#79 Beyond Obamacare: Smart Fixes for the Healthcare System:Dr. Joe Habboushe

The U.S. spends more than $3 trillion a year on healthcare, or nearly $10,000 a year for every man, woman and child. But are we getting a bang for our buck? In many cases, the answer has to be no. And this goes well beyond the raging debate over Obamacare and whether all Americans should have access to coverage.

About a third of money spent on healthcare is now simply wasted or spent on poor decisions, says our guest, emergency room physician and entrepreneur, Dr. Joe Habboushe. The crisis includes clinical waste, excessive prices, fraud and bureaucracy.

 

Dr. Habboushe shares his moving personal story and passion for reducing waste and improving patient outcomes through his work as a physician and as CEO of MDCalc - an online diagnostic app used by about 50% of American doctors.

"Let's not get rid of what we do really well and that's drive innovation for the world," says Dr. Joe. "If we focus on waste, we have to look at why healthcare costs a lot and if we want to reduce that how can we do it in a way that doesn't damage our system.

Solutions:

  • Greater use of technology to help doctors improve decision-making.
  • Take a careful look at how much money, and intense care, is spent on the final months of life. In some cases, doctors and hospitals profit from treatment 
  • Government and taxpayers need to continue funding research that leads to potential drugs and breakthrough treatments.
  • Allow pharmaceutical companies to profit from new drugs and medical treatments that benefit patients.
  • Patients: Be better informed about successful medicine, which doesn't always mean a pill for every ailment.

#7 Fix It Shorts: Why Trump Won. What Should Happen Next?

We recorded this the day after the stunning U.S. Presidential election.  This show is our attempt to explain the reasons for Donald Trump's win.

Despite his deeply divisive rhetoric and attacks on Muslims and undocumented Mexican immigrants that deeply offended many voters, Trump emerged victorious. 

We examine why Trump won the election but also solutions and takeaways from his surprise victory.

Solutions:

  • Infrastructure: Large parts of America feel overlooked. One solution is investing in infrastructure, which would increase productivity and create more jobs.
  • Reform business regulation: “It’s a lot harder to enter a new occupation than it should be,” said Michael Strain, an economist at the American Enterprise Institute. How can we fix that? We can reform occupational licensing laws which have increased five-times in the past sixty years. These laws make it especially hard for people without a college degree to change careers.
  • Congress should meet before the new Administration takes office and discuss bipartisan reform, including taxes, trade, infrastructure and justice reform. 
  • Americans who are deeply distressed by the election can commit themselves to constructive change where they live, volunteering and rebuilding the public square. 
  • We need a civility revolution: stop vilifying people you disagree with. Let's heal our divided nation one conversation at a time.

#6 Fix It Shorts: Election 2016:The Problem is Us.We The Voters

The news media have bombarded us with stories about the candidates, the contest and - to a lesser extent - the crucial issues America faces as people vote for the next President.

This podcast is about the voters.

We went back to four past episodes of "How Do We Fix It?" pulling extracts about how we make decisions and why the information that you and I receive from internet search engines and other sources may be radically different than the news and views our friends and neighbors are hearing.

On episode 24 podcast host and author David McRaney told us "we are not so smart," using confirmation bias as a defining example. "It would do us all good to actually think what are we wrong about," said David, who argues in favor of challenging our own personal biases. "Whenever you have an understanding of something, create an alternate explanation."

Psychologist Robert Epstein joined us on episode 11 to discuss whether Google is too powerful for our democracy. The former Editor-in-Chief of "Psychology Today" has done extensive research on Google's search rankings and algorithms. "There is a problem is the monopoly in search" that Google holds in most of the world, Robert said. "They're customizing what people see." 

Search rankings can have a big influence on how people vote. We are not getting challenged by ideas that we haven't heard before.

Joan Blades of Living Room Conversations aims to bring people together.  A progressive herself, Joan has engaged with evangelical conservatives and leaders of the tea party in lively, but respectful dialog about climate change, criminal justice reform and other questions. 

