EPISODE SUMMARY
The Audience will learn about Dr. Marschall Runge and his two books where he describes the chaos that ensues in his novel Coded To Kill and the chaos ensuing today in his upcoming book The Great Healthcare Disruption.
Marschall S. Runge, M.D., Ph.D., is the executive vice president for Medical Affairs at the University of Michigan, dean of the Medical School, and CEO of Michigan Medicine. He earned his doctorate in molecular biology at Vanderbilt University and his medical degree from Johns Hopkins School of Medicine, where he also completed a residency in internal medicine. He was a cardiology fellow at the Massachusetts General Hospital. He is the author of over 250 publications and holds five patents for novel approaches to health care. As a Texas native who spent fifteen years in North Carolina and an avid thriller reader, Runge has experienced so many you-can’t-make-this-up events that his transition to fiction was inevitable.
#TheGreatHealthcareDisruption
https://www.linkedin.com/in/marschallsrunge/
Frank R. Harrison kicks off the episode with returning guest Phyllis Quinlan and introduces Dr. Marschall Runge, author of the upcoming book The Great Healthcare Disruption, to explore the complexities and systemic challenges facing modern healthcare. Together, they discuss how fragmentation, miscommunication, and policy shifts—particularly around Medicare—are creating confusion for both patients and providers, emphasizing the need for informed advocacy and structural reform. Dr. Runge’s book, set for release on May 6th, aims to spark essential conversations about improving care quality, leveraging AI, and ensuring equitable access for all.
Frank R. Harrison formally introduces Dr. Marschall Runge, a top healthcare executive and author, who joins Phyllis Quinlan to examine why the U.S. healthcare system remains the most expensive globally without delivering superior outcomes. They discuss systemic shortfalls including the declining number of primary care providers, unequal reimbursement models, and the flawed RVU system, all of which disincentivize essential yet lower-paid roles. Dr. Runge emphasizes that true healthcare reform requires educational overhaul, smarter use of AI, and a societal shift in expectations—moving from reactive high-cost treatments to proactive, accessible care for long-term wellness.
Frank, Phyllis, and Dr. Marschall Runge explore Chapter 10 of The Great Healthcare Disruption, emphasizing the need for systemic, technological, and behavioral transformation in healthcare. They highlight how tools like wearable devices and AI-driven monitoring (especially for chronic conditions like diabetes) can reduce long-term complications and healthcare costs—if patients are engaged and educated from an early age. Dr. Runge advocates for policy shifts toward longitudinal, government-supported primary care access, drawing on international models like Denmark, and suggests that federal purchasing power and long-term ROI thinking are key to curbing pharmaceutical and insurance-driven cost inflation.
As the episode wraps up, Dr. Marschall Runge addresses the deep disconnect between the clinical mission of care providers and the profit-driven motives of insurers and pharmaceutical companies. He underscores how private equity and shareholder pressures often drive up healthcare costs, while also acknowledging the life-saving innovations from Big Pharma—if only those could be made more equitably accessible through mechanisms like federal purchasing power. The discussion ends with a call for value-based insurance models, readiness for future health crises, and a shared belief that patients must become empowered co-navigators of their health in this age of disruption and innovation.
00:00:35.120 --> 00:00:38.920 Frank R. Harrison: Hey, everybody, and welcome to a new episode of Frank about health
00:00:39.050 --> 00:00:45.619 Frank R. Harrison: today it is my honor to bring back Phyllis Quinlan to join me in a follow-up discussion of what we had
00:00:46.030 --> 00:00:57.389 Frank R. Harrison: a couple weeks ago, when we questioned if healthcare disruption was fact or fiction, however, no better than to have Dr. Marshall Runji, today's guest
00:00:57.600 --> 00:01:11.639 Frank R. Harrison: help us outline that further, especially in his upcoming book, The Great Healthcare Disruption, to be released on May 6th next Tuesday, and for that reason this is going to be kind of an experiment here on Frank about health.
00:01:11.770 --> 00:01:33.239 Frank R. Harrison: We're 1st going to have a usual episode, which is a discussion that Phyllis and I will have with Dr. Marshall Runji to explain his background, to explain his thoughts on healthcare disruption in our society as well as in medicine and in healthcare, as an example.
00:01:33.370 --> 00:01:36.249 Frank R. Harrison: But then, on the 8th we'll have a live.
00:01:36.430 --> 00:01:57.840 Frank R. Harrison: actual discussion about the book, which, when is is released, you will be able to have live question and answers and interaction with Dr. Ranji, and we hope to to be a very good campaign of sorts, but showing how frank about health continues to advocate for innovators and medical practitioners in healthcare.
00:01:58.030 --> 00:02:18.660 Frank R. Harrison: Now I will issue my disclaimer. Anyone out there listening to any of the content we are discussing today about healthcare related issues that could be sensitive in nature, based on personal or professional experience. They are not the views of talkradio Dot, Nyc. Or of Frank about health, but rather the views of
00:02:18.720 --> 00:02:30.609 Frank R. Harrison: medical professionals and experts and individuals like myself, who have been patients of various services, and who know whether or not what we discussed today has efficacy or not.
00:02:30.680 --> 00:02:56.640 Frank R. Harrison: If you find it disagreeable. I have no problem saying, this is not the show for you. I just want it clear that we're here to educate and explain that health care is not only something that we all have to learn to manage, but we have to own outright, and that's what I'm aiming Frank about health to do with Dr. Marshall Runji and Phyllis Quinlan on today's show as well as on the special show that we will have next week.
00:02:57.480 --> 00:03:21.009 Frank R. Harrison: There's my disclaimer that all being said first, st Phyllis, thank you again. You have always been my wingwoman of sorts, especially when dealing, as you know, with very serious medical topics, but me without the credibility of being a medical professional myself. I know you are able to help me double and triple. Check the facts and issues that we will be discussing.
00:03:21.110 --> 00:03:24.910 Frank R. Harrison: And then, Dr. Marshall Runji, we've only spoken for the last
00:03:25.140 --> 00:03:40.239 Frank R. Harrison: 4 months. But I'm glad we finally have a chance to have you here on Frank about health. Even our initial discussions have been amazing in terms of the pending book which is now to become a reality. And
00:03:40.410 --> 00:03:45.560 Frank R. Harrison: I can say that I've had a lot of personal experience with many of the issues you discuss on the book.
00:03:46.046 --> 00:03:51.180 Frank R. Harrison: So welcome to Frank about health. I do want to introduce your background. But
00:03:51.300 --> 00:03:57.930 Frank R. Harrison: why don't you unmute yourself? Why don't you give your own thoughts first, st and then I'll really give your bio the full
00:03:59.510 --> 00:04:01.730 Frank R. Harrison: expression it deserves.
00:04:02.450 --> 00:04:04.869 Marschall Runge: Well, thank you, Frank, and thank you, Phyllis. It's
00:04:05.010 --> 00:04:09.609 Marschall Runge: privileged to be on with you today, and I look forward to our discussion very much.
00:04:10.485 --> 00:04:19.450 Marschall Runge: This book that it's been completed will come out next week. The great healthcare Disruption is
00:04:19.860 --> 00:04:24.819 Marschall Runge: something that I had the opportunity to write with Forbes, and
00:04:25.400 --> 00:04:29.450 Marschall Runge: really was a unique opportunity to discuss
00:04:29.700 --> 00:04:44.199 Marschall Runge: in the book topics that I think are going to be very important in healthcare over the coming 5 to 10 years, and I've spent virtually my entire well, not quite my entire adult life, but the last 40 years in healthcare, and
00:04:45.680 --> 00:04:46.820 Marschall Runge: think that there's
00:04:47.030 --> 00:04:52.419 Marschall Runge: no better time than today to be thinking about, how can we improve the health of Americans?
