The Dose

By The Commonwealth Fund

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The Dose is a podcast to help you make sense of current issues in health care. Every other Friday, join Shanoor Seervai in conversation with leading health policy experts to break down complicated questions that shape the way Americans experience health care in their daily lives. Produced by the Commonwealth Fund, a foundation dedicated to health care for everyone.

Episode Date
"It's Really, Truly Everywhere": How the Opioid Crisis Worsened with COVID-19
25:05

When the pandemic hit last March, the U.S. was still facing another major public health crisis —the opioid epidemic. Between COVID-19 lockdowns and economic devastation, overdose deaths soared. Experts estimate that around 90,000 people died of a drug overdose in 2020. That’s the highest number of overdose deaths ever, and it represents the largest one-year increase.

On the latest episode of The Dose, we explore why drug deaths are rising and how policymakers can help fix the problem with guests Brendan Saloner, professor of health policy at the Johns Hopkins School of Public Health, and Jesse Baumgartner, a research associate at the Commonwealth Fund.  

Jun 04, 2021
“They’re Not Going to Say They’re Hungry”: Designing Health Care for Trauma Survivors
29:08

Many of us can recall a time we felt nervous about seeing a doctor. Maybe it was because we were wary about how much the visit would cost, or what a diagnosis would mean for our health. Now, imagine how much more stress you would feel if you had experienced trauma — from domestic violence or human trafficking, for example.

Trauma survivors are the people family medicine physician Anita Ravi, M.D., cares for. On the latest episode of The Dose, Ravi and Keisha Walcott, one of her former patients, talk about how to design health systems for women and girls who have experienced gender-based violence. Ravi and Walcott explain how health, poverty, and trauma are interlinked and why providers must address all three.

May 21, 2021
Sick in the Shadows: Why Immigrants Should Have Health Care
20:41

Migrants are crossing the southern border in record numbers this year, many of them unaccompanied children. What happens to them once they make it into the U.S., or if they've been here for a long time, when they need health care?

On the latest episode of The Dose podcast, Carrie Byington, executive vice president of University of California Health explains, drawing on her expertise as a pediatrician and infectious disease specialist, and personal experience treating immigrants and their families.

Byington, a member of the Commonwealth Fund’s Board of Directors, describes how the pandemic has illustrated the urgent public health need for immigrants to have health care, because “people may choose to forgo testing, or choose to postpone vaccination if they're afraid to sign up for a vaccine.”

May 07, 2021
What Will the Biden Administration Do for Women’s Health?
24:52

The Biden-Harris administration has taken several measures in its first three months to strengthen the nation’s social safety net. Many of these policies will have an outsized impact on women — particularly women of color, who often struggle to access health care and now are bearing the brunt of the COVID-induced economic crisis.

From mandating paid sick leave and shoring up childcare to addressing the maternal health crisis, the new administration clearly recognizes the ways health and economic security are intertwined and how this impacts women.

On the latest episode of The Dose, Debra Ness, president of the National Partnership for Women and Families, makes the case that the pandemic has exposed inequities too difficult to ignore. And she believes women will emerge “smarter and stronger” from this crisis.

Apr 23, 2021
For Asian Americans, a Dual Pandemic of COVID-19 and Racism
23:10

Hate crimes against Asians in the United States more than doubled from 2019 to 2020. Last month, in one of the most conspicuous acts of violence against Asians in recent history, six Asian American women were shot dead in Georgia.

Racism against people of Asian descent is not a new problem, but it has been exacerbated of late by politicians using racist rhetoric to describe the coronavirus. Asians in America are now facing a dual pandemic: a heightened fear of racist abuse, from verbal slurs to physical assault, on top of all the anxiety of living through COVID-19.

In this episode, Vivian Shaw and Susanna Park of the AAPI COVID-19 project talk about the deep roots of anti-Asian bias, as well as their research into how the pandemic is affecting the lives of Asians in the U.S.

Apr 09, 2021
A Marathon, Not a Sprint: The Race Between COVID-19 Vaccines and Variants
24:38

If you’re an optimist, then every piece of good news about vaccine approvals and shots in arms has put the end of the pandemic in sight. If you’re a pessimist, then all the new variants with names sounding like computer-generated passwords signal the apocalypse. Will hope win, or will dread?

On the latest episode of The Dose podcast, Eric Schneider, M.D., talks about the high-stakes race between the quick-spreading variants of COVID-19 and the effective vaccines that more Americans receive each day.

Schneider brings us up to speed on the state of the pandemic and the challenges ahead. Drawing on his expertise in public health, he explains how we can “break the back of the virus” and ultimately win the race.

Share your stories of pandemic optimism or pessimism—send an email to thedose@commonwealthfund.org.

Mar 26, 2021
“All Hands On Deck”: The COVID-19 Pandemic Through Nurses’ Eyes
22:17

Health care workers are among the heroes of the pandemic. One year in, many of us are experiencing stress, fatigue, and grief. But this can pale in comparison to the toll faced by those caring for the sick and dying on a daily basis. On this episode of The Dose, we listen to the stories of one group of frontline health workers: nurses. Often dealing with inadequate PPE and staff shortages, nurses are putting their own lives at risk — and many are experiencing burnout and exhaustion.

Our guest, Mary Wakefield, takes us on a journey from rural hospitals to clinics in underserved areas, all through the eyes of nurses. Mary, a nurse with a long career in health care and public service, says the pandemic has revealed that America’s public health infrastructure is “incredibly anemic.”

Mar 12, 2021
Violence, Interrupted: Breaking Cycles of Violence in the Hospital and on the Street
24:07

Violence kills thousands of Americans each year and sends many more to the hospital with life-threatening injuries. Even though many people recover physically, the issues that cause violence often go unchecked.

On today’s episode of The Dose, we talk about how interventions, both in hospitals and in communities, that can help break the cycle of violence that traumatizes people over time.

