2024 Rewind & Look Ahead for Health Care Issues

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Mark Masselli ( 00:04 ):
Conversations on Healthcare covered all of the big issues in 2024 from the White House to the
Metropolitan Opera House. We examined how America designs, delivers and pays for healthcare during
the past 12 months.

Margaret Flinter ( 00:19 ):
As President Trump, a new congress and other new leaders in the states prepare for office, we offer this
recap and we look ahead to the policies, the innovations, and the insights driving healthcare. This is
Conversations on Healthcare.

Mark Masselli ( 00:41 ):
Well, welcome to Conversations on Healthcare. We hope you're resting up during the holidays, because
2025 promises to get off to a fast start, Margaret, with intense confirmation hearings for President
Trump's appointees to the top healthcare positions in the federal government.

Margaret Flinter ( 00:59 ):
That's right. But let's look back on how we got here. This was a year a lot of people wish they had a
crystal ball. We often asked our guests what would happen if President Donald Trump was reelected? In
late June, we heard the predictions from Julie Rovner, Chief Washington Correspondent for KFF Health
News. Let's hear it.

Julie Rovner ( 01:18 ):
There is this Project 2025 that's been put together by, well, it's been spearheaded by the Heritage
Foundation, but a lot of other groups have contributed to it, and it's basically a Republican wish list of
everything they would like to do on health, on every issue, but there's big section on health and work
requirements for Medicaid and I think block granting Medicaid, and turning Medicare into even more
privatized than it is now.
( 01:43 ):
So, whether if Trump was elected he would actually do those things, it's hard to know. The other part of
Project 2025 is that they are vetting people who would like to come into the administration and do
some of these things. So, there's a probably better than 50/50 chance on a lot of these things, but that's
certainly something that we would be looking at.
( 02:07 ):
Trump himself, obviously when he was president, did talk a lot about drug prices. It's something he feels
strongly about. He did talk about preserving Medicare and Social Security. Basically, I think he knew
what a hot button issue it was and didn't want to get into it. We'll see if that would still be the same as
we get... Some point, Congress has to do something about Social Security and Medicare if we would like
them to still be there. So, you can't duck them forever.

Mark Masselli ( 02:33 ):
Just before the election, we talked to Sarah Overmohle, Washington Correspondent for STAT about a
possible Trump victory. Specifically we discussed the Make America Healthy Again, focus of the
Republican campaign.

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Sarah Overmohle ( 02:46 ):
Make America Healthy Again, obvious parallels to Make America Great Again. Intentional. Robert F.
Kennedy is one of the main people behind this, and he has been closely associated with Trump,
especially since dropped out of the race himself. He's on Trump's transition team. Even this weekend,
Trump was saying that he is committed to putting Kennedy in his administration somehow.
( 03:09 ):
There's many arms to the Make America Healthy Again movement. A lot of it has to do with food policy,
chronic illnesses, how to better manage chronic illnesses. But also a lot of it has to do with this idea that
public health agencies are not always incentivized to make the right decisions for people, because of
pharmaceutical industry influence. And that's the part that has a lot of people nervous, because there's
Robert F. Kennedy himself has had anti-vaccine commentary in the past, and he said in more recent
months that that's not how he feels, but the record is there, and the way that he's discussing the
pharmaceutical industry and the review that agencies like the Food and Drug Administration have of
these drugs, we already have a confidence issue in the United States towards vaccines, towards
treatments, and so it has a lot of people nervous about what he would do and who he would pick to be
the people who oversee these very agencies.
( 04:09 ):
So, I think it's a discussion that we're still going to see happen over the next few weeks. Trump has
absolutely doubled down on Kennedy having some sort of role, but I'll note that he said that his first
time that he got elected and Kennedy was not there. So, we can have a little bit of a reality check here.
And certainly of course Kennedy, if he was to be put up for any position like HHS Secretary, that's a
Senate confirmed position. So, we don't think that's what's going to happen. But could he be in the
White House? Could he have a lot of influence? Absolutely.

Margaret Flinter ( 04:43 ):
Well, no disrespect to Sarah, but in this instance her crystal ball was off. President Trump has indeed
nominated Robert F. Kennedy Jr. as Secretary of the US Department of Health and Human Services. His
confirmation hearing will be a big story in the coming weeks as opponents are sure to seek to block his
appointment.

