Health & Veritas

Howie and Harlan are joined by Ryan Schwarz, a Yale-trained MD-MBA who oversees accountable care for the Massachusetts Medicaid program, to discuss new models for addressing the severe shortage of primary care doctors in the U.S. Harlan looks at the fallout from the bankruptcy of 23andMe; Howie reports on Match Day at Yale and medical schools around the country. Links: New Leadership “Senate Confirms Bhattacharya and Makary to H.H.S. Posts” “Keir Starmer Wants to Abolish N.H.S. England: What to Know About His Plan” 23andMe “23andMe Files for Bankruptcy Amid Concerns About Security of Customers’ Genetic Data” “Data Breach at 23andMe Affects 6.9 Million Profiles, Company Says” “23andMe user data targeting Ashkenazi Jews leaked online” “Attorney General Bonta Urgently Issues Consumer Alert for 23andMe Customers” U.S. Senate Bill S.5433: Genomic Data Protection Act Ryan Schwarz “The Health of US Primary Care: 2025 Scorecard Report—The Cost of Neglect” “Finger on the Pulse: The State of Primary Care in the U.S. and Nine Other Countries” Massachusetts Health Insurance Survey “Revisiting the Time Needed to Provide Adult Primary Care” “How Algorithms Could Improve Primary Care” Ryan Schwarz: “Primary Care Sub-capitation in Medicaid: Improving Care Delivery in the Safety Net” MassHealth Primary Care Sub-Capitation: Program Overview “The first community health centers: a model of enduring value” “Community Health Centers’ Progress and Challenges in Meeting Patients’ Essential Primary Care Needs” Match Day “Biggest Match Day ever: Here’s what the 2025 numbers reveal” “Yale School of Medicine Celebrates Match Day” Video: Match Day 2025: Winners & Losers Edition Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Mark McLellan, a physician, economist, and longtime public servant, to discuss lessons learned from the COVID-19 response and the successes and failures of the healthcare payment innovations he helped to create. Harlan reports on a wave of illness caused by slushy drinks; Howie considers the merits of accelerated training for doctors. Links: The Dangers of Slushies “Glycerol intoxication syndrome in young children, following the consumption of slush ice drinks” Institute for Government: Sugar tax Mark McClellan Health economist Alan M. Garber, MD, PhD Mark McClellan: “Catheterization and Mortality in Elderly Patients With Acute Myocardial Infarction-Reply” Mark McClellan: “National Coronavirus Response: A Road Map to Reopening” “COVID-19 pandemic-related excess mortality and potential years of life lost in the U.S. and peer countries” “Medicare Should Put Its Dollars on Value, Says McClellan” “What Forced CMS to Terminate the MA Value-Based Insurance Design Model?” “How to Create Incentives for Improvement” Accelerating Med School “Outcomes of Accelerated 3-Year MD Graduates at NYU Grossman School of Medicine During Medical School and Early Residency” “Three-Year Medical School Has Benefits, Ethicist Says” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan check in on health issues in the news, including the big bet that went wrong for Walgreens, prohibited words at federal health agencies, the weaknesses of a much-discussed study suggesting that people age in bursts, and the long-term impact of the HPV vaccine.  Links: Walgreens “Walgreens to Be Bought by Private Equity Firm in $10 Billion Deal” “Walgreens is heading down a risky path” “Walgreens to Be Acquired by Sycamore Partners: Where Did the Retail Giant Go Wrong?” “Amazon, CVS, and Walgreens went all in on primary care. Their bets are bleeding money.” Cuts to the ACA “Trump administration plans to restrict Obamacare enrollment period” “DACA recipients worry about being ensnared in Trump's immigration crackdown” Medicaid “Cutting Medicaid?” “WATCH: Dr. Jay Bhattacharya testifies at Senate confirmation hearing for NIH director” “‘Wrong,’ ‘misleading,’ and ‘reasonable’: How Jay Bhattacharya became, for some, the least bad option to run NIH” “The Debate Over Federal Medicaid Cuts: Perspectives of Medicaid Enrollees Who Voted for President Trump and Vice President Harris” “Medicaid’s True Improper Payments Double Those Reported by CMS” “Hundreds of Billions in Medicaid