The Dose

In post-Roe America, many women seeking abortions are treading on landmines, particularly in states where access is banned or severely restricted. On the latest episode of The Dose, host Shanoor Seervai talks to Raegan McDonald-Mosley, M.D., about a tool that makes it easier for people to determine what the laws are in their state and where they can get care. Mosley, the CEO of Power to Decide, talks about the huge risks for women – particularly low-income women of color – who can't get the reproductive health services they need. "Instead of… investing in maternal health services on the ground in communities that need it, [some states are] literally doing the opposite to make it harder for people to connect to care and services," she says.

The midterm elections are around the corner, and health care is likely to be a major factor in how Americans vote. Abortion and reproductive health access will motivate many people, as will inflation (which impacts the cost of care). On the latest episode of The Dose, host Shanoor Seervai talks about the most pressing health care battles to watch with Katie Keith, director of the Health Policy and the Law Initiative at Georgetown University Law Center's O'Neil Institute. Keith talks about how access to abortion may play out at the federal and state level, legal challenges to the Affordable Care Act's guarantee of free preventive care, and the impact of the impending end of the public health emergency.

Bills targeting the rights of LGBTQ+ people are under consideration in state legislatures across the country. Many aim to make it more difficult for transgender people to get health care — something that's already a challenge for many, particularly trans youth. On the latest episode of The Dose, host Shanoor Seervai interviews Austin Johnson, an assistant professor of sociology at Kenyon College and the research and policy director for the Campaign for Southern Equality, an advocacy and direct services organization. One way to expand access to care for transgender youth, Johnson says, is to "make sure you center trans experience, center trans people's understandings of their health care, education, and family life, and rely on … scholarship that is led by trans people."

Earlier this week, President Biden declared the pandemic over. This tracks with public opinion: most Americans have long abandoned their masks, and federal funds may soon dry up for testing, treatment, and even vaccines. Of course, this doesn't mean the virus has disappeared. In fact, hundreds of Americans are still dying each day from COVID-19, and thousands more are suffering from long COVID, a host of protracted symptoms that could lead to severe health complications down the line. On the latest episode of The Dose, host Shanoor Seervai talks to Dr. Bob Wachter about what it's like to live with COVID in 2022. Dr. Wachter, professor and chair of the Department of Medicine at the University of California, San Francisco, is one of the nation's foremost experts on the pandemic.

Among other things, the Inflation Reduction Act is being hailed as a potential breakthrough in making health care more affordable. But what does this landmark legislation, enacted last month, really mean for Americans – now and in the future? To open the new season of The Dose, host Shanoor Seervai interviews Stacie Dusetzina, an associate professor in health policy and cancer research at Vanderbilt University. Dusetzina breaks down the key health provisions of the new law, from drug price negotiation in Medicare to the redesign of Part D coverage. We've "repeatedly been burned by the health care system… [so] we're all suspicious when something sounds really too good to be true," she says. "The changes here for people who have very expensive drugs are almost too good to be true."

Social programs like Medicaid are supposed to help people, but often they reproduce racial inequities — and sometimes actually create them. That's because even well-intentioned policymakers can't always see the disproportionate impact their decisions have on people of color. But what if there were a tool to help legislators and government officials identify when and how they should be thinking about racism? Well, Jamila Michener has developed one. And on this encore episode of The Dose podcast, she explains how it can be applied to Medicaid's transportation benefit specifically and to health policy more broadly. Michener, an associate professor in Cornell University's Department of Government, speaks about how her research on, and personal experiences with, Medicaid has highlighted the importance of hearing from people impacted by policy choices. "You can't really address the ways that racism manifests… unless you have people who experience it directly at the table, not only having voice, but also having some power," she says. This encore episode was originally released on 2/11/2022.

Climate change can have a devastating impact on our health. When people are injured or exposed to disease related to floods or fires, it's up to health systems to pick up the pieces. But health care itself is one of the world's most carbon-intensive industries, responsible for 4.5 percent of all greenhouse gas emissions. What can health systems do to address climate change? In the United Kingdom, the National Health Service (NHS) has set some ambitious goals to reduce its carbon footprint. On this encore episode of The Dose, Nick Watts, the NHS's chief sustainability officer, talks about how the health service is meeting these goals, and whether its efforts could be replicated in countries like the United States. A low-carbon health care system, he says, is actually just a good health care system. This encore episode was originally released on 1/28/2022.

The Dose will be taking a short summer break while our team works on brand-new episodes for the next season. Listen to our season finale, in which we highlight some of the accomplishments of our guests. Join us in the fall, for new conversations with health policy experts as they share ideas about how the U.S. can improve health care for everyone. Episodes Mentioned: Priti Krishtel on "For Global Vaccine Access, Overhaul the Patent System" Kevin Simon on "Closing the Mental Health Care Gap for Black Teens" Rachel Hardeman on "The Quest for Equity in Reproductive Health"

A well-functioning public health system is vital to keeping individuals, and the population at large, safe and healthy. Except that success is often invisible when it comes to public health—we don't notice it until the system breaks down. The U.S. public health system has taken a drubbing from COVID-19. But the pandemic has also driven home just how critical it is to invest in this key component of national infrastructure. On the latest episode of The Dose, Dr. Dave Chokshi, who led New York's pandemic response as the city's health commissioner, talks about how we can apply the lessons of the past two years in rebuilding the U.S. public health system. "If we take the opportunity to build [a] community-based public health infrastructure, to embrace a mission of health equity as fundamental to health, then that's what will help to protect… our community as a whole," he says.

Racial bias in medical care extends all the way to the prescription pad. Research shows that people of color are less likely to receive the most effective treatments for life-threatening conditions, including cancer and heart disease. One way to address this is by aiming for "pharmacoequity" — where all patients, regardless of race, socioeconomic status, disability, or other characteristics, have access to the highest-quality evidence-based medical therapies that meet their health needs. On the latest episode of The Dose, the man who coined this term, Utibe Essien, M.D., an assistant professor of medicine at the University of Pittsburgh, explains what it will take to achieve pharmacoequity. "The data are not lying about how we're prescribing medications," Essien says. To eliminate such biases, he believes we must be honest about the data and develop strategies to ensure greater equity.