Health & Veritas

Sachin Jain, CEO of Scan Health Plan and advocate for patient-centered care, discusses the urgent need for managed care to prioritize patients over profit. He highlights the troubling state of the industry, marked by high deductibles and diminished trust in healthcare providers. The conversation also touches on the health impacts of wildfire smoke and a shift in obesity classification, advocating for broader health metrics. Jain emphasizes the importance of trust in healthcare, especially in combating vaccine hesitancy.

Howie and Harlan discuss health and healthcare headlines, including misaligned incentives keeping medicine from its mission, burdensome out-of-pockets costs, ultraprocessed foods, and serving the growing population of cancer survivors effectively. Links: Vivek Murthy’s parting letter to America “Surgeon General Urges Americans to 'Rethink How We're Living Our Lives' in Closing Letter to the Country (Exclusive)” Discontent with the Health System in the United States “View of U.S. Healthcare Quality Declines to 24-Year Low” “What We Know About the UnitedHealthcare C.E.O.’s Killing and the Suspect” “Killing of UnitedHealthcare CEO brings resentment of the health care system to the fore” “Out‐of‐Pocket Annual Health Expenditures and Financial Toxicity From Healthcare Costs in Patients With Heart Failure in the United States” Bird Flu “First Bird Flu Death in U.S. Reported in Louisiana” “First H5 Bird Flu Death Reported in United States” “H5N1 Bird Flu” “Eyeing Potential Bird Flu Outbreak, Biden Administration Ramps Up Preparedness” “What is the HMPV virus in China? The human metapneumovirus and its symptoms, explained.” “Respiratory Virus Activity Levels” Alcohol and Cancer “Alcohol and Cancer Risk” “The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis” “Alcohol Exposure and Disease Associations: A Mendelian Randomization and Meta-Analysis on Weekly Consumption and Problematic Drinking” “No level of alcohol consumption is safe for our health” Cancer Survivorship “Prevalence of cancer survivors in the United States” Cancer Survivorship: Cancer.Gov Ultra-Processed Foods “Trans fat” “Low-Grade Inflammation and Ultra-Processed Foods Consumption: A Review” “The Power RFK Jr. Would Have Over Food” Lawsuits: "Bad Behavior" on the Physician side “Sixteen Cardiology Practices to Pay a Total of $17.7M to Resolve False Claims Act Allegations Concerning Inflated Medicare Reimbursements” “CVS-owned insurer Aetna sues Radiology Partners alleging multiphase ‘fraud scheme’” Jimmy Carter  “Jimmy Carter, Peacemaking President Amid Crises, Is Dead at 100” 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 physician Dana Dunne, who leads a new coaching program designed to help medical students develop a lifelong orientation toward growth and building knowledge. Harlan reports on a new generation of AI that can diagnose patients more consistently than human doctors; Howie explains how the state of Connecticut wiped out medical debt for thousands of low-income residents.  Links: AI Diagnosis “Superhuman performance of a large language model on the reasoning tasks of a physician” “Reasoning Foundations of Medical Diagnosis: Symbolic logic, probability, and value theory aid our understanding of how physicians reason” (1959) Coaching Medical Students Yale School of Medicine: The Yale System Yale School of Medicine: Longitudinal Coaching Program “Developing Master Adaptive Learners: Implementation of a Coaching Program in Graduate Medical Education” “Risky Business: Psychological Safety and the Risks of Learning Medicine” Amy C. Edmondson: Psychological Safety Review: The Fearless Organization Medical Debt “Governor Lamont Announces Nearly 23,000 Connecticut Residents Will Have $30 Million in Medical Debt Erased Under First Round of State’s Newly Launched Partnership With Nonprofit” “CT cancels $30M in medical debt for thousands of residents” “Disparities in Medical Debt Among U.S. Adults with Serious Psychological Distress” “63% of workers unable to pay a $500 emergency expense, survey finds. How employers may help change that” White House Fact Sheet: Biden-⁠Harris Administration Announces New Actions to Reduce Medical Debt and Address Illegal Medical Debt Collection Practices Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Jaewon Ryu, CEO of Risant Health, a nonprofit company that brings together integrated health systems with the goal of spreading the adoption of value-based care. Harlan reports from the annual Cardiovascular Clinical Trialists Forum on progress toward faster and more effective clinical trials; Howie reflects on the murder of UnitedHealthcare CEO Brian Thompson.  