Podcasts about Health Affairs

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.On May 13, A Health Podyssey's Rob Lott chatted with Andrew Ryan of Brown University about his paper in the May 2025 edition of Health Affairs that explores how Rhode Island's affordability standards impacted hospital prices and insurance premiums. Order the May 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Jeff Byers welcomes Christina Farr, advisor, investor, editor-in-chief of Second Opinion Media, to the pod to discuss recent moves by Omada Health and Hinge Health to take the companies public, how the IPOs could impact the digital health market, and what gains her attention when companies make their investment pitches.Health Affairs released their first trend report, which is exclusive for Health Affairs Insiders. The first report focuses on AI in health care and you can get full access to this report by becoming an Insider. Insiders also will receive access to our June 17 event on risk adjustment trends.Related Links:Pre-order Christina Farr's upcoming book, The Storyteller's Advantage: How Powerful Narratives Make Businesses ThriveSign up for Second Opinion Media's newsletters

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Rob Lott interviews Thomas Buchmueller of the University of Michigan to discuss his recent paper that explores how during the Medicaid 'Unwinding' of 2023, the reduction in Medicaid-paid prescriptions was offset by increased commercial coverage.Order the May 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Jeff Byers welcomes Katie Keith of Georgetown Law back to the pod to discuss President Trump's potential changes to the rulemaking process, how that may impact rulemaking at HHS, and break down the house Republican budget reconciliation bill and the impacts it could have on Medicaid and more.Become an Insider today to get access to our May 29 event on the FDA under the second Trump Administration as well as our upcoming premiere trend report on AI in health care.Also, join us on May 27 for a free virtual event featuring a conversation between Clifford Ko and Katherine Ornstein on how the new Age-Friendly Hospital Measure aims to improve the quality and experience of inpatient care for older Americans.Related Articles:The House Republican Budget Reconciliation Legislation: Unpacking The Coverage Provisions (Health Affairs Forefront)New Trump Directive To Further Erode Notice And Comment Rulemaking (Health Affairs Forefront)Tracking The Trump Administration's Early Deregulation Agenda (Health Affairs Forefront)The House Republican Budget Reconciliation LegislationRFK Jr. kills policy on public comment for health regulations (Axios)

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Senior Deputy Editor Rob Lott interviews Caitlin Carroll of the University of Minnesota to discuss her recent paper that explores how rural hospital closures led to an increase in prices for nearby remaining hospitals.Order the May 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Jeff Byers welcomes Farzad Mostashari, founder & CEO of Aledade and the former National Coordinator for Health IT, to the pod to break down insights in the latest MedPAC report, quality measurement reform, and areas of opportunity for value-based care.Health Affairs is hosting an Insider exclusive event on May 29 focusing on the FDA's first 100 days under the second Trump administration featuring moderator Rachel Sachs alongside panelists Richard Hughes IV and Arti Rai.Related Links:Crossing the Chasm: How to Expand Adoption of Value-Based Care (The New England Journal of Medicine)2025 MedPAC Report

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Senior Deputy Editor Rob Lott interviews Eric Topol, Executive Vice President of Scripps Research, on his new book, Super Agers, which provides an evidence-based approach on extending healthy lifespans.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Jeff Byers welcomes Senior Editor Akilah Wish to the program to discuss the impacts of preserving the Behavioral Risk Factor Surveillance System, the effects of physical exercise on health, and how this type of data helps inform policy making.We are hosting another live podcast recording of A Health Podyssey featuring host Rob Lott and guest Andrew Ryan where they will discuss his paper in the May 2025 edition of Health Affairs and take questions from a live audience. Sign up today.Health Affairs is hosting an Insider exclusive event on May 29 focusing on the FDA's first 100 days under the second Trump administration featuring moderator Rachel Sachs alongside panelists Richard Hughes IV and Arti Rai.Related Links:CDC's Population Health Office Is Gone (MedPage Today)Adult Physical Inactivity Outside of Work (CDC)Adult Activity: An Overview (CDC)How Exercise Helps You Age Well (NCOA)Establishing The President's Make America Healthy Again Commission (The White House)

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.Health Affairs' Jeff Byers welcomes Senior Editor Akilah Wise to the program to discuss the impacts of preserving the Behavioral Risk Factor Surveillance System, the effects of physical exercise on health, and how this type of data helps inform policy making.We are hosting another live podcast recording of A Health Podyssey featuring host Rob Lott and guest Andrew Ryan where they will discuss his paper in the May 2025 edition of Health Affairs and take questions from a live audience. Sign up today. Health Affairs is hosting an Insider exclusive event on May 29 focusing on the FDA's first 100 days under the second Trump administration featuring moderator Rachel Sachs alongside panelists Richard Hughes IV and Arti Rai.Related Links:CDC's Population Health Office Is Gone (MedPage Today)Adult Physical Inactivity Outside of Work (CDC)Adult Activity: An Overview (CDC)How Exercise Helps You Age Well (NCOA)Establishing The President's Make America Healthy Again Commission (The White House)

In Episode 474 of 'Relentless Health Value', host Stacey Richter interviews Dr. Yashaswini Singh, an economist and assistant professor at Brown University, about the growing influence of private equity (PE) in healthcare.  The conversation delves into the corporate transformation of medicine, highlighting the potential misalignment between business interests and patient care. Dr. Singh discusses the diverse strategies PE firms use to drive profitability, such as increasing negotiated prices, consolidating market share, employing real estate leasebacks, and emphasizing performance metrics that may not align with patient benefits.  The episode also examines the significant impacts these strategies have on physicians, including increased turnover and changes in practice patterns, as well as the broader implications for patients and communities. Dr. Singh stresses the importance of informed leadership, education, policy enforcement, and transparency to ensure that private investments ultimately benefit healthcare systems without compromising patient care. === LINKS ===

