The Intersection of Healthcare, Food, and Economic Systems with Ellen Brown

In this insightful episode of the Regenerative by Design Podcast, host Joni Kimall Moore sits down with healthcare strategist Ellen Brown from BP2 Health to discuss the powerful connection between healthcare, food, and economic systems. Ellen shares her 30+ year journey in the healthcare industry, diving deep into how outcomes-based care and food as medicine can radically transform the way we think about health. Together, Joni and Ellen explore the broken aspects of both our food and healthcare systems and the critical need for alignment to create healthier, more sustainable communities.

They discuss the concept of lifestyle disease and how food and behavioral changes can lead to the reversal of chronic conditions like diabetes. Ellen also offers a compelling vision for how farmers and healthcare providers can collaborate to create healthier communities, with the idea of paying farmers for the healthcare savings generated by their regenerative, nutrient-dense crops. This episode highlights the untapped potential of food systems in improving public health and reshaping the future of healthcare.

Key Takeaways:

• Ellen’s journey from actuarial work to healthcare innovation and outcomes-based care.
• The crucial role of food in reversing chronic lifestyle diseases and reducing healthcare costs.
• How regenerative farming and health-focused food systems can create significant economic and societal benefits.
• The potential for collaboration between healthcare providers and farmers to improve health outcomes and reduce costs.
• Insight into Accountable Care Organizations (ACOs) and how they align financial incentives with better health outcomes.

Resources Mentioned:

• Visit BP2 Health to learn more about Ellen Brown’s work.
• Check out the Reverse Mullet Healthcare Podcast for more on outcomes-based care and healthcare innovation.
• Listen to the Food is Health Revolution Podcast for discussions on food systems and healthcare.

Connect with Us:

• Follow Joni Kimall Moore on social media for updates on future episodes.
• Subscribe to the Regenerative by Design Podcast and leave a review if you enjoyed the show!

Call to Action:

If you enjoyed this episode, be sure to share it with your friends, leave a rating on your favorite podcast platform, and help us spread the word about the powerful impact of aligning food systems with healthcare outcomes.

Regenerative by design is hosted by Snacktivist.  Snacktivist creates baking mixes and finished products that are allergy-friendly, soil, water, and carbon-focused, all while radically impacting human nutrition by transforming staple foods into something more than just empty calories.   Visit snacktivistfoods.com to learn more.

Episode Transcript

(00:00):
Jon, hello, everyone. You arelistening to the regenerative by

(00:04):
design podcast where we will begetting to the root of health,
climate, economics and food. Iam your host. Joni kinware. Join
me on this journey as we explorethe stories of individuals and
organizations who are working torealign our food system with
both human health and the healthof our planet. All right, hello,
everybody.
I'm Joni kimalmore, your host ofthe regenerative by design

(00:27):
podcast. And I am so thrilled tohave Ellen brown on this, on the
on our session today. This isabsolutely fantastic. Welcome
Ellen,
thank you. I'm I'm superexcited. We were talking right
before we hopped on, right abouthow we feel like we know each
other, but we don't know eachother.
So Exactly, yeah, it's like themodern digital friendship, where

(00:48):
you get to know somebody via achat or a social platform, and
then you realize you've actuallynever even been on camera, so
you didn't actually know whatthey look like. It's always kind
of fun when that happens otherthan
other than your your profile,right? Yeah, your profile shot?
Yeah, I took the one where I'mlaughing because the formal ones

(01:08):
just still seemed a little bittoo exactly
when we're delving into topicslike we both work in, which is
the nexus point of wherehealthcare and food and
nutrition and medicine and eveneconomics all intersect. It is
such a hot topic right now, andI know Ellen, you are like a
lifelong, passionate systemsthinker when it comes to

(01:30):
healthcare and delivery of truehealth to people. So I'm excited
because we have not taken enoughof a dive into this topic on the
show. As our listeners know,regenerative by design is really
just digging into the principlesof regeneration, and it really
starts at the food system leveland nature. I mean, we're a
reflection of the health of ourenvironment and the health of

(01:52):
our food, but we cannot talkabout regeneration without
really taking on conversationsaround healthcare, healthcare
delivery, food is medicine andthe economic impacts of what an
alien population that is likesuffering from diet related
disease means for us as acountry. Like, as a former
nurse, I can't tell you howpassionate I am about this
topic, and you are an expert, soI am so excited for you to just

(02:15):
share your life experience.Like, how did you get to this
point? Like, I bet our audienceis like, who is Ellen, and what
does she do? And I'm aregenerative farmer, and I don't
hear about people in healthcare,so take it away. Let us know how
you came to be doing the workyou're doing today. Well,
I'd like to have a perfectanswer for you, but I kind of
feel like the universe honoredme, not particular woo, woo

(02:36):
person. But I I say to peopletoday, I feel like the this is
all happening. It's sort of likea higher frequency, if that's
what you want to say. And I'mjust lucky enough to be pulled
in for the ride, and I'm all in.I'm like, 100% I love it. So,
yeah, so I mean quickly, mybackground and sort of how I
ended up here, I suppose, right,you used to say like, I don't

(02:58):
sound like I intended to end upin the space that I'm in,
necessarily, but in allseriousness, so I've been in
healthcare on the business sidefor 30 plus years, and I started
out actually as an underwriterand on the actuarial side of
things, Which is totally geekyfinancial. And I stumbled there

(03:22):
because I couldn't cut it in Iwanted to be a physician, and I
just could not cut it in collegechemistry like I admit it. It
was not my it's not my jam. Andso I came home and I was like my
mom, and I had a full ridescholarship at the time, but I
was on academic formation aftermy lackluster performance in Kim

(03:43):
and my mom, and I'm like, a dogwith a bones. I'm like, Well, I
will be taking that over again.I am. I'm in. My mom was like,
you know, and this kind of goesback to that universe thing,
which is, like, you I think whendoors close too hard, you have
to pay attention to that. And soshe's like, Wait a minute. But
you took economics as anelective, and you loved it. So

