{"id":2569,"date":"2024-03-28T09:44:22","date_gmt":"2024-03-28T09:44:22","guid":{"rendered":"https:\/\/healthynewsusa.com\/?p=2569"},"modified":"2024-03-28T09:44:22","modified_gmt":"2024-03-28T09:44:22","slug":"maybe-its-a-health-care-election-after-all","status":"publish","type":"post","link":"https:\/\/healthynewsusa.com\/?p=2569","title":{"rendered":"Maybe It\u2019s a Health Care Election After All"},"content":{"rendered":"

\n

\n\t\tThe Host\t<\/h3>\n
\tJulie Rovner
\n\tKFF Health News<\/p>\n
\t\t\t
\n\t\t\t\t@jrovner\t\t\t<\/a><\/p>\n
\t\t\t
\n\t\t\t\tRead Julie’s stories.\t\t\t<\/a><\/p>\n
\t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News\u2019 weekly health policy news podcast, \u201cWhat the Health?\u201d A noted expert on health policy issues, Julie is the author of the critically praised reference book \u201cHealth Care Politics and Policy A to Z,\u201d now in its third edition.\t\t<\/p>\n
The general election campaign for president is (unofficially) on, as President Joe Biden and former President Donald Trump have each apparently secured enough delegates to become his respective party\u2019s nominee. And health care is turning out to be an unexpectedly front-and-center campaign issue, as Trump in recent weeks has suggested he may be interested in cutting Medicare and taking another swing at repealing and replacing the Affordable Care Act.<\/p>\n
Meanwhile, the February cyberattack of Change Healthcare, a subsidiary of insurance giant UnitedHealth Group, continues to roil the health industry, as thousands of hospitals, doctors, nursing homes, and other providers are unable to process claims and get paid.<\/p>\n
This week\u2019s panelists are Julie Rovner of KFF Health News, Anna Edney of Bloomberg News, Joanne Kenen of Johns Hopkins University and Politico Magazine, and Margot Sanger-Katz of The New York Times.<\/p>\n

\n\t\tPanelists\t<\/h3>\n
\tAnna Edney
\n\tBloomberg<\/p>\n
\t\t\t
\n\t\t\t\t@annaedney\t\t\t<\/a><\/p>\n
\t\t\t
\n\t\t\t\tRead Anna’s stories.\t\t\t<\/a><\/p>\n
\tJoanne Kenen
\n\tJohns Hopkins Bloomberg School of Public Health and Politico<\/p>\n
\t\t\t
\n\t\t\t\t@JoanneKenen\t\t\t<\/a><\/p>\n
\t\t\t
\n\t\t\t\tRead Joanne’s articles.\t\t\t<\/a><\/p>\n
\tMargot Sanger-Katz
\n\tThe New York Times<\/p>\n
\t\t\t
\n\t\t\t\t@sangerkatz\t\t\t<\/a><\/p>\n
\t\t\t
\n\t\t\t\tRead Margot’s stories.\t\t\t<\/a><\/p>\n
Among the takeaways from this week\u2019s episode:<\/p>\n
\n
It is unclear exactly what Trump meant in his recent remarks about possible cuts to Medicare and Social Security, though his comments provided an opening for Biden to pounce. By running as the candidate who would protect entitlements, Biden could position himself well, particularly with older voters, as the general election begins.<\/li>\n
Health care is shaping up to be the sleeper issue in this election, with high stakes for coverage. The Biden administration\u2019s expanded subsidies for ACA plans are scheduled to expire at the end of next year, and the president\u2019s latest budget request highlights his interest in expanding coverage, especially for postpartum women and for children. Plus, Republicans are eyeing what changes they could make should Trump reclaim the presidency.<\/li>\n
Meanwhile, Republicans are grappling with an internal party divide over access to in vitro fertilization, and Trump\u2019s mixed messaging on abortion may not be helping him with his base. Could a running mate with more moderate perspectives help soften his image with voters who oppose abortion bans?<\/li>\n
A federal appeals court ruled that a Texas law requiring teenagers to obtain parental consent for birth control outweighs federal rules allowing teens to access prescription contraceptives confidentially. But concerns that if the U.S. Supreme Court heard the case a conservative-majority ruling would broaden the law\u2019s impact to other states may dampen the chances of further appeals, leaving the law in effect. Also, the federal courts are making it harder to file cases in jurisdictions with friendly judges, a tactic known as judge-shopping, which conservative groups have used recently in reproductive health challenges.<\/li>\n
And weeks later, the Change Healthcare hack continues to cause widespread issues with medical billing. Some small providers fear continued payment delays could force them to close, and it is possible that the hack\u2019s repercussions could soon block some patients from accessing care at all.<\/li>\n<\/ul>\n
Also this week, Rovner interviews Kelly Henning of Bloomberg Philanthropies about a new, four-part documentary series on the history of public health, \u201cThe Invisible Shield.\u201d<\/p>\n
Plus, for \u201cextra credit\u201d the panelists suggest health policy stories they read this week that they think you should read, too:<\/p>\n
Julie Rovner:<\/strong> The Washington Post\u2019s \u201cNavy Demoted Ronny Jackson After Probe Into White House Behavior<\/a>,\u201d by Dan Diamond and Alex Horton.<\/p>\n
Joanne Kenen:<\/strong> The Atlantic\u2019s \u201cFrigid Offices Might Be Killing Women\u2019s Productivity<\/a>,\u201d by Olga Khazan.<\/p>\n
Margot Sanger-Katz:<\/strong> Stat\u2019s \u201cRigid Rules at Methadone Clinics Are Jeopardizing Patients\u2019 Path to Recover From Opioid Addiction<\/a>,\u201d by Lev Facher.<\/p>\n
Anna Edney:<\/strong> Scientific American\u2019s \u201cHow Hospitals Are Going Green Under Biden\u2019s Climate Legislation<\/a>,\u201d by Ariel Wittenberg and E&E News.<\/p>\n
Also mentioned on this week\u2019s podcast:<\/p>\n
\t\t\t\t\tClick to open the transcript\t\t\t\t<\/p>\n
\t\t\t\t\t\tTranscript: Maybe It\u2019s a Health Care Election After All<\/strong>\t\t\t\t<\/p>\n
[Editor\u2019s note: <\/strong>This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em><\/p>\n
Julie Rovner:<\/strong> Hello, and welcome back to \u201cWhat the Health?\u201d I\u2019m Julie Rovner, chief Washington correspondent for KFF Health News, and I\u2019m joined by some of the best and smartest health reporters in Washington. We\u2019re taping this week on Thursday, March 14, at 10 a.m. Happy Pi Day, everyone. As always, news happens fast and things might have changed by the time you hear this, so here we go. We are joined today via video conference by Margot Sanger-Katz of The New York Times.<\/p>\n
Margot Sanger-Katz:<\/strong> Good morning, everybody.<\/p>\n
Rovner:<\/strong> Anna Edney of Bloomberg News.<\/p>\n
Anna Edney<\/strong>:<\/strong> Hi there.<\/p>\n
Rovner:<\/strong> And Joanne Kenen of the Johns Hopkins University and Politico Magazine.<\/p>\n
Joanne Kenen<\/strong>:<\/strong> Hey, everyone.<\/p>\n
Rovner<\/strong>:<\/strong> Later in this episode we\u2019ll have my interview with Dr. Kelly Henning, head of the public health program at Bloomberg Philanthropies. She\u2019ll give us a preview of the new four-part documentary series on the history of public health called \u201cThe Invisible Shield;\u201d It premieres on PBS March 26. But first this week\u2019s news. We\u2019re going to start here in Washington with the annual State of the Union \/ budget dance, which this year coincides with the formal launch of the general election campaign, with both President Biden and former President Donald Trump having clinched their respective nominations this week.<\/p>\n