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Mary Kathryn Poole of Harvard University to discuss her recent paper that breaks down and compares economic assistance models on food security and diet quality. Order the April 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Deputy Editor Jessica Bylander to the program to celebrate the 200th episode of Health Affairs This Week and take a look back at the health care world of 2020 and see what has changed in terms of COVID-19, vaccinations, telehealth, and more.  Health Affairs published an ahead-of-print article this week from Yashaswini Singh and coauthors exploring explore how the expansion of private equity-owned physician practices has led to a decrease in access for certain eye conditions such as retinal detachment.  Yasahswini Singh also appeared as a guest on a live episode of A Health Podyssey discussing private equity's effect on health care staff turnover. Health Affairs is hosting an Insider exclusive event on May 29 focusing on the FDA's first 100 days under the second Trump administration featuring moderator Rachel Sachs alongside panelists Richard Hughes IV and Arti Rai.Related Links:The Many Ways Kennedy Is Already Undermining Vaccines (The New York Times)Health secretary RFK Jr. endorses the MMR vaccine — stoking fury among his supporters (NPR)Measles tracker: Follow cases, outbreaks and vaccination rates across the U.S. (NBC News)Fact Sheet: Telehealth (American Hospital Association) Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Shuyue (Amy) Deng of Tufts University to discuss her recent paper that takes a closer look at the estimated impact of medically tailored meals on health care use and expenditures in the US.Order the April 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Bob Herman of STAT News to the program to discuss the state of deals in the health care space, how vertical integration and consolidation have played a role in mergers & acquisitions as it relates to hospitals, and what might fly under the radar from even the most savvy of health policy wonks.Health Affairs Insiders can join us April 23 for an exclusive virtual event exploring site-neutral payments with health economist and health services researcher Brady Post of Northeastern University and Health Affairs' Meg Winchester.Also, we are hosting another Insider exclusive event on May 29 focusing on the FDA's first 100 days under the second Trump administration featuring moderator Rachel Sachs alongside panelists Richard Hughes IV and Arti Rai. Related Links:Sign up for STAT+Sign up for STAT newsletters including Bob Herman's Health Care Inc. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Welcome to the final episode in a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health, which is currently available to read.In this episode, Health Affairs' Jessica Bylander and Ellen Bayer speak with Heather Thomas from the nonprofit A Place to Stand about her Narrative Matters essay from the issue, "A Different Type of Hunger." The essay explores Thomas' experience fighting to access and maintain food benefits in the US as a mother of six whose family is food insecure.Order the Food, Nutrition, and Health Issue. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Welcome to the final episode in a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health, which is currently available to read.In this episode, Health Affairs' Jessica Bylander and Ellen Bayer speak with Heather Thomas from the nonprofit A Place to Stand about her Narrative Matters essay from the issue, "A Different Type of Hunger."The essay explores Thomas' experience fighting to access and maintain food benefits in the US as a mother of six whose family is food insecure.Order the Food, Nutrition, and Health Issue. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Kurt Hager of the University of Massachusetts to discuss his recent paper that explores how Medicaid nutrition supports were associated with reductions in hospitalizations and emergency department visits in Massachusetts through 2020–23. Order the April 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes David Simon from The University of Connecticut to the program to discuss the recent news that the Trump administration implemented reciprocal tariffs on imported goods and what this could mean for the health care industry.Become an Insider today to never miss out on David Simon's exclusive newsletter, Economic Intersections.Insiders can join us April 23 for an exclusive virtual event exploring site-neutral payments with health economist and health services researcher Brady Post of Northeastern University and Health Affairs' Meg Winchester.Order the April 2025 theme issue of Health Affairs focusing on food, nutrition, and health.And, join Health Affairs April 29 for a free and open for all virtual event featuring a conversation between consumer advocate, nutritionist, and award-winning author Marion Nestle of New York University and Angela Odoms-Young of Cornell University. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Welcome to the third episode in a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health to be released this week.In this episode, Health Affairs' Jessica Bylander and Ellen Bayer discuss the content in the theme issue.Order the Food, Nutrition, and Health Issue. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Welcome to the third episode in a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health to be released this week.In this episode, Health Affairs' Jessica Bylander and Ellen Bayer discuss the content in the theme issue.Order the Food, Nutrition, and Health Issue. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Seth Berkowitz of the UNC School of Medicine to discuss his recent paper that explores a new approach to help guide research and policy at the intersection of income, food, nutrition, and health. Order the April 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Senior Editor Michael Gerber back to the program to discuss the recent announcement from the Trump administration to cancel certain alternative payment models, their previous impact on health spending, and the difficult task of measuring success over a long period of time and across different administrations.Order the April 2025 theme issue of Health Affairs focusing on food, nutrition, and health.Join us for our theme issue briefing on April 8 featuring panels on Food is Medicine, Government Programs & Policies, Community Voices, and more. Save the date.Also, join us April 23 for an exclusive Insider virtual event exploring site-neutral payments with health economist and health services researcher Brady Post of Northeastern University and Health Affairs' Meg Winchester.Related Articles:Kennedy to slash 10,000 jobs in major overhaul of US health agencies (Reuters)Internal fallout at HHS delays 10,000 firings (Politico)Maryland Hospital All-Payer Model: Can It Be Emulated? (Health Affairs Forefront)CMMI cancels 4 payment models early (Healthcare Dive)Statement on CMS Innovation Center Aligning Portfolio with Statutory Obligation (CMS) Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Welcome to the second episode in a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health to be released April 7, 2025.In this episode, Health Affairs' Jessica Bylander speaks with Diane Schanzenbach from Northwestern University on the topic of food support programs and their impacts on very young children.Pre-order the Food, Nutrition, and Health Issue.Related Links:Food Support Programs and Their Impacts On Very Young Children (Health Policy Brief)SNAP's Short- and Long-Term Benefits (Northwestern Institute for Policy Research)Long-Run Impacts of Childhood Access to the Safety Net (American Economic Association) Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Welcome to the second episode in a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health to be released April 7, 2025.In this episode, Health Affairs' Jessica Bylander speaks with Diane Schanzenbach from Northwestern University on the topic of food support programs and their impacts on very young children.Pre-order the Food, Nutrition, and Health Issue.Related Links:Food Support Programs and Their Impacts On Very Young Children (Health Policy Brief)SNAP's Short- and Long-Term Benefits (Northwestern Institute for Policy Research)Long-Run Impacts of Childhood Access to the Safety Net (American Economic Association) Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Dr. Meena Seshamani, the incoming Maryland Secretary of Health, to discuss her time as the director of Medicare at the Centers of Medicare & Medicaid Services and what the future holds in her new role. Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.

Health Affairs' Jeff Byers welcomes Seth Berkowitz of UNC School of Medicine back to the program to discuss nutrition in the US, the current state of SNAP benefits, and his upcoming paper to be featured in our April 2025 theme issue on food, nutrition, and health.Preorder the April 2024 theme issue of Health Affairs.Join us April 23 for an exclusive Insider virtual event exploring site-neutral payments with health economist and health services researcher Brady Post of Northeastern University and Health Affairs' Meg Winchester.Learn more about Seth's book, Equal Care: Health Equity, Social Democracy, and the Egalitarian State.Related Articles:Tennessee bill could ban candy and soda from SNAP benefits (WJHL)

Welcome to a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health to be released April 7, 2025.In the first episode, Health Affairs' Ellen Bayer speaks with Na'Taki Osborne Jelks from Spelman College on the topic of water insecurity.Pre-order the Food, Nutrition, and Health Issue.Related Links:Water Insecurity and Population Health: Implications for Health Equity and Policy (Health Affairs' Health Policy Brief)

Welcome to a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health to be released April 7, 2025.In the first episode, Health Affairs' Ellen Bayer speaks with Na'Taki Osborne Jelks from Spelman College on the topic of water insecurity.Pre-order the Food, Nutrition, and Health Issue.Related Links:Water Insecurity and Population Health: Implications for Health Equity and Policy (Health Affairs' Health Policy Brief)

On March 12th, A Health Podyssey's Rob Lott invited Yashaswini Singh of Brown University to the program for a virtual podcast taping to discuss her paper on the effect of private equity on physician turnover. The two discussed the paper and took questions from the audience in attendance.Order the March 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.

Health Affairs' Jeff Byers welcomes Deputy Editor Chris Fleming and Katie Keith of Georgetown Law to the program to discuss the 15th anniversary of the Affordable Care Act and the first 50 days of the new Trump administration.Katie Keith is a frequent contributor to the Health Affairs Forefront series Health Policy At A Crossroads. Catch up on what you may have missed.Health Affairs will be hosting a theme issue briefing on April 8 to celebrate the release of our April 2025 issue focusing on food, nutrition & health. RSVP for the event and preorder your copy of the new issue today!Also, join Health Affairs on April 23 for an exclusive Insider virtual event exploring site-neutral payments.  Make sure you sign up for all of our free newsletters to stay up to date on new events, podcasts, Forefront, and journal articles.Related Articles:HHS Proposes To Restrict Marketplace Eligibility, Enrollment, And Affordability In First Major Rule Under Trump Administration (Part 1) and (Part 2) (Health Affairs Forefront)What Lies Ahead For Medicaid In Budget Reconciliation? (Health Affairs Forefront)Health Affairs Forefront's Following The ACA seriesThe Affordable Care Act At Fifteen: Policy Surprises And Lessons (Health Affairs Forefront)

Health Affairs' Senior Deputy Editor Rob Lott interviews Erica Eliason of Rutgers University on her recent paper that explores how continuous eligibility policies and the Children's Health Insurance Program (CHIP) structure affected children's coverage loss during Medicaid unwinding. Order the March 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.

Health Affairs' Jeff Byers welcomes Brian Anderson, President & CEO of the Coalition for Health AI (CHAI), to the program to discuss the adoption of artificial intelligence technology in health care and the future application of these tools.Health Affairs is hosting an Insider-exclusive virtual event on March 19th examining the potential policy and administrative changes surrounding the Medicaid program and what they may mean in terms of coverage, operations, and financing. Sign up today.Related Links:Artificial Intelligence In Health And Health Care: Priorities For Action (Health Affairs)

