Ep. 160: From Data to Action: A Conversation with The Commonwealth Fund's Dr. Joseph Betancourt

Why are children across the U.S. falling behind on key health measures – and what can we do about it? Joseph R. Betancourt, MD, President, The Commonwealth Fund, joins us to explore solutions. We discuss the Fund’s long-standing work in child and maternal health, recent state health findings, and key factors affecting pediatric care, from policy and primary care investment to trust, data and urgent mental health needs.

Watch the episode on YouTube.

Featuring:
Joseph R. Betancourt, MD, President, The Commonwealth Fund

Host/Producer: Carol Vassar

Views expressed by guests do not necessarily reflect the views of the host or management.

Subscribe, review or let your voice be heard at NemoursWellBeyond.org.

Transcript

Announcer:

Welcome to Well Beyond Medicine, the world's top-ranked Children's health podcast produced by Nemours Children's Health. Subscribe on any platform at NemoursWellBeyond.org or find us on YouTube.

Carol Vassar, podcast host/producer:

Each week, we'll be joined by innovators and experts from around the world, exploring anything and everything related to the 85% of child health impacts that occur outside the doctor's office. I'm your host, Carol Vassar, and now that you are here, let's go.

Music:

Let's go, Well Beyond Medicine.

Carol Vassar, podcast host/producer:

We are so honored today to have with us Dr. Joseph Betancourt. Dr. Betancourt is the president of the Commonwealth Fund, and he's a national leader in healthcare policy, quality, and community health. And we could absolutely spend our entire podcast simply touting his leadership bona fides, but I really am excited to get into our conversation. So welcome to the Nemours Well Beyond Medicine Podcast, Dr. Betancourt.

Joseph Betancourt, MD, President, The Commonwealth Fund:

Thank you so much, Carol. I really appreciate it. And it's an honor and a pleasure to get a chance to humbly share some thoughts with you and the listeners, so look forward to a great conversation. And again, really appreciate the invitation, certainly at a very interesting time.

Carol Vassar, podcast host/producer:

Definitely interesting. For listeners who may not know, and I think most people do, they've heard of the Commonwealth Fund, give us a bit of an introduction, the history of the mission, and the role it plays, a very important role, in shaping healthcare in America today.

Joseph Betancourt, MD, President, The Commonwealth Fund:

Fantastic. Well, a bit about the Commonwealth Fund. The Commonwealth Fund is a national philanthropy foundation that focuses on health policy in a couple of different areas that I'll describe and a bit more, but I want to go back to our history because it's really, really important. We were started in 1918, created in 1918 by our founder, Anna Harkness. Which, I always like to bring up as the first and most important point, we were a foundation that was started by a woman who, in essence, set aside $10 million from revenue and wealth that they had generated, her and her husband, through investments in Standard Oil and the Rockefellers, to do something for the well-being of mankind. And so our history goes back to 1918, $10 million, which is the equivalent of several billion today, a mission focused on the well-being of mankind with a particular focus on health.

And if we look back at some of our earliest contributions, we are really proud of the types of things that the Commonwealth Fund supported, including our nation's first public health departments, our nation's first medical schools in urban areas. We funded the first rural hospitals, which then led to legislation called the Hill-Burton Act that provided federal funding for the construction of hospitals nationally. We funded some of the first advanced practice practitioner programs that include nurse practitioners and the like. We funded a little bit of science; we funded the research behind the cervical cancer test, the pap smear. And probably in the last 30 to 40 years, pivoting more concretely from funding on the ground to policy, which I referenced before. We did a lot of the research that undergirded the Affordable Care Act.

Our mission is affordable, high-quality healthcare for everyone, and we've been focused particularly in a couple of different areas: the pillars of healthcare, healthcare coverage, healthcare delivery, and healthcare costs built on a foundation of equity and the notion that we should leave no one behind. And anyone, no matter who they are or where they're from or how much resources they have, should get the best we have to offer from the standpoint of healthcare and wellbeing. Maybe I'll just end here by tying it to our conversation today. In the 1920s, the Commonwealth Fund really was very, very committed to child health and welfare, given the challenges of that time, going into the depression. And so we launched the first child health demonstration program in four communities, rural communities, that really aimed to address infant and maternal mortality. So, kind of a full circle moment as we see both of those numbers precariously high and rising.

