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Recent episodes
The European Union Explained with Christiaan Alting von Geusau
May 4, 2026
1h 03m 20s
Hungary Election After Orban with Christiaan Alting von Geusau
Apr 30, 2026
50m 24s
Obamacare, HSAs, and Reference Pricing with Dr. John Goodman
Apr 21, 2026
47m 42s
340B | Part D | the Real Drivers of Drug Costs with Ryan Long
Mar 31, 2026
54m 26s
State AI Laws, Preemption and Health Innovation with Adam Thierer
Mar 20, 2026
55m 45s
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| Date | Episode | Description | Length | ||||||
|---|---|---|---|---|---|---|---|---|---|
| 5/4/26 | ![]() The European Union Explained with Christiaan Alting von Geusau | In Episode 133 of DC EKG, Joe Grogan welcomes back Dr. Christiaan Alting von Geusau for Part 2 of their conversation, this time turning to the European Union. Christiaan walks Joe through the post-World War II origins of the EU as a peace initiative built around the Schuman Plan, the pooling of coal and steel between France and Germany, and the visionary leadership of Robert Schuman and Konrad Adenauer. He explains why understanding the EU's founding purpose is essential to understanding what has gone wrong since. Joe and Christiaan unpack the principle of subsidiarity, the rise of EU bureaucracy and over-regulation, the ideological capture of Brussels institutions, and the long detour into cultural battles that were never the EU's job to fight. They discuss Germany's strategic mistake of abandoning nuclear energy, the widening economic gap between the US and Europe, and why Friedrich Merz himself has called the EU the world champion of over-regulation. The second half of the episode looks at the US-EU relationship under President Trump's second term, including the Digital Services Act and free speech, decades of European free-riding on American defense, and the rise of bilateral engagement between Washington and individual European capitals. The conversation closes with a sharp discussion of the leadership vacuum across the West and Europe's growing economic dependence on China. In This Conversation How the European Union began as a Franco-German peace project Why the Schuman Plan and the pooling of coal and steel still shape Europe today The principle of subsidiarity and how Brussels has overstepped it Why Germany's abandonment of nuclear energy was a strategic disaster How EU institutions have been captured by ideology The Digital Services Act and the threat to free speech in Europe Why the US-EU relationship is under serious strain Whether Washington should deal with Brussels or with national capitals Europe's leadership vacuum and growing dependence on China Timestamps 0:00 Why Brussels has become the global champion of over-regulation 1:10 Joe welcomes back Christiaan for Part 2 1:32 Christiaan reintroduces himself and his background 3:00 Why the EU is misunderstood on both sides of the Atlantic 4:15 The historical origins of the EU and the Franco-German conflict 6:00 The Schuman Plan and the pooling of coal and steel 11:30 Truman, the Marshall Plan, and Dean Acheson 12:37 What went wrong with the EU 14:50 Bureaucracy, nuclear energy, and the German mistake 19:35 The principle of subsidiarity and why it matters 23:24 Cultural overreach by Brussels 26:44 Friedrich Merz on EU over-regulation 27:28 The widening US-EU economic gap 32:03 Free speech, the Digital Services Act, and Trump 38:33 European free-riding on American defense 44:07 Should Washington bypass Brussels 48:30 The rise of bilateral engagement 51:23 The leadership vacuum across the West 58:30 Europe's economic dependence on China 1:01:12 Wrap-up European Union, EU history, Schuman Plan, Franco-German conflict, subsidiarity, EU bureaucracy, EU overregulation, German nuclear energy, Digital Services Act, free speech Europe, US-EU relations, Trump and the EU, NATO defense spending, Europe-China dependence, transatlantic relationship, Christiaan Alting von Geusau, DC EKG About Our Guest Dr. Christiaan Alting von Geusau is a lawyer, professor, advisor, and host of the podcast The Educated Leader. Born in the United States and raised in the Netherlands, he studied law at Leiden University and Heidelberg University. He earned his doctorate in philosophy of law at the University of Vienna. He leads the International Catholic Legislators Network, serves as the principal of Ambrose Advice, and is the Rector emeritus and Professor of Philosophy of Law and Education at ITI Catholic University in Austria. Podcast: DC EKG with Joe Grogan Episode: 133 Guest: Dr. Christiaan Alting von Geusau Sponsor: Survivors for Solutions – https://survivorsforsolutions.org Executive Producer: John “CZ” Czwartacki, DC EKG Podcast Producer: Stay on Course Studios – https://www.stayoncourse.studio | 1h 03m 20s | ||||||
| 4/30/26 | ![]() Hungary Election After Orban with Christiaan Alting von Geusau | In Episode 132 of DC EKG, Joe Grogan sits down with Dr. Christiaan Alting von Geusau for a timely discussion on Hungary’s election, Viktor Orbán’s loss, and what comes next under Peter Magyar. Christiaan explains why the size of the election wipeout surprised even seasoned observers, why the mainstream narrative about democracy in Hungary misses key facts, and why the new Hungarian parliament remains entirely on the right side of the political spectrum. Joe and Christiaan break down the structure of Hungary’s political system, the collapse of Orbán’s long-running coalition, the rise of Peter Magyar out of a political scandal, and the challenge of governing with a brand new party full of political newcomers. They also discuss whether Western media is misreading the result as a rejection of conservatism and why the more important question may be whether the new government has the experience to govern effectively. The second half of the episode turns to Hungary’s position on Russia and Ukraine, the country’s cultural conservatism, the future of its relationship with the European Union, and the dangers of revenge politics after a major political transition. This is a