Join AnneMarie Schieber, managing editor of Health Care News, and Devon Herrick of the Goodman Institute Health Blog as they discuss how fraud in two programs—both aimed at addressing non-medical “social determinants” of health care—has contributed to this explosive growth.

Also in the show: the troubling connection between untreated mental illness and the recent wave of violence and murder-suicides across the country, including incidents in Michigan, New York City, Atlanta, and Austin, Texas, between July 28 and August 11.

• Why weren’t these individuals in institutional care?
• Should privacy laws be loosened so extended families can better monitor and help their loved ones?
• Can Medicaid be revised to provide more flexibility for substance abuse and mental health treatment?
• Should we investigate the link between marijuana use and psychosis?

Helpful resources include the Treatment Advocacy Center and the discussion of outpatient civil commitment in Committed: The Battle over Involuntary Psychiatric Care.

Other topics covered in this episode:

• Trump backing down on mandating IVF coverage in insurance plans
• The shocking cost of a $21,000 post-exposure rabies shot

🔹 Prior Authorization Reform
HHS Secretary RFK Jr. & CMS’s Dr. Oz secured voluntary pledges from major insurers to streamline prior authorization—cutting red tape, boosting transparency, and digitizing approvals by 2026–2027. Devon shares a personal story of how prior auth actually saved his wife thousands—and why this process isn’t always the bogeyman.

🔹 Healthcare for Gig Workers
With gig roles rising, rigid benefits laws in states like California have faltered. We discuss how personal HSAs and portable coverage could replace one-size-fits-all models—and help millions working flexibly.

🔹 The Heat Wave & Health Risks
From Chicago’s 1995 heat disaster to Europe’s recent summer crisis, air conditioning isn’t a luxury—it’s lifesaving. We highlight how cooling can protect vulnerable populations and why power reliability matters.

🔹 Whole Milk Isn’t the Enemy
New research (Maha Commission) reveals full-fat milk may benefit kids more than skim—boosting nutrition and curbing junky snack cravings. Is it time to rethink “fat-free” school policies?

Get a clear, free-market perspective on these vital health care issues. Visit Health Care News and the Goodman Institute Health Blog for more insights.

Also in the podcast: how tariff policy could impact the low cost of generic drugs in the U.S., and how far Trump should go in getting foreign countries to pay their fair share of drug R&D. Herrick and Schieber also discuss states now authorizing ivermectin to be sold over the counter, and why it’s so difficult for Medicare patients to get good post-acute hospital care. Lots of gaps—and reasons why facilities are closing.

Be sure to check out Health Care News at the Heartland.org website and the Goodman Institute Health Blog for the free-market perspective on the very latest in health care news. 

New parody book out critical of MI Gov. Gretchen Whitmer and her pandemic lockdowns.  True Gretchen is a hilarious parody of the governor’s own tome, True Gretch.

Be sure to check out Health Care News at the Heartland.org website and the health care blog and the Goodman Institute Health Blog for the free market perspective on the very latest in health care news.

AnneMarie and Devon also highlight Ohio’s groundbreaking step to enforce price transparency at hospitals—holding institutions accountable by barring debt collection if hospitals fail to disclose clear pricing. Additionally, they examine troubling conflicts of interest within medical boards, spotlighting cases from Texas and beyond, raising crucial questions about whether medical boards protect patients or physicians' profits.

Tune in for these insights and more in this timely discussion on the evolving landscape of health care policy.

Discover why health insurance remains prohibitively expensive for many Americans, how government mandates distort the market, and what steps can be taken to promote transparency, competition, and patient-centered care. This episode also delves into topics like the unintended consequences of employer-provided insurance, the future of telemedicine, and creative alternatives for long-term care.

With insights backed by decades of research and expertise, AnneMarie and Devon shed light on how we can move toward a more efficient and accessible healthcare system. Whether you're a policymaker, healthcare professional, or concerned citizen, this episode offers valuable perspectives you won’t want to miss.

Health Care News managing editor AnneMarie Schieber talked to Kansas State Senator Beverly Gossage as to why Retton may have gone without health insurance. The likely answer is Obamacare, the only option for people without an employer health plan. Gossage discusses what Retton might have paid for an Obamacare plan without subsidies and why there are almost no other options today for middle income people.  She also discusses what Congress needs to do about it.

Read more: https://heartlanddailynews.com/2024/02/i-couldnt-afford-it-olympic-champion-mary-lou-retton-on-health-insurance/

PHOTO: ROBIN MARCHANT/GETTY IMAGES NEWS

Klessig: “People defined to be brain dead or dead by neurological criteria have beating hearts, digest food, excrete urine, and even gestate pregnancies and deliver healthy babies. These people are not biologically dead, and their spirits have not departed. Brain death is not death. Many people who were diagnosed as being brain dead have recovered. If brain death was real death, people should not recover even once.”

Klessig also discusses the Uniform Declaration of Death Act, and how New Jersey is the only state that allow families to demand treatment for patients declared “brain dead.”  Patients and families can take measures before a crisis to make sure hospitals do not violate their wishes when it comes to life and death issues.  For more information, see respectforhumanlife.org

Dr. Singer traces the issue back to the Combat Methamphetamine Epidemic Act (CMEA), enacted 18 years ago in response to the methamphetamine crisis. This legislation pushed pseudoephedrine, an effective decongestant, behind the counter, leading drug companies to modify their formulas to include PE for over-the-counter sales.

Throughout the episode, Dr. Singer discusses several key points:

• The factors that led the FDA to reconsider its stance on over-the-counter decongestants.
• An overview of different decongestant drugs and tips for consumers to differentiate them.
• The process for purchasing pseudoephedrine, the effective decongestant.
• An exploration of why the FDA initially overlooked the ineffectiveness of PE.
• The sales strategies of drug manufacturers for OTC decongestants.
• Evaluating the CMEA's impact on the Meth epidemic.
• The potential for a class-action lawsuit against this misleading practice.
• The future: Is there a possibility that Congress will repeal the CMEA?

For further insights, don't miss Dr. Singer’s op-ed in Health Care News, linked in the episode description.