Our guest, Fatimah Loren Dreier, is the executive director of the Health Alliance for Violence Intervention, and a Pozen-Commonwealth Fund fellow in Health Equity Leadership. She talks about how trained violence interruption specialists can help people navigate conflict, and how the national protests around police violence towards Black Americans has created an opportunity for communities to rethink the role of the police.

Feb 26, 2021
“Not Just a Black Body”: How COVID-19 Hit Home for One Doctor
27:27

Living with the COVID-19 pandemic for a year, it’s hard to process the numbers. What we know is that nearly 500,000 Americans have lost their lives, and that Black, Latino, and Indigenous people are worst impacted.

But behind the statistics are stories, and on the latest episode of The Dose, we listen to one of those stories. Our guest, Dr. Magdala Chery, is a primary care physician and Commonwealth Fund Fellow in Minority Health Policy. 

Magdala is also a daughter, and she experienced firsthand the racial inequities of our health care system when she lost both her parents to COVID-19 last spring. Magdala speaks of her personal tragedy without rancor: she believes that sharing stories like hers will help us see the people of color affected by COVID-19 not as case numbers and fatalities, but as lives.

Feb 12, 2021
COVID-19 is Making Us Lonelier: Is There a Way Out?
22:12

Almost a year into the COVID-19 pandemic, the U.S. faces another health crisis – one of loneliness. Between lockdowns, social distancing, and the fear that contact with others could make us sick, many people are living in isolation.

But there are ways to cope.

On this episode of The Dose podcast, Matthew Pantell and Laura Shields-Zeeman, researchers at the University of California, San Francisco, talk about how innovative programs from around the world could help mitigate the effects of isolation.

Jan 29, 2021
The U.S. Is Missing Key Opportunities to End the COVID-19 Pandemic
29:09
A year into the COVID-19 pandemic, the United States appears to have learned few lessons from its disastrous early response.
 
Hasty lockdowns and bungled reopenings have now given way to a sluggish and uncoordinated vaccine rollout. This month, the daily death toll crossed 4,000, and hospitals in many parts of the country are overflowing with sick patients.
 
How are we going to get out of this mess?
 
On the latest episode of The Dose, Ashish Jha, M.D., dean of the Brown University School of Public Health, explains how vaccine distribution could be sped up and carried out in a manner that addresses racial and economic disparities. Jha believes that swift action from the incoming administration could help America emerge from the pandemic by mid- to late 2021.
Jan 15, 2021
COVID on Campus: What It’s Like to Run a University in a Pandemic?
22:53

COVID-19 brought the lives of college students to an abrupt standstill – being in a classroom, a dormitory, a dining hall table with friends became risky activities overnight.

How did universities navigate the impossible tradeoff between having students on campus with the risks of the coronavirus, and keeping students remote but putting their education in peril?

Find out on this episode of The Dose podcast with Dr. Michael Drake, President of the University of California. Drake, who is also a member of The Commonwealth Fund Board of Directors, explains the decisions he made to keep students safe – and learning – on and off campus.

Listen here, and then subscribe wherever you find your podcasts.

Dec 18, 2020
Joe Biden’s Presidency Kicks Off With a ‘Once in a Century’ Health Crisis
18:44

A new president doesn’t get four years to shape health care, he gets six months. And for President-elect Joe Biden, the most pressing health care issue is – no surprise here – COVID-19.

On this episode of The Dose, the Commonwealth Fund’s President David Blumenthal, M.D., talks about Biden’s opportunity to leave a lasting health-care legacy by bringing the pandemic under control.

History will judge Biden by how he rises to our new reality, says Blumenthal, in which one in every 1,300 Americans has died of COVID, millions have lost their jobs, and science has been undermined and ignored.

Dec 04, 2020
“A Monumental Effort”: How Obamacare Was Passed (Rebroadcast)
22:55

President-elect Joe Biden says he is committed to strengthening the Affordable Care Act so that all Americans can get the health care they need. He also wants to work with people of all political stripes: in his acceptance speech, he said it’s time “to listen to each other again.”

This week on The Dose podcast, we’re bringing back an earlier episode on the compromise required to bring about big political change — in this case, change in U.S. health care.

The Commonwealth Fund’s Elizabeth Fowler, a key architect of Obamacare, talks about the behind-the-scenes effort it took to get the landmark law passed.

Nov 20, 2020
With Medicaid Expansion, More than “A Bus Pass and A Good Luck” for Formerly Incarcerated People
21:21

People who are incarcerated have complex health needs, and to make matters more complicated, prisons and jails have seen some of the worst COVID-19 outbreaks in the U.S.

 But what happens when they leave prison or jail and need to receive health care on the outside?

Many states that have expanded Medicaid are also trying to ensure that people leaving jail or prison are able to enroll in health coverage upon release.

On the latest episode of The Dose podcast, learn how these and other health care and criminal justice reform efforts work together from guests Vikki Wachino, who heads a nonprofit that connects jails with community health care providers, and Rebekah Gee, who oversaw Medicaid expansion as Secretary of the Louisiana Department of Health.

Nov 13, 2020
‘Not a Magic Wand’: The Race for a COVID-19 Vaccine
20:25

Masks. Lockdowns. Shuttered businesses. Hospitals strained beyond capacity.

Weary of the pandemic’s myriad disruptions to normal life, many Americans are pinning their hopes on a COVID-19 vaccine. But even if an effective one is developed, it won’t make the virus magically disappear.

On today’s episode of The Dose podcast, Dr. Margaret “Peggy” Hamburg, former commissioner of the U.S. Food and Drug Administration and a member of the Commonwealth Fund’s board, talks about the race to develop and deploy a vaccine.

“Even the world's most safe and effective vaccine won't make a difference if people don't trust it and won't take it,” she warns.

Oct 30, 2020
Americans are Struggling with the Mental Health and Economic Impact of COVID-19
22:14

Americans are stressed about COVID-19 – both the disease and what it’s doing to the economy.

And while the virus has touched every corner of the globe, many high-income countries have been more successful than the U.S. at easing some of the pandemic’s pain.