wide-ranging conversation on democracy, power, media narratives, and the future of Hungary in Europe. In This Conversation What happened in Hungary and why Orbán lost so badly Who Peter Magyar is and why his rise shocked the political class Why Hungary’s new parliament is still entirely right of center What the election means for democracy and conservatism Hungary’s position on Russia Ukraine and the European Union Why the competence of the new government may matter more than ideology The risks of revenge politics after a major political transition Timestamps0:00 Is Hungary’s election really a repudiation of conservatism0:55 Joe welcomes Christiaan Alting von Geusau1:14 Christiaan’s background and his dual US Dutch perspective4:00 Why Hungary matters and what makes its politics unique5:30 What happened in Hungary and why the wipeout was so large10:06 How Hungary’s electoral system magnified the result11:48 What happened to Fidesz and the Christian Democrats12:37 Why the new parliament is still entirely right of center16:00 The scandal that changed Hungarian politics18:20 Peter Magyar’s rise and political comeback20:00 Who Peter Magyar is and what he believes22:50 What changes Peter Magyar is likely to make24:00 The risks of governing with political newcomers28:50 What this means for Russia Ukraine and the EU34:33 Will Hungary remain culturally conservative36:34 Are Western media misreading the result41:06 Has Christiaan’s view changed since election night43:24 The economic challenges facing the new government44:04 Why revenge politics can damage a country48:03 Outro Hungary election, Viktor Orban, Peter Magyar, Christiaan Alting von Geusau, Fidesz, Christian Democrats, Hungary politics, European Union, Russia Ukraine war, democracy, conservatism, revenge politics, cultural conservatism, political transition, DC EKG About Our GuestDr. Christiaan Alting von Geusau is a lawyer, professor, advisor, and host of the podcast The Educated Leader. Born in the United States and raised in The Netherlands, he studied law at Leiden University and Heidelberg University and earned his doctorate in philosophy of law at the University of Vienna. He leads the International Catholic Legislators Network, serves as principal of Ambrose Advice, and is Rector emeritus and Professor for Philosophy of Law and Education at ITI Catholic University in Austria. Podcast: DC EKG with Joe GroganEpisode: 132Guest: Dr. Christiaan Alting von GeusauSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio | 50m 24s | ||||||
| 4/21/26 | ![]() Obamacare, HSAs, and Reference Pricing with Dr. John Goodman | In Episode 131 of DC EKG, Joe Grogan sits down with Dr. John Goodman to discuss what both parties continue to get wrong about healthcare, why patient incentives still matter, and how market-based reforms could lower costs and improve access. Drawing on decades of work in health economics and policy, Dr. Goodman explains how special interests helped shape Obamacare, why supply-side constraints still distort care, and why patients are too often left out of the policymaking process. The conversation then turns to Health Savings Accounts, Medicaid reform, emergency room overuse, and why policymakers remain so resistant to giving patients more control over healthcare dollars. Dr. Goodman also outlines his view that self-directed care and consumer choice can improve value and expand access, especially for vulnerable populations. In the second half, Joe and Dr. Goodman dive into reference pricing as a major reform idea. Using real-world examples, they discuss how clearer prices and patient-driven decision-making could create more meaningful competition across healthcare markets. The episode closes with a broader conversation on bipartisan reform, the tax code, and why durable change remains so hard to achieve in Washington. In This Conversation What both parties keep getting wrong about healthcare How special interests shaped Obamacare and why patients were left out Why HSAs remain controversial and what they change about incentives Medicaid reform, emergency room use, and patient access How self-directed care can improve outcomes and satisfaction What reference pricing is and why it could create real competition Why bipartisan healthcare reform keeps breaking down in Washington Timestamps0:00 How special interests shaped Obamacare0:46 Joe welcomes Dr. John Goodman1:09 Dr. Goodman’s background and the origins of HSAs5:22 What both parties get wrong about healthcare7:36 Why physician supply stays restricted9:26 Spending more without getting healthier14:16 What Washington should actually be debating15:52 Insurance that meets patients’ needs20:06 HSAs and consumer-directed care22:29 Why Medicaid patients rely more on emergency rooms24:50 Medicaid reform and letting patients pay the difference28:07 Self-directed care and “Cash and Counseling.”29:35 Reference pricing explained32:14 How reference pricing could reshape insurance markets36:06 Why Dr. Goodman is optimistic40:36 The tax code and healthcare policy44:22 Where to find Dr. Goodman’s work45:42 Outro Obamacare, health savings accounts, HSA, John Goodman, Joe Grogan, healthcare reform, healthcare policy, Medicaid reform, emergency room visits, patient incentives, consumer-directed care, reference pricing, tax policy, bipartisan reform, healthcare economics About Our GuestJohn C. Goodman is President of the Goodman Institute for Public Policy Research and is widely known for his work in health economics, Health Savings Accounts, and consumer-directed healthcare reform. Podcast: DC EKG with Joe GroganEpisode: 131Guest: John C. GoodmanSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio | 47m 42s | ||||||
| 3/31/26 | ![]() 340B | Part D | the Real Drivers of Drug Costs with Ryan Long | In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan’s work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio | 54m 26s | ||||||
