Health Policy Podcast

Ross Marchand, executive director of the Taxpayers Protection Alliance, discusses his organization's report Blocking Breakthroughs, which examines FDA drug rejection rates. He said that regulatory barriers, shifting standards, and excessive risk aversion are delaying patient access to potentially life-saving treatments, even as other developed countries approve the same drugs.

Nurse practitioner and author Cynthia Thurlow discusses her transition from traditional allopathic medicine to a lifestyle-focused practice centered on perimenopause and menopause care. She explains the evolving role of nurse practitioners in the U.S. healthcare system, including their training, scope of practice, and ability to help fill gaps created by physician shortages.  Thurlow highlights key systemic challenges shaping modern healthcare, including insurance-driven decision-making, declining reimbursement rates, consolidation of private practices, and the growing administrative burden on clinicians. She also addresses the rise of concierge medicine and the tension between efficiency and patient-centered care, particularly as technology and electronic medical records reshape doctor-patient interactions.  The conversation also explores the potential and risks of artificial intelligence in medicine, with Thurlow emphasizing the importance of maintaining human judgment and connection in clinical care. She warns against overreliance on AI while acknowledging its usefulness in streamlining certain tasks.  Finally, Thurlow introduces her book The Menopause Gut, which focuses on the role of the gut microbiome in women's health during midlife. She outlines how hormonal changes impact gut health and presents a holistic framework involving lifestyle, nutrition, and targeted therapies to support long-term wellness.

  Emergency physician Dr. Colleen Smith discusses how government regulations and market distortions have contributed to the rise of large, vertically integrated healthcare corporations. In the interview, she explains how policies such as certificate-of-need laws, Stark regulations, and the structure of employer-based insurance have limited competition and consumer choice in healthcare. Smith argues that simply breaking up large healthcare companies will not solve systemic problems unless policymakers also reform regulations, expand health savings options, and restore competition in the healthcare marketplace. Smith is an emergency medicine physician in New York City and a visiting fellow at the Center for Modern Health.  

Peter Mihalick, health policy and advocacy director for the International Hearing Society and a former congressional staffer, discussed the federal 340B drug discount program on a recent episode of the Health Policy Podcast, highlighting concerns about its rapid expansion and lack of oversight.  Mihalick explained that the program was originally designed to help safety-net providers serve low-income patients by allowing them to purchase outpatient drugs at steep discounts. However, he said the structure does not require hospitals or clinics to pass those savings directly to patients, raising questions about whether the program is meeting its intended goals.  The discussion focused on how large hospital systems can generate significant revenue through the program, while patients may still face high out-of-pocket costs for medications. Mihalick also pointed to the growing role of contract pharmacies and the complexity of drug pricing flows as barriers to transparency and accountability.  He noted that recent policy efforts, including provisions tied to the Inflation Reduction Act and regulatory actions, aim to increase transparency, but may not address underlying structural issues. Mihalick said reforms such as clearer definitions, stronger guardrails, and mechanisms to ensure patients benefit directly from discounts could help realign the program with its original purpose.  

Nathan Benefield, Chief Policy Officer of the Commonwealth Foundation, joins the Health Policy Podcast to examine whether the Affordable Care Act has achieved its core promise of lowering health care costs. Sixteen years after its passage, Benefield argues that rising premiums, expanded subsidies, and increased government spending have failed to reduce costs for families. The conversation explores the impact of temporary COVID-era subsidy expansions, declining competition on insurance exchanges, and what Benefield describes as "perverse incentives" built into the subsidy structure. He discusses the difference between insurance coverage and actual access to care, the strain Medicaid places on providers, and how mandates and regulations shape pricing in the current system. Benefield also outlines potential reforms, including expanded health savings accounts, interstate insurance competition, direct primary care models, scope-of-practice reforms, and greater price transparency. As debates continue in Congress over subsidies and federal spending, this episode examines whether meaningful reform is possible — and what a more patient-centered system might look like.  

