EP 662 A Safety Net Hospital: A Model for Health Care Reform in America?
Healthcare is the number one cause of bankruptcy in America. Nearly 30 million Americans have no insurance and those who do face staggering increases each year. We all interact with the healthcare system and to a person I do not come across anyone who thinks it’s a good model. And while we might have the most advanced technologies and very capable medical professionals, they are hamstrung by bureaucracy, out of control costs and demands from intermediaries that often have little to do with the care they want to provide. And whether you call the health care system you interact with for profit or non-profit, they all continue to get bigger and more focused on the bottom line than on patient care. Dr. Ricardo Nuila is the author of “The People’s Hospital” and practices medicine at Ben Taub Hospital in Houston, Texas. It is a ‘safety net’ hospital funded through property taxes by Harris County and serves a majority of patients who have no health insurance. Doctors are allowed to be doctors and not focus on the business of medicine. We discuss what is wrong with America healthcare(more accurately described as sick care)and at its root is the private health insurance model which encourages differentiated care depending on your wealth and status in our society. He offers a different perspective and some policy solutions. Won’t we ever engage as a country on this vital issue?
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While the belief is that all young people are in lockstep with liberal ideas, many flirting with socialism, the truth is that the enthusiasm of young people on the right is better financed and has some charismatic leaders who are working diligently to get those ideas to their age cohort who feel marginalized by the changes going on in our society. This movement is not just taking place among those who are ending their academic careers after high school. There is an active recruitment effort by many well known groups like the NRA to bring young people into the fold early on. Leaders of the effort include Charlie Kirk of Turning Point USA and Candace Owens a media favorite who has abandoned the ’emotionally abusive’ Democratic Party and evinces the passion of a convert to the conservative cause. Award-winning journalist, Kyle Spencer, spent five years researching and following this movement and reports what she found in her book, “Raising Them Right: The Untold Story of America’s Ultraconservative Youth Movement and Its Plot for Power.”
Our guest has been warning America for decades that our government has become unaccountable tied up in overlapping jurisdictions and strangled by reams of rule books and regulation. The ability to make decisions based on common sense and human
Imagine getting a check for $1,000 from this point on, on the first day of every month, deposited directly into your bank account. What would that do to give you peace of mind that there’s an income floor under you? Andrew Yang made this concept a basic tenet of his 2020 presidential run calling it a ‘Freedom Dividend’ as he saw frightened Americans looking at their downside prospects in the wake of automation and job outsourcing. To those who think the idea of Universal Basic Income is a liberal utopian concept, it actually harkens back to conservative economist Milton Friedman who preferred this notion to the many categorical programs we have now, like SNAP benefits. Richard Nixon actually proposed something like it during his presidency. Today, municipalities across the country are experimenting with it in various forms. And early research tells us that people put the money to good effect, helping them to provide food and shelter in these uncertain times. We’re joined today by Jim Pugh, co-director of the Universal Income Project(universalincome.org)to describe how it works and what the likelihood that it will gain more traction in the years ahead.
Faced with mounting Medicaid costs, powerful public employee unions and often underfunded pension and medical obligations, state and local governments can present fiscal dilemmas that, at times and as a last resort, the federal government gets dragged into. It is hard to overstate the importance of making certain that the 50 states and Puerto Rico and thousands of local municipalities have the resources they need to operate since they provide the most essential, visible, government services important to all of us–teaching our children, building and maintaining most infrastructure, public health and public safety. And yet with the din of our obsession with national news, we do not see substantial reporting on their fiscal health. And as David Schleicher, a Yale Law School professor and expert in this field reminds us, in his book “In a Bad State: Responding to State and Local Budget Crises”, while we have a moment in time when many state governments are awash in federal pandemic dollars, it is a good time to take a true assessment of the health of state and local governments to perform their vital tasks.