| 3/20/26 | ![]() State AI Laws, Preemption and Health Innovation with Adam Thierer | In Episode 129 of DC EKG, Joe Grogan sits down with returning guest Adam Thierer, Resident Senior Fellow for Technology and Innovation at the R Street Institute, to break down the surge of state by state AI laws and why a patchwork approach could slow innovation, especially in healthcare. Adam explains how more than a thousand state AI bills are flooding the zone, what types of “everything bills” are emerging, and why some states are trying to set national standards from Albany or Sacramento. Joe and Adam connect the federalism debate to real world health innovation, including mental health chatbots, algorithmic discrimination laws, and why compliance costs hit “little tech” hardest. They also discuss Adam’s “AI Articles of Confederation” framing, the failed effort to create a federal moratorium on state AI rules, and what a better model could look like, such as regulatory inventories, learning labs, and sandbox style approaches that allow experimentation without shutting innovation down. Key link: https://www.rstreet.org/commentary/congress-should-lead-on-ai-policy-not-the-states/ In This Conversation Why state AI bills are accelerating and what is driving them “Mega measures” that try to regulate frontier models, child safety, jobs, and copyright in one bill New York and California style rulemaking with national spillover The Micron example and how permitting and lawsuits can stop progress Algorithmic discrimination laws and why healthcare gets hit hardest Mental health chatbot bans and the access and workforce tradeoffs Preemption and why Congress keeps punting Alternative models: inventories, learning labs, sandboxes, and targeted gap fixes Timestamps0:00 What is happening with state AI bills right now1:36 Adam’s background and how he got into AI policy5:55 The shift from federal regulation to state action10:27 What these state bills try to regulate13:29 Micron, permitting delays, and stopping progress20:00 Why some red states are pushing AI Bills of Rights26:24 “AI Articles of Confederation” and why it matters31:01 The attempted moratorium in the “big, beautiful bill”38:03 Preview of “The AI Terrible Ten” and worst state models39:43 Mental health chatbot bans and the mental health crisis44:25 What governors should do instead of rushing to regulate49:05 What Adam is tracking next51:48 What AI tools Adam uses52:42 Where to find Adam’s work SEO Keywordsstate AI laws, AI policy, federal preemption, healthcare innovation, algorithmic discrimination, mental health chatbots, interoperability, AI regulation About Our GuestAdam Thierer is a Resident Senior Fellow at the R Street Institute focused on technology and innovation policy. He writes and speaks widely on AI governance, federalism and preemption, and how regulatory models can either accelerate or stall innovation, including in healthcare. Podcast: DC EKG with Joe GroganEpisode: 129Guest: Adam Thierer, Resident Senior Fellow, Technology and Innovation, R Street InstituteSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios – https://www.stayoncourse.studio | 55m 45s | ||||||
| 3/16/26 | ![]() HTI 5, Health Data Control and AI with Kat McDavitt and Lisa Bari | In Episode 128 of DC EKG, Joe Grogan is joined by Kat McDavitt and Lisa Bari, co-hosts of the Health Tech Talk Show, for a practical conversation on what the next wave of health IT policy could unlock for patients and innovation. They break down the proposed HTI 5 rule from ONC, why it is framed as deregulation, and how it aims to shift the market away from long EHR certification checklists toward one core goal: data that moves. The conversation digs into information blocking, TEFCA, patient access, and the reality of who controls health data in practice. Joe presses a simple question: if it is “my data,” why do patients still struggle to pull a complete record? Kat and Lisa explain how HIPAA is often used as a barrier instead of a bridge, how secondary data use markets operate, and why privacy gets complicated in a world of apps, brokers, and advanced compute. They also explore how HTI 5 connects to the AI wave, why state AI laws can create risk for innovation, and whether ideas like a Medicare app library help patients or end up picking winners too late. In This Conversation What HTI 5 is and why ONC is scaling back parts of EHR certification Information blocking, TEFCA, and what real interoperability requires Patient access vs business-to-business exchange and why complete records are still hard to get HIPAA and the gap between intent and real-world data sharing Screen scraping, automation, and why data access is becoming an AI issue State AI regulation and federal direction on AI policy ,Timestamps0:36 Intro1:14 Welcome Kat McDavitt and Lisa Bari2:05 Lisa on her new role and what she is working on4:17 First reactions to HTI 5 and EHR deregulation7:34 HTI 5 in plain English11:27 Who controls health data and why this rule matters14:08 Why patients still cannot easily access complete records17:36 HIPAA and how it is used today22:24 Privacy outside HIPAA and secondary use25:50 How HTI 5 targets information blocking28:16 Screen scraping and why it is controversial36:09 How HTI 5 connects to healthcare AI47:28 Medicare app library concerns52:05 Closing and where to find Health Tech Talk Show Health Tech Talk Show YouTube channel: https://www.youtube.com/@HealthTechTalkShow/streams SEO Keywords (Megaphone)HTI 5, ONC, information blocking, TEFCA, interoperability, healthcare APIs, HIPAA, health data access, healthcare AI policy, data liquidity, screen scraping, Medicare app library About Our GuestsKat McDavitt is co-host of the Health Tech Talk Show, President and Founding Partner of Innsena, and CEO and Founder of the Zorya Foundation.Lisa Bari is the Vice President of Policy and Partnerships at Innovaccer, where she leads health and AI policy, government relations, and global partnerships. She is the creator and host of the Policy Stack podcast, co-host of the Health Tech Talk Show, and a board member of the Zorya Foundation. Previously, she was the founding CEO of Civitas Networks for Health.Podcast: DC EKG with Joe GroganEpisode: 128Guests: Kat McDavitt and Lisa BariSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios – https://www.stayoncourse.studio | 54m 10s | ||||||