(04:05):
maybe there's like, maybe youcould consider business, and
this was in the early 90s whenthe business you could not get a
job at in business to save yourlife. I mean, you were like, a
marketing assistant, and, youknow, it was a really difficult
time. And I was like, I am notgoing into business. Going to be
a physician. And she's like, howabout you just take accounting

(04:27):
this summer? I was like, Okay,so, so I did, and the rest is
history, because i Because, youknow, accounting is sort of like
chemistry for a business likethat. Some people say, right?
So,
yeah, there's so many parallels.And as someone who did pre med
as well, I understand the focusthat it like chemistry is the
hurdle of hurdles for pre med,for all the premies, yeah, if

(04:50):
you can't, if you can't, cut thefirst two years, like, you know,
physical and then, okay, that'slike, the litmus test, you're
dying. And it's so frustrating,because, in retrospect. Act. Is
it really as important as wethink, or is it just a rite of
passage? Because honestly, thethinking that does make somebody
good at accounting or economics.Economics and accounting are

(05:11):
literally very similar tochemistry. When you think about
it, it's all about interactionsand properties and how they fit
together. It is.
It's very much a systems thingand so. And actually, I mean,
I'll say this, and then I'lljust kind of quick finish my
background more. I won't make itthis long, don't worry. I just
think it's an interesting pieceto this story, how I ended up
part of the puzzle. Yeah, it is.It is. And so I'll just try to

(05:34):
hit on a couple of the importantpieces that brought me to this
point. Not so much just mybackground, but what's
interesting about that is I havehad a lot of recent
conversations, and I am a littlebit controversial in this, but I
I shared. I choose not to have areally strong voice, because I
don't feel like it's important,and I don't want to muddy things
up. But when I look at how carereally should be delivered in

(05:56):
the future, I think that AI,whether we like it or not, it
does give physicians atremendous amount of information
that they don't normally haveaccess to, that we can't
possibly expect them to memorizeand know. And I think med
school, I think our wholeconstruct around education is is
very misaligned now with it'svery antiquated. When you look

(06:20):
at what is accessible, and Ithink we miss a lot of really
talented people that should bein clinical care delivery, but
they can't. They can't cut itright in in organic chemistry.
And so when you think
about like the selection processby personality type and aptitude
level that has now come todominate our medical provider

(06:43):
environment. You can see theculture shift that has happened.
And not to be rude, but there'sa lack of EQ often. I mean, I
worked in ICU. I worked incardio cardiothoracic surgery,
like recovery, so it's like,you're working with like that
cut, and they're amazing at whatthey do. I mean, they're like
incredible technicians, but theEQ and the soft skills and the

(07:06):
communication part is where itoften falls short, and
unfortunately, that's the dividewhere we lose a lot of success
metrics in healthcare, becauseit's not just about the
procedure, it's about theholistic experience of healing
and the interface of the patientwith the system,
and it's also about behavior,right? Is, is we have to change,

(07:28):
we have to change people'sbehavior around lifestyle. And
if you don't have EQ, you're notgoing to do them. You're not
even going to want to do that,right? So it's a really
interesting time to your pointin medicine. So, so that's kind
of an interesting nugget in mybackground. So I I basically was
desperate to get to Marylandbecause my husband was there,
and I just wanted to be withhim. He was going to law school,

(07:50):
and his dad had a locker andstuff. So I was lucky. I had a
professor who got me a reallygreat paid internship that was
at a health plan while I was incollege. And so I was like,
Well, I'm going to run withthis. So I landed an underwriter
job, which was unheard of, to beable to jump right into
underwriting, yeah, which was,which was fantastic, and kind of

(08:12):
the rest was history on thepayer side. But what's
interesting about it was, what Ireally wanted was to do strategy
and product development, thingslike that. And so I at one
point, had a little stint, whichis an important piece of my
background of back in the late90s when Medicare did the this
was called Medicare plus choice,and they had about a one year

(08:33):
blip, really, where suddenlyproviders could take financial
risk. It was, I think it was1997 and I 96 and so I happened
to have an opportunity to gowork for provide organizations
that want to take full risk andstart a Medicare Advantage plan
back then, though, there weren'tthe analytics tools to do that,
and so pretty much every everyclinical delivery system that

(08:55):
jumped in then failed, there'sonly a handful that really
survived that time, and Itunfortunately left some real
deep scars in the healthcareindustry for That's why, I think
that's one of the big barriers alot of people don't realize to
organizations taking downsiderisk in moving towards out based
outcomes, based care, becausethey still have legacy folks
that were involved in that.Yeah, the scar tissue is real.

(09:17):
It is. And so then whathappened, though, was it showed
me. I was like, we have to dothis. We have to move towards
outcomes based care. So then Iwent back to the I got
recruited. I really wanted to doproduct development, but I was
quote, unquote, too young. Sothen I got recruited back
through a recruiter that said,Hey, will you come back and do
product development? I was like,Yes, that's what I wanted to do
in the first place, but you guystold me I was too young. So I

(09:38):
came back in. And what's funnyis I didn't even remember this
until I was talking to AaronMartin the other day, which is
to get promoted to a directorjob. I ended up doing a demo on
alternative medicine to theleadership team as part of my
like, why you should hire me asthe director, as opposed to, you
know, my other co workers and I.Brought in an acupuncturist and

(10:02):
and I brought in some other,some other, quote, unquote,
alternative medicine. And sowhat I realized is, I've been
after this for since I kind ofcame out of the sense too,
probably, yeah, and so then, butthen I just went deep. I was
like, okay, payment reform iswhere it's at. So I'm going to
make a difference in that if wecan get health systems and