Here's my new idea for an episode. Welcome to it. I want to talk about a major theme running through the last few episodes of Relentless Health Value. And this theme is, heads up, going to continue through a few upcoming shows as well. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. We have Matt McQuide coming up, talking about patient engagement, and Christine Hale, MD, MBA, talking about high-cost claimants. And we also have an encore coming up with Kenny Cole, MD, talking about a lot of things; but patient trust is one of them. But before I get to the main theme to ponder here, let me talk about what gets selected to talk about on Relentless Health Value. I will freely admit, how topics for shows get picked, it's not exactly a linear sort of affair. And furthermore, even if it were, I can't always get the stars to align to get a specific cluster of guests to all come on like one after the other. So, for sure, it might be less than obvious at times where my head is at—and sometimes, admittedly, I don't even know. This may sound incredibly scattershot (and it probably is), but in my defense, this whole healthcare thing, in case you didn't know, it's really complicated. Every time I get a chance to chat with an expert, I learn something new. I feel like it's almost impossible to sit in a vacuum and mastermind some kind of grand insight. Very, very fortunately, I don't need to sit in a cave and do all this heavy thinking all by myself. We got ourselves a tribe here of like-minded, really smart folks between the guests and you lot, all of you in the tribe of listeners who are here every week. Yeah, you rock! And I can always count on you to start teasing out the themes and the through lines and the really key actionable points. You email me. You write great posts and comments on LinkedIn and elsewhere. Even if I am a little bit behind the eight ball translating my instinct into an actual trend line, it doesn't slow this bus down. It's you who keeps it moving, which is why I can confidently say it's you all who are to blame for this new idea I came up with the other day after the podcast with Al Lewis (EP464) triggered so much amazing and really deep insight and dot connecting back and forth that hooked together the past six, I'm gonna say, or so shows. Let's just start at the beginning. Let's start with the topics that have been discussed in the past several episodes of the pod. Here I go. Emergency room visits are now costing about 6% of total plan sponsor spend on average. That was the holy crap moment from the episode with Al Lewis (EP464). Emergency room volume is up, and also prices are up. In that show with Al Lewis, I did quote John Lee, MD, who is an emergency room doctor, by the way. I quoted him because he told a story about a patient who came into the ER, winds up getting a big workup in his ER. Dr. Lee says he sees this situation a lot where the patient comes in, they've had something going on for a while, they've tried to make an appointment with their PCP or even urgent care, they could not get in. It's also really hard to coordinate and get all the blood work or the scans and have that all looked at that's needed for the workup to even happen. I've spoken with multiple ER doctors at this point, and they all say pretty much the same thing. They see the same scenario happen often enough, maybe even multiple times a day. Patient comes in with something that may or may not be emergent, and they are now in the ER because they've been worried about it for weeks or months. And the ER is like the only place where they can get to the bottom of what is going on with their body. And then the patient, you know, they spend the whole day in the ER getting what amounts to weeks' worth of outpatient workup accomplished and scans and imaging and labs. And there's no prior authing anything down. It's also incredibly expensive. Moving on from the Al Lewis show, earlier than that I had had on Rushika Fernandopulle, MD (EP460) and then also Scott Conard, MD (EP462). Both are PCPs, both talking about primary care and what makes good primary care and what makes bad primary care and how our current “healthcare marketplace,” as Dr. Conard puts it, incentivizes either no primary care and/or primary care where volume driven throughput is the name of the game—you know, like seeing 25 patients a day. These visits or episodes of care are often pretty transactional. If relationships are formed, it's because the doctor and/or the patient are rising above the system, not the other way around. And none of that is good for primary care doctors, nurses, or other clinicians. It's also not good for patients, and it's not good for plan sponsors or any of the ultimate purchasers here (taxpayers, patients themselves) because while all of this is going on, those patients getting no or not good primary care are somebody's next high-cost claimant. Okay, so those were the shows with Rushika Fernandopulle and Scott Conard. Then this past week was the show with Vivian Ho, PhD (EP466), who discusses the incentives that hospital leadership often has. And these incentives may actually sound great on paper, but IRL, they wind up actually jacking up prices and set up some weird incentives to increase the number of beds and the heads in them. There was also two shows, one of them with Betsy Seals (EP463) and then another one with Wendell Potter (EP384), about Medicare Advantage and what payers are up to. Alright, so let's dig in. What's the big theme? What's the big through line here? Let's take it from the top. Theme 1 is largely this (and Scott Conard actually said this flat out in his show): Primary care—good primary care, I mean—is an investment. Everything else is a cost. And those skyrocketing ER costs are pure evidence of this. Again, listen to that show with Al Lewis earlier (EP464) for a lot of details about this. But total plan costs … 6% are ER visits. Tim Denman from Premise Health wrote, “That is an insane number! Anything over 2% warrants concern.” But yeah, these days we have, on average across the country, 200 plan members out of 1000 every single year dipping into their local ER. That number, by the way, will rise and fall depending on the access and availability of primary care and/or good urgent cares. Here's from a Web site entitled ER Visit Statistics, Facts & Trends: “In the United States, emergency room visits often highlight gaps in healthcare accessibility. Many individuals turn to ERs for conditions that could have been managed through preventative or primary care. … This indicates that inadequate access to healthcare often leads to increased reliance on emergency departments. … “ED visits can entail significant costs, particularly when a considerable portion of these visits is classified as non-urgent. … [Non-urgent] visits—not requiring immediate medical intervention—often lead to unnecessary expenditures that could be better allocated in primary care settings.” And by the way, if you look at the total cost across the country of ER visits, it's billions and billions and billions of dollars. In 2017, ED visits (I don't have a stat right in front of me), but in 2017, ED visits were $76.3 billion in the United States. Alright, so, the Al Lewis show comes out, I see that, and then, like a bolt of lightning, François de Brantes, MBA, enters the chat. François de Brantes was on Relentless Health Value several years ago (EP220). I should have him come back on. But François de Brantes cemented with mortar the connectivity between runaway ER costs and the lack of primary care. He started out talking actually about a new study from the Milbank Memorial Fund. Only like 5% of our spend going to primary care is way lower than any other developed country in the world—all of whom, of course, have far higher life expectancies than us. So, yeah … they might be onto something. François de Brantes wrote (with some light editing), “Setting aside the impotence of policies, the real question we should ask ourselves is whether we're looking at the right numbers. The short answer is no, with all due respect to the researchers that crunched the numbers. That's probably because the lens they're using is incredibly narrow and misses everything else.” And he's talking now about, is that 5% primary care number actually accurate? François de Brantes continues, “Consider, for example, that in commercially insured plans, the total spend on … EDs is 6% or more.” And then he says, “Check out Stacey Richter's podcast on the subject, but 6% is essentially what researchers say is spent on, you know, ‘primary care.' Except … they don't count those costs, the ER costs. They don't count many other costs that are for primary care, meaning for the treatment of routine preventative and sick care, all the things that family practices used to manage but don't anymore. They don't count them because those services are rendered by clinicians other than those in primary care practice.” François concludes (and he wrote a great article) that if you add up all the dollars that are spent on things that amount to primary care but just didn't happen in a primary care office, it's conservatively around 17% of total dollars. So, yeah … it's not like anyone is saving