upstream Doctors
Rishi's TEDx Talk: "What Makes Us Get Sick? Look Upstream."
New collaborative community health planning model in California
Policy requiring California Medicaid health plans to invest 5-7.5% of profits into local communities
California Medicaid investments in practice transformation
Kaiser Permanente's health, housing and justice initiative
Oregon CCO model
An interview with Rishi Manchanda
About Our Guest
Dr. Manchanda is Founder and President of HealthBegins, a social enterprise that provides training, clinic redesign, and technology to transform health care and the social determinants of health. Dr. Manchanda is a dual board-certified internist and pediatrician, a board member of the National Physicians Alliance, and a fellow in the California Health Care Foundation’s Healthcare Leadership Program. He is the lead physician for homeless primary care at the VA in Los Angeles, where he has built clinics for...
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June 18th is “Maya Petersen” day in San Francisco, in honor of her work building disease models that guided the region through the early days of COVID and saved countless lives.
With projects spanning from developing HIV prevention strategies in East Africa to shaping new Medicaid models in California, the UC Berkeley epidemiologist is building a future where local public health leaders have the tools and data to ask and answer complex policy decisions in real time. Now that’s a world I want to live in.
We discuss:
How much better our pandemic response would have been if Public Health had access to integrated and linked dataHer work to bring sophisticated data tools to the point of decision in East AfricaHow California is building population management infrastructureSan Francisco’s Director of Health, Grant Colfax, taught her an important lesson about showing up and helping:
“I remember… saying, ‘You know what? You really need to find somebody who's an expert in this, I'm not an expert in this.’ And he said, ‘Okay, Maya, but if you're gonna find me someone it needs to be in the next 24 hours, because I need help.’ And it was just a reminder that, you know, you're not always going to be an expert, sometimes you just need to show up, do your best… be clear about your uncertainty and communicate well, and that can be… a big service”
Relevant Links
Local Epidemic Modeling for the San Francisco Department of Public Health
San Francisco’s COVID strategy
Multi-sectorial Approach to HIV in East Africa
Maya Petersen Day in San Francisco
Maya’s UC Berkeley page
About Our Guest
Dr. Maya L. Petersen is Professor of Biostatistics and Epidemiology at the University of California, Berkeley. Dr. Petersen’s methodological research focuses on the development and application of novel causal inference methods to problems in health, with an emphasis on longitudinal data and adaptive treatment strategies (dynamic regimes), machine learning methods, adaptive designs, and study design and analytic strategies for cluster randomized trials. She is a Founding Editor of the Journal of Causal Inference and serves on the editorial board of Epidemiology. Her applied work focuses on developing and evaluating improved HIV prevention and care strategies. She currently serves as co-PI (with Dr. Diane Havlir and Dr. Moses Kamya) for the Sustainable East Africa Research in Community Health consortium, and as co-PI (with Dr. Elvin Geng) for the ADAPT-R study (a sequential multiple assignment randomized trial of behavioral interventions to optimize retention in HIV care).
Source: https://publichealth.berkeley.edu/people/maya-petersen
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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email
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If there’s one thing politicians do little of these days it’s change their minds. But, that’s exactly what North Carolina’s General Assembly did in 2023. Ten years after the ACA was passed, and in a historic bipartisan move, they changed their minds and voted to expand Medicaid. NC Secretary of Health & Human Services Kody Kinsley joined us to talk about what it took to get this done and how it’s been going so far.
We discuss:
How to get stuff done in a politically divided stateOne move that would dramatically increase access to healthy food in America - automatically enroll all Medicaid beneficiaries in SNAP Why NC Medicaid has gone deep on peer to peer support for prenatal care and mental healthThe importance of building a better narrative about the role and value of public healthKody points out NC’s strategy of investing in community organizations is creating both health and economic opportunities:
“75% of our community based organizations are minority or women owned throughout those 33 counties. So, this isn't just about getting good access to what drives health in the long run. This is also about building that infrastructure and having a financing model that sustains it that is in the balance, a good value for the taxpayer.”
