Health Care News Podcast

A new Gallup poll shows that 35 percent of physicians are Democrats, 27 percent are Republicans and 36 percent, Independents. This is a large demographic shift from decades earlier when physicians ran more independent practices and identified as Republican. Now more physicians are employees with large health care systems. 

Three policy advisors with The Heartland Institute discuss this trend and why the public ought to be concerned as medical practices look to shift away from small and independent clinics to large, possibly even government run collectives.

Health Care News

More Doctors Are Leaning Left (Guests: Dr. Jane Orient, Dr. Roger Klein, Adam Habig)

Christina Herrin, Director of Free to Choose Medicine with The Heartland Institute, and Richard Garr,  Founder of Access Hope CRO, discuss the drug approval process, the inner workings of Federal Drug Administration (FDA) regulatory structure, and recently passed Right to Try legislation.

Patient Voices: Fighting for FDA Reform (Guest: Richard Garr)

When the state of Tennessee chose not to expand Medicaid and decided instead to explore block grant funding for the program, Tennessee residents in Shelby County came out to register their complaints that the state was going rogue.

Many of those residents, who who use Medicaid and believed that a block grant would somehow mean they would no longer have access to health insurance and care, even asserted that the state should have m ore oversight from the federal government on the program.

If an independent-minded Southern state like Tennessee is terrified of the state making a decision about how they want to fund Medicaid, it's clear the message of health care reform and the inefficiency in government-run programs has been distorted.

Health care scholar Naomi Lopez-Bauman joins The Heartland Institute's Health Care News podcast again this week to discuss the folly of Medicaid expansion and why residents in Tennessee have been given bad information about emerging health care reform efforts, and why they have no reason to fear.

Dangers of Medicaid Expansion (Guest: Naomi Lopez-Bauman)

Trump’s order is expected to expand health care options to 11 million workers. A number of employers don’t offer group health insurance because of cost or may offer only one plan. Trump’s order reverses restrictions placed on HRA’s when the Affordable Health Care went into effect. HRA’s can give employees more options for health insurance.  William Sweetnam,legislative director with the Employers Council on Flexible Compensation, discusses what HRA’s are, how they work, how employees can use them, how they differ from Health Savings Accounts and Flexible Spending accounts, and what employers who don’t offer health insurance would want to fund them.

Health Reimbursement Accounts (Guest: William Sweetnam)

On Wednesday, Oct. 31, Democrats in the Senate took a vote that ultimately failed that would have rolled back some of the expansion of the 1332 waivers that allow states to innovate and design their own health insurance structure. The Trump administration had made it easier for states to request those waivers, originally made available under Obamacare, and, as a result, more and more states had begun taking advantage of the opportunity. While the Senate vote failed, it undoubtedly was an attempt to send a message to the Trump administration about coverage for pre-existing conditions (a strange move since the waiver expansion didn't affect coverage for those consumers) and the desire to hang onto Obamacare. Pye, a health policy expert who is regularly on the Hill talking with legislators, discusses this vote and other moves the Trump administration has made toward free market health care. He also discuss Freedomworks' recent contributions to the Republican Study Committee's health policy framework intended to give legislators grassroots ideas to bear in mind as they craft legislation. Listen below!

Freeing Up the Health Movement (Guest: Jason Pye)

Medicare is a program Americans have come to know and love. But it is faced with a number of challenges, fiscal stability, waste, fraud and abuse.  On October 3, President Trump delivered an executive order aimed at shoring up Medicare. Hyman discusses the fundamental problems with a “transfer” program and how the U.S. might look to senior health programs like that in Singapore.

Hyman is an expert on health care policy, as a medical doctor, professor of law at Georgetown University and Cato fellow. The podcast discusses Medicare in general, the problems of a “pay as you go” system, Medicare’s trust fund, its vulnerability to politics, waste, fraud and abuse and why a tax-advantaged savings program similar to a 401k might be a better way to address Medicare’s fundamental problems. Do Americans have the will to take more responsibility for senior health?

Can President Trump’s Executive Order Fix Medicare? (Guest: David Hyman)

Under Obamacare, there was a way for states to apply for waivers that would allow them to innovate when it came to health care regulation, presumably with the idea that they would innovate in the direction of strengthening the Obamacare Exchange in their state. The Trump administration, back in 2018, refined that waiver process and relaxed some of the so-called "guardrails" so that states could apply for waivers that would take innovation to the next level — even away from Obamacare altogether. And that is exactly what the state of Georgia has done with their "Georgia Access" program, applied for under the original 1332 waiver process. 