money by not making sure that every plan member or patient across the country has a relationship with an actual primary care team—you know, a doctor or a nurse who they can get on the phone with who knows them. Listen to the show coming up with Matt McQuide. This theme will continue. But any plan not making sure that primary care happens in primary care offices is shelling out for the most expensive primary care money can buy, you know, because it's gonna happen either in the ER or elsewhere. Jeff Charles Goldsmith, PhD, put this really well. He wrote, “As others have said, [this surge in ER dollars is a] direct consequence of [a] worsening primary care shortage.” Then Dr. John Lee turned up. He, I had quoted on the Al Lewis show, but he wrote a great post on LinkedIn; and part of it was this: “Toward a systemic solution, [we gotta do some unsqueezing of the balloon]. Stacey and Al likened our system to a squeezed balloon, with pressure forcing patients into the [emergency room]. The true solution is to ‘unsqueeze' the system by improving access to care outside the [emergency room]. Addressing these upstream issues could prevent patients from ending up in the [emergency room]. … While the necessary changes are staring us in the face, unsqueezing the balloon is far more challenging than it sounds.” And speaking of ER docs weighing in, then we had Mick Connors, MD, who left a banger of a comment with a bunch of suggestions to untangle some of these challenges that are more challenging than they may sound at first glance that Dr. Lee mentions. And as I said, he's a 30-year pediatric emergency physician, so I'm inclined to take his suggestions seriously. You can find them on LinkedIn. But yeah, I can see why some communities are paying 40 bucks a month or something for patients without access to primary care to get it just like they pay fire departments or police departments. Here's a link to Primary Care for All Americans, who are trying to help local communities get their citizens primary care. And Dr. Conard talked about this a little bit in that episode (EP462). I can also see why plan sponsors have every incentive to change the incentives such that primary care teams can be all in on doing what they do. Dr. Fernandopulle (EP460) hits on this. This is truly vital, making sure that the incentives are right, because we can't forget, as Rob Andrews has said repeatedly, organizations do what you pay them to do. And unless a plan sponsor gets into the mix, it is super rare to encounter anybody paying anybody for amazing primary care in an actual primary care setting. At that point, Alex Sommers, MD, ABEM, DipABLM, arrived on the scene; and he wrote (again with light editing—sorry, I can't read), “This one is in my wheelhouse. There is a ton that could be done here. There just has to be strategy in any given market. It's a function of access, resources, and like-minded employers willing to invest in a direct relationship with providers. But not just any providers. Providers who are willing to solve a big X in this case. You certainly don't need a trauma team on standby to remove a splinter or take off a wart. A great advanced primary care relationship is one way, but another thing is just access to care off-hours with the resources to make a difference in a cost-plus model. You can't help everybody at once. But you can help a lot of people if there is a collaborative opportunity.” And then Dr. Alex Sommers continues. He says, “We already have EKG, most procedures and supplies, X-ray, ultrasounds, and MRI in our clinics. All that's missing is a CT scanner. It just takes a feasible critical mass to invest in a given geography for that type of alternative care model to alter the course here. Six percent of plan spend going to the ER. My goodness.” So, then we have Ann Lewandowski, who just gets to the heart of the matter and the rate critical for primary care to become the investment that it could be: trust. Ann Lewandowski says, “I 100% agree with all of this, basically. I think strong primary care that promotes trust before things get so bad people think they need to go to the emergency room is the way to go.” This whole human concept of trust is a gigantic requirement for clinical and probably financial success. We need primary care to be an investment, but for it to be an investment, there's got to be relationships and there has to be trust between patients and their care teams. Now, neither relationships nor trust are super measurable constructs, so it's really easy for some finance pro to do things in the name of efficiency or optimization that undermine the entire spirit of the endeavor without even realizing it. Then we have a lot of primary care that doesn't happen in primary care offices. It happens in care settings like the ER. So, let's tug this theme along to the shows that concern carriers, meaning the shows with Wendell Potter (EP384) on how shareholders influence carrier behavior and with Betsy Seals (EP463) on Medicare Advantage plans and what they're up to. Here's where the primary care/ER through line starts to connect to carriers. Here's a LinkedIn post by the indomitable Steve Schutzer, MD. Dr. Schutzer wrote about the Betsy Seals conversation, and he said, “Stacey, you made a comment during this fabulous episode with Betsy that I really believe should be amplified from North to South, coast to coast—something that unfortunately is not top of mind for many in this industry. And that was ‘focus on the value that accrues to the patient'—period, end of story. That is the north star of the [value-based care] movement, lest we forget. Financial outcome measures are important in the value equation, but the numerator must be about the patient. As always, grateful for your insights and ongoing leadership.” Oh, thank you so much. And same to you. Grateful for yours. Betsy Seals in that podcast, though, she reminded carrier listeners about this “think about the value accruing to the patient” in that episode. And in the Wendell Potter encore that came out right before the show with Betsy, yeah, what Wendell said kind of made me realize why Betsy felt it important to remind carriers to think about the value accruing to patients. Wall Street rewards profit maximization in the short term. It does not reward value accruing to the patient. However—and here's me agreeing with Dr. Steve Schutzer, because I think this is what underlies his comment—if what we're doing gets so far removed from what is of value to the patient, then yeah, we're getting so removed from the human beings we're allegedly serving, that smart people can make smart decisions in theoretical model world. But what's being done lacks a fundamental grounding in actual reality. And that's dangerous for plan members, but it's also pretty treacherous from a business and legal perspective, as I think we're seeing here. Okay, so back to our theme of broken primary care and accelerating ER costs. Are carriers getting in there and putting a stop to it? I mean, as aforementioned about 8 to 10 times, if you have a broken primary care system, you're gonna pay for primary care, alright. It's just gonna be in really expensive care settings. You gotta figure carriers are wise to this and they're the ones that are supposed to be keeping healthcare costs under control for all America. Well, relative to keeping ER costs under control, here's a link to a study Vivian Ho, PhD, sent from Health Affairs showing how much ER prices have gone up. ER prices are way higher than they used to be. So, you'd think that carriers would have a huge incentive to get members primary care and do lots and lots of things to ensure that not only would members have access to primary care, but it'd be amazing primary care with doctors and nurses that were trusted and relationships that would be built. It'd be salad days for value. Except … they're not doing a whole lot at any scale that I could find. We have Iora and ChenMed and a few others aside. These are advanced primary care groups that are deployed by carriers, and these organizations can do great things. But I also think they serve—and this came up in the Dr. Fernandopulle show (EP460)—they serve like 1% of overall patient populations. Dr. Fernandopulle talked about this in the context of why these advanced primary care disruptors may have great impact on individual patients but they have very little overall impact at a national scale. They're just not scaled, and they're not nationwide. But why not? I mean, why aren't carriers all over this stuff? Well, first of all—and again, kind of like back to the Wendell show (EP384) now—if we're thinking short term, as a carrier, like Wall Street encourages, you know, quarter by quarter, and if only the outlier, mission-driven folks (the knights) in any given carrier organization are checking what's going on actually with plans, members, and patients like Betsy advised, keep in mind it's a whole lot cheaper and it's easier to just deny care. And you can do that at scale if you get yourself an AI engine and press Go. Or you can come up with, I don't know, exciting new ways to maximize your risk adjustment and upcoding. There's an article that was written by Sergei Polevikov, ABD, MBA, MS, MA