Despite earlier claims that this year\u2019s campaign would mostly ignore health issues, that\u2019s turning out not so much to be the case. Biden in his speech highlighted reproductive health, which we\u2019ll talk about in a minute, as well as prescription drug prices and the Affordable Care Act expansions. His proposed budget released on Monday includes suggestions of how to operationalize some of those proposals, including expanding Medicare\u2019s drug negotiating powers. Did anything in particular in the speech or the budget jump out at any of you? Anything we weren\u2019t expecting.<\/p>\n
Edney:<\/strong> I wouldn\u2019t say there was anything that I wasn\u2019t expecting. There were things that I was told I should not expect and that I feel like I\u2019ve been proven right, and so I\u2019m happy about that, and that was the Medicare drug price negotiation. I thought that that was a win that he was going to take a lap on during the State of the Union, and certainly he did. And he\u2019s also talking about trying to expand it, although that seems to face an extremely uphill battle, but it\u2019s a good talking point.<\/p>\n
Rovner:<\/strong> Well, and of course the expanded subsidies from the ACA expire at the end of next year. I imagine there\u2019s going to be enough of a fight just to keep those going, right?<\/p>\n
Edney:<\/strong> Yeah, certainly. I think people really appreciate the subsidies. If those were to go away, then the uninsured rate could go up. It\u2019s probably an odd place in a way for Republicans, too, who are talking about, again, still in some circles, in some ways, getting rid of Obamacare. We\u2019re back at that place even though I don\u2019t think anyone thinks that\u2019s entirely realistic.<\/p>\n
Rovner:<\/strong> Oh, you are anticipating my next question, which is that former President Trump, who is known for being all over the place on a lot of issues, has been pretty steadfast all along about protecting Medicare and Social Security, but he\u2019s now backing away from even that. In an interview on CNBC this week, Trump said, and I\u2019m quoting, \u201cThere is a lot you can do in terms of entitlements in terms of cutting\u201d \u2014 which his staff said was referring to waste and fraud, but which appears to open that up as a general election campaign issue. Yes, the Biden people seem to be already jumping on it.<\/p>\n
Sanger-Katz:<\/strong> Yes. They could not be more excited about this. I think this has been an issue that Biden has really wanted to run on as the protector of these programs for the elderly. He had this confrontation with Congress in the State of the Union last year, as you may remember, in which he tried to get them to promise not to touch these programs. And I think his goal of weaponizing this issue has been very much hindered by Trump\u2019s reluctance to take it on. I think there are Republicans, certainly in Congress, and I think that we saw during the presidential primary some other candidates for president who were more interested in rethinking these programs and concerned about the long-term trajectory of the federal deficit. Trump has historically not been one of them. What Trump meant exactly, I think, is sort of TBD, but I think it does provide this opening. I\u2019m sure that we\u2019ll see Biden talking about this a lot more as the campaign wears on and it wouldn\u2019t surprise me at all to see this clip in television ads and featured again and again.<\/p>\n
Kenen:<\/strong> So it\u2019s both, I mean, it\u2019s basically, he\u2019s talked about reopening the repeal fight as Julie just mentioned, which did not go too well for the Republicans last time, and there\u2019s plenty to cut in Medicare. If you read the whole quote, he does then talk about fraud and abuse and mismanagement, but the soundbite is the soundbite. Those are the words that came out of his mouth, whether he meant it that way or not, and we will see that campaign ad a lot, some version of it.<\/p>\n
Rovner:<\/strong> My theory is that he was, and this is something that Trump does, he was on CNBC, he knew he was talking to a business audience, and he liked to say what he thinks the audience wants to hear without \u2014 you would think by now he would know that speaking to one audience doesn\u2019t mean that you\u2019re only speaking to that one audience. I think that\u2019s why he\u2019s all over the place on a lot of issues because he tends to tailor his remarks to what he thinks the people he is speaking directly to want to hear. But meanwhile, Anna, as you mentioned, he\u2019s also raised the specter of the Affordable Care Act repeal again.<\/p>\n
Sanger-Katz:<\/strong> I do think the juxtaposition of the Biden budget and State of the Union and these remarks from Trump, who now is officially the presumptive nominee for president, I think it really does highlight that there are pretty high stakes in health care for this election. I think it\u2019s not been a focus of our discussion of this election so far. But Julie, you\u2019ve mentioned the expiration of these subsidies that have made Affordable Care Act plans substantially more affordable for Americans and substantially more appealing, nearly doubling the number of people who are enrolled in these plans.<\/p>\n
That is a policy that is going to expire at the end of next year. And so you could imagine a scenario, even if Trump did not want to repeal the Affordable Care Act, which he does occasionally continue to make noises about, where that could just go away through pure inertia if you didn\u2019t have an administration that was actively trying to extend that policy and you could see a real retrenchment:<\/strong> increases in prices, people leaving the market, potentially some instability in the marketplace itself, where you might see insurers exiting or other kinds of problems and a situation much more akin to what we saw in the Trump administration where those markets were \u201cOK, but were a little bit rocky and not that popular.\u201d<\/p>\n
I think similarly for Medicare and Medicaid, these big federal health programs, Biden has really been committed to, as he says, not cutting them. The Medicare price negotiation for drugs has provided a little bit more savings for the program. So it\u2019s on a little bit of a better fiscal trajectory, and he has these additional proposals, again, I think long shots politically to try to shore up Medicare\u2019s finances more. So you see this commitment to these programs and certainly this commitment to \u2014 there were multiple things in the budget to try to liberalize and expand Medicaid coverage to make postpartum coverage for women after they give birth, permanently one year after birth, people would have coverage.<\/p>\n
Right now, that\u2019s an option for states, but it\u2019s not required for every state. And additionally to try to, in an optional basis, make it a little easier to keep kids enrolled in Medicaid for longer, to just allow states to keep kids in for the first six years of life and then three years at a time after that. So again, that\u2019s an option, but I think you see the Biden administration making a commitment to expand and shore up these programs, and I do think a Trump administration and a Republican Congress might be coming at these programs with a bit more of a scalpel.<\/p>\n
Rovner:<\/strong> And also, I mean, one of the things we haven\u2019t talked about very much since we\u2019re on the subject of the campaign is that this year Trump is ready in a way that he was not, certainly not in 2016 and not even in 2020. He\u2019s got the Heritage Foundation behind him with this whole 2025 blueprint, people with actual expertise in knowing what to turn, what to do, actually, how to manipulate the bureaucracy in a way that the first Trump administration didn\u2019t have to. So I think we could see, in fact, a lot more on health care that Republicans writ large would like to do if Trump is reelected. Joanne, you wanted to add something.<\/p>\n