“Site-neutral payment would end the unfair policies promoting consolidation and encouraging higher prices,” Kube writes. “Such proposals have bipartisan support in Congress. Several congressional committees are currently debating a health reform package, including provisions to establish site neutrality under limited circumstances. This would be an essential first step, one that physicians nationwide hope will soon extend to other services. After all, reimbursing providers equally for the same service is only fair.”

In the podcast, Kube discusses:

- The reasons why Medicare pays more money to hospitals for the same service

- Examples of the differences in costs

- How this policy leads to increased consolidation in the healthcare industry and raises costs for everyone

- The track record of Congress and the administration, including under Trump and Biden, in promoting site-neutral payments

- The influence of the hospital lobby and the feasibility of implementing site-neutral payments

- Actions the public can take to support the advancement of more free-market policies

Autumn was admitted to the teaching hospital for an e-coli infection but within days, she became critically ill, receiving care in the ICU, being given intravenously a cocktail of risky drugs, and eventually put on a ventilator. When the parents questioned the treatment, the hospital reported them to Child Protective Services.  They are working with advocates and a lawyer to have her moved to another hospital where their daughter won’t be viewed as a “case study,” and the family is treated like an ally not an adversary.

Autumn was referred to Lucile Packard Children’s Hospital for a diagnostic work to examine her bowel after a week-long case of diarrhea. Her bowel was normal, but the hospital diagnosed an e-coli condition and wanted to admit her. After the parents agreed, the hospital proceeded with an aggressive treatment plan including powerful drugs such as Lasix, Diarel, and Aminophalen. 

 “Their protocol was very aggressive. My daughter was never on Tylenol before.  She was never really sick and when they’re throwing all these diuretics at you, and given the side effects these can produce, I just thought it was a lot for her constitution,” said Hope Schacter.

The family has been working with Remnant Nursing advocacy services which has identified multiple ethical and clinical lapses.  

Schacter believes the hospital is trying to cover up clinical errors at the beginning of care that damaged her daughter’s kidneys and caused her to have a seizure.  They complied with all treatment recommendations, even an MRI, which required intubation. Autumn has also had to undergo a blood transfusion. There was a hearing involving the CPS complaint.  The hospital is trying to get the parents to sign off on all intervention deemed “emergency,” but the parents say it has been vaguely defined.  

Related Health Care News articles on patient advocacy in hospitals:

Minnesota Legislature Considers ‘Trusted Doctor’ Bill, May 3, 2023

Down Syndrome Patient’s Family Sues Hospital for Do Not Resuscitate Order, June 20, 2023

Judge Plans Three Week Jury Trial in Do Not Resuscitate Case, August 1, 2023

Patient Takes Hospital to Court for Life-Saving COVID -19 Treatment, Feb. 12, 2021

Ivermectin obstacles during COVID

Moses, and the Paragon Institute released their latest report on the problems with long term care in the U.S., called Long-Term Care: The Solution. In October 2022, Moses and Paragon outlined the problems in Long-Term Care: The Problem.   

People prefer to live out their final years in the comfort of their own home but surprisingly, many of the elderly end up in institutional care. That is no accident. Medicaid is the largest payer of long-term care, and one reason is because you don’t have to be impoverished to qualify. This has put a huge strain on the federal budget, on Medicaid reimbursements and significantly compromised the quality and supply of care.  Few innovations exist because there is little presence of a free market. As a result, institutional care has become the “go-to.”

This podcast begins with a discussion on Medicaid loopholes, the response from Congress, whether a solution is workable immediately, and how special interests might respond to closing off loopholes. The conversation then turns to why the public needs to be better educated on long-term care. The idea that it must be debilitatingly expensive isn’t true.

Established in 2018, the Grand Rapids-based Christian Healthcare Centers offers a unique, direct-pay primary care model that also caters to patients' spiritual well-being. While they serve all patients irrespective of sexual preference and identity, their hiring process requires employees to resonate with their religious beliefs and confirm this with a signed statement. Potentially, CHC could be sued for not hiring someone who does align with its mission.

In this episode, Frampton addresses:

1. If there has been no fine or penalty yet against CHC, why is it being sued?

2. The significance of faith in CHC's practice model.

3. The quagmire that can be presented by expanding civil rights protections to include “gender” and “sexual preference.”

4. The potential of this case reaching the U.S. Supreme Court.

Read more:

Christian Healthcare Centers, Inc. v. Dana Nessel et. al., U.S. District Court for the Western District of Michigan Southern Division, August 29, 2023: https://adfmedialegalfiles.blob.core.windows.net/files/ChristianHealthcareCentersComplaint.pdf

(appellate briefs will be submitted mid-October)

Health Care News articles on Christian Healthcare Centers

Health Care News articles on Alliance Defending Freedom

Herrick delves into various topics, including the expansion of Medicaid, and the concept of Medicare for All — or as he terms it, “Medicaid for All.” Since the enactment of the ACA, 21 states have contemplated bills advocating for single-payer systems. However, the majority of these proposals were thwarted due to their exorbitant costs. For instance, Vermont terminated its program, while California’s initiative never came to fruition. Colorado’s electorate decisively rejected a similar proposition. Currently, Michigan is weighing the adoption of a single-payer system, prompting Herrick to pose crucial questions that demand consideration. These include whether employers will participate, if employees will face surcharges for the state plan, and if the state will request the federal government to allocate all Medicaid and Medicare funds directly to the state’s program.

Moreover, the “Medicare for All” concept continues to persist, with a bill garnering the support of 100 legislators introduced this past May. Herrick and Schieber engage in a discussion about the public’s susceptibility to the false promise of efficient government-managed health care as opposed to a free-market approach. They ponder why the public readily embraces the free market in sectors like retail and technology — which have witnessed significant innovation and competitive pricing — yet hesitates to do the same for health care.

Goodman shed light on the problems with Obamacare in his recent article for the Wall Street Journal. He delves into the financial burdens faced by families with severe health challenges who, without an employer plan, turn to Obamacare exchanges. For these families, Obamacare effectively becomes a staggering 182% "tax." Even with insurance subsidies, they face the pitfalls of Obamacare's limited networks. Alarmingly, both Democrats and Republicans remain silent on this issue, and Goodman sheds light on their reticence.

