The Dose

In this special, two-part edition of The Dose, we're bringing listeners along to an exhilarating gathering of health care's most innovative thinkers and changemakers—Aspen Ideas: Health. In part 1, host Joel Bervell speaks with two people dedicated to supporting communities that have been excluded from our health care system: Lola Adedokun, executive director of the Aspen Global Innovative Group at the Aspen Institute and leader of the Healthy Communities Fellowship; and Elizabeth Lutz, executive director of The Health Collaborative in San Antonio, Texas.

This month, a 12-year-old boy in Washington, D.C., became the first person in the world to undergo a grueling gene therapy treatment that could cure his sickle cell disease. It is a game-changer for a disease whose history has been plagued by the racism baked into our health care system. On The Dose podcast, host Joel Bervell sits down with Dr. Cece Calhoun, a leading adolescent sickle cell specialist from Yale University. The two dive into what it means to be a young Black person in America with the disease; why it took nearly 100 years for us to get to this point; and how health inequities continue to pose life-and-death challenges for sickle cell patients.

In Dr. Joseph Betancourt's vision for the future of U.S. health care, "any patient who goes to any health care system around the country should get the highest quality of care, no matter who they are or where they're from." As the Commonwealth Fund's new president, he's tackling some of the biggest challenges facing the U.S. health system while trying to ensure equity is embedded in health care policy, coverage, technology, and practice. Join Joel Bervell, host of The Dose podcast, for a wide-ranging conversation with Betancourt about AI and health care, America's primary care crisis, and what the corporatization of health care means for doctors and patients.

As a physician, researcher, and educator, Dr. Cheryl R. Clark wants her students to understand what vision, love, and equity can bring to health care if we prioritize them — and why she believes doing so is critical to advancing health equity. In the latest episode of The Dose podcast, host Joel Bervell talks with Clark about how she brings health equity to life, taking medical residents to Mississippi to break bread with the Civil Rights leaders who founded community health centers. They also discuss her work at the forefront of emancipatory research to connect the dots between academics, clinicians, and communities' lived experiences.

In medical school, students learning about illness, pathology, and disease are trained almost exclusively on images of white patients. Even materials on illnesses that predominantly affect Black people, like sickle cell disease, and textbooks used in medical schools in countries where most people are Black, are filled with illustrations of white bodies and white skin. This leaves doctors underprepared to care for Black patients. For Nigerian medical student and illustrator Chidiebere Ibe, accurate representation is a starting point for health care equity. Ibe has founded Illustrate Change, the world's largest open-source digital library of medical illustrations featuring people of color. In the newest episode of The Dose podcast, host Joel Bervell talks to Ibe about his efforts to make inclusive imagery widely accessible — a critical step toward building health systems that can provide Black patients with the care they deserve. This is the third episode in a new series of conversations with leaders at the forefront of health equity.

Montgomery, Alabama's capital, is known as the birthplace of gynecology. It's a brutal history, as the field's "founding father," J. Marion Sims, advanced his work through the experimentation on enslaved women and babies. Artist and health care activist Michelle Browder has forced a reckoning with this legacy with one clear goal — we need to talk about the mothers. On the newest episode of The Dose podcast, host Joel Bervell talks to Browder about her efforts to honor Sims's victims — the names of only three of whom we know today: Anarcha, Betsey, and Lucy. They also discuss Browder's work to channel the painful legacy of the past into a healthier future for Black women and their babies, as she prepares to open a midwifery clinic and birthing center as well as a national education center for medical students.

This year in the United States, an estimated 2 million people will receive a new cancer diagnosis, and a growing proportion will be younger adults and people of color. Many of these cases could be prevented — nearly 60 percent of colorectal cancers, for example, could be avoided with early detection. Physician and UCLA researcher Dr. Folasade May is trying to understand why cancer screening rates are lagging, and what we can do to get people these potentially lifesaving tests. In the newest episode of The Dose podcast, host Joel Bervell talks to Dr. May about what might be behind the rise in colorectal cancer among younger people, the barriers to widespread cancer screening — especially for underserved communities — and her work empowering people to save their lives. This episode kicks off a new series of conversations with leaders at the forefront of health equity.

Overtreatment is a big problem in American health care. The proliferation of unnecessary medical tests and procedures not only harms patients but costs the United States billions of dollars every year. Between 2019 and 2021, Medicare spent as much as $2.4 billion on unnecessary coronary stents alone. At some hospitals, it's estimated that more than half of all stents are unwarranted. For this week's episode of The Dose podcast — the latest in our series on the affordability of health care — host Joel Bervell talks to Vikas Saini, M.D., a cardiologist and the executive director of the Lown Institute, a think tank that examines overspending and overtreatment in the health care system. Dr. Saini unpacks how health care practices are misaligned with patient needs and discusses strategies for "rightsizing" U.S. health care.

Health care is a $4.3 trillion business in the United States, accounting for 18 percent of the nation's economy. It should come as no surprise then that the industry has become attractive to private investors, who promise cost savings, expanded use of technology, and streamlined operations. But according to Yale University's Howard Forman, M.D., "most private equity money does seem to be making matters worse rather than better." One issue is that investors chase the healthiest and most profitable patients, undermining another kind of equity — health equity — in an already deeply unequal health care system. In the latest episode of The Dose podcast, host Joel Bervell charts a wide-ranging discussion with Dr. Forman, a professor of radiology and biomedical imaging, public health, management, and economics, about private equity's growing role in American health care. This is the second episode of our new series of conversations about health care affordability.

Nearly one in five Americans has medical debt. Black households are disproportionately affected, carrying higher amounts of debt at higher rates. Berneta Haynes, senior attorney with the National Consumer Law Center, describes Black Americans' medical debt burden as a continual cycle fed by higher rates of chronic illness and lower rates of wealth. As a result, many are left without savings or family resources to tap into when faced with an unexpected medical bill. Join host Joel Bervell on the newest episode of The Dose podcast, where he talks to Haynes about the history of medical debt and efforts to ease pressure on the families and communities hit hardest, including the Consumer Financial Protection Bureau's initiative to change what kinds of medical debt can show up on a person's credit report. This episode kicks off a new series of conversations about affordability, including everything from the role of private equity in health care to why Americans pay more for care than any other high-income country.