00:04:52.770 --> 00:04:58.039 Marschall Runge: And I am involved in medical student training, resident training
00:04:58.260 --> 00:05:01.159 Marschall Runge: run in large health system. So it's
00:05:02.210 --> 00:05:07.120 Marschall Runge: I really look forward to our conversation because you both will bring great wisdom to the topic.
00:05:07.920 --> 00:05:09.530 Frank R. Harrison: Excellent, excellent!
00:05:10.390 --> 00:05:22.159 Frank R. Harrison: Oh, well, I was also going to say that. You know it has been probably 135 episodes. Now that I've done this podcast and for the 1st 3 and a half years of it, it has been like
00:05:22.270 --> 00:05:39.140 Frank R. Harrison: an individual growing into the role of advocate, especially when doing actual caregiving for members of my family, as well as having guests come on the show and really talk about their own personal stories and whatever. But I've always been
00:05:39.490 --> 00:05:57.589 Frank R. Harrison: seeking a medical professional such as yourself, to be on the show, and I'm very excited. You're actually helping me pivot the show, and to be the advocacy platform it's headed towards in 2025, especially with all the chaos that we are experiencing, and Phyllis knows firsthand
00:05:57.620 --> 00:06:26.279 Frank R. Harrison: how I had to take a hiatus just to retool everything for the unknown changes we were going to be seeing at the turn of the year. So that being said, I have this thought of healthcare disruption, like in the title of your book, but I think it's kind of obvious that I'm starting with the disruption that we see in our society at large without getting into names or specifics. Can you give an overview as to where that chaos is coming from? Is it coming from
00:06:26.410 --> 00:06:31.440 Frank R. Harrison: any planned place or just basic ignorance. What would you say.
00:06:33.278 --> 00:06:34.750 Marschall Runge: I I think that
00:06:35.670 --> 00:06:44.460 Marschall Runge: the it's at several levels 1st Level is, I'll bet the 3 of us could agree that health care in the United States is not perfect.
00:06:44.990 --> 00:06:53.319 Marschall Runge: agree with that. And this this. So the concept that we can do better in healthcare, and particularly in
00:06:53.430 --> 00:06:57.650 Marschall Runge: helping all of us, meaning all Americans be healthier
00:06:57.770 --> 00:07:06.890 Marschall Runge: is not a new idea. There certainly are strong feelings about how to best accomplish that, and I think those are throughout
00:07:07.130 --> 00:07:10.019 Marschall Runge: the spectrum of being
00:07:10.400 --> 00:07:17.199 Marschall Runge: very dogmatic about what needs to be done versus more inclusive, and thinking about what needs to be done, and and I think
00:07:17.830 --> 00:07:21.620 Marschall Runge: that I hope that conversations like this will lead us to
00:07:23.380 --> 00:07:31.350 Marschall Runge: being advocates, for how can we best improve health care? Make it highest quality? We all focus on
00:07:32.130 --> 00:07:38.499 Marschall Runge: the patient. And what can we do for the patient? I think as long as we keep our focus on the patient, we'll do right
00:07:38.970 --> 00:07:41.580 Marschall Runge: with our patients and with healthcare.
00:07:42.000 --> 00:07:43.809 Frank R. Harrison: Yes, yes, I agree.
00:07:43.990 --> 00:08:07.720 Frank R. Harrison: I mean for me, disruption is a case where you go to the doctor, and it's not one solution fits all, you have a doctor or a nurse, or an emergency room attendant, or an Ems person, all looking at your case and having a different interpretation based on their skill level, and it can be confusing if you're the patient and not really know what's happening.
00:08:07.720 --> 00:08:33.060 Frank R. Harrison: But if you're someone who already has a sense of what to look for and what to ask and how to describe your condition. You have a way of managing and creating a team building exercise, but I think that's why it's not perfect. Not everyone has that expertise, and I guess if you have already been living your life with a chronic illness, you kind of inherit the expertise through experience. But if you're not in that position, and you're just finding yourself.
00:08:33.340 --> 00:08:48.660 Frank R. Harrison: as they would say, flying blind and trying to deal with all the interpretations I can only imagine the anxiety that any patient would have without having the right advocate behind them, and, I gather, is that safe to say, that's what your book is going to be helping
00:08:48.840 --> 00:08:55.780 Frank R. Harrison: patients and other professionals learn how to muddle through the chaos that's going on.
00:08:56.290 --> 00:08:59.420 Marschall Runge: I hope it. I hope it'll be an opportunity for people to.
00:08:59.520 --> 00:09:03.119 Marschall Runge: I think, at least reflect on what I think are the biggest
00:09:03.300 --> 00:09:12.480 Marschall Runge: disruptions. Some are positive, some are not so positive that will be seen, and how they incorporate that into their view of health and view of their own health.
00:09:13.220 --> 00:09:15.169 Frank R. Harrison: Yes, no, I agree
00:09:15.500 --> 00:09:22.880 Frank R. Harrison: so, Phyllis. What do you think I mean? Obviously it is a matter of fact, not fiction. What? What would you say? Are your views
00:09:23.320 --> 00:09:23.810 Frank R. Harrison: similar.
00:09:23.810 --> 00:09:30.490 Phyllis Quinlan: Well, you know, as we spoke about a couple of weeks back, I am concerned. You know about the
00:09:30.760 --> 00:09:33.430 Phyllis Quinlan: the recent
00:09:33.550 --> 00:09:39.839 Phyllis Quinlan: executive orders that are coming out of Washington, and how disruptive they are potentially going to be. Because I'm
00:09:40.360 --> 00:09:56.339 Phyllis Quinlan: here's the thing. I'm not sure what's fact and what's fiction? And we spoke at length, a couple of weeks ago, about making sure wherever you got your information it was factual and reliable, and that's very difficult to ascertain.
00:09:56.530 --> 00:10:23.089 Phyllis Quinlan: You know I am concerned that there are going to be cuts to Medicare again. I don't think people realize that 2 thirds of the people who are in nursing homes and and need skilled nursing care of some sort. Some nature are dependent upon Medicare. I don't think people really understand that the remaining portion of the people on Medicare are children, and
00:10:23.210 --> 00:10:25.529 Phyllis Quinlan: and perhaps their mothers and
00:10:25.640 --> 00:10:42.739 Phyllis Quinlan: people with developmental issues and and people who have cognitive disabilities. So you know, I think there's a misrepresentation that there are healthy people gaming the system. Therefore we should discontinue Medicare
00:10:42.970 --> 00:10:44.960 Phyllis Quinlan: in and of itself, and
00:10:45.420 --> 00:11:13.500 Phyllis Quinlan: that that could just be catastrophic for so many. Yeah, just catastrophic. So the it's it's we we see disruptions coming out of Washington. But I think what Marshall has has really written about is, you know, really trying to bring to light and bubble up, you know, and stimulate conversation around much needed issues that talk about cost versus return on investment access?
00:11:13.908 --> 00:11:26.100 Phyllis Quinlan: You know. What does the future hold? As far as AI is concerned? How can we benefit from that? What are some of the things that are holding us back from having the best health care.
00:11:26.100 --> 00:11:46.969 Phyllis Quinlan: you know, on the planet. And I think the book is rich with food for thought and discussion, and I do think that it can start a very healthy conversation that hopefully will raise awareness and lead to some steps that can be very concrete
00:11:46.970 --> 00:12:03.800 Phyllis Quinlan: in nature that can again maybe move us towards better investments with return on investment, better access for all, and the positivity that AI brings to health care.
00:12:03.800 --> 00:12:21.059 Phyllis Quinlan: and I know a lot of people are very concerned about AI. But you know, if you use a GPS in your car to get from here to there. You're already using AI. You know. People don't realize how much you know. AI is already, you know, in our day to day life, and we were like.