Despite the U.S. pouring billions into health care across both private and public sectors, glaring coverage gaps persist, leading to mounting medical debts for many. Goodman believes there's a viable solution: the Health Care Fairness for All Act, proposed by Rep. Pete Sessions (R-TX). He also explores the potential of a "Medicare Advantage" style program to revolutionize public health care and insurance exchanges. Goodman contends that insurers should vie to support those with health issues, rather than shying away.

Fioretti discusses his cancer diagnosis and how he was never formally informed of it. He also shares the difficulties he faced in making treatment decisions and how rising costs impacted his mental health. His book, My Cancer Journey, documents his experiences and offers insights into how the healthcare system could be improved, including the use of "center of excellence" insurance plans tailored for cancer care.

To stay in the know, follow Robert Fioretti's on Twitter.

The Personalized Care Act, reintroduced in Congress by Rep. Chip Roy (R-TX), and the U.S. Senate by Sen. Ted Cruz (R-TX) will address one of the biggest obstacles to DPC: freedom. The government restricts health savings accounts to high deductible health insurance plans, which removes options for people who don’t have employer health care and don’t want government plans or be confined to Medicaid. The bills also give workers without employer health insurance the same tax advantages to pay for health care that are now only given to employers. 

Useful links:

DPC Action:  https://dpcaction.com/personalized-care-act-for-healthcare-transformation/

How Four Pages Could Transform Health Care, January 1, 2020, Townhall 

Congress has a Prescription for Health Care’s Sickly Status Quo, January 27. 202, Real Clear Policy

Dr. Hal Scherz, Fonder of Docs for Patient Care Foundation and a doctor at  Georgia Urology, where 24 physicians were ranked "best" by Atlanta Magazine joins Health Care News Podcast to discuss the difference between small independent private practice and large corporate health care.

The American Academy of Neurology has petitioned the ULC to revise the legal definition of death. Option one uses the word “irreversible,” and Option 2 uses the word “permanent.” Klessig says Option 2 will give hospitals and doctors huge discretion in whether to give or continue life-sustaining treatment. Klessig will discuss cases of patients, such as Zack Dunlap, who survived sustained unresponsiveness and went on to describe their level of consciousness during that time.  

Canada has now adopted provisions similar to “Option 2.” Two factors may be driving the change in the U.S.:  the live donor organ transplants where patients need to be alive for their organs to be harvested and given to others (i.e., heart, lung) and legal liability, where an expanded definition of death might potentially protect hospital defendants in wrongful death actions. 

Key links for patients and families:

Respectforhumanlife.org

Halovoice.org

Declared Brain Dead – the story of Zack Dunlap

Uniform law commission:  determination of Death Committee

Redefining Definition of Clinical Death Under Consideration, Kevin Stone, Health Care News, February 24, 2023

Procedure to Harvest Live Organs Raises Red Flags, Kevin Stone, Health Care News, January 6, 2023

Would I Receive a Transplant, Heidi Klessig, M.D., American Thinker, April 22, 2023

Canada Updates Death Determination Standards. Is America Next?, Heidi Klessig, M.D., Health Care News, July 24, 2023

Topics discussed:

1. Is the proposed HIPAA rule a tacit admission that privacy under HIPAA is a myth?

2. What is the proposed rule?  Will it block states from investigating providers who violate their laws?

3. What is the “personal representative” as mentioned in Biden’s proposed rule?

4. What about protecting minors who flee to other states for “reproductive health” services - will this rule encourage that?

5. Does HIPAA protect any medical information?

6. Do you expect Biden to eventually sign this legislation into law?

Read more on the issue here: 

Congress Moves to Protect Abortion With New Privacy Rules - https://heartlanddailynews.com/2023/07/hhs-wants-to-change-hipaa-privacy-to-protect-reproductive-health-care-by-annemarie-schieber/

With their drug no longer used in it’s original form, pharmaceutical company Syntex tried to introduce the drug in an oral form. However, the FDA overcompensated for their initial error, restricting dosage to levels not useful for medicinal applications 

Today’s guest, Charles L. Hooper worked at Syntex when Toradol was coming onto the market as a nonsteroidal anti-inflammatory drug. This was a time of excitement for the company says Hooper. They were eager to cooperate with the FDA for a successful launch.

What went wrong? Hooper discusses how a decision on something like the “loading dose” can come down to a single person, and people are fallible. The FDA’s position of final the final say had disastrous consequences, leading credence to the position that they should act as a “guiding agency. Even with all the FDA’s power and authority, nothing is a certainty.

On April 19, 2023, when asked about the opioid crisis, FDA Commissioner Robert Califf told the Senate Appropriations subcommittee it would help if pharma could develop a “non-addictive” pain medicine. “It is a tough job, but we are not successful in having nonaddictive pain medicines coming through the pipeline. We need to do everything we can do to push industry and make this happen.”

 
Learn more here: FDA Commissioner Called Out for Remark on Non-Addictive Painkillers

Read Charles Hooper’s article in the Wall Street Journal for more: How the FDA Helped Fuel the Opioid Epidemic

The discussion covers various topics such as:

1.      The need for patience in passing healthcare reforms, as it sometimes takes multiple attempts.

2.      The concept of "financial credentialing" by hospitals and its negative impact on consumers.

3.      How the Certificate of Need hinders competition and increases costs.

4.      The events leading up to the bill's passing in 2023.

5.      Non-compete clauses that hospitals require healthcare professionals to sign and how it affects market competition.

6.      The role of "Indy Docs" in advocating for healthcare market reforms.

7.       The challenges physicians face in remaining independent and having ownership in their practice.

Schara insists that this lawsuit extends beyond mere malpractice. He says his family initiated the legal battle to highlight concerning issues related to hospital care, COVID-19 treatment policies, financial incentives, DNR orders, and the rights of the disabled. Supporting his argument, Scott shared three documents: Section 1553 of the Affordable Care Act (Public Law 111-148, March 28, 2010), which tackles the "prohibition against discrimination on Assisted Suicide," a letter from Jennifer Garrett of the Wisconsin Department of Safety and Professional Services which refers to Chapter 154 of WS Statutes indicating there was no action against the physician who implemented the DNR order against Grace, and policy guidance from the Palliative Care Network of Wisconsin outlining how medical professionals should treat individuals with Down Syndrome. To learn more about Grace and her case, click here.

