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The European Union Explained with Christiaan Alting von Geusau May 04, 2026

Show notes

In Episode 133 of DC EKG, Joe Grogan welcomes back Dr. Christiaan Alting von Geusau for Part 2 of their conversation, this time turning to the European Union. Christiaan walks Joe through the post-World War II origins of the EU as a peace initiative built around the Schuman Plan, the pooling of coal and steel between France and Germany, and the visionary leadership of Robert Schuman and Konrad Adenauer. He explains why understanding the EU's founding purpose is essential to understanding what has gone wrong since.

Joe and Christiaan unpack the principle of subsidiarity, the rise of EU bureaucracy and over-regulation, the ideological capture of Brussels institutions, and the long detour into cultural battles that were never the EU's job to fight. They discuss Germany's strategic mistake of abandoning nuclear energy, the widening economic gap between the US and Europe, and why Friedrich Merz himself has called the EU the world champion of over-regulation.

The second half of the episode looks at the US-EU relationship under President Trump's second term, including the Digital Services Act and free speech, decades of European free-riding on American defense, and the rise of bilateral engagement between Washington and individual European capitals. The conversation closes with a sharp discussion of the leadership vacuum across the West and Europe's growing economic dependence on China.

In This Conversation

How the European Union began as a Franco-German peace project

Why the Schuman Plan and the pooling of coal and steel still shape Europe today

The principle of subsidiarity and how Brussels has overstepped it

Why Germany's abandonment of nuclear energy was a strategic disaster

How EU institutions have been captured by ideology

The Digital Services Act and the threat to free speech in Europe

Why the US-EU relationship is under serious strain

Whether Washington should deal with Brussels or with national capitals

Europe's leadership vacuum and growing dependence on China

Timestamps

0:00 Why Brussels has become the global champion of over-regulation

1:10 Joe welcomes back Christiaan for Part 2

1:32 Christiaan reintroduces himself and his background

3:00 Why the EU is misunderstood on both sides of the Atlantic

4:15 The historical origins of the EU and the Franco-German conflict

6:00 The Schuman Plan and the pooling of coal and steel

11:30 Truman, the Marshall Plan, and Dean Acheson

12:37 What went wrong with the EU

14:50 Bureaucracy, nuclear energy, and the German mistake

19:35 The principle of subsidiarity and why it matters

23:24 Cultural overreach by Brussels

26:44 Friedrich Merz on EU over-regulation

27:28 The widening US-EU economic gap

32:03 Free speech, the Digital Services Act, and Trump

38:33 European free-riding on American defense

44:07 Should Washington bypass Brussels

48:30 The rise of bilateral engagement

51:23 The leadership vacuum across the West

58:30 Europe's economic dependence on China

1:01:12 Wrap-up

European Union, EU history, Schuman Plan, Franco-German conflict, subsidiarity, EU bureaucracy, EU overregulation, German nuclear energy, Digital Services Act, free speech Europe, US-EU relations, Trump and the EU, NATO defense spending, Europe-China dependence, transatlantic relationship, Christiaan Alting von Geusau, DC EKG

About Our Guest

Dr. Christiaan Alting von Geusau is a lawyer, professor, advisor, and host of the podcast The Educated Leader. Born in the United States and raised in the Netherlands, he studied law at Leiden University and Heidelberg University. He earned his doctorate in philosophy of law at the University of Vienna. He leads the International Catholic Legislators Network, serves as the principal of Ambrose Advice, and is the Rector emeritus and Professor of Philosophy of Law and Education at ITI Catholic University in Austria.

Podcast: DC EKG with Joe Grogan

Episode: 133

Guest: Dr. Christiaan Alting von Geusau

Sponsor: Survivors for Solutions –

https://survivorsforsolutions.org

Executive Producer: John “CZ” Czwartacki, DC EKG Podcast

Producer: Stay on Course Studios –

https://www.stayoncourse.studio

Hungary Election After Orban with Christiaan Alting von Geusau Apr 30, 2026

Show notes

In Episode 132 of DC EKG, Joe Grogan sits down with Dr. Christiaan Alting von Geusau for a timely discussion on Hungary’s election, Viktor Orbán’s loss, and what comes next under Peter Magyar. Christiaan explains why the size of the election wipeout surprised even seasoned observers, why the mainstream narrative about democracy in Hungary misses key facts, and why the new Hungarian parliament remains entirely on the right side of the political spectrum.

