DC EKG

Stay On Course Studios

Join former White House policy expert Joe Grogan as he cuts through the complexities of healthcare legislation and its real-world implications. Each episode of DC EKG aims to demystify the policies shaping our healthcare system, uncovering how these changes impact patients, providers, and payers across the country.

  1. 4 days ago

    "REFILL" | Peter Pitt on FDA Advisory Committees, Make America Healthy Again, and Drug Pricing (Originally Aired: May 23, 2025)

    Joe Grogan sits down with Peter Pitt, FDA veteran and expert on healthcare regulation, to discuss FDA advisory committees, the Make America Healthy Again initiative, and critical gaps in pharmaceutical labeling. Pitt addresses why obesity-related drug dosing information is missing from labels, the importance of vaccine safety, food regulation reform, and strategies for lowering drug prices through generic drug reviews and supply chain diversification. He also discusses the need for FDA and CMS to work together and warns against mission creep at CMS. Key Timestamps 0:44 Background: East Coast native, McGill University, from New York City 1:07 How he got a professorship at University of Paris School of Medicine 2:35 Mark McClellan connection and FDA career start 5:19 Conflicts of interest versus interests in FDA advisory committees 7:07 Why people need to be dismissed from advisory committees 9:13 Three basic reasons FDA holds advisory committee meetings 11:08 Why Canada keeps advisory committees secret versus FDA transparency 14:08 Advisory committees for CYA, new science, and lack of consensus 19:44 Op-ed on vaccines and nutrition under Make America Healthy Again 22:44 Cancer drug dosing for obese patients and missing label information 27:15 Learning about drug dosing outside of clinical trials 30:42 Food regulation and FDA's second-class treatment of food safety 32:02 MAHA moment and removing red food dyes from food supply 34:00 Dietary supplements regulation under DSHEA 35:21 Nutrition labeling updates and soda bottle serving sizes 38:21 PDUFA reauthorization and user fees 40:32 User fees about predictability not speed 42:54 CMS mission creep and encroaching on FDA authority Key Topics FDA advisory committees, transparency, vaccine safety, Make America Healthy Again, pharmaceutical labeling, obesity and drug dosing, food regulation, dietary supplements, generic drug review, PDUFA reauthorization, user fees, CMS mission creep, drug pricing About the Guest (at time of recording, May 2025) Peter Pitt is President and Co-Founder of the Center for Medicine in the Public Interest and a visiting professor at the University of Paris School of Medicine. He is a former associate commissioner at the FDA where he oversaw advisory committees and served as a senior policy and communications advisor. Pitt is a native of New York City, a McGill University graduate, and speaks fluent French. Podcast: DC EKG with Joe Grogan Host: Joe Grogan Guest: Peter Pitt Sponsor: Survivors for Solutions Executive Producer: John CZ Czwartacki, DC EKG Podcast

  2. 6 Jul

    "REFILL" - Ryan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340B

    Podcast TitleDC EKG with Joe Grogan: A Healthcare Policy Podcast This is a REFILL of Episode124 - (Original air date: January 27, 2026) Episode Title - Ryan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340B Episode Description - Joe 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 Timestamps 00:01 Intro 00:23 Welcome, and what is on the agenda 01:25 California wealth tax and structural deficits 11:20 Enhanced ACA subsidies and the shutdown fight 16:54 Income caps, zero premium plans, and phantom enrollees 21:50 Fraud, Medicaid exposure, and public trust 30:39 Medical loss ratio incentives and ACA market fixes 38:41 340B: how arbitrage works and why it drives consolidation 44:51 What reform could look like 47:20 Closing SEO Keywords | Affordable 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 Guest | Ryan 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