Scott also addressed his removal from the hospital by a security guard due to his stance of being "against medical advice." 

Nager provides an in-depth discussion on how the PFA would operate, the origins of the plan, why attempts to privatize entitlement programs failed under President George W. Bush, why the plan would appeal to younger generations, and how it could guarantee the same benefits currently associated with Social Security and Medicare. He also addresses the prospect of most people accruing sufficient funds in their accounts to bequeath a financial legacy to their families.

The PFA has recently held its inaugural major conference and is in the midst of updating its future projections.

To learn more, click these links:

‘Plan for America’ Pushes Private Accounts to Fix Entitlement Programs, Health Care News, May 16. 2023 (includes links to the first PFA conference, April 28, 2023, Principia College)

Plan for America, A Public-Private Partnership:  https://www.theplanforamerica.us

Terry Nager, CFP, CHFC, CLU, Eric Nager, CRPS, Kyre Lahtinen, Ph.D.

The Plan for America:  How to Place the American Dream on a Sure Foundation Forever, (2020),

Amazon, $9.95

Goodman revealed that between 186 and 308 drugs experience shortages, including some life-saving medications. As a result, hospitals and doctors are often forced to delay treatment or use alternative drugs, which can lead to even more significant issues down the line. One contributing factor is the FDA's stringent regulations, which make it exceedingly difficult for drug manufacturers to swiftly respond to fluctuations in demand. Consequently, competitors struggle to fill the gap.

Other factors exacerbating the situation include a rule that mandates pharmacies to utilize the least expensive alternative for a drug, often a generic version. This regulation suggests that the only critical aspect of a drug is its price. Moreover, rules governing Medicare Part B can contribute to shortages, as well as a lesser-known program called 340B. This program enables large hospital corporations to acquire drugs at extremely low prices and then mark them up for third-party payers.

Goodman’s testimony can be read here.

Minnesota is considering a bipartisan "Trusted Doctor" bill, the first of its kind in the country, that allows patients to choose a trusted physician to treat them, regardless of whether the physician has hospital privileges. This issue arose during the pandemic when family physicians were prevented from treating hospitalized COVID-19 patients with drugs like Ivermectin, as hospitals followed other protocols. Outside physicians were even banned from treating their patients in hospitals from New York to Florida.

Brase discusses when the trend that led to hospitalists really took off, which was during the introduction of the Accountable Care Organizations under Obamacare. Hospitals could receive revenue based on the ACA's "shared savings programs," and so physicians were pressured to be more accountable to their hospital employers.

Additionally, Brase highlights the continued work on HIPAA, the often-misunderstood privacy protection provision in healthcare.

His book, "My Cancer Journey," details the many factors that he needed to consider for his quality of life while fighting cancer, and how ever rising bills impacted his mental health. Bob and AnneMarie discuss potential solutions, such as "center of excellence" insurance plans tailored specifically for cancer care. Tune in to hear an eye-opening account of navigating the healthcare system as a cancer patient.

Mehta discusses how the public health emergency declaration has gone beyond its original mission, and what authority the Public Health Services Act gives the federal government. He explains the potential implications of this decision and how it could impact state regulations on abortion.

The discussion also touches on the expected Texas court decision on whether the FDA overstepped its authority in approving the chemical abortion pill, mifepristone, and how it is driving the Biden administration's decision. Mehta explains how a public health emergency declaration for abortion will allow the federal government to override this decision and discusses the history of the Act, and what Congress can do about it.

Don't miss this informative episode on a pressing issue in the healthcare sector. And for more free market perspectives on health care, subscribe to Health Care News, a monthly newspaper. To get your free subscription, email HealthCareNews@protonmail.com with your name and mailing address.

Chris Jacobs, founder of Juniper Research, has been investigating the AARP’s cozy deals with health insurance companies for years. Jacobs joins the podcast to discuss his new analysis of the AARP as well as the organization’s support of anti-Medicare policies. He also highlights the hidden surcharges the AARP collects off Medigap policies it promotes.

Jacob’s new analysis, which can be found here, found that the AARP collected $627.2 million in surplus fees that were secretly tacked on to health insurance policies AARP promoted for the United Health Group. The fees comprise 69 percent of the AARP’s revenue. Not surprisingly, the AARP supports policies such as drug price controls contained in the recent Inflation Reduction Act (IRA) that work more to the benefit of insurers than policy holders.

In the podcast, host AnneMarie Schieber and Jacobs discuss:

1) How the IRA reduced Medicare spending by more than $250 billion. The cut comes at the expense of a position the AARP purports to favor.

2) How insurance companies benefit from the IRA, which AARP supported.

3) The arrangement AARP has with United Health and the surcharges that are tacked on to Medigap policies which are not fully disclosed to policy holders.

4) How to turn this cronyism around.

We will also discuss the definition of social determinants, how they may affect tax dollars, the validity of their impact on health, the potential encouragement of harmful choices, and how the push for diversity, equity, and inclusion is expanding the definition of "essential" healthcare while posing a threat to fiscal health. Don't miss out on this insightful conversation that will leave you questioning the role of the government in our healthcare system.

Other topics:

-          CDC’s COVID data tracker, which cited 1,099,866 deaths from COVID 19 as of January 17, 2023. How are we to regard that number?

-          Uniformity in death certificates

-          The importance of autopsies in “sudden deaths” 

-          How Gov. DeSantis’s “grand jury” approach may bear fruit in getting to the bottom of the COVID shot marketing and coercion

-          The recent Rasmussen survey showing that now even those who received the vaccines are becoming skeptical of safety

In this case, Younes is representing Jay Bhattacharya, Aaron Kheriaty, Martin Kuldorff, and Jill Hines; four leading experts in public health who were deplatformed and/or censored by social media companies.  During discovery, emails surfaced between Facebook and the White House’s director of digital media, Rob Flaherty, that show this was more than a friendly relationship. The tone was more between a demanding boss and an underling. Communications were so flagrant that Younes and Kheriaty wrote about them in an op-ed in the Wall Street Journal.

Younes also discusses whether a public health emergency declaration gives the federal government more leeway in cozying up to private companies, and how digital communication is different from what happens normally under an expansive administrative state. Finally, does the explosion of public interest lawsuits against the federal government indicate a new age in governance?