Savings from Financing Schemes” Prohibited Words “C.D.C. Suggests Terms Like ‘Race’ and ‘Health Equity’ Are Off-Limits, Then Backtracks” “For Google, health equity becomes ‘health optimization’ as Trump targets DEI” Aging “Do We Age Steadily, or in Bursts?” “Nonlinear dynamics of multi-omics profiles during human aging” “What does it take to be a super-ager?” The HPV Vaccine “Trends in Cervical Precancers Identified Through Population-Based Surveillance — Human Papillomavirus Vaccine Impact Monitoring Project, Five Sites, United States, 2008–2022” “People Have Been Having Less Sex—whether They’re Teenagers or 40-Somethings” “RFK Jr. says he’ll stop collecting fees from HPV vaccine lawsuit, but other ethics questions remain” Norovirus “An oral norovirus vaccine tablet was safe and elicited mucosal immunity in older adults in a phase 1b clinical trial” “How to Prevent Norovirus” The Measles Outbreak CDC: Expanding Measles Outbreak in the United States and Guidance for the Upcoming Travel Season “Texas measles cases grow to 223, mostly among children and teens” “West Texas measles outbreak expands to three states” 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 neonatologist Sarah Taylor to discuss our growing understanding of breastfeeding, including the active role that infants play in shaping the composition of breast milk. Harlan discusses the rapid growth of Hims & Hers Health, which provides treatment and medication over the internet; Howie reports on the promising initial results from a pilot program in North Carolina that seeks to reduce healthcare costs by providing support in non-medical areas like food security and housing.  Links: Hims & Hers “Why Hims & Hers Stock Has Further to Fall: Heard on the Street” “Hims & Hers Super Bowl Spot Draws Drug-Industry Backlash” “Why We Don’t Trust Doctors Like We Used To” Breastfeeding Sarah Taylor and Howard Forman: “No such thing as a free lunch: The direct marginal costs of breastfeeding” Sarah Taylor: “Infant factors that impact the ecology of human milk secretion and composition—a report from ‘Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)’ Working Group 3” Sarah Taylor: ”Parent and grandparent neonatal intensive care unit visitation for preterm infants” Sarah Taylor: “Quantifying the Association between Pump Use and Breastfeeding Duration” The North Carolina Healthy Opportunities Pilot Program “Reflecting on Nearly Two Years of North Carolina’s Healthy Opportunities Pilots” Health & Veritas, Episode 97: Mallika Mendu: Improving Operations “Medicaid Spending and Health-Related Social Needs in the North Carolina Healthy Opportunities Pilots Program” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by infectious disease specialist Michael Dunne to discuss the growing problem of antimicrobial resistance and what’s needed to incentivize the development of new antibiotics. Harlan reflects on the controversy sparked by the release of his study on post-vaccination syndrome; Howie provides an update on the measles outbreak in Texas.  Links: Post-Vaccine Syndrome 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” “Scientists Describe Rare Syndrome Following Covid Vaccinations” Antimicrobial Resistance and New Antibiotics "New bill would create a subscription payment model to jumpstart antibiotic development" Antimicrobials Working Group H.R.4127—DISARM Act of 2021 S.1355—PASTEUR Act of 2023 CDC: Antimicrobial Resistance Facts and Stats Michael Dunne: “Impact of Empirical Antibiotic Therapy on Outcomes of Outpatient Urinary Tract Infection Due to Nonsusceptible Enterobacterales” Michael Dunne: “A multicenter analysis of trends in resistance in urinary Enterobacterales isolates from ambulatory patients in the United States: 2011-2020" CDC: Core Elements of Antibiotic Stewardship "Crisis Looms in Antibiotics as Drug Makers Go Bankrupt" "Bill & Melinda Gates Medical Research Institute Initiates Phase 3 Clinical Trial of Tuberculosis Vaccine Candidate" Michael Dunne: “Replacing serum with dried blood microsampling for pharmacokinetics, viral neutralisation and immunogenicity bioanalysis supporting future paediatric development of RSM01, a candidate respiratory syncytial virus neutralising