The Healthcare Policy Podcast ® Produced by David Introcaso

Ms. Kelly Willis Discusses the IPCC's "Last Warning" Report and the Upcoming COP 28 Meeting (April 18th)

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This past March 20^th the United Nation's Intergovernmental Panel on Climate Change (IPCC) published its fourth and last sixth assessment cycle (AR6) report.  This last report integrates the main findings of the IPCC's three, sixth assessment working group reports published over the past 18 months.  The report has been informally termed the “last warning” since the IPCC 7^th assessment work will likely not be published until after 2030 - at which time we’ll know whether we have succeeded or not in reducing CO2e emissions by approximately 45% in order to limit avg global warming to the preferred Paris climate accord goal of 1.5C.  Among other conclusions the IPCC authors warned, “There is a rapidly closing window of opportunity to secure a livable and sustainable future for all.”  “The choices and actions implemented in this decade will have impacts now and for thousands of years.”   The UN Secretary General, Antonio Guterres, termed this last report “a clarion call to massively fast-track climate efforts by every country, every sector and on every timeframe.”  An excellent summary of the AR6 fourth report was published in late March by Carbon Brief, at: https://www.carbonbrief.org/carbon-briefs-definitive-guide-to-the-entire-ipcc-sixth-assessment-cycle/.

This 35-minute interview Ms. Willis discusses Malaria No More's work, related/relevant IPCC findings and those in context of her attendance last month at a climate/health summit meeting in Abu Dhabi held in preparation for subsequent related discussions during this coming December's IPCC COP 28 meeting also taking place in the UAE.  

Ms. Kelly Willis is currently the Managing Director of Strategic Initiatives at Malaria No More.  Ms. Willis has more than 20 years of experience working in infectious disease and global health, helping to build permanent capacity in health systems throughout sub-Saharan Africa and Southeast Asia, in roles including Senior Vice President at United States Pharmacopeia, Executive Director of Accordia Global Health Foundation and through her consulting firm Willis Solutions LLC.  Ms. Willis's field experience includes several years living in East Africa where she helped launch and support the Infectious Diseases Institute at Makerere University and led a multi-year research program to better understand the impact of medical training programs on standards of care and health outcomes.  Prior to that, Ms. Willis spent five years in multiple finance and economics management roles at Pfizer where she also served as a Global Health Fellow in Uganda.   She holds a Distinguished Alumni award from Michigan State University where she earned a BA in French and an MBA in Supply Chain Management.

The IPCC report is at: https://report.ipcc.ch/ar6syr/pdf/IPCC_AR6_SYR_SPM.pdf.  

Dr. Lise van Susteren and I Discuss Climate Crisis-Related Health Harm and Healthcare Policy (April 18th)

Late last week Dave Castro, President and CEO of i-LEAD (at: https://i-leadusa.org/), interviewed Dr. van Susteren and myself regarding these topics.  The interview was on behalf of the Alliance of Leadership Fellows.  

The hour long discussion is at: https://youtu.be/9e-BFFTXXp0. 

Feel free to forward any comments.

Thank you. 

Upcoming Podcasts: the UN IPCC's "Final Warning" Report and America's Post-COVID "Food Cliff"

On April 18th, Ms. Kelly Willis, Managing Director, Malaria No More, will discuss the UN Intergovernmental Panel on Climate Change's (IPCC's) recent publication, the "AR6 Synthesis Report," released March 20th.  This is the last report in the IPCC's sixth assessment cycle.   The document has been termed the "final warning," because it will likely constitute the IPCC's last report this decade, or before anticipated global warming reaches an average of 1.5C.  See: https://www.ipcc.ch/report/sixth-assessment-report-cycle/. 

On May 3rd, Center for Budget and Policy Priorities (CBPP) staff will discuss the end of pandemic-expanded Supplemental Nutrition Assistance Program (SNAP) benefits, causing what has been termed a "food cliff," and what this means for those Americans experiencing hunger and food insecurity.  We will also discuss this year's anticipated Congressional farm bill and the effects of inflated food prices.  The CBPP's related February SNAP paper is at: https://www.cbpp.org/sites/default/files/2-6-23fa.pdf.   Listeners will recall I interviewed the CBPP's Joseph Llobrera in March 2020 regarding Trump administration SNAP policy.  

