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Ep. 92 Why Is the Antibiotics Market Broken?

David Shlaes, MD, PhD

Big Pharma is abandoning its R&D efforts for antibiotics. What are the regulatory, scientific, and economic factors responsible for this potentially dangerous trend?

Our guest on this episode is Dr. David Shlaes. Dr. Shlaes is an infectious diseases specialist who trained was formerly professor of medicine at Case Western medical school in Cleveland, Ohio. He left academia in 1996 to become Vice President for infectious diseases at Wyeth Pharmaceuticals. He has been very prominent in the field of antibiotics research and development. In 1998 he was on the cover of Business Week in recognition of his contributions. In 2005 he established a consulting company and has been active in advising companies and policy makers. He has since retired but remains involved in the field. as an editor for the journal Antimicrobial Agents and Chemotherapy and as a blogger on his site called Antibiotics, The Perfect Storm, which is the title of a book that he wrote a few years ago.

GUEST:

David Shlaes, MD, PhD Website

RELATED EPISODE:

Ep. 15 Lethal Regulations: The 1962 FDA Amendments (with guest Mary Ruwart, PhD)

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Ep. 91 On Abortion

Niran Al-Agba, MD

This past May, the governor of Alabama signed into law a piece of legislation that imposes great restrictions on abortion. Niran Al Agba recently wrote an op ed about that law and she returns to the show to discuss that op ed and, more generally, to share with us her position on abortion. We are very grateful for her willingness and ability to carry this conversation with utmost civility.

Dr. Al-Agba is a board-certified pediatrician who is also a prolific writer. She speaks widely and openly on a variety of issues, including policy, ethics, and medical practice. She is a regular contributor to the Kitsap Sun, to The Deductible blog, and to a variety of other outlets, including her own blog, MommyDoc. She is a mother of four children who’s been voted best doctor in Kitsap County on multiple occasions. She also serves on the clinical staff and admissions committee at the University of Washington School of Medicine.

GUEST:

Niran Al-Agba, MD Twitter

LINKS:

Niran Al-Agba. “Alabama’s Law Is Not Pro-Life. Here’s Why.” (Kitsap Sun)

Niran Al-Agba’s columns for Kitsap Sun

Niran Al-Agba’s personal blog

Niran Al-Agba’s page on The Deductible

UCSF Bixby Center for Global Reproductive Health: Abortion page

RELATED EPISODE:

Ep. 74 Can We Have a Reasonable Discussion About Vaccines? (with guest Niran Al-Agba)

SUPPORT THE SHOW:

Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 90 Why Employer-Funded Health Plans Are Turning to Free Market Medicine

Jay Kempton

How do businesses purchase healthcare services for their employees? What are the factors that bear on their purchasing decisions? These important questions are rarely part of the policy conversation. Our guest on this episode is Jay Kempton, President and CEO of the Kempton group, helping employers obtain and administer health care benefits for their employees. He relates his professional journey, shares his insights as a third-party administrator, and tells us about his recent efforts to turn employers away from the wasteful and corrupt health insurance benefit model.

Mr. Kempton is one of the founding members of the Free Market Medical Association, a board member of the Society of Professional Benefit Administrators, and a member of the Health Care Administrators Association. He obtained a Bachelor of Science degree in Business Administration from Oklahoma State University and holds Life, Health, AD&D, and Property and Casualty Insurance licenses in multiple states.

GUEST:

Jay Kempton (Twitter), CEO of The Kempton Group.

LINKS:

Free Market Medical Association website

RELATED EPISODES:

Ep. 10 Free-Market Medicine: Ethical, Workable, and Unstoppable (with Keith Smith)

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Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 89 From Fortress to Frontier in American Health Care, with Bob Graboyes

Robert Graboyes, PhD

According to our guest, American health care is stuck in a fortress mentality that stifles innovation, constrains medical advances, and yield low quality care. That fortress was erected more than 100 years ago but, in many ways, is being circumvented by creative actors who are seizing opportunities to make changes outside of the political process.

Bob Graboyes is Senior Research Fellow at the Mercatus Center at George Mason University. He holds a PhD in Economics from Columbia University and has held a number of academic positions in higher education in Virginia. He is the author of “Fortress and Frontier in American Health Care,” a booklet which offers many examples of individuals adopting a risk-tolerant frontier attitude to compete with insiders and pave the way to the future without having to rely on political reform. Prior to focusing his career on health care, Bob Graboyes was regional economist/director of education at the Federal Reserve Bank of Richmond.

GUEST:

Robert Graboyes Twitter

LINKS:

Robert Graboyes. “Fortress and Frontier in American Health Care” (2014, Mercatus Center)

RELATED EPISODES:

Ep. 83. The Faulty Economics of Health Insurance: Arrow Revisited (part 2, with Bob Murphy)

SUPPORT THE SHOW:

Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 88 The Stupidity of the American Healthcare Consumer?

Dr. G. Keith Smith

The Affordable Care Act was allegedly passed thanks to “the stupidity of the American voter.” The economist who made that claim—and who is also considered to be one of the architects of the law—has recently published a working paper that examines whether better informed patients make better healthcare decisions. He and his colleagues conclude in the negative.

To help us gain a better perspective on that paper we’ve invited Dr. Keith Smith back to the show. Dr. Smith is the co-founder of the Surgery Center of Oklahoma, a pioneering institution in free-market medicine. As such, he has direct knowledge of the behavior of healthcare consumers and offers us his insights on the chasm that exists between the way healthcare policy makers conceive of medical practice and how ordinary patients actually seek the best possible healthcare value for themselves.