  3. 29 Jun

    "REFILL" White House Rivalries and CDC Reform with Dr. Tevi Troy

    An episode pulled from the archives, Joe Grogan and Eric Ueland welcome Dr. Tevi Troy, former Deputy Secretary of Health and Human Services, presidential historian, and best selling author of Fight House: Rivalries in the White House from Truman to Trump. First aired in February 2023 at the midpoint of the Biden administration, this conversation diagnoses how White House infighting actually works, why the Biden team leaked so much less than its predecessors, and what discipline does and does not buy a president. From there the conversation turns to the machinery of the State of the Union, why the speech always collapses into a laundry list, and how Ronald Reagan invented the pageantry that every president has copied since. Troy then makes the bipartisan case for reforming the Centers for Disease Control, arguing for a congressional charter and a sharper pandemic mission separate from behavioral health. Along the way Joe, Eric, and Tevi cover Lyndon Johnson and Vietnam, Ed Koch and the art of criticizing opponents without alienating voters, the real origin of the Bull Connor line in Biden speeches, and why Troy believes the Republican party has a brighter future after Trump than the Democrats have after Biden. TIMESTAMPS 0:00   Tevi Troy on a brighter Republican future after Trump 0:47   DC EKG intro 1:10   Joe and Eric welcome Tevi Troy, refill context from February 2023 3:00   Why the Biden White House leaks far less than Trump's did 6:15   Neera Tanden, Afghanistan, and where the grumbling did surface 9:30   Is the press softer on Democratic administrations 12:10   Lessons from the hyper disciplined Bush 43 operation 15:00   Friction as a feature: Johnson, Ford, and creative tension 18:20   Johnson, Vietnam, and the limits of dominating Congress 21:00   Biden faces a Republican House and a debt ceiling fight 24:15   How a State of the Union actually gets built 27:30   Why every State of the Union becomes a laundry list 30:45   Reagan, Lenny Skutnik, and the birth of pageantry 33:50   The case for reforming the CDC with a congressional charter 36:20   Behavioral health versus the pandemic mission 39:10   Ed Koch, Carter, and criticizing without alienating voters 41:40   Where Meacham's Bull Connor line came from 44:30   Troy's path to DC: AEI, Ben Wattenberg, and the PhD 47:15   The conservative movement in flux and the future of the parties 48:33   Wrap up ABOUT OUR GUEST Dr. Tevi Troy is a presidential historian, best selling author, and former Deputy Secretary of the Department of Health and Human Services. An insider's insider in Washington, he warned of US vulnerability to coronavirus in 2016 and has since written widely on the failures at the CDC. He began his career at the American Enterprise Institute working for Ben Wattenberg, earned a PhD from the University of Texas at Austin, and served in a range of roles in the George W. Bush administration, including at the Domestic Policy Council. He is the author of Fight House: Rivalries in the White House from Truman to Trump, What Jefferson Read, Ike Watched, and Obama Tweeted, and Intellectuals and the American Presidency, along with more than four hundred articles. CREDITS Podcast: DC EKG with Joe Grogan Episode: 137b Guest: Dr. Tevi Troy, former Deputy Secretary of Health and Human Services Sponsor: Survivors for Solutions, https://survivorsforsolutions.org Executive Producer: John “CZ” Czwartacki, DC EKG Podcast Producer: Stay on Course Studios, https://www.stayoncourse.studio

  4. 22 Jun

    "REFILL" | Dr. Jay Bhattacharya on COVID Infection Rates, Natural Immunity, and the Great Barrington Declaration (Originally Aired: July 20, 2023)

