This week, we close out our three-part series on rethinking drug access and costs with a must-listen encore episode. After detailing the scope of the drug price crisis with Mark Cuban and how we can re-purpose drugs to treat rare illnesses with David Fajgenbaum, we turn to a leader who is actively changing the dynamic: Paul Markovich. Now the CEO of Ascendiun (the parent company of Blue Shield of California), Paul argues that healthcare affordability isn't just a patient pocketbook issue - it’s a massive economic crisis for the nation.

In this episode, Paul and Claudia discuss:

• His conviction that reducing healthcare costs is essential to averting a national fiscal crisis
• The upside-down economics that make PBMs reject cheaper drug prices
• Paul’s candid advice on what it takes to be a courageous leader in a dysfunctional system

Paul Markovich challenges healthcare leaders to shift from explaining high costs to being accountable for lowering them:

“Almost everybody in the entire value chain, whether it's health plans or hospitals or all the way through, they want to explain why healthcare is so expensive and why there's this inflation rate as if that absolves them of any responsibility to make it different. And so, what I really want is accountability, and a level of accountability that doesn't exist yet in our industry, to say, 'Hey, we own this' ". 

Relevant Links

Part 1: Listen to our episode “New Life for Old Drug with David Fajgenbaum”

Part 2: Listen to our episode “Lessons in Disruption with Mark Cuban”

Rethinking how Americans get affordable medications

California’s new PBM reform law

About Our Guest

Paul Markovich is president and chief executive office of Ascendiun, a nonprofit corporate entity as part of the new parent to the family of organizations that includes Blue Shield of California.

Paul Markovich was president and chief executive officer at Blue Shield of California, a nonprofit health plan with $25 billion in annual revenue, serving 6 million members in the state's commercial, individual, and government markets. Paul launched and led numerous initiatives to drive innovation and help reimagine health care, including funding support for a statewide provider directory to make it easier for Californians to find physicians and facilities in their plan; supporting the development of a statewide health information network for patients’ records, enabling more seamless and holistic care; and investing in a partnership with the California Medical Association to help physicians pilot new care delivery models and leverage technology.

At Blue Shield, Paul previously served as chief operating officer (responsible for healthcare services, network management, e-business, marketing, product development, and customer operations). He was senior vice president of the large group and CalPERS business units. He led the company’s product development unit, introducing numerous products and services such as the first California Health Maintenance Organization to allow self-referrals to specialists and initiating online access to member benefits.

He currently serves on the board of the Chicago-based Blue Cross Blue Shield Association, the national umbrella organization across the country. Together, these plans provide health coverage for more than 100 million Americans. Paul also serves on the board of America’s Health Insurance Plans.

Paul is a North Dakota native and Rhodes Scholar with a master’s degree in philosophy, politics, and economics from Oxford University. He is a graduate of Colorado College, where he earned a Bachelor of Arts degree in International Political Economy and played Division I hockey.

Source: https://www.linkedin.com/in/paul-markovich/

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Investor and healthcare disruptor Mark Cuban joins The Other 80 to talk about his online pharmacy, Cost Plus Drugs, that is bringing affordable drugs with transparent markups to American households. Mark lays out his basic formula for taking overhead and complexity out of the US healthcare system by disaggregating huge vertical businesses and disintermediating middlemen.

In this episode, Mark Cuban pitches:

• That direct contracting with hospitals is his next healthcare disruption
• Why he thinks medical schools should be free
• How financial audits are a first step to lowering healthcare prices
• Why price transparency is contagious

Mark thinks the best way to make change is from outside the system:

“What makes [Cost Plus Drugs] radical is when we started, everybody presumed and expected that we would work within the system. That we would partner with the big three wholesalers that control 98% of the sale of drugs - that we would partner with the big three PBMs that control 85% of prescriptions. And, we did the exact opposite because we knew they were the problem.”

