Texas Governor Greg Abbott has been on a tear lately, and his central theme appears to be “revanchism.” Faced with declining demographics, he is retaliating against enemies and newcomers alike, aligning himself with slippery politicians and vigilantes. As they say in Texas, “He’s on a first-name basis with the bottom of the deck”, and the game he’s playing appears to be “South Africa – 1950.”
The formal establishment of apartheid in South Africa occurred in 1948, though racial injustice had been baked in centuries earlier. Violence and intimidation, embedded in legislation supported by a 15% white minority, led to the creation of the African National Congress (ANC) which launched what they called their “Defiance Campaign.” By 1962, their party had been outlawed, and their dynamic leader, Nelson Mandela, was imprisoned.
And yet resistance continued to grow, inside and outside the country. Religious leaders, like Archbishop Desmond Tutu, took to the street, organizing huge, peaceful rallies. In 1976, images of Black children being attacked and killed in Soweto township during a protest spread like wildfire around the world. 176 died and thousands were injured. In response, the United Nations called on its member states to divest and impose economic sanctions. Only 2 leaders did not. (More on that in a moment.)
Minority rule, oppression, vigilantism, and disenfranchisement are eventually losing propositions as Greg Abbott is learning. A majority of 52% now say his state is moving in the wrong direction. The list of grievances is long and continues to grow. Catholic bishops decried his inhumane handling of immigrant families this year. Baptist minister Rev. Frederick Haynes III spotlighted the Republican legislature’s voter suppression law recently suggesting they were “dressing up Jim and Jane Crow in a tuxedo.” Only 39% approve of his handling of the pandemic, and many Texans find the renewed endorsement of “vigilante justice” for unfortunate women and girls seeking abortions to be a disturbing and dystopian new reality. By the way, 1 in 5 Texans lack health insurance, and Texas is one of twelve Republican-led states that continue to refuse federal offers to expand Medicaid coverage of their citizens.
The Affordable Care Act (ACA) survived its third challenge at the Supreme Court on June 18, 2021, by a 7-2 vote, signaling that Obamacare is here to stay. With a divided Congress and a Biden administration challenged by multiple urgencies, there is little hope for national legislation to address healthcare’s access, cost, and quality deficiencies comprehensively.
Despite this lack of dramatic progress or sweeping change at the federal level, reformers need not lose hope. Quietly, state-based marketplaces are making health insurance provision more accessible, affordable and effective.
A Biden Administration’s executive order signed in January 2021, reopened the federal health insurance marketplace to individuals seeking to purchase or modify health insurance policies. The fifteen state-based marketplaces (SBMs) followed suit by enacting their own versions of this special enrollment period.
The Administration’s $1.9 trillion American Rescue Plan, enacted on March 11, 2021, includes a narrow but powerful provision that temporarily grants premium subsidies to higher-income Americans and reduces premium costs for lower-income Americans. The “Build Back Better Act” currently moving through the House of Representatives would make these subsidies permanent. It would also provide funding for more experimentation with state-based health insurance affordability programs.
These new policies align with measures undertaken by many SBMs during the past eight years to improve the quality, affordability, and marketability of their health insurance offerings. In this decentralized, real-world way, SBMs have operated as experimental policy laboratories to assess programming modifications for stabilizing local markets, expanding consumer choice, increasing access to vital healthcare services, and lowering premiums.
We’re already living in an era of unprecedented misinformation/disinformation, as we’ve seen repeatedly with COVID-19 (e.g., hydroxychloroquine, ivermectin, anti-vaxxers), but deepfakes should alert us that we haven’t seen anything yet.
ICYMI, here’s the 60 Minutes story:
The trick behind deepfakes is a type of deep learning called “generative adversarial network” (GAN), which basically means neural networks compete on which can generate the most realistic media (e.g., audio or video). They can be trying to replicate a real person, or creating entirely fictitious people. The more they iterate, the most realistic the output gets.
The power to mandate vaccines was litigated and resolved over a century ago. Justice John Marshall Harlin, a favorite of current Chief Justice Roberts, penned the 7 to 2 majority opinion in 1905’s Jacobson v. Massachusetts. Its impact was epic.