Mark Masselli ( 05:02 ):
Well, Margaret, it's one of many big stories that will be out there during the confirmation season. There
was a feeling throughout the year that the healthcare issues, including abortion, would be very
important to voters. Joyce Frieden oversees MedPage Today coverage of Washington and the health
policy and filled us in when we talk to her this spring.

Joyce Frieden ( 05:23 ):
We've seen in states where abortion has been on the ballot, it's really played out, people have turned
out to vote and it's been a lot in the Democrat's favor. So, I'm sure the Republicans are watching that
and figuring out how they can spin the issue. And there are just so many other healthcare-related issues
on the ballot. Not necessarily, excuse me, on the ballot, but healthcare generally I think is on people's
minds. Access to healthcare and the high price of prescription drugs, which the Biden administration has
taken some actions on. So, I don't know it'll be the top thing on everybody's mind, but I think it'll be
there.

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Margaret Flinter ( 06:09 ):
Of course, at the end of the day, the election was a clash of ideas and approaches. We heard from each
side about how they view healthcare. First, Andrea Ducas, the Vice President of Health Policy at the
Center for American Progress, explained the problems that she saw with the Trump-Vance approach.

Andrea Ducas ( 06:25 ):
It's a pretty disastrous health policy. Like much of what you see in the Trump-Vance agenda, it is a
hearkening to the past. Going back to systems that don't work, or that service just a small number of
Americans. I think many voters forget what the world was like before the Affordable Care Act. It's sort of
amazing how much that bill reshaped the entire American healthcare system, just fundamentally
changed what people expect from the healthcare system. But all we need to do is look... It's not even
that old, right? It's 14 years old, but all we need to do is look pre-2010 to get a glimpse at how
ineffective a tool like a high-risk pool is.
( 07:10 ):
So, how does insurance work? Everybody buys into a system, risk gets spread out, premiums are kept
relatively low so that when people need to use coverage, they get really sick, they get cancer, they get
into an accident, there's enough money in the pool to pay for those kinds of services without effectively
breaking that bank.
( 07:31 ):
The plan to separate very chronically ill people into high-risk pools completely upends the notion of
insurance, right? Those folks would be in their own pool with very, very, very high healthcare expenses.
States tried to do this before, again, before the ACA. They had a very, very, very, very difficult time doing
it. It's very expensive to finance those pools, they're very volatile. Because their expenses don't just
magically go away, you've just moved them into their own pool, you run out of the money that gets
allocated toward those risk pools very quickly. And you can't finance them necessarily on premiums
alone because, again, the expenses are so high, it would effectively be unaffordable unless you really
heavily subsidize enrollment in such a risk pool.
( 08:22 ):
So, what you would probably see again is what we saw in the past, which is enrollment would be
capped. There'd need to be really, really a fine-tooth comb that goes through to decide whether or not
people even qualify, because maybe they're too expensive. So, I think it's a throwback to the wild, wild
west that we had for folks who didn't have job-based coverage, or public coverage, pre-ACA. It's a plan
that doesn't work. It's a plan that we as a nation, that signed into law, or we got to a place where we
had a landmark health reform, the Affordable Care Act. to get us out of that past. So, it would be great
to not go back to it.

Mark Masselli ( 09:08 ):
Margaret, we also heard a counterpoint, the free market perspective from Wayne Winegarden, the
Senior Fellow and Director of the Center for Medical Economics and Innovation at the Pacific Research
Institute. He spoke about first about IVF coverage and then addressed the larger issue within the
insurance industry.

Wayne Winegarden ( 09:28 ):

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Speaking for myself, not for PRI, the important issue is not to mandate it so that we need some
insurance, absolutely we're going to cover it, because people demand it and people want that. But part
of the problem that we're seeing with the ACA is that there are so many different mandates of different
types of coverage that it's harder and harder for people to get the insurance that's appropriate for
them, let alone the fact that our insurance isn't actually providing that key insurance benefit that we
need. Right?
( 09:56 ):
If health insurance was doing what it was supposed to do, it wouldn't be covering first dollar payments
of when you go to a checkup, and that's not a financial risk. What we really need is health insurance to
be there for in vitro fertilization, right? When you actually have a costly medical procedure that's an
actual risk, that's where insurance is supposed to come into play. That's what we're actually missing. But
the best way to get that type of coverage is to reduce the mandates and allow insurance companies to
be competing for enrollees by providing that best coverage. We don't have that, and that's the system
we really want to start moving toward. But the problem with mandates is that it makes it that much
harder for insurance companies to actually tailor plans to the way that people need it.