Relevant Links
NC enrollment dashboard
Crisis warmline
Healthy Opportunities pilots
“NC Launches Additional Phone Support for People Experiencing Mental Illness or Substance Use Disorfer” [RELEASE]
About Our Guest
Kody Kinsley serves as North Carolina’s Secretary of Health & Human Services, overseeing a department with over 18,000 staff and a $38 billion budget. With experience centered on health policy and operations, Kinsley worked on digital healthcare transformation, national education and labor policies, and served as COO and CFO of the U.S. Treasury.
Secretary Kinsley’s three priorities for the department include: Investing in behavioral health and resilience, improving child and family well-being, and building a strong and inclusive workforce. Under his leadership, North Carolina expanded Medicaid and received the largest investment to bolster the mental health system in over a decade. Kinsley grew up in Wilmington, earning his bachelor’s degree from Brevard College and his master’s in Public Policy from the University of California at Berkeley.
Source: https://www.ncdhhs.gov/about/leadership/kody-kinsley
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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams...
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One thing is clear from the last four years: public health leaders need to seriously upgrade their skills in communication and partnering. In this episode Anne Zink, who is stepping down as Alaska’s Chief Medical Officer, brings us a master class in both topics. Guiding the state through COVID she inspired both a Facebook fan group and the hashtag #ThinkLikeZink. Take a listen and you will see why.
We discuss:
How we might have avoided the politicization of COVID Partnering with Alaska’s tribes to get vaccines to every corner of the stateThe ways her background as a fine art major, mountaineer and emergency medicine doctor shapes her leadership approachAnne is committed to breaking the silos between medical care and public health:
“Public health is population health and if you want to make a difference … public health and health care have to be braided together. We need to not think about this in terms of separate systems, but we need to think in terms of patients and to get there, public health is that key chief strategist for population health and needs to be at the table.”
Relevant Links
NPR Story on #ThinkLikeZink
Article on the Five Reasons Dr. Zink is crushing it as a crisis communicator
An interview with Alaska’s top doctor
Article on the rural Alaskan towns leading the country in vaccination
Case study on the partnership between public health and tribes for vaccine distribution in Alaska
Information on the Watson Fellowship
About Our Guest
Anne Zink grew up in Colorado and moved through her training from College in Philadelphia to Medical School at Stanford and then Residency at the University of Utah. As a mountaineering guide she had fallen in love with Alaska and after residency in Emergency Medicine became lucky enough to call Alaska home. Not only does she love the people and the place, but also the medicine. She quickly became involved in helping improve systems of care as the medical director of her group, then in her hospital and with state and federal legislation, including state legislation to improve care coordination, opioid addiction treatment options, and integration between private systems and the VA, DOD, and IHS facilities and more.
Dr. Zink became Alaska’s Chief Medical Officer in July 2019. In all the work she does, she strives to create work environments, policies and practices that are data-driven, foster collaboration and build system efficiencies that put patients first. Zink was a visible public presence in the early months of the pandemic,...
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Today’s guest is Susannah Fox, author of Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care. The book is a deep dive into the expert network of patients, survivors and caregivers who are charting a new path of innovation and research. It is for anyone who feels alone, forgotten or lost in the shadows of suffering as they navigate a new diagnosis. But, it’s also for anyone working inside healthcare who is fed up with the status quo.
We discuss:
How patients – like those first affected by long COVID - accelerate solutions by making invisible problems visible That data liberation is often the foundation for patient rebel movementsThe pop up peer groups forming in Amazon reviewsA framework for understanding, and embracing patient expertise: seekers, networkers, solvers and championsSusannah reminds all innovators to talk with people living with rare and life-changing diagnoses:
“If you are going to try to understand the intersection of healthcare and technology, you need to put down your clipboard – which is the classic status symbol of a survey researcher – and get out there and just talk to people. Talk to people especially who are dealing with rare and life-changing diagnoses, because those are the people who are going to use technology in ways that we can't even imagine.”
