Conversations on Health: How We Get There - with Stephani Shelton

Episode 27: A Continued Conversation with Dr. Steven D. Culler, Associate Professor of Health Policy and Management at Emory University, on Medicaid and Obamacare Updates for 2025

 Open enrollment for Medicare supplement plans, which continues until December 7, runs somewhat concurrently with the annual sign up period for the Affordable Care Act plans - commonly called Obamacare. The plans became available on state marketplaces on November 1 and the window closes on December 15 for coverage beginning January 1. We explained the major Medicare changes for 2025 in Episode 26 - check it out if you or someone in your family still needs the podcast’s actionable information. But right now let’s talk about the other actionable information – the 2025 Obamacare plans and who’s eligible for them. Back again is Dr. Steven D. Culler - our expert from Episode 26 and last year’s more extensive Episodes 14 and 15. He’s an Associate Professor at the Rollins School of Public Health, and Affiliated Associate Professor at the Goizueta Business School at Emory University in Atlanta.
Note: all episodes are also available in video form on YouTube
 

Episode 26: A Conversation with Dr. Steven D. Culler, Associate Professor of Health Policy and Management at Emory University, on Medicare Updates for 2025

Once again it’s open enrollment time for Medicare plans - which runs for just 6 weeks each year - from October 15 until December 7th. Millions more Americans who don’t get health insurance through their jobs or Medicaid can find or change so-called Obamacare insurance plans from November 1st through January 15th of next year. 
In this episode we’re concentrating on the biggest changes to Medicare for 2025, including qualifications for weight loss drug Wegovy coverage and the Medicare Advantage plans used by about 50 percent of Medicare recipients. Episode 27 – dropping on November 19th – will catch you up on the Affordable Care Act changes and their relationship to the state-run Medicaid coverage. This is hard information you can – and should use right now. We’re also taking a look at the effect of the top Medicare changes on private, work–related insurance plans, which are likely to make adjustments for 2025.
If you need a primer on how these programs actually function – check out Episodes 14 and 15. Dr. Steven D. Culler - our expert from those earlier episodes – was kind enough to come back again for this update.  He’s an Associate Professor at the Rollins School of Public Health, and affiliated Associate Professor at the Goizueta Business School – at Emory University in Atlanta.
Note: all episodes are also available in video form on YouTube
https://www.kiplinger.com/retirement/medicare/three-medicare-changes-on-the-horizon-for-2025
https://www.kff.org/medicare/issue-brief/what-to-know-about-medicare-part-d-premiums/
https://www.cms.gov/
 

Episode 25: A Conversation with Dr. Mirella M.N. Minkman on Neighbors Helping Neighbors Toward Better Health in the Netherlands

Health experts in many countries – including the United States – are looking beyond standard health care and medical treatments to some kind of community-based care.  Both as a way to improve people’s general health - and as a way to cut the spiraling costs of medical procedures and new drugs.
The Netherlands appears to be well ahead of most countries with its varied efforts to re-invent what is generally called “social care” - starting right at the neighborhood level.
With the huge Boomer population aging quickly - the Netherlands also has a particular focus on integrated care for people with multiple health issues. Which includes giving them access to adequate health care before those issues become serious.
My guest is one of the Netherlands’ top experts in these areas - Professor Dr. Mirella M. N. Minkman of Tilburg University, Tias Business School and CEO of Vilans, National Center of Expertise for Care and Support. We cover a lot of territory – including what is a growing problem virtually everywhere – more and more young people with mental health needs. You’ll be surprised to find out how varied – and sometimes how simple social care can be.
Note: all episodes are also available in video form on YouTube
 
 

Episode 24: A Conversation with Maggie and Suzanne about Having Friends and Loved Ones in Rehabilitation and Skilled Nursing Facilities

Do you know someone – perhaps in your own family – who has spent time in a rehabilitation facility? Maybe after an illness or operation? Lots of people – and particularly older people who live alone – find themselves in rehab or long term care facilities. These are somewhat different from the assisted living or independent care communities we talked about in Episode 10 - when we explored one family’s exhaustive effort to find a place for their Mom in North Carolina. Rehab facilities are often affiliated with hospital groups and deal with everything from recovering from knee replacements to stroke and even dementia care.  The residents may be there for just a few weeks – or much longer.
My husband and I discovered that two good friends each have someone they care about in residential care at the same, independently owned, northern New Jersey facility. One day they started talking about the issues they’re encountering – like staffing, adequate physical therapy, mental stimulation and the overall differences between this independently owned facility and the more common and usually larger, company-owned facilities. My husband – the video editor and producer for this podcast series said – “you know -– this would make an interesting episode”. And I thought it may also be very helpful. We decided not to use the actual name of the place – or the names of our friends. So – cozy up with a cup of tea or coffee – and join “Maggie”, “Suzanne” and me for the conversation.
Note: all episodes are also available in video form on YouTube

