Civic Rx

More fundamentally than any other event of the past decade, the COVID-19 crisis has kindled a wholesale re-imagination of how we conceive, deliver, evaluate, and pay for health care. Foremost among these changes is the sudden ubiquity of telehealth, but the pandemic has also unleashed a wave of investment and regulatory innovation not seen perhaps since the launch of the Affordable Care Act.

Few are better poised to unpack these trends than Dr. Bob Kocher, an industry titan who for nearly two decades now has stood at the vanguard of efforts to make healthcare work better, faster, cheaper across this country. Today, Bob is a Partner at venture capital firm Venrock, where he leads healthcare IT and services investments and serves on the Boards of Virta Health, Aledade, Renew Health, Lyra Health as well as Devoted Health, both of which he cofounded. He's an Adjunct Professor at Stanford's School of Medicine and a Senior Fellow at USC's Leonard D. Schaeffer Center for Health Policy & Economics. Before coming to Silicon Valley, Bob played a key role crafting the Affordable Care Act — serving as Special Assistant to President Obama for Healthcare and Economic Policy. Most recently, Bob was tapped by Governor Gavin Newsom to serve on California's COVID-19 Testing Task Force, which quickly and substantially expanded the state's testing capacity.

Bob is a brilliant physician, entrepreneur, policy wonk and scientist. His reflections on this moment are not to be missed.

More on Bob's work, including his reflections and scholarship on health care writ large, can be found on his website.

For more on Civic Rx, visit civic-rx.org.

We are now four weeks from November 3 and arguably the most consequential election of our lifetime. By that date, millions of Americans — hopefully, the vast majority of Americans — will have cast their ballot for our next president. Alongside that choice, as well, are myriad other offices at the state and local level that wield a profound impact on our day-to-day lives. These so-called down-ballot races are the site of the largest loss of Democratic power since the years of Eisenhower, as more than 1000 seats slipped from blue to red in the decade after Barack Obama's historic victory.

Here to discuss why these races are so critical, how the Democratic Party has mobilized in the wake of 2016, and in what ways campaigning has adapted amid a global pandemic is Swati Mylavarapu. Swati is a Cofounder and Board Chair of Arena, a Founding Partner at Incite.org, and the former National Investment Chair of Pete for America, where she raised over $100M for Pete Buttigieg's presidential campaign. Across every role, Swati has worked to catalyze the next generation of Democratic leadership. And in February, 2020, she and her husband pledged $200K more to help flip the U.S. Senate and protect hard-won Democratic majorities in the U.S. House.

For more:

Register to vote.

Learn more about Arena, which is building the pipeline of progressive political leadership.

Learn more about Incite, which invests in rising leaders across the country.

And listen to more episodes of Civic Rx.

Mayor Michael Tubbs is Stockton's first Black mayor and America's youngest mayor ever to lead a city of greater than 100,000 residents. Since his election in 2016, Mayor Tubbs has pledged himself to revitalizing and reinventing the city of his birth, spearheading a bevy of new programs to fight violent crime, boost the college enrollment rate, and lower unemployment. In 2019, he launched the country's first mayor-led guaranteed income pilot; this summer, he mobilized 24 other mayors to advocate the same.

Today, Mayor Tubbs discusses his childhood in Stockton -- how his own hard journey at once epitomizes and indicts our obsession with American exceptionalism. He talks about his struggle to cultivate trust with his constituents, and the lessons he's learned leading an ideologically diverse city council. He shares the work Stockton has done to reform its police department, after municipal bankruptcy forced a critical rethinking of police funds. And he describes the history and impact of Stockton's successful guaranteed income pilot.

For more, stream Stockton on My Mind, HBO's new documentary on Mayor Tubbs, on HBO and HBO Max. Learn more about the array of initiatives he's spearheaded through his nonprofit organization, the Reinvent Stockton Foundation, and check out his 2020 re-election platform, to learn what he's envisioning for his city next.

A couple weeks ago we heard from Richard Barth, President of the KIPP public charter school network, about how K-12 schools across the country are navigating the capricious and unprecedented demands of COVID-19 this school year. Today we hear from a leader in higher education about how one major university is managing the same. Marc Tessier-Lavigne is a pioneering neuroscientist, biotechnology executive, and, since 2016, the president of Stanford University, where he has accelerated the university's commitment to not only advancing knowledge but also leveraging those discoveries to solve real-world problems.