So our history around children's health, maternal wellbeing brings us to our present where we're heavily invested, as well as thinking more about rural health. And we did additional work in the years focused on anticipatory guidance. So we do have roots, Carol, and I want to be very clear on children's health. And so, happy to touch about that a little bit more later if the opportunity presents itself.

Carol Vassar, podcast host/producer:

It's interesting to hear the history, the very early history, when you were established in 1918. Nemours comes from very similar roots, where Alfred I DuPont had a similar vision that this is for everyone, and every child deserves high-quality healthcare that is equitable. It's just heartening to hear that we're on very similar paths with the Commonwealth Fund. As an adjunct to that, at Nemours, whole child health is what we're all about. We define it in a very succinct way, pay for health, define health, and you start with children. So I think there's a very strong commonality in there. Let's talk about that as a commonality with the Fund's mission of access, quality, and equity. Those really do align, especially for kids and families.

Joseph Betancourt, MD, President, The Commonwealth Fund:

Absolutely. At the end of the day, we understand that this is a journey. We think about our nation's health and wellbeing, the journey is one that includes people having health insurance that's affordable, accessible, and that it could be carried out in a way that patients and families can have meaningful conversations and get high-quality care. We understand, too, that coverage does not access make. As I mentioned, affordability, accessibility, meaningful engagement also leads to how we're designing healthcare. And so our focus, particularly in primary care is very well-aligned with children's health. Primary care is pediatrics, it's family medicine, it's OB/GYN, it's internal medicine. I'm a practicing internist still, so I'm a practicing primary care doctor. This is meaningful to me, so I see it every day. And so clearly, whole health is all those things.

We also understand that the costs are critical. When we compare the United States to our peers internationally, other OECD nations, what we see is that we spend the most and we have the least to show for it. We have the lowest life expectancy, highest infant mortality, highest burden of chronic disease, most disparities. And so, clearly it's not about having enough money, it's about how we deploy those resources to the improvement of the well-being of the American people, and child health, whole person health really needs to be central to that. And again, your calling out and my calling out earlier the importance of this concept... Which I want to just call out, this term equity has been highly weaponized today, sadly. And I think fundamentally, when we're talking about equity, we're simply saying, again, that we want high-quality care and the best health and well-being for everyone, and want to take all the paths it will take to get there.

And so I think it's important to continue to articulate that narrative carefully and to be very direct and clear around what we mean when we talk about equity, so as to not let that narrative get co-opted. And I think every American understands the importance of not leaving anyone behind, and that's the principle that undergirds all of this work.

Carol Vassar, podcast host/producer:

I want to pull on a string that you mentioned, and that is worsening infant mortality, especially in 20 states, according to your 2025 scorecard on state healthcare performance. In that performance report, we did see some improvements in insurance, but some pediatric trends like the one I just mentioned, 20 states worsening infant mortality, a decline in childhood vaccinations since 2019. This is a big elephant. Where do we take a bite? What actions can and should states and systems take first when it comes to getting at those issues, especially for kids?

Joseph Betancourt, MD, President, The Commonwealth Fund:

Yeah, I think first we need to acknowledge how tragic that data is in a nation with as many resources as we have. I just highlighted the comparisons between us and our peers, and not only are our numbers rising, but compared to our peers, wildly out of line and much poorer. So when we think about the idea of growing infant mortality, obviously, we tie it directly to maternal health and the maternal mortality crisis we have as well. Those things go hand-in-hand. And fundamentally, we know that certainly primary care is really foundational. The United States spends 5% on primary care compared to its peers, who spend upwards of 14% to 15%. That's one important distinction. How can states, how can healthcare systems prioritize accessible, affordable primary care? That's, I think one big anchor.

