EP 650 Do Minority Cancer Patients Receive Different Care Than White Patients?
The answer to the question posed in the title to this podcast was the basis of a substantial research project undertaken by a team at the Yale Cancer Center, led by Dr. Sajid Khan,an associate professor of surgery and section chief of hepato-pancreato-biliary and mixed tumors at Yale School of Medicine. He is our guest today. The findings are rather stunning. In a study encompassing over a half million patients over more than a decade and with a variety of gastrointestinal cancers, it was discovered that Black patients are less likely than white patients to have “negative surgical margins”, and have adequate lymph node removal in surgery. Following surgery Black patients are less likely to be offered chemotherapy or radiation. The looming question in my mind when I did this interview with Dr. Khan was ‘why.’ The answers may surprise you and beg more questions as you think about what the research tells us.
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From disease to long term care to natural disasters, insurance offers hope for security in an uncertain world. But it often fails to deliver. In this podcast we explore what makes insurance markets work and what makes them fail. Our guest, Amy Finkelstein, an economics professor at MIT, and her co-authors Liran Einav and Ray Fisman in their book “Risky Business: Why Insurance Markets Fail and What to Do About It,” describe what it means to be part of a selection market–the defining feature of insurance-in which some customers are more expensive than others. They point to a great example to explain this concept. While a grocer does not care who buys broccoli, an auto insurer most definitely wants to know who is a terrible driver. The composite picture some insurers need to put together, like those selling life policies, may include an actual physical exam to determine if they want to write the policy and at what cost. In this podcast we explore a range of coverages and their vagaries including pet, dental, long-term care,health, auto and disaster insurance. If you didn’t think this topic could be made interesting, listen in. It is..and it is an important industry to help us sleep at night.
Labor is having a moment in America. With unemployment at its lowest rate in 50 years, even workers at the low end of the pay scale, in industries like fast food, retail and hospitality, are finding jobs that pay $15 an hour or better and come with benefits, such as medical insurance, tuition assistance and retirement plans. Labor is in short supply as baby boomers age out, immigration policy is restrictive and fewer jobs require a college degree. It’s a perfect storm for those looking for work in the service sector, in particular. But, will it last? In their new book, “Moving the Needle: What Tight Labor Markets Do for the Poor” Katherine Newman and our guest, Elisabeth Jacobs, explore this topic fully and introduce us to those whose lives are being turned around to the benefit of all. We touch upon government policies that may be required to sustain this good news story when the business cycle reverts back to a higher rate of unemployment, as it no doubt will at some point.
Who better to explain the remarkable changes that have taken place in Ireland over the last sixty years than one of its greatest modern writers, Fintan O’Toole, author of “We Don’t Know Ourselves: A Personal History of Modern Ireland?” Designated one of the New York Times Book Review’s Top Ten Books of 2022 is now out in paperback and I was honored to speak to such a thoughtful and gifted writer and commentator. He explains how the Irish have always presented a certain ambiguity about life’s complexities and that its history is riddled with “known unknowns.” He uses his upbringing as a window into the dramatic changes that have seen the society go from a near theocracy to a willful casting off the yoke and double standards of the Catholic Church to present a new image to the world, where same sex marriage, abortion and divorce are all accepted norms in the society that once forbade all. He also provides insights into the Troubles in North Ireland and captures the essence of of the particular Irish habit of “deliberate unknowing” which allowed myths of national greatness to persist as the foundations were collapsing. It’s a perfect time to present this conversation on the heels of President Biden’s visit to Ireland.
If there is a technology story trending in America today it’s the presumed impact of ChatGPT on all manner of writing and communicating in our business lives, academic careers and every day interactions. While this description has been written by a real human being it could have been written by this enhanced form of artificial intelligence. After all, it is capable of composing poetry, creating chord progressions that adhere to music theory and translate 100 languages. The awesome capabilities of this new generation of AI are hard for most of us to grasp. That’s why we reached out to Naomi Baron, Professor Emerita of World Languages and Cultures at American University and the author of a new book, soon to be released, called “Who Wrote This? How AI and the Lure of Efficiency Threaten Human Writing.” White collar workers beware as an Oxford study suggests AI could replace 47 percent of U.S. jobs, including paralegals, copywriters, digital-content producers, entry-level computer programmers(yes it can code)and some journalists. Professor Baron makes clear the implications of this most powerful new tool on this podcast.
From my curiosity generated by the headline of an op-ed piece in the New York Times titled “The Boss Is Back in Silicon Valley” came the following wide ranging conversation with Carol Schultz, the founder and CEO of Vertical Elevation and author of “Powered By People: How Talent-Centric Organizations Master Recruitment, Retention, and Revenue(and How to Build One)” discussing the changing workplace in America as its most valued sector has employees taking a haircut when it comes to perks and benefits. We discuss the new hybrid work environment, the great resignation, quiet quitting, the four day work week, labor’s moment because of supply and demand and other buzzwords in the world of work. It’s a lively discussion sure to find issues you can relate to whether your are a manager or a person being managed.
Few of us can imagine the difficult life circumstances that bring teenage children into a detention facility, which to them is simply another word for a jail. Jeff Hobbs, an author who immersed himself in different kinds of facilities to capture first hand accounts of the experience from these children describes in vivid, and painful, detail what happens there in his book “Children of the State: Stories of Survival and Hope in the Juvenile Justice System.” While some in society might look at these kids as society’s throwaways, to Hobbs there’s always hope, even if it turns out to be difficult to find redemption in a society that offers few choices and low ceilings once you have been detained in this way. Circumstances are different, state by state, county by county, in America but given the ongoing brain development research, it seems defeatist not to believe that even these troubled teens cannot rebound from these early interactions with the system. Our guest will introduce you to what he saw as part of his immersive reporting on juvenile justice in three different facilities.
The Constitution reserves many responsibilities to states and enumerates clearly those that the federal government can undertake. Wildlife management was one of those state focused responsibilities until the earliest days of the 20th century and then with the Lacey Act and Migratory Bird Treaty Act, responsibilities began to be shared or taken over by the federal government. In the case of wildlife management, such as migratory birds or many other species of animals who traverse boundaries of states, it makes sense that policy be directed from a national perspective. In 1973 with the passage of the Endangered Species Act further duties were taken on by the federal government but still much of the work on the ground was being done by the states. The friction now results in where the funding comes from to protect species further impacted by climate change. If you care about critters, please listen in and make your voice heard about public policy debates ongoing. Lawyer, conservationist, historian and author, Lowell Baier, joins us today on the podcast to discuss.