(10:23):
provide organizations to eitherstart health plans or take, you
know, get into value based care,not just by dipping their toes
in the water, start ACOs, alignthemselves with outcomes based
care delivery. I was like, thisis making a difference. I know
it doesn't seem like it, butit's down. It's in the
underpinnings, right? Like, ifwe can change that foundational
economic framework.
That's a design feature likewhen you shift the target of

(10:47):
what the outcomes and everythingthat is approvable starts to
align behind these outcomemetrics, that actually starts to
shift the whole system in asignificant way. Yeah, and you
know, the other thing thathappened during your career that
I experienced firsthand as anurse, like when I came in, it
was paper charting and maybeearly digital charting. And, you

(11:09):
know, 15 years later, it's alldigitized. We have huge data
sets to learn from. EvidenceBased Practice became the
mantra. And again, it's thatmore outcomes focused of like,
okay, we're, you know, we'restarting to understand trends.
And importantly, I always talkabout this, and for you guys on
the insurance side, this isreally important. We started to

(11:29):
realize a lot of the habits thatwe had in healthcare were
contributing to poor patientoutcomes. We just didn't realize
it until we had large enoughdisparate data sets from
different geographical areasdifferent patient demographics,
where we can suddenly go, Oh, wedidn't realize we're actually,
like, killing our patients. Andwe didn't realize it like, you
know, and because you know,like, that's the beauty of like

(11:51):
AI, like you mentioned as well.I feel like AI is going to help
us move these preconceivednotions, these like inabilities,
to take risk or think in aninnovative way because of being
burned in the past, or it seemstoo expensive, or it seems like
a barrier to adoption from alearning perspective. But when
you have that data, and AI canhelp us see data that we might

(12:13):
not be able to see on our own, Ithink that's where we're going
to really start making theseleaps. The fact that you are on
the insurance side gives you anincredible vantage point that
very few people in the industrysee
absolutely yeah and so. So whathappened was I had I spent 10
years as a payer. I ultimatelyended it was a multi billion

(12:35):
dollar blues plan. I was reallylucky where I was able to watch
an attempted transaction. I wason the ground floor. I was
working for the CEO, and becauseI ran strategy for the
organization, I sat on the Csuite floor. So literally, one
door into my office was into theboardroom. One door went into
the chief medical officers, andthe other door went into the

(12:56):
CEOs. Like, I'm not kidding you.So it was, it was a, it was,
it was firehose.
That is an understatement. And Iwas, I wasn't even 30 yet, and
so maybe I was 30. I mean, I wasreally young, but it was
amazing, because I it reallytaught me so, so very much. Um,

(13:17):
but then I left, and this is thefun fact. Is my husband, I took
a year and a half to go on an RVtrip, yeah, to see if we really
wanted to be grown ups in thecorporate world. And come to
find out we did. So we resumedour careers, but I did it as a
consultant so I could still stayin Colorado. We fell in love

(13:38):
with it when our on our trip andbut I came back in to really
work on payment transformation.So that was really my jam. So,
so, you know, the last 20 years,I've been working with big
health systems, big payers inthat payment transformation
space. So, you know, like Isaid, starting Medicare
Advantage plans, starting ACOs,creating ventures together,

(14:02):
doing white label things, createa clinically integrated network,
show all
the things that we've done. Canyou define ACOs? Oh, yeah,
sorry.
So so on the I'll just kind ofback up for a second. So when I
talk about paymenttransformation, that's the whole
notion of moving from what themajority of payments in the

(14:24):
healthcare system are today,which is a which is fee for
service, which means you go tothe doctor, right, and then that
doctor gets paid for that onespecific service. If that doctor
provides a couple of differentthings while you're there, there
will be a bill that gets sent toyour insurance company that will
show like three services, forexample, and they all go back to

(14:46):
a code. I mean, you you knowthis very well as well, but, and
that is what everybody talksabout with this fee for service
hamster wheel, because, again,the doctor is incented
financially to perform moreservices, not to keep. Too
healthy. If you don't come in,the doctor doesn't get paid,
right?
So it's such an important piece,and I'm sorry to interrupt, but

(15:08):
because I don't think peoplefully understand that. And they
get it, like, when they get abill from the ER, and they're
like, how did that cost $17,000that's usually people's very
first experience with the feefor service framework for
compensation within the medicalsystem, and considering that the
United States has the mostexpensive healthcare system in

(15:30):
the world with some of thepoorer outcomes associated to
spend this piece, is such acritical part of that puzzle,
absolutely is I just had to haveyou stop and like, make a like,
make some, yeah, you know some.Like, real, solid concept around
that for our listeners, becauseour listeners are a lot of
people on the farming side andthe Ag side and the food system

(15:52):
side, very few are have deepknowledge and insurance and how
our healthcare system operates.And when we appreciate that
fact, a lot of it starts to makesense of how we fix it
absolutely the same, exactly,exactly. And I didn't mean to
derail you, Ellen, but I'm
so didn't derail me at all. Itotally and I would, I think
there's an opportunity here thatyou know, maybe you and I do

(16:14):
another episode where we kind ofdo a deep dive on just the
health insurance and healthcarefundamentals, so people can, you
know, for people that want tolearn that, and I don't have to
junk up your podcast, we can doit over on the reverse mallet if
you want. Definitely do both.
No, but this is so good becauseour farmers are locked in a
similar system, where they have,like, the insurance they have,

(16:38):
they have, you know, cropinsurance, but they also have
local regulatory things and andwhen we start to see that the
systems in parallel have a lotof similar barriers to
innovation and barriers toprioritizing and realigning,
realigning the way they workwith human health outcomes and
climate resiliency, we start tounderstand that we can borrow a
lot from the medical frameworkor from the Ag Food System

(16:59):
framework. There's a lot ofenergy, interesting synergies
there so totally
are they're totally but I thinkwhat's important for people
understand and why you're makingsuch a point to stop here, and I
will stop here too, to reinforcethat, is that when we are when
healthcare is delivered underthe current construct, which

