The Dose

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.

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.

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.

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.

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.

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.

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.

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.

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.

***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.