The US leads the world in biomedical innovation, with about 40% of patents being filed by US scientists and companies. The FDA plays a critical role in supporting and enabling this innovation pipeline and our guest Dr. Robert Califf was commissioner of the agency not once, but twice under Presidents Obama and Biden. He joins us to talk about what Americans should know about FDA’s critical role and the threats to its functioning from the dramatic cuts the Trump administration has made over the last three months.

We discuss:

• The broad sweep of FDA’s purview from drugs and medical devices to cosmetics, food, tobacco and dog food
• Concern that the FDA is now “decapitated and eviscerated” from the massive and multiple rounds of dismissals
• While most industries want less regulation, the pharma industry wants more information and guidance from the FDA
• Califf has been affiliated with Duke for 50 of its 100 years, but a part of his heart is still with Clemson

What would Califf’s “Make America Healthy Again” agenda be?

“We need to develop reliable, repetitive sources of information that help people do things that are healthy and beneficial. That part of MAHA I like a lot…The second thing is… I'm developing connections with people who are thinking differently about primary care because I think everybody agrees there's no way you can take the current workforce and deliver what's needed. So it's got to be linked up with AI and digital technologies, but also with a very different looking workforce that gets paid differently, has more respect.”

Relevant Links

• Read Califf’s WSJ opinion letter: “Work with the Bureaucracy, Not Against It”
• Peter Marks’ resignation letter
• NYT article on the impact of FDA layoffs
• Califf’s “Public Health on Call” podcast episode on the state of the FDA
• Opinion article from 7 previous FDA commissioners on how recent changes are undermining credibility of the FDA

About Our Guest

Robert M. Califf, MD served as FDA Commmissioner under Presidents Biden and Obama. Califf is a nationally recognized expert in cardiovascular medicine, health outcomes research, health care quality, and clinical research, and a leader in the growing field of translational research. Prior to rejoining the FDA in 2022, Califf was head of medical strategy and senior advisor at Alphabet, contributing to strategy and policy for its health subsidiaries Verily Life Sciences and Google Health. Prior to Alphabet, he was professor of medicine and vice chancellor for clinical and translational research at Duke University, director of the Duke Translational Medicine Institute, and founding director of the Duke Clinical Research Institute. Dr. Califf is a graduate of Duke University School of Medicine. He completed a residency in internal medicine at the University of California, San Francisco and a fellowship in cardiology at Duke.

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Could primary care at home unlock better health and lower costs for American families? Rebekah Gee, a physician and policymaker turned entrepreneur, joins us to talk about the big bet her company Nest Health is making on home-based primary care. It’s a model that makes sense for families and delivers results. In the first year of operations Nest doubled primary care visits, reduced ER visits, and increased childhood immunizations.

We discuss:

• The sound economics behind the Medicaid expansion in Louisiana
• What she learned from her mentor, astronaut John Glenn
• How to close the primary care gap for children and parents
• Whether ultra processed foods are the next tobacco

Rebekah shared about an exchange with Elon Musk on the short sightedness of Medicaid cuts:

“So Nest came out with our savings numbers. We put out some really good information about the health of children and the opportunities. And Elon Musk retweeted it. So as a result of that, we actually got a lot of press. But I wrote back to him and said, ‘I'm glad you like this concept. And just remember, don't cut health care for children because we'll be paying far more for that than you will ever save.’ ”

Relevant Links

• Read more about Nest Health
• Watch: Dr. Rebekah Gee on what entrepreneurs need to know about Medicaid
• Learn about Alaska’s Nuka system of care
• Evidence from the Nurse Family Partnership about the impact of home-based care

About Our Guest

Dr. Rebekah Gee is the founder and CEO of Nest Health, a technology-enabled whole-family primary care provider providing care at home and virtually to Americans who struggle to receive comprehensive care. Previously, Dr. Gee served as Secretary of Health for the State of Louisiana. In that cabinet-level role, she led the expansion of Medicaid. As Secretary, she was responsible for nearly half the state budget including Medicaid, public health, aging and adult services, licensure, sanitation, disability services, and a nearly 2,000 bed state hospital system. As Secretary, she developed a first-in-the-nation subscription model for the drugs that cure Hepatitis C that is being used as a national and international model for increased drug access and affordability.

