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Ep 70  |  John Kitzhaber

John Kitzhaber: “What Makes a Healthy Society?”

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TGS70 John Kitzhaber The Great Simplification

Episode 70
May 10th, 2023

(Conversation recorded on April 13th, 2023)  

Show Summary

On this episode, former Governor of Oregon and ER Doctor John Kitzhaber joins Nate to discuss the shortcomings of the medical system in the United States. With health outcomes below average compared to other developed nations and healthcare spending at nearly 20% of GDP, creating medical systems that are less costly while also keeping people healthier is critical to the well-being of the country and its citizens. Dr. Kitzhaber’s hands-on experience working in medicine and systemic perspective as a policymaker gives him a unique perspective on healthcare resource allocation, the effectiveness of medicine, and the real world effects of how we incentivize medical care. Can we extend our time horizons by making long-term investments in the most effective preventative care? How do we take care of more people with fewer resources available? Most of all, can we come together to think critically about how we can create a system that prioritizes holistic health, based in community and accessible to everyone?

About John Kitzhaber

John Kitzhaber has more than 40 years of experience in health care and health policy in both public and private sectors. He practiced as an emergency room physician for 15 years; served 14 years in the Oregon Legislature, and served three terms as Governor of the State of Oregon.

Kitzhaber is the author of the groundbreaking Oregon Health Plan, through which hundreds of thousands of low- and moderate-income Oregon families gain access to health care. During his third term as Governor, Kitzhaber was the chief architect of Oregon’s Coordinated Care Organizations, the first effort in the country created on a statewide basis to meet the Triple Aim—better health, better quality, lower cost—with a focus on community and population health.

In French, we have a motto that says that a simple drawing is often better than a long explanation. Jean-Marc Jancovici Carbone 4 President

That’s very understandable because with left atmosphere thinking, one of the problems is that you see everything as a series of problems that must have solutions. Iain McGilchrist Neuroscientist and Philosopher

We can’t have hundreds and hundreds of real relationships that are healthy because that requires time and effort and full attention and awareness of being in real relationship and conversation with the other human. Nate Hagens Director of ISEOF

This is the crux of the whole problem. Individual parts of nature are more valuable than the biocomplexity of nature. Thomas Crowther Founder Restor

Show Notes & Links to Learn More

00:00 – John Kitzhaber Works + Info

00:23 – Healthcare is 19% of the size of our economy

00:29 – The US has lower health outcomes compared to other developed nations

00:56 – Oregon Health Plan and Coordinated Care Organization

02:36 – 12,900 per capita is spent on healthcare in the US per year

02:55 – US has the highest infant mortality rate and lower life expectancy among OECD nations

03:29 – US healthcare focuses on acute medical care rather than early life investment

03:52 – US is 4% of the global population but has 50% of the prescriptions

04:28 – The US has no limited price regulations on pharmaceuticals 

04:32 – 1 of 2 nations that allows direct to consumer advertising 

07:17 – Half of cancer patients will have been in collections, and 4-5% have to file bankruptcy

07:42 – [First] leading cause of bankruptcy is having to pay a medical bill

10:34 – Coby Howard

12:35 – Controversiality of OHP in Washington

14:17 – 25 cents on every dollar is wasted in terms of positive outcome in the medical system

20:13 – Medicare Advantage

20:36 – Risk Adjustment

21:04 – 31 trillion dollars in debt federally

21:25 – Healthcare is a huge lobbying force

22:25 – Issues with GDP as a measure for success

22:35 – Bhutan alternative to GDP

22:49 – WHO definition of health

24:40 – [93%] of Americans have some metabolic dysfunction

25:17 – A bulk of Americans’ lifetime healthcare costs are in the last 6 months of their life

25:45 – Epigenetics

25:53 – Poor nutrition and toxic stress alters the genetic expression in the unborn child which increases risk for behavioral and addiction issues in the future

28:28 – Other OECD nations spend more on social investments that are predictors of health

29:05 – Processed food is 3 times cheaper than ‘real’ food

29:44 – Poverty and race are huge predictors of health outcomes

30:13 – Investing in early life care will have economic returns of 7:1

31:14 – 10% of your lifetime health status is a result of involvement with the health system

37:08 – ¼ of FDA employees now work at/consult for pharmaceutical companies

37:29 – ⅔ of the 2019 members of Congress who are now retired work in the lobbying industry

42:18 – Fee-for-service reimbursement

44:56 – Thích Nhất Hạnh

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