Relevant Links

• The Cost Plus Drugs mission statement
• Read and watch Mark Cuban testimony for the Senate Special Committee on Aging 
• More on Mark’s hospital negotiation strategy

About Our Guest

Mark Cuban is an investor who lives for his family, his "Shark Tank" companies and the Dallas Mavericks. He is the owner of the 2011 World Champion Dallas Mavericks and bestselling author of "How to Win at the Sport of Business," and was an entrepreneur from the early age of 12 when he sold garbage bags door to door. Today, Cuban is the highly successful entrepreneur and investor with an ever-growing portfolio of businesses.

A lifelong entrepreneur and investor, Cuban has started and built multiple industry-changing organizations including Costplusdrugs.com, which sells medications at industry low pricing with total cost transparency, which he founded with Dr. Alex Oshmansky. Named a winner of the GQ Men of the Year in 2006 and included in The New York Times Magazine's Year in Ideas, Cuban is recognized as being among the most influential people in both the cable and sports industries. He may be best known for his purchase of the Dallas Mavericks on Jan. 4, 2000. Under his leadership, the team's home games have become a total entertainment experience.

Prior to his purchase of the Mavericks, Cuban co-founded the first commercial streaming company AudioNet, which became Broadcast.com, the leading provider of multimedia and streaming on the Internet. Broadcast.com was sold to Yahoo! Inc. in July 2000. MicroSolutions, a leading national systems integrator, was co-founded by Cuban and partner Martin Woodall in 1983, and later sold to CompuServe.

In 2001, Cuban founded AXS TV (www.axs.tv) and sister network, HDNet Movies, the very first all high-definition TV network. He also co-owns the Landmark Theater chain, Magnolia Pictures, Magnolia Home Video and 2929 Productions along with partner Todd Wagner. With the release of the movie "Bubble" in 2005, Magnolia and Landmark Theaters pioneered the release of the movie's "day and date," meaning the movie was released in theaters, on TV (HDNet Movies) and on DVD all on the same day. Taking this process one step further, Cuban created the Ultra VOD platform, releasing movies to video on demand on both cable and satellite up to four weeks prior to their release in theaters. As an executor producer for 2929 and HDNet Films, Cuban has been nominated for seven Academy Awards® for "Enron," "The Smartest Guys In the Room" and "Good Night and Good Luck." He later sold HDNet in 2018.

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When David Fajgenbaum nearly died of Castleman disease for the fifth time, he decided to take fate into his own hands. Using his medical training, he searched for an existing drug that might save his life—and found one. Now his organization, Every Cure, is scaling the same approach to uncover hidden treatments for other diseases with no known cure.

David and Claudia discussed: 

• How Every Cure is using AI to test 75 million possible disease-drug combinations 
• The perverse incentives that keep generic drug repurposing in the shadows
• Why the hardest part of innovation isn’t discovery, it’s getting proven treatments into clinical practice

Repurposing existing drugs makes so much sense. But as David points out, there’s no market for it:

“Once a drug is generic.. the price is going to plummet… And even if you were to double the sales of your drug because you found a new disease area, now you've gone from 1% to 2% of what you got before… So there's no incentive whatsoever for our system to find a new use for a generic drug. Zero incentive.”

Relevant Links

• Learn more about Every Cure
• Read David’s book Chasing My Cure: A Doctor’s Race to Turn Hope Into Action
• Watch David's TEDTalk 
• Listen to David’s Podcast interview with Adam Grant
• Get info on the Dada2 Foundation
• Watch a video on Matt Might’s story 

About Our Guest

David Fajgenbaum, MD, MBA, MSc, is co-Founder & President of Every Cure and a physician-scientist at the University of Pennsylvania, where he is one of the youngest faculty members ever to receive tenure at Penn Medicine. He is also the national bestselling author of Chasing My Cure: A Doctor’s Race to Turn Hope Into Action, which is being adapted into a film by Forrest Gump producer Wendy Finerman. 

During medical school, Fajgenbaum discovered a treatment that saved his own life and founded the Castleman Disease Collaborative Network. He has advanced 13 more repurposed treatments for cancers and rare diseases and co-founded Every Cure to unlock more hidden cures from existing medicines which has received over $100M from ARPA-H and TED’s Audacious Project. He also serves on the Board of Directors for the Reagan-Udall Foundation for the FDA. 

