Turn on the Lights Podcast

America’s drug crisis isn’t a science problem; it’s a pricing and policy problem that blocks patients from medicines that already exist. In this episode, Dr. Jerry Avorn, a professor of medicine and leading expert in pharmacoepidemiology and medication policy, discusses why many patients still can’t afford essential treatments even as breakthrough drugs for cancer and inflammatory disease proliferate. He shares a personal case where “nonadherence” was really unaffordability, then unpacks how US exceptionalism in drug pricing, patent “thickets,” and delayed competition keep costs unsustainably high. Dr. Avorn also contrasts access failures with overuse concerns, explores why other countries negotiate on the basis of value, and addresses objections to innovation and rationing, including a sobering example of cystic fibrosis in the UK. Finally, he explains how academic detailing spreads evidence-based prescribing and evaluates recent US attempts to let Medicare negotiate prices alongside more deal-driven approaches.  Tune in and learn how drug prices, patents, and public funding shape what patients can actually access! Resources: Connect with and follow Dr. Jerry Avorn on LinkedIn. Follow Harvard Medical School on LinkedIn and explore their website! Learn more about Brigham and Women’s Hospital on LinkedIn and visit their website. Visit Dr. Avorn’s personal website. Buy the Rethinking Meds book here and learn more about it here. Learn more about your ad choices. Visit megaphone.fm/adchoices

Mindfulness isn’t a “nice-to-have”; it’s a low-cost public health lever that changes how people handle pain, emotions, and community life. In this episode, Brother Phap Luu, a monk in the Plum Village tradition founded by Thich Nhat Hanh, discusses how mindfulness can be practiced as “everyday meditation” through breathing, walking, eating, and even cultivating awareness of dreams. He shares his personal journey from activism and disillusionment to depression, and then to healing through mindful breathing and finding community at Plum Village. Brother Phap Luu explores the roots and global reach of Plum Village, why mindfulness naturally fosters compassion, and how “watering” emotions like anger through rumination can prolong suffering. He also unpacks mindfulness as an “invitation,” the challenge of scaling it, through training, ethics, trauma sensitivity, and limited profit incentives, and its potential integration into schools of public health and policy. Tune in and learn how mindful breathing, community practice, and compassion can become practical tools for healthier lives and societies! Resources: Connect with and follow Brother Phap Luu on LinkedIn. Learn more about Plum Village on their LinkedIn and explore their website. Learn more about your ad choices. Visit megaphone.fm/adchoices

Quality measurement matters only if it helps patients and clinicians deliver better care in real time, not just prove compliance after the fact. In this episode, Vivek Garg, President and CEO of NCQA, reflects on how growing up with an immigrant physician father, living with his mother’s undiagnosed bipolar disorder, and training in internal medicine shaped his commitment to patient-centered improvement. He explains why he pursued “edge-case” primary care roles at innovative organizations and how those experiences led him to focus on quality, value-based care, and complex populations. Vivek also clarifies NCQA’s role in convening standards, accrediting health plans and practices, and validating performance through audits and support. He critiques today’s bloated measurement ecosystem and argues for digital, interoperable, clinically meaningful metrics that reduce burden and truly improve care delivery. Tune in and learn how quality standards can evolve from checklists into a continuous improvement engine that patients can actually feel! Resources: Connect with and follow Vivek Garg on LinkedIn. Learn more about the National Committee for Quality Assurance (NCQA) on their LinkedIn and website. Learn more about your ad choices. Visit megaphone.fm/adchoices