Margaret Flinter ( 10:45 ):
We learned about research in Lancet Child and Adolescent Health that found that children of color in
America receive less treatment and fewer life-saving interventions than White children. Dr. Nia Heard-
Garris, pediatrician, and a researcher at the Feinberg School of Medicine at Northwestern University
helped lead the project and make this clear to us.

Dr. Nia Heard-Garris ( 11:06 ):
Some of this is rooted in hundreds of centuries of racialized thinking and racialized medicine. Back in the
days, and actually it wasn't that long ago, but when med students still believed and were taught that
Black children, Black adults have thicker skin, so they don't feel pain in the same way, or they have
stronger lungs and so they can handle more infections and harder work, these are ideologies that were
held in times of enslavement to justify how Black people, especially children, were treated.
( 11:43 ):
If you believe they're not feeling as much pain, you can inflict more pain, more work, more burden. And
those ideologies, those thoughts, those ideas continue to get passed on into medicine. So, much so that
you can look at studies from maybe even just 10 years ago where medical students said, "Yes, I think
there's something different about Black skin versus White skin, so you don't need as much pain
medicine. You don't need as much attention to pain because the pain is not there." Or we don't believe
that people are in such pain. When we think about children that really deal with pain crises, so sickle
cell.

Margaret Flinter ( 12:16 ):
Sickle-cell, of course.

Dr. Nia Heard-Garris ( 12:17 ):
Yeah, how those children and also those adults are seen as we called them drug seekers. They're not
really in that much pain, they're just looking for drugs, they're just looking for pain medicine when really
they don't need it. And it's that sort of teaching from medical students, and then they grow up to be
attendings and residents and trainees, and that keeps it going. And so, that's really our thought. This

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study didn't parse out why these disparities exist within pain, but just that they exist. But we do know
from years and decades of the studies about the beliefs that physicians hold specifically.
( 12:53 ):
But with that being said, it's unacceptable. If a kid breaks their arm, if they have appendicitis, if they're
having migraines, and in some cases what we studied was having a digit replaced. So, having a finger or
toe replaced, you can imagine, incredibly painful, so they need adequate pain medicine, no matter what
race or ethnicity they are.

Mark Masselli ( 13:14 ):
Absolutely. And you found that children of color face longer wait times for care at the emergency room.
Maybe a couple of questions. How much longer of a wait time are we talking about? And I'm wondering,
do you know if this is unconscious bias at play?

Dr. Nia Heard-Garris ( 13:32 ):
These are all... You guys are asking the questions that we need... The next study is the next steps to try
to figure out what is happening here. Just in my other work, I know that there are extensive structural
barriers to care for many marginalized groups and many racialized groups, meaning they might have to
access care that's further away. They don't have as many physicians. Their insurance isn't taken
everywhere, at every different healthcare facility. And so, that could be leading to overcrowding and
longer wait times, or delays in care. You don't go. You're like, "Oh, it's not that bad. I don't want to wait
four hours, five hours in the emergency room."
( 14:14 ):
Or you have waited for four or five hours in the emergency room and you've got your second shift job,
you can't continue to wait. So, we've also found that racial and ethnic minority families are more likely
to leave without being seen at all in the emergency room. So, they did seek care, they tried and then for
whatever reason had to leave. But to your question and to your point, we need to do more work to try
to figure out what is that? What are the reasons for that? Is it accessibility to care? There's literally not
enough places where they can get care? Or there's not enough places that will accept insurance? Or
there's not enough providers? What is the issue here?

Mark Masselli ( 14:51 ):
Innovations with artificial intelligence was a big focus for us. No surprise, right? Everyone's talking about
AI. Including in mental health space, Dr. Jodi Halpern is the psychiatrist, noted author and co-founder of
the University of California Berkeley's Group for Ethics and Regulation of Innovative Technology. And
really, she laid bare the problems that are rising from marketing of these AI services, especially to young
people.

Margaret Flinter ( 15:18 ):
That gave us quite a bit to chew on as we were ending up the year.

Dr. Jodi Halpern ( 15:22 ):
So, I said 61% of adolescents and young adults, we have that data now, suffer from extreme loneliness in
the United States, two thirds. And the only country with data like that is South Korea. What does the US

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and South Korea have in common? Our children spend eight to 10 hours a day on online social activities.
This is in addition to doing their homework online.
( 15:46 ):
So, they basically are either gaming or on social media, as far as I can tell every minute they're awake,
unless they're really not sleeping.