One of the youngest recipients of multiple top NIH and FDA grants, Fajgenbaum has authored over 100 scientific papers in leading journals, including The New England Journal of Medicine, The Lancet, and The Journal of Clinical Investigation. He has been profiled by The New York Times, Good Morning America, TODAY, and Forbes 30 Under 30 and has received numerous honors, including the 2016 Atlas Award alongside then VP Joe Biden, 2022 NDRI Service to Science Award alongside Nobel Laureates Katalin Kariko and Drew Weissman, 2023 Philadelphia Citizen of the Year Award, and selection to the 2025 TIME100 Health list of the world’s most influential people in health. Fajgenbaum earned a BS from Georgetown University, MSc from the University of Oxford, MD from the University of Pennsylvania, and MBA from The Wharton School.

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Richmond, California used to be called America’s “Murder Capital”. But when city leaders chose a different path the city’s gun violence problem dramatically declined.  DeVone Boggan and UC Berkeley’s Jason Corburn join Claudia to discuss their new book “Advancing Peace”, which chronicles their efforts to reduce gun violence in Richmond and other cities by focusing on those most likely to pull the trigger. Boggan and Corburn make a case for an approach to gun violence interruption grounded in deep mentorship, community investment and healing and accountability.  

We discuss:

• The book's core ideas: ending urban gun violence with redemptive love
• How public health overlooks community strengths by fixating on risk
• Why Richmond’s Office of Neighborhood Safety sits in government - but outside policing

DeVone says that the greatest demonstration of this approach has always been Richmond: 

“From the moment we implemented the Peacemaker Fellowship in 2010, within 18 to 24 months after we did that, there were dramatic, precipitous reductions in gun violence… Our argument has been [that] when you get the right people to get at the right people the right way over a long period of time, here's living proof and demonstration of what can happen…In 2014, we achieved a 40 year low in gun violence [in Richmond].” 

Relevant Links

• Read Jason and DeVone’s book “Advancing Peace: Ending Urban Gun Violence through the Power of Redemptive Love”
• Listen to an episode from our archives with Megan Ranney on gun violence as a public health issue
• Check out Richmond, California’s Office of Neighborhood Safety
• Read more about Jason Corburn’s work at UC Berkeley
• Get more information on DeVone’s organization Advance Peace

About Our Guests

DeVone Boggan serves as Founder and CEO of Advance Peace. Advance Peace interrupts gun violence in American urban neighborhoods by providing transformational opportunities to young men involved in lethal firearm offenses and placing them in a high-touch, personalized fellowship. By working with and supporting a targeted group of individuals at the core of gun hostilities, Advance Peace bridges the gap between anti-violence programming and a hard-to-reach population at the center of violence in urban areas, thus breaking the cycle of gun hostilities and altering the trajectory of these men’s lives. 

DeVone is the former Neighborhood Safety Director and founding director of the Office of Neighborhood Safety (ONS) for the City of Richmond, California. The ONS is a government, non-law enforcement agency that is charged with reducing firearm assaults and associated deaths in Richmond. Under his leadership as Neighborhood Safety Director, the city experienced a 71% reduction in gun violence between 2007 when the office was created and 2016. His work with ONS has been recognized in national publications and media, including the New York Times, Mother Jones, The Nation, Detroit Free Press, The Washington Post, TIME Magazine, PBS NewsHour, NPR, NBC Nightly News, ABC Nightline, CNBC, MSNBC, and CNN. 

Prior to his tenure in Richmond, DeVone served as Policy Director for Safe Passages, a nonprofit public/private partnership focused on improving urban health outcomes for children, youth and families.

Jason Corburn is a Professor in the Department of City and Regional Planning and School of Public Health. He directs the Center for Global Healthy Cities and co-directs the joint Master of City Planning (MCP) and Master of Public Health (MPH) degree program at UC Berkeley. His research focuses on the links between environmental health and social justice in cities, notions of expertise in science-based policy making, and the role of local knowledge in addressing environmental and public health problems. Professor Corburn’s research and practice works to build partnerships between urban residents, professional scientists and decision-makers in order to collaboratively generate policy and planning solutions that improve the qualities of cities and the well-being of residents, particularly the poor and people of color.