Dr. Gee has served as an advisor to multiple Governors, presidential campaigns, and policy efforts at the state and national level. Her board service includes medical advisory support of public companies Select Quote and 3D systems. She has also served as a board member or advisor to Ready Responders, Ouva, Noble, NCQA, NQF, IHI, the Penn Center for Behavioral Economics, and the Duke-Margolis Institute.

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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and LinkedIn

Subscribe to The Other 80 on YouTube so you never miss our video extras or special video...

Whether it's the civil rights movement, marriage equality or even seatbelt laws, community organizing is how change happens in America. In this encore episode, Dr. Tony Iton shares a masterclass in how social, political and economic power shape health outcomes and how to meaningfully shift those dynamics when it matters most. Tony argues that reinvigorating democracy at the community and local level is where we should be doubling down. This episode was impactful when it was first released but is even more relevant and timely now.

We discuss:

• The ABC’s of health for all: agency, belonging and social contracts
• How California communities applied this framework to dramatically change school climate and reduce suspensions
• The role of narrative in shaping policy choices towards belonging or exclusion

Tony digs into why power matters in health:

“We're talking about essentially community-level power, what we refer to as community agency, and we basically theorized that if we could build social, political and economic power in a critical mass of people in 14 low-income communities that have documented health disparities, that we could improve the health status of those populations over a 10-year period… We weren't thinking that there was something that we needed to do to people. In other words, it wasn't like increasing access to healthcare or, you know, enhancing the quality of public health education. This was fundamentally about unleashing the power of communities to [determine how resources are distributed].“

Relevant Links

• Read about our UC Berkeley School of Public Health Social Impact Fellows (Tony included)
• Learn more about the California Endowment
• Visit Dr. Tony Iton’s website
• Read Dr. Tony Iton’s “Understanding How Health Happens – Your Zip Code is More Important Than Your Genetic Code” by Dr. Tony Iton, MD, JD, MPH and Robert K. Ross, MD.
• Order “Advocacy for Public Health Policy Change: An Urgent Imperative” which is co-authored by Dr. Tony Iton

About Our Guest

Dr. Tony Iton is a Social Impact Fellow and lecturer at UC Berkeley School of Public Health. He was the Senior Vice President of Programs & Partnerships at The California Endowment from October 2009 to June 2024.

Prior to his appointment at The Endowment, Iton served from 2003 as both the director and County Health Officer for the Alameda County Public Health Department. In that role, he oversaw the creation of an innovative public health practice designed to eliminate health disparities by tackling the root causes of poor health that limit quality of life and lifespan in many of California's low-income communities.

Iton also served for three years as director of Health and Human Services and School Medical Advisor for the City of Stamford, Connecticut. Concurrent to that, he also served as a physician in internal medicine for Stamford Hospital's HIV Clinic. In addition, Iton served for five years as a primary care physician for the San Francisco Department of Public Health.

Iton's varied career also includes past service as a staff attorney...

California is full of hardworking people—nurses, teachers, delivery drivers, baristas—who keep our communities running. Many of them live paycheck-to-paycheck, making too much to qualify for most government benefits, but not enough to afford the basics. For nearly 2 million Californians, Covered California provides a critical lifeline, offering access to affordable health insurance and now basic needs support. Dr. Monica Soni, Chief Medical Officer of Covered California, joins Claudia to talk about the program’s important and expanding role in the California landscape.

We discuss:

• What the working poor really need: breathing room in their budgets to afford healthy food
• Operating a startup within government
• How collaboration across Covered California, Medi-Cal and CalPERS – which together cover 45% of Californians – will drive faster and more aligned health improvement in California

Monica’s team uses experiments and user research to shape every aspect of the program:

“But I do think in our DNA is this idea of innovation. In-house, we have a research team that does randomized controlled trials. We're committed to hyper transparency. Almost all of our data is released. We stratify it by everything we can think of to really identify where there might be pockets of coverage that aren't there or outcomes that are suboptimal. And we do a lot of deep listening with consumers and with the community to help inform what we do.“

Relevant Links

• Read more about Covered California’s Innovative Program to Improve Population Health
• See the details on Covered California’s Data and Research tools
• Announcement of the launch of Covered Californians Population Health Investments
• More info on how Covered California uses email nudges for enrollment

About Our Guest

Dr. S. Monica Soni is the Chief Medical Officer, and a Chief Deputy Executive Director at Covered California, leading the organization’s Health Equity and Quality Transformation division. In this capacity she is responsible for health equity, health care strategy, medical policy, and other clinical operations to continuously improve not only the health services provided through Covered California’s contracted health plans, but also California’s delivery system.

