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“Necessitous Men Are Not Free Men” – Words to Remember

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By MIKE MAGEE

In the second half of the 19th century, Emily Dickinson wrote a short poem that could easily have been a forward looking tribute to two American Presidents – one from the 20th, the other the 21st century.

Dickinson’s poem “A WORD is dead” is hardly longer than its title.

“A WORD is dead

When it is said,

  Some say.

I say it just

Begins to live

  That day.”

She certainly was on the mark when it came to President Franklin Delano Roosevelt’s signature legislation. FDR’s New Deal, extending from 1933 to 1939, ultimately came down to just three words – the 3R’s – Relief , Recovery, and Reform.

He promised “Action, and action now!”  This included a series of programs, infrastructure projects, financial reforms, a national health care program and industry regulations, protecting those he saw as particularly vulnerable including farmers, unemployed, children and the elderly.  And he wasn’t afraid to make enemies. Of Big Business, he said in a 1936 speech in Madison Square Garden, “They are unanimous in their hate for me – and I welcome their hatred.”

But he was also a political realist. And by his second term of office Justice Hughes and his Conservative dominated Supreme Court had begun to undermine his legislative successes and were threatening his signature bill- the Social Security Act. So FDR compromised, and in the face of withering criticism from the AMA, postponed his plans for national health care.

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THCB Gang Episode 53, Thursday May 6

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Episode 53 of “The THCB Gang” was live-streamed on Thursday, May 5 at 1pm PT -4PM ET. Matthew Holt (@boltyboy) was joined by regulars: futurists Ian Morrison (@seccurve) & Jeff Goldsmith; privacy expert and now entrepreneur Deven McGraw  @HealthPrivacy; policy expert consultant/author Rosemarie Day (@Rosemarie_Day1); medical historian Mike Magee (@drmikemagee), & THCB regular writer Kim Bellard (@kimbbellard)

Matthew was celebrating Chelsea’s Champion’s League Semi final win, but the rest of the gang talked about some big picture issues behind public health, COVIUD and health care policy!

The video is below but if you’d rather listen to the podcast. it will be available on our iTunes & Spotify channels from Friday. 

Time to Reboot “Medicare-For-All”

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By MIKE MAGEE

In the fog of the Covid pandemic, many are wondering what ever happened to prior vocal support for universal coverage and Medicare-for-All. Expect those issues to regain prominence in the coming months. A bit of recent history helps explain why.

The January 6th insurrection, followed by the past weeks two mass shootings, have served to remind our citizens that we must address a range of issues while continuing to confront the pandemic threat.

Modern civilized societies rely on a double-armed approach to maintain order, peace and security. The first arm is laws. But laws are of little value without even and unbiased enforcement.

The second guardrail of civility is culture. MIT professor Edgar Schein described it this way: “Culture has three layers: the artifacts of a culture — our symbols and signs; its espoused values — the things we say we believe; and, most important, its underlying assumptions — the way things really are.”

In the Senate chamber this week, and in Republican controlled state houses across the nation, Americans witnessed a colossal collision of reality and ideals in the form of new Jim Crow laws to suppress minority voting rights, and refusal to address gun violence.  In the wake of a constant stream of racial animus and mass shootings, this lethal epidemic demands a response as well.

Were these the only flashing alerts signaling danger ahead, that would be enough to cause sleepless nights. But unenforced or unevenly enforced laws, and value dissonance in America, do not occur in isolation, but are supported by an even more erosive underpinning – greed-induced economic inequality.

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THCB Gang Episode 48, Friday March 26

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This week (for one week only) #THCB Gang was on Friday. Matthew Holt (@boltyboy) was joined by regulars medical historian Mike Magee (@drmikemagee), Fard Johnmar (@fardj), from digital health consultancy Enspektos, THCB regular writer Kim Bellard (@kimbbellard), and employer health expert Jennifer Benz (@jenbenz). Sadly Casey Quinlan was ill and couldn’t join last minute.

It was an extraordinary week, especially in terms of digital health investment. We talked a bit about that and a lot more about high deductible health plans, whether the filibuster will be busted, and what that might mean for Medicare for all. A wide ranging and big picture conversation!

The video is below but if you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels. 

Pandemic Accelerants: Life Under the “New-Normal.”

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By MIKE MAGEE

Confrontation is good. Governor Abbott’s “We are getting out of the business of telling people what they can and cannot do” was “Neanderthal thinking” as President Biden said. Insurrectionist Richard Bennett, whose feet sat on Speaker Pelosi’s desk two month’s ago, does need to cool his jets in jail awaiting trial. And states lagging in immunizing teachers, opening schools, and accelerating their vaccine efforts need to realize that they will be held accountable by voters in the near future.

That is surface turbulence, but quietly below the surface, there are other transformational forces underway fueled by pandemic accelerants.

How long would it have taken under normal circumstances to advance equitable access to broadband and tech devices for all students in America? A decade from now, would we have advanced teacher skills in long-distance learning to the degree we are now witnessing? And how many at-home workers will be willing to return to off-site offices in the near future?

These are just a few of the questions being considering as we return to “normal” or life under the “new-normal.” And while we are all doing our best to cope with the fear and worry that comes with change, most of our collective anxiety is now focused on economic security and jobs.

This past month we added 379,000 jobs. Sounds great, that’s if you ignore the fact that there remain 9.5 million fewer jobs in our economy compared to a year ago, or that first-time jobless claims rose last week. As former Federal Reserve economist Julia Coronado reported, “We’re still in a pandemic economy.”