Susan Goldhaber, writer for the American Council on Science and Health and a former EPA researcher, joins the Health Policy Podcast to examine the renewed debate over fluoride in drinking water. With decades of experience studying fluoride standards, Goldhaber explains the history of fluoridation — from early 20th-century dental discoveries to its adoption as a major public health measure after World War II. The conversation explores why the EPA is conducting a new toxicity assessment, the controversy surrounding recent National Toxicology Program findings linking higher fluoride levels to potential IQ effects, and the arguments from both sides of the debate. Goldhaber breaks down the science behind fluoride exposure levels, discusses how today's broader sources of fluoride complicate the issue, and weighs the growing influence of the "Make America Healthy Again" movement against the longstanding position of the American Dental Association. As legal challenges and regulatory reviews unfold, this episode examines where the science stands — and where the battle over fluoridation may head next.  

On this episode of the Health Policy Podcast, Brian Hyde speaks with Pete Sepp, President of the National Taxpayers Union, about the accelerating financial crisis facing Medicare and other federal healthcare programs  Sepp outlines how Medicare Part A is projected to become insolvent in 2033—just one year after Social Security's trust fund is expected to fall short—triggering an automatic 11% cut in hospital insurance benefits unless Congress acts. He explains that healthcare spending now accounts for more than a quarter of federal expenditures and continues to grow, even after recent reforms to Medicaid. A central focus of the conversation is the bipartisan "No Upcode Act," introduced by Senators Bill Cassidy and Jeff Merkley, which aims to curb an estimated $40 billion in annual Medicare Advantage overpayments caused by insurers overstating patient diagnoses  Sepp describes how the bill would require stronger verification of diagnoses—such as in-person doctor visits and multi-year data review—to protect both taxpayers and patients. Beyond Medicare, Sepp warns that Social Security and even the Highway Trust Fund face similar fiscal countdowns, arguing that lawmakers elected this cycle will confront unavoidable funding cliffs during their terms  The episode explores the intersection of healthcare policy, federal spending, and economic freedom—and the urgent need for reform before automatic cuts or tax hikes become the only remaining options.  

On this episode of the Health Policy Podcast, Jennifer and Maya Reinhardt share their powerful story of battling cystic fibrosis and a life-threatening antibiotic-resistant infection. When traditional treatments failed and FDA barriers stood in the way, Jennifer fought to access bacteriophage therapy — an international treatment not approved in the United States at the time. The journey required extensive research, travel to Oregon, international coordination, and navigating federal red tape, all while Maya's health rapidly declined. The treatment ultimately stabilized Maya long enough for her to later benefit from FDA-approved breakthrough therapy Trikafta. Their experience highlights the urgency behind Right to Try 2.0 legislation, which aims to streamline access to individualized, doctor-supervised treatments without lengthy federal delays. The Reinhardts argue that when patients are facing terminal or severe illness, time and access should not be determined by bureaucracy. Their story is a case for restoring hope and medical autonomy to families fighting for survival.  

Joel White, president of the Council for Affordable Health Coverage, joins the Health Policy Podcast to discuss why health care costs continue to rise despite years of reform efforts. Drawing on his experience as former staff director of the House Ways and Means Health Subcommittee and co-author of the Health Savings Account law, White argues that market consolidation, regulatory complexity, and structural flaws in the Affordable Care Act have created localized monopolies that drive prices higher for American families. White outlines how vertically integrated insurers and providers shape today's health system, explains why subsidies may unintentionally fuel premium increases, and proposes principles for reform — including transparency, consumer choice, direct support to individuals instead of insurers, and stronger enforcement of antitrust laws.  