Joe and Christiaan break down the structure of Hungary’s political system, the collapse of Orbán’s long-running coalition, the rise of Peter Magyar out of a political scandal, and the challenge of governing with a brand new party full of political newcomers. They also discuss whether Western media is misreading the result as a rejection of conservatism and why the more important question may be whether the new government has the experience to govern effectively.

The second half of the episode turns to Hungary’s position on Russia and Ukraine, the country’s cultural conservatism, the future of its relationship with the European Union, and the dangers of revenge politics after a major political transition. This is a wide-ranging conversation on democracy, power, media narratives, and the future of Hungary in Europe.

In This Conversation

What happened in Hungary and why Orbán lost so badly

Who Peter Magyar is and why his rise shocked the political class

Why Hungary’s new parliament is still entirely right of center

What the election means for democracy and conservatism

Hungary’s position on Russia Ukraine and the European Union

Why the competence of the new government may matter more than ideology

The risks of revenge politics after a major political transition

Timestamps0:00 Is Hungary’s election really a repudiation of conservatism0:55 Joe welcomes Christiaan Alting von Geusau1:14 Christiaan’s background and his dual US Dutch perspective4:00 Why Hungary matters and what makes its politics unique5:30 What happened in Hungary and why the wipeout was so large10:06 How Hungary’s electoral system magnified the result11:48 What happened to Fidesz and the Christian Democrats12:37 Why the new parliament is still entirely right of center16:00 The scandal that changed Hungarian politics18:20 Peter Magyar’s rise and political comeback20:00 Who Peter Magyar is and what he believes22:50 What changes Peter Magyar is likely to make24:00 The risks of governing with political newcomers28:50 What this means for Russia Ukraine and the EU34:33 Will Hungary remain culturally conservative36:34 Are Western media misreading the result41:06 Has Christiaan’s view changed since election night43:24 The economic challenges facing the new government44:04 Why revenge politics can damage a country48:03 Outro

Hungary election, Viktor Orban, Peter Magyar, Christiaan Alting von Geusau, Fidesz, Christian Democrats, Hungary politics, European Union, Russia Ukraine war, democracy, conservatism, revenge politics, cultural conservatism, political transition, DC EKG

About Our GuestDr. Christiaan Alting von Geusau is a lawyer, professor, advisor, and host of the podcast The Educated Leader. Born in the United States and raised in The Netherlands, he studied law at Leiden University and Heidelberg University and earned his doctorate in philosophy of law at the University of Vienna. He leads the International Catholic Legislators Network, serves as principal of Ambrose Advice, and is Rector emeritus and Professor for Philosophy of Law and Education at ITI Catholic University in Austria.

Podcast: DC EKG with Joe GroganEpisode: 132Guest: Dr. Christiaan Alting von GeusauSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio

Obamacare, HSAs, and Reference Pricing with Dr. John Goodman Apr 21, 2026

Show notes

In Episode 131 of DC EKG, Joe Grogan sits down with Dr. John Goodman to discuss what both parties continue to get wrong about healthcare, why patient incentives still matter, and how market-based reforms could lower costs and improve access. Drawing on decades of work in health economics and policy, Dr. Goodman explains how special interests helped shape Obamacare, why supply-side constraints still distort care, and why patients are too often left out of the policymaking process.

The conversation then turns to Health Savings Accounts, Medicaid reform, emergency room overuse, and why policymakers remain so resistant to giving patients more control over healthcare dollars. Dr. Goodman also outlines his view that self-directed care and consumer choice can improve value and expand access, especially for vulnerable populations.

In the second half, Joe and Dr. Goodman dive into reference pricing as a major reform idea. Using real-world examples, they discuss how clearer prices and patient-driven decision-making could create more meaningful competition across healthcare markets. The episode closes with a broader conversation on bipartisan reform, the tax code, and why durable change remains so hard to achieve in Washington.