monoclonal antibody” The Measles Outbreak “An unvaccinated child has died in the Texas measles outbreak” CDC: Measles, Mumps, Rubella (MMR) Vaccine Safety WHO: Measles "Consequences of Undervaccination—Measles Outbreak, New York City, 2018-2019" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by legal historian Paul Lombardo to discuss his work exploring the role of the legal and medical establishments in eugenics and sterilization in the United States. Harlan reports on his new research on post-vaccination syndrome, a constellation of chronic symptoms experienced by some people after getting the COVID-19 vaccine; Howie discusses the science behind a measles outbreak in Texas. Links: Anxiety in Academia Yale Office of the President: Our commitment to our research mission Post-Vaccination Syndrome Harlan Krumholz: “Immunological and Antigenic Signatures Associated with Chronic Illnesses after COVID-19 Vaccination” “Immune markers of post vaccination syndrome indicate future research directions” Eugenics in America U.S. Supreme Court: Buck v. Bell, 274 U.S. 200 (1927) Paul Lombardo, New England Journal of Medicine: “‘Ridding the Race of His Defective Blood’—Eugenics in the Journal, 1906–1948” “Clarence Thomas tried to link abortion to eugenics. Seven historians told The Post he’s wrong.” Paul Lombardo: Three Generations, No Imbeciles In the Name of Eugenics Paul Lombardo: “Republicans, Democrats, & Doctors: The Lawmakers Who Wrote Sterilization Laws” Measles and Herd Immunity “West Texas measles outbreak grows to 58 cases, including some people who said they were vaccinated” “Supreme Court rejects challenge to Connecticut law that eliminated religious vaccination exemption” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Deborah Rhodes, a Yale internist and the chief quality officer for Yale Medicine and Yale New Haven Health System. They discuss how she helped develop a better approach to scanning for breast cancer in women with dense breast tissue, and the obstacles to wide adoption. Harlan reports on the Trump administration’s plan to slash indirect support for research; Howie explains the potential consequences of cuts to Medicaid. Links: Flu and Research Cuts “Weekly US Influenza Surveillance Report: Key Updates for Week 5, ending February 1, 2025” “This Is One of the Worst Flu Seasons in Decades” “Court Pause on Trump Cuts to Medical Research Funds Is Expanded Nationwide” “What National Institutes of Health funding cuts could mean for U.S. universities” Harlan Krumholz: “The NIH’s drastic cut to indirect cost rates is a critical threat to U.S. research infrastructure" Breast-Cancer Screening TED Talk by Deborah Rhodes: “A test that finds 3x more breast tumors, and why it's not available to you” Deborah Rhodes: “A Survey of Patient Experience During Molecular Breast Imaging” Mayo Clinic Breast Clinic: “How To Decide What To Do If You Have Dense Breasts On Mammogram” Deborah Rhodes: “Dedicated dual-head gamma imaging for breast cancer screening in women with mammographically dense breasts” Cleveland Clinic: Fibroglandular Density Are You Dense? “Evaluation of a Clinical Decision Support System for Imaging Requests” Medicaid “House Republicans release budget plan, with trillions in tax and spending cuts” “Trump's return puts Medicaid on the chopping block”  “Red states likely to feel the pain of Medicaid cuts” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss a breakthrough pain medication, studies on AI-assisted medicine, the explosion of sports gambling, and the health consequences of the shutdown of USAID.  