Episode Summary

Dr. Don Berwick joins Chris Malone and Terry Akin on The Unity Forum for a timely discussion about the state of U.S. healthcare. Drawing directly from current policy developments, Dr. Berwick examines looming Medicaid and Affordable Care Act coverage losses, rising insurance premiums, workforce strain, and growing threats to science and public trust. He reflects on what these changes mean for patients, families, clinicians, and communities—and why caring for one another must remain the central priority of healthcare reform.

Guest

Dr. Don Berwick — former Administrator of the Centers for Medicare & Medicaid Services and founding President and CEO of the Institute for Healthcare Improvement. A pediatrician and internationally recognized leader in healthcare quality, safety, and policy reform.

Chapter Markers

00:00 – Welcome to The Unity Forum and Program Overview

01:30 – Introduction of Dr. Don Berwick

03:05 – Urgent changes facing the U.S. healthcare system

03:40 – Medicaid cutbacks and coverage loss concerns

04:15 – Rising premiums and affordability challenges

9:45 – Impact on hospitals, clinicians, and safety-net providers

17:30 – Trust in science and the consequences of misinformation

26:10 – Workforce burnout and patient safety risks

33:00 – Payment reform and value-based care

40:15 – Hopeful examples and reasons for optimism

45:30 – Caring for one another as a guiding principle

Episode Highlights

- Millions of Americans risk losing health coverage due to Medicaid and ACA policy changes.

- Rising premiums place increasing strain on families and healthcare organizations.

- Workforce stress and burnout threaten patient safety and care quality.

- Attacks on science undermine prevention, trust, and effective public health.

- Healthcare outcomes depend on social and community conditions, not medical care alone.

- Civic engagement and advocacy remain essential to protecting population health.

Notable Quotes

“Science is not a set of facts chiseled into rock.”

“When nurses are under a lot of stress, patient safety goes down.”

“We are in this together. A virus doesn’t check what party you belong to.”

Closing Message

Dr. Berwick emphasizes that healthcare should never be a partisan issue. By grounding decisions in science, compassion, and a shared responsibility to care for one another, communities can navigate uncertainty and build a more humane and effective healthcare system.

Recommended Book & Podcast

The Health Gap: The Challenge of an Unequal World by Michael Marmot

Turn on the Lights Podcast with Dr. Don Berwick and Dr. Kedar Mate

Episode Summary Social psychologist Dr. Ronnie Janoff-Bulman joins Chris Malone to explain how two distinct moral systems—proscriptive (“do no harm”) and prescriptive (“help others”)—shape liberal and conservative worldviews. Drawing on her book The Two Moralities, she describes how approach-and-avoidance motivations give rise to social-order and social-justice moralities, why both are essential for a healthy democracy, and how understanding them can bridge America’s political divide.

Guest Dr. Ronnie Janoff-Bulman — Professor Emerita of Psychology at the University of Massachusetts Amherst and author of Shattered Assumptions and The Two Moralities: Conservatives, Liberals, and the Roots of Our Political Divide. Recipient of the Morton Deutsch Award for Justice Research.

Chapter Markers

00:00 – Welcome to The Unity Forum

00:52 – Guest introduction and career overview

02:17 – Origin of “left” and “right” during the French Revolution

04:26 – From ideological diversity to modern polarization

04:46 – Approach vs. avoidance motivation: the basis of two moralities

06:01 – Proscriptive (“don’t harm”) vs. prescriptive (“help others”) morality

07:06 – Group-level morality: social order (protection) vs. social justice (provision)

