Health & Veritas

Howie and Harlan discuss recent headlines, including the latest round of COVID and flu vaccines, a lousy report card for the U.S. healthcare system, and a rare case of swine flu. Plus: Howie investigates a mysteriously escalating pharmacy bill.  Links: COVID and Flu Vaccines CDC FluView: Weekly US Influenza Surveillance Report: Key Updates for Week 36, ending September 7, 2024 CDC: Staying Up to Date with COVID-19 Vaccines “Florida discourages use of mRNA Covid vaccines in older adults” “Florida’s New Covid Booster Guidance Is Straight-Up Misinformation” CDC: COVID Data Tracker A Failing Grade “Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System” CMS Health Equity Conference “What is Driving Widening Racial Disparities in Life Expectancy?” Swine Flu “Minnesota reports 2 H3N2v flu infections in fairgoers” Shohei Ohtani “Shohei Ohtani reaches 50-50 in spectacular style as Dodgers clinch postseason berth” “The Shohei Ohtani Goal Matrix” Baseball Almanac: A Definition of 50-50 Club Drug Prices Mayo Clinic: Flecainide “Column: Less choice, higher prices feared in CVS’ takeover of health insurer Aetna” “How to Save Money on Your Prescription Drugs” Brain Age “Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations” “Brain aging patterns in a large and diverse cohort of 49,482 individuals” “Associations between alcohol consumption and gray and white matter volumes in the UK Biobank” “Environmental Cardiology: Studying Mechanistic Links Between Pollution and Heart Disease” AirPods as Hearing Aids “FDA Authorizes First Over-the-Counter Hearing Aid Software” Oak Street Health Department of Justice: Oak Street Health Agrees to Pay $60M to Resolve Alleged False Claims Act Liability for Paying Kickbacks to Insurance Agents in Medicare Advantage Patient Recruitment Scheme “CVS Reaches $10.6 Billion Deal to Buy Clinic Owner Oak Street Health”  

Howie and Harlan are joined by Ania Jastreboff, a Yale endocrinologist and an expert on obesity medication, to talk about the remarkable range of diseases treated by drugs like Ozempic, Mounjaro, and Wegovy. Harlan discusses new Apple devices with the ability to detect sleep apnea and aid in hearing; Howie reports on outbreaks of polio in Pakistan, Afghanistan, and Gaza.  Links: Apple and Health “FDA clears Apple’s sleep apnea detection feature for use. Here’s how it works” FDA: “FDA Authorizes First Over-the-Counter Hearing Aid Software” “FDA approves some Apple AirPods to be used as hearing aids” National Council on Aging: Reasons for Low Hearing Loss Treatment Obesity Drugs “Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity” “An Obesity Drug Prevents Covid Deaths, Study Suggests” “Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes” “The New Anti-Obesity Drugs: What You Should Know” Video: Oprah Winfrey and Ania Jastreboff, “What Exactly Is Obesity? A Yale Doctor Explains” “Obesogenic environments and obesity: a comment on ‘Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England’” “Oprah Takes on Weight Stigma in the Ozempic Era” “Once-Weekly Semaglutide in Adults with Overweight or Obesity” Ania Jastreboff: “Tirzepatide Once Weekly for the Treatment of Obesity” Ania Jastreboff: “Triple-Hormone-Receptor Agonist Retatrutide for Obesity—A Phase 2 Trial” “Daily Oral GLP-1 Receptor Agonist Orforglipron for Adults with Obesity” “Obesity drug black market thrives online in S. Korea” “Novo Nordisk’s Wegovy Weight-Loss Drug Gets Approval in China” “A Popular Weight Loss Drug Is Getting a Price Cut” Polio Poliovirus outbreak in New York State, August 2022: qualitative assessment of immediate public health responses and priorities for improving vaccine coverage CDC: Vaccine-Derived Poliovirus WHO: “Humanitarian pauses vital for critical polio vaccination campaign in the Gaza Strip” Howard Forman Discusses Polio in Gaza on TikTok CDC: Progress Toward Poliomyelitis Eradication—Pakistan, January 