Relevant Links
Susannah’s book Rebel Health
Susannah’s blog: Wow! How? Health
Patient-Led Research Scorecards
An article about how patient-led research could speed up medical innovation
A story about Tidepool Loop receiving FDA clearance
OpenAPS and #WeAreNotWaiting
Hugo Campos’s TedX talk about not being able to access his cardiac device data
Graphic used by Sarah Riggare to show the time spent in self-care for Parkinson’s disease
About Our Guest
Susannah Fox is a health and technology strategist. Her book, Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care, was recently published by MIT Press. She is a former Chief Technology Officer for the U.S. Department of Health and Human Services during the Obama Administration, where she led an open data and innovation lab. Prior to federal service, she was the entrepreneur-in-residence at the Robert Wood Johnson Foundation. For 14 years she directed the health portfolio at the Pew Research Center’s Internet Project where she helped define a new market at the intersection of health, social media, and patient engagement. Fox currently serves on the board of directors of Cambia Health Solutions of Portland, OR, and Hive Networks of Cincinnati, OH. She is an advisor to Alladapt Immunotherapeutics, Archangels, Article 27, Atlas of Caregiving, Before Brands, Citizen, Equip Health, Faster Cures, and the Lemelson Center for the Study of Invention and Innovation at Smithsonian Institution. Fox is a...
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We'll be unpacking lessons from the COVID 19 pandemic for many years to come. Dr. Tomás Aragón, who leads public health for the State of California, joins us to discuss what he learned guiding America's most populous state through this challenging and disruptive period.
We discuss:
That public health’s deepest power lies in the ability to help diverse groups reach consensus under great uncertaintyHow California redeployed an army of census workers to support the COVID responseThe biggest opportunities to use AI for public healthThree great book recommendations: “How Emotions Are Made” by Lisa Feldman Barrett, “High Conflict” by Amanda Ripley and “Fifth Discipline” by Peter M. SengeDr. Aragón shared insights about leadership:
“The other thing is to really appreciate the importance of human psychology. It is so incredibly important … You're going to come up against people who are going to “resist”. I don't think of it as resistance. I just think they're being human. That's just all it is. People have variability in how they process information … And so rather than seeing things as resistance, you really just see it as part of the diversity of ingenuity that exists in an organizational culture.”
Relevant Links
Dr. Tomás Aragón’s UC Berkeley Public Health profile
Dr. Tomás Aragón’s GitHub blog
Article on Bay Area pandemic response: The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay Area
“How Emotions Are Made” by Lisa Feldman Barrett
“High Conflict” by Amanda Ripley
“Fifth Discipline” by Peter M. Senge
About Our Guest
Dr. Tomás Aragón, MD, DrPH, has served as the director of the California Department of Public Health and the State Public Health Officer, since January 4, 2021. Prior to coming to CDPH, he was the health officer for the City and County of San Francisco and director of the public health division. Dr. Aragón has served in public health leadership roles for more than 20 years (communicable disease controller, deputy health officer, health officer, community health and chronic disease epidemiologist), including directing a public health emergency preparedness and response research and training center at the University of California, Berkeley School of Public Health.
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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and LinkedIn.
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Using AI in healthcare comes with a lot of promise - but access to data, lack of clarity about who will pay for these tools and the challenge of creating algorithms without bias are holding us back.
In 2023, TIME named Dr. Ziad Obermeyer one of the 100 most influential people working in AI. As a professor at UC Berkeley School of Public Health, and the co-founder of a non-profit and a startup in the AI healthcare space, his work centers on how to leverage AI to improve health and avoid racial bias.
We discuss:
The idea of a safe harbor for companies to discuss and resolve AI challengesHow his company Dandelion Health is helping solve the data log jam for AI product testingWhy academics need to spend time “on the shop floor”The simple framework for avoiding AI bias he shared in his recent testimony to the Senate Finance CommitteeZiad says without access to the right data, AI systems can’t offer equitable solutions:
“I think data is the biggest bottleneck to these things, and that bottleneck is even more binding in less well-resourced hospitals… When we look around and we see, ‘well, there are all these health algorithms that are in medical journals and people are publishing about them’. The majority of those things come from Palo Alto, Rochester, Minnesota [and] Boston. And, those patients are wonderful and they deserve to have algorithms trained on them and learning about them, but they are not representative of the rest of the country – let alone the rest of the world. And so, we have these huge disparities in the data from which algorithms are learning. And then those mirror the disparities and where algorithms can be applied.”
