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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An incredible 43% of Americans are unpaid caregivers, who are often alone with the burden and blessing of caring for their loved ones as life begins and in the complex and heartbreaking final days. Studies show their mental health is suffering – 52% of “sandwich generation” caregivers report that they have actively thought about suicide in the last 30 days. Alexandra Drane, CEO of ARCHANGELS, joins us to talk about the urgent need for culture and policy change to see, honor and support unpaid caregivers.

We discuss:

• The huge and mostly unseen toll of unpaid caregiving
• Engage With Grace, the national movement Alex launched to talk about death
• Whether “hospital at home” is a boon or a curse for family caregivers

Alex reminds us to reach out to caregivers in our lives:

“And most importantly, unpaid caregivers are drowning, right? Don't wait for them to ask for help .. Don't say, “How can I help you”? Because they're too tired. Oh, well, just freaking help fill their fridge, mow their lawns, sit with their mom, whatever it takes.”

Relevant Links

Read more about Alex’s venture ARCHANGELS

See data on caregivers from The COPE Initiative

Learn more about the movement Alex founded called “Engage With Grace”

See information on the Care Badge

About Our Guest

Alexandra Drane is co-founder and CEO of ARCHANGELS, a national movement and a platform that is reframing how caregivers are seen, honored, and supported using a combination of data and stories, through public and private partnerships. She co-founded Eliza Corporation (acquired by HMS Holdings Corp: HMSY), Engage with Grace, and three other companies (all boot-strapped). A serial entrepreneur, she is also a cashier-on-leave for Walmart. She believes communities are the frontline of health, that caregivers are our country’s greatest asset, and that we need to expand the definition of health to include life. She has one hobby outside of her passion for revolutionizing health care, and her love of family and adventure…car racing.

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If AI is going to rapidly improve healthcare, shouldn’t we start at the ground floor - with primary care? Cityblock’s Chief Health Officer Dr. Kameron Matthews joins us to talk about how AI can reduce complexity and burnout, improve patient outcomes and free care teams to focus on human connections.

We discuss:

• What it takes to design with and for the communities
• Her work with the Coalition for Health AI (CHAI) to drive the development, evaluation, and appropriate use of AI in healthcare
• Lessons Kameron learned being a student leader for the National Medical Association

Kameron reminds us that we cannot just drop new technologies onto care teams:

“We have respect for the change management that is required to bring forward these new technologies and allow our care teams to really merge them into their current day to day practice. It's not about, as we have seen for years with EHRs. It's not about just putting them through some horrible modular training, but about actually bringing them to a level of understanding and being a part of the decision making of how we're adopting this technology, how we're blending it into their day to day, how it's making their job easier.”

Relevant Links

• About Cityblock
• CNBC Disruptor 50: Cityblock CEO breaks down the business of health care
• At Cityblock Health, ‘Everything is Driven by Data’
• Tour for Diversity in Medicine
• Coalition for Health AI (CHAI)

About Our Guest

As the Chief Health Officer at Cityblock Health, I lead the clinical strategy and operations for a rapidly growing company that provides innovative, personalized, and accessible care to individuals and communities with complex health and social needs. I bring over 15 years of experience as a board-certified family physician, a health policy expert, and a mentor to aspiring and practicing health professionals from diverse backgrounds.

My mission is to transform health care delivery and outcomes for underserved populations by leveraging innovative operations, data, technology, and human-centered design. I have co-founded and directed Tour for Diversity in Medicine, a national initiative that educates and inspires future physicians, dentists, and pharmacists of color, and serve as a Health Innovators Fellow at the Aspen Institute, a prestigious program that fosters entrepreneurial and values-driven leadership in health care. I have been elected to the National Academy of Medicine, the highest honor in the field, and served as a senior executive at the U.S. Department of Veterans Affairs, where I oversaw the largest integrated health care network in the country in the Office of Community Care and later served as Chief Medical Officer of the health system. I am passionate about advancing health equity, quality, and innovation, and empowering the next generation of health care leaders.

Source: https://www.linkedin.com/in/kameronmatthews/

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For the past 20 years, under both Republican and Democratic administrations, the ONC has played a pivotal role shaping and regulating the health tech market. On the eve of the election, Micky Tripathi joined me to discuss the agency’s recently expanded role. Now, two months later—though it feels like a decade—the future is uncertain. Will the ONC and ASTP continue as market regulators and opportunity catalysts, or is a new direction on the horizon?

Here’s what we covered:

• The government’s role in shaping and regulating the health tech ecosystem
• AI in healthcare: balancing the risks of misuse vs. the risk of “missed uses”
• Health information sharing: why Micky is optimistic about the future
• Can technology take the pain out of prior auth?

Micky thinks we are standing on the edge of a transformative era:

“We are just at the beginning of the most exciting decade...health information technology can really start to show… the return on investment for patients. We've done a lot of hard work over the last 10 years… [With that foundation in place] we have the opportunity to say there's an ROI here for patients.”