| 3/6/26 | ![]() Rural Health on the Front Lines: Dr. Manny Sethi on Access, Private Equity, and Prevention | Episode 127 Rural Health on the Front Lines: Dr. Manny Sethi on Access, Private Equity, and Prevention In Episode 127 of DC EKG, Joe Grogan sits down with Dr. Manny Sethi of Vanderbilt and Healthy Tennessee to talk about what rural health looks like up close and what policy changes could actually improve access. Dr. Sethi shares his story growing up in small town Tennessee as the son of immigrant physicians, then training as an orthopedic traumatologist and treating high-energy injuries that often collide with chronic disease and limited access to care. The conversation centers on why rural communities struggle to find primary care and specialists, how administrative burden and electronic medical record requirements can crush independent practices, and why private equity and large systems buying clinics can reduce real access for patients. Dr. Sethi also explains how Healthy Tennessee built a volunteer, community-based model of prevention through health fairs that screen hundreds to thousands of people, partner with food banks, and connect high-risk patients to follow-up care. If you care about rural healthcare, access to care, private equity in medicine, physician shortages, preventative care, EHR burden, Medicaid, Medicare, and community health, this episode is a practical look at what is broken and what can be done. In This Conversation Joe and Dr. Sethi cover: Dr. Sethi’s background and why he returned to Tennessee to practice trauma care Why Healthy Tennessee was created and how prevention can reduce downstream costs and complications How volunteer health fairs work, who shows up, and why many attendees now have insurance but still cannot get appointments The role of insurers, employers, food banks, and community partners in scaling prevention and screening How private equity consolidation can narrow access and accelerate monopolies in rural markets Policy ideas that could move clinicians to rural communities, including better reimbursement and stronger incentives Timestamps (Audio platforms) 0:52 Intro 1:14 Meet Dr. Manny Sethi (Vanderbilt, Healthy Tennessee) 4:38 Why he launched Healthy Tennessee 6:59 Volunteers, screenings, and what the health fairs deliver 12:09 Who shows up and why access is still hard even with insurance 21:51 The biggest rural health problems and the access crunch 24:18 Private equity buying practices and what changes for patients 28:24 What policy fixes could actually move doctors to rural areas 31:41 Follow-up care for uninsured and high-risk patients 34:09 Trauma care realities and why we pay for sickness, not wellness 40:27 Faith, meaning, and why he keeps doing the work Key Takeaways Rural access problems are not only about coverage; they are about workforce, consolidation, and appointment availability. Administrative and EHR burdens can push small practices toward sale, accelerating consolidation. Prevention works when it is local, trusted, and paired with real follow-up pathways. Incentives matter; better rural payments and stronger recruitment tools can move clinicians where they are needed. About Our GuestDr. Manny Sethi is an orthopedic traumatologist at Vanderbilt and co-founder of Healthy Tennessee, a nonprofit he launched with his wife in 2011 to bring prevention and screening to underserved communities through volunteer-driven health fairs and partnerships across the state. --- Show Sponsor: Survivors for Solutions – https://survivorsforsolutions.org Executive Producer: John “CZ” Czwartacki, DC EKG Podcast Producer: Julie Riga, Stay on Course Studios – https://www.stayoncourse.studio | 43m 57s | ||||||
| 2/17/26 | ![]() Alzheimer’s in Real Life: Sue Peschin on Early Detection, Biomarkers, CED, and the ASAP Act | In Episode 126 Joe speaks with Sue Peschin, President and CEO of the Alliance for Aging Research, about what Alzheimer’s and dementia look like in the real world and how policy determines who gets help and when. Sue explains the mission and 40–year history of the Alliance for Aging Research and lays out the scope of the Alzheimer’s crisis in plain language: who is affected, how dementia types differ, and why neuropsychiatric symptoms like agitation, psychosis, and depression are so often ignored in policy and practice. They discuss why early detection matters more than ever now that disease-modifying therapies and amyloid inhibitors exist, and why so many cases are still missed in primary care. Sue walks through new blood biomarkers, digital cognitive assessments, and how Medicare coverage, CED restrictions, and the proposed ASAP Act will shape access to testing and treatment. Joe and Sue also dig into Coverage with Evidence Development (CED) in Medicare, whether CMS is overstepping what Congress intended under Section 1801, and how restrictive coverage decisions have limited access to Alzheimer’s drugs to a tiny fraction of eligible patients. Finally, they talk about caregiver burden, stigma around behavioral symptoms, and what families and clinicians can realistically do today. If you care about Alzheimer’s, dementia, early detection, blood biomarkers, Medicare coverage, CED, the ASAP Act, primary care, caregiver burden, vascular dementia, and aging research, this episode connects the science with the politics and the lived experience. In This ConversationJoe and Sue cover: What the Alliance for Aging Research is and why it focuses on “gap” aging and brain health issues How many Americans are living with Alzheimer’s and dementia, including younger-onset cases The difference between Alzheimer’s, vascular dementia, and other dementias, and why neuropsychiatric symptoms matter Why early and accurate detection is critical, even before someone qualifies for a disease-modifying therapy New tools: blood-based biomarkers, digital assessments, PET scans, and when they are used How Medicare coverage, Coverage with Evidence Development (CED), and the ASAP Act