    Dr. Jay Bhattacharya on COVID-19 Seroprevalence, Natural Immunity, and the Great Barrington Declaration (Originally Aired July 20, 2023) This episode originally aired on July 20, 2023, the same day Stanford University President Tessier-Levine was forced to resign. Dr. Jay offers detailed commentary on the hostile work environment at Stanford and how government, big tech, and academia conspired to suppress scientific voices. Episode Description In this wide-ranging conversation, Joe Grogan and Eric Ueland sit down with Dr. Jay Bhattacharya to discuss his groundbreaking work on COVID-19 seroprevalence studies, the suppression of natural immunity data, and the origins of the Great Barrington Declaration. Dr. Bhattacharya shares his immigrant family story and early recognition that COVID-19 was far more widespread than official counts indicated. He conducted one of the first seroprevalence studies in April 2020 in Santa Clara and Los Angeles Counties, using antibody test kits provided by Major League Baseball, and found that the disease was 40 to 50 times more common than reported cases. The episode covers the intense backlash Dr. Bhattacharya faced for publishing these findings, including death threats, racist attacks, and institutional pressure from Stanford to suppress the research. He discusses how public health authorities suppressed evidence of natural immunity, the unethical decision-making by officials like Tony Fauci and Debbie Birx, and the formation of the Great Barrington Declaration. Dr. Bhattacharya details the coordinated campaign against him, censorship on social media, including Twitter blacklisting, federal government threats to ensure censorship, and the terrible price paid that will echo through generations. He reflects on the failures of scientific institutions and the reforms needed to restore public trust in science. Key Timestamps 4:27 Background: born in India, immigrant family, father was a rocket scientist 14:07 COVID enters consciousness: late December 2019, early January 2020 16:47 Wall Street Journal op-ed calling for seroprevalence studies 19:06 Major League Baseball provides 10,000 antibody test kits 20:30 Study results: 3 percent of Santa Clara had COVID by April 2020 26:12 Death threats, racist attacks, and pressure from Stanford 34:51 Evidence of natural immunity being suppressed by Fauci and Birx 39:52 Genesis of Great Barrington Declaration, October 2020 50:10 Hostile work environment at Stanford and Tessier-Levine impact 56:44 FOIA requests revealing government targeting 1:00:16 Twitter blocklist discovery and Elon Musk's Twitter Files 1:05:00 Reform is needed in the scientific community to restore public trust About the Guest (at time of recording, July 2023) Dr. Jayanta Jay Bhattacharya is a Professor of Health Policy at Stanford University's School of Medicine and a Senior Fellow at the Hoover Institution. He holds an MD and a PhD in Economics from Stanford. Born in Kolkata, India, he immigrated to the US at age four. His research focuses on the health and well-being of vulnerable populations. He has published over 160 peer-reviewed articles and is the author of a leading textbook on health economics. Dr. Bhattacharya co-authored the Great Barrington Declaration and is a co-founder of the Academy of Science and Freedom. Dr. Jay's Current Role (June 2026) Since this episode was recorded in July 2023, Dr. Bhattacharya has assumed significant leadership roles in the federal government. He is the 18th Director of the National Institutes of Health (NIH), confirmed March 25, 2025, and took office April 1, 2025. As of February 18, 2026, he also serves as Acting Director of the Centers for Disease Control and Prevention (CDC), bringing his emphasis on scientific integrity and evidence-based policy to these critical positions. Podcast: DC EKG with Joe Grogan Guest: Dr. Jay Bhattacharya Host: Joe Grogan and Eric Ueland Sponsor: Survivors for Solutions Executive Producer: John CZ

  5. 15 Jun

    Tax Expenditures, 340 B Drug Pricing, and Kidney Donation Reform

    DC EKG with Joe Grogan   Episode 137: Tax Expenditures, 340 B Drug Pricing, and Kidney Donation Reform   Air Date: June 15, 2026   Episode Description In this episode, Joe Grogan sits down with Dr. Ike Brannon, President of Capital Policy Analytics and Senior Fellow at the Jack Kemp Foundation, to discuss hidden tax expenditures, the 340 B drug pricing program, and innovative solutions to the kidney shortage crisis.   Dr. Brannon brings decades of Capitol Hill experience, including roles as chief economist of the House Energy and Commerce Committee and senior advisor to Senator Orrin Hatch. He and co-author Tony LoSasso recently published groundbreaking research in Health Affairs Forefront arguing that the 340 B drug pricing program should be classified as a hidden tax expenditure costing the federal government 15 to 20 billion dollars annually.   The conversation covers how the 340 B program evolved from providing discounted drugs to uninsured patients into a massive subsidy for nonprofit institutions with little benefit to poor patients. Dr. Brannon explains how the same drug acquired at a 340 B discount often results in full commercial copays for patients.   Joe and Dr. Brannon explore other problematic tax expenditures including the mortgage interest deduction, employer health insurance exclusion, and credit union tax breaks. The episode pivots to Dr. Branons passionate work on kidney donation reform. Forty-five thousand Americans die annually from end stage renal failure due to kidney shortage, disproportionately affecting African Americans. Dr. Brannon advocates for fully reimbursing kidney donors for all expenses.   Key Topics 340 B drug pricing program, tax expenditures, pharmaceutical discounts, nonprofit hospitals, mortgage interest deduction, kidney donation, end stage renal failure, organ shortage, entitlement reform, social security, Medicare, federal deficit, health economics   Key Timestamps   0:00 Opening: What should be in a reconciliation bill? 4:38 The 340 B drug pricing program explained 13:54 How the 340 B discount does not reach patients 20:13 Mortgage interest deduction: the most irritating tax break 31:00 Prospects for reconciliation under Trump administration 34:57 The kidney donation crisis: 45,000 deaths per year 39:02 How kidney donation reimbursement would work 40:00 Would you allow kidney sales? The ethical debate 45:13 Final thoughts   About the Guest Dr. Ike Brannon is President of Capital Policy Analytics and Senior Fellow at the Jack Kemp Foundation. He holds a PhD in Economics from Indiana University. Dr. Brannon served as chief economist of the House Energy and Commerce Committee, senior advisor to Senator Orrin Hatch on tax and trade policy, and has worked at the Congressional Joint Economic Committee, Treasury Department, and for the McCain presidential campaign. He is founder of the Prosperity Caucus and focuses on growth-oriented economic policy and healthcare innovation.   Featured Research The 340 B Drug Pricing Program is a Hidden Tax Expenditure Health Affairs Forefront, April 24, 2026 Co-authored by Ike Brannon and Tony LoSasso https://www.healthaffairs.org/content/forefront/340b-drug-pricing-program-hidden-tax-expenditure   Podcast: DC EKG with Joe Grogan Episode: 137 Guest: Dr. Ike Brannon   Sponsor: Survivors for Solutions Producer: Stay on Course Studios Executive Producer: John CZ Czwartacki, DC EKG Podcast