(17:24):
I'll add another element thatpeople should understand, which
really has, has is the reasonthat our healthcare system is
designed the way it is, is thereare two main forces here, right?
How you get your healthinsurance is typically through
your employer, because youremployer gets a really good tax
advantage to offer you thathealth insurance and those

(17:46):
health insurance benefits arenot your choice. They're your
employer's choice, right? And sowe have been, as people, we have
been completely removed from ourhealth care in terms of the
decision making process, we'rehanded a network that the
insurance company will let yousee. So it's like, here are the

(18:08):
physicians you're allowed tosee. You don't have full choice,
and this is how much you have topay to go see them. And
unfortunately, this fee forservice payment system
underlying it, it re it's a it'sa hamster wheel, because it just
reinforces that. In order youhave to have volume, right? And

(18:28):
the same, when you talk aboutfarming, it's not quantity over
quality, right? It's quantityover quality. And so healthcare
is quantity over quality, stillin that fee for service. And so
when I talk about paymenttransformation. What I'm talking
about is there has been atremendous effort in the last
decade after Obamacare. A lot ofpeople look at Obamacare really

(18:51):
negatively. I have a completelydifferent opinion of Obamacare.
I believe that people need tounderstand it is why we all have
security of knowing we can gethealth insurance. It did away
with medical underwriting forpeople that are within small
employers, or that areindividuals, you used to not be

(19:11):
able to just get healthinsurance that you could pay for
if you were sick. And I thinkpeople need to understand it's a
really big deal. And the other,really, another really important
aspect of Obamacare is that itput into account the Affordable
Care Act, and with that, theycreated what's called CMMI,

(19:32):
which is basically thegovernment CMS, which is the
Centers for Medicare andMedicaid Services. So they have,
they have created an innovationcenter, which is CMMI, and in
that it is focused almost solelyon payment transformation of

(19:53):
creating programs to move into aan outcomes based payment. Them.
So instead of it, the sickerpeople are, the more money
physicians make. It's the betterthe care is, the higher the
quality, more efficient, right?Then the better that goes. And
so in that, they created anumber of different things

(20:15):
outside of just healthinsurance. One of them is called
the accountable careorganization. They created that
through CMMI, and that is whatan ACO is, is an accountable
care organization. And so itallows physicians to say, we're
going to come together as agroup, right, and we're going to

(20:36):
deliver better care, and inexchange, we're going to get
paid a portion of whateversavings we generate from the
government by having thisAccountable Care Organization.
I'm making it. This is like,I'm, you know, it's a very I'm
making this very basic. This
is a fantastic explanation. Ifeel like we should just cut

(20:56):
this explanation out and put iton YouTube for people to
understand, because this is socritical, and this is one of the
reasons I was so excited to haveyou on the show, because I talk
a lot about incentives andcreating systems that
incentivize the outcomes thatyou'd like to see that benefit
people and planet, and how weshift the equation back to being

(21:19):
balanced between efficiency andeffectiveness, because in the
last 50 years, all of oursystems have gone to dominate a
very narrow slice of whatefficiency is, and it's been at
the expense of effectiveness,which is health outcomes. And
you know, planetary outcomes aswell, like balance with nature
and our planet. And also, if youlook at True Cost Accounting,

(21:43):
it's actually less efficientthan it would be if we looked at
a balanced a balanced picturebetween effectiveness and
efficiency, because theinefficiencies are coming home
to roost in externalities, whichis reflected in our health care
spending, which is literally aburden to our GDP, it's a burden
to the success and happiness inthe American people. You cannot

(22:06):
talk about health care withoutgetting real about that part.
So so then take this notion ofoutcomes based payment right the
Accountable Care Organizationwas created for the Medicare
segment. So because thegovernment so the other really
important piece, and I won'tspend too much time on this,

(22:28):
because this gets complicated,but I'm going to try to keep it
I think this is a superimportant element that I want
people to understand, is we haveto acknowledge there's something
called insurance risk, andpeople love to point fingers at
health plans and say, thepayers, the insurance companies,
the whatever right we all andthey're the big bad guys because

(22:50):
they don't want to authorize ourcare. They this or the right
they are, actually, when youlook at the list of quote,
unquote, insurance companies,they hold actually not the
majority of the insurance riskin this country for people, it's
a way more complicated system.So when I talk about insurance

(23:12):
risk, I'm talking about themoney that's being paid on my
behalf to cover my health careexpense. That healthcare
expense, somebody's signing upto cover it. I'm not, right? So
whoever I send my check to,well, if I'm over 65 and I don't
sign up with a health plan, sayI just have a supplemental plan,

(23:34):
right? I take like Plan F orplan A, or one of those plans,
and then I pay Mutual of Omahato cover my deductibles and
such. The government is stillinsuring me. They're still
paying for my health care.There's no insurance. There's no
big, bad insurance companythat's covering it. If I'm
Medicaid eligible, unless I'm ina state that's mandating that a

(23:56):
Medicare, I mean, a Medicaidorganization, health
organization, HMO, kind of thingis covering the care again, the
state's paying for it. They'reholding my insurance risk. So
the government said, Hey, halfof the people that we pay for we
were bankrupting the trusteesfund, right? So we've got to
figure out a way to manage thisother half that isn't with an

(24:20):
insurance company, and so that'swhere they created these
accountable care organizations.And so the important thing is,
when we talk about outcomesbased care, there's you have to
also comes with that is theinsurance risk. So if I'm a
provider and I'm saying, Hey,I'm going to, I'm going to
become an accountable careorganization. I'm going to

(24:41):
create one. We're going to haveprimary care physicians and and
I won't go into all the nuts andbolts of it, but I'm in essence
saying to the government, hey, Ithink that I can deliver the
care to the people that see meas my primary care like I
believe that I do it well, Ihave a model of care that's
going to cost less. And 1000bucks a month. So I want to, and