In This Conversation

What both parties keep getting wrong about healthcare

How special interests shaped Obamacare and why patients were left out

Why HSAs remain controversial and what they change about incentives

Medicaid reform, emergency room use, and patient access

How self-directed care can improve outcomes and satisfaction

What reference pricing is and why it could create real competition

Why bipartisan healthcare reform keeps breaking down in Washington

Timestamps0:00 How special interests shaped Obamacare0:46 Joe welcomes Dr. John Goodman1:09 Dr. Goodman’s background and the origins of HSAs5:22 What both parties get wrong about healthcare7:36 Why physician supply stays restricted9:26 Spending more without getting healthier14:16 What Washington should actually be debating15:52 Insurance that meets patients’ needs20:06 HSAs and consumer-directed care22:29 Why Medicaid patients rely more on emergency rooms24:50 Medicaid reform and letting patients pay the difference28:07 Self-directed care and “Cash and Counseling.”29:35 Reference pricing explained32:14 How reference pricing could reshape insurance markets36:06 Why Dr. Goodman is optimistic40:36 The tax code and healthcare policy44:22 Where to find Dr. Goodman’s work45:42 Outro

Obamacare, health savings accounts, HSA, John Goodman, Joe Grogan, healthcare reform, healthcare policy, Medicaid reform, emergency room visits, patient incentives, consumer-directed care, reference pricing, tax policy, bipartisan reform, healthcare economics

About Our GuestJohn C. Goodman is President of the Goodman Institute for Public Policy Research and is widely known for his work in health economics, Health Savings Accounts, and consumer-directed healthcare reform.

Podcast: DC EKG with Joe GroganEpisode: 131Guest: John C. GoodmanSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio

340B | Part D | the Real Drivers of Drug Costs with Ryan Long Mar 31, 2026

Show notes

In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act.

Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program.

They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act.

In This Conversation

Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan’s work52:38 Outro

340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance

About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform.

Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio

340B, Part D, and the Real Drivers of Drug Costs with Ryan Long Mar 31, 2026

Show notes

In This Conversation

Why does 340B incentivize higher costs and hospital consolidation
Contract pharmacies, diversion risk, and fraud exposure
Who really benefits from 340B and why rural hospitals can lose out
Medicare Part D premium pressure and the IRA tradeoffs
Copays vs coinsurance and what seniors experience at the pharmacy counter
Fraud, program integrity, and why limited resources should go to patients who need them

State AI Laws, Preemption and Health Innovation with Adam Thierer Mar 20, 2026

Show notes

In Episode 129 of DC EKG, Joe Grogan sits down with returning guest Adam Thierer, Resident Senior Fellow for Technology and Innovation at the R Street Institute, to break down the surge of state by state AI laws and why a patchwork approach could slow innovation, especially in healthcare.

Adam explains how more than a thousand state AI bills are flooding the zone, what types of “everything bills” are emerging, and why some states are trying to set national standards from Albany or Sacramento. Joe and Adam connect the federalism debate to real world health innovation, including mental health chatbots, algorithmic discrimination laws, and why compliance costs hit “little tech” hardest.

They also discuss Adam’s “AI Articles of Confederation” framing, the failed effort to create a federal moratorium on state AI rules, and what a better model could look like, such as regulatory inventories, learning labs, and sandbox style approaches that allow experimentation without shutting innovation down.

Key link: https://www.rstreet.org/commentary/congress-should-lead-on-ai-policy-not-the-states/

In This Conversation

Timestamps0:00 What is happening with state AI bills right now1:36 Adam’s background and how he got into AI policy5:55 The shift from federal regulation to state action10:27 What these state bills try to regulate13:29 Micron, permitting delays, and stopping progress20:00 Why some red states are pushing AI Bills of Rights26:24 “AI Articles of Confederation” and why it matters31:01 The attempted moratorium in the “big, beautiful bill”38:03 Preview of “The AI Terrible Ten” and worst state models39:43 Mental health chatbot bans and the mental health crisis44:25 What governors should do instead of rushing to regulate49:05 What Adam is tracking next51:48 What AI tools Adam uses52:42 Where to find Adam’s work

SEO Keywordsstate AI laws, AI policy, federal preemption, healthcare innovation, algorithmic discrimination, mental health chatbots, interoperability, AI regulation

About Our GuestAdam Thierer is a Resident Senior Fellow at the R Street Institute focused on technology and innovation policy. He writes and speaks widely on AI governance, federalism and preemption, and how regulatory models can either accelerate or stall innovation, including in healthcare.