"We've become increasingly divided," Joan told us on episode 43. "We don't even share the same facts." Joan explained some of the ground rules of having conversations with those you disagree with. 

This brief "Fix It Shorts" podcast also features John Gable of AllSides. This news website puts stories from different sources next to each other -  columns from left, right and center-leaning news newspapers and online sites. 

"We want people to be able to see quickly the differences," John said in episode 49. "What we started doing with All Sides is breaking that filter bubble."

#71 How to Reduce Cyclist and Pedestrian Deaths: Nicole Gelinas

“Vision Zero” is the highly ambitious plan put in place two years ago by New York's Mayor Bill de Blasio. The goal: no traffic deaths by 2024.

America's largest city is nowhere near reducing fatal crashes to zero, but great progress has been made since 1990.  "The good news is that we've gone from 701 deaths back then to an average of 245 deaths a year under the de Blasio Administration," says urban economics and transportation researcher Nicole Gelinas in this "Fix It" episode.

Nicole is a senior fellow at the Manhattan Institute. She writes for City Journal, The Washington Post, LA Times and a bunch of other publications.

In this show we look at why so many pedestrians and bicycle riders are killed on the streets of U.S. cities and what we can learn from safety initiatives in Sweden and elsewhere.

The bad news is that New York is far safer than almost every other American city. 

"You're three times more like to be killed in Atlanta whether you're in a car or walking - and you're two times more likely to be killed in LA," says Nicole.

We also learn the lessons of the Times Square traffic and pedestrian redevelopment initiative and why it turned critics into fans.  During our show Nicole Gelinas unpacks surprising research on the pros and cons of wearing bicycle helmets on busy urban streets. 

Solutions:

  • Data shows that redesigning streets to slow down and calm traffic is the best way to prevent injuries and deaths.
  • Lower speed limits, especially in dense urban areas.
  • Invest in a comprehensive mass transit system, which will reduce crashes and improves the quality of life for city residents.
  • The old adage, safety in numbers is true when it comes to biking in traffic: bicyclists are safer when they ride in a group.
  • Cyclists should always wear lights to make themselves as visible as possible to motorists. 

#70 Electile Dysfunction: A Cure For Our Campaign: Alan Dershowitz

Electile Dysfunction (is), “a terrible pun plus insightful commentary" is how TV host and wit Seth Myers describes" the new book by Professor Alan Dershowitz.

Dershowitz became a professor at Harvard Law when he was 25 years old. In his long and distinguished career, Newsweek described Dershowitz as "the nation's most peripatetic civil liberties lawyer and one of its most distinguished defenders of individual rights." We recorded this episode of "How Do We Fix It?" at his Manhattan home. "Electile Dysfunction" is his 35th book.

(Left to Right) Jim Meigs, Richard Davies and Alan Dershowitz

Voters are anxious, frustrated and they feel impotent. In this show we look at the strangest political campaign of our lifetime and what can be done to improve the way we elect Presidents.

We are not alone in facing a threat to our democracy.  "I'm afraid of what's going on in Europe today and what's going in the United States may reflect a trend rather than a pendulum swing," Alan Dershowitz tells us. "A trend toward extremes and we have to fight back."

Jim, Richard and Dershowitz discuss the rise of extremism on the right and left, the threat to free speech on college campuses and the virtue of compromise.

(Left to Right) Jim Meigs, Richard Davies and Alan Dershowitz

"I think centrist liberals and centrist conservatives have to get together and take back the center and stop the alt right from taking over the Republican Party and the alt left from taking over the Democratic Party," says Professor Dershowitz

We look at solutions:

A voter's Presidential checklist. Before voting, weigh where the candidates stand on the most important issues - from who will best protect us from terrorism to who will keep America's economy strong and produce more stability.

  • Shortening the nation's extremely long Presidential campaign with one national primary day in June, weeks before the party conventions.
  • Reducing the destructive power of the media to hype conflict and obscure the electorate's understanding of vital issues.
  • Encouraging free speech and open dialog that is now under threat at leading colleges and universities.