09:36 – Government intervention: contrasting liberal and conservative domains

10:55 – Finding balance between the two moralities

12:00 – Parenting analogy: demandingness and responsiveness

13:56 – Why “don’ts” are easier than “dos” in moral learning

15:52 – Moral obligations and the trolley problem

17:11 – Religion’s role in reinforcing morality and group identity

19:52 – Bridging divides: both sides as moral, not immoral

22:53 – Media and social media: loss of a shared public sphere

26:27 – Holiday and family conversations: practicing attributional generosity

27:46 – Q&A: rural-urban moral divide

31:15 – Q&A: finding common ground and worthy intent

32:26 – Q&A: libertarians and communitarians

34:57 – Q&A: defining “protecting society” across moralities

37:18 – Q&A: bridging divides when identities are denied

39:02 – Closing reflections and call to re-humanize each other

Episode Highlights

• Political polarization stems from two core moral motives: providing (care) and protecting (order).
• Liberals emphasize social justice and equality; conservatives emphasize stability and tradition.
• Both moralities are legitimate and necessary for societal balance.
• Contact and conversation remain the best tools to reduce demonization and build trust.
• Attributional generosity—assuming good intent—helps restore civility.

Notable Quotes

• “There really are two different forms of morality that map onto approach and avoidance … don’t harm and help others.”
• “Social order and social justice moralities are both legitimate — we want to live in groups where we’re protected and provided for.”
• “Eight of the Ten Commandments are what you should not do … it’s easier to learn the proscriptive than the prescriptive.”
• “Both sides are grounded in morality. We demonize each other when we forget that.”
• “Ask for attributional generosity with your family … remember that person would still help you in a crisis.”

Closing Message Dr. Janoff-Bulman reminds us that America’s political divide is a moral one rooted in two valid human instincts—to protect and to provide. Recognizing the worth in both approaches can help us listen more generously, disagree more respectfully, and re-humanize each other in the process.

Episode Summary Dr. Patrick T. Harker joins The Unity Forum to unpack the moment we’re in: why he describes the backdrop as “stagflation light,” how to read the Fed’s dot plot as guidance—not a promise, and why long-term rates may not fall soon despite policy moves. The discussion explores the Fed’s independence, the neutral rate (r★), AI’s potential productivity boost, and listener questions on the U.S. dollar’s reserve-currency status.

Guest Dr. Patrick T. Harker — economist and academic leader; served on the FOMC while leading the Federal Reserve Bank of Philadelphia; currently a Rowan Distinguished Professor.

Chapter Markers:

00:00 – Welcome & format

02:34 – Guest introduction

06:29 – Is policy being swayed by politics?

08:31 – “Stagflation light”: mixed labor signals and sticky inflation

11:44 – The dot plot as assessment, not commitment

14:02 – Neutral rate (r★) and AI’s productivity potential 19:00 – What the Fed can and can’t do: long end vs. fed funds

22:21 – Appointments & central-bank independence

24:16 – Risks of political interference in central banking

31:57 – Defining stagflation

33:06 – Listener question: Will the U.S. dollar lose reserve status?

40:19 – Why long rates may not go down soon

42:46 – Closing reflections

Key Takeaways

• Politics are not part of the FOMC’s internal policy debates; decisions are fact-based.
• The economy is best described as “stagflation light”: slowing labor market and sticky inflation.
• The dot plot shows participants’ views, not a promise of rate moves.
• A higher neutral rate may hinge on productivity gains from AI.
• Long-term rates drive mortgages and consumer borrowing more than the fed funds rate.
• The Fed has no “secret data”—all information used is public.
• Independence of the central bank is crucial to avoid short-term political manipulation.
• Given deficits and Treasury supply, long rates are unlikely to fall soon.

Notable Quotes “I don’t think it’s political pressure.” “This is an assessment of appropriate monetary policy, not a commitment.” “AI is going to dramatically improve productivity of the U.S. economy.” “The long end has not moved at all… even though the Fed cut 25 basis points.” “People think the Fed has secret sauce. They don’t.” “Do not expect long rates to go down anytime soon.” “Stop demonizing each other… let’s get down to work.”

Listener Question Highlight On the U.S. dollar’s reserve-currency status: it would take a long time to displace, as contracts worldwide are written in dollars and no clear replacement exists today.

Closing thoughts from Professor and former President & CEO of the Federal Reserve Bank of Philadelphia, Dr. Patrick Harker.