President Tessier-Lavigne's own story — as the son of a Canadian military family, a first-generation college student and Rhodes Scholar who went on to perform groundbreaking neurological research and serve as both Genentech executive and now two-time university president — itself deserves a full conversation. But suffice it to say that, as a Stanford alum, I'm grateful that the university and my second home have President Tessier-Lavigne at the helm during this crisis.

Across the country, over 88,000 cases have already been reported on college campuses. Stanford made headlines last month when it announced that, in response to these numbers, it was closing its campus to most undergraduates this fall. Today, President Tessier-Lavigne and I explore how Stanford has reimagined its campus to prepare for COVID-19. We unpack why school leaders pivoted their reopening strategy amid the virus's summer surge. We discuss college sports, and the Pac-12's contentious decision to cancel football this season. We examine the financial consequences that this, and many other necessary changes, have exacted, both from students and from the university as an institution. And all of these issues we consider through the lens of equity.

For more details on the discussion, check out:

• Stanford's reopening plans,
• this profile of President Marc Tessier-Lavigne, and
• NYT's college cases tracker, which only continues to grow.

And for more about Civic Rx, visit www.civic-rx.org.

Since the earliest weeks of 2020, we've seen the federal government take a backseat to the states in directing America's COVID-19 response. Though we could devote an entire episode to the frailties of this laissez-faire federalism, instead I want to help us dissect where we stand at the state level, by talking with one of the most robust state leaders during this crisis: North Carolina's Secretary of Health & Human Services, Dr. Mandy Cohen. Secretary Cohen held several leadership roles in the Obama administration before moving to North Carolina in 2017. Since then, she and her team have been working hard to transform the state's health system into one that integrates and pays for not only medical care, but also its underlying drivers: from housing to food security to transportation to domestic safety. This vision for whole-person health has propelled a cascade of new programs that establish North Carolina, as Politico mused last year, quite possibly as "the most innovative health care state in America." And the COVID-19 pandemic, rather than distract from this mission, has only underlined its urgency. On today's episode, Secretary Cohen and I discuss some of these new programs. We review her personal story and journey to North Carolina, and consider how her experience coordinating Affordable Care Act implementation has informed her approach to crisis management today. We talk about the void in federal leadership on COVID-19, and the avenues by which states are striving to learn from and collaborate with one another instead. And we explore what the next few months might look like, should the coronavirus continue to spread.

For more on North Carolina's health and human services work, check out:

• the Department of Health & Human Services's website
• this New York Times's feature, "Inside North Carolina's Big Effort to Transform Health Care"
• this Politico profile, "Why North Carolina might be the most innovative health care state in America"

And for more on the Civic Rx podcast, visit www.civic-rx.org.

As August slides into September, the absence of a national strategy on school reopening has left thousands of families to struggle alone with the decision about whether and how to send their kids back to school. In every state, school districts are fending for themselves to develop a plan that balances sometimes conflicting risks to public health, economic security, and emotional wellbeing.

Here to elucidate the challenges and considerations demanded of such a decision is Richard Barth, CEO of the KIPP Foundation, the largest network of public charter schools in the country. Founded in 1994, KIPP today serves over 100,000 predominantly underprivileged students across 255 schools, 88% of whom qualify for federal free or reduced-price lunch; 95%, from Black or Latinx families. When COVID-19 hit, the KIPP Foundation lept into action: reaching out to its 28,000 alumni, enrolling teachers in digital learning courses, launching a virtual mental health program, standing up local food banks, and providing vital human services in students' communities. Every community presented unique challenges, yet what distinguished KIPP's response was its commitment to engaging deeply with the families that it serves and to ensuring that both its messaging and its policies were community driven.

If you're interested in learning how a nationwide K-12 public school network has mobilized to respond to COVID-19; how it's deciding which of its schools should and should not open; why it has prioritized investments in community resilience; and how racial and socioeconomic inequities have looked in practice for students and families, this episode is for you. And if you enjoy it, follow it up in two weeks, with our episode on colleges and universities.

Until then, learn more about KIPP here. See the state-by-state progress on school reopenings here.

And learn more about Civic Rx here.

