18-45 Segment 2: Leprosy in the Modern Era

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Thanks in part to its Biblical past, the disfiguring disease leprosy carries more stigma than most diseases. We hear little about it today, but it still exists, and because it’s now treatable, often the stigma is worse than the disease. An expert discusses.

Guest:

  • Dr. David Scollard, Director, National Hansen’s Disease Program

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18-42 Segment 2: Getting Rid of Those Old Style Hospital Gowns

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Surveys show that hospital gowns are one of the things that most makes a hospital stay unpleasant. Finally hospitals may be moving to get rid of the old style gowns toward a less revealing, more dignified design that is still functional for healthcare workers. Experts discuss.

Guests:

  • Chat Razdan, co-founder and CEO, Care+Wear garment maker
  • Dr. Deborah Mullen, Associate Professor of Health Care Administration, University of Tennessee-Chattanooga and consultant, Health Partners-Park Nicollet Health System

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18-40 Segment 1: Health Crises and Financial Disaster

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Medical bills have long been labeled the number one cause of bankruptcy in the US. A recent study has examined how medical crises produce personal financial disaster. Researchers say for the uninsured, medical bills are, indeed, a heavy burden. But for both insured and uninsured, illness or injury can cause disruption of employment that may linger for years, and from which family finances may never recover. Experts discuss causes and possible solutions to the problem.

Guests:

    • Dr. David Himmelstein, Distinguished Professor of Public Health, City University of New York at Hunter College
    • Dr. Matthew Notowidigdo, Associate Professor of Economics & Strategy, Northwestern University

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18-36 Segment 2: Saving Talk Therapy for Mental Illness

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Decades ago, psychiatric treatment meant talk therapy. Now it usually means drugs or cognitive behavioral therapy for an extremely short time. A noted clinical psychologist and author explains why patients are better served when talk therapy is an option for recovery.

Guest:

  • Dr. Enrico Gnaulati, clinical psychologist and author, Saving Talk Therapy: How Health Insurers, Big Pharma, and Slanted Science are Ruining Good Mental Health Care

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18-35 Segment 1: Healthcare and the Homeless

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Homeless Americans have a life expectancy of only around 50, and often use the ER for primary care at a huge cost. The lack of follow-up care for their illnesses and the mental health or substance abuse disorders common in this population add up to an enormous health burden. Experts discuss how doctors on the street can improve health for the homeless and lower cost for society.

Guests:

  • Dr. Jim Withers, Medical Director and Founder, Pittsburgh Mercy Health System Operation Safety Net and the Street Medicine Institute 
  • Dr. Jim O’Connell, President, Boston Healthcare for the Homeless Program and author, Stories from the Shadows: Reflections of a Street Doctor

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18-23 Segment 1: Tackling High Drug Prices

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High prescription drug costs are a problem that most Americans deal with. In response to this, President Donald Trump announced last month that his administration is introducing a 50-point plan to cut drug prices. Dr. David Hyman, Professor of Law at Georgetown University Law Center and co-author of Overcharged: Why Americans Pay Too Much for Healthcare, talks through some of the major points of the plan and how effective they could truly be in the long run.

Two important parts of the plan are an attempt to ease the entry of generic drugs into the market and to make their prices more flexible. Eric Hargan, Deputy Secretary of the US Department of Health and Human Services, says branded drug companies must stop the “gamesmanship” that slows the creation of a competitive, free market for drugs. And, getting more drugs into “part D” allows Medicare to negotiate for lower prices through pharmaceutical benefit managers (PBMs).

But, the PBMs bring a problem of their own into the industry. President Trump says that these middlemen have been part of the problem by stopping the distribution of rebates and discounts to consumers and pocketing the money themselves, which also leads to artificially high list prices for drugs. Dr. Hyman says that PBMs are still important to the industry, because they structure the pharmaceutical market, but the plan will hopefully help to create a fairer market.

Another potentially influential part of the plan, announced by Alex Azar, Secretary of the US Department of Health and Human Services, will be to require drug companies to announce the list prices of drugs in their advertisements in the interest of transparency.

In his book, Dr. Hyman introduces several points that he believes would be beneficial in helping Americans pay less for drugs, although these points are not in President Trump’s recent plan. He suggests that allowing Americans to import generic drugs from foreign markets would help solve the generic drug price hikes. Dr. Hyman also stressed that high insurance costs are the biggest driver of high costs for prescription drugs.

For more information about the plan to lower drug prices or about our guests, visit the links below.

Guests:

  • Dr. David Hyman, Professor of Law at Georgetown University Law Center and co-author of Overcharged: Why Americans Pay Too Much for Healthcare
  • Eric Hargan, Deputy Secretary of the US Department of Health and Human Services

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18-17 Segment 1: Medicare Tackles the Opioid Epidemic

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With the opioid epidemic continuing to take many lives every year, people are concerned with how to stop it. In order to help counter this epidemic, Medicare has taken steps to implement limits on the prescriptions of opioids. However, the Medicare proposal has left doctors wondering if these new limits will do more harm than good for patients.

Currently, the United States is experiencing the second wave of the opioid epidemic. Dr. Anna Lembke, Associate Professor and Chief of Addiction Medicine at Stanford University School of Medicine, explains that opioid addiction arises from the prescription of these medications as a go-to for doctors even if the medical condition does not necessarily call for it. Furthermore, Dr. Sally Satel, an addiction psychiatrist and lecturer at Yale University School of Medicine and Resident Scholar at American Enterprise Institute, states that another issue is not just the prescribing of opioid medications, but the over-prescribing. In many cases, a doctor will prescribe a patient an unnecessary amount of opioids, but this often leads to leftover medication that tends to get into the hands of people who are likely to abuse it. So, one way that Medicare is working to counteract this is by regulating the quantity and overall dose of opioids that are allowed to be prescribed to a patient. Dr. Satel explains that by limiting the number of pills allowed when refilling a prescription, not only will it decrease the number of leftover pills, but it will also guarantee that those who benefit from opioids continue to take them appropriately. Along with this, Dr. Lembke states that this limit on the number allowed to be prescribed is important because doctors most likely would not limit their prescriptions enough to a point that would allow for a decrease in the epidemic. With this regulation, the number of leftover pills being circulated outside of who they were prescribed to will decrease which will allow for a drop in the number of people addicted to prescription opioids.

The proposed Medicare regulations also came with a second leg to it. This other guideline would cut-off any doctor from prescribing a high-dose of opioid medications. However, Dr. Satel explains that many pain physicians had problems with this regulation because it would make it extremely difficult for patients who do benefit from these prescriptions, and use them properly, to have access to them. So, when the final Medicare proposal was released, this second guideline was altered to allow physicians to prescribe high-doses of opioid medications, but it gave pharmacists the power to override a high-dose request that seemed unnecessary.

While these Medicare limits are a step in the right direction for managing the opioid epidemic, there is still much that can be done to improve it. For instance, other medical treatments should be made more accessible through Medicare, explains Dr. Lembke. It’s important to reduce the access to opioids. However, it is also important to facilitate the use of other medical treatments to help with pain. Improvements are being made in the healthcare system to stop the opioid epidemic, but those who benefit from opioid prescriptions should not have to suffer.

Guests:

  • Dr. Anna Lembke, Associate Professor and Chief of Addiction Medicine at Stanford University School of Medicine
  • Dr. Sally Satel, addiction psychiatrist and lecturer at Yale University School of Medicine, and Resident Scholar at American Enterprise Institute

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