00:12:21.060 --> 00:12:40.399 Phyllis Quinlan: not necessarily clicking with that idea. We're just taking those things for granted. So I'm hoping that the book serves that purpose. It's certainly well written, and it does discuss those things that need to be discussed. So I'm looking forward to what comes after the book coming out next week.
00:12:40.820 --> 00:12:42.680 Frank R. Harrison: Absolutely absolutely
00:12:42.860 --> 00:12:54.219 Frank R. Harrison: well. It's funny we just hit the point of the 2 min mark that being said, ladies and gentlemen, this particular episode of Frank about health is going to give a preview of the great
00:12:54.460 --> 00:13:03.849 Frank R. Harrison: healthcare disruption to be released on the 6th of May. In the next section we're going to dedicate to one of the chapters which both
00:13:03.990 --> 00:13:20.110 Frank R. Harrison: Dr. Ranji, as well as Phyllis, will discuss in detail as will segment, 3. Focus on another poignant chapter, and when we wrap up the show we will go into the future of health care. When we talk about not just the next
00:13:20.200 --> 00:13:40.029 Frank R. Harrison: show that we're doing on the 8.th But we will touch upon AI as well as also hear more about what Dr. Ranji is planning on doing in the near future. And when we start the second segment I will deliver as promised, his complete background. So all of you know that we're dealing with a leader, an innovator.
00:13:40.030 --> 00:13:53.900 Frank R. Harrison: and a real major advocate that everyone must know, especially when that book comes out. So stay tuned right here on Talkradio, dot Nyc. And on our Youtube Linkedin Facebook and Twitch channels, and we will continue in a few.
00:13:54.020 --> 00:13:54.950 Frank R. Harrison: See you soon.
00:15:36.610 --> 00:15:39.149 Frank R. Harrison: Hey, everybody, and welcome back. So
00:15:39.350 --> 00:16:05.969 Frank R. Harrison: Marshall S. Runji, Md. Phd. Is the Executive Vice President for Medical Affairs at the University of Michigan, Dean of the Medical school and CEO of Michigan medicine. He earned his doctorate in molecular biology at Vanderbilt University, and his medical degree from Johns Hopkins, School of medicine, where he has also completed a residency in internal medicine. He was a cardiology fellow at the Massachusetts General Hospital.
00:16:06.110 --> 00:16:28.530 Frank R. Harrison: Dr. Ranji is the author of over 250 publications, holds 5 patents for novel approaches to health care. He's a Texas native who spent 15 years in North Carolina, and an avid thriller, reader, Runji has experienced so many, you can't make this up events that inform his writing. Now that being said.
00:16:28.740 --> 00:16:32.920 Frank R. Harrison: aside from the nonfiction, you're going to be writing it
00:16:33.060 --> 00:16:40.370 Frank R. Harrison: a real fictional book, or rather, you've already written it, and it's going to be published next Tuesday, or it's going to be released next Tuesday.
00:16:40.480 --> 00:16:53.059 Frank R. Harrison: I think that is what we want to talk about now, along with Phyllis, especially when dealing, not just in discussing disruption, but discussing about the different lacks about
00:16:53.670 --> 00:17:01.330 Frank R. Harrison: doctors and nurses that are being aged out of the system to talk about other kind of health care
00:17:01.530 --> 00:17:15.859 Frank R. Harrison: cuts that are going on as well, as I'm sure we've already received some questions that you want to elaborate on. So I think I'm not going to go into any more details. Phyllis, you take it away, and I'm ready to learn and take notes myself.
00:17:16.190 --> 00:17:16.910 Phyllis Quinlan: You bet.
00:17:17.690 --> 00:17:40.300 Phyllis Quinlan: Well, Marshall, you characterize the United States health care system as the most expensive in the world, but it doesn't necessarily have the clinical outcomes to justify that expenditure. I'm not quite sure what you are inferring. But who needs to take responsibility for that? And could you elaborate on that that thought.
00:17:41.842 --> 00:17:45.100 Marschall Runge: Excuse me. Yes, thanks, Phyllis, and
00:17:46.790 --> 00:17:48.609 Marschall Runge: before I start I want to
00:17:48.760 --> 00:17:51.169 Marschall Runge: completely endorse what you said earlier.
00:17:53.360 --> 00:18:02.660 Marschall Runge: A 70,000 foot view with cuts to Medicare or Medicaid or other programs could be. And I'll use your word catastrophic.
00:18:03.160 --> 00:18:07.540 Marschall Runge: And I think we are at risk of that. Always when people
00:18:08.410 --> 00:18:13.639 Marschall Runge: develop policy who aren't engaged, you yourself and me myself.
00:18:13.750 --> 00:18:20.340 Marschall Runge: We know health care from a hands-on standpoint, and that's a very different level than many policymakers
00:18:21.410 --> 00:18:33.140 Marschall Runge: know about. So when you look, when you just look at the cost of health care, the United States healthcare in the United States per capita is more expensive than anywhere else in the world.
00:18:34.270 --> 00:18:37.530 Marschall Runge: you might say. Well, why is that? And I think
00:18:37.880 --> 00:18:54.879 Marschall Runge: there are a lot of different reasons. One that I talk about in the 1st chapter of the book is the dearth in primary care, so it'll be no surprise to any of you that it's hard to find primary care providers whether they're a physician, advanced practice providers
00:18:55.220 --> 00:18:57.440 Marschall Runge: at any level. We all need that.
00:18:57.550 --> 00:19:00.040 Marschall Runge: and that is such an important con
00:19:00.230 --> 00:19:04.490 Marschall Runge: component of our being able to be healthy and
00:19:05.180 --> 00:19:20.529 Marschall Runge: be proactive, such that we don't end up entering a system like ours which does fantastic things. But we enter it, I think, at a point that could be delayed considerably if we were more focused on our own health.
00:19:20.850 --> 00:19:24.100 Marschall Runge: And so so a reflection of that is.
00:19:24.340 --> 00:19:38.249 Marschall Runge: I talked about how health care in the United States costs are very high. If you look at the number of primary care providers per capita, our number is low, very, very low compared to other like countries in the world. And so
00:19:38.981 --> 00:19:47.559 Marschall Runge: that's that is part of this critical occasion. Equation. One other comment I'll make is that most other countries
00:19:47.660 --> 00:19:55.540 Marschall Runge: of like wealth have figured out a way to provide basic healthcare.
00:19:55.660 --> 00:20:06.429 Marschall Runge: such that people don't go without healthcare and then have to enter a system, when in a fragmented way, go into emergency rooms for care or urgent care centers for care.
00:20:06.720 --> 00:20:13.669 Marschall Runge: And I think that, too, is a challenge that we need to take on. And I think we need to take that on as a society.
00:20:14.580 --> 00:20:15.159 Phyllis Quinlan: I I
00:20:15.160 --> 00:20:31.009 Phyllis Quinlan: I absolutely agree. The whole idea of primary care. I'm behind you 100%. And I do think that some of the advanced care. Practitioners, nurse practitioners, physician assistant programs are doing a great job in turning out graduates that are
00:20:31.010 --> 00:20:50.869 Phyllis Quinlan: really starting to fill that gap. We certainly saw that during Covid, you know, we didn't have enough physicians and surgeons, you know, to pull out of the or to serve everyone if it wasn't for the advanced care practitioners. I think we certainly would have struggled to meet the success that we did on the level that we did.
00:20:50.870 --> 00:20:59.720 Phyllis Quinlan: I have my own opinion about why we don't have enough primary care. Physicians, could you share with us? Why, you think that that is.
00:21:01.090 --> 00:21:08.410 Marschall Runge: Yes, I'll speak to our own medical students. So every year we enter a new class of about 170 medical students.
