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Ep. 95 Polygenic Risk Scoring: An Epidemiologist’s Perspective

A. Cecile Janssens, PhD

Has cardiovascular genetics come of age? Are “polygenic risk scores” ready to inform us in clinically meaningful ways? In the final analysis, who or what are epidemiological data informing? Our guest is A. Cecile Janssens, PhD, Professor of Translational Epidemiology at the Rollins school of Public Health at Emory university in Atlanta, GA.

Professor Janssens’ research concerns the translation of genomics research to applications in clinical and public health practice and focuses on the genetic prediction of common diseases such as diabetes, cardiovascular disease and cancer. She also studies how the predictive ability and utility of genetic testing can best be measured.

GUEST:

A. Cecile Janssens, PhD:  Twitter and website

LINKS:

The following graphs referred to on the podcast are taken from the paper by Torkamani, Wineinger, and Topol: The personal and clinical utility of polygenic risk scores.

 

 

 

 

 

 

 

 

 

 

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Ep. 94 The Trojan Horse of Surprise Billing Legislation

Daniel E. Choi, MD

Are out-of-network physicians deliberately trying to price-gouge patients in need of emergency care? Will “surprise billing legislation” solve the problems of narrow networks in a socially responsible manner? In this episode, Dr. Koka leads a conversation with our guest, Dr. Daniel E. Choi, on the topic of surprise billing legislation.

Dr. Choi obtained his MD degree from Northwestern University Feinberg School of Medicine in Chicago, completed his residency training at Rutgers State Univeristy of New Jersey, and completed a combined neurosurgical and orthopedic fellowship in spine surgery at Harvard Medical School.

GUEST:

Daniel E. Choi MD: Twitter

LINKS:

Fix Surprise Billing (website)

Cho AM: Congress Is About to Give Health Insurance Companies the Nuclear Weapon. Available at: https://www.highyieldscript.com/take-action-against-the-benchmark-solution/. Accessed October 9, 2019.

Corlette S, Hoppe O: New York’s 2014 Law to Protect Consumers from Surprise Out-of-Network Bills Mostly Working as Intended: Results of a Case Study. Available at: https://georgetown.app.box.com/s/6onkj1jaiy3f1618iy7j0gpzdoew2zu9. Accessed October 9, 2019.

New York State: Governor Cuomo Announces Success of New York’s Landmark Out-of-Network Law Protecting Consumers from Surprise Medical Bills. Available at: https://www.governor.ny.gov/news/governor-cuomo-announces-success-new-yorks-landmark-out-network-law-protecting-consumers. Accessed October 9, 2019.

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

Ep. 93 Neurosurgery, Health Policy, and the Free Market: A Conversation with Richard Menger

Richard Menger, MD

Can a graduate of the Harvard Kennedy School hold on to free market principles? Evidently so! We talk health policy and economics with our guest Richard Menger, MD, MPA, a neurosurgeon serving as Chief of Complex Spine Surgery at the University of South Alabama.

Dr. Menger completed medical school with honors at Georgetown University School of Medicine where he was elected to the Alpha Omega Alpha Honor Society and received the Barbara Bregman PhD Award. He then trained at Louisiana State University Shreveport and at Columbia University for a fellowship in scoliosis treatment. At the Harvard Kennedy School of Government he completed a Master in Public Administration and was awarded the Hale Champion Public Service Fellowship.

Dr. Menger has authored numerous scientific papers in academic journals and is the lead editor of the textbook The Business, Policy, and Economics of Neurosurgery. His op-ed/policy work has been published in the Wall Street Journal, Forbes, Navy Times, the Hill and others. He has a joint appointment as Assistant Professor of Political Science at the University of South Alabama.

GUEST:

Richard Menger MD, MPA:  LinkedIn

LINKS:

Articles by Richard Menger:

Milton Friedman at the Mayo Clinic: YouTube video

Michel Accad. “The Mayo Clinic and the Free Market” (Mises Institute website)

RELATED EPISODES:

Ep. 10 Free Market Medicine: Ethical, Workable, Unstoppable  (with guest G. Keith Smith, MD)

Ep. 22 Free Markets in Healthcare: Objecting to the Objections (with guest Roman Zamishka)

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

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)

SUPPORT THE SHOW:

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)

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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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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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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

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