(25:03):
I want to get some of thatmoney, because then I, instead
of worrying about somebody beinglike, just getting as many sick
people in the door, I'm incentedto actually make people healthy.
Okay, so that's super importantto keep
them out of this system. It'slike a reverse economic thing.
So here's the last part of mystory, Joanie, I've done that

(25:24):
now for the whole decade thatCMS has been doing it. And more
I've that that is, I have beendeep in the trenches of doing
that, sitting in hospitalboardrooms, sitting in health
plan boardrooms, at the top,with the middle, the whole thing
doing great. But about a yearand a half ago, what I realized
was, well, two things. One,about eight years ago, I had my

(25:46):
own health kind of derailment,and during that process, I
realized just how broken ourfood system was, and I realized
that my own health, I healedmyself through food entirely.
There was no medicine that wasgoing to bait me better. I had a
toxic exposure, I had chronicstress. I had it. It all came to

(26:08):
a head. And I thought I had MS,and I thought I had thyroid
cancer. It was, it was ahorrific time. I went down the
diagnostic rabbit holes, andwhat ultimately pulled me back
into health was I had atremendous amount of
inflammation. It was in mybrain. It was horrible, but what
I learned was eating clean. Sowhen we talk about regenerative

(26:29):
I learned that that's what I Ineeded, I and then suddenly I
went really deep into food. Andso for the last eight years,
I've had this, literally, likethis kind of bipolar
relationship of my passion forfood and health and my work in
healthcare, and I thought, if Ijust keep focused on laying the

(26:50):
underpinnings of as many clientsas I can that will take outcomes
based care and implement itright, like many that'll that'll
put more and more lives and willmake but what I finally realized
a year and a half ago is wedon't actually deliver care in a
manner even when it's outcomesbased. We don't have a care
delivery model that actuallyreverses anything or makes

(27:13):
anybody better. We basicallytreat sick people. And so I I
almost walked away from theindustry, because I was like,
I'm tired of this and so. But Istopped and said, No, I need it.
I need to just broaden myhorizon. Maybe, maybe food is
medicine. Because, you know,last year, food is medicine was
getting a lot of traction. Maybefood is medicine will yield

(27:36):
some, some, like, I don't know,some fruit for me, right? And
get and I gotta tell you, itkind of went from there. I met
Carter, I met Aaron. I And andCarter Williams has, you know,
he has. He really showed me thatthere is a huge underbelly. It's
not a bad underbelly. It's likethe good part of people, of

(27:59):
farmers that are like, Hey, wehave to fix this. We can't have
a broken food system. And I waslike, okay, so everybody doesn't
think like Zach Bush, there'shope yet, right? Not that Zach
doesn't have hope, but you getwhat I'm saying. And I was like,
okay, maybe I don't have to giveup here. And and so then what I
realized is, we need translatorslike me that can say, hey,

(28:23):
health system, CEO, if youreverse lifestyle disease on
these lives that you hold thatinsurance risk, we can take 40
to 60 to 80% of the cost of careof a big chunk of Your
population. Oh, by having themeat healthy and teaching them
and changing behaviors and allof that. So that's my story. It

(28:46):
was very long.
It's an amazing story. I'm soglad because we, you know,
really, it weaves in this wholeexperience of, like, really the
big picture design, redesignprocess that we're all up
against. And, you know, havingthe understanding and the deep,
deep understanding of how thesesystems work, like insurance, is

(29:07):
critical to how we think throughthe the design for the future
that we want to see, because wecannot ignore the pieces of the
puzzle that actually drive thesystem, like like financial
systems, like banks, insurancesystems, they they have so much
to do with, like, how societyoperates and how the systems

(29:27):
work, and when you're dealingwith incentivization, um,
incentivization is the enginethat will drive change, and so,
like, it's all the moving partscoming together. How do we
rethink the model? And I lovethat you're passionate and
experienced and knowledgeableabout healthcare insurance,
because I think it is actuallyone of the most intimidating,

(29:49):
complex topics on the planet.Like I would take almost
anything all day long. But ifyou hand me like an insurance
manual, like my eyes cross andyou'd think that I like, I. You
know, kind of reading problemlike I literally had the hardest
time getting through it andmaking any sense of it at all.
So I'm appreciative that youhave this expertise. It's
fantastic.
And the other thing is, I don'tthere nobody's at fault here.

(30:16):
And unfortunately, I think inthe healthcare industry and then
in society, people want to pointfingers at the healthcare system
and say, you're greedy. You'rebroken because, oh, this CEO
makes this many millions ofdollars, and, you know,
whatever, I'm like, But whatabout all the other CEOs in
every other industry in the inthe world? You're not yelling at

(30:36):
them for making that much money.You know, it's like, it's a
private industry. We haven'tcreated healthcare for all. We
don't have socialized medicine.And so, quite frankly, when you
become sick, you want the bestcare
and and you you want the besttalent in leadership. And guess

(30:57):
what? They're business leaders,and they will go to other
industries if there's notcompetitive compensation exactly
at the leadership level. Soyeah, that's just the reality,
right? As a nurse, I've heard alot of grumbling about this. I
have done my fair share ofgrumbling because I've worked
with, I have worked, I haveworked with some of the most
fantastic, forward thinking CEOsof healthcare systems and or

(31:20):
hospitals, especially in ruralhospitals, that were just
absolutely fantastic. And thenI've worked for some that really
do epitomize just the kind oftransactionality mindset, like
it's just the transactions. Thisis just a business and, you
know, and it's clear that theydon't spend time at the bedside
when people are suffering, youknow. And absolutely they don't
see that full effect. But thenthey really don't see the full