Jenin Younes Bio: https://nclalegal.org/jenin-younes/

Younes Case: https://nclalegal.org/2022/08/ncla-clients-join-missouri-and-louisiana-suit-challenging-govt-directed-social-media-censorship/

Wall Street Journal Op-Ed: https://www.wsj.com/articles/white-house-covid-censorship-machine-social-media-facebook-meta-executive-rob-flaherty-free-speech-google-11673203704?mod=Searchresults_pos3&page=1

On December 13, Blahous and Liam Sigaud published “The Affordable Care Act’s Medicaid Expansion is Shifting Resources away from Low-Income Children.”

Host AnneMarie Schieber and Blahous discuss why spending growth for low-income children did not keep pace with growth in non-expansion states.  Why is it that children have been particularly impacted? What might have been a smarter approach? Are waivers the answer? Is expanding insurance coverage to a wider group incompatible with caring for the most vulnerable? This and more are discussed on today’s episode.

1. The Republicans in Congress will have a long list of priorities. Can something meaningful happen on health care policy?

2. “Anti-inflationary” agenda: Many people think the solution is more government spending to offset the high costs of health care. Why is this boneheaded thinking?

3. How will ending the COVID emergency help all Americans?

4. Medicaid oversight… has abuse and waste gotten worse during the current administration and how does this impact all health care, private care, and care for the needy?

5. Restoring trust in CDC and NIH…what can Congress really do here since this is under control of the current administration? What can Congress do to make sure these agencies are service all Americans, not just special interest groups?

6. Senate HELP committee led by Sanders, Cassidy. What will happen: fireworks or a miracle?

Keyes and Blase released a brief on December 5, 2022:  “A Health Policy Agenda for the 118th Congress”

Read the report: https://www.va.gov/oig/pubs/VAOIG-22-00813-253.pdf

Our veterans put their lives on the line to protect the freedoms America stands for. They deserve the best when it comes to health care. Sadly, this isn’t the case, especially when it comes to mental health and crisis care. Veterans get care through the Veterans Health Administration, a health system managed by the government.  It provides a glimpse of care under a socialized medicine model.

On this episode, Pipes discusses:

- The October report from the Inspector General and what it says about mental health care

- The prevalence of suicide among vets

- How VA care functions

- Long waits and why vouchers for private care could provide the best solution

Pipes has written about VA care in many articles and speaks on the issue.  Two recent articles include:

The VA is Failing America’s Heroes - Again

Dec 4, 2022, News-Press

https://www.news-press.com/story/opinion/2022/12/04/va-failing-americas-heroes-again/10799464002/

Veteran Suicides Testify to a Health Care Travesty

Nov 1, 2022, Washington Examiner

https://www.washingtonexaminer.com/restoring-america/patriotism-unity/veteran-suicides-testify-to-a-healthcare-travesty

Today’s guest is Rik Mehta, Pharm.D., J.D., biotech entrepreneur, and former consumer safety officer at the U.S Food and Drug Administration. Mehta, who knows first-hand how politics and public policy are intertwined as a former U.S. Senate candidate in New Jersey, discusses how seriously the public should take the report. He covers whether the CDC or schools will use the report as a basis to mandate masks, how the federal government can compel people to wear masks, why the Democrats backed off from masks in early 2022, the significance of the descriptions of “discrimination” mentioned in the report by people claiming to suffer from Long COVID, what the Biden administration can do if it really wanted to help patients and the public in general, and how effective a Republican led Congress will be in staving off more COVID policies.

HHS Report: https://www.hhs.gov/sites/default/files/healthplus-long-covid-report.pdf

Related Reading: https://heartlanddailynews.com/2022/12/hhs-report-on-long-covid-encourages-return-to-mask-mandates/

UDODA, passed in 1981, states that to declare someone legally dead, there must be irreversible cessation of cardiopulmonary function or irreversible cessation of all functions of the entire brain, including the brain stem. These determinations are to be made in accordance with accepted medical standards, but hospitals can never be 100 percent sure.  Klessig says there are many cases where people have been resuscitated and survived 10 minutes after the heart stopped beating, but a transplant team may begin the harvest of organs in a matter of minutes.

The procedure is banned in Australia and the American College of Physicians has asked for a pause until legal and ethical issues can be ironed out. Yet, hospitals have been vigorously pushing the procedure to increase the supply of organs which require a patient to be alive before they can be harvested.

She also discusses:

• How hospitals can take your live organs if you are incapacitated, no family can be reached, and they determine your condition is “irreversible,” which Klessig says, “is terrifying because their interest lies in what money can be made from your organs, not what is in your best interest.” Organs can be worth about $5 million to transplant centers.  The only way to prevent this is by carrying a card: https://halovoice.org/wp-content/uploads/donor_refusal_card.pdf
   
• How putting all resources into “live organ harvesting” has nearly eliminated research and development of alternatives to people with failing organs
    
• Ethical donations (tissue after death, kidney or lobe of liver from healthy donors)

Eugenics has a long history going back way before the Nazi’s practiced it in World War Two. It really got its origins in Victorian England and it got some cover because it was associated with an emerging field at the time, statistics. Graboyes said it entered the U.S. before the Nazi’s came into power and practitioners at first, and in a much more gruesome way. Euthanasia was too controversial, so sterilization of was the weapon of choice and the practice continued well into the 20th century when it was discovered prisons were sterilizing people who were incarcerated. Graboyes also discusses the expansion of euthanasia in Canada and even in the U.S. He discusses whether it could be used for nefarious purposes.

 Our guest today, Raymond March, a research fellow for the Independent Institute and assistant professor of agribusiness and applied economics at North Dakota State University, says this was a costly mistake. In an op-ed, March explains why it took so long for the U.S. to get access to the Novavax vaccine. March discusses Novavax’s different technology, the history of protein-based vaccines, and the dangers in using a one-size-fits-all approach when dealing with a public health threat. 
  