Relevant Links
Dr. Obermeyer’s profile at UC Berkeley School of Public Health
Ziad Obermeyer’s testimony to the Senate Finance Committee on how AI can help healthcare
More about Nightingale Open Science
More about Dandelion Health
Article on dissecting racial bias in algorithms
Article On the Inequity of Predicting A While Hoping for B. AER: P&P 2021 (with Sendhil Mullainathan)
About Our Guest
Dr. Ziad Obermeyer is the Blue Cross of California Distinguished Associate Professor of Health Policy and Management at UC Berkeley School of Public Health. His research uses machine learning to help doctors make better decisions, and help researchers make new discoveries—by ‘seeing’ the world the way algorithms do. His work on algorithmic racial bias has impacted how many organizations build and use algorithms, and how lawmakers and regulators hold AI accountable. He is a cofounder of Nightingale Open Science and Dandelion Health, a Chan Zuckerberg Biohub Investigator, a Faculty Research Fellow at the National Bureau of Economic Research, and was named one of the 100 most influential people in AI by TIME. Previously, he was...
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Black women in the US are 3-4 times more likely to die than white women from a pregnancy-related cause and overall the US has the highest rate of maternal mortality in the industrialized world. These deaths are preventable.
Dr. Monica McLemore, a Professor at the University of Washington School of Nursing, says we should stop blaming women for their own deaths and instead address the underlying social and healthcare drivers that impact pregnancy outcomes. In other words, we need to focus on the other 80.
We discuss:
The Momnibus, a comprehensive legislative package to improve maternal health in the US which has still not been passed into lawHow disruptive periods, such as the COVID-19 pandemic and Dobbs, provide opportunities to re-imagine maternal and child health in the USWhy community-centered research is essential for improving health equityMonica says we need to change our views on scientific evidence:
“There is no way we're going to get … changes in health outcomes at a population level if you don't bring the social and the clinical together, it's just not happening. And so that requires a change in mindset of the scientific community about what is evidence, who generates evidence, who can contribute to evidence, what evidence is needed and what methods are we going to use to obtain said evidence? Because community is over extraction. They are over participating in studies and not getting anything back. They are over funding science as taxpayers and not being able to access it.”
Relevant Links
CDC’s Report on Maternal Mortality
JAMA Articles on trends in maternal mortality:
https://edhub.ama-assn.org/jn-learning/audio-player/18796651https://jamanetwork.com/journals/jama/fullarticle/2806661?utm_source=podcast_platforms&utm_medium=referral&utm_campaign=related_article_linksSummary of JAMA webinar on maternal mortality
Op-Ed: How We Can Reimagine Black Maternal Health in the Changed Landscape of Dobbs
Centering the health of mothers
To Prevent Women from Dying in Childbirth First Stop Blaming Them
About Our Guest
Monica McLemore is a preeminent scholar of antiracist birth equity research, community-informed methods, and policy translation. Dr. McLemore is a Professor in the Department of Child, Family, and Population Health Nursing at the University of Washington School of Nursing. She earned a bachelor’s degree in Nursing from The College of New Jersey in 1993 after declaring at eight years old that she would become a nurse. She has a Master’s in Public Health from San Francisco State University and a PhD in Oncology Genomics at the University of California, San Francisco. She’s worked her entire career in reproductive health, rights, and justice. Monica retired from active...
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What is your just cause? Karen Dale is DC Market President for Amerihealth Caritas. She is a bold and fearless leader whose “Why” is to be a catalyst for change to promote equity and deeply support people encountering difficulties. In this episode she shares the leadership practices that support this work from sharing power, to community co-design and embracing disagreement on teams.
We discuss:
A powerful partnership with the Children’s Law CenterThe path to value-based payment for community organizationsThe future of public health education: providing the system, structure and culture that encourages every student to be a catalyst for positive changeHow DC is starting to address decades of under-investment in Wards 7 and 8 through its equity budget reviewKaren discusses the just cause for a school of public health in today’s world:
“It would be to create … a system, structure and culture that infuses what every student needs to be a catalyst for positive change for human beings … [A] school that creates that culture, gives people the tools, gives them the encouragement, gives them the freedom to try and fail, but learn and apply – that would be amazing. Because … we need a whole generation of people who are in the fight.”