Kenen:<\/strong> Yeah, I mean, we all didn\u2019t see this year as a health care election, and I still think that larger existential issues about democracy, it\u2019s a reprise. It\u2019s 2020 all over again in many ways, but abortion yes, abortion is a health care issue, and that was still going \u2026<\/p>\n
Rovner:<\/strong> We\u2019re getting to that next.<\/p>\n
Kenen:<\/strong> I know, but I mean we all knew that was still going to be a ballot driver, a voter driver. But Trump, with two remarks, however, well, there\u2019s a difference between the people at the Heritage Foundation writing detailed policy plans about how they\u2019re going to dismantle the CDC [Centers for Disease Control and Prevention] as we currently know it versus what Trump says off the cuff. I mean, if you say to a normal person on the street, we want to divide the CDC in two, that\u2019s not going to trigger anything for a voter. But when you start talking about we want to take away your health care subsidies and cut Medicare, so these are sort of, some observers have called them unforced errors, but basically right now, yeah, we\u2019re in another health care election. Not the top issue \u2014 and also depending on what else goes on in the world, because it\u2019s a pretty shaky place at the moment. By September, will it be a top three issue? None of us know, but right now it\u2019s more of a health care election than it was shaping up to be even just a few weeks ago.<\/p>\n
Rovner:<\/strong> Yeah. Well, one thing, as you said, that we all know will be a big campaign issue this fall is abortion. We saw that in the State of the Union with the gallery full of women who\u2019d been denied abortion, IVF services, and other forms of reproductive health care and the dozens of Democratic women on the floor of the House wearing white from head to toe as a statement of support for reproductive health care. While Democrats do have some divides over how strongly to embrace abortion rights, a big one is whether restoring Roe<\/em> [v. Wade<\/em>] is enough or they need to go even further in assuring access to basically all manner of reproductive health care.<\/p>\n
It\u2019s actually the Republicans who are most on the defensive, particularly over IVF and other state efforts that would restrict birth control by declaring personhood from the moment of fertilization. Along those lines, one of the more interesting stories I saw this week suggested that Donald Trump, who has fretted aloud about how unpopular the anti-abortion position is among the public, seems less likely to choose a strong pro-lifer as his running mate this time. Remember Mike Pence came along with that big anti-abortion background. What would this mean? It\u2019s not like he\u2019s going to choose Susan Collins or Lisa Murkowski or some Republican that we know actually supports abortion rights. I\u2019m not sure I see what this could do for him and who might fit this category.<\/p>\n
Kenen:<\/strong> Well, I think there\u2019s a good chance he\u2019ll choose a woman, and we all have names at the tip of our tongues, but we don\u2019t know yet. But yeah, I mean they need to soften some of this stuff. But Trump\u2019s own attempt right now bragging about appointing the justices that killed Roe<\/em>, at the same time, he\u2019s apparently talking about a 15-week ban or a 16-week ban, which is very different than zero. So he\u2019s giving a mixed message. That\u2019s not what his base wants to hear from him, obviously. I mean, Julie, you\u2019ll probably get to this, but the IVF thing is also pitting anti-abortion Republican against anti-abortion Republican, with Mike Pence, again, being a very good example where Mike Pence\u2019s anti-abortion bona fides are pretty clear, but he has been public about his kids are IVF babies? I\u2019m not sure if all of them are, but at least some of them are. So he does not think that two cells in a freezer or eight cells or 16 cells is the same to child. In his view, it\u2019s a potential child. So yeah.<\/p>\n
Edney:<\/strong> I think you can do a lot with a vice president. We see Biden has his own issues with the abortion issue and, as people have pointed out, he demurred from saying that word in the State of the Union and we see just it was recently announced that Vice President Kamala Harris is going to visit an abortion clinic. So you can appease maybe the other side, and that might be what Trump is looking to do. I think, as Joanne mentioned, his base wants him to be anti-abortion, but now you\u2019re getting all of these fractures in the Republican Party and you need someone that maybe can massage that and help with the crowd that\u2019s been voting on the state level, voting on more of a personal level, to keep reproductive rights, even though his base doesn\u2019t seem to be that that\u2019s what they want. So I feel like he may be looking to choose someone who\u2019s very different or has some differences that he can, not acknowledge, but that they can go out and please the other side.<\/p>\n
Rovner:<\/strong> Of course, the only person who really fits that bill is Nikki Haley, who is very, very strongly anti-abortion, but at least tried, not very well, but tried to say that there are other people around and they believe other things and we should embrace them, too. I can\u2019t think of another Republican except for Nikki Haley who\u2019s really tried to do that. Margot, you wanted to say something?<\/p>\n
Sanger-Katz:<\/strong> Oh, I was just going to say that if this reporting is correct, I think it does really reflect the political moment that Trump finds himself in. I think when he was running the last time, I think he really had to convince the anti-abortion voter, the evangelical voter, to come along with him. I think they had reservations about his character, about his commitment to their cause. He was seen as someone who maybe wasn\u2019t really a true believer in these issues. And so I think he had to do these things, like choosing Mike Pence, choosing someone who was one of them. Pre-publishing a list of judges that he would consider for the Supreme Court who were seen as rock solid on abortion. He had to convince these voters that he was the real deal and that he was going to be on their side, and I just don\u2019t think he really has that problem to the same degree right now.<\/p>\n
I think he\u2019s consolidated support among that segment of the electorate and his bigger concern going into the general election, and also the primaries are over, and so his bigger concern going into the general election is how to deal with more moderate swing voters, suburban women, and other groups who I think are a little bit concerned about the extreme anti-abortion policies that have been pursued in some of these states. And I think they might be reluctant to vote for Trump if they see him as being associated with those policies. So you see him maybe thinking about how to soften his image on this issue.<\/p>\n
Rovner:<\/strong> I should point out the primaries aren\u2019t actually over, most of states still haven\u2019t had their primaries, but the primaries are effectively over for president because both candidates have now amassed enough delegates to have the nomination.<\/p>\n
