POLITICO's Pulse Check

Karen DeSalvo was a top HHS official in the Obama administration, where she spent months simultaneously running the Office of National Coordinator for Health IT and serving as the acting assistant secretary for health. She also will be a familiar voice for longtime PULSE CHECK listeners: Karen appeared on an early episode of PULSE CHECK, where she talked about her work and her life story. (You can find a link to that earlier episode in the show notes below.)

Karen and POLITICO's Dan Diamond caught up at the J.P. Morgan Healthcare Conference to discuss what she's been up to in the year since leaving HHS (starts at the 1:35 mark), how her old departments are performing under the Trump administration (starts at 7:15), whether the focus on social determinants of health is overblown (starts at 14:00), and her latest gig at the new Dell Medical School (starts at 22:00).

Then after the break, Dan runs through some of last week's big health care stories that got overshadowed by Congress' fight over a government shutdown (starts at the 23:45 mark).

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Stories referenced on the podcast:

Karen DeSalvo's first appearance on PULSE CHECK in June 2016, where she talked at length about her work and career path: https://simplecast.com/s/14426be4

A summary of Karen's comments on health IT on that earlier episode: https://www.politico.com/story/2016/06/desalvo-we-are-seeing-the-returns-on-ehr-investments-224064

Jennifer Haberkorn and Brianna Ehley's story on the CDC director's financial conflicts of interest: https://www.politico.com/story/2018/01/18/cdc-director-avoids-congressional-testimony-297284

Sarah Karlin-Smith and Brianna's story on the Trump administration targeting the drug policy office: https://www.politico.com/story/2018/01/18/trump-targets-drug-policy-office-297422

Dan and Jen's story on HHS' push to institute new protections for health workers with religious objections: https://www.politico.com/story/2018/01/16/conscience-abortion-transgender-patients-health-care-289542

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The health care business world gathered at the J.P. Morgan Healthcare Conference this week, with thousands of attendees haggling over deals and gossiping over drinks in San Francisco.

One of the standouts at the conference: venture capitalist Bob Kocher, a doctor and Obama administration alumnus known for his provocative thinking and Silicon Valley influence. At Venrock, Bob focuses on health IT and services, with investments in companies like Aledade, Castlight, Stride Health and Zenefits.

Speaking with POLITICO’s Dan Diamond, Bob discussed his approach to investing in health care (Starts at the 1:20 mark), how he got into venture capital (8:15), the difference between innovating in government and the private sector (13:45), the sector’s never-ending job growth (17:15), how the current administration is affecting the health care market (21:15) and his 2018 predictions (28:00). There’s also a quick lightning round at 30:15.

Then after the break, Dan caught up with Victoria Colliver, POLITICO’s California correspondent for health care, on how the JPM conference went and the biggest health policy stories coming out of the state this year. (Starts at the 32:15 mark.)

Note: This podcast was recorded on location, and that’s why the audio sounds rougher than usual.

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Stories referenced on the podcast:

Dan’s story, with Bob’s quotes, on the ACA’s failure to cut wasteful jobs: https://www.politico.com/agenda/story/2016/07/what-is-the-effect-of-obamacare-economy-000164

Bob’s predictions for health care in 2018: https://www.cnbc.com/2017/11/27/venrocks-health-investors-make-predictions-for-2018.html

Victoria’s story on California’s effort to shore up the ACA: https://www.politico.com/story/2017/11/01/obamacare-california-new-york-coastal-244386

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FDA’s influence can be summed up in a simple statistic: About 20 cents of every dollar that Americans spend is on a product — whether food, drug or tobacco — that’s regulated by the agency. But that enormous responsibility has also exposed the FDA to a broad array of critics, including President Donald Trump, who last year bashed the agency’s reviews as “slow and burdensome.”

Trump’s pick to reform the agency? Commissioner Scott Gottlieb, who’s steered FDA since last May to the praise of conservatives — and, surprisingly in this political moment, some progressives who think he’s successfully balanced political pressures with public health priorities.

Gottlieb joined POLITICO’s Dan Diamond to reflect on the agency’s 2017 achievements and why he joined the Trump administration (Starts at the 1:30 mark), the FDA’s nutrition policy and its role in keeping food safe (9:30), whether FDA is approving too many drugs (13:15), his to-do list for 2018 and looming policy priorities (19:00), the ongoing crisis in Puerto Rico and the effect on medical product development (22:10), how his role as a sometime-critic of FDA has squared with running the agency (25:45), FDA’s tobacco strategy (27:15), and a quick lightning round on Gottlieb’s infamous skinny jeans and other not-so-pressing questions (28:15).

Then after the break, POLITICO senior food and agriculture reporter Helena Bottemiller Evich and pharma reporter Sarah Karlin-Smith analyze Gottlieb’s comments and discuss the looming challenges for the agency. (Starts at the 30:00 mark.)