280th Interview: Mr. Clark Reed, the EPA's Energy Star National Program Manager, Explains the Energy Star Program (March 24th)

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In June 2021 I argued in STAT News that HHS require healthcare providers to publicly disclose their GHG emissions that in turn would help enable the healthcare industry to decarbonize.  In order to do this, I argued the the Environmental Protection Agency's (EPA’s) Energy Star Portfolio Manager tool be exploited.  Already well over 50% of hospitals use Energy Star to better manger their energy consumption, i.e., improve their energy efficiency.  Energy Star, an online energy benchmarking tool widely used to track commercial building energy consumption - that accounts for 20% of US GHG emissions - was jointly created by the Department of Energy (DOE) and the EPA in 1992 under authority of the Clean Air Act.  Energy Star has become the standard against which approximately 40 cities and other governing jurisdictions throughout the US, and authorities overseas including the European Union, measure mandated GHG emission reductions.   Energy use is particularly a concern to the US healthcare industry.  Among other things, while representing less than 5% of the total area in the commercial sector, healthcare facilities account for over 10% of total energy consumption.  This is largely due to the fact US hospitals are on average more than two times more energy intensive as European hospitals.   

During this 37-minute interview Mr. Reed begins by explaining why Energy Star was created.  He proceeds to explain that any building can be benchmarked, how Energy Star Portfolio Manager scores buildings, the meaning thereof and the meaning of an Energy Star "certified" score.  He notes scoring can automatically calculate GHG emissions.  Mr. Reed next provides an overview of what data elements are required for scoring, discusses the use and benefit by healthcare industry by profiling Memorial Hermann Health System's success, provides Energy Star performance data, for example, savings from avoided energy costs, avoided greenhouse gas emissions and public health benefits, potential use by community health clinics and potential effects of related Inflation Reduction Act provisions.   

Mr. Clark Reed has been a national program manager for ENERGY STAR® at the US Environmental Protection Agency (EPA) since 1997.  His work supports hospitals and other healthcare providers, Fortune 500 companies, and numerous other companies in use of ENERGY STAR to create energy management programs that substantially improve energy performance and reduce greenhouse gas emissions.  He has managed the EPA's efforts to establish an ENERGY STAR score for acute care hospitals, medical offices, and senior care communities.  Mr. Reed has also served on the American Hospital Association's American Society for Healthcare Engineering's (ASHE's) Operational Excellence task force and the steering committees of the U.S. Green Buildings Council and the Green Guide for Health Care.  Mr. Reed writes regularly on energy issues for numerous trade publications.  He hold an an MA in environmental policy from Tufts University and a BA in economics from the University of Washington.  He lives in a certified net zero energy home in Maryland with his wife and son.

For more information on Energy Star go to: https://www.energystar.gov/. 

Oxford Professor Neta Crawford Discusses Her Just-Published, "The Pentagon, Climate Change and War" (March 22nd)

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The US government is frequently defined generally as an army with an insurance company.  Regarding the latter, podcast listeners are well aware federal healthcare policymakers have essentially done nothing to address the healthcare industry's annual 500 million ton carbon footprint, 9% of total annual US GHG emissions, despite the fact that at $1.5 trillion the federal government is far and away the largest purchaser of healthcare services.  What about the army?  The army, or the Department of Defense (DOD), is the single largest institutional fossil fuel user and consequently the single largest GHG emitter in the world.  The DOD along with the military-industrial complex annually emit over 110 million tons of greenhouse gas emissions that represents 80% of the federal governments total annual GHG emissions.  This reality is particularly disturbing and paradoxical because the DOD’s contribution to the climate crisis compromises its mission to ensure our nation’s security.  Despite the fact climate crisis-caused geopolitical instability is increasing, absent proactively working toward building climate security, or climate crisis-related conflict prevention the Pentagon is, Prof. Crawford concludes, inadvertently or deliberately militarizing climate change, that is preparing to fight climate-related battles.  (Listeners are also encouraged to read MIT Press's related 2021 work by Gus Speth titled, They Knew, The US Fed Govt’s 50 Year Role in Causing the Climate Crisis.)       

This 35-minute interview begins by Prof. Crawford describing what largely accounts for the DOD GHG emissions and problems associated with calculating total DOD emissions.  She explains the 1997 Kyoto agreement that permitted countries to exempt military emissions from nations' reduction goals.  She explains the DOD's use of fossil fuels since Vietnam to present and reductions in DOD emissions over the past few years, discusses US continuing the emission costs of continuing to defend the Persian Gulf, the debate between DOD building resilience versus mitigating GHG emissions and the interview concludes with Prof. Crawford's comments concerning whether increasing climate disruption will necessarily lead to conflict or war.         