Sanger-Katz:<\/strong> Yes, that\u2019s right. And it\u2019s not over until the convention, although I think the way that the Republicans have arranged their convention, it\u2019s very hard to imagine anyone other than Trump being president no matter what happens.<\/p>\n
Rovner:<\/strong> Yes.<\/p>\n
Sanger-Katz:<\/strong> Or not being president. Sorry, being the nominee.<\/p>\n
Rovner:<\/strong> Being the nominee, yes, indeed. Well, we are only two weeks away from the Supreme Court oral arguments in the abortion pill case and a little over a month from another set of Supreme Court oral arguments surrounding whether doctors have to provide abortions in medical emergencies. And the cases just keep on coming in court this week. A three-judge panel from the 5th Circuit Court of Appeals upheld in part a lower court ruling that held that Texas\u2019 law requiring parents to provide consent before their teenage daughters may obtain prescription birth control, Trump\u2019s federal rules requiring patient confidentiality even for minors at federally funded Title X clinics.<\/p>\n
Two things about this case. First, it\u2019s a fight that goes all the way back to the Reagan administration and something called the \u201cSqueal Rule,\u201d which I did not cover, I only read about, but it\u2019s something that the courts have repeatedly ruled against, that Title X is in fact allowed to maintain patient privacy even for teenagers. And the second thing is that the lower court ruling came from Texas federal Judge Matthew Kacsmaryk, who also wrote the decision attempting to overturn the FDA\u2019s approval of the abortion drug mifepristone. This one, though, we might not expect to get to the Supreme Court.<\/p>\n
Kenen:<\/strong> But we\u2019re often wrong on these kinds of things.<\/p>\n
Rovner:<\/strong> Yeah, that\u2019s true.<\/p>\n
Kenen:<\/strong> I mean, things that seem based on the historical pathway that shouldn\u2019t have gotten to the court are getting to the court and the whole debate has shifted so far to the right. An interesting aside, there is a move, and I read this yesterday, but now I\u2019m forgetting the details, so one of you can clarify for me. I can\u2019t remember whether they\u2019re considering doing this or the way they\u2019ve actually put into place steps to prevent judge-shopping.<\/p>\n
Rovner:<\/strong> That\u2019s next.<\/p>\n
Kenen:<\/strong> OK, I\u2019m sorry, I\u2019m doing such a good job of reading your mind.<\/p>\n
Rovner:<\/strong> You are such a good job, Joanne.<\/p>\n
Kenen:<\/strong> But I mean so many in these cases go back to one. If there was a bingo card for reproductive lawsuits, there might be one face in it.<\/p>\n
Rovner:<\/strong> Two, Judge [Reed] O\u2019Connor, remember the guy with the Affordable Care Act.<\/p>\n
Kenen:<\/strong> Right. But so much of this is going back to judge-shopping or district-shopping for the judge. So a lot of these things that we thought wouldn\u2019t get to the court have gotten to the court.<\/p>\n
Rovner:<\/strong> Yeah, well, no, I was going to say in this case, though, there seems to be some suggestion that those who support the confidentiality and the Title X rules might not want to appeal this to the Supreme Court because they\u2019re afraid they\u2019ll lose. That this is the Supreme Court that overturned Roe<\/em>, it would almost certainly be a Supreme Court that would rule against Title X confidentiality for birth control, that perhaps they want to just let this lie. I think as it stands now it only applies to the 5th Circuit. So Texas, Louisiana, and I forget what else is in the 5th Circuit, but it wouldn\u2019t apply around the country and in this case, I guess it\u2019s just Texas because it\u2019s Texas\u2019 law that conflicts with the rules.<\/p>\n
Kenen:<\/strong> Except when one state does something, it doesn\u2019t mean that it\u2019s only Texas\u2019 law six months from now.<\/p>\n
Rovner:<\/strong> Right. What starts in Texas doesn\u2019t necessarily stay in Texas.<\/p>\n
Kenen:<\/strong> Right, it could go to Nevada. They may decide that they have a losing case and they want to wait 20 years, but other people end up taking things \u2014 I mean, it is very unpredictable and a huge amount of the docket is reproductive health right now.<\/p>\n
Rovner:<\/strong> I would say the one thing we know is that Justice Alito, when he said that the Supreme Court was going to stop having to deal with this issue was either disingenuous or just very wrong because that is certainly not what\u2019s happened. Well, as Joanne already jumped ahead a little bit, I mentioned Judge Kacsmaryk for a specific reason. Also this week, the Judicial Conference of the United States, which makes rules for how the federal courts work, voted to make it harder to judge-shop by filing cases in specific places like Amarillo, Texas, where there\u2019s only one sitting federal judge. This is why Judge Kacsmaryk has gotten so many of those hot-button cases. Not because kookie stuff happens all the time in Amarillo, but because plaintiffs have specifically filed suit there to get their cases in front of him. The change by the judicial conference basically sets things back to the way they used to be, right, where it was at least partly random, which judge you got when you filed a case.<\/p>\n
Kenen:<\/strong> But there are also some organizations that have intentionally based themselves in Amarillo so that they\u2019re there. I mean, we may also see, if the rules go back to the old days, we may also still say you have a better case for filing in where you actually operate. So everybody just keeps hopping around and playing the field to their advantage.<\/p>\n
Rovner:<\/strong> Yeah. And I imagine in some places there\u2019s only a couple of judges, I think it was mostly Texas that had these one-judge districts where you knew if you filed there, you were going to get that judge, so \u2014 the people who watch these things and who worry about judge-shopping seem to be heartened by this decision by the judicial conference. So I\u2019m not someone who is an expert in that sort of thing, but they seem to think that this will deter it, if not stop it entirely.<\/p>\n
Moving on, remember a couple of weeks ago when I said that the hack of UnitedHealth [Group] subsidiary Change Healthcare was the most undercovered story in health? Clearly, I had no idea how true that was going to become. That processes 15 billion \u2014 with a B \u2014 claims every year handles one of every three patient records is still down, meaning hospitals, doctor\u2019s offices, nursing homes, and all other manner of health providers still mostly aren\u2019t getting paid. Some are worrying they soon won\u2019t be able to pay their employees. How big could this whole mess ultimately become? I don\u2019t think anybody anticipated it would be as big as it already is.<\/p>\n
Sanger-Katz:<\/strong> I think it\u2019s affecting a number of federal programs, too, that rely on this data, like quality measurement. And it really is a reflection, first of all, obviously of the consolidation of all of this, which I know that you guys have talked about on the podcast before, but also just the digitization and interconnectedness of everything. All of these programs are relying on this billing information, and we use that not just to pay people, but also to evaluate what kind of health care is being delivered, and what quality it is, and how much we should pay people in Medicare Advantage, and on all kinds of other things. So it\u2019s this really complex, interconnected web of information that has been disrupted by this hack, and I think there\u2019s going to be quite a lot of fallout.<\/p>\n