Professor Corburn is currently leading the evaluation of the Advance Peace, urban gun violence reduction program. This project is operating in 10 cities across the US, hires formerly incarcerated residents to act as ‘credible messengers’ to interrupt conflicts and mentor those at the center of gun violence in each city.  The work takes a public health approach to eliminating gun violence, which means addressing the traumas experienced in disinvested in neighborhoods and helping to heal impacted people and places.

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Investor Nancy Brown joins us at Aspen Ideas Health to share her blueprint for impactful investments. Identify public health breakthroughs that deliver measurable cost and quality improvements — then show how they can thrive in the marketplace. You don’t have to look far to see this playbook in action. One of the year’s biggest health exits, Omada Health, is a digital version of the CDC’s Diabetes Prevention Program. At Oak HC/FT, Nancy has partnered with entrepreneurs who are redefining how America stays healthy — and she’s eager to see more people with public health roots take the leap into building impactful companies.

Please note: this conversation happened before HR1 was passed, so big Medicaid cuts were a threat but not yet a reality when we spoke.

In this episode, we discuss:

• Lessons from Todd Park in the early days of athenahealth
• How to turn good ideas into great businesses
• Nancy’s advice in an era of policy disruption: keep on building and proving value
• The lesson Kaiser Permanente is still teaching us

Nancy reminds us that in reality, even a brilliant idea needs to have ROI built in:

“We look for entrepreneurs, for innovators, who have really defined a way in which to find a cohort of patients,  it could be pregnant Medicaid moms... And they have identified if they apply a certain clinical process consistently to that population, they will get a consistently good outcome, quality outcome, and they can do it in a sustainable [way] at a sustainable price.”

Relevant Links

• Read Oak HC/FT’s AI Investment Policy
• Explore businesses Nancy mentioned from Oak HC/FT’s investment portfolio:
• Maven Clinic
• Oshi Health 

About Our Guest

Nancy Brown is a General Partner at Oak HC/FT, a leading venture and growth equity firm investing in transformative healthcare and fintech companies. Since joining Oak HC/FT at its inception in 2014, Ms. Brown has focused on identifying and supporting technology-enabled healthcare services that deliver measurable clinical and financial impact. She focuses on growth equity and early-stage venture investments in healthcare, serving on the boards of innovative companies such as Firefly Health, Groups Recover Together, InterWell Health, Maven Clinic, Oshi Health, Regard, Unite Us, and Wayspring. Her portfolio also includes Noom, TurningPoint Healthcare Solutions, Limeade (ASX: LME), OncoHealth, and OODA Health.

Ms. Brown brings over three decades of operational and leadership experience to her investment role. Prior to Oak HC/FT, she was Vice President of Strategy and Business Development at McKesson Technology Solutions and Chief Growth Officer at MedVentive (acquired by McKesson in 2012). Previously, she served as Senior Vice President of Clinical Services and Corporate Development at athenahealth, and earlier held senior roles at McKesson and Harvard Community Health Plan. She also co-founded Abaton.com, one of the first web-based clinical solution companies, which was later acquired by McKesson.

A graduate of the University of New Hampshire (B.S. in Zoology) and Northeastern University (MBA), Ms. Brown is an active mentor and advisor. She serves on Northeastern’s D’Amore‑McKim School of Business Dean’s Executive Council and is involved in the Roux Institute’s Future of Healthcare Founder Residency program.

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Grey’s Anatomy Executive Producer and physician Dr. Zoanne Clack joins The Other 80 at Aspen Ideas: Health to talk about what public health leaders can learn from Hollywood storytelling. After training as a doctor and working for the CDC, Zoanne followed her childhood dreams and moved to Hollywood. With no job or warm leads, Zoanne set out to use the power of storytelling to drive health change. 

We discuss:

• What Shonda Rhimes taught Zoanne about standing in power
• Making it as a Hollywood “showrunner”
• Why public health leaders should lean into storytelling

Zoanne reminds us that stories - even about fictional characters - have the ability to help us move the world: 

“I think just having that, that feeling of belonging, that feeling of these are my people, and I am very interested in what they're doing and thinking is just a great way for the media in Hollywood to have impact.”