Podcast: DC EKG with Joe GroganEpisode: 129Guest: Adam Thierer, Resident Senior Fellow, Technology and Innovation, R Street InstituteSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios – https://www.stayoncourse.studio

HTI 5, Health Data Control and AI with Kat McDavitt and Lisa Bari Mar 16, 2026

Show notes

In Episode 128 of DC EKG, Joe Grogan is joined by Kat McDavitt and Lisa Bari, co-hosts of the Health Tech Talk Show, for a practical conversation on what the next wave of health IT policy could unlock for patients and innovation.

They break down the proposed HTI 5 rule from ONC, why it is framed as deregulation, and how it aims to shift the market away from long EHR certification checklists toward one core goal: data that moves. The conversation digs into information blocking, TEFCA, patient access, and the reality of who controls health data in practice.

Joe presses a simple question: if it is “my data,” why do patients still struggle to pull a complete record? Kat and Lisa explain how HIPAA is often used as a barrier instead of a bridge, how secondary data use markets operate, and why privacy gets complicated in a world of apps, brokers, and advanced compute.

They also explore how HTI 5 connects to the AI wave, why state AI laws can create risk for innovation, and whether ideas like a Medicare app library help patients or end up picking winners too late.

In This Conversation

,Timestamps0:36 Intro1:14 Welcome Kat McDavitt and Lisa Bari2:05 Lisa on her new role and what she is working on4:17 First reactions to HTI 5 and EHR deregulation7:34 HTI 5 in plain English11:27 Who controls health data and why this rule matters14:08 Why patients still cannot easily access complete records17:36 HIPAA and how it is used today22:24 Privacy outside HIPAA and secondary use25:50 How HTI 5 targets information blocking28:16 Screen scraping and why it is controversial36:09 How HTI 5 connects to healthcare AI47:28 Medicare app library concerns52:05 Closing and where to find Health Tech Talk Show

Health Tech Talk Show YouTube channel: https://www.youtube.com/@HealthTechTalkShow/streams

SEO Keywords (Megaphone)HTI 5, ONC, information blocking, TEFCA, interoperability, healthcare APIs, HIPAA, health data access, healthcare AI policy, data liquidity, screen scraping, Medicare app library

About Our GuestsKat McDavitt is co-host of the Health Tech Talk Show, President and Founding Partner of Innsena, and CEO and Founder of the Zorya Foundation.Lisa Bari is the Vice President of Policy and Partnerships at Innovaccer, where she leads health and AI policy, government relations, and global partnerships. She is the creator and host of the Policy Stack podcast, co-host of the Health Tech Talk Show, and a board member of the Zorya Foundation. Previously, she was the founding CEO of Civitas Networks for Health.Podcast: DC EKG with Joe GroganEpisode: 128Guests: Kat McDavitt and Lisa BariSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios – https://www.stayoncourse.studio

Rural Health on the Front Lines: Dr. Manny Sethi on Access, Private Equity, and Prevention Mar 06, 2026

Show notes

Episode 127

Rural Health on the Front Lines: Dr. Manny Sethi on Access, Private Equity, and Prevention

In Episode 127 of DC EKG, Joe Grogan sits down with Dr. Manny Sethi of Vanderbilt and Healthy Tennessee to talk about what rural health looks like up close and what policy changes could actually improve access.

Dr. Sethi shares his story growing up in small town Tennessee as the son of immigrant physicians, then training as an orthopedic traumatologist and treating high-energy injuries that often collide with chronic disease and limited access to care.

The conversation centers on why rural communities struggle to find primary care and specialists, how administrative burden and electronic medical record requirements can crush independent practices, and why private equity and large systems buying clinics can reduce real access for patients.

Dr. Sethi also explains how Healthy Tennessee built a volunteer, community-based model of prevention through health fairs that screen hundreds to thousands of people, partner with food banks, and connect high-risk patients to follow-up care.

If you care about rural healthcare, access to care, private equity in medicine, physician shortages, preventative care, EHR burden, Medicaid, Medicare, and community health, this episode is a practical look at what is broken and what can be done.

In This Conversation Joe and Dr. Sethi cover:

Timestamps (Audio platforms) 0:52 Intro 1:14 Meet Dr. Manny Sethi (Vanderbilt, Healthy Tennessee) 4:38 Why he launched Healthy Tennessee 6:59 Volunteers, screenings, and what the health fairs deliver 12:09 Who shows up and why access is still hard even with insurance 21:51 The biggest rural health problems and the access crunch 24:18 Private equity buying practices and what changes for patients 28:24 What policy fixes could actually move doctors to rural areas 31:41 Follow-up care for uninsured and high-risk patients 34:09 Trauma care realities and why we pay for sickness, not wellness 40:27 Faith, meaning, and why he keeps doing the work

Key Takeaways

About Our GuestDr. Manny Sethi is an orthopedic traumatologist at Vanderbilt and co-founder of Healthy Tennessee, a nonprofit he launched with his wife in 2011 to bring prevention and screening to underserved communities through volunteer-driven health fairs and partnerships across the state.