Edney:<\/strong> And the coverage that I\u2019ve read we\u2019re potentially, and not in an alarmist way, but weeks away from maybe some patients not getting care because of this, particularly at the small providers. Some of my colleagues did a story yesterday on the small cancer providers who are really struggling and aren\u2019t sure how long they\u2019re going to be able to keep the lights on because they just aren\u2019t getting paid. And there are programs now that have been set up but maybe aren\u2019t offering enough money in these no-interest loans and things like that. So it seems like a really precarious situation for a lot of them. And now we see that HHS [Department of Health and Human Services] is looking into this other side of it. They\u2019re going to investigate whether there were some HIPAA violations. So not looking exactly at the money exchange, but what happened in this hack, which is interesting because I haven\u2019t seen a lot about that, and I did wonder, \u201cOh, what happened with these patients\u2019 information that was stolen?\u201d And UnitedHealth has taken a huge hit. I mean, it\u2019s a huge company and it\u2019s just taken a huge hit to its reputation and I think \u2026<\/p>\n
Rovner:<\/strong> And to its stock price.<\/p>\n
Edney:<\/strong> And it\u2019s stock price. That is very true. And they don\u2019t know when they\u2019re actually going to be able to resolve all of this. I mean, it\u2019s just a huge mess.<\/p>\n
Rovner:<\/strong> And not to forget they paid $22 million in ransom two weeks ago. When I saw that, I assumed that this was going to be almost over because usually I know when a hospital gets hacked, everybody says, don\u2019t pay ransom, but they pay the ransom, they get their material back, they unlock what was locked away. And often that ends it, although it then encourages other people to do it because hey, if you do it, you can get paid ransom. Frankly, for UnitedHealthcare, I thought $22 million was a fairly low sum, but it does not appear \u2014 I think this has become such a mess that they\u2019re going to have to rebuild the entire operation in order to make it work. At least, not a computer expert here. But that\u2019s the way I understand this is going on.<\/p>\n
Kenen:<\/strong> But I also think this, I mean none of us are cyber experts, but I\u2019m also wondering if this is going to lead to some kind of rethinking about alternative ways of paying people. If this created such chaos, and not just chaos, damage, real damage, the incentive to do something similar to another, intermediate, even if it\u2019s not quite this big. It\u2019s like, \u201cWait, no one wants to be the next one.\u201d So what kind of push is there going to be, not just for greater cybersecurity, but for Plan B when there is a crisis? And I don\u2019t know if that\u2019s something that the cyberexperts can put together in what kind of timeline \u2014 if HHS was to require that or whether the industry just decides they need it without requirements that this is not OK. It\u2019s going to keep happening if it\u2019s profitable for whoever\u2019s doing it.<\/p>\n
Rovner:<\/strong> I remember, ruefully, Joanne and I were there together covering HIPAA when they were passing it, which of course had nothing whatsoever to do with medical privacy at the time, but what it did do was give that first big push to start digitizing medical information. And there was all this talk about how wonderful it was going to be when we had all this digitally and researchers could do so much with it, and patients would be able to have all of their records in one place and \u2026<\/p>\n
Kenen:<\/strong> You get to have 19 passwords for 19 different forums now.<\/p>\n
Rovner:<\/strong> Yes. But in 1995 it all seemed like a great, wonderful new world of everything being way more efficient. And I don\u2019t remember ever hearing somebody talking about hacking this information, although as I point out the part of HIPAA that we all know, the patient medical records privacy, was added on literally at the last minute because someone said, \u201cUh-oh, if we\u2019re going to digitize all this information, maybe we better be sure that it doesn\u2019t fall into the wrong hands.\u201d So at least somebody had some idea that we could be here. What are we 20, 30 \u2026 are we 30 years later? It\u2019s been a long time. Anyway, that\u2019s my two cents. All right, next up, Mississippi is flirting with actually expanding Medicaid under the Affordable Care Act. It\u2019s one of only 10 remaining states that has not extended the program to people who have very low incomes but don\u2019t meet the so-called categorical eligibility requirements like being a pregnant woman or child or person with a disability.<\/p>\n
The Mississippi House passed an expansion bill including a fairly stringent work requirement by a veto-proof majority last week, week before.<\/p>\n
Kenen<\/strong>:<\/strong> I think two weeks ago.<\/p>\n
Rovner<\/strong>:<\/strong> But even if it passed the Senate and gets signed by the governor, which is still a pretty big if, the governor is reportedly lobbying hard against it. The plan would require a waiver from the Biden administration, which is not a big fan of work requirements. On the other hand, even if it doesn\u2019t happen, and I would probably put my money at this point that it\u2019s not going to happen this year, does it signal that some of the most strident, holdout states might be seeing the attraction of a 90% federal match and some of the pleas of their hospital associations? Anna, I see you nodding.<\/p>\n
Edney:<\/strong> Yeah, I mean it was a little surprising, but this is also why I love statehouses. They just do these unexpected things that maybe make sense for their constituents sometimes, and it\u2019s not all the time. I thought that it seemed like they had come around to the fact that this is a lot of money for Mississippi and it can help a lot of people. I think I\u2019ve seen numbers like maybe adding 200,000 or so to the rolls, and so that\u2019s a huge boost for people living there. And with the work requirement, is it true that even if the Biden administration rejects it, this plan can still go into place, right?<\/p>\n
Kenen:<\/strong> The House version.<\/p>\n
Edney:<\/strong> The House version.<\/p>\n
Kenen:<\/strong> Yes.<\/p>\n
Edney:<\/strong> Yeah.<\/p>\n
Rovner:<\/strong> My guess is that\u2019s why the governor is lobbying so hard against it. But yeah.<\/p>\n
Kenen:<\/strong> I mean, I think that we had been watching a couple of states, we keep hearing Alabama was one of the states that has been talking about it but not doing anything about it. Wyoming, which surprised me when they had a little spurt of activity, which I think has subsided. I mean, what we\u2019ve been saying ever since the Supreme Court made this optional for states more than 10 years ago now. Was it 2012? We\u2019ve been saying eventually they\u2019ll all do it. Keeping in mind that original Medicaid in [19]65, it took until 1982, which neither Julie nor I covered, until the last state, which was Arizona, took regular Medicare, Medicaid, the big \u2014 forget the ACA stuff. I mean, Medicaid was not in all states for almost 20 years. So I think we\u2019ve all said eventually they\u2019re going to do it. I don\u2019t think that we are about to see a domino effect that North Carolina, which is a purple state, they did it a few months ago, maybe a year by now.<\/p>\n