The second is, as you compare us to our international peers, where they perform much better, the coverage issue is very, very important. So, what we're thinking about infant mortality, maternal mortality, coverage, and particularly things like strong prenatal care, things like assuring that community birthing, doulas...really issues that bring midwifery to the center of our work that is more patient-centered. I think that it's evidence-based; those are opportunities for states and health systems to really dig in when we think about these numbers. So we have lessons, Carol, not only from our international peers, but we rank all 50 states as well, and our state scorecard as well.

And you see that the states that do better around infant mortality, the states that do better around maternal mortality, are those that do a lot by way of coverage, Massachusetts being a great example, leading in coverage. Really focus on primary care, and pay great attention to the importance of really centering maternal health as a vehicle to addressing not only maternal health, but infant mortality. Those are the lessons that we really want to put forward here. And it is, again, bringing back to the original notion of whole child health; it is built on a foundation of strong primary care.

Carol Vassar, podcast host/producer:

What would you see as being the ideal pediatric healthcare system moving forward? You mentioned that you've done some international work...there are great international models. Can some of them be transferred to the US?

Joseph Betancourt, MD, President, The Commonwealth Fund:

Yeah. We definitely see other countries doing interesting work, and maybe the one thing that I left out as I was thinking about our international comparisons is investments in the social safety net and the social drivers of health. When we look at our peer nations, they do better by way of coverage, they invest more in the social drivers of health, and they invest more in primary care. So I want to sit with that for a second and now bring us to the social drivers. Simple things, such as paid parental leave. You might argue that's not a health policy. I would argue it absolutely is a health policy. And we see several nations who do much better around parental leave as it relates to both illness, but also around birthing, that make a fundamental difference in these areas.

And so I think we need to bring in the intersection of public policy, health policy, and look at some of our peer nations. And again, I want to keep drawing us to looking at some of our high-performing states. They are key success factors, even within our nation as we suffer around national data, but we look at state data, they're pretty drastic differences. So it's not like some states don't have this figured out. Federal policy matters, but so does state health policy, and so does the strength of healthcare systems within states. So I think there's a lot of examples that we could bring forward here from international partners and states. I think, again, they focus on those cares, and our mix of public policy, health policy, good healthcare delivery, coverage, and a focus on the social drivers.

Carol Vassar, podcast host/producer:

What states are doing it well? You mentioned Massachusetts a little bit earlier.

Joseph Betancourt, MD, President, The Commonwealth Fund:

Yeah, Massachusetts is routinely number one just this past year in three areas, quality, access, and outcomes, as one as part of our state quality scorecard. Number one in equity and number one in our women's health scorecard. And so what do we see that's unique about Massachusetts? I think it's investments in all those areas. Strong investments in coverage, lowest number of uninsured across the country. We see also significant investments in primary care, great attention to maternal health, good investments in the social drivers. All those things I think are really important. We see other states. Hawaii is also always in the top. The New England states tend to do particularly well. And again, this is very predictable. It's a series of, it's less about who the states are and more about what the states are doing, and it's those critical success factors that make a difference.

Carol Vassar, podcast host/producer:

Dr. Betancourt, given the very central role of Medicaid, CHIP in supporting children, supporting children's health, how might eligibility policies, redeterminations, or work requirement proposals impact children's coverage, their continuity thereof, and access to preventive care, which is so important?

Joseph Betancourt, MD, President, The Commonwealth Fund:

I think the numbers show that, what, upwards of 50% of kids are covered by Medicaid and CHIP So let's just lift that up as how important those programs are for the health and well-being of kids in our country. There have been very significant changes to the Medicaid program that include changes in the way people provide information around eligibility, what we call redetermination, work requirements. What does the data tell us? When we think about those parents who lose their coverage, it absolutely impacts all aspects of the kids as well. So, above and beyond the changes that might happen in Medicaid CHIP that impact kids and their coverage, more directly, we understand the ripple effects of fundamentally changing such an important program that has an important impact on children's health and wellbeing.