Margaret Flinter ( 15:55 ):
Also a problem.

Dr. Jodi Halpern ( 15:57 ):
Well, no, it's related. It's extremely related, because a lot of my work has been showing how, as a
psychiatrist who's also studied neuroscience, the mechanisms that social media for-profit companies, all
the large companies, which any two of which have more money... The seven largest companies, digital
companies, Google, Meta, et cetera, any two of them have equivalent money to the whole federal
government. So, their power to determine and keep us from having regulation is very, very large.
( 16:30 ):
So, we're the most unregulated country compared to Europe and some of the Asian countries that have
anything like our scope. And one of the things that the UK did years ago was regulate marketing to
children for social media and gaming and the technology that gets kids addicted, which is irregular
rewards. It's the same thing that gets us addicted. In fact, Instagram uses it, which most people don't
know, Instagram doesn't... Every time you put up something, a picture, it doesn't just give you back your
likes, it saves them up in bundles and gives them to you irregularly the way slot machines work in Las
Vegas. And that technology, which we saw the patents for 10 years ago and started talking about then,
that develops dopamine surges that get you addicted.
( 17:16 ):
So, the fact that we're all addicted to our phones, addicted to social media, and addicted to gaming is
not accidental. It's not accidental. It's the marketing model of those companies. And I am seeing the
same marketing model in the relational support bots for children. And so, that is what concerns me,
because it's one thing to say we need to get mental health resources that use technology into the
schools for kids. We do. We do need to help kids, and kids are comfortable with technology, so if we
have ways of them connecting with real humans or other kids, or using some online technologies that I'll
describe that don't make you addicted in the same way, that would all be very useful. But we actually
have a good series of reviews by business reviewers, including the Harvard Business School has a letter
that's very in-depth from an engineering and business expert on how one of the most important mental
health companies that has gone through the FDA and is held up as a role model, how their business
model is giving the app free to kids in schools, the app that just has a bot.
( 18:26 ):
You never talk to a human, because it's, quote, a sticky technology, and therefore children will get used
to going to a bot rather than a human for mental health, and they'll grow up to be adults who are used
to only using bots, and so it's a very good business model for a company. So, there's a for-profit motive
in getting this, even from very professionally endorsed companies that are for-profit, if they are for-
profit in the mental health sphere.

Margaret Flinter ( 18:57 ):

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Well, interest in AI has led the New England Journal of Medicine to appoint its first editor-in-chief to a
publication devoted to the topic. Dr. Isaac Kohane serves in that role. He is a groundbreaking Harvard
University professor. He spoke about the nascent technology and its potential for bias as well, of course,
as for good.

Dr. Isaac Kohane ( 19:16 ):
You can actually run tests on these AI programs and say, "Oh, would you propose that diagnosis more
often if this was an African-American, or an Indian-American?" And you can actually adjust these
programs to reflect that bias, so that they en masse are changing their behavior.
( 19:44 ):
But that raises a kind of opposite question which is, right now, yes, a lot of the biases come from the
data, but I think that most people are less aware of how many more biases, most of them with good
intent, come from what's called steering or alignment of these models. After these models are trained
up, it turns out they will talk about pretty uninteresting things. And so, one of the early understandings
in the last three, four years was that use of reinforcement learning and the so-called instruct model to
steer these models towards interesting conversations, and to acceptable conversations, was important.
( 20:35 ):
So for example, you would not want a program to respond to a person with a detailed request for
suicidal procedures or for lethal homicidal procedures. And OpenAI and others have worked a lot on
that steering now-

Mark Masselli ( 20:58 ):
And when you say steering, this is really prompting of AI in terms of how we frame up our questions?

Dr. Isaac Kohane ( 21:06 ):
It's more than just prompting. What it does is it creates essentially a layer on top of these programs
where it says, "Here are a bunch of prompts, here are the kind of answers we're expecting to those
prompts." And then there's an automation process whereby we start saying to it, "Give us prompts and
we'll just rate your answers to those prompts."
( 21:35 ):
And in a somewhat amusing example of perhaps an overshoot, Google famously in its early steering of
Gemini, was so concerned about representation that it overshot. And so, when you asked it for pictures
of Nazi soldiers, they were showing African-Americans, or Africans, Nazi soldiers. And so that's being
taken care of and it's no longer such a problem, but here's where looking forward we have to ask what
values are going to be inserted in?
( 22:09 ):
And you can imagine, when you see a doctor most of the time, until they start talking about the yacht
they want to buy, you assume that your interest as a patients' are the ones that are being optimized for,
but who are developing these models? Whose interest do they have the most? Could be public health,
which is not always aligned with personal health. It could be the healthcare institutions, which is also
not always aligned. And so, those questions are, in my mind, more important than the bias questions.