Neta Crawford is Montague Burton Chair in International Relations and also holds a Professorial Fellowship at Balliol College, Oxford.  She previously taught Boston University and the University of Massachusetts, Amherst.   Prof. Crawford is a co-founder and co-director of the Costs of War Project, based at Brown University and since 2017 has served on the board of the nuclear non-proliferation advocacy organization, Council for a Livable World.   She also serves on the editorial boards of The Journal of Political Philosophy and Global Perspectives.  Prof. Crawford received the Distinguished Scholar award from the International Ethics section of the International Studies Association in 2018.   She was a co-winner of the 2003 American Political Science Association Jervis and Schroeder Award for best book in International History and Politics for her work, Argument and Change in World Politics: Ethics, Decolonization, Humanitarian Intervention.  Professor Crawford’s most recent publication is The Pentagon, Climate Change, and War (MIT Press, 2022). She is also working on To Make Heaven Weep: Civilians and the American Way of War.  She has authored several other books including, Accountability for Killing: Moral Responsibility for Collateral Damage in America’s Post‑9/11 Wars (2013).  Her opinion pieces have appeared in The Washington Post.  Prof. Crawford earned her undergraduate degree at Brown and her doctorate in political science at MIT.  

Information on Prof. Crawford's book is at: https://mitpress.mit.edu/9780262047487/the-pentagon-climate-change-and-war/.

 

Dr. Eric Reinhart Remembers Paul Farmer (March 13th)

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Dr. Paul Farmer unexpectedly passed away on February 21, 2022.   He was 62.  Trained as physician and medical anthropologist, Dr. Farmer was known moreover for his healthcare work in Haiti that he more formally forwarded via Partners in Health (PIH), an organization he cofounded in 1987.   Over the subsequent years Dr. Farmer and PIH expanded their work around the world in Africa, Russia, South America and in the US.  Dr. Farmer and his colleagues were also widely known for their international efforts to address multi-drug resistant tuberculosis (MDR TB).  Among other notable achievements, Dr. Farmer served as a University Professor and a department chair at Harvard, served in United Nations’ positions, on numerous boards and as editor in chief of Health and Human Rights.  He authored over 100 articles and a dozen books.  His most recent was the 2020 work, “Fevers, Feuds and Diamonds: Ebola and the Ravages of History.”  Among numerous awards Dr. Farmer received a MacArthur fellowship, was elected to the National Academy of Sciences was the recipient of numerous honorary doctorate degrees and prizes.  (Listeners may recall I interviewed Dr. Reinhart on June 24, 2021 regarding mass incarceration, public health and structural racism during the COVID era.)

During this 38-minute conversation, Dr. Reinhart begins by noting his relationship with Dr. Farmer.  He goes on to discuss or attempt to interpret Dr. Farmer's work, what informed his work or motivated him, how he pursued his work and what might his legacy be or should be.       

Dr. Eric Reinhart is a political anthropologist, psychoanalyst, and physician.  His teaching and research addresses the anthropology of law, inequality, and public health; psychoanalysis, ethnography, and aesthetic politics; and medicine, policing, and logics of apartheid and abolition.  In addition, he conducts conduct policy-oriented public health research to address carceral-community epidemiology,  or how the health and welfare of incarcerated people are always intertwined with that of broader communities. The work examines systemic prejudice in healthcare and legal systems, the uses of confinement and punishment in the US and internationally, and large-scale decarceration policies in relation to public health and safety, pandemic preparedness, and biosecurity.  His research has been published in medical and legal journals including The New England Journal of Medicine, The Lancet, Proceedings of the National Academy of Sciences, Health Affairs, and Journal of Legal Studies – and in popular media venues, such as The New York Times, The Atlantic, TIME, Slate, The Nation, Boston Review, The New Republic, and USA TODAY.  

 

Stanford's Mark Jacobson Discusses His Latest, "No Miracles Needed, How Today's Technology Can Save Our Climate and Clean Our Air" (March 6th)

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Listeners may recall two years ago this past month I interviewed Professor Jacobson regarding his text “100% Clean Renewable Energy and Storage for Everything.”  I noted in my introduction to that 2021 interview Prof. Jacobson argued since 2009 100% of the world’s energy supply could be produced via solar, wind and water power within 20 to 30 years.  The barriers to a 100% conversion to renewables are not, he continues to argue, technological or even economic but social and political.  In “No Miracles Needed,” Prof Jacobson argues we can transition to 80% wind, water and solar (WWS) power by 2030 and to 100% by 2050, ideally 2035. 