She is a board-certified internal medicine physician with more than a decade of experience working in both inpatient and outpatient settings and continues to see patients. She is an Associate Professor within the UCLA Department of Medicine and the Charles R. Drew University Department of Internal Medicine, where she is committed to residency diversification and pipeline development.

Prior to joining Covered California, Dr. Soni served as Associate Chief Medical Officer within Evolent Health focused on the delivery of high-quality, cost-effective specialty care for the over 16 million supported Medicaid lives across the United States. During her time at the organization, she played a critical role in clinical informatics, provider engagement, value-based strategies and innovation. Dr. Soni also served as the Director of Specialty Care for the Los Angeles County Department of Health

In the wake of massive layoffs at HHS - and so many other federal agencies and programs - we are sharing the powerful stories of federal workers who had no choice but to leave their important work when they were fired post-election. You’ll hear from a former marine who was improving primary care for fellow veterans, a child of farmworkers who was expanding economic opportunities for rural communities and a technologist who was improving the organ transplant distribution system. They used their exquisite talents to help communities thrive and connect people with care they desperately needed. And now they aren’t.

Relevant Links

If you’re interested in hiring one of the amazing leaders who shared their story in this episode, connect with them on LinkedIn:

Andrew Lennox: https://www.linkedin.com/in/andrewlennoxmi/

Aileen Wood: https://www.linkedin.com/in/aileen-wood-163585108/

Jesus Morillo: https://www.linkedin.com/in/jesusmurillo97/

Amy Paris: https://www.linkedin.com/in/amy-paris-4950831/

Ashley Hackett: https://www.linkedin.com/in/ashley-hackett/

Jennifer Robinson: https://www.linkedin.com/in/jennifer-robinson-phd-mph/

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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and LinkedIn

Subscribe to The Other 80 on YouTube so you never miss our video extras or special video episodes!

With the House approving a plan to slash $880 billion from the federal budget, all eyes are turning to Medicaid as the most likely source of cuts. I asked former North Carolina Health Secretary Kody Kinsley, KFF’s Larry Levitt and California Health Care Foundation’s Katie Heidorn to join me to discuss the likely shape and impact of proposed cuts, and take questions from UC Berkeley students.

Kody called it a “self-licking ice cream cone”—cuts that destabilize the government, leading to further cuts. Larry warned of formula battles that will soon erupt. Katie laid out the devastating effects on state budgets.

We’ve also released this episode as a full video episode on YouTube. Subscribe to The Other 80 YouTube channel for video extras, video episodes and viral healthcare policy content. Click here to watch this episode in full.

Watch the full VIDEO version of this episode: https://www.youtube.com/watch?v=X110GShMTtE&t=52s

Relevant Links

• KFF: The Public’s View on Potential Changes to Medicaid
• KFF: Impact of Medicaid Per Capita Cap
• Kody Kinsley testimony to Congress on Medicaid
• Pre-election episode with Larry Levitt
• KFF: Can Republicans cut $880 Billion without Slashing Medicaid?
• CBPP: Impact of Medicaid Cuts
• CHCF: Defending Medi-Cal in 2025

About Our Guests

Katie Heidorn is the director of state health policy at CHCF, where she leverages the foundation’s data, expertise, and partnerships to help California’s state government make informed decisions about health care. Katie is based in CHCF’s Sacramento office.

Katie has nearly two decades of experience working in health policy, government, and nonprofits and is a skilled leader, facilitator, and communicator. She comes to CHCF after more than two years as executive director for the Insure the Uninsured Project (ITUP). Before that, Katie was the government affairs advocate for Health Net and the development director and policy lead at the nonprofit California Coverage and Health Initiatives. Katie spent a decade in California state government, including as a deputy secretary for the California Health and Human Services Agency and principal consultant in the Senate Appropriations Committee. She is also an alumna of the California Senate Fellows Program.