There was talk then that, \u201cOh, all the rest will do it.\u201d No, all the rest will probably do it eventually, but not tomorrow. Mississippi is one of the poorest states in the country. It has one of the lowest health statuses of their population, obesity, diabetes, other chronic diseases. It has a very small Medicaid program. The eligibility levels are even for very, very, very poor childless adults, you can\u2019t get on their plan. But have we heard rural hospitals pushing for this for a decade? Yes. Have we heard chambers of commerce in some of these states wanting it because communities without hospitals or communities without robust health systems are not economically attractive? We\u2019ve been hearing the business community push for this for a long time. But the holdouts are still holdouts and I do think they will all take it. I don\u2019t think it\u2019s imminent.<\/p>\n
Rovner:<\/strong> Yeah, I think that\u2019s probably a fair assessment.<\/p>\n
Kenen:<\/strong> It makes good economic sense, I mean, you\u2019re getting all this money from the federal government to cover poor people and keep your hospitals open. But it\u2019s a political fight. It\u2019s not just a \u2026<\/p>\n
Rovner:<\/strong> It\u2019s ideology.<\/p>\n
Kenen:<\/strong> Yes, it\u2019s not a [inaudible]. And it\u2019s called Obamacare.<\/p>\n
Edney:<\/strong> And sometimes things just have to fall into place. Mississippi got a new speaker of the House in their state government, so that\u2019s his decision to push this as something that the House was going to take up. So whether that happens in other places, whether all those cards fall into places can take more time.<\/p>\n
Kenen:<\/strong> Well, the last thing is we also know it\u2019s popular with voters because we\u2019ve seen it on the ballot in what, seven states, eight states, I forgot. And it won, and it won pretty big in really conservative states like Idaho and Utah. So as Julie said, this is ideology, it\u2019s state lawmakers, it\u2019s governors, it\u2019s not voters, it\u2019s not hospitals, it\u2019s not chambers of commerce. It\u2019s not particularly rural hospitals. A lot of people think this makes sense, but their own governments don\u2019t think it makes sense.<\/p>\n
Rovner:<\/strong> Yes. Well, another of those stories that moves very, very slowly. Finally, \u201cThis Week in Medical Misinformation\u201d: I want to call out those who are fighting back against those who are accusing them of spreading false or misleading claims. I know this sounds confusing. Specifically, 16 conservative state attorneys general have called on YouTube to correct a, quote, \u201ccontext disclaimer\u201d that it put on videos posted by the anti-abortion Alliance Defending Freedom claiming serious and scientifically unproven harms that can be caused by the abortion pill mifepristone.<\/p>\n
Unfortunately, for YouTube, their context disclaimer was a little clunky and conflated medication and surgical abortion, which still doesn\u2019t make the original ADF videos more accurate, just means that the disclaimer wasn\u2019t quite right. Meanwhile, more anti-abortion states are having legal rather than medical experts try to \u201cexplain\u201d \u2014 and I put explain in air quotes \u2014 when an abortion to save the life of a woman is or isn\u2019t legal, which isn\u2019t really helping clarify the situation much if you are a doctor worried about having your license pulled or, at best, ending up having to defend yourself in court. It feels like misinformation is now being used as a weapon as well as a way to mislead people. Or am I reading this wrong?<\/p>\n
Edney:<\/strong> I mean, I had to read that disclaimer a few times. Just the whole back-and-forth was confusing enough. And so it does feel like we\u2019re getting into this new era of, if you say one wrong thing against the disinformation, that\u2019s going to be used against you. So everybody has to be really careful. And the disclaimer, it was odd because I thought it said the procedure is [inaudible]. So that made me think, oh, they\u2019re just talking about the actual surgical abortion. But it was clunky. I think clunky is a good word that you used for it. So yeah.<\/p>\n
Rovner:<\/strong> Yeah, it worries me. I think I see all of this \u2014 people who want to put out misinformation. I\u2019m not accusing ADF of saying, \u201cWe\u2019re going to put out misinformation.\u201d I think this is what they\u2019ve been saying all along, but people who do want to put out misinformation for misinformation\u2019s sake are then going to hit back at the people who point out that it\u2019s misinformation, which of course there\u2019s no way for the public to then know who the heck is right. And it undercuts the idea of trying to point out some of this misinformation. People ask me wherever I go, \u201cWhat are we going to do about this misinformation?\u201d My answer is, \u201cI don\u2019t know, but I hope somebody thinks of something.\u201d<\/p>\n
Kenen:<\/strong> I mean, if you word something poorly, you got to fix it. I mean, that\u2019s just the bottom line. Just like we as journalists have to come clean when we make a mistake. And it feels bad to have to write a correction, but we do it. So Google has been working on \u2014 there\u2019s a group convened by the Institute of Medicine [National Academy of Medicine] and the World Health Organization and some others that have come out with guidelines and credible communicators, like who can you trust? I mean, we talked about the RSV [respiratory syncytial virus] story I did a few weeks ago, and if you Google RSV vaccine on and you look on YouTube or Google, it\u2019s not that there\u2019s zero misinformation, but there\u2019s a lot less than there used to be. And what comes up first is the reliable stuff: CDC, Mayo Clinic, things like that. So YouTube has been really working on weeding out the disinformation, but again, for their own credibility, if they want to be seen as clean arbiters of going with credibility, if they get something mushy, they\u2019ve got to de-mush it at the end.<\/p>\n
Rovner:<\/strong> And I will say that Twitter of all places \u2014 or X, whatever you want to call it, the place that everybody now is like, \u201cDon\u2019t go there. It\u2019s just a mess\u201d \u2014 has these community notes that get attached to some of the posts that I actually find fairly helpful and it lets you rate it.<\/p>\n
Kenen:<\/strong> Some of them, I mean overall, there\u2019s actually research on that. We\u2019ll talk about my book when it comes out next year, but we have stuff. I\u2019m in the final stages of co-authoring a book that \u2026 it goes into misinformation, which is why I\u2019ve learned a lot about this. Community Notes has been really uneven and \u2026<\/p>\n
Rovner:<\/strong> I guess when it pops up in my feed, I have found it surprisingly helpful and I thought, \u201cThis is not what I expect to see on this site.\u201d<\/p>\n
Kenen:<\/strong> And it hasn\u2019t stopped [Elon] Musk himself from tweeting misinformation about drugs \u2026<\/p>\n
Rovner:<\/strong> That\u2019s certainly true.<\/p>\n
Kenen:<\/strong> \u2026 drugs he doesn\u2019t like, including the birth control pill he tells people not to use because it promotes suicide. So basically, yeah, Julie, you\u2019re right that we need tools to fight it, and none of the tools we currently have are particularly effective yet. And absolutely everything gets politicized.<\/p>\n