00:21:08.830 --> 00:21:12.829 Marschall Runge: about a quarter of them are very passionate about primary care.
00:21:12.960 --> 00:21:31.700 Marschall Runge: and that's what they see as a future for themselves. By the time they graduate we're down to a much lower percentage of the class, and I think the components of that are, 1st of all, they don't have the kind of experiences in a big Academic Medical center and primary care that they would if they went to
00:21:31.930 --> 00:21:33.480 Marschall Runge: clinics and worked with
00:21:33.970 --> 00:21:42.100 Marschall Runge: various primary care providers. And when when our students do do that, and they do that. They they get very engaged and.
00:21:42.100 --> 00:21:42.480 Frank R. Harrison: They!
00:21:42.480 --> 00:21:45.909 Marschall Runge: Learned firsthand what it's like to be a primary care provider
00:21:46.640 --> 00:22:00.270 Marschall Runge: in their case they'll be a physician, but they work shoulder to shoulder side to side with nurse practitioners and physician assistants, and they see how medical team can come together. So I think we need to work on how we provide that education.
00:22:00.500 --> 00:22:10.650 Marschall Runge: The second, though, is that, as we all know, reimbursement for primary care, I think, is inappropriately low.
00:22:10.820 --> 00:22:19.000 Marschall Runge: And that's true for everyone who provides primary care. And it's so important, it's it's not properly recognized.
00:22:19.120 --> 00:22:26.239 Marschall Runge: So when when somebody has gone through medical school and they've accumulated a significant amount of debt, they start worrying?
00:22:26.370 --> 00:22:35.329 Marschall Runge: Will they be able to pay that debt back? And I think it's practical considerations like that. And there, there are some unique models out there that I think could be helpful, unique.
00:22:36.101 --> 00:22:42.310 Marschall Runge: For physicians, primary care, training, practice, both in medical school and in residency, many of which
00:22:43.050 --> 00:22:46.700 Marschall Runge: could accommodate loan repayment after they start their career.
00:22:46.910 --> 00:22:51.410 Marschall Runge: So so I think there's some levers we could pull. But we're we're not pulling them right now.
00:22:51.410 --> 00:22:58.830 Phyllis Quinlan: Yeah, I think the the reimbursement, quite honestly is, is a serious one, and I think the term is Rvus.
00:22:58.830 --> 00:22:59.260 Marschall Runge: Yes.
00:22:59.260 --> 00:23:24.230 Phyllis Quinlan: When you do your billing, you know all those units that you can document. That would be would be the basis of your reimbursement. And if you're not in a specialty, then you're not doing the high reimbursable procedures that could, of course, give you the most return. But I agree with you. I have family who spent, you know, upwards of $350,000 on their medical, on their medical surgical
00:23:24.230 --> 00:23:29.590 Phyllis Quinlan: education. He's a surgeon, and you know it's going to take a long time to come out from under that
00:23:29.917 --> 00:23:41.372 Phyllis Quinlan: so you know. Fortunately for him, he's, you know, an in-demand surgeon. But you know, if we're looking at primary care, we certainly have to do a little bit more about equity with the with
00:23:41.700 --> 00:24:06.239 Phyllis Quinlan: the reimbursement. For sure you bring up an interesting concept. In Chapter one, Marshall, you say that you know you're looking to challenge the traditional expectation that Americans hold about health care. And I just want to quote you here, such as the belief that everyone should get every treatment they need when they need it, no matter what the cost.
00:24:06.790 --> 00:24:09.199 Phyllis Quinlan: Could you elaborate a little bit on that.
00:24:10.150 --> 00:24:19.380 Marschall Runge: Yes, so we we. Our system, has not capable of delivering that
00:24:19.911 --> 00:24:24.440 Marschall Runge: and you already pointed out the importance of have
00:24:24.730 --> 00:24:30.409 Marschall Runge: non-physician primary care providers and being able to provide access. But if you go to almost any
00:24:31.090 --> 00:24:39.079 Marschall Runge: medical center today, the wait time to see a primary care provider is is too long. So we fail there.
00:24:39.330 --> 00:24:41.850 Marschall Runge: and when people go
00:24:42.000 --> 00:24:52.669 Marschall Runge: reach a point of unhealthiness and require very high tech procedures, those are very expensive, and when just when you think about it.
00:24:52.880 --> 00:25:02.970 Marschall Runge: we can't. We can't provide that level of care at that cost for everybody, because everybody doesn't need it. If they were able to improve their health along the way.
00:25:03.090 --> 00:25:25.460 Marschall Runge: they wouldn't need that care. So that basic premise is flawed in the way that our health system works. Today I want to give you one little practical example about the payment of primary care providers versus high tech specialists. So the Rvu stands for relative value unit and for a primary care provider
00:25:26.190 --> 00:25:29.340 Marschall Runge: it's hard to generate more than 2 rvus per hour.
00:25:29.440 --> 00:25:32.029 Marschall Runge: Maybe you can generate 3 or 4
00:25:32.320 --> 00:25:36.380 Marschall Runge: for a highly technical and they get paid about
00:25:36.530 --> 00:25:39.829 Marschall Runge: reimbursed at about 70 or $80 per rvu
00:25:40.130 --> 00:25:46.910 Marschall Runge: in a good system. If you then look at somebody who does very complicated surgery
00:25:47.120 --> 00:25:54.829 Marschall Runge: they might, although the surgery takes a while, they might be able to generate a thousand rvus in the course of a 2 h. Surgery.
00:25:54.980 --> 00:25:58.599 Marschall Runge: That's just the way it's been weighted by Medicare starting back in the
00:25:58.960 --> 00:26:09.320 Marschall Runge: 19 seventies. So these are old criteria. When many of the procedures we did today weren't even in existence, and they get paid more per view. But if you think about it.
00:26:09.470 --> 00:26:11.660 Marschall Runge: that disconnect between
00:26:11.940 --> 00:26:20.669 Marschall Runge: a primary care provider being able to generate maybe a hundred dollars an hour and have to pay for overhead and malpractice, insurance and everything else. You have to pay for
00:26:20.810 --> 00:26:25.932 Marschall Runge: another physician being able to have maybe higher expenses, but generate
00:26:27.190 --> 00:26:39.959 Marschall Runge: a hundred times, or or even a thousand times, that many rvus. It's no wonder there's that huge discrepancy, and I think we've let that go along unrecognized, well recognized, but unaddressed.
00:26:40.380 --> 00:26:50.550 Phyllis Quinlan: Recognized with an address. Yes, and you know the disproportion about the the Rv. Use with pediatrics. We had discussed that.
00:26:50.550 --> 00:26:50.970 Marschall Runge: Yes.
00:26:50.970 --> 00:27:13.209 Phyllis Quinlan: Days ago, and the disproportionate rvus for reimbursement for physicians and healthcare providers for women's issues. So if you have a woman who is going to specialize in obgyn. Geographically, you're looking at the same organ system as opposed to a urologist who's treating predominantly. Men
00:27:13.210 --> 00:27:37.500 Phyllis Quinlan: and the rvus are much higher for the treatment of men's reproductive or renal issues than they are for women's reproductive and renal issues. So again, where is? It's not just the incentive. And there's just so much. Well, isn't it a isn't it a calling? Aren't you serving and doing what you want at some point in time you have to pay off those medical bills. You have to put food on the table. You have to provide for your family.
00:27:37.690 --> 00:27:53.100 Phyllis Quinlan: So you know, I really hope that your book starts to stimulate, not just conversation, but action in the direction of you know equity across the board, as far as reimbursement is concerned, and start to take some of the
00:27:53.200 --> 00:28:01.029 Phyllis Quinlan: absolute. I can't even characterize it as unconscious bias. Some of the biased, you know, approaches towards reimbursement.