Relevant Links
Karen’s commencement address to George Mason grads
NPR piece on partnership with Children’s Law Center
New payment approaches for EPSDT
Guidance for Health Care Entities Partnering with Community-Based Organizations: Addressing Health-Related Social Needs in Alternative Payment Models. [hcp-lan.org]
About Our Guest
Karen M. Dale is Market President for AmeriHealth Caritas District of Columbia, a mission-based Medicaid Managed Care Organization in Washington, D.C., and the Chief Diversity, Equity, and Inclusion Officer for the AmeriHealth Caritas Family of Companies. Her focus includes applying a health equity lens to impact all levels of policies, processes, decisions, laws, and outcomes for the communities AmeriHealth Caritas serves.
She also leads a decidedly metric-driven business approach to mobilize leaders and accelerate strategies to advance diversity, equity, and inclusion inside and outside the walls of AmeriHealth Caritas. As a result, opportunities for people to experience health, wholeness, and belonging are enhanced by addressing the social, economic, and environmental conditions that are drivers of poor health.
Her hobbies include gardening, creating healthy Caribbean recipes, traveling, and watching her son’s soccer games.
Connect With Us
For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter...
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We may be politically divided, but when it comes to healthcare there is actually a lot we agree on as a nation. We want healthcare that is affordable. We want a healthcare system that is easy to understand and navigate. We want to know we will receive good care when we need it most. These insights are something our guest Natalie Davis takes to heart in her work at United States of Care. She and her team are fighting hard to help create a more dependable healthcare system for diverse and underserved Americans.
We discuss:
Why we should never use the term “value-based care” ever again.Braidwood vs. Becerra: The court case that may eliminate free preventive services for half of all Americans.The double whammy of US healthcare: system failures and personal shame.How to nurture listening and belonging on a team.Natalie says before you start listening, you need to consider who is being failed by the healthcare system and prioritize hearing their stories:
“If we look at something like maternal health – which is a work that we're doing right now – if you look at the data, it is women of color, especially Black women who are left behind and facing a real failure of our system, which is causing morbidity and mortality. And so, for our organization, we are listening loudly to Black women and we are talking to people in communit[ies], we are talking in focus groups to really make sure we understand those issues. Because, if the people who are not served by this healthcare system are listened to and then served it will make the healthcare system function better for all of us.”
Relevant Links
United States of Care's website
United Solutions for Care
Patient-First Care (a.k.a. Value-Based Care) Messaging Findings
United States of Care Preventive Services Resource Hub
Insight Report from November 2023
The amicus brief United States of Care submitted on Braidwood vs. Becerra
About Our Guest
Natalie Davis has worked for nearly two decades shaping and implementing American health care policies to improve the lives of all people. In 2018, she and fellow national health care leader Andy Slavitt launched United States of Care to ensure that everyone in the country has access to quality, affordable health care regardless of health status, social need, or income. She is relentless in her person-centered approach to building health care solutions and has a history of building partnerships – with organizations, patient advocacy groups and everyday people – that work to create positive change in our country’s health care system. From 2010-2016, Natalie served at the Centers for Medicare and Medicaid Services, with the final two years as Senior Advisor to former CMS Administrator, Andy Slavitt. In 2017, Natalie served as the Director of Strategic Engagement at the Bipartisan Policy Center. A social entrepreneur, Natalie also helped found Town Hall Ventures and The Medicaid Transformation Project, both of which focus on bringing the best of innovation and care
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The modern world, and the products we use everyday, are making us sick. But what if we could shift this trend and start to build health into everyday life? That’s exactly what Steve Downs and Thomas Goetz, co-founders of Building H, are working on. Steve, the former CTO of the Robert Wood Johnson Foundation, joins us to discuss how Building H is helping companies and designers re-engineer products and “product environments” so they improve rather than harm health.