affect access to diagnostics and treatments The tension between FDA’s role on safety and effectiveness and CMS’s role on cost control and coverage Timestamps (Audio platforms) 0:00 Intro and Sue’s background / Alliance for Aging Research 5:30 How big is the Alzheimer’s and dementia problem 10:30 Why early detection matters and why diagnoses are still missed 18:30 Neuropsychiatric symptoms, stigma, and caregiver burden 26:30 Blood biomarkers, digital tools, and primary care 33:30 The ASAP Act and Medicare coverage for biomarkers 38:30 Coverage with Evidence Development (CED) and Section 1801 45:00 How to get involved and where to find resources Key Takeaways Alzheimer’s is one of several dementias, and many patients have mixed dementia (Alzheimer’s plus vascular changes). Early detection is vital, not only for disease-modifying therapies, but to rule out other treatable causes and to help families plan. New blood biomarkers and digital assessments could make detection cheaper and easier, but coverage and adoption lag behind the science. Medicare’s CED policy has sharply limited access to Alzheimer’s therapies despite FDA approval and labeled indications. The ASAP Act aims to secure Medicare coverage for Alzheimer’s blood-based biomarkers without waiting on slow guideline processes. About Our GuestSue Peschin is President and CEO of the Alliance for Aging Research, the leading nonprofit focused on advancing science, policy, and education to improve healthy aging and access to care. At the Alliance, Sue has driven national work on Alzheimer’s, dementia, neuropsychiatric symptoms, Medicare policy, CED reform, and aging research, empowering older adults and caregivers to advocate for better care. | 48m 34s | ||||||
| 1/27/26 | ![]() STLDI and ACA Coverage: Costs, Choice, and Tradeoffs | "Obamacare Exempt" Plans - STLDI and ACA Coverage: Costs, Choice, and Tradeoffs Joe Grogan is joined by Michael Cannon (Cato Institute) to break down short-term, limited-duration insurance (STLDI), also known as “Obamacare-exempt” plans. They explain why STLDI can be far cheaper than ACA exchange coverage, how renewal guarantees work, and why allowing more consumer choice can reduce pressure on exchange risk pools. They also dig into the politics of pre-existing conditions, how ACA rules change insurers' incentives, and why coverage debates often miss the real drivers of cost, access, and quality. The conversation ends with a broader look at public trust, healthcare fear, and how policy choices shape what insurers can and cannot do. Timestamps / Chapters00:01 – Intro00:23 – Michael Cannon joins + what STLDI is02:27 – STLDI explained: “Obamacare-exempt” plans, renewal guarantees, and lower premiums06:00 – ACA history: why STLDI was restricted07:46 – International comparisons + pre-existing conditions incentives and the Colette Briggs story12:10 – Why healthcare stays broken: regulation, lobbying, and “government-designed” systems16:59 – Subsidies and the politics of pre-existing conditions22:22 – Renewal guarantees, employer tax exclusion, and why Medicare entered the picture30:37 – Public trust after Brian Thompson’s murder and Cannon’s letter41:56 – Wrap-up In This Conversation What STLDI is and how it compares to ACA exchange plans Why renewal guarantees matter for long-term protection Risk pools, affordability, and why the “junk insurance” debate persists Pre-existing conditions, politics, and how incentives affect networks and access Why employer-based coverage and Medicare policy shaped today’s system Key Takeaways STLDI is a legal, consumer-driven coverage option that can reduce premiums and expand choice. Renewal guarantees are a major consumer protection that changes the long-term risk story. Pre-existing conditions policy is often debated emotionally, but incentives determine outcomes. About Our GuestMichael Cannon is the Director of Health Policy Studies at the Cato Institute and a leading voice on the ACA, health insurance regulation, and market-based health reforms. | 43m 42s | ||||||
| 1/27/26 | ![]() Ryan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340B | Podcast TitleDC EKG with Joe Grogan: A Healthcare Policy Podcast Episode124 Episode TitleRyan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340B Episode DescriptionJoe Grogan is joined by Ryan Long of Paragon Health Institute and the University of Southern California to break down two fights shaping health policy right now: a California wealth tax pitch framed as a health care fix, and the battle over extending enhanced Affordable Care Act subsidies. They unpack how enhanced subsidies changed who qualifies, why zero-premium plans opened the door to broker-driven enrollment and fraud, and why the medical loss ratio creates perverse incentives that can push premiums higher. They also explain how silver loading and cost-sharing reduction policy distort the exchange market, and what reforms could lower costs without writing a blank check. The episode closes with Ryan's latest work on the 340B program, including why drug arbitrage rewards hospitals with a stronger commercial mix and can fuel consolidation, and why direct, targeted assistance could better support hospitals that truly serve low-income and rural patients. Chapters and Timestamps00:01 Intro00:23 Welcome, and what is on the agenda01:25 California wealth tax and structural deficits11:20 Enhanced ACA subsidies and the shutdown fight16:54 Income caps, zero premium plans, and phantom enrollees21:50 Fraud, Medicaid exposure, and public trust30:39 Medical loss ratio incentives and ACA market fixes38:41 340B: how arbitrage works and why it drives consolidation44:51 What reform could look like47:20 Closing SEO KeywordsAffordable Care Act, ACA subsidies, enhanced subsidies, premium tax credits, exchange plans, zero premium plans, phantom enrollees, medical loss ratio, cost sharing reduction, silver loading, Medicaid fraud, Minnesota fraud, California wealth tax, 340B program, drug arbitrage, hospital consolidation, site neutral payments, commercial mix, Medicare Trust Fund About Our GuestRyan Long is a health policy expert with experience on Capitol Hill, including years in the Speaker's office and on the House Energy and Commerce Committee. He is affiliated with Paragon Health Institute and the University of Southern California. CreditsSponsor: Survivors for SolutionsExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios, https://www.stayoncourse.studio | 49m 12s | ||||||