This week on The Dose podcast, we talk about why Americans are experiencing the anxiety and sadness of the pandemic differently than people in other countries, and how this is tied to economic concerns like food, jobs, and housing.

Oct 16, 2020
COVID-19 and Pre-Existing Conditions Are Voters’ Biggest Health Care Fears
22:16

Health care is always important for voters, but this year, it is at the top of everyone's mind.

The health needs and economic costs of COVID-19, and protections for people with pre-existing health conditions tie for first place in the Commonwealth Fund’s latest poll on which health care issue matters most to voters in the 2020 election.

Voters are also worried about health care costs, the safety of voting in person, and whether or not their vote would be counted if they vote by mail.

Then there’s the question of which candidate – Former Vice President Biden or President Trump – would address voters’ health care concerns. To learn what they said, and unpack some of the poll’s key findings, listen to the latest episode of The Dose with the Commonwealth Fund’s Sara Collins. 

Oct 02, 2020
“We All Had the Same Warning," But Canada's COVID-19 Response Was Different
24:40

Hospitals in the U.S. started preparing for COVID-19 as early as January, but it wasn’t until Italian doctors started tweeting in March that they had to decide which patients would get ventilators that Michael Apkon realized the severity of the crisis.

On the latest episode of The Dose, Apkon, President and CEO of Tufts Medical Center in Boston, takes listeners on one hospital’s journey through the harrowing past six months of dealing with the pandemic.

Apkon recounts conversations with former colleagues from his time running a hospital in Canada, and reflects on how the fundamental differences between the U.S. and Canada’s approach to health care contributed to two very different responses to COVID-19.

Over the next few weeks, The Dose will be covering how the pandemic and other health care issues are playing out in the 2020 Presidential election. Listen to today’s show, and then subscribe wherever you find your podcasts.

Sep 18, 2020
Health Care has a Bias Problem: Here's How to Fix It (Rebroadcast)
20:59

***Originally Aired Nov 2019***

Bias in medicine – based on race and sex – is a well-documented problem. It’s a problem because the health care system has historically marginalized the medical concerns of people of color and women, which has led to worse health outcomes.

On this episode of The Dose, host Shanoor Seervai discusses ways to tackle bias in health care with Ann-Gel Palermo, who works on diversity and inclusion at New York’s Icahn School of Medicine at Mount Sinai, and Joia Crear-Perry, who founded the National Birth Equity Birth Collaborative to address racial disparities in health care.

They explain that bias is not just a concern at the individual provider level; it’s actually baked into the system, starting in medical school. While fundamental change will be an uphill battle, they say, the fight is critical to ensuring that all patients are treated fairly when they seek care.

Sep 04, 2020
What Happens When Young People Can’t Access Reproductive Health Care? (Rebroadcast)
27:27

***Originally Aired Feb 2020***

More than 800 women across the globe die each day from complications related to pregnancy. Some of them bleed to death. Some of them develop infections or severe life-long medical conditions because they are delivering their babies in unsafe environments.

Many of these deaths could be prevented if more young people had access to birth control and other reproductive health care. Pathfinder International is a nonprofit working with communities in 20 countries to make this a reality.

On this episode of The Dose, Pathfinder CEO Lois Quam, a member of the Commonwealth Fund’s board, recounts some of the stories she’s heard from young people around the world. Quam tells host Shanoor Seervai about the challenges they face in deciding whether and when to have children — and how their lives change when they are able to make this choice.

Aug 21, 2020
How Our Health Care System Treats Black Mothers Differently (Rebroadcast)
21:51

***Originally Aired Oct 2019*** 

African American women die of pregnancy-related causes at three times the rate for white women, even after accounting for income, education, and access to other resources.

What is it about being born black in America that leads to such outcomes?

To answer this question, Shanoor Seervai interviews Kennetha Gaines, clinical nurse manager for UCSF Health in San Francisco, for the latest episode of The Dose podcast. Gaines, a Pozen Commonwealth Fund Fellow in Minority Health at Yale University, speaks candidly about her personal experiences and her work to transform the way health care providers treat black women.

Does the health care system treat people differently based on race? Tell us what you think – send an email to thedose@commonwealthfund.org.

Aug 07, 2020
Using Technology in Smarter Ways to Transform Health Care
19:02

When the pandemic hit, millions of Americans found themselves in a tight spot – practice social distancing to avoid COVID-19, but what if you have a health condition that requires seeing a doctor?

Technology could transform the way people access health care, and the U.S. has made huge investments in this over the past decade.

But, as health technology expert Aneesh Chopra explains on the latest episode of The Dose, we still haven’t realized the full potential of digitization when it comes to delivering health care.

Jul 24, 2020
Transgender Americans Just Lost Health Protections. Now What?
22:25

On June 12, the Trump administration eliminated federal protections against discrimination in health care for transgender people. This means that transgender Americans can be denied access to health coverage and care – simply because they are trans.

With the U.S. still grappling with COVID-19, the decision could make it more difficult for trans people to seek testing or treatment for the disease. And it deepens the health risks for a population already facing barriers to care.

The Commonwealth Fund’s Corinne Lewis, Yaphet Getachew, and Mekdes Tsega talk about the implications of the new rule, particularly for trans people of color, on this episode of The Dose podcast.

Jul 10, 2020
Why Are More Black Americans Dying of COVID-19?
22:29

COVID-19 cases in the U.S. are climbing again, and data show that Black and Latinx Americans are contracting and dying of COVID-19 at higher rates than white Americans.

The reasons for are complex, including: people of color are more likely to be poor, work in industries that expose them to the virus, live in crowded spaces, and have chronic health conditions.

Then there’s race -- the discrimination and violence that people of color experience on a daily basis puts their health at risk, further exposing them to the coronavirus.

Against the backdrop of a nationwide reckoning over police brutality against people of color, Dora Hughes, a professor of health policy at George Washington University, talks about the disproportionate impact of the pandemic on Black and Latinx people, and what policymakers could do to address these racial inequities.