During this 33-minute interview, Prof. Jacobson begins by explaining what three problems converting to 100% clean energy simultaneously solve, identifies the technologies that allow for 100% conversion to WWS, what few remaining technologies are still in development and massive efficiencies associated with WWS versus fossil fuel combustion.  He discusses the numerous reasons why subsidizing carbon capture technology is, as he states, a scam, how hospitals can readily decarbonize and concludes with a critique of Inflation Reduction subsidies.                     

Prof. Mark Z. Jacobson’s career has focused on better understanding air pollution and global warming problems and developing large-scale clean, renewable energy solutions to them.  Toward that end, he has developed and applied three-dimensional atmosphere-biosphere-ocean computer
models and solvers to simulate air pollution, weather, climate, and renewable energy. He has also developed roadmaps to transition states and countries to 100% clean, renewable energy for all purposes and computer models to examine grid stability in the presence of high penetrations of renewable energy.  He has numerous awards including being recognized as the #1 impactful world scientist in Meteorology & Atmospheric Sciences among those first publishing past 1985, the World Visionary Clean Tech Influencer of the Year, Clean Tech Business Club (2022) and one of the World’s 100 most influential people in climate policy, Apolitical (2019, 2022).  Prof. Jacobson earned a BA in economics, a BA in civil engineering and a MS in civil engineering from Stanford and a MS and PhD in atmospheric sciences from UCLA.

Information on "No Miracles Needed" is at: https://www.cambridge.org/core/books/no-miracles-needed/8D183E65462B8DC43397C19D7B6518E3.

Mark's recent Samuel Lawrence Foundation interview noted during this interview is at: https://www.youtube.com/watch?app=desktop&v=VUb2T1EPcoQ&feature=youtu.be.    

My Latest Publication, "HHS's Environmental Justice Index Institutionalizes Climate Apartheid" (March 5th)

This past Wednesday, STAT published my latest article, "HHS's Environmental Justice Index Institutionalizes Climate Apartheid"  At: https://www.statnews.com/2023/03/01/hhs-environmental-justice-index-institutionalizes-climate-apartheid/.  While well-intended the index will in practice likely constitute environmental redlining and become, literally, the definition of structural racism.  

Prof. Julianne Holt-Lunstad Discusses Social Isolation and Loneliness (February 15th)

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Since suicides serve as a proxy measure for social isolation and loneliness (SIL), last week the CDC reported after declines in 2019 and 2020, suicides increased 7% in ‘21, particularly among those 25-44, to 48,343 returning their peak in 2018.  Over the past 2 decades suicides have increased 30%, they are now is the 12^th leading cause of death.   Also in 2021, the CDC’s most recent bi-annual Youth Risk Beh Survey, published this past November,  found among other things teenage girls experienced persistent sadness at twice the rate of teen boys and three in five teenage girls reported being persistently sad or hopeless, a 60% increase compared to a decade earlier.  The survey also found 30% of teenage girls had also seriously considered attempting suicide, up nearly 60% from 2011.  Frequent listeners are aware in June 2021 I had related conversations with Brian Alexander regarding his book “The Hospital,” discussed deaths or despair in November 2021 with U of Maryland’s Prof. Carol Graham, published a related piece in December 2021 subtitled “the unrecognized tragedy of working class immiseration,” discussed with psychiatrist, Dr. Lise van Susteren, related climate crisis health effects last March and in December with Susan Linn related issues she raises in her book "Who’s Raising the Kids.”   

The 33-minute interview begins by Prof Holt-Lunstad defining social isolation and loneliness, the magnitude of the problem, i.e.,  and the causes thereof.  To what extent SIL is recognized and addressed in the clinical practice setting, discusses the need for core objectives and for SIL measuring and benchmarking SIL, SIL among clinicians and other medical professionals, discusses related efforts by the Administration for Community Living and the World Health Organizations, what the healthcare insurance industry is doing to address SIL, and offers comments for family caregivers regarding SIL.       