Katie received her master’s degree in Public Administration from the University of Southern California and bachelor’s degree in Biochemistry and Molecular Biology and Comparative Literature from the University of California, Davis.

Source: https://www.chcf.org/person/katie-heidorn/

Kody...

New York Medicaid has made some big bets on social care recently, and Amir Bassiri is here to answer all our questions. The bold new program centers on nine new regional networks that will be hubs for community organizations offering housing, food and other services. Will this program survive the new administration? Only time will tell.

We discuss:

• The state's ambitious plan to screen every Medicaid enrollee for health-related social needs
• How their approach differs from the social care strategies in NC and CA
• The ticking clock: New York's critical three-year window to demonstrate cost savings and improved care outcomes

Amir says he’s hoping negotiating with the Trump administration goes better than last time:

“We will have to negotiate our demonstration or the renewal of our demonstration with the current administration. The waiver does expire in 27. We have to renew it beginning one year prior to its conclusion, which means we will be negotiating with the Trump administration on our waiver. We've done that before, it did not work out well. “

Relevant Links

• Watch Amir’s talk at the 2024 Medicaid Conference
• Get more background on 1115 waivers
• Read more information about New York’s 1115 waiver

About Our Guest

Amir Bassiri, MSW (he, him, his) is the Medicaid Director for the New York State Department of Health. Mr. Bassiri joined the Department of Health in 2019 as Chief of Staff to the Medicaid Director and recently served as the Deputy Medicaid Director, overseeing the operation and performance of nine Medicaid Divisions. Collectively, these nine Divisions are comprised of more than 750 State staff, over 500 contracted staff and management of over 300 contracts, including some of the State's largest technology, actuarial and financial audit contracts, along with health plans.

Prior to his work with the Department, Mr. Bassiri worked as a Senior Policy Advisor for Health in the Governor's Office under the Deputy Secretary of Health and Human Services.

Mr. Bassiri earned his BA in both Economics and Psychology from the University of California, Davis, before earning a Master's in Social Work (MSW) from Columbia University.

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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and LinkedIn

Driving fast on the open road is almost as American as apple pie. We all remember the thrill of our first car - a symbol of American freedom and independence. But is our love affair with cars killing us? David Zipper joins us to talk about the wide ranging health impacts of our car obsession, and how policy innovations like congestion pricing and weight-based taxes could offer a way out.

We dive into:

• Why pedestrian deaths are much higher in the US than Canada
• The successful, but potentially short-lived, NYC experiment with congestion pricing
• How SUVs have replaced sedans as the family vehicle, creating dangers for other drivers and pedestrians
• How Eisenhower’s vision of interstates connecting US cities got turned around

David says it’s time to focus on safety of those outside our vehicles, not just inside:

“We have spent so much time over decades emphasizing the safety of those inside a vehicle that we have… basically enabled the creation of these Goliaths of SUVs and trucks on our roads, where the marginal size provides maybe an incremental marginal safety benefit for occupants, but at an enormous cost to everybody outside of that huge car... We have… recently hit a year high for pedestrian and cyclist deaths in the US… If I were to rewrite Nader's book, like still unsafe at any speed, I would put much more of the focus on the safety of those outside the car as opposed to occupants.”

Relevant Links

Learn more about the MIT Mobility Initiative

Visit David Zipper’s website

Read articles by David Zipper:

In Vox (“Gigantic SUVs are a public health threat. Why don’t we treat them like one?”), Slate (“There is no technology fix for car bloat”) and Fast Company (“Who’s really to blame – and who isn’t – for America’s traffic death epidemic”).

About Our Guest

David Zipper is a Senior Fellow at the MIT Mobility Initiative, examining the intersection of transportation policy, technology, and society. With experience in city government, venture capital, and consulting, he advises public agencies and foundations on improving transportation outcomes. A contributing writer for Vox and Bloomberg CityLab, his work focuses on road safety, climate change, and transit strategies. He previously served in leadership roles in Washington D.C. and New York City, and holds degrees from Harvard, Cambridge, and Swarthmore.

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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and