  6. 8 Jun ·  Bonus

    "REFILL" - The Economics of Ozempic and Other Weight Loss Drugs (Originally Aired: May 2024)

    DC EKG with Joe Grogan The Economics of Ozempic and Other Weight Loss Drugs Episode 136.5 (“Prescription Refill” – A replay from the archives) Original Air Date: May 2024 In this episode, Joe Grogan welcomes Ben Ippolito, Senior Fellow in Economic Policy Studies at the American Enterprise Institute, to discuss the rapidly evolving economics of GLP-1 weight loss drugs like Ozempic and Wegovy. Ben explains the two main competitors in this market—Novo Nordisk's Ozempic and Wegovy versus Eli Lilly's Mounjaro and Zepbound. Revealing how insurance coverage decisions drive pharmaceutical marketing strategy. The conversation reveals a critical irrationality in Medicare policy: the statutory prohibition on covering weight loss drugs despite their profound clinical and quality-of-life benefits. Yet these same drugs are covered for diabetes and cardiovascular risk reduction. Ben explores the surprising economics of drug pricing through gross-to-net pricing—the massive gap between list prices and what insurers actually pay through rebates and discounts. The episode examines critical implications of the Inflation Reduction Act's price negotiation provisions. Once Medicare negotiates Ozempic's price, that same price applies to all products using the same active ingredient. This creates cascading market effects: competitors must match those prices to remain on formularies, new entrants face lower pricing power even if clinically superior, and pharmaceutical companies may abandon promising programs due to regulatory uncertainty. Ben argues Congress doesn't need to act immediately to expand Medicare coverage, but likely will within a few years. Joe and Ben discuss unintended consequences of government price regulation, including effects on innovation and drug development pipelines. They explore how price controls announced before elections affect pharmaceutical strategy and development timelines. Concluding with Ben's research on Medicare Advantage and why both Democrats and Republicans scrutinize this private alternative to traditional Medicare. With over 50 percent of seniors enrolled in Medicare Advantage plans, bipartisan interest in reform is reshaping healthcare policy conversations on Capitol Hill. Key Topics GLP-1 drugs, Ozempic, Wegovy, Mounjaro, Zepbound, weight loss medications, obesity treatment, Medicare coverage, drug pricing, Inflation Reduction Act, pharmaceutical competition, rebates, gross-to-net pricing, health economics, cardiovascular benefits, diabetes treatment, Medicare Advantage, healthcare policy, innovation incentives Key Timestamps 00:00 Cold Open: "Turned Up to 11" 00:24 Welcome to DC EKG 00:46 Meet Ben Ippolito (AEI) 03:48 The GLP-1 Landscape: Ozempic, Wegovy, and the Field 05:04 One Drug, Two Names 06:45 Medicare's Weight-Loss Coverage Ban 07:21 Blockbusters and Big Effect Sizes 09:32 Why Isn't Congress Acting? 10:17 Why It Costs Less Than You Think 12:34 The Coverage Irrationality 14:05 Quality of Life as a Real Benefit 15:17 Beyond Weight: Cravings and Addiction 18:21 Devil's Advocate: Why Cover It At All? 19:48 Gross-to-Net and the Rebate Problem 22:41 Why Can't You Just Pay Cash? 25:43 The IRA and the Ozempic Price Cut 27:32 One Ingredient, One Price 30:10 Unintended Consequences in Part D 34:01 New Competitors and Killed Programs 38:03 What's Next: Medicare Advantage 42:04 Wrap-Up and Credits About the Guest (As of May 2024) Ben Ippolito is a Senior Fellow in Economic Policy Studies at the American Enterprise Institute. He holds a PhD and Master's degree in Economics from the University of Wisconsin-Madison and a Bachelor's degree in Mathematics and Economics from Emory University. Ben examines drug pricing policy, Medicare Advantage, and healthcare innovation economics with regular engagement with Congress. Podcast: DC EKG with Joe Grogan Guest: Ben Ippolito Sponsor: Survivors for Solutions Producer: Stay on Course Studios Executive Producer: John CZ Czwartacki, DC EKG Podcast