Mark Masselli ( 22:49 ):

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Well, that's so impressive that the journal created that new edition. We ended up with some uplifting
themes at the end of the year. First we spoke with Dr. Amit Sood, who is called the Happiness Doctor,
which is kind of nice to have at the end of the year, and is the CEO of the Global Center for Resilience
and Well-being. He explained how to recognize stress and reprogram the brain to deal with it. Useful
information as we close out this really intense year.

Dr. Amit Sood ( 23:21 ):
We've done over three dozen clinical trials that have consistently shown that changing how we look at
our life and becoming more self-aware and aware of others, and small little changes in direction
completely can change how we are experiencing life, how productive, happy, and connected we feel.
( 23:42 ):
So, there's three steps to the program or the approach. The first step is to become aware of why we are
struggling, and that really originates in how the human brain operates. Our brain is not designed for
peace and happiness. It is designed for survival and safety. We have negativity bias. If you're lying on a
bed of flowers, if there's one thorn sticking you'll feel that in your thigh, and that's what happens. You
had a wonderful day, met 20 great people, but one person gave a negative comment, that is the person
you're going to thinking about as you're driving back home. So we have this negativity bias.
( 24:17 ):
Our mind tends to wander a lot. And by the way, our brain gets tired in 90 minutes. So, by 10:00 AM in
the morning, if you're not choosing to rest your brain, you're working with a tired brain and tired brains
don't know how to be happy. So, that's the first part, awareness. We educate people about their brain.
It's like you won't drive your car without knowing how the steering wheel operates. Then why would
you live your life without knowing how the brain operates?
( 24:41 ):
The second part is attention, what you focus on. It's like you're going to a restaurant and there's a menu
of 200 items. Now, if you don't train your attention, you're going to tell the waiter, the server, "Please
get me items that I'm allergic to and the ones that are icky and expensive, and that will make me throw
up tomorrow." That's the kind of thoughts I want to think. But with good attention, you focus on what is
nurturing. So, we help people train their attention to focus on, let's say, gratitude, on kindness, self
compassion self-acceptance.
( 25:15 ):
And third part is mindset or attitude. So awareness, attention, attitude. When stuff happens, like let's
say you're driving to the airport and you got pulled over and you got a ticket, now how long are you
going to keep that cop in your head? Two minutes, two hours, two days? So the goal is to recover
quickly, because stuff happens and you don't want to torture yourself. So, those are the three steps, and
they can be learned relatively quickly, relatively easily. And I find people are hungry for this kind of
authentic stuff that has been scientifically validated.

Mark Masselli ( 25:51 ):
Well, you've had a number of very interesting experiences in your lifetime, including meditating with a
Himalayan monk and meeting with his Holiness the Dalai Lama, but I'm wondering what you say to
those who believe psychotropic medications are best for them, or should we say a glass of wine at
dinner? Some may think reprogramming their mind is not right or it's too tough. What do you have to
say about that?

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Dr. Amit Sood ( 26:18 ):
I will not disagree with them. I try not to disagree with, because everybody has a point and opinion, and
there is some logic to it. Now, people who are really, really struggling, in the trenches, if you have a
fractured bone, then your bone needs help for it to heal. Similarly, some people who have got a
significant genetic predisposition, who were never hugged as a child, who were abused as a child, and
who've got a lot of stress, and that's how they have mental breakdown, they need help with
psychotropic medications. They need help with therapy and with other things.
( 26:54 ):
But I think for a majority of us, I think if we can align our thinking with our core values, that will be
helpful. It's like what I'm not saying is... For example, I live in Minnesota. There's a lot of snow in the
driveway. And when I shovel the snow, when the driveway is full, I can't drive my car, it gets stuck.
When I shovel the snow to the side, I'm not melting the snow, but it opens the driveway.
( 27:23 ):
Similarly, when I have negative thoughts and I have self-doubt and imposterism and all of that, then it'll
clog my mind. It will prevent me from completely blossoming and from being able to help others and
from being authentically happy, so I shovel those thoughts to the side. That's all what we are doing.
We're not brainwashing, negating the mind. We're choosing to live by our values.
( 27:49 ):
And I think it's a healthy combination of both. We need both. We need the right chemicals in our
system, and we also need the right way to think. And when you combine both, sky is the limit. See, the
challenge is, and this really bothers me, that we work so hard, humans do. We're so wonderful. Nobody
can forgive like we do, nobody has the... We donate a trillion dollars in charity. We give our kidneys to
strangers. Yet we suffer the most emotionally. You've never heard of sharks having panic attacks, or
lions walking around with chronic anxiety, but humans experience fear every single day, and we don't
need to do that. A lot of stress is optional, and I think if we can work through some of the ways we are
thinking and focus on common purpose of helping build a better world, we'll be much better off.