Links: Clinical Trials “Artificial Intelligence in Cardiovascular Clinical Trials” Jaewon Ryu Wikipedia: Integrated Delivery System Geisinger: Fresh Food Farmacy “Geisinger opens a new $5.8 million senior-focused primary care center in Pottsville” “Kaiser Permanente Unit to Acquire North Carolina Hospital System” “Value-Based Care: What It Is, and Why It’s Needed” The Killing of Brian Thompson “What We Know About the UnitedHealthcare C.E.O.’s Killing and the Suspect” “A Very Un-American Response to the Murder of Brian Thompson” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Aaron Kesselheim, a physician, attorney, and public health expert, to discuss the shifting legal landscape for healthcare regulation and his experiences serving on an FDA advisory committee. Harlan reports on the growing evidence of widespread health impacts from microplastics; Howie provides an update on the bird flu outbreak.  Links: Microplastics “Landmark study links microplastics to serious health problems” “Microplastics: Are we facing a new health crisis—and what can be done about it?” “Microplastics are inside us all. What does that mean for our health?” “Microplastics are everywhere—we need to understand how they affect human health” “How do plastics, including microplastics and plastic-associated chemicals, affect human health?” “The potential of micro- and nanoplastics to exacerbate the health impacts and global burden of non-communicable diseases” Aaron Kesselheim PORTAL: Program on Regulations, Therapeutics, and Law “The End of Chevron Deference: What Does It Mean, and What Comes Next?” “Biden Administration Proposes Covering Obesity Drugs In Medicare And Medicaid” “Biden-Harris Administration Announces Medicare Advantage and Medicare Part D Prescription Drug Proposals that Aim to Improve Care and Access for Enrollees” “3 Experts Have Resigned From An FDA Committee Over Alzheimer's Drug Approval” X: Aaron Kesselheim’s resignation letter Congressional testimony of Aaron Kesselheim: “The Inflation Reduction Act of 2022: Reducing Excessive Spending and Supporting Patient Access to Brand-Name Drugs while Promoting Meaningful Innovation”  Congressional testimony of Aaron Kesselheim: “How the US Government Supports Meaningful Drug and Device Innovation: Funding Development of Transformative Therapies and Avoiding Excessive Prices for new Products with Limited Benefits” Aaron Kesselheim: “US public investment in development of mRNA covid-19 vaccines: retrospective cohort study” Harvard Online: Prescription Drug Regulation, Cost, and Access: Current Controversies in Context New York Times Weddings/Celebrations: Jennifer Cohn, Aaron Kesselheim Bird flu CDC: USDA Reported H5N1 Bird Flu Detections in US Backyard and Commercial Poultry CDC: H5 Bird Flu: Current Situation “Bird Flu, Explained” “California suspends distribution of Raw Farm raw milk products after bird flu detection” “Canadian probe into teen's critical H5N1 infection finds no clear source” USDA Economic Research Service: Farm Labor Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Vin Gupta, a physician, a medical analyst for NBC News, and the chief medical officer of Amazon Pharmacy. Harlan reports on the Biden administration’s proposal to cover obesity drugs with Medicare and Medicaid; Howie offers some reasons to be thankful.   Links: Coverage of Obesity Medication “White House Fact Sheet: Biden-⁠Harris Administration Takes Latest Step to Lower Prescription Drug Costs by Proposing Expanded Coverage of Anti-Obesity Medications for Americans with Medicare and Medicaid” “The (Minimum) Emergency Savings Needed in America’s 50 Largest Cities” “The implications of defining obesity as a disease: a report from the Association for the Study of Obesity 2021 annual conference” “Expanded Medicare Coverage of Antiobesity Drugs May Cost Billions Each Year” Harlan Krumholz: “Eligibility for Cardiovascular Risk Reduction Therapy in the United States Based on SELECT Trial Criteria: Insights From the National Health and Nutrition Examination Survey” Vin Gupta “Ozempic and Wegovy may help curb alcohol addiction, study suggests” “Amazon Launches $5-a-Month Prescription Drug Plan in Further Healthcare Push” “As Mail Order Pharmacies Continue to Climb in Customer Satisfaction, Chain Drug Stores Fall Behind, J.D. Power Finds” “The Powerful Companies Driving Local Drugstores Out of Business” “Amazon Purchase of One Medical Health Clinics Won’t Be Blocked by FTC” Anthropic: Meet Claude “A.I. Chatbots Defeated Doctors at Diagnosing Illness” Reasons to be Thankful “As Medicaid Unwinding Concludes in Most States, KFF Finds 25 Million Lost Medicaid Coverage but Enrollment is 10 Million Higher Than Pre-Pandemic Levels” “Egypt has been declared malaria-free by the World Health Organization” “FDA Approves First Gene Therapies to Treat Patients with Sickle Cell Disease” “Novel pulsed field ablation offers patients safer and faster atrial fibrillation ablation” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by investor and entrepreneur Halle Tecco to discuss her work connecting the worlds of technology and healthcare, and her latest venture, which allows women to freeze their eggs for future use for free