We discuss:
Shocking trends in American health: 48% of Americans are lonely, 35% dont get six hours a night of sleep and 60% of adult calories come from ultra-processed food.The mistake of thinking of our daily choices as “individual” decisions, when these decisions are profoundly shaped by our environments and the products we use.The Building H Index, which evaluates everyday products against five metrics of health: eating, physical activity, sleep, social connection, and spending time outdoors.Culdesac - A real-estate developer that is building “cities for people without cars”.Steve asks how we could broaden consumer product regulation to focus on broad health impacts, not just safety:
"McDonald's is not responsible for all the food related chronic illnesses in America. But you might argue that they are, I don't know, 1.7%, responsible or 3.8% responsible … I think we ultimately need to get to a place where if your product is leading to unhealthy behaviors, which is leading to illness and disease and cost, there may need to be some accountability for that."
Relevant Links
Building H website
Building H Index
AJHP paper on the product environment
Daniel Lieberman’s book on the history of the human body (no affiliate fee taken)
Culdesac website
HBS Impact-weighted accounts
International Foundation for Valuing Impact
ANNOUNCEMENT: Building H is seeking volunteers with a background in public health, healthcare or health policy to help build the Building H Index by rating products and services on their health impacts. If you’re interested in participating in a short scoring exercise, please go to this site for details and sign up https://www.buildingh.org/index/volunteer-signup
About Our Guest
Steve Downs works at Building H as a co-founder. Prior to his role at Building H, Steve was the chief technology and strategy officer at Robert Wood Johnson Foundation (RWJF) where he led a transformation of the Foundation’s practice of program strategy, putting in place an approach that is highly flexible and adaptive. Over his career at RWJF, Steve held a variety of management roles — including chief technology and...
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Rural America is facing a healthcare crisis. Home to 60 million people, rural areas face a 23% higher mortality rate compared to urban locations due to lack of infrastructure, lower socio-economic status and provider shortages. Indeed, rural areas have half as many primary care providers and an eighth as many specialists as urban locales.
In this episode, Homeward’s CEO, Jennifer Schneider discusses how her company uses remote monitoring, telehealth and a novel staffing model to re-architect care delivery in rural America with the goals of improving access and health outcomes.
We discuss:
Why Jennifer and her co-founder decided to make Homeward a B Corp.How Homeward uses technology and non-physician providers to expand access to care in rural America.Lessons from Homeward’s early rollout in Minnesota.Jennifer says we often underestimate how large the rural healthcare market is:
“I jokingly say [to] people when we started Livongo... we initially started in diabetes care. And people said, “That's amazing, it's going to be a huge business. There's 30 million people living with diabetes, so great that you did this nice little niche company for your next company”. And so well, how many people do you think live in a rural health care markets? [I] kind of get a blank stare. And the answer is – double the size [of] the population of people with diabetes… 60 million people live in… [a] rural market.“
Relevant Links
Homeward website
Lack Of Access To Specialists Associated With Mortality And Preventable Hospitalizations Of Rural Medicare Beneficiaries [Article]
U.S. Government Accountability Office: “ACCESSING HEALTH CARE IN RURAL AMERICA” [PDF]
Forbes: “Healthcare In Rural America Isn’t A Little Broken, It’s A Lot Broken: A Conversation With Dr. Jennifer Schneider, Founder And CEO, Homeward Health”
About Our Guest
Dr. Jennifer Schneider is the co-founder and chief executive officer of Homeward, a company focused on rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Previously, Dr. Schneider served as the chief medical officer and president of Livongo. She also served as chief medical officer of Castlight Health. Dr. Schneider has been honored by Modern Healthcare as one of the “100 Most Influential People in Healthcare” and by Fierce Healthcare as a “Woman of Influence” for her work empowering women and modeling diversity and inclusion in the workplace. Dr. Schneider is also on the boards of Maven and Jasper. Dr. Schneider completed her bachelor's degree in biology at the College of the Holy Cross. She went on to get her MD at The Johns Hopkins University School of Medicine and her master’s degree in Health Services Research at Stanford University.
Connect With Us
For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and
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