Jun 26, 2020
We Need Primary Care More Than Ever to Fight COVID-19
21:23

Every day, primary care providers are on the front lines of the COVID-19 pandemic, treating sick patients even as they worry about bringing the virus home to their families. Many still lack adequate protective gear, and many worry about the financial stability of their practices.

With the U.S. starting to reopen, we need our primary care practices to keep their lights on — not only to test and treat people with mild symptoms but also to address health concerns that people have neglected while staying home.

On this episode of The Dose podcast, health policy expert Farzad Mostashari, M.D., who advises and supports hundreds of primary care practices across the country, explains what it will take to ensure doctors can continue caring for Americans throughout the pandemic.

Jun 12, 2020
How Community Health Workers Put Patients in Charge of Their Health
23:40

Health care is about so much more than medical tests or treatments. But, too often, health care providers forget to ask patients what they think would make them feel better.

Community health workers can help people take charge of their own health. Often living in the same communities and coming from similar backgrounds, they are able to share life experience with their clients and engender trust.

On this episode of The Dose, we talk about one community health worker program, IMPaCT, that is helping some of the poorest and sickest Americans meet their health and social needs.

As the COVID-19 pandemic upends all our lives, this idea of putting patients in charge — rather than telling them what to do — has particular resonance. Listen to our conversation with guest Shreya Kangovi, a primary care doctor and professor at the University of Pennsylvania, and then subscribe wherever you find your podcasts.

May 29, 2020
When Doctors Work with Lawyers to Improve Patients’ Health
22:35

Getting and staying healthy depends on more than just medical care. In some instances, a patient also needs legal services. What if doctors could “refer” their patients to lawyers for help in dealing with a housing dispute, immigration status, or any number of legal issues?

On this episode of The Dose, we hear from Norma Tinubu and Emily Foote about how attorneys from the New York Legal Assistance Group work with health care providers at NYC Health + Hospitals, the largest public health care system in the U.S.

Through this medical-legal partnership, some of the city’s poorest patients can get the support they need to resolve legal problems that, if ignored, could take a toll on their health.

May 15, 2020
How Germany’s Approach to COVID-19 Sets the Country Apart
21:43

Earlier this week, Germany became one of the first countries to start easing COVID-19 restrictions. That’s because its initial response to the pandemic helped keep the death rate low. Germany:

  • Caught the coronavirus early
  • Does lots of testing
  • Has a robust health care system.

As the pressure mounts to reopen economies across the globe, other countries may have something to learn. On this episode of The Dose, Michael Laxy, a health economics researcher at the Helmholtz Center in Munich, talks about the German approach.

May 01, 2020
How Has COVID-19 Changed Health Care for Older Americans?
19:56

The coronavirus pandemic is impacting everyone, but the older you are, the more severe the health consequences. The recommendation is stay home, away from other people.

 

What does that mean for an older person managing a chronic health condition (like diabetes) and needs to fill an insulin prescription?

What about someone who may be used to seeing their grandchildren every weekend, and is not able to because they could be risking their health?

On this episode of The Dose, the Commonwealth Fund’s Gretchen Jacobson, vice president of the Medicare program, lays out just how tough COVID-19 has made life for older Americans.

Apr 17, 2020
COVID-19: What We Know, and What We Don't
24:51

The coronavirus pandemic is wreaking unprecedented havoc around the globe. So many of us are searching for information to keep ourselves and our loved ones safe – but how do we know whom to trust?

On this episode of The Dose, the Commonwealth Fund’s Eric Schneider, M.D., helps us make sense of what we know about COVID-19 so far:

  • We know physical distancing works, even though it is challenging to adapt to this new way of living
  • We don’t know how long we’ll have to adapt –so Dr. Schneider, offers some strategies on how to cope with the unknown.
Apr 03, 2020
'A Monumental Effort': How Obamacare Was Passed
21:40

Ten years ago, it took a monumental effort to pass the ACA, or Obamacare. As a result, today, no American is denied health insurance because of a pre-existing medical condition, and 20 million people who previously lacked coverage now have it.

On this episode of The Dose, The Commonwealth Fund’s Liz Fowler, who was one of the key architects of Obamacare, talks about the behind-the-scenes effort it took to get the law passed.

Mar 20, 2020
Coronavirus Reveals Flaws in the U.S. Health System
22:58

Fear of a coronavirus epidemic is rippling through the country faster than the disease is spreading – and the U.S. health care system may be unprepared to deal with the crisis.

On this episode of The Dose, The Commonwealth Fund’s David Blumenthal, M.D., and Sara Collins, break down how gaps in our health system are placing the entire population at risk in the current outbreak.

People who worry they are sick with the COVID-19 virus need to seek immediate medical care. But in the U.S., 30 million people don’t have health insurance. Another 44 million have such bare-bones coverage that they are always worried about the costs of getting care.

While Medicaid has come to the rescue in past catastrophes like 9/11 and Hurricane Katrina, recent changes to the program mean that millions of Americans living in poverty may not be able to access needed care.

Mar 06, 2020
‘Mom, I have HIV but don't worry about me’: How One City Is Trying to Eliminate HIV
18:17

Nearly 700,000 Americans have died of AIDS since the beginning of the epidemic in the 1980s, and more than 1.1 million are living with HIV today.

Advances in medical science have provided people with access to highly effective treatments for HIV. But is it possible to eliminate the disease altogether?

Some cities are trying. On this episode of The Dose, Grant Colfax and Susan Buchbinder of San Francisco's public health department talk about how the city is trying to eliminate HIV.

Through a range of projects, from increasing the uptake of preventive medicine to running mobile clinics to serve hard-to-reach patients, the city is making progress toward its goal of getting to zero HIV infections, deaths, and stigma.

Feb 28, 2020
What Happens When Young People Can’t Access Reproductive Health Care?
26:31

More than 800 women die each day from complications related to pregnancy across the globe. Some of them bleed to death. Some of them develop infections or severe life-long medical conditions because they are delivering their babies in unsafe environments.

Many of these deaths could be prevented if more young people had access to birth control and other reproductive health care. Pathfinder International is a non-profit working with communities in 20 countries to make this a reality.