2023–June 2024 “Afghanistan risks polio outbreak as Taliban restricts women from delivering vaccines” “Polio eradication: the CIA and their unintended victims” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Margaret McGovern, deputy dean for clinical affairs at the Yale School of Medicine, CEO of Yale Medicine, and chief physician executive of the Yale New Haven Health System. They discuss her path from the lab to healthcare leadership, and her efforts to better align Yale's medical school and its health system. Harlan reflects on the anniversary of the September 11 attacks; Howie provides an update on the bird flu outbreak.  Links: September 11 “60 Minutes remembers 9/11: The FDNY” Margaret McGovern “McGovern Welcomed as Yale Medicine CEO” “Margaret McGovern, MD, PhD, Appointed YSM Deputy Dean and CEO of Yale Medicine” “What is Translational Research?” “Three SBU Leaders Honored for Outstanding Service During Pandemic” “What Are Relative Value Units (RVUs)?” “You’re Invited: Alignment-Focused Town Halls” “Clinically Integrated Networks” “Elevating Patient Access and the Consumer Experience” Bird Flu “Current H5N1 Bird Flu Situation in Dairy Cows” “How CDC is monitoring influenza data among people to better understand the current avian influenza A (H5N1) situation” “5 burning questions about Missouri’s mysterious H5 bird flu case” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Lee Schwamm, associate dean for digital strategy and transformation for Yale School of Medicine and chief digital health officer for Yale New Haven Health System, to discuss how AI and other digital tools can be part of fixing a broken healthcare system. Harlan reports on lightly regulated compounding pharmacies producing anti-obesity drugs; Howie gives an update on efforts by the FDA and CDC to fight bird flu. Links: "2023 Paul Dudley White Award: Dr. Lee Schwamm" Yale School of Medicine | Lisa Leffert, MD Health & Veritas | Dr. Lisa Leffert: Leading in Anesthesiology Testimony Prepared by Dr. Lee Schwamm Submitted to the House Committee on Energy and Commerce Subcommittee on Heath "Ambient AI Is Here, And We Are Blissfully Unaware Of It" "Yale New Haven Health to provide AI-driven clinical documentation" "Abridge, Mayo Clinic, And Epic Collaborate To Develop An Integrated Artificial Intelligence Documentation Solution For Nurses" "Are You Sure Your Ozempic Is Real? Fakes Are on the Rise." "Bill on Drug Compounding Clears Congress a Year After a Meningitis Outbreak" CDC | H5 Bird Flu: Current Situation "Is Bird Flu Spreading Widely to Farm Workers? A Small Study Offers Some Reassurance" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Joshua Sharfstein, a longtime public health official in federal, state, and local government, to discuss the state of the opioid epidemic, lessons from the COVID-19 vaccine rollout, and our readiness for a bird flu outbreak. Harlan reports on the summer surge in COVID-19; Howie remembers his mentor Gail Wilensky, a health economist who directed Medicaid and Medicare programs and led many other organizations over a 50-year career.  Links: COVID-19 Update CDC: COVID Data Tracker CDC: COVID-19 Current Wastewater Viral Activity Levels Map “What to Know About COVID FLiRT Variants” Joshua Sharfstein Joshua Sharfstein: The Public Health Crisis Survival Guide: Leadership and Management in Trying Times Joshua Sharfstein: The Opioid Epidemic: What everyone needs to know” “How Can Over-the-Counter Naloxone Prevent Opioid Overdose Deaths?” CDC: H5 Bird Flu: Current Situation“Millions of US Children Experience Range of Long COVID Effects” Joshua Sharfstein: “The Role for Policy in AI-Assisted Medical Diagnosis”“External Validation of a Widely Implemented Proprietary Sepsis Prediction Model in Hospitalized Patients” “Epic’s overhaul of a flawed algorithm shows why AI oversight is a life-or-death issue” Podcast: “Baltimore cut infant mortality and helped moms