On this episode of the Health Policy Podcast, Brian Hyde speaks with Brian Norman, Director of State Affairs at the Goldwater Institute, about the push to expand "Right to Try" laws to include individualized and gene-based treatments. Norman explains how the original Right to Try movement, signed into federal law in 2018, allowed terminally ill patients to access investigational drugs that had passed Phase I FDA safety trials. Now, Goldwater is advancing "Right to Try 2.0," aimed at creating a clearer regulatory pathway for patients with rare and ultra-rare diseases to access personalized treatments such as gene and immunotherapies. Norman argues that the FDA's traditional approval process—designed for mass-market drugs—can take a decade and cost more than $1 billion, making it impractical for treatments serving small patient populations  The conversation highlights the story of an Arizona family forced to relocate to Italy during the COVID-19 pandemic so their young daughter could receive an individualized gene therapy unavailable in the United States. Norman outlines the safeguards built into the proposal, addresses concerns from medical ethicists about patient safety and "false hope," and explains how Goldwater works at the state and federal levels to reduce regulatory barriers and expand patient choice. The episode explores the tension between innovation and oversight—and asks whether patients facing life-threatening conditions should have greater freedom to pursue promising, personalized care.  

Dr. Valerie Fuller, president of the American Association of Nurse Practitioners (AANP), joined the Health Policy Podcast to discuss a federal policy proposal that could have significant implications for the health care workforce and patient access to care across the country. AANP is the largest organization representing nurse practitioners in the United States. In January, the U.S. Department of Education released a proposed rule that would redefine which degree programs qualify as "professional" for the purposes of federal student loan limits. While this may sound technical, the decision could directly impact nurse practitioner students and, ultimately, the availability of care in communities nationwide. Dr. Fuller discussed what this proposal means and why it has drawn national attention.

Monique Yohanon, a physician and Senior Fellow for Health Policy at Independent Women, joined the Health Policy Podcast to discuss the FDA's newly released dietary guidelines and why decades-old recommendations were overdue for change. Yohanon explained how the traditional food pyramid and low-fat framework shaped American eating habits for more than 40 years, often with unintended consequences for metabolic health. She outlined why newer guidance places greater emphasis on protein, healthy fats, and fiber, and how these shifts better reflect current scientific understanding. The conversation also explored the importance of personalized nutrition, noting that one-size-fits-all dietary advice often fails to account for individual health needs. Yohanon raised concerns about the growing influence of political and bureaucratic priorities in shaping nutrition policy, warning that public health guidance can suffer when ideology overrides evidence. The episode examines what these updated guidelines mean for consumers and policymakers, and why restoring trust in nutrition science requires transparency, flexibility, and a renewed focus on real food.

What does it say about a country's health system when chronic illness becomes normal in childhood? In this episode of the Health Policy Podcast, I sit down with Steve Cortes, former senior advisor to President Trump and a documentary filmmaker, to unpack the thinking behind the Make America Healthy Again, or MAHA, movement. Steve argues that the timing is no coincidence. He points to a convergence of troubling indicators, from rising rates of chronic illness among U.S. children to declining life expectancy and a shrinking pool of young adults physically eligible for military service. Taken together, he believes these trends signal a deeper systemic failure rather than isolated public health challenges. We also reflect on how the COVID-19 pandemic acted as a catalyst rather than a cause. According to Steve, the last few years exposed structural weaknesses in the medical establishment and accelerated public skepticism around authority, incentives, and transparency. Our conversation explores how that moment reshaped attitudes toward informed consent, preventive care, and the role of diet and lifestyle in long-term health outcomes. Rather than framing MAHA as a partisan response, Steve positions it as a reaction to data that many policymakers have struggled to confront head-on. We close by discussing Steve's MAHA documentary and where listeners can watch it. The film shifts the focus away from reactive, late-stage interventions and toward upstream prevention, asking why health systems are so often designed to treat crisis rather than support everyday wellbeing. It is a conversation that challenges assumptions about medicine, policy, and responsibility, and invites a broader rethink of how health is defined and protected in the first place. If the data keeps pointing in the same direction, are we prepared to rethink healthcare before the next crisis forces the issue, and what would that shift actually require?