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THCB Gang Episode 45, Thursday March 4, 1pm PT – 4pm ET

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Joining me, Matthew Holt (@boltyboy), on this week’s THCB Gang will be THCB regular writer Kim Bellard (@kimbbellard), medical historian Mike Magee (@drmikemagee),  policy & tech expert Vince Kuraitis (@VinceKuraitis),  patient safety expert and all around wit Michael Millenson (@MLMillenson), and consumer expert and current President of the Medical Board of California, Denise Pines.

Vaccines at warp speed, some “Neanderthal” state governors opening up, but also a pandemic bill passes the house with some health policy implications. Plus lots of fun and games in the world of digital health and startup health plans. We should have something to discuss!

You can see the video below live and the audio will be on our podcast channel (Apple/Spotify) from Friday

Moderna’s “Secret Sauce”

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By MIKE MAGEE

This week J&J gained FDA approval for their 1-shot COVID vaccine, leading optimists like Pfizer Board member, Scott Gottlieb, to predict that we will have 100 million shots out there by the end of April, and on-demand offerings for the general public. In the race toward herd immunity, we could easily ignore a revolutionary change in pharmaceutical design and manufacturing occurring under our noses.

Case in point: Moderna – subject of a recent case study by Marco Iansiti, Karim Lakhani, Hannah Mayer, and Kerry Herman in the Harvard Business Review.

Moderna – labeled by its CEO as “a technology company that happens to do biology” – was founded in 2010, with $5.1 billion in venture capital backing,  “designed from the ground up as a digital biotech company with a factory for in-house manufacturing capabilities.” Up to this point, as they entered their 11th year, they had not brought a single product to market.

Moderna was the child born of Cambridge-based Flagship, run by Noubar Afeyan, an MIT bioengineer and world leader in bio-instumentation. His raison d’etre was “radical innovation.” He not only wanted to do big things, but do them faster than anyone else. As he said, “Asking ‘What if?’ questions propels you far into the future. It may be unrealistic or overly optimistic, but that’s how radical innovation happens.”

To accomplish this outsized ambition, he invested in a four-step process:

1.   Generate break-through innovation hypotheses (what-if’s).

2.   Explore the hypothesis. If it looks good, set-up a prototype company.

3.   If initials prove out, go permanent with a New Company.

4.   If promising, spin it off as a Growth Company.

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Wiping the Sleep From Our Eyes: The Pandemic Plan Trump Ignored

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By MIKE MAGEE

When awakening from a long sleep, there is a transition period, when the brain struggles momentarily to become oriented, to “think straight.” When the sleep has extended four years, as with the Trump reign, it takes longer to clear the sleepy lies from your eyes.

We are emerging, but it will take time and guidance. This week President Biden and our First Lady showed us the way. As we together observed the startling passage of a half million dead, many needlessly, from the pandemic, the President gave us a crash course on grief. He compared it to entering a “black hole”, and acknowledged that whether you “held the hand” as your loved one passed on, or were unable (by logistics or regulation) to be there to offer comfort, time would heal. “You have to believe me, honey!”, as he is so prone to say.

As important, we saw the First Lady, without fanfare or concious need for attention, at one moment, draw close to him, as she sensed that he was about to be overcome by his own sadness, and place her hand simply on his back, patting him gently, knowing that this was enough to get him through. She, by then, had done this many times before.

And we saw the Vice President and her husband, across from the first couple, there only for support. This was neither a speaking role or super-ceremonial. It was humble. It was supportive. It was human, and far away from a predecessor who for four years had to fawn, and lie, and grovel to satisfy his Commander-in-Chief.

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THCB Gang Episode 43, Thursday Feb 18, 1pm PT – 4pm ET

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THCB Gang was broadcast live on Thurs Feb 18

Joining me, Matthew Holt (@boltyboy) were THCB regular writer Kim Bellard (@kimbbellard), patient advocates Grace Cordovano (@GraceCordovano) and Robin Farmanfarmaian (@Robinff3), newly-minted VC Marcus Whitney @marcuswhitney, and medical historian Mike Magee @drmikemagee.

We touched on the impact of the extremes of global warming on health! And in a pandemic nonetheless!. Plus the wild world of SPACs, more funding for mental health, and the sausage making of health care’s place in the upcoming stimulus bill. But I’m not sure the group is ready for the big policy move that the pandemic may give us the opportunity to pursue! A great conversation nonetheless.

The video is below but if you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

Modern Day “Victory Gardens” – Planting the Seeds for Covid Vaccination Success

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By MIKE MAGEE

In the wake of Pearl Harbor, FDR found our nation ill-prepared for war. He lacked manpower and tools. In response, he took deliberative action with the support of Congress, drafting soldiers and redirecting supply chains toward weapons of war. Compliance was requested, then demanded. Those industries that served, including Pfizer with penicillin production, benefited in the short and long-term.

FDR not only harnessed the power of industry and science, and ramped up the military, but also asked every family and every community to participate in the war effort. Community volunteering soared, and sacrifice for the public good was the rule, not the exception.

One idea was “victory gardens”, planted in back yards,  to allow stressed food manufacturers the ability to focus on meeting the demand to “feed the troops.”  These gardens in 1943 provided 1/3 of all the vegetables consumed in the states that year.

President Biden now finds himself in a similar predicament – the need to redirect our vast industrial productive capacity while mobilizing our citizens to both support and participate in vaccination efforts.

Our President and his team understand that interventional and privatized high science is of little avail if that science (in this case vaccines) is unable – by limited supply or logistic ineptitude or the absence of public trust – to find it’s way efficiently and quickly into the arms of our citizens.

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