On this episode of The Dose, Pathfinder’s CEO, Lois Quam, recounts some of the stories she has heard, firsthand, from young people around the world. Lois tells host Shanoor Seervai about the challenges people face when they are unable to decide whether and when to have children – and how their lives change if they are able to make this choice.

Feb 14, 2020
What’s Missing From the Debate About Controlling Drug Costs?
23:12

Prescription medicines have become so expensive in the United States that we've reached a point where four in five Americans think drug prices are unreasonable. While political leaders have certainly taken notice, what are they doing to solve the problem?

On the latest episode of The Dose, host Shanoor Seervai sits down with the Commonwealth Fund’s Lovisa Gustafsson to talk about how drugs could be made more affordable for those who bear the brunt of high prices – ordinary Americans.

Gustafsson believes some important issues are missing from the drug pricing debate, including a broken patent system, high launch prices, and the lack of cheaper medical treatments.

Jan 31, 2020
“Not on Banker’s Hours”: How Primary Care Differs in the Netherlands and the U.S.
18:18

Primary care is the bedrock of a health care system that works. For most people, seeing a doctor regularly can help prevent small medical concerns from turning into full-blown emergencies.

On this episode of The Dose podcast, we hear from Los Angeles Times reporter Noam Levey, who recently wrote about the differences between the primary care systems in the United States and the Netherlands through the eyes of two doctors, one working in each country.

Jan 17, 2020
Why Do Some Countries Do More C-Sections than Others?
27:38

A cesarean section can be a life-saving procedure for a woman with a complicated pregnancy – but in some countries, too many women deliver by c-section, even when it isn’t necessary. In other countries, women can’t get a c-section when they need it.

Why does this huge difference persist?

On this episode of The Dose, Pierre Barker, who heads global partnerships at the Institute for Healthcare Improvement, explains why some countries have a much higher c-section rate than others. Pierre and his colleagues use a method called quality improvement to change the approach taken by health care systems around the world when it comes to c-sections.

Jan 03, 2020
Everything You Need to Know About Health Care in 2019
23:48

Health care was front and center for the American public in 2019 – and with good reason. It’s one of the top issues voters are worried about going into the 2020 election.

On this episode of The Dose, David Blumenthal, M.D. and Shanoor Seervai review some of the big health care developments of the year, including the Democratic presidential candidates’ health reform plans, legislative activity around drug costs and surprise bills, and Silicon Valley’s growing interest in care delivery.

Dec 20, 2019
How Medicaid Can Help Solve America’s Maternal Mortality Crisis
27:00

The number of women who die in the U.S. because of complications related to pregnancy is shockingly high – nearly 30 deaths for every 100,000 births each year. But some women die at higher rates than others: the maternal mortality rate for black women is three to four times higher than it is for white women.

On this episode of The Dose, the Commonwealth Fund’s Laurie Zephyrin, M.D., and Akeiisa Coleman talk about one way to address this crisis: Medicaid, which pays for nearly half the 4 million births in the U.S. each year. States have a real opportunity, they say, to take innovative steps to improve the care pregnant women and new mothers receive through their Medicaid programs.

Dec 06, 2019
Health Care has a Bias Problem: Here's How to Fix It
20:22

Bias in medicine –based on race and sex – is a well-documented problem. It’s a problem because the health care system has historically marginalized the medical concerns of people of color and women, which has led to worse health outcomes.

On the latest episode of The Dose, host Shanoor Seervai discusses ways to tackle bias in health care with Ann-Gel Palermo, who works on diversity and inclusion at New York’s Icahn School of Medicine at Mount Sinai, and Joia Crear-Perry, who founded the National Birth Equity Birth Collaborative to address racial disparities in health care.

They explain that bias is not just a concern at the individual provider level; it’s actually baked into the system, starting in medical school. While fundamental change will be an uphill battle, they say, the fight is critical to ensuring that all patients are treated fairly when they seek care.

Nov 15, 2019
What We’re Talking About When We Talk About Medicare For All
24:46

Many Americans are worried about how they will afford care if they get really sick, and policymakers are responding to this concern with a whole range of complicated policies. Are you confused about what these policies mean for you, your family, and the health system in general?

You’re not alone, so on this episode of The Dose, host Shanoor Seervai sits down with the Commonwealth Fund’s Sara Collins to break down what she learned in her latest survey on American’s views about health care.

They discuss how Medicare for All, and other Democratic proposals, would change the health system; they also talk about open enrollment, an ongoing court case on the future of the Affordable Care Act, and much more.

What do you think is the best way to fix our health care system? Send us an email on thedose@commonwealthfund.org.

Nov 01, 2019
How Our Health Care System Treats Black Mothers Differently
20:35

African American women die of pregnancy-related causes at three times the rate for white women, even after accounting for income, education, and access to other resources.

What is it about being born black in America that leads to such outcomes?

To answer this question, Shanoor Seervai interviews Kennetha Gaines, clinical nurse manager for UCSF Health in San Francisco, for the latest episode of The Dose podcast. Gaines, a Pozen Commonwealth Fund Fellow in Minority Health at Yale University, speaks candidly about her personal experiences and her work to transform the way health care providers treat black women.

Does the health care system treat people differently based on race? Tell us what you think – send an email to thedose@commonwealthfund.org.

Oct 18, 2019
Medical Emergency? Philadelphia's Fire Department to the Rescue
21:19

Each day, Philadelphia’s fire department responds to nearly a thousand emergencies, whether it’s saving someone from opioid overdose or helping a person having trouble getting out of bed.

What would it be like to spend a day in the life of the person who runs emergency medical services for a big city? Listen to the latest episode of The Dose podcast to find out how Philadelphia EMS deputy commissioner Crystal Yates deals with crises on a daily basis.

Yates, one of the first recipients of the Pozen-Commonwealth Fund Fellowship at Yale University, has made it her mission to find innovative ways to come to the rescue of people with no other resources to turn to.

If you’re enjoying The Dose, tell your friends about it!