Links: A First-in-Class Painkiller “F.D.A. Approves Drug to Treat Pain Without Opioid Effects” “FDA Approves Novel Non-Opioid Treatment for Moderate to Severe Acute Pain” “Peripheral Sodium Channel Blocker Could Revolutionize Treatment for Nerve Pain” “Alabama to Beijing… and Back: The Search for a Pain Gene” AI Screening “Screening performance and characteristics of breast cancer detected in the Mammography Screening with Artificial Intelligence trial (MASAI): a randomised, controlled, parallel-group, non-inferiority, single-blinded, screening accuracy study” “3D mammograms show benefits over 2D imaging, especially for dense breasts”. “The Robot Doctor Will See You Now” USAID and Foreign Aid “Trump and Musk move to dismantle USAID, igniting battle with Democratic lawmakers” “What USAID does, and why Trump and Musk want to get rid of it” “The Status of President Trump’s Pause of Foreign Aid and Implications for PEPFAR and other Global Health Programs” “The Case For Global Health Diplomacy” The Super Bowl and Legalized Sports Gambling “Super Bowl LIX: Betting By The Numbers” “Americans expected to bet $1.39B legally on Super Bowl 2025” “Record 68 million people plan on making Super Bowl bets” “Gambling problems are mushrooming. Panel says we need to act now.” COVID and Flu “The U.S. Is Having Its Mildest Covid Winter Yet” “Estimated Vaccine Effectiveness for Pediatric Patients With Severe Influenza, 2015-2020” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Lisa Rosenbaum, a cardiologist and the national correspondent for the New England Journal of Medicine, to discuss her writing illuminating critical topics in medicine. Harlan reports on the companies claiming to prevent illness through a non-invasive full-body scan; Howie explains the healthcare impact of the Trump administration’s freeze of federal aid.  Links: Body Scanning “Neko Health raises $260M to expand body scan service, fund R&D” Neko Health “Kim Kardashian Promotes $2,500 Body Scan—Here’s What To Know And Why Some Experts Warn Against It”“ “Daniel Ek’s body scanning startup hits £1.4 billion valuation with 100,000 people lining up to pay £299 for a health check” “The rise and fall of Theranos: A timeline” Lisa Rosenbaum Lisa Rosenbaum: “Gray Matters: Analysis and Ambiguity” Lisa Rosenbaum: Not Otherwise Specified podcast Lisa Rosenbaum: “Beyond Moral Injury—Can We Reclaim Agency, Belief, and Joy in Medicine?” Lisa Rosenbaum: “Being Well while Doing Well—Distinguishing Necessary from Unnecessary Discomfort in Training” “The Case Against the Trauma Plot” “The Rise of Therapy-Speak” Lisa Rosenbaum: “On Calling—From Privileged Professionals to Cogs of Capitalism?” “The Moral Crisis of America’s Doctors” The Ezra Klein Show: “Democrats are Losing the War for Attention. Badly.” IMDB: The Doctor The New Administration “Kennedy, Polarizing Pick for Health Secretary, Makes His Senate Debut” “WATCH: Sen. Elizabeth Warren questions RFK Jr. in confirmation hearing” “Trump aid freeze stirs chaos before it is blocked in court” “Trump administration rescinds order attempting to freeze federal aid spending” “Uncertainty Causes Chaos as Trump Threatens Funding Pause for Schools” “Read the Memo Pausing Federal Grants and Loans” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Susan Mayne, a Yale epidemiologist and the former director of the FDA’s Center for Food Safety and Applied Nutrition, to discuss what the agency can and can’t do to keep contaminants out of food and promote healthier eating habits. Harlan reports on the Trump administration’s cancellation of multiple scientific meetings; Howie explains the administration’s health-related executive orders.  Links: Changes at the NIH “Trump administration’s abrupt cancellation of scientific meetings prompts confusion, concern” “The Trump NIH Pick Who Wants to Take On ‘Cancel Culture’ Colleges” Food Safety and the FDA “Beyond Red Dye No. 3: Here’s what parents should know about food colorings” “FDA to Revoke Authorization for the Use of Red No. 3 in Food and Ingested Drugs” U.S. Government Accountability Office: Regulation of Cancer-Causing Food Additives—Time for a Change Nutrition Labeling and Education Act of 1990 FDA: Front-of-Package Nutrition Labeling “Court ruling curbs unfounded claims for memory supplement” FDA: Questions and Answers on Health Claims in Food Labeling FDA Budget Summary FDA: Closer to Zero: Reducing Childhood Exposure to Contaminants from Foods FDA: Food Safety Modernization Act (FSMA) Executive Orders “Breaking Down All of Trump’s Day 1 Presidential Actions” KFF Morning Briefing “Trump orders reflect his promises to roll back transgender protections and end DEI programs” “Trump wants to pull the US out of the World Health Organization again. Here’s what may happen next” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.