Millions of Americans could lose health coverage in the coming years, and the consequences may be more profound than most people realize. In this episode, Dr. Ben Sommers, the Huntley Quelch Professor of Health Care Economics at the Harvard T.H. Chan School of Public Health, and professor of medicine at Harvard Medical School and Brigham & Women’s Hospital, talks about how new federal policies, including Medicaid work requirements and the rollback of Affordable Care Act subsidies, are reshaping access to health insurance in the U.S. Drawing on extensive research, he explains why these changes are expected to increase uninsured rates without meaningfully boosting employment. Dr. Sommers also shares evidence from prior state experiments showing that administrative red tape, not a lack of willingness to work, drives coverage loss. He outlines the ripple effects on patient health, safety-net providers, and hospitals, especially in rural and underserved communities. Tune in to understand what these policy shifts mean for patients, providers, and the future of the U.S. health care system. Resources: Follow the Harvard T.H. Chan School of Public Health on LinkedIn and explore their website! Learn more about the One, Big, Beautiful Bill here! Learn more about your ad choices. Visit megaphone.fm/adchoices

Trust in health care AI won’t happen by hype. It will be earned through transparent standards, independent evaluation, and real-world performance monitoring. In this episode, Dr. Brian Anderson, President & CEO and Co-Founder of the Coalition for Health AI (CHAI), discusses why health care needs a technically specific, use-case-by-use-case definition of “good” AI and how CHAI is building voluntary consensus-driven guidelines around fairness, transparency, safety, robustness, and privacy. He shares how his frustration with bloated EHR workflows pushed him into digital health innovation, then into pandemic-era public-private coordination during Operation Warp Speed, where rapid collaboration revealed what’s possible when incentives align. Brian explores CHAI’s “AI nutrition labels” (model cards), an emerging registry, and why vendors may opt into scrutiny to speed sales cycles and prove value. He also digs into ambient clinical documentation, performance metrics that matter to clinicians, cost pressure through apples-to-apples comparisons, agentic AI to expand rural access, and the alignment and biosecurity risks that demand vigilance. Tune in and learn how to build and verify AI that improves care without sacrificing safety, equity, or trust! Resources Connect with and follow Brian Anderson on LinkedIn. Learn more about the Coalition for Health AI (CHAI) on LinkedIn. Explore CHAI’s website. Learn more about your ad choices. Visit megaphone.fm/adchoices

What happens when a health system decides that quality comes first? In this episode, Dr. Gary Kaplan, who retired as the longtime CEO of Virginia Mason and currently serves on the Board of Stewardship Trustees of CommonSpirit Health, discusses leading one of America’s most influential physician-led health systems through a radical transformation focused on quality, safety, and patient-centered care. He reflects on Virginia Mason’s roots as a Mayo Clinic–style group practice and why shared purpose and clinician leadership created a fundamentally different culture of care. Dr. Kaplan explains how adopting Lean management principles reshaped chaotic health care systems, reduced waste, and supported clinicians in delivering safer, more reliable care. He also discusses why fee-for-service medicine drives unsustainable costs, his advocacy for value-based and capitated payment models, and how market consolidation ultimately led to Virginia Mason's merger, despite its strong performance and independence. Tune in to explore what it truly takes to redesign health care systems around patients, clinicians, and value, rather than volume. Resources: Connect with and follow Dr. Gary Kaplan on LinkedIn. Follow CommonSpirit Health on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

The energy is electric at the IHI Forum, even before the forum officially begins. In this episode, co-hosts Kedar Mate and Don Berwick discuss how AI, patient safety, and administrative waste are shaping the future of health care. They explore the excitement and uncertainty around AI’s growing role in diagnostics, coordination, and clinical decision-making. They discuss why clinicians need real training to use AI safely and effectively, and how learning health networks are driving continuous improvement. They also delve into the persistent administrative burdens, especially in Medicaid and fee-for-service systems, that hinder true efficiency in health care. Tune in to hear how innovation, policy, and technology are colliding at this year’s IHI Forum! Resources Connect with and follow Kedar Mate on LinkedIn or reach out via email!  Connect with and follow Don Berwick on LinkedIn or reach out via email! Check out the Turn on the Lights podcast! Learn more about your ad choices. Visit megaphone.fm/adchoices