Fred Roeder, health economist and managing director of the Consumer Choice Center, joined the Health Policy Podcast to explain why price transparency remains one of the biggest failures in the U.S. healthcare system. Roeder discussed how opaque hospital pricing leaves patients exposed to unexpected medical bills, even for routine procedures such as MRIs and lab work. During the conversation, Roeder outlined how high deductibles and cost-sharing mean patients often pay thousands of dollars out of pocket before insurance coverage applies, making price awareness critical. He shared real-world examples showing how the same medical service can vary dramatically in cost depending on the provider, even when quality and equipment are identical. Roeder also addressed structural issues driving high healthcare costs, including weak enforcement of hospital price transparency rules, administrative overhead, and the misuse of the federal 340B drug pricing program, which allows hospitals to purchase discounted drugs without passing savings on to patients. He argued that these practices contribute to rising premiums, medical debt, and reduced consumer trust. The episode concludes with practical advice for patients, including how to ask the right questions before scheduling non-emergency care, how to compare providers, and why stronger enforcement of existing transparency laws is necessary to restore consumer choice and accountability in healthcare.

Jared Rhoads, Director of the Center for Modern Health, joins the Health Policy Podcast to discuss why healthcare has drifted away from free-market principles and why reform remains so difficult. Rhoads explains how healthcare evolved from an individual responsibility into a government-managed system, driving bureaucracy, compliance costs, and reduced innovation. He also outlines how a more market-driven approach could improve efficiency, lower costs, and restore accountability in today's healthcare system.

In this episode of the Health Policy Podcast, Ryan Ellis, president of the Center for a Free Economy, discusses the expiration of COVID-era Affordable Care Act subsidies and why he believes they should not be extended. Ellis explains how the ACA's design mandates limit competition, drive up insurance premiums, and distort the healthcare market. He also examines the political incentives behind continued subsidy expansion, the role of insurers and hospital systems, and recent examples of fraud within federal assistance programs. The conversation highlights the need for stronger oversight, work requirements, and long-term structural reforms to restore accountability and sustainability in U.S. healthcare policy. 11:00  

In this episode of the Health Policy Podcast, Ross Marchand, executive director of the Taxpayers Protection Alliance, examines how the federal 340B drug pricing program has strayed far from its original intent. Marchand explains how a program designed to lower prescription drug costs for vulnerable patients has evolved into a system that allows large, well-funded hospitals to purchase discounted drugs, sell them at full price, and retain the profits—amounting to billions of dollars annually. The discussion also explores why the Affordable Care Act continues to be treated as politically untouchable, despite market distortions that benefit healthcare providers and insurers while leaving patients and taxpayers behind. Marchand outlines potential paths forward, including meaningful reform of the 340B program or eliminating it entirely to restore transparency, accountability, and fairness in healthcare pricing.  

In this intro episode of the Health Policy Podcast, host Brian Hyde explains why this show exists and what listeners can expect from future conversations. He argues that healthcare policy is among the most complex and consequential areas of public life, yet many of its most important decisions happen behind closed doors in Washington, inside large health systems, or within organizations that benefit from the status quo. Patients and taxpayers often feel the effects of these policies without ever seeing how or why choices were made.  Hyde sets out a clear mission for the podcast: to bring transparency, accountability, and intellectual clarity to healthcare policy discussions. He describes the kinds of guests the show will feature, including policy experts, economists, and analysts, and outlines the core questions that will shape each episode. These include how incentives drive behavior in healthcare, why costs keep rising, how public programs are structured, and where policy design creates friction or failure. The episode also establishes what the podcast will not be, it is not about outrage, clickbait, or defending institutions for their own sake. Instead, it aims to create a space for careful, informed, and practical conversations about how the system operates and where reform is genuinely needed. By the end of the episode, listeners have a clear sense of the show's purpose, its audience, and why deeper understanding is a prerequisite for meaningful policy debate.