Health & Veritas

Howie and Harlan discuss the outlook for U.S. healthcare spending over the next five years, the state of seasonal and avian flu, and an expensive AI-based cardiac test. Show notes: Life expectancy and expenditures "How does U.S. life expectancy compare to other countries?" ACOs and cost savings "After Fifteen Years, is Value-Based Care Succeeding?" Health & Veritas Episode 115: Farzad Mostashari: Aligning Incentives to Fix Primary Care World Prematurity Day WHO: World Prematurity Day 2025 WHO: World Prematurity Day Key Messages WHO: Preterm birth AI concerns "'It keeps me awake at night': machine-learning pioneer on AI's threat to humanity" "Why neural net pioneer Geoffrey Hinton is sounding the alarm on AI" "AI pioneer: 'The dangers of abuse are very real'" "'Malicious use is already happening': machine-learning pioneer on making AI safer" "Fathers of the Deep Learning Revolution Receive ACM A.M. Turing Award" "Deep learning" Bird flu "First U.S. case of human bird flu in 9 months confirmed in Washington state" Cleveland Clinic: Bird Flu (Avian Influenza) "Flu in numbers: NHS faces one of worst winters ever, officials warn, amid concern over mutated strain" "New flu virus mutation could see 'worst season in a decade'" "Australia posts record-breaking flu numbers as vaccination rates stall" FDA: Influenza Vaccine Composition for the 2025-2026 U.S. Influenza Season Cardiology and AI "Coronary CT angiography evaluation with artificial intelligence for individualized medical treatment of atherosclerosis: a Consensus Statement from the QCI Study Group" "Medicare will pay more than $1,000 for AI to analyze a heart scan. Is that too much?" Free speech and drug promotion "High-Engagement Social Media Posts Related to Prescription Drug Promotion for 3 Major Drug Classes" Health & Veritas Episode 195: Jerry Avorn: Countering the Drug Marketing Machine Medicare premiums "Medicare premiums to jump 10% heading into 2026" "Social Security Announces 2.8 Percent Benefit Increase for 2026" Centers for Medicare and Medicaid: 2026 Medicare Parts A & B Premiums and Deductibles In the Yale School of Management's MBA for Executives program, you'll get a full MBA education in 22 months while applying new skills to your organization in real time. Yale's Executive Master of Public Health offers a rigorous public health education for working professionals, with the flexibility of evening online classes alongside three on-campus trainings. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Harvard internist Jerry Avorn to discuss his research on the pharmaceutical industry and his work promoting evidence-based prescribing. Harlan highlights new results from the American Heart Association meeting, including a one-time CRISPR-based therapy for high cholesterol; Howie reports on an outbreak of infant botulism. Show notes: Research from the American Heart Association Meeting "Phase 1 Trial of CRISPR-Cas9 Gene Editing Targeting ANGPTL3" "First-in-human trial of CRISPR gene-editing therapy safely lowered cholesterol, triglycerides" "Cardiac Allograft Vasculopathy Inhibition with Alirocumab: The CAVIAR Trial" "PCSK9 medication plus statin may help lower cholesterol after heart transplant" "Investigational daily pill lowered bad cholesterol as much as injectables" Jerry Avorn Science Direct: Academic Detailing Jerry Avorn: "Principles of Educational Outreach ('Academic Detailing') to Improve Clinical Decision Making" Alosa Health FDA: Accelerated Approval Jerry Avorn: Rethinking Medications: Truth, Power, and the Drugs You Take FDA: Direct-to-Consumer (DTC) Advertisements H.R.5952 - Prescription Drug User Fee Act of 1992 FDA: FY 2025 FDA Budget Summary Centers for Medicare & Medicaid Services: Open Payments H.R.3590 - Patient Protection and Affordable Care Act "Aducanumab Discontinued as an Alzheimer's Treatment" FDA: ELEVIDYS Brigham and Women's Hospital & Harvard Medical School: Division of Pharmacoepidemiology and Pharmacoeconomics Amazon.com: Featured comments on Rethinking Medications Infant Botulism California Department of Public Health: "Outbreak of Infant Botulism Linked to ByHeart Infant Formula" California Department of Public