thrive, too” Remembering Gail Wilensky “In Remembrance Of Gail Wilensky” “Gail Wilensky, Former CMS Administrator, Dies at 81” “In Memoriam: Gail Wilensky, Renowned Health Economist & NORC Trustee”Gail Wilensky: “The Health Care Quality Improvement Initiative” 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 Goodrich, chief medical officer for Humana and a former Medicare staffer, to discuss the improvements in care and outcomes that result when providers are paid for each patient, not each service. Harlan looks at the challenge of payment for AI-based diagnostic tools; Howie asks if free tuition at Johns Hopkins medical school will address the real problems in medical education.  Links: AI Diagnostic Tools “Tempus Receives U.S. FDA 510(k) Clearance for Tempus ECG-AF, an AI-based Algorithm that Identifies Patients at Increased Risk of AFib” “Ensight-Ai Awarded Fda's Breakthrough Device Designation For Their Ecgvision-Ttr© Technology For Early Detection Of Attr-Cardiomyopathy Image” The Cardiovascular Workforce Crisis: Navigating the Present, Planning for the Future “American Medical Association Grants PLA Code to Tempus Algorithmic Test, PurISTSM” Kate Goodrich Humana: Value Based Care Report Centers for Medicare & Medicaid Services: Value Based Care “Medicare Spending on Ozempic and Other GLP-1s Is Skyrocketing” Free Tuition at Johns Hopkins “Bloomberg gives $1 billion to Hopkins to make tuition free for most medical students” Johns Hopkins School Of Medicine: Tuition And Financial Aid “Free med school tuition won’t solve the shortage of primary care physicians” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Timothy Westmoreland to discuss his long career in health policy and law, and the far-reaching consequences of the Supreme Court decision overturning Chevron deference. Harlan looks at President Joe Biden's debate struggles; Howie reports on the many healthcare-related Supreme Court decisions.  Links: The Presidential Debate Harlan Krumholz: “Did Cold Medications Affect Biden's Debate Performance?” CNN Presidential Debate: President Joe Biden and former President Donald Trump Press Briefing by Press Secretary Karine Jean-Pierre, July 2, 2024 “Biden's Evolving Reasons for His Bad Debate: A Cold, Too Much Prep, Not Feeling Great and Jet Lag” Timothy Westmoreland Timothy Westmoreland: “Henry Waxman, the Unsung Hero in the Fight Against AIDS” “LGBTQ History Month: The early days of America's AIDS crisis” Cornell Law School Legal Information Institute: Chevron deference Ballotpedia: Skidmore deference “How the Chevron case has roiled U.S. healthcare agencies”  SCOTUSblog: Corner Post, Inc. v. Board of Governors of the Federal Reserve System “Supreme Court appears likely to allow abortion drug to remain available” The Supreme Court “Implications for Public Health Regulation if Chevron Deference Is Overturned” Supreme Court opinion: Murthy, Surgeon General, et al. v. Missouri et al SCOTUSblog: Food and Drug Administration v. Alliance for Hippocratic Medicine Cornell Law School Legal Information Institute: Moyle v. United States Supreme Court of the United States Health & Veritas Ep. 77: Megan Ranney: What’s Next for Public Health? Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan catch up on healthcare headlines, including the politics of treating gun violence as a public health crisis, the growing evidence for the dangers of artificial sweeteners, and the latest on the bird flu outbreak. Links: Aspen Ideas: Health 2024 Harlan Krumholz: “The Next Era of JACC” "First Issue of JACC Debuts Under Harlan M. Krumholz" "U.S. clinical trials begin for twice-yearly HIV prevention injection" UNAIDS: 2023 Fact Sheet Rush University System: Dr. Omar B. Lateef "Rush Signs on as First Partner for Local Laundry Service" “Health Equity as a System Strategy: The Rush University Medical Center Framework” "Surgeon General Declares Gun Violence a Public Health