Health Affairs' Senior Deputy Editor Rob Lott interviews Richard Leuchter from the University of California Los Angeles on his recent paper that explores how socioeconomically disadvantaged groups may have underused emergency departments for non-avoidable visits.Order the March 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.

Health Affairs' Jeff Byers welcomes Rebecca Pifer of Healthcare Dive back to the program to discuss the 2025 budget resolution that passed the House on its way to the Senate, the current administration's health care agenda, and what ripple effects the current actions of DOGE are having on the health care workforce. Health Affairs just released their March 2025 issue focusing on pharmaceuticals, private equity, child health, & more. Order your copy today. Join a live recording of A Health Podyssey on March 12 featuring Rob Lott and Yashaswini Singh discussing her recent paper on the effect of private equity on physician turnover.  Register for the live taping here.Also, Health Affairs is hosting an Insider-exclusive virtual event on March 19th examining the potential policy and administrative changes surrounding the Medicaid program and what they may mean in terms of coverage, operations, and financing. Sign up today.Related Links:White House orders agencies to prepare for large-scale firings (Axios)Trump revisits health price transparency in new exec order (Axios)Prescription Drug Policy, 2024 And 2025: The Year In Review And The Year Ahead (Health Affairs Forefront)

Dr. Gary Null provides a commentary on "Universal  Healthcare"       Universal Healthcare is the Solution to a Broken Medical System Gary Null, PhD Progressive Radio Network, March 3, 2025 For over 50 years, there has been no concerted or successful effort to bring down medical costs in the American healthcare system. Nor are the federal health agencies making disease prevention a priority. Regardless whether the political left or right sponsors proposals for reform, such measures are repeatedly defeated by both parties in Congress. As a result, the nation's healthcare system remains one of the most expensive and least efficient in the developed world. For the past 30 years, medical bills contributing to personal debt regularly rank among the top three causes of personal bankruptcy. This is a reality that reflects not only the financial strain on ordinary Americans but the systemic failure of the healthcare system itself. The urgent question is: If President Trump and his administration are truly seeking to reduce the nation's $36 trillion deficit, why is there no serious effort to reform the most bloated and corrupt sector of the economy? A key obstacle is the widespread misinformation campaign that falsely claims universal health care would cost an additional $2 trillion annually and further balloon the national debt. However, a more honest assessment reveals the opposite. If the US adopted a universal single-payer system, the nation could actually save up to $20 trillion over the next 10 years rather than add to the deficit. Even with the most ambitious efforts by people like Elon Musk to rein in federal spending or optimize government efficiency, the estimated savings would only amount to $500 billion. This is only a fraction of what could be achieved through comprehensive healthcare reform alone. Healthcare is the largest single expenditure of the federal budget. A careful examination of where the $5 trillion spent annually on healthcare actually goes reveals massive systemic fraud and inefficiency. Aside from emergency medicine, which accounts for only 10-12 percent of total healthcare expenditures, the bulk of this spending does not deliver better health outcomes nor reduce trends in physical and mental illness. Applying Ockham's Razor, the principle that the simplest solution is often the best, the obvious conclusion is that America's astronomical healthcare costs are the direct result of price gouging on an unimaginable scale. For example, in most small businesses, profit margins range between 1.6 and 2.5 percent, such as in grocery retail. Yet the pharmaceutical industrial complex routinely operates on markup rates as high as 150,000 percent for many prescription drugs. The chart below highlights the astronomical gap between the retail price of some top-selling patented pharmaceutical medications and their generic equivalents. Drug Condition Patent Price (per unit) Generic Price Estimated Manufacture Cost Markup Source Insulin (Humalog) Diabetes $300 $30 $3 10,000% Rand (2021) EpiPen Allergic reactions $600 $30 $10 6,000% BMJ (2022) Daraprim Toxoplasmosis $750/pill $2 $0.50 150,000% JAMA (2019) Harvoni Hepatitis C $94,500 (12 weeks) $30,000 $200 47,000% WHO Report (2018) Lipitor Cholesterol $150 $10 $0.50 29,900% Health Affairs (2020) Xarelto Blood Thinner $450 $25 $1.50 30,000% NEJM (2020) Abilify Schizophrenia $800 (30 tablets) $15 $2 39,900% AJMC (2019) Revlimid Cancer $16,000/mo $450 $150 10,500% Kaiser Health News (2021) Humira Arthritis $2,984/dose $400 $50 5,868% Rand (2021) Sovaldi Hepatitis C $1,000/pill $10 $2 49,900% JAMA (2021) Xolair Asthma $2,400/dose $300 $50 4,800% NEJM (2020) Gleevec Leukemia $10,000/mo $350 $200 4,900% Harvard Public Health Review (2020) OxyContin Pain Relief $600 (30 tablets) $15 $0.50 119,900% BMJ (2022) Remdesivir Covid-19 $3,120 (5 doses) N/A $10 31,100% The Lancet (2020) The corruption extends far beyond price gouging. Many pharmaceutical companies convince federal health agencies to fund their basic research and drug development with taxpayer dollars. Yet when these companies bring successful products to market, the profits are kept entirely by the corporations or shared with the agencies or groups of government scientists. On the other hand, the public, who funded the research, receives no financial return. This amounts to a systemic betrayal of the public trust on a scale of hundreds of billions of dollars annually. Another significant contributor to rising healthcare costs is the widespread practice of defensive medicine that is driven by the constant threat of litigation. Over the past 40 years, defensive medicine has become a cottage industry. Physicians order excessive diagnostic tests and unnecessary treatments simply to protect themselves from lawsuits. Study after study has shown that these over-performed procedures not only inflate costs but lead to iatrogenesis or medical injury and death caused by the medical  system and practices itself. The solution is simple: adopting no-fault healthcare coverage for everyone where patients receive care without needing to sue and thereby freeing doctors from the burden of excessive malpractice insurance. A single-payer universal healthcare system could fundamentally transform the entire industry by capping profits at every level — from drug manufacturers to hospitals to medical equipment suppliers. The Department of Health and Human Services would have the authority to set profit margins for medical procedures. This would ensure that healthcare is determined by outcomes, not profits. Additionally, the growing influence of private equity firms and vulture capitalists buying up hospitals and medical clinics across America must be reined in. These equity firms prioritize profit extraction over improving the quality of care. They often slash staff, raise prices, and dictate medical procedures based on what will yield the highest returns. Another vital reform would be to provide free medical education for doctors and nurses in exchange for five years of service under the universal system. Medical professionals would earn a realistic salary cap to prevent them from being lured into equity partnerships or charging exorbitant rates. The biggest single expense in the current system, however, is the private health insurance industry, which consumes 33 percent of the $5 trillion healthcare budget. Health insurance CEOs consistently rank among the highest-paid executives in the country. Their companies, who are nothing more than bean counters, decide what procedures and drugs will be covered, partially covered, or denied altogether. This entire industry is designed to place profits above patients' lives. If the US dismantled its existing insurance-based system and replaced it with a fully reformed national healthcare model, the country could save $2.7 trillion annually while simultaneously improving health outcomes. Over the course of 10 years, those savings would amount to $27 trillion. This could wipe out nearly the entire national debt in a short time. This solution has been available for decades but has been systematically blocked by corporate lobbying and bipartisan corruption in Washington. The path forward is clear but only if American citizens demand a system where healthcare is valued as a public service and not a commodity. The national healthcare crisis is not just a fiscal issue. It is a crucial moral failure of the highest order. With the right reforms, the nation could simultaneously restore its financial health and deliver the kind of healthcare system its citizens have long deserved. American Healthcare: Corrupt, Broken and Lethal Richard Gale and Gary Null Progressive Radio Network, March 3, 2025 For a nation that prides itself on being the world's wealthiest, most innovative and technologically advanced, the US' healthcare system is nothing less than a disaster and disgrace. Not only are Americans the least healthy among the most developed nations, but the US' health system ranks dead last among high-income countries. Despite rising costs and our unshakeable faith in American medical exceptionalism, average life expectancy in the US has remained lower than other OECD nations for many years and continues to decline. The United Nations recognizes healthcare as a human right. In 2018, former UN Secretary General Ban Ki-moon denounced the American healthcare system as "politically and morally wrong." During the pandemic it is estimated that two to three years was lost on average life expectancy. On the other hand, before the Covid-19 pandemic, countries with universal healthcare coverage found their average life expectancy stable or slowly increasing. The fundamental problem in the U.S. is that politics have been far too beholden to the pharmaceutical, HMO and private insurance industries. Neither party has made any concerted effort to reign in the corruption of corporate campaign funding and do what is sensible, financially feasible and morally correct to improve Americans' quality of health and well-being.   The fact that our healthcare system is horribly broken is proof that moneyed interests have become so powerful to keep single-payer debate out of the media spotlight and censored. Poll after poll shows that the American public favors the expansion of public health coverage. Other incremental proposals, including Medicare and Medicaid buy-in plans, are also widely preferred to the Affordable Care Act or Obamacare mess we are currently stuck with.   It is not difficult to understand how the dismal state of American medicine is the result of a system that has been sold out to the free-market and the bottom line interests of drug makers and an inflated private insurance industry. How advanced and ethically sound can a healthcare system be if tens of millions of people have no access to medical care because it is financially out of their reach?  The figures speak for themselves. The U.S. is burdened with a $41 trillion Medicare liability. The number of uninsured has declined during the past several years but still lingers around 25 million. An additional 30-35 million are underinsured. There are currently 65 million Medicare enrollees and 89 million Medicaid recipients. This is an extremely unhealthy snapshot of the country's ability to provide affordable healthcare and it is certainly unsustainable. The system is a public economic failure, benefiting no one except the large and increasingly consolidated insurance and pharmaceutical firms at the top that supervise the racket.   Our political parties have wrestled with single-payer or universal healthcare for decades. Obama ran his first 2008 presidential campaign on a single-payer platform. Since 1985, his campaign health adviser, the late Dr. Quentin Young from the University of Illinois Medical School, was one of the nation's leading voices calling for universal health coverage.  During a private conversation with Dr. Young shortly before his passing in 2016, he conveyed his sense of betrayal at the hands of the Obama administration. Dr. Young was in his 80s when he joined the Obama campaign team to help lead the young Senator to victory on a promise that America would finally catch up with other nations. The doctor sounded defeated. He shared how he was manipulated, and that Obama held no sincere intention to make universal healthcare a part of his administration's agenda. During the closed-door negotiations, which spawned the weak and compromised Affordable Care Act, Dr. Young was neither consulted nor invited to participate. In fact, he told us that he never heard from Obama again after his White House victory.   