Sanger-Katz:<\/strong> And it\u2019s a real challenge I think for these social media platforms. You know what I mean? They don\u2019t really want to be in the editorial business. I think they don\u2019t really want to be in the moderation business in large part. And so you can see them grappling with the problem of the most egregious forms of misinformation on their platforms, but doing it clumsily and anxiously and maybe making mistakes along the way. I think it\u2019s not a natural function for these companies, and I think it\u2019s not a comfortable function for the people that run these companies, who I think are much more committed to free discourse and algorithmic sharing of information and trying to boost engagement as opposed to trying to operate the way a newspaper editor might be in selecting the most useful and true information and foregrounding that.<\/p>\n
Kenen:<\/strong> Yeah, I mean that\u2019s what the Supreme Court has been grappling with too, is another [inaudible] \u2026 what are the rules of the game? What should be legally enforced? What is their responsibility, that the social media company\u2019s responsibilities, to moderate versus what is just people get to post? I mean, Google\u2019s trying to use algorithms to promote credible communicators. It\u2019s not that nothing wrong is there, but it\u2019s not what you see first.<\/p>\n
Rovner:<\/strong> I think it\u2019s definitely the issue of the 2020s. It is not going away anytime soon.<\/p>\n
Kenen:<\/strong> And it\u2019s not just about health.<\/p>\n
Rovner:<\/strong> Oh, absolutely. I know. Well, that is the news for this week. Now, we will play my interview with Dr. Kelly Henning of Bloomberg Philanthropies, and then we\u2019ll come back with our extra credits.<\/p>\n
I am so pleased to welcome to the podcast Dr. Kelly Henning, who heads the Bloomberg Philanthropies Public Health program. She\u2019s here to tell us about a new documentary series about the past, present, and future of public health called \u201cThe Invisible Shield.\u201d It premieres on PBS on March 26. Dr. Henning, thank you so much for joining us.<\/p>\n
Kelly Henning:<\/strong> Thank you for having me.<\/p>\n
Rovner:<\/strong> So the tagline for this series is, \u201cPublic health saved your life today, and you don\u2019t even know it.\u201d You\u2019ve worked in public health in a lot of capacities for a lot of years, so have I. Why has public health been so invisible for most of the time?<\/p>\n
Henning:<\/strong> It\u2019s a really interesting phenomenon, and I think, Julie, we all take public health for granted on some level. It is what really protects people across the country and across the world, but it is quite invisible. So usually if things are working really well in public health, you don\u2019t think about it at all. Things like excellent vaccination programs, clean water, clean air, these are all public health programs. But I think most people don\u2019t really give them a lot of thought every day.<\/p>\n
Rovner:<\/strong> Until we need them, and then they get completely controversial.<\/p>\n
Henning:<\/strong> So to that point, covid-19 and the recent pandemic really was a moment when public health was in the spotlight very much no longer behind an invisible shield, but quite out in front. And so this seemed like a moment when we really wanted to unpack a little bit more around public health and talk about how it works, why it\u2019s so important, and what some of the opportunities are to continue to support it.<\/p>\n
Rovner:<\/strong> I feel like even before the pandemic, though, the perceptions of public health were changing. I guess it had something to do with a general anti-science, anti-authority rising trend. Were there warning signs that public health was about to explode in people\u2019s consciousness in not necessarily a good way?<\/p>\n
Henning:<\/strong> Well, I think those are all good points, but I also think that there are young generations of students who have become very interested in public health. It\u2019s one of the leading undergraduate majors nowadays. Johns Hopkins Bloomberg School of Public Health has more applications than ever before, and that was occurring before the pandemic and even more so throughout. So I think it\u2019s a bit of a mixed situation. I do think public health in the United States has had some really difficult times in terms of life expectancy. So we started to see declines in life expectancy way back in 2017. So we have had challenges on the program side, but I think this film is an opportunity for us to talk more deeply about public health.<\/p>\n
Rovner:<\/strong> Remind people what are some of the things that public health has brought us besides, we talk about vaccines and clean water and clean air, but there\u2019s a lot more to public health than the big headlines.<\/p>\n
Henning:<\/strong> Yeah, I mean, for example, seat belts. Every day we get into our vehicle, we put a seat belt on, but I think most people don\u2019t realize that was initially extremely controversial and actually not so easy to get that policy in place. And yet it saved literally tens of hundreds of thousands of lives across the U.S. and now across the world. So seat belts are something that often come to mind. Similar to that are things like child restraints, what we would call car seats in the U.S. That\u2019s another similar strategy that\u2019s been very much promoted and the evidence has been created through public health initiatives. There are other things like window guards. In cities, there are window guards that help children not fall out of windows from high buildings. Again, those are public health initiatives that many people are quite unaware of.<\/p>\n
Rovner:<\/strong> How can this documentary help change the perception of public health? Right now I think when people think of public health, they think of people fighting over mask mandates and people fighting over covid vaccines.<\/p>\n
Henning:<\/strong> Yeah, I really hope that this documentary will give people some perspective around all the ways in which public health has been working behind the scenes over decades. Also, I hope that this documentary will allow the public to see some of those workers and what they face, those public health front-line workers. And those are not just physicians, but scientists, activists, reformers, engineers, government officials, all kinds of people from all disciplines working in public health. It\u2019s a moment to shine a light on that. And then lastly, I hope it\u2019s hopeful. I hope it shows us that there are opportunities still to come in the space of public health and many, many more things we can do together.<\/p>\n
Rovner:<\/strong> Longtime listeners to the podcast will know that I\u2019ve been exploring the question of why it has been so difficult to communicate the benefits of public health to the public, as I\u2019ve talked to lots of people, including experts in messaging and communication. What is your solution for how we can better communicate to the public all of the things that public health has done for them?<\/p>\n