So we need to think about it not only as what is these changes going to do directly to kids, given how much they depend on this coverage, but of equal or perhaps more importance, the parents of those kids. And now, when they're losing coverage, their ability to make sure that their kids have what they need, I think, is going to be severely impacted. So it's a real concern. We spent a lot of time, again, being very evidence-based, given our mission of affordable, high-quality healthcare for everyone around, what the impact of the changes on Medicaid would be, and they're pretty daunting. And so we're all for thinking about ways to be effective and efficient and to root out waste, but we also need to understand there's a lot about Medicaid and CHIP that works very, very well. So as we think about those things, we understand that these changes will really put kids at great risk, and it's something we're going to continue to track, something we're going to elevate for policymakers, but it certainly does not look promising.

Carol Vassar, podcast host/producer:

Let's change the subject a little bit. You've noted that misinformation plays a role in a lot of families' decision-making and may play a role in falling vaccination rates. How do you see misinformation more broadly undermining children's health, and what can we do about it?

Joseph Betancourt, MD, President, The Commonwealth Fund:

Yeah, I've spent a lot of my career working on the doctor-patient relationship and the importance of building trust. And clearly, we have understood for a long time that certain communities are more mistrustful of the healthcare system for a lot of very significant historical reasons, particularly racial ethnic minorities, given our nation's history of racism and medical experimentation. Oftentimes, we call out the Tuskegee Syphilis study and the like. So I want to say the issue of mistrust and misinformation filling the void is not new in general, and it has particularly impacted certain communities given our nation's history.

Now I want to bring us to 2019, 2020, and entering the pandemic. We enter the pandemic at a place where trust is, I'd say, already challenged, and sadly... And I was heavily involved in surge teams providing clinical care, doing work on community health related to COVID and our pandemic strategy. Our first and most important goal was to build trust, particularly in the information we were providing people, the testing, and, of course, the vaccine. And it's interesting because as I look at that trajectory, there was a lot of trust and support for healthcare professionals going into the pandemic. The vaccine hits, there was almost this rush. Everybody wanted to get it first. There was a competition to get it. And there was a big worry that those communities were mistrustful; we needed to take special attention to bring them in and to welcome them.

But sadly, what happened was a very, very significant politicization of the vaccine that was incredibly difficult, very, very damaging. It broke some of the norms and I think assumptions that we had going into that period about who wanted the vaccine, who would get it. There was divisions around political lines, divisions by socioeconomic status. It was really very difficult to see. And I would say that, really, for me in this contemporary age, is where the issue of mistrust and misinformation takes root. What I would argue, and this is especially pertinent today, is that the seeds of misinformation grow fast, and they grow wildly. If you partner that with the fact that, as caregivers, we haven't always been the best communicators... Meaning, I don't think we've brought as much humility as we've needed to say, "This is what I know now. I want to do the best for you. It might change tomorrow, but I do this because I care," as opposed to, "Here are the five things you need to do because this is what the science says you need to do."

There's a lot of humility I think that we need to bring to our conversations to then counteract a lot of the misinformation that is put forward. Because in the absence of trust, misinformation fills the void. And again, in my experience, just seeing patients more recently, I'm getting more conversations about vaccine hesitancy than I've ever had, even with some vaccines that my patients have been getting for a long time. And so it's important to understand that key to misinformation taking root is lack of trust. And so it's through trust that we open the door of sharing real information, and we need to bring this notion of caring and centering that in our communications, along with humility, with our patients. That's the only way, Carol, in my view, that we're going to win this battle for, quite frankly, what is the well-being of the American people and particularly kids, when there's so much misinformation right now about vaccines.

Carol Vassar, podcast host/producer:

How do we actualize trust? How can that happen? Does that need to happen in the medical school setting? Does it need to happen at home with parents before people hit medical school or nursing school?