00:28:01.975 --> 00:28:02.759 Phyllis Quinlan: Yeah.
00:28:02.760 --> 00:28:07.990 Marschall Runge: Totally agree. And I'll just say that many health policy experts are thinking about
00:28:08.210 --> 00:28:12.519 Marschall Runge: and actively talking about whether the Rvu system needs to be scrapped.
00:28:12.630 --> 00:28:13.349 Marschall Runge: And we need to.
00:28:13.350 --> 00:28:13.969 Phyllis Quinlan: Start again.
00:28:13.970 --> 00:28:14.609 Marschall Runge: Kind of different ways.
00:28:14.610 --> 00:28:39.599 Phyllis Quinlan: Right. So when you say that the American public has to rethink their approach to health care, can you just elaborate a little bit on that. You know that everything has to be treated all at once in every way. I know definitely the primary care piece is there? But you know, in one of my many lives. I'm a legal nurse, consultant, and I have been doing expert witnessing and legal nurse consulting
00:28:39.800 --> 00:28:56.720 Phyllis Quinlan: for the better part of 20 years. Do you think that litigation has a lot to factor into people insisting on specialty physicians as opposed to general practitioners? And do you think that's and the and the threat of litigation influencing cost in healthcare.
00:28:57.610 --> 00:28:59.400 Marschall Runge: The answer is.
00:28:59.710 --> 00:29:05.249 Marschall Runge: know how many questions you had, but it's yes to all of them. So there is no question that
00:29:05.590 --> 00:29:08.570 Marschall Runge: the threat of litigation is
00:29:10.524 --> 00:29:12.264 Marschall Runge: is a concern for
00:29:12.810 --> 00:29:22.549 Marschall Runge: particularly people who are trying to cover a broad range like a primary care provider. So they're expected to be expert in all of these areas as expert as a specialist
00:29:23.190 --> 00:29:30.263 Marschall Runge: be in. You know this much of it. So that that, too, is an issue that I think we have to
00:29:30.740 --> 00:29:36.839 Marschall Runge: reconcile. I will say one thing about primary care providers is
00:29:37.150 --> 00:29:44.710 Marschall Runge: maybe the best protection against litigation is having a great relationship with your patients. And they do.
00:29:45.030 --> 00:29:53.250 Marschall Runge: And it's it's not just technical issues that impact high tech specialties. It's also they don't really have a
00:29:53.696 --> 00:29:56.540 Marschall Runge: ongoing relationship with many of the patients that they see and treat.
00:29:56.820 --> 00:30:14.230 Phyllis Quinlan: I couldn't agree more. So I just want to, you know, finish up this segment by asking you, you know, just one more question about Chapter one. And you know you talk about innovation being hollow, if it's if it's not matched with access. Could you talk about that a little bit more.
00:30:15.470 --> 00:30:30.169 Marschall Runge: Yes, I do think innovation. And you talked briefly about AI. And I agree with you about AI. It has tremendous potential, and it has the potential to be able to fill these gaps. So I'm not talking about.
00:30:30.440 --> 00:30:39.409 Marschall Runge: You call up to get an appointment, and you see a bot. I'm talking about how these AI bots can do a lot of things that now providers have to do.
00:30:39.510 --> 00:31:07.449 Marschall Runge: related to documentation related to billing collection related to scheduling doesn't require, certainly doesn't require a healthcare. Provider doesn't even require a person in a lot of situations. So I think part of our being able to work our way out of this mire we're in is through technology. And that's that's what I was trying to get to. I also think that. And I didn't mention this specifically in Chapter One, and I wish I had.
00:31:07.850 --> 00:31:14.109 Marschall Runge: I think we can do so much more on health education in primary and secondary schools.
00:31:14.530 --> 00:31:16.880 Marschall Runge: Young people are. They're a
00:31:18.470 --> 00:31:27.129 Marschall Runge: their, their brains soak in information. And if we can provide people like yourself, Phyllis or me sometimes, but also
00:31:27.670 --> 00:31:42.850 Marschall Runge: people they hold in high regard to help provide health information and how they can be more healthy. We can start to turn around the generation we've generated over the last 20 years where health is getting worse in the United States and maybe help turn it. Around. Which
00:31:43.390 --> 00:31:48.059 Marschall Runge: again, I think the primary care providers play a critical role. But I think also education does.
00:31:48.290 --> 00:31:50.349 Phyllis Quinlan: Yes, I again I couldn't agree.
00:31:50.720 --> 00:32:17.489 Frank R. Harrison: We're running a little over time. I didn't see the 1 min, Mark, but I'm going to go, and we're going to go into segment. 3. Follow up on what you were starting to talk about in terms of secondary education, because that is definitely an issue, especially in terms of having the right transgenerational primary care physicians in the future. But, more importantly, when we return we'll also talk about chapter 10. So everybody that was just listening to this discussion that Phyllis and Dr. Ed. Marshall.
00:32:17.810 --> 00:32:18.520 Marschall Runge: Thank you.
00:32:18.520 --> 00:32:26.399 Frank R. Harrison: You're very welcome. It was all about reimagining health care. That's the title of that chapter. All right, everybody stay tuned. We'll be back in a few.
00:33:57.760 --> 00:34:25.520 Frank R. Harrison: Hey, everybody, and welcome back, as you've just heard. Both Phyllis and Marshall were discussing about how we are to reimagine healthcare. Given our recent limitations, our challenges, the chaotic shifts that seem to be going on and not to mention new technologies like AI. Now we're going to cover Chapter 10, a prescription for change. That's the title of that chapter that would be in relation to what was initially discussed. There was a little bit of a discussion starting on
00:34:25.520 --> 00:34:54.520 Frank R. Harrison: how we advance within primary and secondary schools, the medical education, and really get people when they're younger and more adaptable with new end technologies to get involved in the healthcare space and help serve our increasing needs, especially as the older population will all be well. Majority of the older population will be above 65 when they graduate. So that being, said, Phyllis, take it away. So we can understand what that chapter is going to show for a good prescription for change.
00:34:56.090 --> 00:34:57.630 Frank R. Harrison: unmute, first.st
00:34:58.980 --> 00:35:20.439 Phyllis Quinlan: I think I want to try to bridge the gap between or bridge a gap between Chapter one and Chapter 10, because what Marshall was alluding to is that people have to change their idea and perspective on health care, whether it's health care on demand? Or are we more proactive and take more responsibility in preventative care. And you know there's also
00:35:20.440 --> 00:35:40.009 Phyllis Quinlan: the idea that people have to be more responsible and engaged in their care, and to tie in that AI piece. All I can think about really is the advances that we've made in monitoring blood glucose for diabetes. And and how significant an impact that has on the lives of people who are living with diabetes.
00:35:40.250 --> 00:35:46.989 Phyllis Quinlan: So you know, is there something that you can can speak about Marshall, that that
00:35:47.090 --> 00:36:08.399 Phyllis Quinlan: you know here, AI, in this particular case, where you can implant something on your skin that's going to take your blood, glucose readings, and you're going to either loop that or hook that with a link to your phone, so that you can now, with your insulin pump, you know, treat yourself so that you stay between the magic numbers of 70 and 120,
00:36:08.400 --> 00:36:21.200 Phyllis Quinlan: you know, glucose levels where we know that that's normal. And you're not going to get the consequences of hypo or hyperglycemia down the road. Can you speak a little bit about how
00:36:21.260 --> 00:36:30.400 Phyllis Quinlan: we can make advances in that regard, knowing full well again to loop in the children.
00:36:30.570 --> 00:36:36.550 Phyllis Quinlan: you know, unfortunately, type one diabetes which is insulin. Dependent diabetes usually starts at a young age.