#69 Migrants and Refugees: Our Response to a Global Crisis. Leonard Doyle

Too often, migrants and refugees are viewed as "other" - not like us. In recent days Donald Trump Jr. compared the Syrian refugee problem to a bowl of Skittles

In this episode, Leonard Doyle of the International Organization for Migration walks us through the worldwide crisis of tens of millions of displaced people, from families fleeing from war and terrorism to young men and women who overstay their visas in search of a better life.  We look at the definitions of these terms - so often glossed over in our discussions of the crisis.

Using personal stories and speaking from years of experience working with migrants, Leonard makes a powerful case for all of us to see migrants as people like ourselves. This is the first small step we can take in responding immense humanitarian challenge.

"When you say the word 'migrant' people tend to have an image in their head,"  Leonard tells us.  That may be a negative image "because there is so much toxic discourse about them from our quite opportunistic political leaders." 

Established in 1951, the International Organization for Migration (IOM) has offices in more than 100 nations and works with governments and non-governmental organizations to promote humane and orderly migration, for the benefit of all.

The movement of peoples from much of Africa, West Asia and The Middle East “is the global phenomenon of our time," says Leonard. "It's kind of the last flick of the globalization monster in a way.  We had free trade in global goods and services. This is the bit they didn't plan very well... But people aren't stupid. They watch television and see a better lifestyle happening somewhere else. We've kind of empowered them with our globalized media and globalized trade."

A summit of world leaders at The United Nations this week put the migrant crisis more firmly on the global agenda. In his address to the U.N. General Assembly, President Obama called the refugee and migrant crisis "a test of our humanity."

This episode also considers the views of voters in the U.S. and other nations who are fearful that the rising numbers of immigrants from nations with distinctly different cultures could lead to lower wages, rising unemployment and higher crime.  Dismissing or marginalizing their concerns can lead to to populist anti-immigrant rage.

Join Richard, Jim and Leonard for a lively and often moving conversation. 

#68 Why Economic Growth Is Slowing Down: Ruchir Sharma

Get ready for slower economic growth and de-globalization, says investor and writer Ruchir Sharma. 

Ruchir invited us to his New York office, where he is the head of emerging markets and chief global strategist at Morgan Stanley Investment Management. He is also the author of "The Rise and Fall of Nations: Forces of Change in the Post-Crisis World."

Our interview looks at Ruchir's rules for spotting political, economic and social change. They include:

  • The depopulation bomb: If the working population shrinks, so does the economy.
  • Good versus bad billionaires: Wealth inequality is exploding, but some types of tycoons are viewed very differently than others.
  • The curse of the cover story: Ruchir looked at every Time Magazine cover on the economy going back to 1980. If the cover was downbeat the economy grew faster 55% of the time. If it was upbeat, the economy slowed in 66% in the following years.
  • Why democratic capitalism beats the Chinese brand: Postwar booms in democratic nations were usually stronger and longer than under authoritarian regimes. 

"What's very apparent and under-appreciated is the major drop off that we've seen in the world's working age population growth rate," Ruchir tells us. "I think that is a major drag on global economic growth currently."

#65 Moms Clean Air Force: Gretchen Dahlkemper

From "nap-time activists" and mommy bloggers to a "stroller march" on Washington, Moms Clean Air Force is using creative and highly effective ways to advance their cause to get dangerous pollutants out of the air. 

In this "How Do We Fix It?" episode we speak about solutions with the group's National Field Director, Gretchen Dahlkemper, a Pennsylvania mom who became an activist - fired up about the threat to her children's health.  Her daughter has asthma. So for her this campaign is personal. 

"I think the more that we connect the average citizen with their elected officials, the better off our entire system is going to be," says Gretchen. "We have forgotten that we can pick up the phone and call our elected officials."

Moms Clean Force fights back against climate change, fossil fuel, methane leaks and other healh problems. But this movement of mothers is about more than the environment and childrens' health.  It's also a way of revitalizing our democracy. 

"That to me is one of the key solutions to eliminating this huge partisan divide that we're seeing in the country right now," says Gretchen.