Joseph Betancourt, MD, President, The Commonwealth Fund:

Yes, I'd say it's a combination. We understand, and part of the importance of primary care as a foundational element is that, when well-designed, you're developing a relationship with a caregiver who, over time, hopefully you begin to trust, you understand they have your wellbeing at heart, and that's what's most important to them, and you are able to kind of drown out misinformation. It's still an ongoing conversation. I still have patients who come to me, and although they trust me, they'll say, "My uncle told me this," or "I heard this," or "I heard that," but we have an honest conversation about it. And they know that what I have at stake and what's most at stake is their health and well-being. That's why I am there. And so I think we absolutely need to understand that the relationship part of caregiving is where trust is built.

That being said, that's a long road to do it onesie-twosie, so that you need a multi-tiered strategy. And particularly at a time where social media is a kind of a fire hose of misinformation, we cannot use the tools of yesterday to solve today and tomorrow's problems. So while we want to invest in strong primary care and relationships, we do need to think about what are some more thoughtful ways we can use trusted messengers and amplify real voices in a way that's much more scalable than the individual relationship? Especially because primary care is in crisis. So it does require, number one, having the skills, bringing humility and caring to the conversation, doing it one-on-one with patients, but also thinking about ways in which you can amplify those voices to the masses and kind of, I would argue, re-anchor the nation's trust in healthcare professionals.

Carol Vassar, podcast host/producer:

And much of that trust comes from evidence-based information. And you've talked about, you've warned actually, about threats to public health datasets. So let's talk a little bit about that. What pediatric datasets do you see as being most at risk, and how do we preserve those datasets so that communities can create the policies and programs that they need to thrive?

Joseph Betancourt, MD, President, The Commonwealth Fund:

Ultimately, we understand it's a very simple concept: you can't manage what you don't measure. If you care, you'll measure it. And datasets, healthcare datasets, really become the map in the cockpit of how we're navigating the improvement of the health and well-being of the American people. In the absence of information, we are fundamentally unable to identify where there are problem spots. And that could mean something as simple as the next pandemic, to where chronic disease is flourishing, and we know that, all the datasets that we've built. And people laugh about data. They say, "Data is not sexy. Oh, that's numbers." And there's almost been this kind of a trivializing of intellectualism and science, if you will, as we're talking about the importance of these datasets. But datasets are essential.

We have seen over the last several months, really a lot of fits and starts around some very, very important datasets. PRAMS. PRAMS is an important dataset that looks at infant mortality and maternal mortality. Up and down, in and out. STAT, a great publication that does reporting on healthcare and healthcare policy, identified several other datasets, the Behavioral Risk Factor Surveillance Survey, another one that's really important around health status, and it's parallel, the Youth Risk Behavioral Surveillance System, which looks at issues related to mental health and emotional health. The Youth Tobacco Survey, the National Survey of Children's Health. There's a series of these that are really, really important, and I would argue they shouldn't end up at the cutting room floor of budget cuts. These are really critical datasets. There are many, many people fighting to ensure that we have the data we need to track and improve the health and well-being of the American people.

So this is a real-time conflict that we're facing and battle that we're facing. But ultimately, I think until we explain to people on the ground, on the street, why is this information important, I think we're at risk. And it's not unlike public health where people say, "Public health works when you don't have to think about it." It's in the air, it's in the ether. Same thing. This data doesn't really come up as an issue until it's at risk, and now you have to explain to people that everything we do is based on the datasets. You don't see it, but really it is critical to navigating our future. So several here at risk for adults, for mothers, for kids, and it's important for us to understand them and to really advocate for keeping them and supporting them going forward.

Carol Vassar, podcast host/producer:

Absolutely. All of those that you just touched on are standard public health datasets and healthcare datasets that have been used longitudinally as long as I've been doing public health and healthcare media. So, very important to the work I do, the work you do, and really to the health of all involved. I want to talk about private equity and its growing role in healthcare delivery. How is that affecting pediatrics?