00:36:37.510 --> 00:36:41.769 Marschall Runge: Phyllis. 1st of all, thank you for the diabetes example. That's a great example
00:36:41.970 --> 00:36:44.530 Marschall Runge: of technology being able to impact
00:36:44.690 --> 00:36:49.480 Marschall Runge: health and what you know, and I know, and Frank knows
00:36:50.290 --> 00:36:54.189 Marschall Runge: but not everybody knows is the problem with diabetes is.
00:36:54.630 --> 00:37:01.129 Marschall Runge: you know. Yes, it's important to keep your blood glucose under control. But why? And the reason is because of all the
00:37:01.910 --> 00:37:08.200 Marschall Runge: the illnesses that occur in poorly controlled diabetes, like kidney failure or heart failure.
00:37:08.200 --> 00:37:08.700 Phyllis Quinlan: Blindness.
00:37:08.880 --> 00:37:11.119 Marschall Runge: Blindness. Yes, absolutely.
00:37:11.350 --> 00:37:14.519 Marschall Runge: So. I think it's a. It's a perfect
00:37:14.730 --> 00:37:20.819 Marschall Runge: example of how, if we can have technology that helps us to avoid
00:37:21.000 --> 00:37:25.070 Marschall Runge: these complications. That's where the big savings is, and that's where health is.
00:37:25.320 --> 00:37:34.129 Marschall Runge: And so so I think you know, in my stage in life I'm not nearly as facile with
00:37:34.240 --> 00:37:42.280 Marschall Runge: devices and wearables as younger people are, but I think there we will see a flood of wearable
00:37:42.520 --> 00:37:54.069 Marschall Runge: monitors, and some of those will be predictive like. You see, the commercials on late night TV, about somebody who has the the button they can push if they've fallen down. Can't get up. I mean, that's that's 1 level. But
00:37:54.220 --> 00:38:08.940 Marschall Runge: these wearable will be able to detect increases in heart rate or any changes in blood pressure changes in movement. They can be very predictive of both physical and mental health issues.
00:38:09.340 --> 00:38:19.300 Marschall Runge: and we'll get people to care much sooner than they would otherwise. It may not be quite as instantaneous as being able to control your
00:38:19.860 --> 00:38:23.060 Marschall Runge: insulin pump. But but things like that.
00:38:23.648 --> 00:38:32.650 Marschall Runge: I'll also I want to pivot just slightly. There's a center in Seattle that does a lot of predicted work on
00:38:32.790 --> 00:38:56.260 Marschall Runge: quality of life, health care. And it's predicted, although the United States we're like 60th in the world right now. But they did publish a recent study this year, suggesting that if we don't change anything we'll be twice that low by 2050, and there are 2 big factors that they found in their study that are predictive, and one is obesity.
00:38:56.370 --> 00:39:14.090 Marschall Runge: and a second is opiate use. And we hear about all of those all the time, and if we could help control those with feedback loops or other approaches, sometimes pharmacological, that can have such a positive impact on life. So
00:39:14.220 --> 00:39:19.519 Marschall Runge: so I think it's, I do think that it's these advances in technology
00:39:19.630 --> 00:39:31.550 Marschall Runge: that can help us as individuals and also as a as a community, reduce complications that we know how to reduce. We just aren't able to do that right now.
00:39:31.550 --> 00:39:35.020 Phyllis Quinlan: Yeah, yeah, and and take ownership in doing that. In other words, partner with your physic.
00:39:35.020 --> 00:39:37.000 Marschall Runge: Yes, absolutely.
00:39:37.000 --> 00:39:44.159 Phyllis Quinlan: One of the other things you allude to or speak about in Chapter 10
00:39:44.160 --> 00:39:50.189 Phyllis Quinlan: is perhaps it's time, for, you know, policy changes, significant policy changes that might
00:39:50.190 --> 00:40:14.720 Phyllis Quinlan: bring in the Federal Government even a little bit more, and I know that, especially in this day and age, it might be a little controversial. I was wondering if you were alluding to the Yale study from 2020 that showed that there would be a significant, a significant health care, savings and health care, improvement. If we had a medicare for all that, it would lower cost, it would make
00:40:14.720 --> 00:40:33.959 Phyllis Quinlan: pharmaceutical products much more reasonable because we could negotiate differently. It would make access different, you know. And and are those some of the policy changes you're you're speaking about in Chapter 10, and if not, what are exactly what you trying to to address.
00:40:34.650 --> 00:40:38.579 Marschall Runge: Well, those are the kind of policy changes I'm thinking about.
00:40:39.111 --> 00:40:48.509 Marschall Runge: They have gotten so politicized over many years. So universal health was an approach discussed back in the early 19 nineties. It got just.
00:40:49.220 --> 00:40:56.240 Marschall Runge: you know, Dan tarred and feathered and sent out of town. The next version was Medicare, for all which.
00:40:56.370 --> 00:40:58.189 Marschall Runge: basically the same concept.
00:40:58.930 --> 00:41:10.640 Marschall Runge: What what I'm going to suggest, what I try to suggest is, well, I didn't call it this in the book, but it's basically longitudinal health care that everybody has some level of health care.
00:41:10.760 --> 00:41:14.490 Marschall Runge: And that's perfectly possible.
00:41:14.620 --> 00:41:17.109 Marschall Runge: And it doesn't mean that we're going to have
00:41:19.430 --> 00:41:28.649 Marschall Runge: governmentized health care for everybody. It means that there's a basal level, and people get primary care, and they get the medications they need at prices that are reasonable.
00:41:28.800 --> 00:41:41.340 Marschall Runge: and when you look around a lot of different health, a lot of our peers, almost all of them, have some level of this, and I'm going to take one that always surprises people, which is Denmark. Denmark gets great
00:41:42.030 --> 00:41:49.749 Marschall Runge: kudos for kudos, for it's it's Federal sponsored healthcare.
00:41:49.980 --> 00:41:58.620 Marschall Runge: But it like so many other countries. What's not talked about is that a large portion of the population also buys supplemental insurance on top of that.
00:41:59.450 --> 00:42:06.780 Marschall Runge: And that's the case almost everywhere. It varies how much in Uk and Canada, Sweden, Denmark.
00:42:07.390 --> 00:42:10.400 Marschall Runge: other countries. But so it's not saying that
00:42:11.260 --> 00:42:28.080 Marschall Runge: the Government needs to take over all the health care. It's saying that what the Government does is provide. It's able to look at the long run, so the government doesn't see an roi on building highways. It doesn't see an roi in a year or 2. It doesn't see an roi in providing clean water.
00:42:28.810 --> 00:42:36.989 Marschall Runge: but those are big investments that are made that pay off in the future. And that's really different than the way commercial insurance has to look at things they have. They have
00:42:37.280 --> 00:42:50.520 Marschall Runge: shareholders who want to see profits and return in 6 months or in a year. So I think the Government can pay it like quite a unique role. And one thing you mentioned, Phyllis, that I think, is so important.
00:42:51.010 --> 00:42:56.710 Marschall Runge: The Government has enormous purchasing power, and for the cost of pharmaceuticals and other
00:42:57.050 --> 00:43:04.629 Marschall Runge: medical needs, devices, etc, could provide those at a much lower cost than is possible by any other provider.
00:43:05.450 --> 00:43:06.390 Phyllis Quinlan: Yes, yes.
00:43:07.220 --> 00:43:29.600 Phyllis Quinlan: Well, I know we're coming up to going into our next break, but I don't think we do anybody any justice if we don't hear Marshall's views on how big Pharma and the insurance companies are playing into the high cost of health care and maybe influencing the poor return on that investment. Perhaps we can talk about that in the next segment for a little bit, Frank.