Episode 23: A Conversation with Dr. Jihad Malasi, Primary Care Physician, Royal College of General Practitioners, Senior Fellow of the Faculty of Medical Leadership and Management, United Kingdom

We’re spending some time this summer revisiting the UK’s National Health Service. It’s celebrating its 76th birthday this month – although I doubt anyone would use that exact word. Actually, right after the Labor Party swept the UK parliamentary elections on July 4th – both the new Prime Minister Sir Keir Starmer and his new Health and Social Care Secretary Wes Streeting said flat out that the NHS is broken. Both promised to save it. And - both stressed it couldn‘t be done overnight. Small comfort to the nearly 10 million people the BBC says may be on NHS waiting lists for doctor visits, operations or tests. That’s somewhat more than the official NHS count of 7 million. But the lists do seem to depend on who’s counting.
There’s a crisis in available hospital beds. In doctors to care for patients in those beds. And - at the point of first patient contact – a shortage of GPs or general practitioners. People in some parts of the UK can wait weeks or months to see their doctor, as overworked GPs retire without being replaced.
So - as the new UK government settles in – how do GPs feel about their own future? Do they think the Labor government – the first in 14 years – can make meaningful changes in the NHS? And make them quickly enough to save it - as the party has promised?
My guest on this episode is Dr. Jihad Malasi. He’s been a practicing physician in the UK for over 20 years and is trained in family medicine and psychiatry. His practice is in Kent and the borough of Medway - an area south of London. Dr. Malasi is a member of the Royal College of General Practitioners and a Senior Fellow of the Faculty of Medical Leadership and Management. His interests are in primary care, health economics and policy. He holds a Master of Science degree in Health Economics from the London School of Economics & Political Science (LSE) and works for the National Institute for Clinical Excellence (NICE) and Kent & Medway Integrated Care Board as Mental Health clinical lead. Full profile on LinkedIn. The interview was recorded AFTER the July 4th UK Parliamentary elections.
Note: all episodes are also available in video form on YouTube
 

Episode 22: A Conversation with Dr. Amani Hassan, Practicing Child and Adolescent Psychiatrist NHS; Faculty Chair, Child and Adolescent Psychiatry Royal College of Psychiatrists, Wales, UK

As the US Surgeon General calls for a social media warning label similar to the one on cigarettes and alcohol, we focus on child and teenage mental health in this somewhat longer than usual episode. And about halfway through – we get into a really good discussion on that really big issue: the role of social media in the growing problems of Gen Z and the youngest children – Gen Alpha.
We’re talking about all this with a child psychiatrist from the United Kingdom’s storied but now struggling National Health System. And she has some ideas you probably haven’t heard before. This is one of several episodes revisiting the NHS and it’s ongoing shortages and waiting lists from the standpoint of the doctors who keep it functioning. Often with great difficulty.
If you haven’t heard or watched Episode 11 – perhaps you might want to for the overall story of the NHS and its current woes. A quick refresher: the NHS began in 1948 – more than 75 years ago – and along with the slightly younger Swedish system – is the basic model for taxpayer financed, government controlled, universal health care. Free at the point of use for all.
Many of the NHS doctors that patients see are also its caretakers. Helping their local systems function while they also work in their specialties. Like my guest in this episode - who lives and works in Wales, one of the UK’s four devolved nations.
Dr. Amani Hassan is an experienced practicing child and adolescent psychiatrist  – a consultant, as many doctors are called in the NHS. She also chairs the Faculty of Child and Adolescent Psychiatry at the Royal College of Psychiatrists in Wales and works as well in learning disability psychiatry. Additionally, Dr. Hassan researches neuro-developmental disorders. She was the Training Program Director (2015 to 2018) of Child and Adolescent Psychiatry at Wales Deanery.
There is some discussion about mentally disturbed young people. So I’ve included information below on how to get help if you or someone you know needs it – in both the UK and the US.
Note: all episodes are also available in video form on YouTube
IN THE UK: NHS National Suicide Prevention Line
0800 689 5652. 6pm to midnight. Backup: 0800 689 0880
999 for life threatening emergencies. Or go to nearest A and E.
https://www.spuk.org.uk/national-suicide-prevention-helpline-uk/
IN THE US: 988  Suicide and Crisis Lifeline 24/7
Reaches local crisis centers similar to the way  911 functions for all other emergencies.
https://988lifeline.org/
 