Henning:<\/strong> Well, Julie, I don\u2019t have one solution, but I do think that public health has to take this issue of communication more seriously. So we have to really develop strategies and meet people where they are, make sure that we are bringing those messages to communities, and the messengers are people that the community feels are trustworthy and that are really appropriate spokespeople for them. I also think that this issue of communications is evolving. People are getting their information in different ways, so public health has to move with the times and be prepared for that. And lastly, I think this \u201cInvisible Shield\u201d documentary is an opportunity for people to hear and learn and understand more about the history of public health and where it\u2019s going.<\/p>\n
Rovner:<\/strong> Dr. Kelly Henning, thank you so much for joining us. I really look forward to watching the entire series. OK, we are back. It\u2019s time for our extra-credit segment. That\u2019s when we each recommend a story we read this week we think you should read, too. As always, don\u2019t worry if you miss it. We will post the links on the podcast page<\/a> at kffhealthnews.org<\/a> and in our show notes on your phone or other mobile device. Joanne, you have everybody\u2019s favorite story this week. Why don\u2019t you go first?<\/p>\n
Kenen:<\/strong> I demanded the right to do this one, and it\u2019s Olga, I think her last name is pronounced Khazan. I actually know her and I don\u2019t know how to pronounce her name, but Olga Khazan, apologies if I\u2019ve got it wrong, from The Atlantic, has a story that says \u201cFrigid Offices Might Be Killing Women\u2019s Productivity.\u201d<\/a> Well, from all of us who are cold, I\u2019m not sure I would want to use the word \u201cfrigid,\u201d but of all of us who are cold in the office and sitting there with blankets. I used to have a contraband, very small space heater hidden behind a trash basket under my desk. We freeze because men like colder temperatures and they\u2019re wearing suits. So we\u2019ve been complaining about being cold, but there\u2019s actually a study now that shows that it actually hurts our actual cognitive performance. And this is one study, there\u2019s more to come, but it may also be one explanation for why high school girls do worse than high school boys on math SATs.<\/p>\n
Rovner:<\/strong> Did not read that part.<\/p>\n
Kenen:<\/strong> It\u2019s not just comfort in the battle over the thermostat, it\u2019s actually how do our brains function and can we do our best if we\u2019re really cold?<\/p>\n
Rovner:<\/strong> True. Anna.<\/p>\n
Edney:<\/strong> This is a departure from my normal doom and gloom. So I\u2019m happy to say this is in Scientific American, \u201cHow Hospitals Are Going Green Under Biden\u2019s Climate Legislation.\u201d<\/a> I thought it was interesting. Apparently if you\u2019re a not-for-profit, there were tax credits that you were not able to use, but the Inflation Reduction Act changed that so that there are some hospitals, and they talked to this Valley Children\u2019s in California, that there had been rolling blackouts after some fires and things like that, and they wanted to put in a micro-grid and a solar farm. And so they\u2019ve been able to do that.<\/p>\n
And health care contributes a decent amount. I think it\u2019s like 8.5% of U.S. greenhouse gas emissions. And Biden had established this Office of Climate Change [and Health Equity] a few years ago and within the health department. So this is something that they\u2019re trying to do to battle those things. And I thought that it was just interesting that we\u2019re talking about this on the day that the top story, Margot, in The New York Times is, not by you, but is about how there\u2019s this huge surge in energy demand. And so this is a way people are trying to do it on their own and not be so reliant on that overpowered grid.<\/p>\n
Rovner:<\/strong> KFF Health News has done a bunch of stories about contribution to climate change from the health sector<\/a>, which I had no idea, but it\u2019s big. Margot.<\/p>\n
Sanger-Katz:<\/strong> I wanted to highlight the second story in this Lev Facher series on treatment for opioid addiction in Stat called \u201cRigid Rules at Methadone Clinics Are Jeopardizing Patients\u2019 Path to Recovery From Opioid Addiction<\/a>,\u201d which is a nice long title that tells you a lot about what is in the story. But I think methadone treatment is a really evidence-based treatment<\/a> that can be really helpful for a lot of people who have opioid addiction. And I think what this story highlights is that the mechanics of how a lot of these programs work are really hard. They\u2019re punitive, they\u2019re difficult to navigate, they make it really hard for people to have normal lives while they\u2019re undergoing methadone treatment and then, in some cases, arbitrarily so. And so I think it just points out that there are opportunities to potentially do this better in a way that better supports recovery and it supports the lives of people who are in recovery.<\/p>\n
Rovner:<\/strong> Yeah, it used the phrase \u201cliquid handcuffs,\u201d which I had not seen before, which was pretty vivid. For those of you who weren\u2019t listening, the Part One of this series was an extra credit last week, so I\u2019ll post links to both of them. My story\u2019s from our friend Dan Diamond at The Washington Post. It\u2019s called \u201cNavy Demoted Ronnie Jackson After Probe Into White House Behavior.\u201d<\/a> Ronnie Jackson, in case you don\u2019t remember, was the White House physician under Presidents [Barack] Obama and Trump and a 2021 inspector general\u2019s report found, and I\u2019m reading from the story here, quote, \u201cthat Jackson berated subordinates in the White House medical unit, made sexual and denigrating statements about a female subordinate, consumed alcohol inappropriately with subordinates, and consumed the sleep drug Ambien while on duty as the president\u2019s physician.\u201d In response to the report, the Navy demoted Jackson retroactively \u2014 he\u2019s retired \u2014from a rear admiral down to a captain.<\/p>\n
Now, why is any of this important? Well, mainly because Jackson is now a member of Congress and because he still incorrectly refers to himself as a retired admiral. It\u2019s a pretty vivid story, you should really read it.<\/p>\n
OK. That is our show. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We\u2019d appreciate it if you left us a review; that helps other people find us, too. Special thanks as always to our technical guru, Francis Ying, and our editor, Emmarie Huetteman. As always, you can email us your comments or questions. We\u2019re at whatthehealth@kff.org, or you can still find me at X, @jrovner<\/a>. Margot, where are you these days?<\/p>\n
Sanger-Katz:<\/strong> I\u2019m at all the places @Sanger-Katz<\/a>, although not particularly active on any of them.<\/p>\n
Rovner:<\/strong> Anna.<\/p>\n
Edney:<\/strong> On X, it\u2019s @annaedney<\/a> and on Threads it\u2019s @anna_edneyreports<\/a>.<\/p>\n
Rovner:<\/strong> Joanne.<\/p>\n
Kenen:<\/strong> I\u2019m Threads @joannekenen1<\/a>, and I\u2019ve been using LinkedIn more. I think some of the other panelists have said that people are beginning to treat that as a place to post, and I think many of us are seeing a little bit more traction there.<\/p>\n
Rovner:<\/strong> Great. Well, we will be back in your feed next week. Until then, be healthy.<\/p>\n
\n\t\tCredits\t<\/h3>\n
\tFrancis Ying
\n\tAudio producer<\/p>\n
\tEmmarie Huetteman
\n\tEditor <\/p>\n
To hear all our podcasts,\u00a0click here<\/a>.<\/em><\/p>\n
And subscribe to KFF Health News\u2019 \u201cWhat the Health?\u201d on\u00a0Spotify<\/a>,\u00a0 Apple Podcasts<\/a>,\u00a0 Pocket Casts<\/a>, or wherever you listen to podcasts.<\/em><\/p>\n<\/div>\n