Julianne Holt-Lunstad, Ph.D., is a professor of psychology and neuroscience at Brigham Young University, where she was recently named the Martin B Hickman Outstanding Scholar and is also the director of the social neuroscience lab.  She also has an adjunct professorship at Iverson Health Innovation Research Institute Swinburne University of Technology; Melbourne, Australia; and the founding Scientific Chair for the US Coalition to End Social Isolation and Loneliness and the Foundation for Social Connection.  Prof Holt-Lunstad has provided expert testimony in a US Congressional Hearing, expert recommendations for the US Surgeon General Emotional Well-Being in America Initiative, served as a member of the scientific advisory committee for the UK Cross Departmental Loneliness Team, and a member of a National Academy of Sciences Engineering & Medicine consensus committee, and the US Administration for Community Living.  She has been awarded the George A. Miller Award from the American Psychological Association, Karl G. Maeser Distinguished Faculty Research Award, Mary Lou Fulton Young Scholar Award, Marjorie Pay Hinkley Endowed Chair Research Award from BYU, and is a Fellow for the Association of Psychological Science and American Psychological Association.  

Prof. Holt-Lunstad's SIL review published last year in the Annual Review of Public Health, discussed during this interview, is at: https://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-052020-110732.

 

Prof. Toshihiro Higuchi Discusses His Work, "Political Fallout, Nuclear Weapons Testing and the Making of a Global Environmental Crisis" (February 8th)

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The word Anthropocene has been used over the past 20 years to define the modern era during which time man has come to shape the environment.  This reality became significantly more pronounced with the advent of the nuclear Anthropocene.  As Prof. Higuchi explains in the introduction of  "Political Fallout," from 1945 to 1963, when the Partial Test Ban Treaty (PTBT) was signed by the US, the Soviet Union and Britain, these three nations conducted approximately 450 nuclear weapons tests, in sum equal to 26,000 Hiroshima-sized bombs, that caused worldwide radioactive contamination.  Though in small concentrations, radioactive particles from this period of atmospheric nuclear weapons tests are still present around the world.  How and why the 1963 Partial Test Ban Treaty, signed by the US, the Soviet Union and Britain, came into effect remains important.  Among other reasons, this past August the UN Secretary General, Antonio Guterres, concluded the world has entered “a time of nuclear danger not seen since the height of the Cold War.”  Two weeks ago the Science and Security Board of the Bulletin of the Atomic Scientists forwarded its Doomsday Clock to 90 seconds to midnight.  The clock has move forward 4:30 since 2010.  This history is also important because it potentially offers lessons regarding how we address the climate crisis.   

During this 46 minute discussion, Prof. Higuchi begins by defining the Japanese word hibakusha and defines what is radioactive fallout.  He next discusses how concerns regarding nuclear fallout became publicly known, how the US's understanding of radioactive contamination evolved through the 1950s, discusses his "politics of risk" framework used to discuss fallout's biological effects, social acceptability and policy implications, how ultimately a PTBT was achieved, and discusses what lessons can be learned from the nuclear Anthropocene relative to the climate crisis.          

Prof. Toshihiro Higuchi is an Assistant Professor of History at Georgetown University and field chair of Regional and Comparative Studies (RCST) in the School of Foreign Service (SFS), Georgetown University.  Prof. Higuchi is also an official historian for the International Commission on Radiological Protection, serves on the editorial board of Kagakusi kenkyu, the executive board of Peace History Society, and a committee of the Japan Society for the Promotion of Science.  A native Japanese, Prof. Higuchi received his PhD at Georgetown University in 2011.  Before he returned to Georgetown in 2016, he was a postdoctoral fellow at the Center for International Security and Cooperation, Stanford University (2011-12); an American Council of Learned Societies New Faculty Fellow at the University of Wisconsin - Madison (2012-14); and, a Hakubi Project assistant professor at Kyoto University (2014-15).  His Political Fallout: Nuclear Weapons Testing and the Making of a Global Environmental Crisis (Stanford University Press, 2020) won the 2021 Michael H. Hunt Prize for International History from the Society for Historians of American Foreign Relations.  His academic works have also appeared in Peace & Change, Journal of Strategic Studies, Historia Scientiarum, and International Relations of the Asia-Pacific.  His opinion pieces have also appeared in a number of news outlets, including the Bulletin of the Atomic Scientists and Asahi Shimbun.  Prof. Higuchi is a member of several professional societies including the Society for Historians of American Foreign Relations, History of Science Society, Association for Asian Studies, American Society for Environmental History, Peace History Society, and Japan Association of International Relations.

Information on "Political Fallout" is at: https://www.sup.org/books/title/?id=23212.