Past efforts to even raise the issue have been viciously attacked. A huge army of private interests is determined to keep the public enslaved to private insurers and high medical costs. The failure of our healthcare is in no small measure due to it being a fully for-profit operation. Last year, private health insurance accounted for 65 percent of coverage. Consider that there are over 900 private insurance companies in the US. National Health Expenditures (NHE) grew to $4.5 trillion in 2022, which was 17.3 percent of GDP. Older corporate rank-and-file Democrats and Republicans argue that a single-payer or socialized medical program is unaffordable. However, not only is single-payer affordable, it will end bankruptcies due to unpayable medical debt. In addition, universal healthcare, structured on a preventative model, will reduce disease rates at the outset.    Corporate Democrats argue that Obama's Affordable Care Act (ACA) was a positive step inching the country towards complete public coverage. However, aside from providing coverage to the poorest of Americans, Obamacare turned into another financial anchor around the necks of millions more. According to the health policy research group KFF, the average annual health insurance premium for single coverage is $8,400 and almost $24,000 for a family. In addition, patient out-of-pocket costs continue to increase, a 6.6% increase to $471 billion in 2022. Rather than healthcare spending falling, it has exploded, and the Trump and Biden administrations made matters worse.    Clearly, a universal healthcare program will require flipping the script on the entire private insurance industry, which employed over half a million people last year.  Obviously, the most volatile debate concerning a national universal healthcare system concerns cost. Although there is already a socialized healthcare system in place -- every federal legislator, bureaucrat, government employee and veteran benefits from it -- fiscal Republican conservatives and groups such as the Koch Brothers network are single-mindedly dedicated to preventing the expansion of Medicare and Medicaid. A Koch-funded Mercatus analysis made the outrageous claim that a single-payer system would increase federal health spending by $32 trillion in ten years. However, analyses and reviews by the Congressional Budget Office in the early 1990s concluded that such a system would only increase spending at the start; enormous savings would quickly offset it as the years pass. In one analysis, "the savings in administrative costs [10 percent of health spending] would be more than enough to offset the expense of universal coverage."    Defenders of those advocating for funding a National Health Program argue this can primarily be accomplished by raising taxes to levels comparable to other developed nations. This was a platform Senator Bernie Sanders and some of the younger progressive Democrats in the House campaigned on. The strategy was to tax the highest multimillion-dollar earners 60-70 percent. Despite the outrage of its critics, including old rank-and-file multi-millionaire Democrats like Nancy Pelosi and Chuck Schumer, this is still far less than in the past. During the Korean War, the top tax rate was 91 percent; it declined to 70 percent in the late 1960s. Throughout most of the 1970s, those in the lowest income bracket were taxed at 14 percent. We are not advocating for this strategy because it ignores where the funding is going, and the corruption in the system that is contributing to exorbitant waste.    But Democratic supporters of the ACA who oppose a universal healthcare plan ignore the additional taxes Obama levied to pay for the program. These included surtaxes on investment income, Medicare taxes from those earning over $200,000, taxes on tanning services, an excise tax on medical equipment, and a 40 percent tax on health coverage for costs over the designated cap that applied to flexible savings and health savings accounts. The entire ACA was reckless, sloppy and unnecessarily complicated from the start.    The fact that Obamacare further strengthened the distinctions between two parallel systems -- federal and private -- with entirely different economic structures created a labyrinth of red tape, rules, and wasteful bureaucracy. Since the ACA went into effect, over 150 new boards, agencies and programs have had to be established to monitor its 2,700 pages of gibberish. A federal single-payer system would easily eliminate this bureaucracy and waste.    A medical New Deal to establish universal healthcare coverage is a decisive step in the correct direction. But we must look at the crisis holistically and in a systematic way. Simply shuffling private insurance into a federal Medicare-for-all or buy-in program, funded by taxing the wealthiest of citizens, would only temporarily reduce costs. It will neither curtail nor slash escalating disease rates e. Any effective healthcare reform must also tackle the underlying reasons for Americans' poor state of health. We cannot shy away from examining the social illnesses infecting our entire free-market capitalist culture and its addiction to deregulation. A viable healthcare model would have to structurally transform how the medical economy operates. Finally, a successful medical New Deal must honestly evaluate the best and most reliable scientific evidence in order to effectively redirect public health spending.    For example, Dr. Ezekiel Emanuel, a former Obama healthcare adviser, observed that AIDS-HIV measures consume the most public health spending, even though the disease "ranked 75th on the list of diseases by personal health expenditures." On the other hand, according to the American Medical Association, a large percentage of the nation's $3.4 trillion healthcare spending goes towards treating preventable diseases, notably diabetes, common forms of heart disease, and back and neck pain conditions. In 2016, these three conditions were the most costly and accounted for approximately $277 billion in spending. Last year, the CDC announced the autism rate is now 1 in 36 children compared to 1 in 44 two years ago. A retracted study by Mark Blaxill, an autism activist at the Holland Center and a friend of the authors, estimates that ASD costs will reach $589 billion annually by 2030. There are no signs that this alarming trend will reverse and decline; and yet, our entire federal health system has failed to conscientiously investigate the underlying causes of this epidemic. All explanations that might interfere with the pharmaceutical industry's unchecked growth, such as over-vaccination, are ignored and viciously discredited without any sound scientific evidence. Therefore, a proper medical New Deal will require a systemic overhaul and reform of our federal health agencies, especially the HHS, CDC and FDA. Only the Robert Kennedy Jr presidential campaign is even addressing the crisis and has an inexpensive and comprehensive plan to deal with it. For any medical revolution to succeed in advancing universal healthcare, the plan must prioritize spending in a manner that serves public health and not private interests. It will also require reshuffling private corporate interests and their lobbyists to the sidelines, away from any strategic planning, in order to break up the private interests' control over federal agencies and its revolving door policies. Aside from those who benefit from this medical corruption, the overwhelming majority of Americans would agree with this criticism. However, there is a complete lack of national trust that our legislators, including the so-called progressives, would be willing to undertake such actions.    In addition, America's healthcare system ignores the single most critical initiative to reduce costs - that is, preventative efforts and programs instead of deregulation and closing loopholes designed to protect the drug and insurance industries' bottom line. Prevention can begin with banning toxic chemicals that are proven health hazards associated with current disease epidemics, and it can begin by removing a 1,000-plus toxins already banned in Europe. This should be a no-brainer for any legislator who cares for public health. For example, Stacy Malkan, co-founder of the Campaign for Safe Cosmetics, notes that "the policy approach in the US and Europe is dramatically different" when it comes to chemical allowances in cosmetic products. Whereas the EU has banned 1,328 toxic substances from the cosmetic industry alone, the US has banned only 11. The US continues to allow carcinogenic formaldehyde, petroleum, forever chemicals, many parabens (an estrogen mimicker and endocrine hormone destroyer), the highly allergenic p-phenylenediamine or PBD, triclosan, which has been associated with the rise in antibiotic resistant bacteria, avobenzone, and many others to be used in cosmetics, sunscreens, shampoo and hair dyes.   Next, the food Americans consume can be reevaluated for its health benefits. There should be no hesitation to tax the unhealthiest foods, such as commercial junk food, sodas and candy relying on high fructose corn syrup, products that contain ingredients proven to be toxic, and meat products laden with dangerous chemicals including growth hormones and antibiotics. The scientific evidence that the average American diet is contributing to rising disease trends is indisputable. We could also implement additional taxes on the public advertising of these demonstrably unhealthy products. All such tax revenue would accrue to a national universal health program to offset medical expenditures associated with the very illnesses linked to these products. Although such tax measures would help pay for a new medical New Deal, it may be combined with programs to educate the public about healthy nutrition if it is to produce a reduction in the most common preventable diseases. In fact, comprehensive nutrition courses in medical schools should be mandatory because the average physician receives no education in this crucial subject.  In addition, preventative health education should be mandatory throughout public school systems.   Private insurers force hospitals, clinics and private physicians into financial corners, and this is contributing to prodigious waste in money and resources. Annually, healthcare spending towards medical liability insurance costs tens of billions of dollars. In particular, this economic burden has taxed small clinics and physicians. It is well past the time that physician liability insurance is replaced with no-fault options. Today's doctors are spending an inordinate amount of money to protect themselves. Legions of liability and trial lawyers seek big paydays for themselves stemming from physician error. This has created a culture of fear among doctors and hospitals, resulting in the overly cautious practice of defensive medicine, driving up costs and insurance premiums just to avoid lawsuits. Doctors are forced to order unnecessary tests and prescribe more medications and medical procedures just to cover their backsides. No-fault insurance is a common-sense plan that enables physicians to pursue their profession in a manner that will reduce iatrogenic injuries and costs. Individual cases requiring additional medical intervention and loss of income would still be compensated. This would generate huge savings.    No other nation suffers from the scourge of excessive drug price gouging like the US. After many years of haggling to lower prices and increase access to generic drugs, only a minute amount of progress has been made in recent years. A 60 Minutes feature about the Affordable Care Act reported an "orgy of lobbying and backroom deals in which just about everyone with a stake in the $3-trillion-a-year health industry came out ahead—except the taxpayers.” For example, Life Extension magazine reported that an antiviral cream (acyclovir), which had lost its patent protection, "was being sold to pharmacies for 7,500% over the active ingredient cost. The active ingredient (acyclovir) costs only 8 pennies, yet pharmacies are paying a generic maker $600 for this drug and selling it to consumers for around $700." Other examples include the antibiotic Doxycycline. The price per pill averages 7 cents to $3.36 but has a 5,300 percent markup when it reaches the consumer. The antidepressant Clomipramine is marked up 3,780 percent, and the anti-hypertensive drug Captopril's mark-up is 2,850 percent. And these are generic drugs!    Medication costs need to be dramatically cut to allow drug manufacturers a reasonable but not obscene profit margin. By capping profits approximately 100 percent above all costs, we would save our system hundreds of billions of dollars. Such a measure would also extirpate the growing corporate misdemeanors of pricing fraud, which forces patients to pay out-of-pocket in order to make up for the costs insurers are unwilling to pay.    