Novavax Authorization: https://ir.novavax.com/2022-10-19-U-S-FDA-Grants-Emergency-Use-Authorization-for-Novavax-COVID-19-Vaccine,-Adjuvanted-as-a-Booster-for-Adults

Op-ed: https://blog.independent.org/2022/08/12/take-so-long-novavax-vaccine/

Read the report: https://paragoninstitute.org/wp-content/uploads/2022/10/202208_Moses_LongTermCareTheProblem_FINAL_2.pdf

Seventy percent of people who reach age 65 today will require a severe need for long-term care. Long-term care provides medical and social services for those who are unable to care for themselves. 48 percent will receive paid care.  The need spikes after age 85. In ten years, the baby boomers will reach that threshold, causing demand for long-term care to soar.  Due to the loose financial guidelines, even well-off families can qualify for Medicaid coverage. This market manipulation crowds out private long-term care services. Our guest, Stephen Moses is about to release part two of a report which covers the solutions to this Medicaid problem.  His hope is that a new Congress will be open to better alternatives that improve care at more affordable prices.

In the interview, Moses discusses:

1.  How easy is it to get Medicaid to pay for long-term care?

2. How has this compromised the quality of long-term care over the decades?

3. Who will need long term care? Can any of us live independently until we die?

4. Baby boomers…most are now 65…what kind of pressure will that put on long-term care and Medicaid in 10, 20, and 30 years from now?

5. What about counting on family members to care for you? How about covering your care with your own wealth and investments?

Savage says there is plenty of COVID-19 relief money unspent, just sitting on the sidelines. As a physician, Savage worries how more government spending will drive inflation further, increasing costs for working families. COVID is now becoming an excuse for Congress to continue its spending binge.

Savage wrote about COVID-19 relief spending in an op-ed in Real Clear Health this summer.  He also discussed the emergency declaration extension, now scheduled to end in December. Savage covers opportunity costs involved when funds are directed to COVID-19 versus where our health care priorities should be.

Real Clear Health Op-Ed: https://www.realclearhealth.com/articles/2022/07/06/dont_buy_into_the_covid_relief_spending_spree_111363.html

Increasingly, health care professionals are being reprimanded, attacked and even fired for refusing to perform procedures that violate their religious convictions. It is not clear why CVS changed its position this summer regarding Casey. Interestingly, the MinuteClinic where Casey worked is located in Virginia where there are conscience protections in the law. CVS has stated it did not believe the “Morning After” bills are abortifacients but contraception. Kevin Theriot, an attorney with the Alliance Defending Freedom, discusses the facts of the case, the arguments, how the Dobbs decision comes into play, how there will likely be more cases similar to this, and the possibility that the issue could end up in the U.S. Supreme Court.

Alliance Defending Freedom: https://adflegal.org/paige-casey

On his health care blog, Goodman posted a rebuttal to the NY Times article on the day it was published. In the blog post, “Another Hit Job on MA Plans,” Goodman explains why risk payments are not overpayments, and certainly are not something that constitute fraud. Goodman points out in the podcast that some of the accusations come from whistleblowers who may receive rewards for their claims. Traditional fee-for-service Medicare has long been victimized by fraudsters and is rife with waste. Goodman points out MA plans, because they are private, have an incentive not to waste money. Medicare Advantage is the only system in the health care market that actually competes to take care of sick people.

New York Times Article: https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html

John Goodman Article: https://www.goodmanhealthblog.org/another-hit-job-on-ma-plans/

Hirschhorn’s list of questions: https://joelshirschhorn.substack.com/p/most-physicians-are-ignorant-cowards?utm_source=email

About today’s guest: Joel Hirschhorn is the editor of the Pandemic Blunder Newsletter, and author of the book Pandemic Blunder. He has been working tirelessly on the issue of the pandemic since the onset and was one of the earliest voices to ring the alarm bell on the “new age” in health care in which the bio-pharma industrial complex has taken control. As a full professor at the University of Wisconsin, Madison, he directed a medical research program between the colleges of engineering and medicine. As a senior official at the Congressional Office of Technology Assessment and the National Governors Association, he directed major studies on health-related subjects. Hirschhorn has testified at over 50 U.S. Senate and House hearings and authored hundreds of articles and op-eds in major newspapers. He served as an executive volunteer at a major hospital for more than 10 years. Finally, he is a member of the Association of American Physicians and Surgeons and America’s Frontline Doctors.

Topics of discussion:

1. Has the relationship between doctor and patient changed over the years and why?

2. For most of us, COVID seems like history. Are doctors still bringing it up and recommending COVID shots?

3. Questions patients should ask if the subject of COVID comes up and their doctor says “get the vaccine.”

4. What letter did Hirschhorn receive from a doctor that prompted him to draft these patient questions?

5. Could this same scenario happen with a different virus? 

6. Should wearing a mask in a doctor’s office, a practice we never did years ago, be a red flag to a patient?

Open the Books has been investigating Fauci and the NIH regarding his salary and retirement package as well as the hundreds of media appearances during the pandemic. Now the group, through FOIA is trying to get the names, amounts and payers of royalty payments government scientist get from private companies if their research is eventually licensed by a private company.

Discussed during the 20-minute podcast:

1.  Should this be a bi-partisan concern?

2.  What about Fauci’s point that guidance, vaccine approval came from non-NIH agencies?

3. Why Open the Books got interested in probing royalty payments

4. How the payments work. Shouldn’t these royalty payments go back to taxpayers for funding the salaries of the researchers? (Federal law allows the payments)

5. How forthcoming has NIH been on document requests?

6. Does Fauci get royalty payments?  Where will Fauci go after he retires from NIH in December? Andrezewjewski speculates

Useful links:

REP. MOOLENAAR, U.S. House Appropriations hearing:
 https://www.openthebooks.com/nih-acting-director-admits-royalty-payments-have-appearance-of-conflict-of-interest/

Homeland Security Government Accountability Committee Letter To NIH: https://www.paul.senate.gov/news/dr-rand-paul-and-hsgac-republicans-send-letter-acting-director-nih-requesting-information

Singleton and Schieber discuss:
 1.  Who will determine what  COVID  “misinformation” is
 2.  The possibility that a  physician could lose their medical license over COVID misinformation?
 3. Will this chase doctors out of state?
 4. Could Anthony Fauci be in violation given his flipflopping on COVID -19?
 5.  What could happen if SB 107 is signed into law?
 6. Will the constitutionality of this law likely be challenged in court?
 7. What would happen if a minor runs away to CA and seek emancipation? 
 8.  How these policies could spread to other states
 
 
 Check out more of Dr. Marilyn Singleton’s work on her website.