As podcasters go, I don’t generally insert myself into the story line like so many others do. To me, it’s about the guest, their book or their expertise. In the case of this story, I was right in the middle of helping to elevate women’s basketball in America to new heights. As the chief programming executive at Connecticut Public Television for a quarter of a century, one of the achievements I’m most proud of was bringing UConn Women’s basketball to our airwaves in 1994 and developing a franchise that would become the most successful ongoing local PBS project of all time, whether measured in viewers, membership response or underwriting. It was an absolutely amazing 17 year run. ESPN, another Connecticut media outlet, saw our success and, in a sense, the rest is history. What we point out today in this podcast is how that story continues to evolve with the women’s game getting bigger and with more media exposure on both the collegiate and professional level. Kate Fagan, a former ESPNer, along with curator Seimone Augustus and illustrator, Sophia Chang, should be rightly proud of their stunning book, “Hoop Muses: An Insider’s Guide to Pop Culture and the (Women’s)Game.” I truly enjoyed talking with her. Listen in. You will enjoy it, too.
Enron. Theranos. Purdue Pharma. Harvey Weinstein. The Nazis. Awful behavior abounds. The question is what do we do when we see it? Do we become a whistleblower or an enabler? Max Bazerman, a Professor of Business Administration at Harvard Business School and a behavorial ethicist, has written a new book entitled, “Complicit: How We Enable the Unethical and How to Stop.” While it is easy to condemn obvious wrongdoers, his focus is on the many people around them who ignored or supported tacitly or actively the commission of unethical or criminal behaviors. Let’s admit it. We all have to one degree or another, either by acts of commission or omission. In his book and on this podcast we take these issues on directly and he offers strategies for recognizing and avoiding the psychological and other traps that lead us to ignore, condone, or actively support wrongdoing in our businesses, organizations, communities and politics. I share my own sense of complicity in a dubious personnel practice at one point in my career. If you have an ethical compass, this podcast will have you asking questions of yourself by the end.
America lost the Vietnam War. End of sentence. The reasons most scholars give are many. Chief among them is the notion that the North Vietnamese and Vietnam Congress wanted to win more than we did and understand how to fight this asymmetrical war better than our conventional forces. Dr. Mark Moyar, a military historian at Hillsdale College disputes conventional wisdom in his new book “Triumph Regained”. He argues that what most consider a military folly, built on the domino theory, was actually a strategic necessity that could have ended in victory had President Johnson heeded the advice of his generals. He makes his case and we have a lively discussion as to whether America today and going forward is as strong as we are led to believe militarily or whether our projection of force is greater than our actual battlefield capability.
Like all rites of passage in modern America, the wedding is undergoing a transformation. From who officiates to the vows that are taken to whether a church setting is involved, wedding bells ring in very personal ways for couples, some of whom have only been allowed to marry in the last few years. In fact for many couples co-habitation and no official license is the culminating step in their relationship. Shane McMurray is the CEO of The Wedding Report(wedding.report)and he does market research on what is happening in the wedding industry. We talk with him about the cost of weddings and who pays, the most desirable settings and the impact of marriage itself on our economy and changing as so much did in the wake of the pandemic.
America projects both economic and military muscle all across the globe. And while we tell ourselves its all in pursuit of goals that will help people live better lives and rise from poverty in truth there is much that we do to benefit the rich and powerful in America.The help we provide benefits a select few in those countries and allows us to exploit low income countries and their precious raw materials in a scheme that is carried out by what our guest calls ‘economic hit men.’ He himself was one and regrets the suffering he says it has caused and degradation of the planet that results. John Perkins, author of “Confessions of an Economic Hit Man 3rd Edition-China’s EHM Strategy: Ways to Stop the Global Takeover”, is a road map to how rich nations get richer and poor countries remain that way. His role in the 1970’s led him to write a compelling work as to how a corrupt system of government agencies and businesses did whatever it took-including overthrowing and killing government leaders- to enable US companies to prosper. He details the approach and the way that China is now in the game, using and adapting the tools we developed around the globe. It’s a thrilling–and chilling–account of how the economic order really works.