if they donate half of them to a couple in need. Harlan checks in from the annual meeting of the American Heart Association; Howie discusses his concerns about Robert F. Kennedy Jr.’s appointment as secretary of health and human services. Links: American Heart Association Meeting “Tirzepatide Reduces LV Mass and Paracardiac Adipose Tissue in Obesity-Related Heart Failure”   “Intensive Lifestyle Intervention, Cardiac Biomarkers, and Cardiovascular Outcomes in Diabetes: LookAHEAD Cardiac Biomarker Ancillary Study” “Accelerometer-Measured Sedentary Behavior and Risk of Future Cardiovascular Disease” Halle Tecco  Halle Tecco: Blog Halle Tecco: Investing in Digital Health Startups Course “This power couple bought bitcoin in 2013, and just donated all their gains to a cancer hospital” Rock Health Natalist Cofertility RFK Jr. “What to know about RFK Jr.’s views on food, vaccines, abortion, and the FDA” “How a Kennedy built an anti-vaccine juggernaut amid COVID-19” “With Trump coming into power, the NIH is in the crosshairs” “RFK Jr.’s Inside Job” “How RFK Jr.’s MAHA movement could shake up public health” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Rahul Rajkumar, founder and CEO of Accompany Health, which provides a team of providers for patients who are on both Medicare and Medicaid. Harlan reflects on a visit to China and the healthcare ramifications of proposed legislation that would force U.S. biotech companies to cut ties with some Chinese partners. Howie provides an update on healthcare-related measures on state ballots in last week’s election.  Links: China and the Biosecure Act “Congress takes up a series of bills targeting China, from drones to drugs” “U.S. Drugmakers Are Breaking Up With Their Chinese Supply-Chain Partners” Accompany Health Accompany Health Medicare: Dual-Eligibles Centers for Medicare & Medicaid Services: Dual Eligible Special Needs Plans “Medicaid Enrollees by Enrollment Group” “Justice Department sues to block UnitedHealth Group’s $3.3 billion purchase of Amedisys” “10 Reasons Why Medicare Advantage Enrollment is Growing and Why It Matters” Healthcare on the Ballot “7 states vote to protect abortion rights, while efforts to expand access in Florida, Nebraska and South Dakota fail” “Marijuana and Drug Policy on the Ballot” “Massachusetts voters reject proposal to legalize certain psychedelic drugs” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss health and healthcare headlines, including generational shifts in doctors’ approach to work, a promising vaccine for norovirus, the latest on the bird flu outbreak, and the struggles of corporate-backed primary care companies.  Links: Norovirus CDC: Norovirus “Bivalent norovirus mRNA vaccine elicits cellular and humoral responses protecting human enteroids from GII.4 infection”  “Doctors trial world’s first mRNA vaccine against vomiting bug norovirus” “Who Didn’t Get a Second Shingrix Shot? Implications for Multidose COVID-19 Vaccines” Work-Life Balance “Young Doctors Want Work-Life Balance. Older Doctors Say That’s Not the Job.” “State of Women in Medicine: History, Challenges, and the Benefits of a Diverse Workforce” Bird Flu “CDC Confirms Human H5 Bird Flu Case in Missouri” STAT: H5N1 Bird Flu Primary Care Goes Corporate  “Why Large Corporations Are Entering Primary Care” “Cigna Turns $739 Million Profit Despite $1 Billion Loss On VillageMD” Prescription for the Future: The Twelve Transformational Practices of Highly Effective Medical Organizations E. coli “E. coli Outbreak Linked to Onions Served at McDonald’s” “How disease detectives’ quick work traced deadly E. coli outbreak to McDonald’s Quarter Pounders” CDC: Outbreaks of E. coli infections Elon Musk’s Grok AI Platform “Elon Musk wants you to submit medical data to his AI chatbot” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Stephen Knight, president and managing partner of the healthcare and technology venture capital firm F-Prime Capital, to discuss his varied career and the breakthroughs he has helped enable. Howie and Harlan discuss AI in medicine and what a second Trump administration could mean for healthcare.  Links: Respiratory Illnesses, AI, and the Physician Shortage CDC: Respiratory Illnesses Data Channel “Capabilities of Gemini Models in Medicine” “Yale New Haven Health partners with AI company on ambient listening tech” Stephen Knight F-Prime Capital Genentech F-Prime Capital: Stories and Ideas “How AIDS Activists Fought for Patients’ Rights” VC: An American History Bluebird Bio F-Prime Capital: Orchard Therapeutics Severe Combined Immunodeficiency “Pfizer to Acquire FoldRx Pharmaceuticals” Beam Therapeutics Trump and Healthcare Project 2025: Policy Agenda “Robert F. Kennedy Jr.’s ‘Make America Healthy Again’ Draws Wellness Influencers to MAGA” Video: Trump on Robert F. Kennedy Jr. Robert F. Kennedy Jr. on X Video: the Trump rally at Madison Square Garden Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.