00:43:29.600 --> 00:43:30.770 Frank R. Harrison: Absolutely, absolutely.
00:43:31.210 --> 00:43:39.096 Frank R. Harrison: And and I think the one takeaway as an observer like I've just been watching the 2 of you really exchange in this dialogue is that
00:43:39.640 --> 00:43:54.049 Frank R. Harrison: as I've been always saying on the show, everyone has to learn to shift their behavior, to not look like the passive participant in their health care with their doctor, or whoever's taking care of them, their specialist, their therapist, whomever it is
00:43:54.050 --> 00:44:12.970 Frank R. Harrison: they have to, I guess, like you say in the book create a behavioral shift in their own sense of how they are participating in themselves as part of the bigger picture. And I think that's a mindset shift as well. That probably needs to be educated if it hasn't already been so, would that be safe to say.
00:44:14.530 --> 00:44:20.180 Phyllis Quinlan: I would say that the American consumer has very high demands and expectations.
00:44:20.310 --> 00:44:26.170 Frank R. Harrison: Yes, and they have to be. They have to be more subdued, especially when it comes to their healthcare. So, ladies and gentlemen.
00:44:26.170 --> 00:44:26.956 Phyllis Quinlan: Pushing it.
00:44:27.350 --> 00:44:32.970 Frank R. Harrison: Proportionately. Yes, exactly that. All being said. Just stay tuned. We'll be back in a few.
00:46:09.910 --> 00:46:33.740 Frank R. Harrison: Hey, everybody, and welcome back as we conclude this very special episode of Frank about health, as you've just seen during the commercial break, it is available for pre-order right now on amazon.com. It is coming out on the 6, th but if you pre-order right now you will get it in your mailbox by the 6, th and that, all being said, I know, Phyllis, you brought up a good point that if Marshall you could go into exactly
00:46:34.280 --> 00:46:37.247 Frank R. Harrison: just go ahead. You said it best, Phyllis.
00:46:37.530 --> 00:47:00.370 Phyllis Quinlan: I was just interested in your thoughts about the influence of you know, health care is a business, and I'm often talking to clinicians who are having some sort of moral dilemma and questioning around those of us who are professional care providers, and and then the business people who are running the business of health care, and
00:47:00.370 --> 00:47:24.590 Phyllis Quinlan: I often say to people, Please don't try to align them or make them dovetail into one another, they will never align. It's coming from 2 different perspectives and 2 different purposes and missions. I just would love to hear your thoughts about the whole idea of what's going on with the insurance companies. And of course, big Pharma. Yes, we need research and development. But does insulin have to bankrupt you?
00:47:25.770 --> 00:47:42.439 Marschall Runge: So, Phyllis. 1st of all, I really like the way you drew the distinction between clinicians and people in business, because I do think at the heart of almost all clinicians. They're in healthcare because they want to improve health for the people they touch.
00:47:43.590 --> 00:47:57.780 Marschall Runge: and but we have to recognize. Healthcare is a enormous business now comprising, depending on where you look 1718% of the gross national product of the United States of America. That's a gigantic amount of money.
00:47:58.100 --> 00:48:11.090 Marschall Runge: And so there are strong forces for investment. For example, you know, in the last several years medical groups.
00:48:11.930 --> 00:48:30.070 Marschall Runge: including all kinds of providers, are being purchased by venture capitalists to try to run that more efficiently and and turn a profit on it. I mean, that was a real epiphany epiphany to me seeing how much investment there is in healthcare. So you specifically talked about insurance and big pharma.
00:48:30.260 --> 00:48:33.069 Marschall Runge: And I want to address those. So
00:48:33.220 --> 00:48:36.130 Marschall Runge: they are 2 areas in which
00:48:36.830 --> 00:48:41.400 Marschall Runge: there is a very important profit model.
00:48:41.630 --> 00:48:52.050 Marschall Runge: They're they're publicly owned companies, generally or privately owned companies. They report to shareholders. They each do important functions.
00:48:52.850 --> 00:48:55.140 Marschall Runge: I think that as I
00:48:55.840 --> 00:49:02.830 Marschall Runge: discussed in the last section, I think there are alternatives for basic health care that could probably be
00:49:03.490 --> 00:49:09.059 Marschall Runge: done better and much less expensive expensively, not being part of that profit model.
00:49:09.240 --> 00:49:12.120 Marschall Runge: Now, what about Big Pharma? So
00:49:12.560 --> 00:49:15.030 Marschall Runge: big? Pharma has developed some incredible drugs.
00:49:15.030 --> 00:49:15.460 Phyllis Quinlan: Hmm.
00:49:16.450 --> 00:49:24.789 Marschall Runge: I think that's very important, and I think we don't want to see that innovation go away, but they are extremely expensive. So take, for example.
00:49:25.800 --> 00:49:29.779 Marschall Runge: what are now called weight loss drugs, but initially were diabetes, drugs.
00:49:30.080 --> 00:49:34.559 Frank R. Harrison: They cost much less than they do as weight loss drugs. These are.
00:49:34.870 --> 00:49:43.370 Marschall Runge: Their technical title is Glp one agonists, and in general they cost consumers
00:49:43.600 --> 00:49:55.390 Marschall Runge: or somebody. Whoever's paying about a thousand dollars a month. I mean. That's if you have to pay that yourself. You could never afford it. And that's why insurance companies and others are pushing back on that price.
00:49:55.770 --> 00:50:06.150 Marschall Runge: One thing that will certainly happen is, there are more and more entrants of these drugs. The prices will come down. But I think, also, looking at how we can
00:50:06.690 --> 00:50:13.050 Marschall Runge: help pharmaceutical companies meet meet their goals, which are to be profitable, and be able to invest
00:50:13.410 --> 00:50:16.680 Marschall Runge: and meet our goals, of being able to provide those
00:50:16.840 --> 00:50:28.249 Marschall Runge: those medications at a reasonable cost has to be related to purchasing power. And again, I'll go back to how Federal government has enormous purchasing power, and
00:50:28.780 --> 00:50:38.849 Marschall Runge: you know that's an easy win, for everybody costs less and makes important drugs available widely. And I
00:50:39.440 --> 00:50:50.889 Marschall Runge: I'll give you 2 examples. One is the glp example which I just gave, and I know from talking to colleagues, you know, they could probably get down to 300 $200 a month, which puts them in line with many other
00:50:52.540 --> 00:50:55.130 Marschall Runge: brand name pharmaceuticals.
00:50:55.605 --> 00:50:57.080 Marschall Runge: But it's a volume issue.
00:50:57.270 --> 00:51:16.670 Marschall Runge: and not everybody needs those drugs. I mean, I think we need to accept that not everybody needs to be on those drugs. But there are some people that do need to be on them. Let me take something at the far other end of the spectrum. You were talking about children previously, and they're children who have inherited genetic diseases, and we now have genetic therapies. They have been developed
00:51:16.870 --> 00:51:19.420 Marschall Runge: that can cure these diseases.
00:51:19.710 --> 00:51:24.850 Marschall Runge: The diseases, fortunately, are fairly rare. They're sometimes called orphan diseases.
00:51:25.270 --> 00:51:50.210 Marschall Runge: but they can cure it. And so, children that would be sick for their entire life, and die at a very young age. That disease can be cured, but it's enormously expensive. It could cost a million dollars for that therapy. So you have to take a step back and say, Well, what is it worth for that child not to have to go through 10 years of misery and high cost medicine. Is it worth a million dollars?
00:51:50.730 --> 00:51:57.600 Marschall Runge: Probably it's not worth a million dollars, but it's worth a lot of dollars. And so how do we more rationally think about?