Joseph Betancourt, MD, President, The Commonwealth Fund:

It's a great question. Just a bit of background for listeners, what we've seen is that private equity investments and healthcare systems, with the fundamental notion that there's an opportunity to generate revenue, they've been on the move and increasing in a variety of different ways. The one that was probably in the news the most in the last few years is Steward Health Care, the nation's largest for-profit healthcare system, which I think is a case study in where private equity can go wrong when you focus on wealth generation, not health generation. And so the promise of private equity, just to be clear, is that, yes, of course, when you bring resources, when you bring scale, when you can take a struggling practice and say, "Look, we're going to invest and we're going to decrease administrative burden, we're going to bring in technology. We're going to help you not only provide better care, but perhaps better balance in life." It is very appealing. There's many practices that are struggling and could use those resources, and there's many cases where those resources do great things.

But without the appropriate guardrails, what we do see and what the research tells us is that private equity investments tend to pick certain areas that are particularly high margin, such as surgical services, whether it be orthopedics, whether it be ophthalmology. There's certain services that I think have a larger revenue margin, profit margin, and they become more appealing to private equity. But we see it in nursing homes, we see it in hospital chains. So private equity has really embedded itself in a lot of aspects of the healthcare system. And so we had the Commonwealth Fund take an agnostic look at this, and we say, "Okay, no judgment, do those investments yield improvements in care and improvements in cost and improvements in overall health outcomes?" And I would say to date, the evidence is quite mixed. What we're seeing more often than not is that in situations, particularly hospitals or other facilities where private equities come in, we have tended to see higher costs, higher volume, perhaps lower quality, and no demonstrable improvements in health outcomes.

Now, to your point more particularly about children's health, the data there is very, very scant because most of the data is focused on commercial healthcare, Medicare, mostly on the adult side. And so this is an area that will be explored, I think, going forward. Private equity I think has demonstrated some interest in some pediatric services, but clearly I think there's a lot more to be told in this story, and we are tackling that as part of our area that focuses on costs. So the commercial drivers of health, private equity, is something we'll be studying going forward.

Carol Vassar, podcast host/producer:

Philanthropy is another driver of health. How do they do what they do and improve children's health? What kinds of models are they bringing to the fore that are working, and can they be expanded?

Joseph Betancourt, MD, President, The Commonwealth Fund:

Yeah, if you go back to our history, even our work in the '80s and '90s, the investments that the Commonwealth Fund made in improving child health guidance, the investments that the Commonwealth made in other aspects of children's health, in identifying promising models, evaluating them, really bringing attention through convenings of others to scale these models, is really I think the bread and butter that foundations could bring. Ours, in particular, focuses on health policy. What we try to do is work with partners who are perhaps investing in these innovations, and then really shedding a light on them, bringing our communications assets to bear, really evaluating them, and hoping that they will then be adopted into payment models and care models.

And I think that's where we can really add value. Our healthcare system is trillions of dollars. We have to be also in philanthropy, humble about the changes that we could expect to catalyze. That being said, we have plenty of examples historically, we and other foundations, on the differences that we can make. And we are in a privileged position to be able to take people who have great ideas, support them, and demonstrate a better way forward, and I think that certainly goes for children's health in the future.

Carol Vassar, podcast host/producer:

You talked a little bit and alluded to the COVID-19 era, which is a time we learned a lot about what we could do as a nation, as a society. We could reduce red tape, we could bring forward vaccines quickly, we could bring forward telemedicine quickly. What would it take to bring that kind of urgency and red tape reduction to areas of concern today, especially when it comes to children's health, behavioral health, school readiness, etc?

Joseph Betancourt, MD, President, The Commonwealth Fund:

I'll tell you, Carol, you channeled me in my mindset during the pandemic. When I was operating during the pandemic, it almost became a joke amongst us that we'd say, "Remember the days when if we were trying to do something, I'd say, 'Yeah, I'll set up a call with you in two weeks?'" And today it's, "I'll set up a call with you at 8:00 tonight." It was, in many ways, what I call the best of times and the worst of times. Worst of times for all the reasons we know, the best of times because it was adrenaline-fueled change, saving lives, pushing away bureaucracy and red tape. It was phenomenal. And as we were coming out of the pandemic, this is exactly what I said, I said, "We need to bring these types of energies to particularly what I would consider the epidemic of behavioral health in kids." Imagine if we could say, "For this next year, we're going to bring all of our efforts to bear, like we did during COVID, to focus on behavioral health, substance use disorder, children's mental health."