(31:44):
effect of like, how do we keeppeople out of here in the first
place? Because they know that'stheir business models. The more
they come, the more they make.And that's where that whole it's
so incredibly difficult to wrapyour head around where to even
start with changing it andbringing in diet and
foundational things likefarming, seed, genetics,
agronomy, processinginfrastructure, like, that's

(32:05):
where I spend most of my timenow, is like that little piece
of the puzzle, because you can'thave high quality food if you
don't have connected networksof, you know, people at the crop
production level, or, you know,whatever The product is. It can
be animal or whatever, but andthen going into those first and
second tiers of processing, thatis like a divide that is so hard

(32:29):
to manage and navigate in ourcountry, and it's one of the
things that dictates thedominance of so many of these
big processed food giants inlike literally making or
breaking what we can buy on theshelves today. So it's like,
Yeah, huge system pieces.
And so I mean, a couple ofinteresting things with what you

(32:50):
just said. So I mean, first ofall, I've chosen, as you know,
which is how we met. I've chosento go deep on food, which
doesn't really try to understandthe food system itself. And I
think it's really important thatif you, if we want to, we want
to bring food and health backtogether again, then if you're

(33:14):
on the food side, I think it'simportant to understand where
health care is coming from. Andif you're on the health care
aside. You have to understandwhere the food is coming from,
and then try and think aboutthose disruptive, unexpected and
disruptive is hard for mebecause that sort of implies
this, like, I'm just gonna comein and spinning around and like,
do it the way I want, and Idon't know I destruction can

(33:38):
be dangerous. It actually cancreate some negative
consequences. And withhealthcare, we can't afford to
have a dangerous disruptionevent like we just can't afford
for that to happen. We need tofigure out a stable transition
and a realignment of thepriorities, and then the systems
need to be built to support thatreprioritization, which is

(34:01):
wellness, and the understandingthat that wellness starts on the
plate,
it does and but what I think alot of people miss in this whole
situation and you or this wholestory, and you'll see this with
me, is I don't talk aboutwellness and prevention, and
that's very purposeful, becauseinsurance is Insurance. It's

(34:26):
there to cover you when badthings happen, my homeowner's
insurance does not cover my roofbeing maintained right, my
health insurance, my homeowner'sinsurance, right does not come
that i i caulk around thecorners of my house so that I

(34:47):
don't have leaks, right and andso, but, but right it. And so
there's a I think a lot ofpeople can't separate. Uh,
insurance from health, right?And so Harvard and I've actually
spent a fair bit of timerecently kind of talking about

(35:09):
this is we really need to, Ispend a lot of time talking
about a new healthcare modelthat is a care delivery model
that is based on health, asopposed to based on sickness,
sick care needs to stay. Westill have a need to have a
network of sick care facilities,sick right? Sick care physician

(35:30):
really good at sick care. Imean, a former er and I see you
are in like, oh my gosh, like Iif I am in a car accident, I
want to go to our ers. I want togo to arc ICUs, but I want them
where the staff is focused ontrauma, where the reality is, is
any ICU in America, like half,half of it or more, is full of

(35:51):
chronic, renal chronic, youknow, complications of diet
related disease, and that's whatsucks the resources away from
delivery of trauma and emergentinterventions, the sick care
gets diluted by the needs of thechronic care, because that's the
top 5% right? So the sickest ofthe sick consume. They're only

(36:13):
5% of the people, but theyconsume 90% you know, 80%
resources, right? Yeah, and andso, but it's, it's not quite
that bad, but it's, it's, it'spretty grossly big, like that,
um, disproportionate that way,however, um, there's a, there's
a huge amount of money to besaved in the lifestyle bucket of

(36:36):
that, and in the lifestyledisease. And so I right now, I
think it's super important. Isit we really should just be
focusing, like, let's just stayfocused on the first step, if,
if we can get a system in placewhere, economically, there's

(36:58):
money in the system to pay toreverse lifestyle disease. It is
a condition for which we arepaying for. It is a sick
condition, and so I'll use mymom as an example. She went into
the ER, year and a half ago withinseptic shock from a kidney
infection that was a she had noidea she had. That was a

(37:19):
complication from uncontrolleddiabetes that had been going on
for years that unfortunately,she had the belief she was pre
diabetic. Now, when I got to theER in the ICU, actually not the
ER, when I got to the ICU, theywere giving her insulin, and I
asked, I said, What's What isthis? Because my dad's like,
she's not diabetic. And thenurse said, was her a 1c was 9.5

(37:40):
and I was like, Okay, papa,She's diabetic. That's an that's
a 30 day marker. I'm like,That's not that didn't happen
because she ate chocolate twodays ago, like, and so, but, but
here's the interesting I learnedfrom this experience, because
when she came out of it, shewanted to get healthy. She

(38:01):
didn't want to be sick anymore,and what I realized is there was
no avenue for her. HerTransition of Care back to home
was about keeping her fromgetting back in the hospital. It
was keeping her from beingacutely sick. There was no care
plan for her to engage with tobecome healthy, to reverse the

(38:23):
disease that took her into thehospital. I'm not talking about
metastatic metastatic cancerthat is likely not going to be
reversed, right? I'm talkingabout the millions and millions
of people that have lifestyledisease that could reverse their
chronic conditions, and it's assimple as food and and also
having physicians that aretrained to deliver care in a

(38:47):
manner that focuses on theirlifestyle and educates them and
engages them, we have given upon people. There is this. I had
given up on people like, oh,people are just lazy, people.
People just want to eat. Whatthey want to eat, right?
Whatever they are overwhelmed.They and somebody really, this
guy, Eric hiker, who's abranding person, who's really

(39:08):
into health, he said to me, weneed to give people permission
to be healthy. It's not. Theydon't think they have permission
anymore. They feel like they'renot invited, right? Yeah, yeah.
And that's to me, Joanie, that'slike, at the core of all this.
And so I go back to and say,Hey, okay, so let's take the

