What if instead of treating illness we also confronted the reasons Americans get sick in the first place? That’s the origin of this podcast and also the 4 billion dollar question Dr. Bechara Choucair is tackling at Kaiser Permanente. Bechara, who is KP’s Chief Community Health Officer, joins Claudia to talk about the organization’s focus on climate change and health, workforce pipelines and addressing broader social needs.

We discuss:

• The surprising fact that two-thirds of KP’s members (who are mostly covered by employer insurance) have at least one unmet social need
• The common sense moves the Common Health Coalition is taking to build bridges between healthcare and public health
• What KP is doing to tackle a big problem limiting the mental health workforce: only 57% of masters trained therapist get licensed
• What it took for KP to achieve carbon neutrality

Bechara reminds us that bridge-building is a crucial part of this community health work:

“We need more and more bridges between public health and healthcare... [They have] operated as two separate disciplines operating in their own silos... [When] there is a public health emergency we build more bridges, we strengthen those bridges that already exist. And then when that public health emergency subsides, we all retreat into our own disciplines and we continue that siloed journey.”

Relevant Links

• Read about the NAM initiative on climate change and health
• Explore why the US needs more community health workers from this article
• Learn more about the Common Health Coalition
• Dive into details on KP’s sustainability journey

About Our Guest

Dr. Bechara Choucair, MD, is executive vice president and chief community health officer for Kaiser Foundation Health Plan, Inc. and Hospitals — known as Kaiser Permanente, one of America’s leading integrated health care providers and not-for-profit health plans. Dr. Choucair oversees the organization’s national community health efforts and philanthropic giving activities aimed at improving the health of its 12.2 million members and the 68 million people within the communities it serves.

Previously, Dr. Choucair served as senior vice president, Safety Net and Community Health, at Trinity Health, and was the commissioner of the Chicago Department of Public Health.

Dr. Choucair, a family physician by training, completed his Family Practice Residency at Baylor College of Medicine in Houston, Texas. He holds an MD from the American University of Beirut and a master’s degree in health care management from the University of Texas at Dallas.

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The US leads the world in biomedical innovation, with about 40% of patents being filed by US scientists and companies. The FDA plays a critical role in supporting and enabling this innovation pipeline and our guest Dr. Robert Califf was commissioner of the agency not once, but twice under Presidents Obama and Biden. He joins us to talk about what Americans should know about FDA’s critical role and the threats to its functioning from the dramatic cuts the Trump administration has made over the last three months.

We discuss:

• The broad sweep of FDA’s purview from drugs and medical devices to cosmetics, food, tobacco and dog food
• Concern that the FDA is now “decapitated and eviscerated” from the massive and multiple rounds of dismissals
• While most industries want less regulation, the pharma industry wants more information and guidance from the FDA
• Califf has been affiliated with Duke for 50 of its 100 years, but a part of his heart is still with Clemson

What would Califf’s “Make America Healthy Again” agenda be?

“We need to develop reliable, repetitive sources of information that help people do things that are healthy and beneficial. That part of MAHA I like a lot…The second thing is… I'm developing connections with people who are thinking differently about primary care because I think everybody agrees there's no way you can take the current workforce and deliver what's needed. So it's got to be linked up with AI and digital technologies, but also with a very different looking workforce that gets paid differently, has more respect.”

Relevant Links

• Read Califf’s WSJ opinion letter: “Work with the Bureaucracy, Not Against It”
• Peter Marks’ resignation letter
• NYT article on the impact of FDA layoffs
• Califf’s “Public Health on Call” podcast episode on the state of the FDA
• Opinion article from 7 previous FDA commissioners on how recent changes are undermining credibility of the FDA

About Our Guest

Robert M. Califf, MD served as FDA Commmissioner under Presidents Biden and Obama. Califf is a nationally recognized expert in cardiovascular medicine, health outcomes research, health care quality, and clinical research, and a leader in the growing field of translational research. Prior to rejoining the FDA in 2022, Califf was head of medical strategy and senior advisor at Alphabet, contributing to strategy and policy for its health subsidiaries Verily Life Sciences and Google Health. Prior to Alphabet, he was professor of medicine and vice chancellor for clinical and translational research at Duke University, director of the Duke Translational Medicine Institute, and founding director of the Duke Clinical Research Institute. Dr. Califf is a graduate of Duke University School of Medicine. He completed a residency in internal medicine at the University of California, San Francisco and a fellowship in cardiology at Duke.

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Could primary care at home unlock better health and lower costs for American families? Rebekah Gee, a physician and policymaker turned entrepreneur, joins us to talk about the big bet her company Nest Health is making on home-based primary care. It’s a model that makes sense for families and delivers results. In the first year of operations Nest doubled primary care visits, reduced ER visits, and increased childhood immunizations.

We discuss:

• The sound economics behind the Medicaid expansion in Louisiana
• What she learned from her mentor, astronaut John Glenn
• How to close the primary care gap for children and parents
• Whether ultra processed foods are the next tobacco

Rebekah shared about an exchange with Elon Musk on the short sightedness of Medicaid cuts:

“So Nest came out with our savings numbers. We put out some really good information about the health of children and the opportunities. And Elon Musk retweeted it. So as a result of that, we actually got a lot of press. But I wrote back to him and said, ‘I'm glad you like this concept. And just remember, don't cut health care for children because we'll be paying far more for that than you will ever save.’ ”

Relevant Links

• Read more about Nest Health
• Watch: Dr. Rebekah Gee on what entrepreneurs need to know about Medicaid
• Learn about Alaska’s Nuka system of care
• Evidence from the Nurse Family Partnership about the impact of home-based care

About Our Guest

Dr. Rebekah Gee is the founder and CEO of Nest Health, a technology-enabled whole-family primary care provider providing care at home and virtually to Americans who struggle to receive comprehensive care. Previously, Dr. Gee served as Secretary of Health for the State of Louisiana. In that cabinet-level role, she led the expansion of Medicaid. As Secretary, she was responsible for nearly half the state budget including Medicaid, public health, aging and adult services, licensure, sanitation, disability services, and a nearly 2,000 bed state hospital system. As Secretary, she developed a first-in-the-nation subscription model for the drugs that cure Hepatitis C that is being used as a national and international model for increased drug access and affordability.

Dr. Gee has served as an advisor to multiple Governors, presidential campaigns, and policy efforts at the state and national level. Her board service includes medical advisory support of public companies Select Quote and 3D systems. She has also served as a board member or advisor to Ready Responders, Ouva, Noble, NCQA, NQF, IHI, the Penn Center for Behavioral Economics, and the Duke-Margolis Institute.

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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and LinkedIn

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