Kyle Wingfield, President and CEO of the free market think tank Georgia Public policy Foundation, has been urging state leaders to make use of the refined waiver process and go bold. Georgia took him up on those calls and has designed a health care regulatory system in the state that takes the control very nearly completely out of federal purview. It is the most radical use of the 1332 waiver process to date, and Wingfield hopes other states will begin to follow suit and design their own regulatory regimes that best suit the citizens of their states. Wingfield joins HCN podcast to discuss the Georgia plan and how it is yet another building block in the move toward federalism in health care.

Redefining the 1332 Obamacare Waver (Guest: Kyle Wingfield)

The Trump administration has been flirting with the idea of importing prescription drugs as a way to informally introduce price controls on pharmaceuticals to help control the exorbitant cost of prescription medications and address surprise billing. The progressive wing of the Democrat party is attempting to formalize this idea by introducing what Jim Martin, Chairman of the 60 Plus Association (a free-market alternative to the the AARP) calls "Pelosi's Plan". 

While Martin is a Trump supporter and has generally agreed with the administration on their moves in the health care space, he worries that price controls will ultimately stifle innovation in the drug market and allow government a larger share of negotiating power, while helping "Big Insurance" make a profit off seniors who will be affected more than most. Martin and his group recently penned a letter to Congressional members not to be taken in by "Pelosi's Plan" — which could show up in the end-of-the-year budget deal — and to let the free market determine the price of medicines. He joins the Health Care News podcast to discuss.

Controlling Drug Price Control (Guest: Jim Martin)

Rik Mehta, biotech entrepreneur and candidate for Senate in New Jersey, discusses regulatory health care issues and what the future holds for medicine.

Diagnosing the Regulatory Pretzel Known as the FDA (Guest: Rik Mehta)

Increasingly, employers, mainly hospitals, are compelling physicians from signing long-term, restrictive non-compete clauses that go as far as prohibiting them from informing patients if they leave an organization and go elsewhere. 

Non-compete clauses have been under scrutiny not just for physicians but any number of professions. Attorneys don’t agree to them because it interferes with the practice of law but for some reason, they are acceptable in medical practice.  Hochman explains how non-competes interfere in practice in South Carolina and how physicians can fight it. Habig, who has explored this issue in depth, discusses how states across the country are addressing the issue and how these clauses can actually limit new modes of health care delivery.

Non-Compete Clauses are Stopping Doctors from Serving Patients

President Trump is expected to sign the $1.5 trillion omnibus bill that will fund government spending for the remainder of fiscal year 2020.  Brian Blase, of the Galen Institute and Heritage Foundation says this was a lost opportunity for lawmakers to reign in some of the biggest cost drivers of health care. The bill eliminates the tax on “Cadillac” health insurance plans, which will open the door for wasteful health care spending, and does nothing to address abuse of Medicaid expansion programs and ties the Administration’s hands from doing anything to stop insurers from gaming Obamacare’s subsidy formula.

Omnibus Spending Bill Will Drive Up Health Care Costs (Guest: Brian Blase)

Colin Craig of secondstreet.org describes how his organization has been monitoring how patients leave the country because they cannot get quick access to a doctor in the country’s single payer health care system.

Secondstreet.org says more than 271,000 Canadians left the country in 2017 seeking medical care in other countries.  He describes one woman, a nurse with debilitating back pain, who paid for surgery in Tijuana, Mexico when she was told there would be a two year wait for treatment in Canada. 

Craig goes on to say that Canadians pay stiff taxes for their single payer health system so it says a lot when they spend their limited discretionary income to get medical attention in other countries. These are stories Americans will want to hear as lawmakers talk seriously about bringing socialized medicine to the U.S.

Medical Tourism from Canada (Guest: Colin Craig)

Due to a number of factors, the U.S. is currently facing a shortage on primary care physicians that will see some states with shortages that number in the hundreds. Given the already over-taxed emergency rooms and overworked existing primary care clinics and physicians, this is a problem that could become increasingly difficult to solve if something isn't done soon.

Courtney Joslin, an expert in commercial freedom, joins The Heartland Institute's Health Care News podcast to discuss the issue and its seriousness — and to offer what she says could play a role in helping alleviate the problem before it gets out of hand. Medical licensing reform — specifically expanding the scope of practice of licensed professionals such as physicians assistants, pharmacists, and registered nurses, who already work alongside primary care physicians, could address the shortage until academia and the marketplace catch up to make primary care an attractive field again to young medical professionals.

By allowing these professions to take on an expanded role, it helps over worked doctors, and frees up these professions to grow accordingly. And, most importantly, it makes licensed and trained health care professionals available to undeserved areas in desperate need of quality health care. Listen below.

The U.S. Primary Care Shortage (Guest: Courtney Joslin)

Rep. Walker lead a letter to the FDA in support of reform earlier this year. The letter strongly urged the FDA to expand upon methods already in place to expedite approval for potentially life saving medication. The full body of the letter can be viewed at the following link below: 

https://walker.house.gov/sites/walker.house.gov/files/ParallelTrackFDALetter.pdf

Listen now to hear about his efforts to push for more reform.