In 1905, Massachusetts was one of 11 states that required compulsory vaccinations. The Rev. Henning Jacobson, a Lutheran minister, challenged the city of Cambridge, MA, which had passed a local law requiring citizens to undergo smallpox vaccination or pay a $5 fine. Jacobson and his son claimed they had previously had bad reactions to the vaccine and refused to pay the fine believing the government was denying them their due process XIV Amendment rights.
In deciding against them, Harlan wrote, “liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own [liberty]…”
Of course, a state’s right to legislate compulsory public health measures does not require them to do so. In fact, as we have seen in Texas and Florida among others, they may decide to do just the opposite – declare life-saving mandates (for masks or vaccines) to be unlawful. At least 14 states have passed laws barring employer and school vaccine mandates and imposing penalties in Republican-controlled states already.
So state powers are clearly a double-edged sword when it comes to health care.
An article in NPJ Science of Food explains how scientists combined additive manufacturing (a.k.a, 3D printing) of food with “precision laser cooking,” which achieves a “higher degree of spatial and temporal control for food processing than conventional cooking methods.” And, oh, by the way, the color of the laser matters (e.g., red is best for browning).
Very nice, but wake me when they get to replicators…which they will. Meanwhile, other people are 3D printing not just individual houses but entire communities. It reminds me that we’ve still not quite realized how revolutionary 3D printing can and will be, including for healthcare.
The New York Timesprofiled the creation of a village in Mexico using “an 11-foot-tall three-dimensional printer.” The project, being built by New Story, a nonprofit organization focused on providing affordable housing solutions, Échale, a Mexican social housing production company, and Icon, a construction technology company, is building 500 homes. Each home takes about 24 hours to build; 200 have already been built.
Not all who wander are lost: Nomad Health lands a $63M Series D round after a year of 5X revenue growth for their tech-driven healthcare staffing marketplace that helps hospitals hire nurses on-demand. This round, led by Adams Street Partners with participation from all existing investors, brings the company’s total fundraising up to $113M. Co-founder & CEO Alexi Nazem stops by to tell us how the startup is not only planning to expand its focus from nurses to other types of healthcare providers but how the process of doing so will transform Nomad from an on-demand staffing agency to “‘THE’ workforce management platform for healthcare.”
Alexi puts it this way: “In healthcare, the product is CARE. And, who is the product team? It’s the doctors, the nurses, the allied health professionals…and the fact that there’s no intentional management of this group of people who steward $1.5 trillion dollars of cost in the US every year is beyond unbelievable.”
The problem is twofold. First, there’s the way temporary staffing is currently being handled: by 2,500 different staffing agencies that take a fragmented, predominantly people-powered approach to sourcing, vetting, and hiring candidates. The cost is high to a health system looking to shore up their nursing staff, and the experience for job-seeking nurses is very opaque, with information being revealed about a job only after a significant investment of time within the application process. If the match falls apart, all the people involved in the process are left to try again.
This leads to the second issue – that, big picture, the status-quo way of temporary staffing is leaving behind a LOT of valuable data. Data about the clinician that is useful to the management of their career, and data about the workforce that would prove valuable to a hospital looking to better manage its care delivery resources.
We journey into the details behind Nomad’s business model, which is cutting costs for hospitals while also increasing pay for the 150,000+ clinicians on its platform. AND, while we’re there, we also find out how they expect their on-demand staffing approach to playing out in the booming virtual care space.
If you, like me, continue to think that TikTok is mostly about dumb stunts (case in point: vandalizing school property in the devious licks challenge; case in point: risking lives and limbs in the milk crate challenge), or, more charitably, as an unexpected platform for social activism (case in point: spamming the Texas abortion reporting site), you probably also missed that TikTok thinks it could take on LinkedIn.
Welcome to #TikTokresumes. Welcome to the Gen Z workplace. If healthcare is having a hard time adapting to Gen Z patients – and it is — then dealing with Gen Z workers is even harder.