Health: Infant Botulism Treatment and Prevention Program CDC: "Infant Botulism Outbreak Linked to Infant Formula, November 2025" "ByHeart recalls all baby formula sold nationwide as infant botulism outbreak grows" California Department of Public Health: What is BabyBIG? California Department of Public Health: Postponement of BabyBIG Fee Increase California Department Of Public Health: Invoice and Purchase Agreement for BabyBIG In the Yale School of Management's MBA for Executives program, you'll get a full MBA education in 22 months while applying new skills to your organization in real time. Yale's Executive Master of Public Health offers a rigorous public health education for working professionals, with the flexibility of evening online classes alongside three on-campus trainings. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by cardiologist Ali Rahimi, the founder of ALYKA Health, which uses a personalized mobile app to help patients manage their heart health between doctor's visits. Harlan discusses new developments in GLP-1 obesity drugs, including untested microdose treatments; Howie reviews a landmark study investigating whether broad prostate cancer screening saves lives. Show notes: GLP-1 Drugs "Microdosing aims to extend the lifespan of the GLP-1 compounding market" NIH: Regulatory Framework for Compounded Preparations Health & Veritas Episode 140: Lee Schwamm: Smarter Healthcare Systems With AI "FDA takes on GLP-1 compounding boom with warnings about misleading marketing" "Should You Microdose GLP-1 Drugs?" "How microdosing GLP-1 drugs became a longevity 'craze'" "Bidding war between Pfizer, Novo Nordisk for obesity startup Metsera escalates" "Trump Negotiating Deal With Ozempic Maker to Sell Some Weight-Loss Drugs for $149""Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment" "How Ozempic's Maker Lost Its Shine After Creating a Wonder Drug" Ali Rahimi ALYKA Health Harlan Krumholz and Ali Rahimi, "Financial Barriers to Health Care and Outcomes After Acute Myocardial Infarction" "Why High Blood Pressure Matters to Your Health" Building a Better Delivery System: A New Engineering/Health Care Partnership NIH: The 21st Century Cures Act New Evidence on Prostate Cancer Screening and Breast Cancer Treatment National Cancer Institute: Cancer Stat Facts: Prostate Cancer" U.S. Preventive Services Task Force: Prostate Cancer: Screening" "The pros and cons of PSA tests for prostate cancer for midlife and older men" "Share on European Study of Prostate Cancer Screening — 23-Year Follow-up" "Early Detection of Prostate Cancer — Time to Fish or Cut Bait" "Ten-Year Survival after Postmastectomy Chest-Wall Irradiation in Breast Cancer" "Omission of Chest-Wall Irradiation after Mastectomy for Breast Cancer" In the Yale School of Management's MBA for Executives program, you'll get a full MBA education in 22 months while applying new skills to your organization in real time. Yale's Executive Master of Public Health offers a rigorous public health education for working professionals, with the flexibility of evening online classes alongside three on-campus trainings. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Nate Wood, a Yale School of Medicine internist and trained chef, to discuss his work combining lifestyle guidance with hands-on training in making healthy, tasty food. Harlan shares new guidance on what counts as a healthy blood pressure; Howie provides an update on rising health insurance costs. Links: Blood Pressure Harlan Krumholz, "Severe Hypertension: The Next Never Event" JACC: 2025 High Blood Pressure Guidelines Resources "Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension" Obesity Drugs "Semaglutide and Tirzepatide for Obesity: Effectiveness and Value" "Institute for Clinical and Economic Review Publishes Evidence Report on Treatments for Obesity" Harlan Krumholz and Jason Abaluck, "Changes in Cardiovascular Risk Factors and Health Care Expenditures Among Patients Prescribed Semaglutide" Culinary Medicine "Culinary Medicine: The Secret Ingredient to Good Health" American College of Lifestyle Medicine "How each lifestyle medicine pillar supports good nutrition" Dr. John La Puma "What to know about 