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Stories referenced on the podcast:

Matthew Herper’s review of Gottlieb’s top articles for Forbes: https://www.forbes.com/sites/matthewherper/2017/03/10/the-best-stories-scott-gottlieb-the-next-fda-commissioner-wrote-for-forbes/#5e1234d1c523

Gottlieb’s January 2016 article on the need for FDA to change its regulation of novel technologies: https://www.forbes.com/sites/scottgottlieb/2016/01/12/fda-needs-to-change-how-it-regulates-novel-technologies/#45a8b372191e

Sarah’s look at what’s ahead for pharma in 2018: https://www.politico.com/newsletters/prescription-pulse/2018/01/03/pharma-weathers-storm-over-drug-prices-may-shift-tactics-062669

Helena’s article, “The Great Nutrient Collapse,” one of POLITICO’s most-read stories in 2017: https://www.politico.com/agenda/story/2017/09/13/food-nutrients-carbon-dioxide-000511

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On today's PULSE CHECK, we’re bringing you a bonus conversation that captures this moment in politics and one of the key voices shaping the debate — a discussion with activist Ady Barkan.

A Yale-trained lawyer, Ady worked with the Center for Popular Democracy to push progressive economic policies and reform the Federal Reserve, high-profile battles that led POLITICO to name Ady to our list of 50 leaders and influencers in 2016.

But Ady's life radically changed after a diagnosis of ALS last year. Now he's fighting to stop Republicans' tax bill and avoid possible cuts to Medicare — an argument that Ady made in a viral video where he confronted Sen. Jeff Flake aboard an airplane over Flake's support for the tax bill

On today's episode, Ady discusses his life, his advocacy work and what average Americans can do to shape the policy debate.

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Too often, there's too much media focus on Obamacare. But with a surprise Senate upset throwing a wrench into Republican repeal plans, and with HealthCare.gov sign-ups poised to end on Friday, this was a week to go a little deeper on the ACA.

First, POLITICO’s Paul Demko discusses his reporting on the ACA enrollment period and insurers’ profitability (starts at the 2:25 mark), as well as the health care ramifications of the shifts in the Senate (16:00), with Alabama's Doug Jones and Minnesota's Tina Smith poised to join the Democratic caucus.

Then after the break, Sarah Gollust — a University of Minnesota professor who studies health care and the media and has closely tracked advertising around the Affordable Care Act — joins PULSE CHECK to discuss her latest findings (starts at the 24:20 mark).

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Stories referenced on the podcast: Paul's story on insurers finally turning a profit on the ACA: https://www.politico.com/story/2017/12/07/obamacare-profits-health-care-285258

Paul's story on ACA enrollment lagging behind last year: https://www.politico.com/story/2017/12/12/obamacare-sign-ups-enrollment-numbers-218764

Dan's story on Mayo Clinic's rural consolidation, a regional controversy that drew in Tina Smith: https://www.politico.com/story/2017/11/16/mayo-clinic-rural-health-care-244955

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Congress continues to try and hammer out a year-end spending bill, while outside of Washington, health care organizations dramatically ramped up their deal-making this week.

First, POLITICO’s Sarah Ferris and Adriel Bettelheim join PULSE CHECK to parse what’s happened with the spending negotiations and what’s next. (Starts at the 1:30 mark.)

After the break, Craig Garthwaite, a health economist with Northwestern University’s Kellogg School of Management, discusses why there were so many eye-catching health care mergers this week and what he likes about CVS’s $69 billion deal to buy Aetna. (Starts at the 16:00 mark.)

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It’s been another packed week in health care, and PULSE CHECK — with help from a conservative health care analyst — is here to help make sense of it all.

First, POLITICO’s Jennifer Haberkorn and Adam Cancryn join Dan Diamond to talk about their reporting about the tax package that’s poised to pass the Senate (starts at the 1:45 mark), the fight over HHS Secretary-nominee Alex Azar (11:00), and the latest timing on funding for Children’s Health Insurance Program (15:00). Dan also discusses the false reports about Kellyanne Conway being appointed “opiods czar.” (19:45)

Then after the break, Chris Jacobs — the CEO of the Juniper Research Group and a prominent conservative health care analyst — explains his criticism of the tax package (starts at the 25:30 mark), his review of the GOP’s health care efforts after 10 months of controlling government (35:00), and his thoughts on the state of conservative health care analysis (37:45).