Oct 04, 2019
One Doctors Approach to Treating People with Sickle Cell Disease
19:27

Sickle cell disease is a life-threatening blood disorder that affects around 100,000 Americans, mostly African Americans. In addition to coping with the disease itself, many face a host of other challenges, like getting to the hospital for treatment, paying bills, and figuring out where their next meal will come from.

On the latest episode of The Dose, Dr. Cecelia Calhoun talks about her work helping children and young adults with sickle cell cope with these issues day to day. Calhoun is one of the first experts to receive the Pozen-Commonwealth Fund Fellowship at Yale University to advance her work on health disparities.

Sep 20, 2019
What Happened When One State Made Having a Job a Requirement for Medicaid
28:32

Many poor Americans get health coverage through Medicaid. Last year, with encouragement from the Trump administration, some states decided to try and change their Medicaid programs. For people to be eligible for health coverage, they needed to show that they were working, or met some other requirement.

On this episode of The Dose, Ben Sommers, a professor of health policy, and economics at the Harvard School of Public Health, talks to host Shanoor Seervai about what happened in Arkansas the first state to implement a “work requirements” program.

The program was intended to promote better health and employment – instead, it led to more than 17,000 people losing health coverage in just three months, and no significant increase in the number of people with jobs.

Listen to learn more, and then subscribe to The Dose wherever you get your podcasts.

Should having a job be a requirement to get health coverage through Medicaid? Tell us what you think – send an email to thedose@commonwealthfund.org.

Sep 06, 2019
Two Ways to Make Medicines More Affordable to Women (Rebroadcast)
25:12

Most Americans are indignant about high prescription drug prices. But for women living in poverty, life-saving medicines are often completely out of reach.

Many poor women skip getting needed care because of the high cost, putting themselves and their families at risk. On the latest episode of The Dose, host Shanoor Seervai sits down with two women who have found innovative ways to tackle this problem.

Jessica Grossman, who works for the nonprofit pharmaceutical company Medicines360, sells medicines at a lower price so that all women can get the treatment they need. Reforming the complex U.S. patent system, one of the root causes of high drug prices, is how Priti Krishtel, with the Initiative for Medicines, Access and Knowledge (I-MAK), is trying to remove barriers to treatment.

Have you or someone you know gone without a medicine because it’s too expensive? Send us an email on thedose@commonwealthfund.org.

 

Aug 23, 2019
Health Care in America – How Doctors Can Make Life Easier for Patients (Rebroadcast)
24:55

When a homeless person gets discharged from hospital, he needs a safe place to recover. When a poor patient faces a high co-pay for a medicine she needs, she is often too embarrassed to tell her doctor – instead, she may not fill the prescription.

Doctors don’t typically try to solve these social problems, but some want to do better at understanding patients’ lived experiences. In the latest episode of The Dose, Ishani Ganguli and Janine Knudsen, both primary care providers at innovative clinics, talk to Shanoor Seervai about how they are trying to treat a patient as a whole person, rather than focusing on a single medical condition. They discuss the successes and challenges of caring for patients in their daily practice in light of the findings of a recent survey of people living with serious illness in the United States.

Aug 09, 2019
How “Medicare for All” and Other Bills Would Change Health Care (Rebroadcast)
21:58

Several bills introduced in Congress over the past year seek to make health care more accessible to all Americans while also tamping down growing health care costs. In particular, “Medicare for All” proposals have garnered a lot of recent attention.

How would these proposals change the way Americans get health care? On this episode of The Dose, Shanoor Seervai sits down with the Commonwealth Fund’s Sara Collins to break down the different options policymakers are weighing as they try to reform our health care system.

Jul 26, 2019
The Truth About Waiting To See A Doctor In Canada (Rebroadcast)
22:44

When Americans talk about the Canadian health system, they often bring up wait times. But how long do people really have to wait to get care? This week, we talk to Christopher Hayes, the chief medical information officer at an academic and research health care organization in Canada. In spite of being neighbors, the U.S. and Canada take dramatically different approaches to health care. Join us as we try to untangle what this means for people on both sides of the border when they go to see a doctor.

Jul 12, 2019
Cuba: Where Primary Care Is All About Community
25:49

In Cuba, the neighborhood is not only the center of public life, it is the center of the health care system as well. Primary care is delivered at a consoltorio, a community-based clinic staffed by doctors, nurses, and even statisticians.

When Commonwealth Fund staff traveled to Cuba recently to learn about its primary care system, they discovered that the secret sauce missing from primary care in the United States might just be the role of community.

On this episode of The Dose, we talk about how cultural differences play out in the way Cuba and the U.S. approach the delivery of health care. As a bonus, you’ll also hear a listener’s response to our recent episode on “Medicare for All.”

Jun 28, 2019
Two Ways to Make Medicines More Affordable to Women
24:39

Most Americans are indignant about high prescription drug prices. But for women living in poverty, life-saving medicines are often completely out of reach.

Many poor women skip getting needed care because of the high cost, putting themselves and their families at risk. On the latest episode of The Dose, host Shanoor Seervai sits down with two women who have found innovative ways to tackle this problem.

Jessica Grossman, who works for the nonprofit pharmaceutical company Medicines360, sells medicines at a lower price so that all women can get the treatment they need. Reforming the complex U.S. patent system, one of the root causes of high drug prices, is how Priti Krishtel, with the Initiative for Medicines, Access and Knowledge (I-MAK), is trying to remove barriers to treatment.

Have you or someone you know gone without a medicine because it’s too expensive? Send us an email on thedose@commonwealthfund.org.

 

Jun 14, 2019
How “Medicare for All” and Other Bills Would Change Health Care
21:20

Several bills introduced in Congress over the past year seek to make health care more accessible to all Americans while also tamping down growing health care costs. In particular, “Medicare for All” proposals have garnered a lot of recent attention.

How would these proposals change the way Americans get health care? On this episode of The Dose, Shanoor Seervai sits down with the Commonwealth Fund’s Sara Collins to break down the different options policymakers are weighing as they try to reform our health care system.