'hyperpalatable' foods" Food is Medicine Coalition: Our Model American Academy of Family Physicians: Shared Medical Appointments/Group Visits Cleveland Clinic: GLP-1 Agonists Yale New Haven Hospital: Irving and Alice Brown Teaching Kitchen "Bringing Culinary Medicine to Yale's New Teaching Kitchen" Dr. Nate Wood Nate Wood on Instagram Health Insurance Costs Kaiser Family Foundation: 2025 Employer Health Benefits Survey "Health Benefits In 2025: Family Premiums Rise 6 Percent, Large Employers Increase Coverage Of GLP-1s For Weight Loss" "Annual Family Premiums for Employer Coverage Rise 6% in 2025, Nearing $27,000, with Workers Paying $6,850 Toward Premiums Out of Their Paychecks" "8 Things to Watch for the 2026 ACA Open Enrollment Period" "ACA Insurers Are Raising Premiums by an Estimated 26%, but Most Enrollees Could See Sharper Increases in What They Pay" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Yale School of Medicine immunologist Akiko Iwasaki, a leading authority on vaccines and long COVID. Harlan reflects on America's crisis of trust in federal agencies; Howie provides some good news about bird flu. Links: Losing Trust Harlan Krumholz: "When Your Patient Dies" "Federal Agents Stage Raid on Canal Street in New York City, Arresting 9" "White House expands East Wing demolition as critics decry Trump overreach" "Americans' Job Ratings of Six Key U.S. Agencies Worsen" "NEJM and public health group are launching rival to CDC's MMWR publication" "South Carolina measles outbreak rises as schools with low vaccination see new cases" Akiko Iwasaki Health & Veritas Ep. 9: Dr. Akiko Iwasaki: Is Long COVID One Disease or Many? "The Long COVID Puzzle: Autoimmunity, Inflammation, and Other Possible Causes" "A New Kind of Clinical Trial: Bringing Long COVID Research Into Patients' Homes" "New Evidence Supports Autoimmunity as One of Long COVID's Underlying Drivers" "Scientist Dr. Akiko Iwasaki Joins SPEAR Study Group to Investigate Monoclonal Antibodies for Long COVID and COVID-19 Post-Vaccination Syndrome" "Long Covid: A parallel pandemic" "Effectiveness of Colchicine for the Treatment of Long COVID" Akiko Iwasaki and Harlan Krumholz: "Nirmatrelvir–ritonavir versus placebo–ritonavir in individuals with long COVID in the USA (PAX LC): a double-blind, randomised, placebo-controlled, phase 2, decentralised trial" "Does Paxlovid Reduce Long COVID Symptoms? Yale-Led Trial Finds Out" Akiko Iwasaki: "Unexplained post-acute infection syndromes" "Post-Acute Infection Syndromes Will Be the Focus of New YSM Center" CDC: ME/CFS Basics "Varicella-zoster virus reactivation and the risk of dementia" Akiko Iwasaki and Harlan Krumholz: "Immunological and Antigenic Signatures Associated with Chronic Illnesses after COVID-19 Vaccination" "A small study on Covid vaccine safety sparks an online tempest" "We have 'post-vaccination syndrome.' We are tired of being used to score anti-vax points" Health & Veritas Ep. 162: Paul Lombardo: Reckoning with the Dark History of Eugenics Health & Veritas Ep. 163: Michael Dunne: Confronting the Antibiotic Resistance Crisis Mayo Clinic: Alpha-gal syndrome Akiko Iwasaki: Woman shares what it's like to live with alpha-gal meat allergy triggered by tick bite" "'Explosive increase' of ticks that cause meat allergy in US due to climate crisis" "Why Is Martha's Vineyard Going Vegan? It's All About Tick Bites." "Beneficial Bloodsucking" Akiko Iwasaki on X Bird Flu "Bird Flu Is Back" CDC: H5 Bird Flu: Current Situation "RNA replicon vaccination confers long-lasting protection against H5N1 avian influenza in 23 zoo bird species" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Rajlakshmi Krishnamurthy, Associate Dean for Population Health at Yale, discusses her experience building innovative care systems. She shares insights from her work with community health workers to reduce emergency department overcrowding. Raj highlights the importance of integrated care models learned from her time at the VA and her efforts in Boston and Chicago to implement value-based care initiatives. She also delves into global health access, particularly regarding weight-loss drugs, showing her commitment to improving healthcare outcomes.