Discussion About FDA Reform (Guest: U.S. Rep. Mark Walker)

Department of Health and Human Services Deputy Secretary Eric Hargan has had an expansive career in both the public and private sector on regulatory health care policy. He served as Acting Secretary upon the departure of HHS Secretary Tom Price in October 2017 and held the helm until Alex Azar assumed the role in January 2018. Hargan wants to eliminate health care bureaucracy to deliver better care to the patient while also maintaining patient safeguards such as privacy. He and host AnneMarie Schieber about the Stark Law, anti-kickback statute, HIPAA and privacy protections for substance abuse disorder in this edition of Health Care News podcast.

Getting Regulatory Obstacles Out of the Way for Better Health Care (Guest: Eric Hargan)

The desire to lower drug prices is one of the rare issues that both political parties agree on in this hyper-partisan era of Congress. Agreeing to a solution on how to achieve this remains an ongoing battle. Congress has the ability to influence this without hampering growth and development, but not through the hefty bureaucracy of the FDA. Free to Choose Medicine Director Christina Herrin invites Policy Advisor Jeff Stier to discuss how to go about this.

For the full New York Times article "The F.D.A. is in Trouble, Here's How to Fix It," visit:
https://www.nytimes.com/2020/01/11/opinion/sunday/fda-commissioner-stephen-hahn.html

For further reading, visit:
https://thefederalist.com/2020/01/20/yes-the-fda-is-in-trouble-but-the-new-york-times-prescription-would-make-it-worse/?fbclid=IwAR1IUBtBoDjDfMubFKIkSJAKkPUnYaU6AW8VYxggvw-jwp0QVEM6C5xhvQ0
https://www.realclearhealth.com/articles/2019/04/11/lower_drug_prices_without_harming_innovation_110896.html

Lower Drug Prices Without Harming Innovation (Guest: Jeff Stier)

What is the threat of the coronavirus? More people may have been exposed than we know. There is no treatment, just prevention and quarantines may or may not work. Orient also discusses two unrelated matters involving her organization’s lawsuit again Congressman Adam Schiff for trying to stifle information on vaccinations and an amicus brief AAPS filed in the abortion case before the Supreme Court in March, stating states are not out of bounds for requiring abortion doctors to have hospital privileges.

Is the U.S. Prepared for a Coronavirus Pandemic? (Guest: Dr. Jane Orient)

Under Obamacare, the federal government enticed states to expand their programs to able-bodied people under 138 percent of the poverty level. Initially, the federal government reimbursed 100 percent of these expense. States saw it as an easy way to bring more federal tax money into their coffers and underwrite expense for hospitals and insurance companies. Brian Blase, scholar at the Galen Institute and Heritage Foundation also discusses whether block grants can make Medicaid more responsible and how at least 2.3 to 3.3 million people are improperly enrolled in the program because they make too much money and why states have failed to monitor this more closely

Medicaid Out of Control (Guest: Brian Blase)

California's progressive governor Gavin Newsom, taking cues from Speaker of the House Nancy Pelosi who proposed something similar in the House, has included in the state's budget a proposal to allow the state itself to work with generic pharmaceutical manufacturers to negotiate the price of prescription drugs.

In short: Newsom wants to create a California generic prescription drug label that would import price controls and leverage the negotiating power of the state to keep the price of drugs low. With 1 in 3 of the 40 million people that live in California on Medicaid, that could end up being quite the undertaking.

Wayne Winegarden, senior fellow at California's Pacific Research Institute, joins the Health Care News podcast to discuss the idea and recognizes it immediately as a shallow attempt to wrest control of a portion of the health care marketplace without any understanding of the economic drivers that keep costs high.

State Controlled Medicine in California (Guest: Wayne Whinegarden)

While Democratic candidates continue to sell Medicare for All and other centrally-planned health care ideas to the American public in preparation for the eventual demise of Obamacare, Sally Pipes of PRI has written the definitive book on the folly of their proposals. 

In her new book, "False Premise, False Promise: The Disastrous Reality of Medicare for All," Pipes lays out all the proposals being floated at the moment from presidential candidates who flirt with socialism, and dismantles their arguments using the challenges and outright tragedies of the Canadian health care system and the UK's National Health Service.

Interspersed throughout the book are vignettes of real people and the horrors they've experienced through socialized medicine, from a famous Canadian singer seeking cancer treatment in California, to a patient being told they should consider assisted suicide over treatment. Pipes also offers her prescription for what the U.S. should be doing as we look to replace Obamacare, which involves an embrace of free-market strategies and philosophies to shore up the private health insurance marketplace.

The Disastrous Reality of Medicare for All (Guest: Sally Pipes)

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