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Stories and work referenced on the podcast:

Adam and Sarah Ferris’ story on the tax package’s possible cuts to Medicare and other programs: https://www.politico.com/story/2017/11/30/tax-bill-spending-cuts-gop-congress-274337

Jen’s story on pro-Obamacare groups turning on Sen. Susan Collins: https://www.politico.com/story/2017/12/01/susan-collins-healthcare-vote-obamacare-ads-274629

Friday’s issue of PULSE, which had Jen’s scoop on CHIP funding timing: https://www.politico.com/newsletters/politico-pulse/2017/12/01/tax-bill-could-trigger-significant-medicare-cuts-037612

Chris Jacobs’ piece arguing that the GOP would be “crazy” to repeal the mandate in their tax package: https://thefederalist.com/2017/11/09/republicans-crazy-repeal-obamacares-individual-mandate-inside-tax-reform/

Chris’ piece questioning whether ACA cost-sharing reductions would even be paid out under the tax package: https://thefederalist.com/2017/11/30/cost-sharing-reductions-subject-sequester/

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As the year winds down, PULSE CHECK is casting an eye outside of Washington and on what’s coming next for health care. And that's why this week's conversation is with one of the industry's big thinkers — Jeff Goldsmith, who grapples with these questions as a health care futurist and Navigant advisor.

Jeff sat down with POLITICO’s Dan Diamond to discuss what a futurist does and how his predictions have panned out (starts at the 1:20 mark), the trend toward hospital consolidation and what providers are doing right and wrong (9:00), where the health care industry stands and the signals being sent by Washington, D.C. (17:45), and a lightning round on what’s next for major sectors (28:00).

At the end of the episode, listen to a special excerpt from POLITICO MONEY, Ben White’s new podcast on politics, finance and economics, with this week’s episode focused on Republicans' tax bill fight. (Starts at the 31:10 mark).

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Stories and book referenced on the podcast: Dan's story on 'McHospitals': https://www.politico.com/agenda/story/2017/11/08/hospital-chains-dominate-health-care-000574 Jeff's 1981 book, "Can Hospitals Survive": https://www.amazon.com/Can-Hospitals-Survive-Jeff-Goldsmith/dp/0870942484

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It’s been a busy week in health care, and PULSE CHECK is here to help make sense of it all.

First, POLITICO’s Paul Demko and Sarah Karlin-Smith join Dan Diamond to discuss Republicans’ tax reform plans, Alex Azar’s nomination as HHS secretary, the state of ACA enrollment and Dan’s reporting on the Mayo Clinic. (Starts at the 2:00 mark.)

Then, Dartmouth professor Brendan Nyhan sits down with Dan to discuss his research into myths and lies about the ACA, vaccines and other health care issues, and how to change a person’s mind. (Starts at the 27:15 mark.)

Finally, Dan reflects on Uwe Reinhardt, the giant of health policy who passed away this week. (Starts at the 45:35 mark.)

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Stories and work referenced on the podcast:

Sarah and Adam Cancryn's story on Alex Azar, the nominee to lead HHS: https://www.politico.com/story/2017/11/13/alex-azar-hhs-secretary-trump-244837

Paul's story on the early ACA enrollment numbers: https://www.politico.com/story/2017/11/15/obamacare-enrollment-surges-trump-244930

Dan's story on Mayo Clinic's growth and rural patients' anger: www.politico.com/story/2017/11/16/mayo-clinic-rural-health-care-244955

Brendan Nyhan's work on death panel myths: http://www.brendan-nyhan.com/blog/2013/01/new-study-on-difficulty-of-correcting-death-panel-myth.html

The New York Times' obituary of Uwe Reinhardt: https://www.nytimes.com/2017/11/15/obituaries/uwe-reinhardt-a-listened-to-voice-on-health-care-policy-dies-at-80.html?_r=0

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"I don't know why people in rural America should have to settle for insurance that no one else in the industrialized world has to settle for... Just because you live in a rural place, why should you have to pay for insurance that's of no use to you?"

Sen. Michael Bennet is an intriguing figure in the national health care debate. The Colorado Democrat sits on the Senate’s two key health care committees, he’s been pragmatic about the Affordable Care Act, and with Sen. Tim Kaine, he’s the author of Medicare-X, a new plan to expand coverage.

The senator sat down with POLITICO’s Dan Diamond to share his reaction to Democrats’ victories in Tuesday’s election (starts at the 15:45 mark), his Medicare-X bill and his exhaustion with the ACA debate (19:40), Democrats’ desire for universal coverage and why Colorado’s single-payer bill failed (28:45), his role on the Senate Finance and HELP committees overseeing HHS and CMS (34:10) and his thoughts on the state of media (43:00).

But first, Josh Peck — the former Chief Marketing Officer of HealthCare.gov and co-founder of Get America Covered — joins PULSE CHECK to discuss the state of ACA open enrollment and what his group is doing to boost coverage. (Starts at the 2:00 mark.)

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Stories referenced on the podcast: 

Maine voters supported Medicaid expansion, on the same day that CMS’s Seema Verma announced new support for Medicaid work requirements: https://www.politico.com/story/2017/11/07/maine-voters-medicaid-obamacare-244675

Lamar Alexander, Patty Murray had been inching toward a deal to stabilize Obamacare: https://www.politico.com/story/2017/09/28/alexander-murray-obamacare-plan-243258

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