Howie and Harlan discuss the roots of the crisis in emergency departments, the lack of oversight for hydration spas, new approaches in blood pressure treatment, an ingenious method to prevent malaria, and the CDC's backward steps on vaccines. Links: Emergency Departments "I'm an ER doctor. JD Vance's claims about immigrants and wait times are just wrong." "It's Just a Virus, the E.R. Told Him. Days Later, He Was Dead." Video of Ron Paul: "Should society let uninsured die?" American College of Emergency Physicians: Understanding EMTALA "Explaining the G.O.P.'s Misleading Talking Point on the Looming Shutdown" Centers for Medicare and Medicaid: Emergency Medical Treatment & Labor Act (EMTALA) Health & Veritas Ep. 188: Kate Heilpern: Jumping into the Deep End Health & Veritas Ep. 47: Dr. Jeremy Faust: Is COVID Over? It's Complicated. Jeremy Faust: "Inside Medicine Read-Through: Commentary on the New York Times article about a tragic ER case" Harlan Krumholz: "Early Warning Scores With and Without Artificial Intelligence" Howard Forman: "Why Hospitals Need to Stop Boarding Patients in Emergency Rooms" Howard Forman: "How to Keep Emergency Rooms Focused on True Emergencies" The Revolving Door "Peter Marks, FDA vaccine regulator ousted by RFK Jr., joins Eli Lilly" Peter Marks Resignation Letter "Peter Marks, FDA's top vaccine regulator, forced out" "Fired C.D.C. Director Describes Clashes With Kennedy and Turmoil at Agency" "Ex-CDER chief Patrizia Cavazzoni becomes Pfizer's chief medical officer" Hydration Spas Howard Forman: "State Policies and Facility Practices of IV Hydration Spas in the US" Health & Veritas Ep. 123: Margo Harrison: Women's Health as a Path to Empowerment "Hydration spas are largely unregulated, study finds" New Developments in Blood Pressure Treatment "Baxdrostat met the primary endpoint in Bax24 Phase III trial in patients with resistant hypertension" "AstraZeneca's $1.3B bet yields 2nd phase 3 blood pressure win, bolstering differentiation case" Harlan Krumholz: "The Disquieting Plateau" "Under new guidelines, more Americans meet the criteria for high blood pressure" "2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines" "Permethrin-Treated Baby Wraps for the Prevention of Malaria" AI in Medicine: Doximity, OpenEvidence, and UpToDate "OpenEvidence raises $210M, unveils AI agents built for advanced medical research" Health & Veritas, Ep. 183: Seth Berkowitz: The Power Problem "Doximity buys Pathway Medical for $63 million to help doctors get AI-powered answers" "A long-trusted physician's reference finally catches the AI wave" Congenital syphilis Health & Veritas Ep. 178: Sarah DeSilvey: Creating Space for Healing "Are STIs truly declining, or is our data just not very good? What the 2024 CDC STI report really shows" "Why Syphilis Cases in Newborns Are Rising Even as STIs Decline" MMR Vaccine "Acting CDC director calls to 'break up' the measles, mumps and rubella vaccine into three shots" "Worried about splitting up the MMR vaccine into three separate shots? You should be, this doctor says" "More measles cases confirmed in South Carolina, Michigan as US total climbs to 1,563" Nobel Prizes and Science at Yale "Nobel Prize in Physiology or Medicine Is Awarded for Work on Immune Systems" "Nobel Prize in Physiology or Medicine 2025" "Yale's Michel H. Devoret wins 2025 Nobel Prize in Physics" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Vanessa Cooper, a Yale School of Medicine neurologist, to discuss the causes of migraines and promising new treatments for the disorder. Harlan discusses his approach as a journal editor to the use of AI in academic writing; Howie reports on the premium tax credits for insurance purchased through Affordable Care Act exchanges that are at stake in the government shutdown. Links: The Government Shutdown "Government Shutdown Live Updates" "The US government has shut down. Here's what to know" "Watch: Hegseth rails against 'beardos' and 'woke' at gathering of US generals" Harlan Krumholz: "Tools, Not Ghosts: Artificial Intelligence, Writing, and Responsibility" Headaches "The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates" "Migraine with aura" "General neurology: Current challenges and future implications" "Eleven Reasons People Decide to Choose Headache Medicine: There May Be a Headache Medicine Provider Shortage but there are Ways to Foster Interest" "How to Find the Right Doctor for Proper Migraine Management" Cleveland Clinic: Chronic Migraine Mayo Clinic: Cluster headache Mayo Clinic: Trigeminal neuralgia" "Migraine With Aura" American Headache Society: Types of Aura "Rethinking migraine with aura: Why cortical spreading depolarization (depression), not aura, causes headaches" "Effects of anti-epileptic drugs on spreading depolarization-induced epileptiform activity in mouse hippocampal slices" "CGRP