(39:29):
economics of healthcare. Thereare trillions of dollars being
spent, and insurance companiesare taking that revenue, and all
of the middleman in the middle,and all the people that are
holding the insurance risk,right? Those are employers,
their health plans, theirintermediaries that people don't
even realize that are out therethat are holding that financial
risk. And those are the peopleto say, hey, let's create a

(39:52):
program for 100 of yourdiabetics or 500 of your
adiabetics. To start, let's takeboard certified. A lifestyle
medicine physicians, or takeyour primary care physicians and
and get them board certified inlifestyle medicine. Let's
connect use a program like AaronMartin's created with with

(40:13):
regenerative farmed fooddelivered to the person, with
actual booking demonstrationsand engagement. It's a care
model. It's a food based caremodel. See it as such, right?
And change the behavior and andthen, because you're, I'm, I'm

(40:33):
saying, let's focus on peoplethat have financial incentive to
do this. If they are holdinginsurance risk, they have a
financial incentive. Start withthem, and when they see, oh my
gosh, I just had 50% of thepeople in this program drop
their a 1c into pre diabeticrange. They've come off of their
medicines. They they don't havetheir blood pressure has come

(40:55):
down. They feel good. They'reengaged with their health. Let
them be on the glyphs. Let thembe on on GLP ones, it's totally
fine, but put the food with it,and put the lifestyle with it
and help people move back tobeing healthy. There are
millions, if not trillions, ofdollars to be put back in the
pockets of the right people,including farmers like what I

(41:18):
want to see is programs whereyou have an insurance company
that says, Let's do this. Let'shave some docs that are focused
on lifestyle disease reversal,and we have people that want to
reverse lifestyle diseasethemselves and are engaged. We
engage local farmers to growregenerative, nutritionally

(41:39):
dense food provided to thosepeople, teach them how to eat
it. They become addicted to it.We all there are right there.
You know this?
Yeah, when you eat good food,and then you don't for a few
days, if you're used to it like,you're like, oh my gosh, I feel
awful, right? I can't wait toget home and just eat normal
again. That's your baseline. Ifyou eat if you eat garbage all

(42:01):
the time, you don't know what itfeels like to feel good.
You just don't the I told theAgricultural Commissioner for
Kentucky when I was down at AirH recently, my dream is to write
a check to a farmer for thehealth care savings of the
person that's eating his howpowerful would that be? And it's
feasible.

(42:23):
It is we have the frameworks inplace like you know, and you
even look at just how that woulddrive regeneration at the field
and farm level. Because if we'renow incentivizing eating more
diverse diets, more croprotations, growing things that
are actually grown for quality,not for quantity, and suddenly

(42:43):
your farmers are like, this isfantastic, because I've been
wanting to grow these criticalcrops. They're super healthy,
they're super foods, they'rewhatever. But we need a market
incentive to plant them and getthem through the value chain,
like, get them into processingand get them into human form.
Because, you know, often theyneed to be clean, they need to
be dried, they need to be boxed.Even if it's like produce, they
need to be cleaned and boxedgrains. You know all that,

(43:05):
although everything has adifferent process through the
value chain to get to thecustomer. And you know, if we
can figure out how to link andincentivize consumption
patterns, we suddenly now have afeedback loop between field and
farm and and market that isaligned with the interest of
health and climate resiliency,that alone, once that hamster

(43:27):
will starts turning, that'll fixso many things, just the ripple
effect from that realignment andthat closed loop feedback system
exactly.
And I think that that's anincremental step that that
economically aligns to disparatesystems and allows for you could
call it disruption, but it'salso innovation and market, I

(43:49):
think demand. So then whathappens is, then people that
aren't sick are like, wait, Iwant to be able to get the
regenerative food. I want to beable to be part of this program,
right? And then you can say,hey, insurance only covers that
for if you're if you're trulysick, right? But by being part

(44:09):
of this plan, you can stillparticipate in the program, so
you can get your produce fromproduce from here instead of
this other place, right? It'salso looking at it at the
grocery level, it's saying, canwe partner at the at the larger
distribution channels to say youdrive healthcare? So how do we
bring you in as a, as a, youknow, as a gateway drug to

(44:33):
healthcare, as Carter sometimessays, There's big opportunities
there. And then ultimately wedo. We are going to have to
address the actual insurancestructure. So we're going to
have to start to, I thinkultimately we have to break
apart. We've kind of talkedabout, like three or four

(44:53):
buckets where you have truelifetime disease, catastrophic
health. Bridge, which issomebody who's born with the
genetic and the government like,that's where you say, You know
what? The government really justneeds to have a fund that pays
for that. I'm not trying to putmore burden on the government,
but I think that is where someof our pressure is coming from.

(45:17):
Is that that right? So you movethat over, and then you start to
get employers to focus more onproviding catastrophic
insurance. And then you have anew emerging, what I will call,
sort of like a middle maybe it'sa supplemental policy. It's a
kind of like an Aflac where, butit's but it's different in that

(45:38):
it includes things like, youknow, an aura ring or your Apple
Watch and food and some of thethings that we want to invest in
to help us, you know, but take,but again, not locking $1,200 a
month on my behalf into a sickcare insurance policy, if I'm

(46:01):
willing to invest a portion ofthat into my health instead,
you know what I'm saying do,because that's the spend that
could be invested into doing thethings that you need to support
good health, like exercise,investing in gyms, access to
exercise, access to good qualityFood, if you're paying out of
pocket that you know, which weall are in, that in that role,

(46:25):
even as nurses working for ahealth care institution, our
monthly spend on health careinsurance from a family of five
was out. It was just insanebudget for all the other stuff,
exactly, yeah, and
it's so it's cheaper to be sick,and so that's the other really
important piece, is that we haveto address that in the insurance

(46:46):
benefits world. But what I'verealized is there's this
starting point, there's nowthat, and I think this gets back
to the inflection point that youand I talked about, which is
we're at this really interestingtime that all of us have been in
this industry for so long, andnow all of a sudden, we're
talking to each other, and it'slike, oh my gosh, there's like,
momentum. We met in thisWhatsapp group of people that

(47:08):
are coming together around food,is health. There's a momentum
now. And I and so I feel likethat's the important piece. Is
like, don't just say it'sbroken. Don't just say you're
going to blow it up. The moneyis here, let's figure out how
to, how to redistribute thatmoney into the right places,
change behaviors, right try and,you know, start at some points.

