In late 2020 the Congress passed the No Surprises Act largely intended to address patient “surprise,” or out of network bills, typically the result of ER visits. Should settlement between the healthcare provider, e.g., hospital, and insurance company fail, the bill created an arbitration, termed Independent Dispute Resolution (IDR), process. To date the number of disputes going to arbitration have vastly outnumber those expected, the vast majority of provider-initiated disputes have been curiously backed by private equity, arbitration settlements takes take more than twice as long than the sta ..read more

Over the past four decades the US has, per a 2019 JAMA-published study, made a “clear lack of progress on health equity.” Health equity or disparities have almost certainly worsened over the past five years due to COVID and accelerating climate breakdown.  For example, air pollution in 2021 killed over 8 million globally including 2,000 children under age five daily. Foul air, nearly entirely the result of fossil fuel combustion, is 2nd only to malnutrition and hypertension as a risk factor for death among children and adults, respectively. In late May, HHS’s Centers for Medicare and Medi ..read more

Mr. Burger joins me to discuss climate crisis-related litigation here and abroad and its effectiveness in curbing greenhouse gas emissions. Dedicated listeners may recall I interviewed Mr. Burger in May 2020 regarding the Trump administration’s unwinding of numerous environmental regulations.  Michael Burger is the Executive Director of the Sabin Center for Climate Change Law at Columbia University. Prior to, he was an associate professor at Roger Williams University School of Law and served as an attorney in the Environmental Law Division of New York City’s Office of ..read more

Climate-related health effects are typically defined or limited to those resulting from extreme weather events, exacerbations of chronic disease and increases in vector borne diseases. Unfortunately, very little attention or even recognition is afforded the effects the climate crisis has on brain health largely via climate-fueled neurotoxin exposure. Mr. Aldern’s valuable if not indispensable work attempts to explain how the climate crisis infuses our air and water with neurotoxins that increase the range of brain disease vectors and spur PTSD and other psychiatric conditions that can spread i ..read more

In Dobbs v. Jackson Women’s Health Organization, the Supreme Court in June 2022 reversed the court’s previous 1973 Roe v Wade decision, and 20 related cases, wiping out a half century of constitutional protections for women’s reproductive rights.  In Dobbs, the court found the Constitution now excludes a woman’s control over her body as well as the possible continuation of her life.  Compelled pregnancy, involuntary childbirth and forced parenthood is not, the court ruled, an essential part of the “liberty” protected under the 14th amendment - or presumably even the freedom of “invol ..read more

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

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

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

Sepsis presents an enormous public health threat. There are for approximately 1.7 million hospital cases and 270,000 deaths per year. Sepsis is consistently in the top five for hospital case volumes and is the most expensive and resource intensive medical inpatient condition, representing approximately 15% of total hospital costs despite accounting for less than 4% of hospital stays.  Various studies estimate sepsis is present in 30% to 50% of hospitalizations that culminate in death.  Because two-thirds of sepsis cases are paid for by Medicare, beginning this January 1, HHS will add ..read more

According to the non-profit Mapping Police Violence, since 2013 when experts first starting tracking police shootings, last year was the deadliest year on record with 1,176 law enforcement gun deaths, or more than three people per day and nearly 100 per month.  In 2022 Blacks were three three times more likely to be killed by police than Whites.  However in, for example, MPLS and Chicago, Black shooting deaths were respectively 28 and 25 times more likely than White.   In her recently published book by Viking Press, Prof. Schwartz explains how the corruption of the 4th amen ..read more