Crisis" Surgeon General’s Advisory on Firearm Violence "Surgeon General: Why I’m Calling for a Warning Label on Social Media Platforms" “Patient Navigation for Lung Cancer Screening at a Health Care for the Homeless Program A Randomized Clinical Trial” Vinay Prasad: “CT screening for lung cancer for homeless people: the new JAMA IM paper” Supreme Court: Murthy v. Missouri Opinion "US supreme court allows government to request removal of misinformation on social media" Harlan Krumholz: “Why One Cardiologist Has Drunk His Last Diet Soda" “Xylitol is prothrombotic and associated with cardiovascular risk” "Is Xylitol Dangerous?" CDC: A(H5N1) Bird Flu Response Update June 21, 2024 "Michigan stands out for its aggressive bird flu response. Will other states follow its lead?" "Finland to offer bird flu vaccinations to at-risk residents in a world first" 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 Suter, a rheumatologist and the senior director of the Quality Measurement Program at Yale’s Center for Outcomes Research & Evaluation. Harlan reflects on the meaning of Juneteenth and reports on a Yale-led report card on health equity; Howie comments on Surgeon General Vivek Murthy’s call for warning labels on social media.  Links: Juneteenth National Museum of African American History & Culture: Juneteenth Harlan Krumholz: “Excess Cardiovascular Mortality Among Black Americans 2000-2022: A JACC Report Card” “JACC Report Card Highlights Inequities in CV Care, Death Rates” Harlan Krumholz: “Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020” Lisa Suter Center for Outcomes Research and Evaluation National Institute of Arthritis and Musculoskeletal and Skin Disease: Arthritis Lisa Suter: “Medical Decision Making in Patients With Knee Pain, Meniscal Tear, and Osteoarthritis” Lisa Suter: “Projecting Lifetime Risk of Symptomatic Knee Osteoarthritis and Total Knee Replacement in Individuals Sustaining a Complete Anterior Cruciate Ligament Tear in Early Adulthood” “Voices of DEI: Lisa Suter, MD” Harlan Krumholz: “Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study” Harlan Krumholz: “Association of Racial and Socioeconomic Disparities With Outcomes Among Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, and Pneumonia An Analysis of Within- and Between-Hospital Variation” The Surgeon General on Social Media  “Surgeon General: Why I’m Calling for a Warning Label on Social Media Platforms” “Social Media and Youth Mental Health: The U.S Surgeon General’s Advisory” Kids Online Safety Act: Senator Richard Blumenthal Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Anna Reisman, a physician and writer who leads Yale’s Program for Humanities in Medicine. They discuss the gaps in care she encountered when her developmentally disabled sister was diagnosed with cancer, and her work reviewing the “dude wall” of portraits at Yale Medical School. Harlan asks what we’ve gained from a new definition of long COVID; Howie provides an update on the spread of the H5N1 bird flu.  Links: Defining Long COVID “Federal Government, Clinicians, Employers, and Others Should Adopt New Definition for Long COVID to Aid in Consistent Diagnosis, Documentation, and Treatment” National Academies: A Long COVID Definition WHO: Post COVID-19 condition (Long COVID) Anna Reisman U.S. News: Yale University department rankings Wikipedia: The Magic Mountain Anna Reisman: “A doctor’s life, chronicled” “Life on wheels” (Yale School of Medicine article on the documentary Rolling) Anna Reisman: “Standard of Care” “Academic Science Rethinks All-Too-White 'Dude Walls' Of Honor” Wikipedia: Stanhope Bayne-Jones “In Memoriam: Marjorie Rosenthal, MD '95, MPH 1967–2020” “Yale Internal Medicine Residency Writers’ Workshop celebrates 20th anniversary”. Bird Flu FDA: Updates on Highly Pathogenic Avian Influenza (HPAI) “CDC Reports A(H5N1) Ferret Study Results” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.