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Show Sponsor: Survivors for Solutions – https://survivorsforsolutions.org

Executive Producer: John “CZ” Czwartacki, DC EKG Podcast

Producer: Julie Riga, Stay on Course Studios – https://www.stayoncourse.studio

Alzheimer’s in Real Life: Sue Peschin on Early Detection, Biomarkers, CED, and the ASAP Act Feb 17, 2026

Show notes

In Episode 126 Joe speaks with Sue Peschin, President and CEO of the Alliance for Aging Research, about what Alzheimer’s and dementia look like in the real world and how policy determines who gets help and when.

Sue explains the mission and 40–year history of the Alliance for Aging Research and lays out the scope of the Alzheimer’s crisis in plain language: who is affected, how dementia types differ, and why neuropsychiatric symptoms like agitation, psychosis, and depression are so often ignored in policy and practice.

They discuss why early detection matters more than ever now that disease-modifying therapies and amyloid inhibitors exist, and why so many cases are still missed in primary care. Sue walks through new blood biomarkers, digital cognitive assessments, and how Medicare coverage, CED restrictions, and the proposed ASAP Act will shape access to testing and treatment.

Joe and Sue also dig into Coverage with Evidence Development (CED) in Medicare, whether CMS is overstepping what Congress intended under Section 1801, and how restrictive coverage decisions have limited access to Alzheimer’s drugs to a tiny fraction of eligible patients. Finally, they talk about caregiver burden, stigma around behavioral symptoms, and what families and clinicians can realistically do today.

If you care about Alzheimer’s, dementia, early detection, blood biomarkers, Medicare coverage, CED, the ASAP Act, primary care, caregiver burden, vascular dementia, and aging research, this episode connects the science with the politics and the lived experience.

In This ConversationJoe and Sue cover:

Timestamps (Audio platforms)

Key Takeaways

About Our GuestSue Peschin is President and CEO of the Alliance for Aging Research, the leading nonprofit focused on advancing science, policy, and education to improve healthy aging and access to care. At the Alliance, Sue has driven national work on Alzheimer’s, dementia, neuropsychiatric symptoms, Medicare policy, CED reform, and aging research, empowering older adults and caregivers to advocate for better care.

STLDI and ACA Coverage: Costs, Choice, and Tradeoffs Jan 27, 2026

Show notes

"Obamacare Exempt" Plans - STLDI and ACA Coverage: Costs, Choice, and Tradeoffs

Joe Grogan is joined by Michael Cannon (Cato Institute) to break down short-term, limited-duration insurance (STLDI), also known as “Obamacare-exempt” plans. They explain why STLDI can be far cheaper than ACA exchange coverage, how renewal guarantees work, and why allowing more consumer choice can reduce pressure on exchange risk pools.

They also dig into the politics of pre-existing conditions, how ACA rules change insurers' incentives, and why coverage debates often miss the real drivers of cost, access, and quality. The conversation ends with a broader look at public trust, healthcare fear, and how policy choices shape what insurers can and cannot do.

Timestamps / Chapters00:01 – Intro00:23 – Michael Cannon joins + what STLDI is02:27 – STLDI explained: “Obamacare-exempt” plans, renewal guarantees, and lower premiums06:00 – ACA history: why STLDI was restricted07:46 – International comparisons + pre-existing conditions incentives and the Colette Briggs story12:10 – Why healthcare stays broken: regulation, lobbying, and “government-designed” systems16:59 – Subsidies and the politics of pre-existing conditions22:22 – Renewal guarantees, employer tax exclusion, and why Medicare entered the picture30:37 – Public trust after Brian Thompson’s murder and Cannon’s letter41:56 – Wrap-up

In This Conversation

Key Takeaways

About Our GuestMichael Cannon is the Director of Health Policy Studies at the Cato Institute and a leading voice on the ACA, health insurance regulation, and market-based health reforms.

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