Finally, we can acknowledge that our healthcare is fundamentally a despotic rationing system based upon high insurance costs vis-a-vis a toss of the dice to determine where a person sits on the economic ladder. For the past three decades it has contributed to inequality. The present insurance-based economic metrics cast millions of Americans out of coverage because private insurance costs are beyond their means. Uwe Reinhardt, a Princeton University political economist, has called our system "brutal" because it "rations [people] out of the system." He defined rationing as "withholding something from someone that is beneficial." Discriminatory healthcare rationing now affects upwards to 60 million people who have been either priced out of the system or under insured. They make too much to qualify for Medicare under Obamacare, yet earn far too little to afford private insurance costs and premiums. In the final analysis, the entire system is discriminatory and predatory.    However, we must be realistic. Almost every member of Congress has benefited from Big Pharma and private insurance lobbyists. The only way to begin to bring our healthcare program up to the level of a truly developed nation is to remove the drug industry's rampant and unnecessary profiteering from the equation.     How did Fauci memory-hole a cure for AIDS and get away with it?   By Helen Buyniski   Over 700,000 Americans have died of AIDS since 1981, with the disease claiming some 42.3 million victims worldwide. While an HIV diagnosis is no longer considered a certain death sentence, the disease looms large in the public imagination and in public health funding, with contemporary treatments running into thousands of dollars per patient annually.   But was there a cure for AIDS all this time - an affordable and safe treatment that was ruthlessly suppressed and attacked by the US public health bureaucracy and its agents? Could this have saved millions of lives and billions of dollars spent on AZT, ddI and failed HIV vaccine trials? What could possibly justify the decision to disappear a safe and effective approach down the memory hole?   The inventor of the cure, Gary Null, already had several decades of experience creating healing protocols for physicians to help patients not responding well to conventional treatments by the time AIDS was officially defined in 1981. Null, a registered dietitian and board-certified nutritionist with a PhD in human nutrition and public health science, was a senior research fellow and Director of Anti-Aging Medicine at the Institute of Applied Biology for 36 years and has published over 950 papers, conducting groundbreaking experiments in reversing biological aging as confirmed with DNA methylation testing. Additionally, Null is a multi-award-winning documentary filmmaker, bestselling author, and investigative journalist whose work exposing crimes against humanity over the last 50 years has highlighted abuses by Big Pharma, the military-industrial complex, the financial industry, and the permanent government stay-behind networks that have come to be known as the Deep State.   Null was contacted in 1974 by Dr. Stephen Caiazza, a physician working with a subculture of gay men in New York living the so-called “fast track” lifestyle, an extreme manifestation of the gay liberation movement that began with the Stonewall riots. Defined by rampant sexual promiscuity and copious use of illegal and prescription drugs, including heavy antibiotic use for a cornucopia of sexually-transmitted diseases, the fast-track never included more than about two percent of gay men, though these dominated many of the bathhouses and clubs that defined gay nightlife in the era. These patients had become seriously ill as a result of their indulgence, generally arriving at the clinic with multiple STDs including cytomegalovirus and several types of herpes and hepatitis, along with candida overgrowth, nutritional deficiencies, gut issues, and recurring pneumonia. Every week for the next 10 years, Null would counsel two or three of these men - a total of 800 patients - on how to detoxify their bodies and de-stress their lives, tracking their progress with Caiazza and the other providers at weekly feedback meetings that he credits with allowing the team to quickly evaluate which treatments were most effective. He observed that it only took about two years on the “fast track” for a healthy young person to begin seeing muscle loss and the recurrent, lingering opportunistic infections that would later come to be associated with AIDS - while those willing to commit to a healthier lifestyle could regain their health in about a year.    It was with this background that Null established the Tri-State Healing Center in Manhattan in 1980, staffing the facility with what would eventually run to 22 certified health professionals to offer safe, natural, and effective low- and no-cost treatments to thousands of patients with HIV and AIDS-defining conditions. Null and his staff used variations of the protocols he had perfected with Caiazza's patients, a multifactorial patient-tailored approach that included high-dose vitamin C drips, intravenous ozone therapy, juicing and nutritional improvements and supplementation, aspects of homeopathy and naturopathy with some Traditional Chinese Medicine and Ayurvedic practices. Additional services offered on-site included acupuncture and holistic dentistry, while peer support groups were also held at the facility so that patients could find community and a positive environment, healing their minds and spirits while they healed their bodies.   “Instead of trying to kill the virus with antiretroviral pharmaceuticals designed to stop viral replication before it kills patients, we focused on what benefits could be gained by building up the patients' natural immunity and restoring biochemical integrity so the body could fight for itself,” Null wrote in a 2014 article describing the philosophy behind the Center's approach, which was wholly at odds with the pharmaceutical model.1   Patients were comprehensively tested every week, with any “recovery” defined solely by the labs, which documented AIDS patient after patient - 1,200 of them - returning to good health and reversing their debilitating conditions. Null claims to have never lost an AIDS patient in the Center's care, even as the death toll for the disease - and its pharmaceutical standard of care AZT - reached an all-time high in the early 1990s. Eight patients who had opted for a more intensive course of treatment - visiting the Center six days a week rather than one - actually sero-deconverted, with repeated subsequent testing showing no trace of HIV in their bodies.   As an experienced clinical researcher himself, Null recognized that any claims made by the Center would be massively scrutinized, challenging as they did the prevailing scientific consensus that AIDS was an incurable, terminal illness. He freely gave his protocols to any medical practitioner who asked, understanding that his own work could be considered scientifically valid only if others could replicate it under the same conditions. After weeks of daily observational visits to the Center, Dr. Robert Cathcart took the protocols back to San Francisco, where he excitedly reported that patients were no longer dying in his care.    Null's own colleague at the Institute of Applied Biology, senior research fellow Elana Avram, set up IV drip rooms at the Institute and used his intensive protocols to sero-deconvert 10 patients over a two-year period. While the experiment had been conducted in secret, as the Institute had been funded by Big Pharma since its inception half a century earlier, Avram had hoped she would be able to publish a journal article to further publicize Null's protocols and potentially help AIDS patients, who were still dying at incredibly high rates thanks to Burroughs Wellcome's noxious but profitable AZT. But as she would later explain in a 2019 letter to Null, their groundbreaking research never made it into print - despite meticulous documentation of their successes - because the Institute's director and board feared their pharmaceutical benefactors would withdraw the funding on which they depended, given that Null's protocols did not involve any patentable or otherwise profitable drugs. When Avram approached them about publication, the board vetoed the idea, arguing that it would “draw negative attention because [the work] was contrary to standard drug treatments.” With no real point in continuing experiments along those lines without institutional support and no hope of obtaining funding from elsewhere, the department she had created specifically for these experiments shut down after a two-year followup with her test subjects - all of whom remained alive and healthy - was completed.2   While the Center was receiving regular visits by this time from medical professionals and, increasingly, black celebrities like Stokely Carmichael and Isaac Hayes, who would occasionally perform for the patients, the news was spreading by word of mouth alone - not a single media outlet had dared to document the clinic that was curing AIDS patients for free. Instead, they gave airtime to Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases, who had for years been spreading baseless, hysteria-fueling claims about HIV and AIDS to any news outlet that would put him on. His claim that children could contract the virus from “ordinary household conduct” with an infected relative proved so outrageous he had to walk it back,3 and he never really stopped insisting the deadly plague associated with gays and drug users was about to explode like a nuclear bomb among the law-abiding heterosexual population. Fauci by this time controlled all government science funding through NIAID, and his zero-tolerance approach to dissent on the HIV/AIDS front had already seen prominent scientists like virologist Peter Duesberg stripped of the resources they needed for their work because they had dared to question his commandment: There is no cause of AIDS but HIV, and AZT is its treatment. Even the AIDS activist groups, which by then had been coopted by Big Pharma and essentially reduced to astroturfing for the toxic failed chemotherapy drug AZT backed by the institutional might of Fauci's NIAID,4 didn't seem to want to hear that there was a cure. Unconcerned with the irrationality of denouncing the man touting his free AIDS cure as an  “AIDS denier,” they warned journalists that platforming Null or anyone else rejecting the mainstream medical line would be met with organized demands for their firing.    Determined to breach the institutional iron curtain and get his message to the masses, Null and his team staged a press conference in New York, inviting scientists and doctors from around the world to share their research on alternative approaches to HIV and AIDS in 1993. To emphasize the sound scientific basis of the Center's protocols and encourage guests to adopt them into their own practices, Null printed out thousands of abstracts in support of each nutrient and treatment being used. However, despite over 7,000 invitations sent three times to major media, government figures, scientists, and activists, almost none of the intended audience members showed up. Over 100 AIDS patients and their doctors, whose charts exhaustively documented their improvements using natural and nontoxic modalities over the preceding 12 months, gave filmed testimonials, declaring that the feared disease was no longer a death sentence, but the conference had effectively been silenced. Bill Tatum, publisher of the Amsterdam News, suggested Null and his patients would find a more welcoming audience in his home neighborhood of Harlem - specifically, its iconic Apollo Theatre. For three nights, the theater was packed to capacity. Hit especially hard by the epidemic and distrustful of a medical system that had only recently stopped being openly racist (the Tuskegee syphilis experiment only ended in 1972), black Americans, at least, did not seem to care what Anthony Fauci would do if he found out they were investigating alternatives to AZT and death.    PBS journalist Tony Brown, having obtained a copy of the video of patient testimonials from the failed press conference, was among a handful of black journalists who began visiting the Center to investigate the legitimacy of Null's claims. Satisfied they had something significant to offer his audience, Brown invited eight patients - along with Null himself - onto his program over the course of several episodes to discuss the work. It was the first time these protocols had received any attention in the media, despite Null having released nearly two dozen articles and multiple documentaries on the subject by that time. A typical patient on one program, Al, a recovered IV drug user who was diagnosed with AIDS at age 32, described how he “panicked,” saw a doctor and started taking AZT despite his misgivings - only to be forced to discontinue the drug after just a few weeks due to his condition deteriorating rapidly. Researching alternatives brought him to Null, and after six months of “detoxing [his] lifestyle,” he observed his initial symptoms - swollen lymph nodes and weight loss - begin to reverse, culminating with sero-deconversion. On Bill McCreary's Channel 5 program, a married couple diagnosed with HIV described how they watched their T-cell counts increase as they cut out sugar, caffeine, smoking, and drinking and began eating a healthy diet. They also saw the virus leave their bodies.   