Episode 21: A Conversation with Theodore Lawrence, MD, PhD, Professor of Radiation Oncology, University of Michigan

How many times have we all asked – when will they find a cure for cancer? Of course there is no one cure any more than there is just one type of cancer. Each one requires its own research pathway. But there have been great strides in recent years. Some cancers which used to be a death sentence can now be basically cured or turned into treatable, chronic illnesses.
My guest for this episode is Theodore Lawrence, MD, PhD. He’s a Professor of Radiation Oncology at the University of Michigan and has an active oncology medical practice. He’s also researching better treatment outcomes for gastrointestinal and central nervous system cancer.  His research continues to be supported by the National Cancer Institute.
I’ve known Ted for many years – since he was still a medical student, recently married to my second cousin. He’s always been really excited about his work. And he has that rare ability to explain really complicated concepts in a way we can all clearly understand.  
Note: all episodes are also available in video form on YouTube
 

Episode 20: A Conversation with Mohammadali Habibi, MD – an electrophysiologist with The Valley Health System in New Jersey

This may surprise you with all the medical advances we’ve made in the last decade --but heart disease remains the leading cause of death in the US. As it has been since 1921. A recent poll conducted for the American Heart Association found 51 percent of respondents had no idea! According to the Centers for Disease Control and Prevention  – one person dies every 33 seconds in the US from cardiovascular disease. And this may also surprise you. The CDC says in 2019 - the last year it lists - heart disease cost the US about 2 hundred and 40 billion dollars. Think about the inflation you’ve experienced in the last few years and you can imagine how big that number will be for all of 2024. One reason for the growing cost of heart disease is that much of what causes it is treatable now. And as the huge boomer cohort moves into the senior class – older people with heart disease are living longer. So I thought it would be interesting to talk to a heart specialist I know - who would likely have been doing something else just 30 or 40 years ago. Dr. Mohammadali Habibi is an electrophysiologist with the highly rated Valley Health System and Valley Hospital in New Jersey. Valley’s state of the art, new hospital just opened. Valley is also partnered with the country’s top ranked heart hospital – The  Cleveland Clinic.
Note: all episodes are also available in video form on YouTube
 

Episode 19: More of A Conversation with Catharina Barkman, Project Director, Forum for Health Policy in Stockholm on Sweden’s Universal Health Care System

Part 2:  I think we all learned a lot in Episode 18 about Sweden's pioneering universal health care system. Most countries except for the U-S have some version of this – health care that’s paid for by taxes, controlled by the government and essentially free at the point of use. But health care costs are skyrocketing everywhere. So now we're going to talk about how AI and other data-driven innovations may help Sweden - and health care systems in general - cope with the demographic changes and expensive medical breakthroughs already straining budgets. This is the second half of my discussion with Catharina Barkman of Sweden’s Forum for Health Policy It's a non-profit, independent think tank aiming to boost innovation and development in the health care system. Catharina has also held several top positions within the system itself in the region of Stockholm – Sweden’s capital.
Note: all episodes are also available in video form on YouTube

Episode 18: A Conversation with Catharina Barkman, Project Director, Forum for Health Policy, Stockholm on Sweden’s Universal Health Care System

Part 1:  Most of us are familiar with the idea of universal health care. Ideally – tax-paid, “free” health care for all. We know that in the US we don’t have it – while almost all other countries do – in some form. One of the first countries to adopt universal health care was Sweden – in the early 1950s. But how - exactly - does such a system work? And can it keep afloat as health costs keep rising?  I ask Catharina Barkman who heads Sweden's  Forum for Health Policy - a non-profit, independent think tank aiming to boost innovation and development in the health care system. Catharina has also held several top positions within the system itself in the region of Stockholm – Sweden’s capital. I think you’ll learn a lot about how universal health care works from our conversation – not only in Sweden but also in other countries. And you may be surprised – as I was – to see that even here in the US – we have some aspects of health care for all. 
Note: all episodes are also available in video form on YouTube.