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| 1/23/26 | ![]() Healthcare AI Gets Real: Naomi Lopez on ACCESS, TEMPO, and the Future of Care | DC EKG with Joe Grogan: A Healthcare Policy Podcast Ep. 122 In this episode of DC EKG with Joe Grogan: A Healthcare Policy Podcast, Joe recaps the first Healthcare AI Policy Summit, held on December 10th in Washington, DC, with his co-host for the event, Naomi Lopez, founder of Nexus Policy Consulting. They walk through the big themes shaping healthcare AI right now: how HHS is approaching AI adoption, what real regulatory clarity could look like, and how new federal initiatives like ACCESS and TEMPO may reshape chronic disease management for Medicare patients. Joe and Naomi unpack HHS Deputy Secretary Jim O’Neill’s view of AI in government, from using large models to improve physician productivity, payment integrity, and care coordination to managing privacy and re-identification risk when working with federal health data. They dig into the ACCESS Medicare payment model and the FDA TEMPO initiative, explaining how these pilots test AI and machine learning tools in real-world chronic disease management (hypertension, diabetes, musculoskeletal pain, and depression), and what that means for Medicare payment models, FDA oversight, and healthcare innovation. The conversation then widens to physician burnout, interoperability, rural care, and the role of states and federal preemption in setting the rules for healthcare AI. If you care about the real-world impact of healthcare AI on policy, payment, and patients, this episode offers a clear, practical summary of what the summit revealed and what to watch next. Today Joe and Naomi cover: Jim O’Neill’s vision for AI at HHS, including internal AI adoption and keeping a direct line open for small innovators. ACCESS and TEMPO as new federal test beds for AI in chronic disease management and Medicare payment. How wearables, remote monitoring, and “virtual ICU” models can support aging in place and reduce pressure on state budgets. Ways AI can reduce documentation burden, support care coordination, and act as a first-line triage tool without replacing clinicians. The emerging idea of personal AI agents that help patients navigate the system and share the right data with clinicians. How AI-enabled diagnostics and tools can expand access in rural and underserved communities. Why interoperability, ONC’s API rules, and the balance between state AI regulation and federal preemption will shape how quickly these tools scale. The potential for tech companies to become Medicare Part B providers under ACCESS, and what that means for reimbursement and competition. Key Takeaways: Healthcare AI is being built into policy through programs like ACCESS and TEMPO, tying AI tools to Medicare payment and FDA pathways in chronic disease management. Regulatory clarity and predictable routes from FDA clearance to Medicare reimbursement are essential for sustained AI adoption. AI is currently most valuable as a force multiplier for physician productivity, taking on administrative and analytic work so clinicians can focus on patients. Personal AI agents may become a primary interface between patients and the health system, coordinating data, benefits, and care. Rural and underserved communities could benefit significantly if payment and regulatory rules support AI-enabled diagnostics and remote care. Interoperability, state AI laws, and federal preemption will determine whether healthcare AI stays in pilots or reaches patients nationwide. Joe's guest, Naomi Lopez, is the founder of Nexus Policy Consulting and a leading voice in healthcare policy, healthcare AI, and state health reform. She co-founded a healthcare AI working group with Joe Grogan and co-hosted the inaugural Healthcare AI Policy Summit on December 10th in Washington, DC. | 47m 54s | ||||||
| 1/23/26 | ![]() Are We Getting Our Money’s Worth? Jackson Hammond on NHE, CMS Reform & Making Insurance Almost Obsolete | In Episode 123 of DC EKG, Joe Grogan sits down with Jackson Hammond (Senior Policy Analyst, Paragon Health Institute) to unpack what the latest CMS National Health Expenditure (NHE) data says about where U.S. health care is headed. They break down the June 2025 NHE release, compare it to Jackson’s earlier “Paragon Prognosis” analysis, and explain what changed, what didn’t, and what it means for affordability, Medicare, Medicaid, and long-run fiscal pressure. They also connect the spending outlook to Jackson’s paper, “How to Reform the CMS Innovation Center with a Choice and Competition Approach,” and debate whether CMMI is bending the cost curve or just adding bureaucracy without accountability. Jackson argues we should aim for health care so affordable you barely need insurance. Chapters / Timestamps 00:00 – Intro + welcome 00:55 – Jackson’s background: how he got into health policy 03:39 – Focus areas: Medicare, hospitals, drug pricing, PBMs, 340B 05:14 – What the NHE report is showing 06:14 – $5.2T → $5.6T → $8.6T: why the trajectory matters 08:00 – Why health spending isn’t really “optional” 10:11 – Where the money is going: payer mix + per-enrollee costs 12:23 – Medicaid costs, provider taxes, and state financing tactics 15:58 – Medicare spending pressure and fiscal risk 21:06 – Misconception: “coverage = care” 26:18 – Why provider payments keep rising (post-COVID demand + consolidation) 33:01 – Rural care, consolidation, and the REH / hub-and-spoke model 40:08 – Drug pricing: retrospective vs prospective MFN 49:20 – 2026 outlook + closing thanks In This Conversation • NHE 2025: what the June 2025 data confirms about spending growth and the federal share. • Rising prices, flat health: why