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Home Perspectives

Ode to Civics

Daily Remedy by Daily Remedy
August 8, 2021
in Perspectives
0

In a piece of the past, I saw a path for the future.

As I was driving through the rolling roads in the Ridge-and-Valley Appalachians, I could not help but look at all that was around me – passing me by.

I saw the beautiful hills winding off into eternity; I saw majestic trees standing tall like proud soldiers, guarding the land. I saw old scaffolding for abandoned coal mines. I saw the old church houses with its history written on the layers of renovations, completed decade over decade.

I saw the beauty of Appalachia.

I then saw the empty main street, now adorned with vacancy signs and plywood sheet coverings. I saw the rehabilitation centers, filled with souls fighting internal battles that require our support and understanding – fighting a war on two fronts, most recently the viral pandemic, and before that, the opioid epidemic, a fight raging year over year.

I heard the cries for help throughout Appalachia.

When I visited the County Sheriff’s Office, I was fortunate enough to meet with the Sheriff and his staff. We shared our stories, and we exchanged our concerns. Through our conversations we were able to understand what is ailing Appalachia.

A quotation frequently cited, yet erroneously attributed to Alexis de Tocqueville states: “America is great because America is good. If America ever stops being good, it will stop being great.”

In those conversations I saw what makes American good – open, honest dialog. In simply talking, sharing our concerns and learning about one another, we were able to better understand one another.

If America is to embody what makes it great, it must reinvigorate good civic dialog – among us all – those in healthcare and those in law enforcement, those disenfranchised and those empowered.

The pandemic has made apparent what was always present during the epidemic, exposing fundamental rifts formed well in advance – years, if not decades before – rifts in how we understand ourselves, and how we understand others.

Rifts that lead us to show love to those battling addictions, yet show contempt for those we deem to be addicts – rifts that have so greatly widened during the pandemic that we now put public health safety and economic prosperity at odds with one another.

Rifts we bridge by becoming good towards one another.

And we become good when we understand one another.

This is why, as lockdowns and shutdowns begin to lift, we should open the doors of town hall, hold meetings in towns across the land to discuss public health issues – whether it is opioid prescribing patterns or the lack of parking at a new hospital facility – anything from the slightest to the greatest.

Create a forum through which we can express ourselves, share in our victories, and seek solace in our struggles – where law enforcement and physician leaders can discuss the issues they face, and how they are facing them.

We all want what is best for Appalachia.

We all have a desire to see the state emerge out of the pandemic-driven recession and overcome its ghastly legacy of addiction.

We are an incredible land with incredible individuals.

Yet we find ourselves divided within rifts we cannot see, at odds with those we have much in common, overlooking what unites us to focus on what divides us.

But to bring out the greatness in all of Appalachia, we need to return to the time honored tradition of civic dialog.

A piece of the past creating a path for the future.

Bringing us together, so we can bring out the best in one another.

God bless.

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Daily Remedy

Dr. Jay K Joshi serves as the editor-in-chief of Daily Remedy. He is a serial entrepreneur and sought after thought-leader for matters related to healthcare innovation and medical jurisprudence. He has published articles on a variety of healthcare topics in both peer-reviewed journals and trade publications. His legal writings include amicus curiae briefs prepared for prominent federal healthcare cases.

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Videos

Most employers are unknowingly steering their health plans toward higher costs and reduced control — until they understand how fiduciary missteps and anti-competitive contracts bleed their budgets dry. Katie Talento, a recognized health policy leader, reveals how shifting the network paradigm can save millions by emphasizing independent providers, direct contracting, and innovative tiering models.

Grounded in real-world case studies like Harris Rosen’s community-driven initiative, this episode dives deep into practical strategies to realign incentives—focusing on primary care, specialty care, and transparent vendor relationships. You'll discover how traditional carrier networks are often Trojan horses, locking employers into costly, opaque arrangements that undermine fiduciary duties. Katie breaks down simple yet powerful reforms: owning your data, eliminating conflicts of interest, and outlawing anti-competitive contract clauses.

We explore how a post-network framework—where patients are free to choose providers without restrictive network barriers—can massively reduce costs and improve health outcomes. You'll learn why independent, locally owned providers are vital to rebuilding trust, reducing unnecessary procedures, and reinvesting savings into the community. This conversation offers clarity on the unseen legal landmines employers face and actionable ways to craft health plans built on transparency, independence, and aligned incentives.

Perfect for HR pros, benefits advisors, physicians, and employer leaders committed to transforming healthcare from the ground up. If you’re tired of broken healthcare models draining your budget and frustrating your staff, this episode will empower you to take control by understanding and reshaping the very foundations of employer-sponsored health. Discover the blueprint for smarter, fairer, and more sustainable benefits.

Visit katytalento.com or allbetter.health to connect directly and explore how these innovations can work for your organization. Your path toward a healthier, more cost-effective future starts here.

Chapters

00:00 Introduction to Employer-Sponsored Health Plans
02:50 Understanding ERISA and Fiduciary Responsibilities
06:08 The Misalignment of Clinical and Financial Interests
08:54 Enforcement and Legal Implications for Employers
11:49 Redefining Networks: The Post-Network Framework
25:34 Navigating Healthcare Contracts and Cash Payments
27:31 Understanding Employer Health Plan Structures
28:04 The Role of Benefits Advisors in Health Plans
30:45 Governance and Data Ownership in Health Plans
37:05 Case Study: The Rosen Hotels' Health Model
41:33 Incentivizing Healthy Choices in Healthcare
47:22 Empowering Primary Care and Independent Providers
The Hidden Costs Employers Don’t See in Traditional Health Plans
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Semaglutide and the Expansion Problem: When One Trial Becomes a Platform

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by Daily Remedy
March 30, 2026
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Semaglutide has moved beyond its original indication and now sits at the center of a widening set of clinical questions: cardiovascular risk, kidney disease progression, and even neurodegeneration. The question is no longer whether the drug lowers glucose or reduces weight—it does—but how far those effects extend across systems, and whether evidence from one population can be translated into another without distortion. Large, well-powered trials have produced consistent signals, yet those signals are now being applied in contexts that were...

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