What happens when clinicians stop hearing the very people they’re trying to help? In this episode, Dr. Rageshri Dhairyawan, a Consultant Physician in Sexual Health and HIV Medicine at Barts Health NHS Trust and Deputy Director of the SHARE Collaborative at Queen Mary University of London, discusses how patients are often disbelieved or dismissed in healthcare. She shares her own experience of being ignored during a painful hospitalization, which revealed how difficult it can be for even a senior doctor to speak up when vulnerable. Dhairyawan argues that medicine has a long-standing culture of skepticism toward patient testimony, which harms trust, exacerbates inequities, and undermines care. She urges systemic and educational reforms, more time, continuity, staff wellbeing, training in true listening, and structural support for patient voices. While acknowledging resource constraints, she emphasizes that listening is both therapeutic and essential to restoring humanity in healthcare. Tune in to hear Dr. Rageshri Dhairyawan unpack why patients often feel unheard, and how listening might be healthcare’s most powerful, yet overlooked, tool. Resources Connect with and follow Dr. Rageshri Dhairyawan on LinkedIn and visit her website! Follow Barts Health NHS Trust on LinkedIn and explore their website! Follow Queen Mary University of London on LinkedIn and discover their website! Check out Dr. Dhairyawan’s book, Unheard: The Medical Practice of Silencing, here! Learn more about your ad choices. Visit megaphone.fm/adchoices

The collapse of a major hospital system set off one of the most complex healthcare emergencies Massachusetts has ever faced. In this episode, Dr. Gregg Meyer, Incident Manager for the Massachusetts Department of Public Health, discusses how the state responded to the unprecedented Steward Health Care crisis and worked to protect patients, communities, and hospital staff. He explains how years of debt, real estate deals, and private equity extraction destabilized the system and pushed it into bankruptcy. He shares what it took to manage a months-long VUCA public health emergency, including on-site monitoring, emergency closures, and the transfer of six hospitals to new nonprofit operators. He also reflects on the human and financial toll the crisis left behind, as well as why stronger oversight and policy reform are urgently needed. Tune in to learn how Massachusetts led one of the most challenging hospital rescue operations in U.S. history! Resources Follow the Massachusetts Department of Public Health on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

Medicaid is a massive, life-sustaining program whose new work requirements and funding cuts risk stripping coverage from millions of people who can’t afford to lose it. In this episode, Cindy Mann, partner at Manatt Health and former director of the Center for Medicaid and CHIP Services, explains how Medicaid was created alongside Medicare in 1965 and has grown into the nation’s largest public coverage program, serving nearly 80 million people across diverse populations. She details the state–federal financing structure, explains why match rates vary, and highlights how Medicaid remains foundational to the Affordable Care Act’s coverage continuum. Cindy breaks down the proposed Medicaid cuts in HR1 and the impact of work requirements, illustrating how administrative barriers lead to people losing coverage and increasing uncompensated care costs without improving employment outcomes. She also challenges the “deserving versus undeserving poor” narrative and highlights efforts by states and providers to protect coverage gains. Tune in and learn how Medicaid’s design, politics, and future will shape health, budgets, and justice in America! Resources Follow Cindy Mann on LinkedIn. Follow Manatt Health on LinkedIn and explore their website! Learn more about the Medicaid program here. Learn more about your ad choices. Visit megaphone.fm/adchoices

What if the biggest threat to our survival isn’t the next virus, but our failure to learn from the last one? In this episode, Dr. Michael Osterholm, Regents Professor and Director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, explains why America’s public health system is dangerously underprepared for the next major outbreak. He shares how misinformation and political interference have eroded confidence in science, leaving critical institutions like the CDC and NIH struggling to fulfill their missions. Dr. Osterholm discusses lessons from COVID-19 and why failing to apply them could cost millions of lives in the future. He also explores the promise of universal vaccines, the need for sustained investment in pandemic defense, and how rebuilding public trust starts with humility, transparency, and truth-telling. Tune in to hear what it will really take to prepare for “the big one. Resources Connect with and follow Dr. Michael Osterholm on LinkedIn. Follow the University of Minnesota on LinkedIn! Follow the Center for Infectious Disease Research and Policy (CIDRAP) on LinkedIn and visit their website! Learn more about the Vaccine Integrity Project here! Pick up any of Dr. Osterholm’s books here! Check out the Osterholm Update podcast! Learn more about your ad choices. Visit megaphone.fm/adchoices