TikTok actually announced the program in early July, but, as a baby boomer, I did not get the memo. It was a pilot program, only active from July 7 to July 31, and only for a select number of employers, which included Chipotle and Target. The announcement stated:
TikTok believes there’s an opportunity to bring more value to people’s experience with TikTok by enhancing the utility of the platform as a channel for recruitment. Short, creative videos, combined with TikTok’s easy-to-use, built-in creation tools have organically created new ways to discover talented candidates and career opportunities.
Interested job-seekers were “encouraged to creatively and authentically showcase their skillsets and experiences.” Nick Tran, TikTok’s Global Head of Marketing, noted: “#CareerTok is already a thriving subculture on the platform and we can’t wait to see how the community embraces TikTok Resumes and helps to reimagine recruiting and job discovery.”
Marissa Andrada, chief diversity, inclusion and people officer at Chipotle, told SHRM: “Given the current hiring climate and our strong growth trajectory, it’s essential to find new platforms to directly engage in meaningful career conversations with Gen Z. TikTok has been ingrained into Chipotle’s DNA for some time, and now we’re evolving our presence to help bring in top talent to our restaurants.”
…honor achievements that make people LAUGH, then THINK. The prizes are intended to celebrate the unusual, honor the imaginative — and spur people’s interest in science, medicine, and technology.
Some scientists seek the glory of the actual Nobel prizes, some want to change the world by coming up with an XPRIZE winning idea, but I’m pretty sure that if I was a scientist I’d be shooting to win an Ig Nobel Prize. I mean, the point of the awards is “to help people discover things that are surprising— so surprising that those things make people LAUGH, then THINK.” What’s better than that?
1. relating to or denoting an imagined state or society where there is great suffering or injustice.
1. a person who imagines or foresees a state or society where there is great suffering or injustice.
There are certain words that keep popping up in 2021 whose meanings are uncertain and which deserve both recognition and definition. And so, the offering above – the word “dystopian.” Dystopian as in the sentence “The term was coined by writer Neal Stephenson in the 1992 dystopian novel Snow Crash.”
One word leads to another. For example, the above-mentioned noun, referred to as dystopian by science fiction writer Stephenson three decades ago, was “Metaverse”. He attached this invented word (the prefix “meta” meaning beyond and “universe”) to a vision of how “a virtual reality-based Internet might evolve in the near future.”
“Metaverse” is all the rage today, referenced by the leaders of Facebook, Microsoft, and Apple, but also by many other inhabitors of virtual worlds and augmented reality. The land of imaginary 3D spaces has grown at breakneck speed, and that was before the self-imposed isolation of a worldwide pandemic.
But most agree that the metaverse remains a future-facing concept that has not yet approached its full potential. As noted, it was born out of science fiction in 1992, then adopted by gamers and academics, simultaneously focusing on studying, applying, and profiting from the creation of alternate realities. But it is gaining ground fast, and igniting a cultural tug of war.
Join me, in-person or virtual, on 4 consecutive Thursdays this Fall.
Together we’ll examine 250 years of history and case law, to expose what our U.S. Constitution says (and leaves unsaid) about Americans’ “right” to health care. From the Bill of Rights to the Federalist Papers, from McCulloch v. Maryland to Griswold v. Connecticut, from “Comstockery” to Sanger, and FDR’s “Court Packing,” we’ll cover it all.
You’ll learn about “penumbras” from William O. Douglas, and Due Process within the XIV Amendment; how the AMA chose Reagan as their spokesperson against “socialized medicine”, and how LBJ forced integration of hospital wards on Bible Belt states.
We’ll do a deep dive into Roe v. Wade and learn how Justice Blackmun arrived at his compromise solution for “Jane Doe” and others, and examine why Texas Governor Abbott is trying to torpedo it a half-century later.
We’ll revisit the politicization of the Terri Schiavo “Right to Die” case, and uncover “conflicts of interest” and deficiencies in “informed consent” at the University of Pennsylvania that contributed to the research death of Jesse Gelsinger.
We’ll hear the voices and opinions of students and professors, analyze Justice Roberts’ National Federation of Independent Business v. Sebelius split decision that preserved the Affordable Care Act…address mandated vaccines, and much, much more.
In just four 90-minute packed sessions, you’ll gain a perspective on the current struggle for health care in America. Most of all, you’ll learn and participate in the process. That’s a promise!