Relevant Links

• Watch the two episode Zoanne mentioned are her favourites: “Fight the Power” (Season 17, Episode 5) and “The Time Warp” (Season 6, Episode 15)
• See Zoanne’s filmography

About Our Guest

Zoanne Clack is executive producer and showrunner for “Grey’s Anatomy” and “Station 19.” An emergency medicine physician turned TV writer and showrunner, Clack is best known for her influential writing roles on these critically acclaimed ABC-TV series, where she combines her medical background and artistic flair, offering a unique and authentic touch. As a writer/producer on "Grey's Anatomy" since the show began, she has played an integral role in the show's longevity and cultural impact. She uses her knowledge of entertainment education to promote global public health issues through the media, advocating for representation and inclusivity and providing diverse characterizations as well as poignant social commentary. Clack is co-chair of the Norman Lear Center’s Hollywood, Health & Society program at USC’s Annenberg School of Journalism and serves on the board or as an advisor of several global health groups.

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AI is going to transform healthcare - but how do we ensure it does so responsibly, equitably and ethically? Google’s former Chief Health Officer, Dr. Karen DeSalvo, says that AI could be public health’s new best friend - if we use it in the right ways. Karen  sits down with Claudia at Aspen Ideas Health to talk about her longtime career as a public health leader and where she sees a role for AI in helping to take some heat off public health communicators. She’s interested in how AI can support - not replace - our human values. 

We discuss:

• How AI health agents could personalize and simplify care, especially for patients navigating complex health challenges
• Why government should act as both regulator and convener to shape the future of how we use AI in health
• Our failure to scale and implement big ideas because we keep adding new layers instead of simplifying

Karen underscored that AI-enabled robots will bring new ethical challenges:

“I think when robotics becomes more commonplace, that also raises some of the need for us to be very thoughtful as a society about the ethical challenges when there's a physical manifestation of the models that's not just in a computer screen or even through your glasses, but as the robots get more and more humanoid.”

Relevant Links

• Read the Forbes article on Karen’s tenure at Google 
• Watch a Video where Karen introduces “Check Up”
• Read the Association of State and Territorial Health Officials’ spotlight on Karen
• Read Karen’s article about “Public Health 3.0”
• Check out Karen’s Health Affairs article on the future of public health 

About Our Guest

Dr. Karen DeSalvo is a physician executive working at the intersection of medicine, public health, and information technology to help everyone, everywhere, live a healthier life. She leads a team of experts at Google who build helpful products, develop AI solutions focused on some of the biggest health challenges and bring information and insights to consumers, caregivers and communities with the aim of democratizing access to health and healthcare. She provides clinical leadership for Google employee health, including as part of the company COVID response team. Prior to joining Google, Dr. DeSalvo was National Coordinator for Health Information Technology and Assistant Secretary for Health (Acting) in the Obama Administration. Dr. DeSalvo served as the New Orleans Health Commissioner following Hurricane Katrina and was previously Vice Dean for Community Affairs and Health Policy at the Tulane School of Medicine where she was a practicing internal medicine physician, educator, and researcher. She is co-founder of the National Alliance to Impact the Social Determinants of Health. Dr. DeSalvo serves on the Council of the National Academy of Medicine and the Board of Directors for Welltower.

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In a time where we need hope and innovation more than ever, we asked 13 health leaders—all guests on this podcast—what they would do to reimagine health. Tune into the episode to hear what they shared (in order of appearance):

• David Zipper, Senior Fellow, MIT Mobility Initiative 
• Maya Petersen, Professor of Biostatistics, Epidemiology and Computational Precision Health, UC Berkeley 
• Kody Kinsley, Senior Policy Advisor, Johns Hopkins University (former Secretary of HHS in North Carolina)
• Theresa Cullen, Director of Public Health, Pima County, AZ 
• Anne Zink, Lecturer & Senior Fellow, Yale School of Public Health (former Chief Medical Officer, Alaska
• Karen DeSalvo, former Chief Health Officer, Google 
• Palav Babaria,  Chief Quality and Medical Officer, California Department of Health Care Services 
• Jacey Cooper, President, Precision Health Strategies (former Medicaid Director in California)
• Pooja Mittal, Chief Health Equity Officer, Health Net
• Natalie Davis, Co-Founder and CEO, United States of Care
• Steve Downs, Co-Founder, Building H 
• Katie Drasser, CEO, Rock Health
• Zoanne Clack, Executive Producer, Grey’s Anatomy 

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When we think about digital tools and technology, we think of them as moving fast. Katie Drasser, CEO of Rock Health, joins me to discuss what a “slow tech” approach to health innovation could look like. It would ground innovation in participatory design, build community trust and aim for long term impact, not just rapid scaling.