Margaret Flinter ( 28:49 ):
It was an intense year. We were also honored to be joined by opera superstar, Renee Fleming, a real
treat, I think-

Mark Masselli ( 28:56 ):
It was.

Margaret Flinter ( 28:56 ):
... in the course of this year, who served as the editor of a new book this year. It was titled Music and
Mind, and Renee explained how she took part in National Institute of Health study that relied on a
functional MRI to uncover the effect of music on the brain, I think on her brain in particular.

Mark Masselli ( 29:14 ):
That's right.

Margaret Flinter ( 29:15 ):
Very fascinating.

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Renee Fleming ( 29:16 ):
Well, it was really extraordinary. It was I spent two hours in the fMRI machine, so this is a functional MRI
that is measuring blood oxygen in the brain. And the activity included speaking, singing, and imagining
singing. And imagining singing in my experiment was the most impactful part of the experiment. So, it
activated more parts of my brain than the other two activities, and the scientists were perplexed by this
because they assumed that singing would be the most powerful activity. But what they ultimately
surmised is that because I'm a singer, singing is second nature, whereas imagining singing took a little bit
more effort to tune out the noise of the fMRI machine and to stay focused on the audiation. So, I was
audiating a bit the actual music at the same time. But it was fascinating to see what it looks like in the
brain and how many different parts, really all parts of the known mapped brain, show signs of
experiences with music.

Mark Masselli ( 30:20 ):
Well, that is quite fascinating. But I also thought was fascinating is that Dr. Francis Collins, former
Director of NIH, wrote the introduction to the book. What a wonderful introduction. We know him,
we've had him on our show before, we would have loved to have been in that small gathering of you all
singing together with the Supreme Court Justice. Tell us about the connection back to NIH.

Renee Fleming ( 30:46 ):
So, I met him rather randomly at a dinner party when I first was coming to DC on a regular basis, and it
was a wonderful dinner party because we were with the justices literally the day after the marriage
equality decision. So, they were, I would say there was a little tension between them, because this was
such a fraught decision. And we know how close Anthony Scalia and Ruth Bader Ginsburg were, they
were close friends. And I was seated between them, because they're both opera lovers, but it took a
while for people to relax and warm up a little bit. It was a great, great evening. And Francis Collins, now I
know this to be normal for him, brought his guitar, and we joined with the trio that was performing and
had kind of a sing along with everybody. And one of the most, I would say, symbolic songs was The
Times They Are A-changin'.
( 31:39 ):
And I asked him that night, "Why are scientists studying music?" I, at that time, couldn't understand why
they might be looking at music in the brain. And he said, "Because we have a new brain institute and we
want to understand more about the brain, and we've discovered that music in particular is so
impactful." And I said, "Well, I just started at the Kennedy Center as an advisor, what do you think about
us providing a platform for science at the Kennedy Center? Because I think audiences would be
fascinated to know what's happening when we're experiencing great art." And so, this has been become
a tremendous passion for me to share this work with the public and really to be an advocate for the field
of arts in health.

Mark Masselli ( 32:24 ):
Renee has such a wonderful voice. And on that note, it seems like the right time to wish everyone happy
holidays and the best wishes for a terrific 2025.

Margaret Flinter ( 32:35 ):
And just a reminder to be sure to subscribe to our videos on YouTube, find us on Facebook and X with
our account, CHC. As always, you can go online to CHCradio.com to sign up for email updates. And

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please, we welcome you sharing your thoughts and comments about this program. Happy holidays.
Happy New Year to everybody. We'll see you in the new year.
Mark Masselli ( 32:56 ):
Absolutely.
Margaret Flinter ( 33:11 ):
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