A nation’s promise to those who served becomes a lesson in how health care can truly heal. In this special Veterans Day episode, Dr. David Shulkin, the ninth Secretary of the U.S. Department of Veterans Affairs in the Trump Administration and VA’s Under Secretary of Health in the Obama Administration, talks about the mission, history, and transformation of the Veterans Health Administration, one of the nation’s largest and most innovative health systems. He shares how his time leading the VA changed his perspective on what effective, compassionate care looks like, highlighting the system’s holistic, population-based approach and its groundbreaking medical research. Dr. Shulkin also reflects on the challenges of government service, the importance of protecting the VA from privatization, and his continued advocacy for veterans and the workforce that serves them. Tune in to hear how the VA’s model offers vital lessons for the future of American health care! Resources: Connect with and follow Dr. David Shulkin on LinkedIn. Get a copy of Dr. Shulkin’s book, It Shouldn't Be This Hard to Serve Your Government, Our Broken Government and the Plight of Veterans, here! Learn more about your ad choices. Visit megaphone.fm/adchoices

Our information environment has become a social determinant of health. In this episode, Joshua Sharfstein, a public health leader and professor at Johns Hopkins, and Joanne Kenen, journalist in residence at the Johns Hopkins Bloomberg School of Public Health, discuss how the collapse of local journalism, the design of social media algorithms, and politicization have created an “information sickness” that undermines personal and public health. They explain that traditional reporting once filtered out false claims through rules and accountability, while today’s engagement-driven platforms reward emotional misinformation that quickly becomes “sticky.” The guests explore the consequences of vaccine refusal, fractured families, and the urgent need for remedies, such as embedding misinformation experts in health agencies, utilizing trusted platforms, and fostering community trust. They emphasize that artificial intelligence will both fuel and fight misinformation, demanding institutional adaptation. Ultimately, they urge individuals to maintain an informed news diet and practice empathy across information divides, reminding listeners that public health must serve everyone, even those who disagree. Tune in to learn practical ways to counter health misinformation, from rapid pre-bunking to community partnerships and smarter use of AI! Resources: Connect with and follow Joshua Sharfstein on LinkedIn. Follow and connect with Joanne Kenen on LinkedIn. Learn more about Johns Hopkins Bloomberg School of Public Health on their LinkedIn and website. Buy Josh and Joanne’s book Information Sick here. Listen to the What The Health podcast here. Sign up for the Expert Insights Newsletter here. Learn more about your ad choices. Visit megaphone.fm/adchoices

“I just went there for a routine knee replacement, or so I thought.” In this inspiring episode, Rosie Bartel, a patient partner and advocate, educator, and survivor, shares her journey from a devastating MRSA infection acquired during a routine knee replacement to becoming a global voice for patient safety and health care reform. After surviving 58 surgeries, more than 200 hospitalizations, and multiple amputations, she transformed her pain into a mission to prevent others from enduring the same experience. Rosie explains how being invited to her hospital’s root-cause investigation empowered her to advocate for systemic change and demonstrate the power of storytelling with purpose. She reminds health care professionals that patients seek healing, not lawsuits, urging both providers and patients to share their stories because, as she powerfully states, stories aren’t just anecdotes; they’re data that inspire action. Tune in and learn how courage, compassion, and the patient’s voice can light the path toward a safer, more humane health care system! Resources: Connect with and follow Rosie Bartel on LinkedIn. Learn more about The Beryl Institute on their LinkedIn and website. Watch here Rosie’s “One Is Too Many” video. Learn more about your ad choices. Visit megaphone.fm/adchoices