May 31, 2019
How Union Workers Can Transform the Way Americans Get Care
24:35

Truck drivers spend most of their day sitting, which puts them at a high risk of obesity, heart disease, high blood pressure, among other health problems. 

But a visionary doctor who cares for union truck drivers in Tulsa, Oaklahoma came up with a plan to integrate exercise into their daily routine. When they stop to check the tires, for example, they can walk around the truck six times instead of just once.

On this episode of The Dose, Shanoor Seervai interviews Mark Blum of America’s Agenda, an alliance of labor unions, employers, health care providers and government leaders, about how innovative unions are changing the way care is delivered.

May 17, 2019
How One Health Center Treats Patients as Partners
22:13

Put yourself in the shoes of a person diagnosed with diabetes. You have to cope with a new medical reality. To make matters worse, your doctor keeps saying, “stop eating this” and “you can’t eat that.”

What if instead you went to a health center where a team of caregivers – including a nutritionist – asked what your favorite food is, and found a way for you to eat a healthier version?

The team at Stephen and Sandra Sheller 11th Street Family Health Services in North Philadelphia take this approach. In the latest episode of The Dose, Shanoor Seervai speaks to 11th Street’s executive director Roberta Waite, and the Commonwealth Fund’s Sarah Klein, about what makes the health center extraordinary.

From offering a wide range of creative arts therapies, like yoga and dance, to consulting patients about everything (including the color of the walls), 11th Street aims to be a place where people go to be healthy, not just when they’re sick.

May 03, 2019
It’s Harder for Poor People to Get Health Care
21:38

What is it like for people living in poverty to take the afternoon off to go see a doctor?

Not only do they forgo badly needed wages, but often they must also find someone to watch their children and then scramble to catch a ride or come up with bus fare – only to spend five minutes with the doctor and leave with a prescription that doesn’t address their most pressing concerns.

The Commonwealth Fund’s Shanoor Seervai and Corinne Lewis listened to stories like this from more than 100 low-income patients and the primary care providers who serve them.

On this episode of The Dose, they discuss what they learned about the time constraints and financial barriers that can make it an ordeal for people living in poverty to seek even the most routine health care.

Apr 19, 2019
Surprise! It’s a $164,000 Bill for Your Heart Attack
22:02

If you have a heart attack, chances are you won’t feel up to asking the emergency room doctor, “Are you in my network?”

What’s more, if you’re lucky enough to recover, there’s the chance that you’ll be stuck with a bill for health services that you thought your insurance would cover.

On this episode of The Dose, host Shanoor Seervai talks to Kevin Lucia and Jack Hoadley of Georgetown University’s Health Policy Institute about the ubiquitous problem of surprise medical bills. Why do so many people get bills they don’t expect? And what are our leaders doing about it?

Apr 05, 2019
Health Care in America – How Doctors Can Make Life Easier for Patients
24:23

When a homeless person gets discharged from hospital, he needs a safe place to recover. When a poor patient faces a high co-pay for a medicine she needs, she is often too embarrassed to tell her doctor – instead, she may not fill the prescription.

Doctors don’t typically try to solve these social problems, but some want to do better at understanding patients’ lived experiences. In the latest episode of The Dose, Ishani Ganguli and Janine Knudsen, both primary care providers at innovative clinics, talk to Shanoor Seervai about how they are trying to treat a patient as a whole person, rather than focusing on a single medical condition. They discuss the successes and challenges of caring for patients in their daily practice in light of the findings of a recent survey of people living with serious illness in the United States.

Mar 22, 2019
One Campaign to Stop Overuse of Medical Care
22:51

If you have a cold or cough, an antibiotic may not be the cure. If you have a minor injury from playing hockey, a CT scan of the head may not be necessary. Then why do so many doctors prescribe these, and what can be done to stop it?

On this episode of The Dose, Shanoor interviews Wendy Levinson, M.D. and Karen Born, who run the Choosing Wisely Canada campaign. Based on the philosophy, ‘more is not always better,’ Choosing Wisely is a campaign to help clinicians and patients engage in a dialogue to avoid unnecessary medical tests, treatments, and procedures.

Mar 08, 2019
How Health and Social Care Organizations Work Together
19:37

What happens when a bus company teams up with a senior center offering health promotion classes? Older people who want to attend are able arrive on time.

On this episode of The Dose, host Shanoor Seervai talks to Amanda Brewster, a health policy professor at the University of California, Berkeley, about how health care organizations can work with groups providing social services to get older people the care they need.

While most conversations about health care focus on medical issues, Brewster’s work is part of a growing body of research showing that social factors – like food, housing, and transport – can have a big impact on our health.

Feb 22, 2019
Living with a Disability in America
14:48

The U.S. health care system frequently overlooks the needs of Americans with disabilities. Medical offices are often inaccessible to people in wheelchairs, for example, and mammography machines often aren’t equipped with simple modifications that could enable more women to get screened.

Such inaccessibility may be contributing to health problems for people with disabilities: they receive less preventive care than people without disabilities, have higher rates of chronic conditions, and are far more likely to be admitted to the hospital.

On this week’s episode of The Dose, host Shanoor Seervai talks to Martha Hostetter and Sarah Klein, who recently studied several health plans and clinics that have created custom models, helping people with disabilities live with dignity and independence.

Feb 08, 2019
How the U.S. Fails Women When It Comes to Health
22:24

In the midst of the “Me Too” movement and a national reckoning on how women are treated, the Commonwealth Fund published a report on the status of women’s health and health care in the U.S. and 10 other wealthy nations.

The study revealed that women in the U.S. are three times more likely to die in childbirth than those in Sweden and Norway and are more emotionally distressed than women in Germany or France. It also found that nearly half of U.S. women report problems with their medical bills, compared with only 2 percent of women in the U.K.

On this episode of The Dose, the Commonwealth Fund’s Munira Gunja, Roosa Tikkanen, and Shanoor Seervai dig into these findings and discuss how the current political climate may worsen health care for U.S. women.