  7. 1 Jun

    Tom Barker on The Truth About Drug Pricing Policy

    In Episode 136 of DC EKG, Joe Grogan hosts Tom Barker, a top drug-pricing attorney at Foley Hoag and former acting general counsel of Health and Human Services (HHS) under the Bush administration. Tom helped implement Medicare Part D and now advises drugmakers and policymakers on complex pricing issues. The episode traces 20 years of policy: what went right with Part D, what the Inflation Reduction Act (IRA) did, and what effective policy should look like. Tom explains that Part D's success rested on three pillars: private plans only, limited government control over benefit design, and a non-interference clause barring the government from intervening in negotiations among plans, pharmacies, and manufacturers. Competition worked and premiums stayed low, until the government asserted more control and weakened those pillars. The IRA, he argues, was a 16-year Democratic effort to repeal non-interference, creating price controls disguised as negotiations. The Trump administration has taken a different tack, focusing not on the IRA but on MFN and Globe Guard models pegged to other developed countries. Tom also breaks down the 340B program, now the country's second-largest expenditure program, and the fight between manufacturers and covered entities over contract pharmacies. His prescription is simple: let competition work. Speed FDA approval of generics and biosimilars, and trust the marketplace over price controls. He points to hepatitis C, where prices fell sharply once competition entered. In This Conversation The three pillars that made Part D successful for 20 years How non-interference kept government from setting drug prices The IRA as a 16-year Democratic push to repeal non-interference Why Tom calls the IRA price controls disguised as negotiations The Trump administration's focus on MFN and Globe Guard pricing 340B and the battle between manufacturers and covered entities The Chevron repeal's impact on drug pricing law HRSA's proposed rebate model and ongoing 340B litigation Why effective policy means competition, not controls Tom's work helping North Korean defectors and refugees Key Timestamps 1:51 Tom's background at HHS and CMS 2:30 The three pillars of Part D's success 5:10 Why Democrats wanted to repeal non-interference 5:55 Ted Kennedy's compromise and bipartisan votes 11:38 The IRA as a 16-year repeal attempt 12:03 What the IRA changed in Part D 15:02 IRA negotiations vs. real negotiations 16:25 How the excise tax makes it no real negotiation 21:32 Trump's focus on MFN and Globe Guard 25:37 340B's history back to 1991 28:45 340B as the second-biggest expenditure program 29:30 Manufacturer vs. covered-entity acrimony 33:18 The Chevron repeal's impact on pricing 34:54 HRSA's rebate model, the next step on 340B 35:40 The lawsuit over "patient" in 340B 38:18 Tom's advice: let competition work 39:30 Hepatitis C: competition drives prices down 40:34 Competition for gene therapies and CRISPR 41:36 Tom's work for North Korean defectors 44:49 Sponsoring Free North Korea Radio Medicare Part D, drug pricing policy, Inflation Reduction Act, non-interference clause, 340B program, MFN pricing, Globe Guard pricing, pharmacy benefit managers, covered entities, contract pharmacies, biosimilars, generics, federal drug pricing, government price controls, Tom Barker About the Guest Tom Barker is a partner at Foley Hoag in Washington, DC, and one of the country's top drug pricing attorneys. He served as acting general counsel of HHS and chief legal officer at CMS under the Bush administration, where he helped implement Part D from its inception. He is now a go-to expert on drug pricing, and helps North Korean defectors navigate US immigration law. Podcast: DC EKG with Joe Grogan Episode: 136 Guest: Tom Barker Sponsor: Survivors for Solutions - https://survivorsforsolutions.org Executive Producer: John "CZ" Czwartacki, DC EKG Podcast Producer: Stay on Course Studios - https://www.stayoncourse.studio

  8. 25 May

    Dr. Mark McClellan on How FDA and CMS Should Work Together

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Join former White House policy expert Joe Grogan as he cuts through the complexities of healthcare legislation and its real-world implications. Each episode of DC EKG aims to demystify the policies shaping our healthcare system, uncovering how these changes impact patients, providers, and payers across the country.

Information

  • Creator
    Stay On Course Studios
  • Years Active
    2023 - 2026
  • Episodes
    143
  • Rating
    Clean
  • Copyright
    All Rights Reserved ©2026
  • Show Website
    DC EKG

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