Ninety percent of all prescription drugs sold are generic.  Generic drugs are replicas of small molecule drugs (the drugs commonly taken in tablet form) and are cheap and affordable.  They have been revolutionary in driving down drug spending.

Biologic or biotech drugs are the cutting-edge drugs that account for most drug spending and are used by a small percentage of consumers.  Yet, there is no to few cheaper alternatives to these drugs due to regulatory obstacles and “patent padding” that can and are giving drug makers monopoly markets for decades.

 In the interview, Gregg and AnneMarie discuss:

- Evidence that high drug prices don’t necessarily guarantee more research and development. 

- What are biologic drugs are and why are prices for so high?  Do they cost more to research and produce?

- Do biosimilars do the same thing as their biologic counterparts?

- State of biosimilar market in the U.S.

- How is the biosimilar market in Europe different and why?

- Biosimilar Council’s efforts to change the thinking of consumers, pharmacists

- Interchangeability/concerns with the pharmacies

- Why we ALL should be pushing for these reforms

Girvan and Avik Roy have produced a growing body of articles and papers here: https://freopp.org/

The Growing Power of Biotech Monopolies Threatens Affordable Care, Sept. 15, 2020: https://freopp.org/the-growing-power-of-biotech-monopolies-threatens-affordable-care-e75e36fa1529

The Fair Care Act of 2020:  Market Based Universal Coverage: https://freopp.org/the-fair-care-act-of-2020-market-based-universal-coverage-cc4caa4125ae

Drug Companies are Warning that Pricing Reform Spells Doom. (They’re wrong): https://www.washingtonpost.com/opinions/2022/08/08/drug-companies-medicare-pricing-reform/

Push is on to Promote Cheaper Biosimilars: https://heartlanddailynews.com/2022/08/biosimilars/

Europe is Light Years Ahead in Biosimilar Adoption: https://heartlanddailynews.com/2022/09/biosimilar/

Our guest for today’s episode of Health Care News is Dr. Marilyn Singleton. Dr. Singleton previously served as president of the Association of American Physicians and Surgeons. She’s also written and spoken extensively on how the CDC and other government health agencies politicized COVID-19. She says that at the very least, it’s time for an independent investigation of the CDC.

During an interview, CDC Director Dr. Rochelle Walensky made comments on the state of the agency. Dr. Walensky said the CDC is facing three problems: unclear communication, a fragmented public health system, and action reactively, not proactively.

Dr. Walensky made these comments as the agency is facing increasing criticism over its handling of COVID-19. The CDC has received criticism for delving into issues beyond its mission such as critical race theory, climate change, transgender medical treatments for children, and teens.

Singleton discusses whether Walensky has called for a complete overhaul to take heat off the agency right before the midterm election. Singleton discusses her paper, “COVID-19: A Weapon to Fundamentally Transform America,” which highlights the CDC’s other mistakes related to COVID: diagnostic testing, flip-flopping guidance, and early treatment.

Dr. Singleton’s work can be found at her website https://marilynsingletonmdjd.com.

The plan will authorize the federal government, through Medicare Part D and B spending, to hit drug makers with a 95 percent tax on total sales if they fail to lower drug prices to the satisfaction of federal regulators. One economic study found drug research and development fell by 18.5 percent. This tax will also lead to supply shortages of pharmaceuticals. Dems are selling the plan as “drug negotiation,” but Phil Kerpen, president of American Commitment, tells AnneMarie Schieber that it’s a classic mob-style ‘offer you can’t refuse.’

The drug price control measure is being salvaged from the Build Back Better bill that collapsed in Congress a few months ago. Given the upcoming mid-term election, it is likely the Dems will succeed in getting it through. Sen. Joe Manchin is on board, prompted after the Dems changed the name of the bill to the “Inflation Reduction Act of 22.” Kerpen says there is nothing inflation busting about drug price controls. The key to fighting inflation is increasing supply. Kerpen explains how this bill will send a huge chill through the pharmaceutical industry. Companies will not develop drugs if they think the government will dictate the price.

See Kerpin’s latest blog post:
 https://www.americancommitment.org/content/democrats-want-raid-medicare-pay-obamacare-–-again

Medicare Advantage plans have been around for a while. They can save seniors money because they are managed, inclusive plans and spare them the need to buy something called Medigap insurance. Medigap insurance covers things that traditional Medicare does not. But recently, MA plans have come under attack with critics saying they’re a bad deal.  In the discussion, Schieber and Goodman cover the following:

1. What is Medicare Advantage, how does it differ from traditional Medicare?
 2. How do the plans work, sign up for a lifetime or can you go back and forth?
 3. Why has Medicare Advantage been under attack most recently?
 4. Let’s address the criticisms, first denial of authorized service
 5. Are the risk payments a perverse incentive to declare someone sicker?
 6. Are the plans accurately priced. Is the government paying more than it should?
 7. Do you take a risk if you become critically ill and you’re in an MA plan?
 8. What can be done to make MA better?

Goodman also discussed a new service at the Goodman Institute, the “Health Care Toolkit.” Political candidates can use it to become better educated about health care free-market reforms. 

Goodman defended Medicare Advantage in his column in Forbes:
 Are America’s Best Health Plans Being Attacked Unfairly?
https://www.forbes.com/sites/johngoodman/2022/07/13/are-americas-best-health-plans-being-unfairly-attacked/?sh=3f67e3073974

This is the fact sheet the White House released describing the need for medical debt relief and the actions it plans to take: https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/11/fact-sheet-the-biden-administration-announces-new-actions-to-lessen-the-burden-of-medical-debt-and-increase-consumer-protection

Herrick discusses the following:

1.  Wasn’t medical debt what the ACA was designed to prevent?
 2.  Fact sheet says the feds pay $1.5 trillion towards health care, why are people getting bills at all?
 3. Do you have any concerns with preventing credit agencies not being allowed to use medical debt in credit ratings, would this send a chill to providers, might they restrict care unless you can first prove you can pay your extra bill?
 4. Medical Debt forgiveness for low income vets…aren’t vets supposed to get free health care, period?
 5. One action is informing consumers about their rights through the Consumer Financial Protection Bureau. Do we even consider this in industries where the free market is able to rein?
 6.  Pete Sessions bill: What’s in it and how are its chances for success in Congress?