GUEST:

G. Keith Smith’s blog and Twitter

LINKS:

Michael Frakes, Jonathan Gruber, and Anupam Jena. “Is Great Information Good Enough? Evidence from Physicians as Patients” NBER Working Paper 26038

Free Market Medical Association

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Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 87 Trump’s 7/10 Executive Order: A Turning Point for Nephrology?

Joel Topf, MD

President Trump’s July 10, 2019 Executive Order on Advancing American Kidney Health may represent a major turning point in regard to how patients with chronic kidney disease are treated. We have the pleasure of having as our guest Dr. Joel Topf. Dr. Topf is a nephrologist in private practice and a popular blogger and leader in medical social media. He is an adviser to the American Society of Nephrology and was present at the signing or the executive order. He joins Anish Koka to share his insights on the good and bad of the executive order and on the state and future of kidney disease in the United States.

GUEST:

Joel Topf, MD. Twitter and website.

LINKS:

The White House. Executive Order on Advancing American Kidney Health

RELATED EPISODE

Ep. 85 Trump’s 6/24 Executive Order: A Turning Point for Direct Primary Care?

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Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 86 Tales of a Recovering Hospital CEO

John Chamberlain

Hospital executives with a conscience may have a tough time navigating the corrupting waters of our healthcare system. Mr. John Chamberlain is a self-described “recovering” hospital CEO with over 35 years of experience as a hospital and physician practice executive. In this interview with Anish Koka, he relates how his attempts to do right by the patient became increasingly arduous.

Mr. Chamberlain eventually saw the light of free market medicine and currently serves as Chairman for Citizen health, an organization dedicated to “rebuilding healthcare for the next generation.”

GUEST:

John Chamberlain. Twitter

LINKS:

Citizen Health’s website

SUPPORT THE SHOW:

Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 85 Trump’s 6/24 Executive Order: A Turning Point for Direct Primary Care?

Lee Gross, MD

President Trump’s June 24, 2019 Executive Order on health care transparency contains a key provision regarding direct primary care. We have the pleasure of having back on the show Dr. Lee Gross. Dr. Gross and colleagues in the DPC movements were instrumental in getting the White House to clarify a prior ambiguity regarding how direct primary care membership fees ought to be considered from a tax standpoint. Dr. Gross will be telling us about this effort and about the implications of that change for the growth of the direct care movement.

Dr. Gross is a family physician in North Port, FL. He is a pioneer and a leader in the DPC movement. He is a health care consultant to physician practices, medical organizations, insurance groups, hospitals and private businesses. He founded and serves as President of the Docs 4 Patient Care Foundation and he is chairman of a new lobbying organization called DPC Action.

GUEST:

Lee Gross, MD. Twitter

LINKS:

The White House.  Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First

DPC Action’s website

Lee Gross. Direct Primary Care Can Rein In America’s Out-of-Control Healthcare Costs (in the Washington Examiner)

Epiphany Health: Dr. Gross’ practice website

Doc 4 Patient Care Foundation’s website

RELATED EPISODE

Ep. 49. Why Are We Insuring primary Care? (with Dr. Lee Gross)

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Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 84 “You’ll Be Dead in a Year!” A Patient’s Journey Through the Healthcare System

Anish Koka, MD

What can we learn from the experience of a 90-year-old patient who is told point-blank “You’ll be dead in a year!” and who survives to tell the story?

This is a first of its kind in the annals of the Accad and Koka Report.  The episode starts with a 15-minute interview conducted by Dr. Koka of a patient of his, about her journey through the healthcare system.  After the interview, we have an in-depth conversation, prompted by the patient’s testimony, about what to take into consideration when making decisions for elderly patients who contemplate expensive and risky procedures.

SUPPORT THE SHOW:

Patreon.com/accadandkoka

Ep. 83 The Faulty Economics of Health Insurance: Arrow Revisited (Pt. 2)

Robert P. Murphy, PhD

It is commonly believed that healthcare is a sector plagued by “market failure.” A heavy dose of government intervention is therefore necessary to optimize the needs of society. A paper most commonly cited in support of that view is one published in 1963 by Nobel Prize winner Kenneth Arrow, one of the giants of economic theory in the 20th century, and titled “Uncertainty and the Welfare Economics of Medical Care.”

But how does economic theory arrive at the concept of market failure and how do economists conceive of health care when they apply their theoretical models to medical practice?

To help sort this out, we have as our guest Robert P. Murphy, economist, teacher, and author of many books.  Dr. Murphy obtained his PhD from NYU and is Senior Fellow at the Mises Institute.  He is co-host, with Tom Woods, of the popular podcast Contra Krugman and he is also host of The Bob Murphy Show, “a podcast promoting free markets, free minds, and grateful souls.”

The episode in in 2 parts.  In the first part, we reviewed the theoretical framework that forms the background to Arrow’s paper.  In this second part, we delve into the paper itself, discuss how economists conceive (or misconceive) of medical care, and what the implications have been for the US healthcare system as a whole.

GUEST:

Robert P. Murphy: Website and Twitter

LINKS:

RELATED EPISODE:

Ep. 82. The Economics of Health Care: Market Failure or Faulty Models? (Pt. 1 with gust Bob Murphy)

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Patreon.com/accadandkoka