prices climb while outcomes lag. • Medicare and Medicaid: why they remain major budget drivers. • Coverage vs access: why an insurance card doesn’t guarantee care or better health. • Hospitals and consolidation: what’s driving higher payments and fewer choices. • Rural vs urban: why patients bypass local hospitals and what a better model could look like. • Drug pricing: what MFN approaches might mean for costs and innovation. • 2026: what Jackson expects next and what reform could realistically look like. Key Takeaways • NHE data points to continued, unsustainable spending growth. • Medicare and Medicaid drive long-term budget pressure. • Consolidation and payment incentives shape prices as much as utilization. • CMMI reform hinges on accountability, choice, and competition. • Smarter drug pricing policy should lower costs without undermining innovation. About Our Guest Jackson Hammond is a Senior Policy Analyst at the Paragon Health Institute focused on health spending, CMS policy, and reforms centered on choice, competition, and patient-centered care. He authors Paragon’s “Paragon Prognosis” analyses and wrote “How to Reform the CMS Innovation Center with a Choice and Competition Approach.” | 52m 02s | ||||||
| 12/10/25 | ![]() Fixing Obamacare Without Repeal: Tony LoSasso on Competition, Subsidies & Fiscal Reality | In this episode of DC EKG with Joe Grogan: A Healthcare Policy Podcast, Joe sits down with health economist Tony LoSasso to dissect what serious, workable Obamacare reforms could look like without blowing up the Affordable Care Act entirely. They dig into the structure of healthcare subsidies, why current premium tax credits dull price sensitivity, and how that undermines insurance competition, drives up healthcare costs, and threatens the law's fiscal sustainability. Tony lays out a path to modernize the ACA with defined-contribution-style subsidies, patient-directed “health freedom” accounts, and targeted support for people with preexisting conditions through high-risk pools, rather than hiding transfer programs inside community-rated premiums. Along the way, they tackle essential health benefits, community rating, Medicare pricing, certificate-of-need laws, and growing hospital market concentration, and ask what a real bipartisan healthcare reform deal might look like in today’s political climate. | 44m 08s | ||||||
| 10/6/25 | ![]() James Gelfand on Ending Hospital Rip-Offs, Cutting Costs, and the Future of Employer-Sponsored Healthcare | Joe Grogan sits down with James Gelfand, president and CEO of The ERISA Industry Committee (ERIC), to break down the future of employer-sponsored insurance and the challenges shaping healthcare policy. They discuss how rising healthcare costs affect both employers and employees, the evolution of health savings accounts, and why direct primary care and telehealth represent major shifts in employer benefits. The conversation highlights the growing crisis in mental health, the impact of hospital consolidation on costs and quality, and the political battles over healthcare reform. Gelfand explains why employer-sponsored insurance remains a critical safety net and what changes are needed to bring more transparency, value, and balance to the healthcare system. | 58m 46s | ||||||
| 9/24/25 | ![]() Ryan Long on The Hidden Costs of 340B and ACA Subsidies—and Why Reform Matters | In this episode of DC EKG, host Joe Grogan is joined by Ryan Long, Capitol Hill veteran and senior research fellow at the Paragon Institute, to unpack two big health policy debates: the 340B drug discount program and the enhanced ACA premium tax credits. Ryan explains how 340B drives higher drug spending, hospital consolidation, and rising premiums, while often benefiting wealthier hospitals over safety-net providers. He also breaks down why the temporary ACA subsidies are set to expire in 2025, the fraud and enrollment issues they’ve created, and what both parties are gearing up for as the fight continues. | 52m 01s | ||||||
| 9/15/25 | ![]() Dutch Rojas on Physician-Owned Hospitals, Transparency, and Ending Healthcare Monopolies | In this episode of DC EKG, Joe Grogan sits down with healthcare entrepreneur and advocate Dutch Rojas to unpack some of the most pressing and misunderstood issues in American healthcare. From his unconventional path from accounting into healthcare to his outspoken advocacy for physician-owned hospitals, Rojas brings a fresh, unapologetic perspective to how we can break through the gridlock of consolidation and outdated policy. Rojas makes the case for why charity care is often used as a business strategy rather than genuine community support, and explains how site-neutral payments could dramatically lower costs for patients and employers alike. He also outlines how innovations like a healthcare commodities exchange could finally deliver the price transparency Americans deserve, and the competition the system desperately needs. | 53m 31s | ||||||
| 8/24/25 | ![]() Inside the Business of American Healthcare with Wharton’s Dr. Lawton Burns | Join host Joe Grogan for an exclusive masterclass with Dr. Robert Burns, James Joo-Jin Kim Professor of Health Care Management at the Wharton School. A nationally recognized expert on the U.S. healthcare system, Dr. Burns unpacks the complex forces driving healthcare costs. With a background in sociology, anthropology, and decades of research, Dr. Burns reveals why so many healthcare reforms fail, what policymakers and business leaders get wrong, and how the U.S. healthcare ecosystem really works behind the headlines. If you’ve ever wondered why American healthcare is so expensive, and what can actually be done about it, this episode is a must-listen. | 55m 07s | ||||||