Devon Herrick’s health care blog at the Goodman Institute can be found here:
 https://www.goodmanhealthblog.org

To most, telehealth is relatively a new phenomenon. Before the pandemic, Medicare barely covered it. First, Medicare patients had to be living in an underserved rural area. If they did receive a telehealth visit, it had to be done at an approved health care facility. When the pandemic hit, and states instituted lock downs, telehealth was a saving grace because it was the only way many patients could get health care. Telehealth visits are fully covered by Medicare, but only during a public health emergency. Gordan talks about how telehealth could lead to higher health care utilization which would drive up Medicare costs.  He also addresses telehealth innovation and whether “guardrails” could slow this down. The Committee for a Responsible Federal Budget released this paper on the topic on April 21, 2022.

https://www.crfb.org/papers/fiscal-considerations-future-telehealth

Jane Orient, M.D. is the executive director of the Association of American Physicians and Surgeons.  She minces no words, calling the trial used to support approval “a disgrace.” Dr. Orient points out the lack of effort to measure not just efficacy, but safety, in giving the shots to an age group with zero to no risk of dying from COVID-19. 

Jane Orient, M.D. covers a range of questions about the infant and toddler COVID-19 shot approval.  Details of the clinical trial include the fact that 67 percent of participants dropped out. What prompted this interest in wanting to provide these shots to young children and why did the trial reverse this trend in parents?

Orient and host AnneMarie Schieber also go over the history of other childhood vaccines. How long did it take to get those approved and how do those diseases compare to COVID? Why are parents so fearful of COVID-1919 infecting their children even though many have been exposed to it, show antibodies and had few to no symptoms? Orient believes the COVID shots will like be part of the panel of recommended shots for children, perhaps mandated for entry to school, yet there has been no effort to examine whether the shots will cause heart damage, already demonstrated in some trials.

- How have physicians have responded to this new terminology?

- What about the use of “pregnant persons” in some bills in California?  Do they believe someday men could be altered to give birth?

- It is easy to joke about woke language, but could patients be at risk?

- What did Supreme Court Justice Kentanji Jackson mean at her confirmation hearing when she said that she couldn’t describe what a woman was because she was not a biologist?

- Will there be any turning back if woke terminology is used more in articles? How about legislative bills? Is the intent to change the public’s thinking?
 
 Dr. Marilyn Singleton’s website: https://marilynsingletonmdjd.com

Patient rights are under threat as the emergency declaration enacted during COVID-19 concludes as expected in mid-July. This theoretically leads to the end of telehealth. Josh Umbehr is the founder of Atlas MD, one of the first direct primary care practices (DPC) in the U.S. DPC has long been using telehealth to help patients faster and more affordably. Because DPC is independent and not reliant on third-party payers, it can bypass restrictions on telehealth. Umbehr also talks about tele-care, gathering patient data using high tech devices, sharing the data to help patients and deliver better care, and related privacy concerns. Additionally, he discusses the recent case where a telehealth company was red-flagged for writing an unusual number of prescriptions for a controlled substance.

Dr. Josh Umbehr’s March 3 op-ed on telehealth is in RealClearHealth: https://www.realclearhealth.com/articles/2022/03/03/is_telehealth_here_to_stay_yes_but_only_if_we_stick_the_landing__111324.html

Atlas MD:  https://atlas.md/wichita/about-us/our-team/josh-umbehr-md/

Newaygo community leaders ask the direct primary care practice (DPC) if it would consider opening a second facility in their town. Christian Health Care Centers is a facility-based DPC that opened in 2017 and has had remarkable success. The community and CHC worked together to make it happen and on May 10, 2022, they celebrated the grand opening of a new 8,150 square foot facility. Residents are thrilled they don’t have to travel for basic health care and they’ll save a bundle of money under the direct-pay, membership model.

Websites:

Christian Health Care Centers: https://www.chcenters.org

Heartland articles featuring Mark Blocker: https://heartlanddailynews.com/?s=blocher

George Hosu, founding engineer of Eureka Health, joins the show to discuss his recent article on Medium, “Why Doesn’t Healthcare Improve Health?” Hosu cites the extensive work of Robin Hanson, presents several hypothesis on why spending more and increasing access may not improve outcomes, and explains how he personally determines the value of an intervention. The healthcare industry gobbles up 19.7 percent of the nation’s gross domestic product. According to the Centers for Medicare and Medicaid Services, the U.S. spends about $12,530 a person on health care. Yet there are gaps in outcomes. The U.S. ranked 18

th in highest number of COVID-19 deaths.  Deaths from drug overdoses are on the rise. The U.S. has one of the highest obesity rates in the world. Hosu and host AnneMarie Schieber discuss the value of placebos, the limitations of randomized control trials, and how the third-party payer system impacts personal health care decisions.

The most pernicious mask mandates existed in the nation’s public schools.  If schools were open, in many school districts, children were ordered to mask-up. Kerpen has a hypothesis as to why masked schools closed their doors more often than those that made masks voluntary. Kerpen also discusses the work he did on the latest analysis by the National Bureau of Economic Research, A Final Report Card on the States’ Response to COVID 19, that ranked states on economic, health and education outcomes during the pandemic.  At the top of the list, were states that had the least heavy handed COVID policies.

PBM has been around for about 60 years. It is now getting more attention as patients and physicians seek alternatives to prescription pain medication which can lead to chronic dependence. Since its inception, PBM has been used on 100 million people. Patients can get treated at centers or self-treat at home using FDA approved devices. Faukner discusses how PBM provides a long-lasting solution to pain by repairing the cell structures that lead to pain, how much the treatment costs, how long it takes to be effective, and training providers to use PBM, including a new center that opened at Shepherd University in West Virginia.

For more information:
 https://pbmfoundation.org

Clinical trials:
 https://clinicaltrials.gov/ct2/results?cond=&term=Photobiomodulation&cntry=&state=&city=&dist