Relevant Links

• Blog post on ONC reorganization: ONC’s Next Chapter
• TEFCA overview
• Forbes interview: Where is interoperability headed?
• Healthcare Dive: HHS AI Task Force Takes Shape (March 2024)
• Blog post by Micky: Getting real about information blocking and APIs (October 2024)

About Our Guest

Micky Tripathi is the Assistant Secretary for Technology Policy, National Coordinator for Health Information Technology, and Acting Chief Artificial Intelligence Officer at the U.S. Department of Health and Human Services, where he leads the formulation of HHS technology and data strategy and coordinates technology policies, standards, programs, and investments.

Dr. Tripathi has over 20 years of experience across the health IT landscape. Prior to joining the federal government he served as Chief Alliance Officer for Arcadia, a health care data and software company focused on population health management and value-based care, the project manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR, and a board member of HL7, the Sequoia Project, the CommonWell Health Alliance, and the CARIN Alliance.

Dr. Tripathi served as the President and Chief Executive Officer of the Massachusetts eHealth Collaborative (MAeHC), a non-profit health IT advisory and clinical data analytics company. He was also the founding President and CEO of the Indiana Health Information Exchange, a statewide HIE partnered with the Regenstrief Institute, an Executive Advisor to investment firm LRVHealth, and a Fellow at the Berkman-Klein Center for Internet and Society at Harvard University.

He holds a PhD in political science from the Massachusetts...

There’s a lot of hand wringing right now about healthcare affordability, but not enough action. Paul Markovich, the CEO of Blue Shield of California, is on a mission to bring down health costs by reducing administrative overhead and negotiating lower drug prices. In this episode we dive deep into Paul’s call to action for healthcare leaders to tackle the affordability crisis head-on.

Paul and I discuss:

• How Blue Shield slashed the cost of arthritis drug Humira, by offering a biosimilar at 25% of the cost
• Why reducing healthcare costs is critical to averting a national economic crisis
• Whether we need a new national mandate for health data sharing
• Paul’s advice on tackling fear and being a brave leader

Paul says healthcare affordability isn't just a pocketbook issues for patients, it’s also a huge economic issue for the nation:

“The reality is we are facing a huge affordability crisis, a fiscal crisis right now. Even though our economy is running pretty much at or near full employment, we have record fiscal deficits… We cannot keep spending on this program the way that we are. We need to bring the spending down... Even our dysfunctional political system is going to have to deal with that.”

Relevant Links

California’s new data sharing law

Announcement of new Humira biosimilar

Investment in nonprodit Civica for lower cost generics

New prior authorization platform with Salesforce

About Our Guest

Paul Markovich is Chief Executive Officer of Blue Shield of California, a nonprofit health plan with $25 billion in annual revenue serving 4.8 million members in the state's commercial, individual, and government markets. Markovich has launched and led numerous initiatives to drive innovation and help reimagine healthcare, including funding support for a statewide provider directory to make it easier for Californians to find physicians and facilities in their plan; supporting development of a statewide health information network for patients’ records, enabling more seamless and holistic care; and investing in a partnership with the California Medical Association to help physicians pilot new care delivery models and leverage technology.

Markovich is a North Dakota native and Rhodes Scholar with a master’s in Philosophy, Politics and Economics from Oxford University. He is a graduate of Colorado College, where he earned a Bachelor of Arts in International Political Economy and played Division I hockey.

Source: https://www.blueshieldca.com/en/home/about-blue-shield/corporate-information/leadership/paul-markovich

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On so many issues, Congress has not been willing or able to act. But when faced with horrifying stories of death and mismanagement, Congress finally passed legislation to reform the US organ transplant system. They did so because people like Donna Cryer, a transplant recipient and patient advocate, demanded a better system for Americans who need lifesaving organ transplants. Now, as the new law moves into implementation, the work continues.

In this episode, Donna and I discuss:

• The new legislation that is breaking up the deadly organ transplant monopoly
• How ignoring the expertise and insights of patients dooms us to slow progress making healthcare safer and better
• Her advice for young people: “take your shot”

Donna says we all need to start listening more closely to patients with lived experience:

“I often think if you... had many people with great deals of experience and intelligence who were highly motivated to help you achieve your goal. Why would you not want to use them? Why would you not want to partner with them? Why would you work really, really hard to keep them away from solving the problem? And that's how people treat patients and patient advocates.”

Relevant Links

Donna Cryer’s testimony to the Senate Finance Committee on organ transplant system failures (just past the 48:00 mark)

Summary of the new law to break up the organ transplantation monopoly

More about the Global Liver Institute

See more details about the Advanced Advocacy Academy Donna's organization launched

Visit UNOS’ website

About Our Guest

Donna R. Cryer, JD is the Founder and former Chief Executive Officer of Global Liver Institute, the only patient-driven liver health nonprofit operating across the US, EU, and UK. GLI convenes the NASH, Liver Cancer and Pediatric and Rare Liver Disease Councils, as well as the Liver Action Network, collectively more than 200 organizations.

Mrs. Cryer has channeled her personal experience as a patient with inflammatory bowel disease and a 29-year liver transplant recipient into professional advocacy across a career in law, policy, consulting, public relations, clinical trial recruitment, and nonprofit management.