For the past 7 years, Ilyse Hogue has served as the President of NARAL Pro-Choice America, the oldest organization dedicated to building political power around women's reproductive freedom and right to abortion. That time on the front lines has afforded her tremendous opportunity to reflect on the curious and complicated history of abortion rights advocacy — a history she's now distilled into a powerful new book, The Lie that Binds, which chronicles how the formerly non-partisan issue of abortion was reinvented as a political device, to advance a much broader agenda of social control. In this episode, Ilyse and I unpack the emergence and the evolution of the anti-choice movement, from its roots in school segregation to the administration of Donald Trump. We discuss the role that disinformation, then and now, has played in framing the debate. And we explore what those of us on the side of choice can do to re-engage and reclaim the narrative — at a time that reproductive rights seem perilously under threat.

To learn more about Ilyse's work and to purchase her book, The Lie that Binds, you can visit the book's website.

For more about Civic Rx, visit www.civic-rx.org.

I interviewed the United States' 19th Surgeon General, Dr. Vivek Murthy, at a vibrant virtual town hall hosted last week with cultural heritage organization, Indiaspora. At a time of heightened physical isolation, sharing this space and this community to discuss one of the defining struggles of our age — loneliness, and social disconnection — was as cathartic as it was generative. In this episode, Dr. Murthy reflects on the Listening Tour he took as a new Surgeon General in 2014, when to his surprise, loneliness emerged again and again at the root of disparate communities' challenges. We also explore the biological mechanism of loneliness, its evolutionary origins and consequences for our physical and mental health. And finally, we draw a connection from this moment in history — our growing political polarization and the national reckoning with racial injustice — to loneliness as both cultural experience and public health crisis. Interwoven throughout are insights and stories from Dr. Murthy's new book, Together: The Healing Power of Human Connection in a Sometimes Lonely World. The conversation is as timely as it is urgent, reminding us gently of our power and responsibility to lead from a place of love. To learn more about and purchase Dr. Murthy's book, check out the Together website. For more about Civic Rx, check out www.civic-rx.org.

I first met Dr. Abdul El-Sayed 7 years ago at a fellowship retreat. He was still in medical school, but even then it was clear, our healthcare system dismayed him: it was unaffordable, inefficient, and cruel to those who needed it most. The experience galvanized Abdul to pivot from practicing medicine to repairing public health, beginning with the city of Detroit, where he became the youngest health commissioner of a major American city when he was appointed to rebuild the Detroit Health Department, after it was gutted and privatized during municipal bankruptcy. In 2018, Abdul ran for Governor of Michigan on an unapologetically progressive platform of universal health care, clean water for all, debt-free higher education, and a pathway to 100% renewable energy; he didn't win, but earned the endorsements of several progressive leaders, including Senator Bernie Sanders and Congresswoman Alexandria Ocasio-Cortez. Most recently, he's written a book, Healing Politics, which diagnoses our country's epidemic of insecurity and the empathy politics we must embrace to treat it. Abdul is brilliant, a political force, and a bright moral light at a moment when we need such leadership dearly. Over the years, I've been grateful to call him a friend, someone I trust to make sense of the times we live in. So for this episode, I asked Abdul if he would join me to talk about his journey, this unsettling moment in our country's history, and his blueprint for a more equitable and sustainable future, as charted in his book. What results is a thought-provoking conversation about personal agency, what it means to live a life of meaning, why so many people are hurting right now, and what we owe to each other as a society. For more on Abdul and to order his book, Healing Politics, visit his site here. And contact the show anytime at www.civic-rx.org.

Dr. Leana Wen is an emergency medicine physician and a professor of health policy & public health at George Washington University. Previously, she was the Health Commissioner for the City of Baltimore, where she led the nation's oldest continuously operating health department. She's the author of critically acclaimed book, When Doctors Don't Listen, and its ensuing TED talk, now viewed over 2 million times. In 2019, Dr. Wen was named one of TIME 100's Most Influential People. For this episode, Dr. Wen and I delve into her time in Baltimore and, particularly, the lessons it holds for the moment we're in now, as cities hasten to respond to dual crises of racism and infectious disease. We also explore the critical role that trust — institutional trust, social trust, patient-to-physician trust — plays in an effective pandemic response, and discuss what we can do to restore trust in public health and public officials. And through it all, Dr. Wen reflects on her personal journey, and how she came to discover and inhabit her own voice. For more on Dr. Wen's work, check out:

• her TED talk: "What your doctor won't disclose"
• her weekly column in The Washington Post
• her reflections on 4 years as Baltimore's Health Commissioner, in Health Affairs
• her feature in The Atlantic, for a representative day-in-the-life: "Working a million hours to heal a city"

And for more on Civic Rx, visit www.civic-rx.org.