The healers we need now don’t stop at the exam room; they go upstream to the causes of suffering and make safety, dignity, and trust part of the clinical job. In this episode, Dr. Sandeep Kapoor, a physician and academic leader, calls for a broader, more human-centered definition of health care, one that addresses substance use, firearm injuries, pain, and the social realities that shape well-being. Drawing on personal experiences and systemic insight, he advocates for harm reduction, trust-building, and courageous leadership that transforms stigma and obstacles into opportunities for progress. Tune in and learn how broadening medicine’s scope saves lives and restores trust! Resources: Find out more about Dr. Sandeep Kapoor here. Learn more about the Zucker School of Medicine on its website. Follow Northwell Health on LinkedIn and explore their website. Learn more about your ad choices. Visit megaphone.fm/adchoices

The integrity of evidence-based policy is under threat when political agendas override scientific rigor. In this episode, Dr. Robert Califf, former FDA Commissioner and cardiologist, reflects on his experience leading the FDA and the agency’s critical role in protecting public health through rigorous, science-based regulation across multiple sectors. He warns that political interference, disinformation, and mistrust threaten health outcomes but believes meaningful collaboration can still restore integrity and progress. Tune in and learn how protecting science-based regulation may be one of the most important public health actions of our time! Learn more about your ad choices. Visit megaphone.fm/adchoices

The corporatization of health care is driving a mass exodus from primary care, creating a crisis that affects both physicians and patients alike. In this episode, Dr. Peter Grinspoon, a physician and advocate, discusses the worsening state of American primary care, shaped by burnout, poor pay, and a loss of autonomy, while sharing how his recovery from opioid addiction inspired him to support other physicians. He also explores the stigma surrounding mental health in medicine, stalled union efforts, and the need for better education and regulation around the safe use of medical cannabis. Tune in and learn how systemic dysfunction is breaking primary care and how medical cannabis could be part of a more humane, effective future! Learn more about your ad choices. Visit megaphone.fm/adchoices

One of the biggest drivers of high drug prices in America is the opaque rebate system between pharmaceutical companies and insurance providers, where savings rarely reach the patient. In this episode, Vinay Patel explains how drug prices are formed, from R&D and manufacturing to complex negotiations involving insurers and pharmacy benefit managers. He breaks down the mechanics of rebates, formulary restrictions, and the consolidation of power among PBMs, showing how these hidden forces raise prices and limit access. He also offers promising alternatives like cost-plus pricing models and calls on employers to take control of their health care contracts to cut costs. Tune in and learn how this broken system works, and what it might take to fix it! Learn more about your ad choices. Visit megaphone.fm/adchoices

While universal health care offers immense equity and access, it still faces real challenges around fragmentation, funding, and integration. In this episode, Dr. Bob Klaber reflects on the values and challenges of the UK’s NHS, contrasting its universal care model with the U.S. system and advocating for whole-person care over over-medicalization. He emphasizes the importance of trust, collaboration across sectors, and the role of prevention and social determinants, remaining hopeful thanks to the next generation of health care leaders. Tune in and learn how real-world care, leadership, and connection shape a more equitable and effective health system! Learn more about your ad choices. Visit megaphone.fm/adchoices

The key to ending homelessness is not just more housing, but better systems of collaboration, urgency, and coordination at the community level. In this episode, Rosanne Haggerty, president and CEO of Community Solutions, discusses how the rising homelessness crisis in the U.S. reflects deeper systemic issues, from healthcare gaps to housing affordability, and explains why solving it starts with stable housing. She shares how the Built for Zero initiative has helped communities like Denver and Houston make homelessness rare and brief through data-driven collaboration and systems thinking. Tune in and learn how communities are turning coordination into impact and how your city might be next! Learn more about your ad choices. Visit megaphone.fm/adchoices