(47:30):
I mean, we could talk for hours.
That is a that's a designprocess like because we can do
it. It can be done. But it'slike, you need to have that
express to understand thecomplexities of the system, so
that collaboratively, a group ofpeople with diverse perspectives
but aligned around a centralgoal can go, Okay, if we, if we
move this lever and we changethis incentive, and we make this

(47:51):
available, and we bring thesepeople together, suddenly, you
can do these small proofs ofconcept that have powerful data,
takeaways that prove that it canbe done. Now it's a matter of
scale and replication, like whatAaron has done. And we had Aaron
on the show. We actually hadCarter on the show this summer
as well. I and so we're like,really trying to weave in this

(48:12):
concept where we pull throughthe whole system and all the
pieces of the puzzle workingtogether in unison to to
actually show that this is aviable model. Because once we
prove in several places that itcan be done, it is viable, it's
creating the outcomes we want tosee, and it has the economic
ROI, that's when it becomesundeniable that, like that. It's

(48:34):
that it's a unicorns and rainbowdream, like, it's like, we
disprove that whole unicorns andrainbow thing. It's like, No, we
have the proof that this works.This is not just a dream. This
is actually the reality. We justneed to get it in place. So I
love this, Ellen, we are goingto have to do a follow up
anytime. So much to unpack here.I'm happy to join you on your

(48:56):
podcast as well. Yeah, thatwould be super fun, because
it's, again, the reason I evengot into food systems was
because of being in healthcareand just seeing like, where we
were at. It was so urgent and sopressing to me that, you know,
like I could spend the rest ofmy life in the ICU, which I
love. It's a it's a wonderfulplace. I love delivering

(49:17):
healthcare, but I was nevergoing to make the change that I
wanted to see, andunfortunately, would be leaving
my kids the same system, whichis a finite system. So I love
the work you're doing. Thank youfor being so passionate about
it. And for our listeners, I betthere's going to be a lot of
people that want to learn a lotmore about this. How did they
learn more? How do they followyou? Where do they find you?

(49:39):
Yeah. So
I guess my voice is gettingbroader now so they can find our
firm is BP two health.com youknow, B is in boy, if he isn't
Paul at the number twohealth.com that is our actual
firm. But we have a podcastcalled the reverse mullet
healthcare podcast. It's. Ithink it would probably be the

(50:01):
reverse of yours, literally,where we're much more healthcare
centric. But we did, we actuallywill just, we are going to be
releasing an episode with Clintfrom Greenfield. Yes, any day
now. Oh, I went on
the show too. He was going to beon Season One, and now we're in
season two.
Okay, well, he we did him, andwe have had Carter on. We're

(50:23):
gonna have Aaron on. We actuallywork with with Aaron to help
her. We had a just had a greatconversation with a payer like,
it's very exciting. I won't godown that thing. And then the
other place you can find me isactually Carter Williams, Katie
stevins And I just started apodcast called and and Carter's
really fancy, so we have, like,a sub stack channel and

(50:46):
everything, but it's called theright now, it's called the food
is health revolution, and we arereally committed there. We're
really trying to get even, youknow, Silicon Valley, to
understand what's happening hereand and help push this whole

(51:07):
thing forward. So, yeah, so anyof those places you can find, I
love it on LinkedIn, I have abig voice on LinkedIn, as you
know you
do, so I'll make sure that wehave those links in the in the
show notes for people who wantto learn more and want to get
involved. And I'm just seeingthis year like we have a
conference in my own backyardhere that I'm very involved with

(51:29):
year after year at the SpokaneConservation District. We have
our Food Food and Farm summitevery year, and we have great
speakers. This year is totallyfocused on food, is health, and
it's an ag conference. It's agconference. So we're putting
together panels, and we'rebringing in speakers to really
address this topic, which isfantastic. So it's happening.

(51:51):
I'll have
to talk more about that, becauseI have some opinions on the food
is medicine versus food ishealth. I think both are great.
But I think it's reallyimportant to try and get people
to think broader than just food
as medicine. So, yes, exactly.And you know, with this one,
it's, it's, it's fascinating,because we're really talking
about, like, linkingagricultural practices with food

(52:13):
quality and then how thataffects health outcomes. And
it's great because it is largelyan all, like 80% of the people
there are farm and ag. And so Igave a presentation last year on
the linkage between healthoutcomes and food outcomes and
agricultural practices andoutcomes. And it was, like,
kicked off of, you know, kind ofa momentum in that community of

(52:36):
like, okay, we really do need tothink about what we're doing as
farmers through the lens of howthat affects human health, which
is, that's the dream, that'swhere it's happening. So I just,
I'm so happy you took time outof your day to join us. And wow,
lots to unpack. And I can't waitfor the next one. Thanks. Joni,
yeah. If you love the show,share it with your friends. Give

(52:58):
it a reading on whateverplatform you have and just let's
get the word out. And thanks somuch for joining thanks. Joni,
this episode of the regenerativeby design podcast is brought to
you by snacktivist nation,elevating climate smart crops
and regenerative supply chainsthrough innovative products and
transparent market development.Thank

(53:19):
you for joining me on theregenerative by design podcast,
please take a moment to reviewour channel on your favorite
podcasting service and sharethis session with your friends
and colleagues via LinkedIn,Twitter, Instagram, Facebook or
wherever you connect with yourcommunity.

(53:42):
You.