00:51:58.138 --> 00:52:00.350 Marschall Runge: The costs! There's a person, that
00:52:00.500 --> 00:52:04.279 Marschall Runge: University of Michigan in our health policy, health
00:52:04.760 --> 00:52:15.509 Marschall Runge: policy, Innovation group named Mark Fendrick, and he, he touts a program called Vbid Value-based Insurance design. And it talks about these issues of
00:52:15.660 --> 00:52:19.309 Marschall Runge: trying to figure out really, what is the value in certain
00:52:19.480 --> 00:52:33.350 Marschall Runge: medications. What's the value in certain therapies? And what is the right value to be delivered? And he? He does get involved at a federal level and is talking talks to administrations on both sides of the political spectrum.
00:52:33.600 --> 00:52:38.639 Marschall Runge: I think we need more of that to really look at what is the value proposition. And how do we
00:52:40.140 --> 00:52:45.430 Marschall Runge: develop that? And and I think we have to be upfront about saying, Should healthcare
00:52:45.983 --> 00:52:51.259 Marschall Runge: be driven as much as it is, is as it is by the profit motive. Personally, I think we're.
00:52:51.390 --> 00:52:54.089 Marschall Runge: there are many, many layers
00:52:54.590 --> 00:53:10.910 Marschall Runge: that have gotten engaged in healthcare, even in pharmaceuticals. There's several layers that make the cost of drugs much higher than it needs to be. That isn't initiated entirely by the by, the drug companies. So that's a that's a meaty question, and one that I think
00:53:11.070 --> 00:53:21.270 Marschall Runge: again, the more that people understand this, the better they can advocate for fair pricing, for
00:53:21.460 --> 00:53:25.942 Marschall Runge: equity, and being able to achieve and obtain these
00:53:26.550 --> 00:53:28.419 Marschall Runge: goals necessary for their own health.
00:53:29.200 --> 00:53:49.120 Frank R. Harrison: Now, does that kind of bring you into Chapter 8, where you talk about what happens if there's another pandemic, I mean, in order to prepare for that. It looks like we have to be already educated in how to use our newly adapted resources of knowing from experience what it is that we can do to expedite the solutions much quicker right.
00:53:49.540 --> 00:53:55.569 Marschall Runge: Yeah, I. The covid pandemic was a great example of something totally. Nobody had predicted that
00:53:55.800 --> 00:54:03.379 Marschall Runge: yet. I think we responded fairly well. We didn't respond as well as some other countries in terms of
00:54:03.850 --> 00:54:25.250 Marschall Runge: trying to practice better prevention of cross-infection. But but I think we did fairly well, and and certainly the rapid development of testing and vaccines was something that was a bipartisan effort. So we can do that. But we have to be prepared for and we don't. We have no idea what the next crisis is going to be. So we have to be prepared.
00:54:25.780 --> 00:54:37.019 Frank R. Harrison: Now, would you say that Mrna was a form of AI vaccine because it wasn't the actual disease? It was just the coding, the genetic coding that enabled a lot of people to become immune, or at least
00:54:37.480 --> 00:54:41.820 Frank R. Harrison: prevent from minimize the risk of getting infected with Covid.
00:54:41.980 --> 00:54:49.360 Marschall Runge: Yeah, I I would say it's it's not. It's not an AI derived approach, but it's comparable. It's it's as transformational
00:54:49.560 --> 00:54:58.660 Marschall Runge: vaccines usually took 10 years to develop with Mrna vaccines. It took less than a year to develop
00:54:58.780 --> 00:55:00.940 Marschall Runge: vaccines that have been highly effective.
00:55:01.740 --> 00:55:07.659 Marschall Runge: It's like AI AI can do in 6 months what it took the development of the Internet 20 years to do.
00:55:08.350 --> 00:55:09.290 Frank R. Harrison: Exactly.
00:55:09.290 --> 00:55:11.410 Marschall Runge: And so let's leverage all these things.
00:55:11.830 --> 00:55:23.699 Frank R. Harrison: And I'm glad you used the word leverage, because, as you could probably see, we're 2 min till the end of our show, and I just wanted to say that everyone you're not done with Dr. Marshall Runji just yet.
00:55:23.870 --> 00:55:27.820 Frank R. Harrison: On next week's episode of Frank about health which will be live.
00:55:28.100 --> 00:55:42.309 Frank R. Harrison: Marshall Runji will be back again with me, and with another special guest from my Alma Mater Brooklyn Technical High School, who is a genetic engineer out in la! His name is David Yang, and he already has seen your book.
00:55:42.440 --> 00:56:10.769 Frank R. Harrison: I gave him the copy that you forwarded to me, and he is going to ask you all those pivotal questions, including the ones that have been building in my mind, that I want to go back to when we when we meet next week, and it will be live. So all of you out there who have questions as well for this show. Please go ahead and write them all in our in your Youtube chat box or in the Linkedin Comment section and I or Marshall, or even Phyllis, will go ahead
00:56:10.770 --> 00:56:31.270 Frank R. Harrison: and get back to you, or you can reach me at Frankrharrison, one@gmail.com, and in addition, remember to buy the book, the great healthcare Disruption. It is going to be also a useful self guide, especially when you're aware of not only how our society, as well as the advanced technologies
00:56:31.270 --> 00:56:43.559 Frank R. Harrison: that will be heavily discussed on next week's episode. AI, in particular, will be able to show how you can own your healthcare even in the midst of all this chaos, and we can do what we can to mitigate
00:56:43.760 --> 00:57:08.650 Frank R. Harrison: what's going on in the great healthcare disruption. Thank you, Phyllis, again for being here. And Marshall, it was definitely a pleasure talking with you all these months prior to this particular episode, and I'm heavily looking forward to seeing the success of this book next week, especially on Frank about health. Everyone stay tuned for our new series that is debuting right now on talkradio dot Nyc
00:57:09.175 --> 00:57:12.910 Frank R. Harrison: and I will see you all next week. Alrighty.
00:57:12.910 --> 00:57:19.859 Marschall Runge: And Frank, I just want to say thank you to you and Phyllis for what you're doing, because I think it is so important
00:57:20.080 --> 00:57:27.979 Marschall Runge: that you're bringing the message about health out broadly. It's a privilege to be on the show with you, but I really appreciate what you're doing, and
00:57:29.210 --> 00:57:32.480 Marschall Runge: anything that I can do to get more people to listen to you.
00:57:32.700 --> 00:57:34.110 Marschall Runge: I would love to do.
00:57:34.430 --> 00:57:35.370 Phyllis Quinlan: Thank you. Marshall.
00:57:35.370 --> 00:57:55.199 Frank R. Harrison: Exactly. That is also music to my ears, because if anything, Phyllis can tell you firsthand that while I have been successful at bringing frank about health to the social media audience out there, and to fellow patients and advocates and things like that. I have always wanted to engage with the medical system. I am a firm believer in Nyu Langone health.
00:57:55.200 --> 00:58:14.289 Frank R. Harrison: I know you are of Michigan medicine, and I know with Phyllis you have a lot of good relationships in the New York City area that we all want people to learn from this show almost like a webinar type of thing. So you contributing to this particular episode is helping shape that narrative for the future of this podcast and I thank you for that
00:58:14.660 --> 00:58:15.610 Frank R. Harrison: alrighty.
00:58:15.970 --> 00:58:18.610 Frank R. Harrison: All right, everybody. We're signing off. See you next week.
00:58:19.000 --> 00:58:19.840 Frank R. Harrison: Okay.
00:58:19.840 --> 00:58:20.649 Marschall Runge: Thank you.
00:58:20.650 --> 00:58:21.300 Frank R. Harrison: Alright, bye.
Talking Alternative Broadcasting
392 Central Park West Suite 17R - New York, NY 10025
Privacy Policy · Terms & Conditions
Thank You for Visiting TALKRADIO.NYC © 2022.