We discuss:

• How she’s working to fix the broken investment cycle for women’s health
• Why impact—not just return—should guide the future of health innovation
• The big differentiator for youth mental health companies? Kids are at the table 

Katie reminds us that designing for the most overlooked ends up helping everyone:

“There's that theory – the curb cut theory – [that says] if you design for the most marginalized, if you design for the most overlooked, it's actually better for everybody. And so… how might we design for those most left out? And actually, the folks that are always included would actually benefit too.”

Relevant Links

• Visit the Rock Health website
• Listen to Podcast episode with Katie Drasser and Carolyn Witte
• Read the Rock Health report on women as digital health consumers
• Check out MindRight Health’s website - the youth mental health texting resource Katie mentioned in this episode

About Our Guest

Katie is an entrepreneurial leader committed to equality and justice who has launched groundbreaking, inclusive programs that address complex global issues with a focus on public health innovation and the role of innovative financing and leadership in systems change. As the CEO of RockHealth.org, she leads a team of experts in health equity, social enterprise and design to encourage more equitable innovation in digital health. Previously, Katie curated health content for the Aspen Ideas Festival and was Managing Director of the Aspen Global Innovators Group, where she led global leadership programs to address poverty alleviation and human rights. Katie has worked nationally and around the world on initiatives including HIV/AIDS treatment strategies in Romania, private health services delivery in Myanmar, and the scale up of Kenya’s national emergency medical system. She also built a range of start-ups, designing a network of charter schools, and developing Good Capital, a venture fund that invests millions in social enterprises like The Hub Bay Area and the Social Capital Markets Conference.

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On the surface, what the wellness industry is offering feels like an antidote to our fragmented and fast-paced lives. Influencers and companies use words like "mindfulness" or “whole foods” or “self care” to get our stressed out, burnt out buy in. But, somewhere along the line those promises start to morph into luxury services, expensive memberships and supplements you never knew you needed. In her book “How to Be Well” former fashion journalist Amy Larocca explores the blurred line between healing and branding in a $6 trillion dollar industry.

We discuss:

• Why our current wellness craze mirrors 1930s pre-Nazi Germany
• How Abraham Flexner completely changed how we teach medicine in the US for better – and for worse
• Why the spiritual and community void left by declining religious participation leads people to look to the wellness industry for both

Amy says what attracts people to the modern fitness class has parallels to religious practices:

“So if you look at what happens in ritual religious gatherings… You see a lot of that replicated in a lot of these boutique fitness settings. You have ritual, you have music, you have ecstatic movement, you have charismatic leaders, you have a sermon. And these sermons have increasingly moved away from talk of muffin tops and bikini bodies and losing that whatever it is, to kindness, community, thinking about your place in the world, thinking about taking the energy that you are building up in that room and spreading it forward. ”

Relevant Links

• Buy Amy’s book “How to Be Well: Navigating Our Self-Care Epidemic, One Dubious Cure at a Time”
• Read this Wikipedia page on Martine Rothblatt’s robot replica of her wife Bina
• Check out  this article on the impact of the Flexner report on US medicine
• Read the book “McMindfulness” Amy mentions in the episode
• Sign up for Lamar’s SoulCycle class

About Our Guest

Amy Larocca is an award-winning American journalist. She spent 20 years working at New York Magazine as both Fashion Director and Editor at Large. Her writing has appeared in the New York Times, Vogue, Town & Country, and the London Review of Books, among others. She lives with her family in New York and North London.

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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 [email protected] and follow us on twitter @claudiawilliams and LinkedIn

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