Inhibitors" "Top migraine medication effective for preventing migraines, treating drug-induced headaches is hard to access" "Review: An Update on CGRP Monoclonal Antibodies for the Preventive Treatment of Episodic Migraine" International Neuromodulation Society: About Neuromodulation American Association of Neurological Surgeons: Vagus Nerve Stimulation Cefaly Gammacore American Headache Society: First Contact: Headache in Primary Care ACA Tax Credits and the Government Shutdown "Why ACA tax credits for 22 million Americans are at the center of the government shutdown drama" "Employer-Sponsored Health Insurance 101" Center for Medicare and Medicaid Services: Medicare Monthly Enrollment Medicaid.gov: June 2025 Medicaid & CHIP Enrollment Data Highlights "ACA Marketplace Premium Payments Would More than Double on Average Next Year if Enhanced Premium Tax Credits Expire" "The Estimated Effects of Enacting Selected Health Coverage Policies on the Federal Budget and on the Number of People With Health Insurance" "How an ACA Premium Spike Will Affect Family Budgets, and Voters" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Kate Heilpern, president of Yale New Haven Hospital, to discuss the innovation and adaption needed to lead NewYork-Presbyterian Hospital through the worst of the COVID-19 pandemic, and how Yale New Haven Health structures itself to provide quality care across five hospitals. Harlan reflects on the many biotech startups emerging from Yale; Howie responds to the Trump administration's assertion of a link between acetaminophen and autism. Links: Biotech at Yale and Beyond "Investors Flock Back to Biotech After a Long, Cold Spell "Boom, Bust and Recover: What Happens Next as Biotech VC Cycle Resets". "Pfizer to Buy Weight-Loss Drug Developer Metsera for Up to $7.3 Billion" Yale Ventures Health & Veritas Ep. 80: Josh Geballe: Turning Yale Innovation into Startups Yale Ventures Annual Report 2025 Cloverleaf Bio Allyx Therapeutics EvolveImmune Therapeutics Normunity Inozyme Pharma "BioMarin to buy rare disease drugmaker Inozyme for $270M" "Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018" Kate Heilpern "Yale New Haven Hospital announces new president" "Yale New Haven Health announces Katherine Heilpern, MD, as the new president of Yale New Haven Hospital" "Heilpern sees society reflected in the busy ER" "Meet the Heroes Fighting on the Front Lines Against Covid-19" "'Adrenaline, Duty, and Fear': Inside a New York Hospital Taking on the Coronavirus" Health & Veritas Ep. 116: Christopher O'Connor: Hospital Leadership in Trying Times "Saving America's ERs" "The 600 Pathways Yale New Haven Health Takes to Improved Care Delivery" Tylenol and Autism "Trump Issues Warning Based on Unproven Link Between Tylenol and Autism" "Trump links autism and Tylenol: is there any truth to it?" "Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability" "Study reveals no causal link between neurodevelopmental disorders and acetaminophen exposure before birth" "Does Stress Cause Ulcers?" "The Effect of Vitamin E and Beta Carotene on the Incidence of Lung Cancer and Other Cancers in Male Smokers" "The U.S. government has jumped the public health shark" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Yale School of Medicine geriatrician Barry Wu, who provides a framework for family caregivers and physicians to understand the needs of older adults. Harlan reports on Congress's shifting approach to funding research; Howie reflects on a survey showing that many college students believe that violence is an acceptable way to protest a campus speaker. Links: Congressional Directives on Funding Research House Appropriations Committee Press Release: "Committee Approves FY26 Labor, Health and Human Services, Education, and Related Agencies Appropriations Act" "Report of the Committee on Appropriations House of Representatives" "House Committee on Appropriations Approves FY 2026 Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) Appropriations Bill & Accompanying Report" Supporting Older Adults John A. Hartford Foundation: Age-Friendly Care Barry Wu: "Medical students applying the 4Ms during their first week of school" "Caregiving from 460 Miles Away: A Geriatrician's Experience Caring for His Mother" "2020 Census: 1 in 6 People in the United States Were 65 and Over" "The Paradoxical Decline of Geriatric Medicine as a Profession" Violence and Speech "What You Need to Know About Charlie Kirk's Assassination" "Student acceptance of violence in response to speech hits a record high" "Yale Political Union attendees challenge King's son on nonviolence" ACA Subsidies "ObamaCare fight meets shutdown politics: What to know" "Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?" "Explaining the Muddle on ACA Tax Credits" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.