| 8/13/25 | ![]() Debunking the Myths of the One Big Beautiful Bill with Brian Blase | Critics have been quick to attack the One Big Beautiful Bill (OBBB), but how much of what you’ve heard is true? In this episode, Joe Grogan sits down with Brian Blase to set the record straight on the bill’s health policy reforms and why they matter. From Medicaid funding changes to the role of provider taxes, Brian and Joe break down the bill’s impact, debunk common myths, and explore what’s next for U.S. healthcare policy. They cover how work requirements, eligibility reviews, and a focus on value could transform the system. Paragon Institute Myth-Busting Series on OBBB: https://paragoninstitute.org/issue-library/obbb-myths-and-facts/ Brian Blase X: https://x.com/brian_blase?lang=en | 56m 08s | ||||||
| 8/4/25 | ![]() Sean Spicer on Why Legacy Media Is Failing, Trump’s Impact & the Future of GOP Messaging | In this episode of DC EKG, Joe Grogan sits down with Sean Spicer, former White House Press Secretary and host of The Sean Spicer Show. Spicer shares his experiences from working in various political roles, his thoughts on Republican strategies for the midterms, and the challenges of communicating healthcare policies. The discussion also delves into the differences between legacy media and new media, highlighting the need for self-reflection within traditional news outlets. | 53m 06s | ||||||
| 8/4/25 | ![]() Stephen Parente on How Transparency Can Fix U.S. Healthcare Costs | Stephen Parente, former White House Chief Economist for Health Policy and current Minnesota Insurance Industry Chair of Health Finance and Associate Dean at the Carlson School of Management, joins host Joe Grogan to discuss the state of healthcare transparency. They dive into the pros and cons of price transparency, the impact of the No Surprises Act, challenges for insurers and providers, and what transparency means for healthcare costs and future policy. Parente also hosts the On Background podcast, where he explores key issues in health finance and public policy. | 59m 57s | ||||||
| 7/21/25 | ![]() Dan Troy on the FDA, Free Speech, and the Future of Drug Innovation | In this episode of DC EKG, host Joe Grogan sits down with Dan Troy, former Chief Counsel of the FDA and a nationally recognized expert on healthcare law and the First Amendment. They explore Troy’s unique journey from free speech litigator to one of the FDA’s top legal voices, examining how the agency regulates what drugmakers, doctors, and companies are allowed to say—and what they’re not. The conversation dives into the legal boundaries of off-label promotion, the impact of direct-to-consumer advertising on patient care, and the growing tension between innovation and regulation in the pharmaceutical industry. Troy also offers his perspective on the Inflation Reduction Act and its potential chilling effect on drug development, underscoring the need for bipartisan support in shaping healthcare policy. | 59m 57s | ||||||
| 6/11/25 | ![]() How to Rescue Medicare and Rebuild America’s Health Insurance Market with Michael Cannon | In this episode, Michael F. Cannon, the Cato Institute’s Director of Health Policy Studies, dives into the policy decisions that shaped Medicare and fundamentally distorted the U.S. health insurance market. From how tax incentives nudged Americans into employer-sponsored plans to the unintended consequences that left many seniors uninsured, Cannon breaks down the government’s role in creating systemic challenges in health care. He also explores how tax policy has long been used as a tool to mandate certain health behaviors, and what a less distorted, freer market might look like. If you want to understand the policy roots behind today’s health care complexities, this conversation is a must-listen. | 56m 36s | ||||||
| 5/23/25 | ![]() Peter Pitts on Navigating FDA Bureaucracy and Unlocking Health Innovation | In this conversation, Joe Grogan interviews Peter Pitts, a former FDA associate commissioner and current president of the Center for Medicine and the Public Interest. They discuss the role of FDA advisory committees, the importance of transparency in regulatory processes, and the intersection of vaccination and nutrition in public health. Pitts emphasizes the need for better dosing guidelines for obese patients and the significance of user fees in ensuring predictable FDA reviews. The conversation highlights the challenges and opportunities within the FDA and the broader healthcare landscape. | 46m 17s | ||||||
| 5/14/25 | ![]() Tevi Troy on Power, Politics, and the Fight to Reclaim Big Pharma’s Image | In this episode of DC EKG, host Joe Grogan interviews historian and political veteran Tevi Troy about the complex relationship between U.S. presidents and powerful industries. They discuss themes from his book The Power and the Money: The Epic Clashes Between Commanders in Chief and Titans of Industry and his op-ed In Defense of Big Pharma. The conversation explores why pharmaceutical companies are often political targets and the impact on innovation, how historical antitrust cases shape today’s tech and biotech battles, insights on Trump’s leadership and the future of the GOP, the importance of communication skills in politics and business, and behind-the-scenes stories from the Trump administration, offering valuable leadership lessons. This episode provides important insights for policymakers, investors, and anyone interested in the intersection of health, economics, and democracy. | 47m 01s | ||||||
| 4/18/25 | ![]() How to Restore Patient Care in a Broken System with Dr. Anthony DiGiorgio | Joe Grogan sits down with Dr. Anthony DiGiorgio, a neurosurgeon and health policy researcher, for a wide-ranging conversation on the challenges facing America’s healthcare system. Drawing on his experience at a safety net hospital, Dr. DiGiorgio discusses the realities of trauma care, including the treatment of traumatic brain and spinal cord injuries, and the systemic issues within Medicaid that hinder access and quality of care. The conversation also explores the misuse of the 340B program, the ethics and logistics of overlapping surgeries, and the growing crisis of physician burnout. Dr. DiGiorgio shares his advocacy for direct primary care and the promise of AI as tools to reduce administrative burdens and improve patient outcomes. | 45m 35s | ||||||
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