At GLI, Mrs. Cryer has raised more than $10 million for liver health initiatives. She is a frequent speaker on the topic of patient-centeredness and patient engagement in healthcare transformation and created a unique model for advocacy that mobilizes patients, influences policy, and coalesces clinicians to improve patient outcomes.

Mrs. Cryer serves on the Boards of Directors for the Council of Medical Specialty Societies, Sibley Memorial Hospital/Johns Hopkins Medicine, the Innovation and Value Initiative (IVI), and the Clinical Trials Transformation Initiative. She was the first patient to serve on the ABIM Gastroenterology Specialty Board, was one of the founding members of the AASLD Patient Advisory Committee and is the Community Representative on the AASLD NASH Task Force. She has been named one of the Top Blacks in Healthcare by the Milken Institute at GW School of Public Health and BlackDoctors.org, one of the Top 10 Patients Who Make An Impact by Health 2.0 and one of PharmaVoice’s 100 Most...

Dr. Theresa “Terry” Cullen is on a mission to make Pima County, Arizona one of the healthiest counties in the nation. It’s a challenging goal, and one that will take dedication and a willingness to fight for what’s right. But, Terry is a self-described, life-long pugilist – with an approach to healthcare that goes beyond policies and programs. Everything she does is rooted in her deep belief in accompaniment; that her role is to walk alongside her patients and community offering empathy, dignity and respect.

We discuss:

• Her work as a rural doctor with the Indian Health Service
• Deploying to West Africa in 2014 for the Ebola crisis
• Why the VA and DOD could not agree on electronic health records
• Her commitment to make Pima county one of the healthiest in the nation

Terry reminds us that sometimes we need to step back and look at the work we do through a new lens:

“My husband's an artist, and he challenges me all the time to look at something and look at the light. Look at the composition. Look at where it is. What's the pattern there? You know, and a lot of medicine is based on pattern, but think of a disruptive pattern. Think of a puzzle where the piece doesn't fit and what do you need to do to make that piece fit? Because if it falls into place, maybe the whole thing will heal.”

Relevant Links

Definition of pugilist

Resolve to save lives - 717 alliance

Healthy Pima Indicators

About Our Guest

Theresa Cullen is currently the Public Health Director of Pima County, Arizona. She has developed a strategic approach to transformational health status change with a goal of health equity through supporting a learning public health system model based on data and action. She continues to work closely with Tribal, federal, state and local partners to ensure that community needs are integrated into planning with a goal of health justice. Dr. Cullen, RADM (retired) USPHS, began her family medicine clinical career with Indian Health Service (IHS) and worked in leadership positions for 25 years with American Indian/Alaska Native communities with a goal of improving health status through innovation and data informatics. Dr. Cullen worked as the Chief Medical Information Officer for the Veterans Health Administration from 2012-2015 and Associate Director of Global Health Informatics at the Regenstrief Institute. She has been honored with multiple local, state and national awards including the USPHS Distinguished Service Medal, the University of Arizona Medical College Alumni Award, and the AMIA Don Detmer Award for informatics health policy contributions.

Source: https://academyhealth.org/about/people/theresa-cullen-md-ms

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With the election just days away, Larry Levitt joins me to discuss where Harris and Trump stand on key health issues: reproductive health, affordability and Medicaid. While health has not taken center stage (as it has in the past), the outcome of this election will have profound impacts on every aspect of health in the years ahead.

We discuss:

• Why the ACA is no longer a political battlefield
• The shifting dynamics of abortion as a single-issue vote
• Why medical debt and drug prices are key affordability issues to watch
• Whether we could see bipartisan progress on AI governance, long term care or PBM reform over the next four years

Larry reminds us that health IS an economic issue:

“People think of the economy and health care being separate issues, but they're In fact, not separate issues at all. I mean, we spend an enormous amount on health care. A lot of people's household budgets go to health care. So, you know, when you talk about an economic issue, health is an economic issue, issue for people.”

Relevant Links

KFF panel: What the 2024 election could mean for health coverage, affordability and the budget

KFF election 2024 page

How medical debt is the canary in the coal mine for health affordability [article]

Project 2025

Abortion-related state ballot measures

About Our Guest

Larry Levitt is the executive vice president for health policy, overseeing KFF’s policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women’s health, and global health. He previously was editor-in-chief of kaisernetwork.org, which was KFF’s online health policy news and information service and directed KFF’s communications.

Prior to joining KFF, Levitt served as a senior health policy adviser to the White House and the Department of Health and Human Services, working on the development of the Clinton Administration’s Health Security Act and other health policy initiatives. Earlier, he was the special assistant for health policy with California Insurance Commissioner John Garamendi, a medical economist with Kaiser Permanente, and served in a number of positions in the Massachusetts state government.

Levitt holds a bachelor’s degree in economics from the University of California, Berkeley, and a master’s degree in public policy from the Kennedy School of Government at Harvard University.

Source: https://www.kff.org/person/larry-levitt/

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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...