That's what it really is going to take. We demonstrated how effective that could be, and quite frankly, that's exactly what is needed if we want to make the changes with urgency. And so I think I oftentimes said, "This is what we need." And I still say it in many different venues, bringing forward that urgency and that kind of singular focus around the next biggest epidemic, in my view, behavioral health. And we know how much that challenges young people, and we've seen the data on depression and anxiety, on suicide. We understand the impact of social media is just one of a series of vehicles. Social isolation. We have all this data. If we could bring this together and channel that focus, I think the sky would be the limit, but it would require that urgency. And so, a long way of saying I think it's that level of focus that's needed, and I'm hoping that we could still capture a little of that going forward.

Carol Vassar, podcast host/producer:

What gives you hope right now, Dr. Betancourt? If we were to act today, what gives you hope for better outcomes tomorrow, a year, five years, 10 years?

Joseph Betancourt, MD, President, The Commonwealth Fund:

What gives me hope is that we have absolutely a nation full of very, very, very deeply committed and dedicated health professionals, scientists, individuals at the front line, individuals at the bedside, at the doorstep of patients in their communities. You cannot underplay how important passion, dedication, commitment, and hope is. And so in the midst of a lot of very difficult challenges that we face, we also understand that people are still doing the work every day and that people will fight and will continue to fight for a better tomorrow. So I think you lose hope when you feel a sense of defeat, and people feeling defeated. And I would say there might be anger, frustration, disappointment, but there is no loss of hope, dedication, action, and energy. And so that's what fuels me, and I think we have a lot to be hopeful for. It's who we are as a people, and particularly the healthcare and research community, these are people who sacrifice incredible amounts of their lives to make a difference for people, and they're not going to stop now.

Carol Vassar, podcast host/producer:

Dr. Joseph Betancourt is a primary care physician and the president of the Commonwealth Fund.

Music:

Well Beyond Medicine.

Carol Vassar, podcast host/producer:

We are so grateful to Dr. Betancourt for spending some time with us and sharing his insights. It was a really great conversation, and we hope you enjoyed it. Thanks for listening.

Healthcare is an intricate and complicated topic. We all know that. But it's one we're willing to take on by bringing you healthcare leaders and experts from across a variety of fields to provide well-rounded, evidence-based insights and knowledge that make us all a little bit smarter when it comes to whole child health. Your suggestions and ideas for future podcast episodes are always welcome. You can send those to this email, producer@nemourswellbeyond.org, or leave a voicemail on our website, NemoursWellBeyond.org. That, of course, is the place to find previous episodes of Well Beyond Medicine, subscribe to it, subscribe to our monthly e-newsletter, leave a review, or listen to episodes you may have missed. That's NemoursWellBeyong.org. You can also find the podcast on your favorite podcast app and on the Nemours YouTube channel. And don't forget, you can find it by telling your smart speaker to play the Nemours Well Beyond Medicine Podcast.

Production assistance for this episode comes from the best podcast production team in the business: Susan Masucci, Cheryl Mann, Lauren Teta, and Alex Wall. Video production by Britt Moore. Audio production by yours truly. Next time we're talking about CMV, cytomegalovirus. Never heard of it? You're not alone. But in-utero exposure can lead to severe hearing loss for kids, and that's why we're talking with the experts, the policymakers, and a couple of families affected. That's on the next two episodes of the Nemours Well Beyond Medicine Podcast. Don't miss it. I'm Carol Vassar. Until then, remember, we can change children's health for good, Well Beyond Medicine.

Music:

Let's go, Well Beyond Medicine.