Jan 24, 2019
The Future of the Health Care Marketplaces
25:34

How many people bought health insurance for 2019 on the individual market? What is going to happen in the first year after the penalty for not having insurance is repealed? Why did a federal judge in Texas say that the Affordable Care Act (ACA) is unconstitutional?

Jan 24, 2019
A Whirlwind Tour of the Major Health Care Events of 2018
21:41

On this year-end episode of The Dose, host Shanoor Seervai talks to David Blumenthal, M.D. about the big health care events of 2018, and what they mean for next year. They discuss how executive action may impact the working of the Affordable Care Act, decisive action that some states are taking on Medicaid, and how large corporations made deeper inroads into health care.

Dec 21, 2018
How the Individual Mandate Makes People More Free
14:48

On today’s show, Shanoor talks to Don Moulds about what freedom means when it comes to health care. They look at the individual mandate, the controversial provision of Obamacare that requires people to have health insurance. Don argues that getting rid of the mandate restricts freedom in America, because having health insurance frees us from the fear that if we fall ill, we may not have access to care.

 

Dec 14, 2018
Health Care in America: What It Means To Be Sick
19:07

The U.S. health care system leaves many of the sickest Americans feeling helpless, facing serious problems with the care they receive, and struggling to make ends meet. These were the findings of a recent survey conducted by the Commonwealth Fund, the New York Times, and the Harvard T.H. Chan School of Public Health. This week, Shanoor talks to two of the lead researchers about how American adults who visit the doctor and hospital multiple times a year navigate the challenges and costs of using the health care system.

Nov 30, 2018
What the U.S. Can Learn From Health Care Abroad
14:01

Different countries have different ways of meeting the health needs of their residents. What do Americans  see when we look at health care in other industrialized countries?

What can the differences between our health system and some of those abroad teach us about improving health care coverage, access, and affordability here in the U.S.?

This week, Shanoor Seervai talks to Eric Schneider, senior vice president for policy and research at the Commonwealth Fund, about the challenges facing the U.S. as it seeks to become one of the world's best health systems.   

Nov 16, 2018
The Truth About Waiting To See A Doctor In Canada
22:22

When Americans talk about the Canadian health system, they often bring up wait times. But how long do people really have to wait to get care? This week, we talk to Christopher Hayes, the chief medical information officer at an academic and research health care organization in Canada. In spite of being neighbors, the U.S. and Canada take dramatically different approaches to health care. Join us as we try to untangle what this means for people on both sides of the border when they go to see a doctor.

Nov 02, 2018
What Are All These Medical Bills For?
19:55

This week we’re talking about the Netherlands, where by law, everyone must have health insurance, so everyone gets access to the same care. With us for this episode is Marthe Haverkamp, a medical doctor, and former health policy advisor to the Dutch government. Marthe was astonished when she found herself facing medical bills running into thousands of dollars shortly after she came to the U.S. with her family.

Oct 19, 2018
Single Payer in New Zealand
17:20

As the U.S. continues to debate how to deliver affordable health care to all Americans, it’s worth exploring the systems in other countries. Some, like New Zealand, have a "single-payer" system in which the government uses tax money to provide coverage.

To understand how a single-payer system works for people who need care, Shanoor speaks with Robin Gauld, a professor of health policy at the University of Otago Medical School, in New Zealand.

Robin explains how New Zealand handles wait times, the health care disparities between indigenous and non-indigenous people, and why a third of New Zealanders carry private insurance in addition to their public coverage.

For more of The Dose, subscribe to our newsletter on our website, www.thedose.show/newsletter

Show Links:

Harkness Fellowships
(https://www.commonwealthfund.org/fellowships/harkness-fellowships-health-care-policy-and-practice)


International Profile: New Zealand (https://international.commonwealthfund.org/countries/new_zealand/)

Sep 26, 2018
A Menu of Medical Prices
20:59

Adjusting to life in a new country can be difficult. Along with new cultural customs, food, and language, there’s a new health care system to get used to.

In this episode Shanoor speaks with Natacha Lemaire of the French Ministry of Health. Natacha spent a year in the U.S. on a fellowship, and experienced multiple moments of surprise and frustration as she learned to navigate the U.S. health system to care for herself and her family.

Coming from France, where everyone has coverage, Natacha was struck by the high costs of care in the U.S., the lack of transparency around prices, and the frequency with which medical tests were ordered for her and her family.  

For more of The Dose, subscribe to our newsletter on our website, www.thedose.show

Show Links:
Harkness Fellowships
(https://www.commonwealthfund.org/fellowships/harkness-fellowships-health-care-policy-and-practice)


International Profile: France (https://international.commonwealthfund.org/countries/France/)

Sep 26, 2018
A Prescription For Cooking Classes
17:35

Has your doctor ever written you a prescription for cooking classes? Does your doctor know your parents? Your siblings? The medical history of your uncle and grandparents? Yeah, we’re serious.

This week, Shanoor sits down with Martin Marshall, a primary care physician from the U.K. Through the stories of his patients, Martin explores the differences between his home country and the United States when it comes to delivering primary care. Martin talks about managing a patient’s diabetes with cooking classes, how he can lean on his intimate knowledge of a patient's family history to arrive at a diagnosis, and about his experience with our health system during a stay in the U.S.

For more of The Dose subscribe to our newsletter on our website, https://www.thedose.show/

Show Links:

Harkness Fellowships https://www.commonwealthfund.org/fellowships/harkness-fellowships-health-care-policy-and-practice

International Profile: England (https://international.commonwealthfund.org/countries/england/)

Sep 26, 2018
What’s The Dose?
02:09

Health care is complicated – and in the moments when we need it most, we realize we don’t understand how it works. Shouldn’t we?

Join Shanoor Seervai, the host of The Commonwealth Fund’s new podcast The Dose, as she interviews different health policy experts to discuss their latest research, personal stories about the health system, and innovations that could make life easier for people when they need care.


For more of The Dose subscribe to our newsletter on our website, https://www.thedose.show

Sep 26, 2018