For HIV-positive viewers surrounded by fear and negativity, watching healthy-looking, cheerful “AIDS patients” detail their recovery while Null backed up their claims with charts must have been balm for the soul. But the TV programs were also a form of outreach to the medical community, with patients' charts always on hand to convince skeptics the cure was scientifically valid. Null brought patients' charts to every program, urging them to keep an open mind: “Other physicians and public health officials should know that there's good science in the alternative perspective. It may not be a therapy that they're familiar with, because they're just not trained in it, but if the results are positive, and you can document them…” He challenged doubters to send in charts from their own sero-deconverted patients on AZT, and volunteered to debate proponents of the orthodox treatment paradigm - though the NIH and WHO both refused to participate in such a debate on Tony Brown's Journal, following Fauci's directive prohibiting engagement with forbidden ideas.    Aside from those few TV programs and Null's own films, suppression of Null's AIDS cure beyond word of mouth was total. The 2021 documentary The Cost of Denial, produced by the Society for Independent Journalists, tells the story of the Tri-State Healing Center and the medical paradigm that sought to destroy it, lamenting the loss of the lives that might have been saved in a more enlightened society. Nurse practitioner Luanne Pennesi, who treated many of the AIDS patients at the Center, speculated in the film that the refusal by the scientific establishment and AIDS activists to accept their successes was financially motivated. “It was as if they didn't want this information to get out. Understand that our healthcare system as we know it is a corporation, it's a corporate model, and it's about generating revenue. My concern was that maybe they couldn't generate enough revenue from these natural approaches.”5   Funding was certainly the main disciplinary tool Fauci's NIAID used to keep the scientific community in line. Despite the massive community interest in the work being done at the Center, no foundation or institution would defy Fauci and risk getting itself blacklisted, leaving Null to continue funding the operation out of his pocket with the profits from book sales. After 15 years, he left the Center in 1995, convinced the mainstream model had so thoroughly been institutionalized that there was no chance of overthrowing it. He has continued to counsel patients and advocate for a reappraisal of the HIV=AIDS hypothesis and its pharmaceutical treatments, highlighting the deeply flawed science underpinning the model of the disease espoused by the scientific establishment in 39 articles, six documentaries and a 700-page textbook on AIDS, but the Center's achievements have been effectively memory-holed by Fauci's multi-billion-dollar propaganda apparatus.     FRUIT OF THE POISONOUS TREE   To understand just how much of a threat Null's work was to the HIV/AIDS establishment, it is instructive to revisit the 1984 paper, published by Dr. Robert Gallo of the National Cancer Institute, that established HIV as the sole cause of AIDS. The CDC's official recognition of AIDS in 1981 had done little to quell the mounting public panic over the mysterious illness afflicting gay men in the US, as the agency had effectively admitted it had no idea what was causing them to sicken and die. As years passed with no progress determining the causative agent of the plague, activist groups like Gay Men's Health Crisis disrupted public events and threatened further mass civil disobedience as they excoriated the NIH for its sluggish allocation of government science funding to uncovering the cause of the “gay cancer.”6 When Gallo published his paper declaring that the retrovirus we now know as HIV was the sole “probable” cause of AIDS, its simple, single-factor hypothesis was the answer to the scientific establishment's prayers. This was particularly true for Fauci, as the NIAID chief was able to claim the hot new disease as his agency's own domain in what has been described as a “dramatic confrontation” with his rival Sam Broder at the National Cancer Institute. After all, Fauci pointed out, Gallo's findings - presented by Health and Human Services Secretary Margaret Heckler as if they were gospel truth before any other scientists had had a chance to inspect them, never mind conduct a full peer review - clearly classified AIDS as an infectious disease, and not a cancer like the Kaposi's sarcoma which was at the time its most visible manifestation. Money and media attention began pouring in, even as funding for the investigation of other potential causes of AIDS dried up. Having already patented a diagnostic test for “his” retrovirus before introducing it to the world, Gallo was poised for a financial windfall, while Fauci was busily leveraging the discovery into full bureaucratic empire of the US scientific apparatus.   While it would serve as the sole basis for all US government-backed AIDS research to follow - quickly turning Gallo into the most-cited scientist in the world during the 1980s,7 Gallo's “discovery” of HIV was deeply problematic. The sample that yielded the momentous discovery actually belonged to Prof. Luc Montagnier of the French Institut Pasteur, a fact Gallo finally admitted in 1991, four years after a lawsuit from the French government challenged his patent on the HIV antibody test, forcing the US government to negotiate a hasty profit-sharing agreement between Gallo's and Montagnier's labs. That lawsuit triggered a cascade of official investigations into scientific misconduct by Gallo, and evidence submitted during one of these probes, unearthed in 2008 by journalist Janine Roberts, revealed a much deeper problem with the seminal “discovery.” While Gallo's co-author, Mikulas Popovic, had concluded after numerous experiments with the French samples that the virus they contained was not the cause of AIDS, Gallo had drastically altered the paper's conclusion, scribbling his notes in the margins, and submitted it for publication to the journal Science without informing his co-author.   After Roberts shared her discovery with contacts in the scientific community, 37 scientific experts wrote to the journal demanding that Gallo's career-defining HIV paper be retracted from Science for lacking scientific integrity.8 Their call, backed by an endorsement from the 2,600-member scientific organization Rethinking AIDS, was ignored by the publication and by the rest of mainstream science despite - or perhaps because of - its profound implications.   That 2008 letter, addressed to Science editor-in-chief Bruce Alberts and copied to American Association for the Advancement of Science CEO Alan Leshner, is worth reproducing here in its entirety, as it utterly dismantles Gallo's hypothesis - and with them the entire HIV is the sole cause of AIDS dogma upon which the contemporary medical model of the disease rests:   On May 4, 1984 your journal published four papers by a group led by Dr. Robert Gallo. We are writing to express our serious concerns with regard to the integrity and veracity of the lead paper among these four of which Dr. Mikulas Popovic is the lead author.[1] The other three are also of concern because they rely upon the conclusions of the lead paper .[2][3][4]  In the early 1990s, several highly critical reports on the research underlying these papers were produced as a result of governmental inquiries working under the supervision of scientists nominated by the National Academy of Sciences and the Institute of Medicine. The Office of Research Integrity of the US Department of Health and Human Services concluded that the lead paper was “fraught with false and erroneous statements,” and that the “ORI believes that the careless and unacceptable keeping of research records...reflects irresponsible laboratory management that has permanently impaired the ability to retrace the important steps taken.”[5] Further, a Congressional Subcommittee on Oversight and Investigations led by US Representative John D. Dingell of Michigan produced a staff report on the papers which contains scathing criticisms of their integrity.[6]  Despite the publically available record of challenges to their veracity, these papers have remained uncorrected and continue to be part of the scientific record.  What prompts our communication today is the recent revelation of an astonishing number of previously unreported deletions and unjustified alterations made by Gallo to the lead paper. There are several documents originating from Gallo's laboratory that, while available for some time, have only recently been fully analyzed. These include a draft of the lead paper typewritten by Popovic which contains handwritten changes made to it by Gallo.[7] This draft was the key evidence used in the above described inquiries to establish that Gallo had concealed his laboratory's use of a cell culture sample (known as LAV) which it received from the Institut Pasteur.  These earlier inquiries verified that the typed manuscript draft was produced by Popovic who had carried out the recorded experiment while his laboratory chief, Gallo, was in Europe and that, upon his return, Gallo changed the document by hand a few days before it was submitted to Science on March 30, 1984. According to the ORI investigation, “Dr. Gallo systematically rewrote the manuscript for what would become a renowned LTCB [Gallo's laboratory at the National Cancer Institute] paper.”[5]  This document provided the important evidence that established the basis for awarding Dr. Luc Montagnier and Dr. Francoise Barré-Sinoussi the 2008 Nobel Prize in Medicine for the discovery of the AIDS virus by proving it was their samples of LAV that Popovic used in his key experiment. The draft reveals that Popovic had forthrightly admitted using the French samples of LAV renamed as Gallo's virus, HTLV-III, and that Gallo had deleted this admission, concealing their use of LAV.  However, it has not been previously reported that on page three of this same document Gallo had also deleted Popovic's unambiguous statement that, "Despite intensive research efforts, the causative agent of AIDS has not yet been identified,” replacing it in the published paper with a statement that said practically the opposite, namely, “That a retrovirus of the HTLV family might be an etiologic agent of AIDS was suggested by the findings.”  It is clear that the rest of Popovic's typed paper is entirely consistent with his statement that the cause of AIDS had not been found, despite his use of the French LAV. Popovic's final conclusion was that the culture he produced “provides the possibility” for detailed studies. He claimed to have achieved nothing more. At no point in his paper did Popovic attempt to prove that any virus caused AIDS, and it is evident that Gallo concealed these key elements in Popovic's experimental findings.  It is astonishing now to discover these unreported changes to such a seminal document. We can only assume that Gallo's alterations of Popovic's conclusions were not highlighted by earlier inquiries because the focus at the time was on establishing that the sample used by Gallo's lab came from Montagnier and was not independently collected by Gallo. In fact, the only attention paid to the deletions made by Gallo pertains to his effort to hide the identity of the sample. The questions of whether Gallo and Popovic's research proved that LAV or any other virus was the cause of AIDS were clearly not considered.  Related to these questions are other long overlooked documents that merit your attention. One of these is a letter from Dr. Matthew A. Gonda, then Head of the Electron Microscopy Laboratory at the National Cancer Institute, which is addressed to Popovic, copied to Gallo and dated just four days prior to Gallo's submission to Science.[8] In this letter, Gonda remarks on samples he had been sent for imaging because “Dr Gallo wanted these micrographs for publication because they contain HTLV.” He states, “I do not believe any of the particles photographed are of HTLV-I, II or III.” According to Gonda, one sample contained cellular debris, while another had no particles near the size of a retrovirus. Despite Gonda's clearly worded statement, Science published on May 4, 1984 papers attributed to Gallo et al with micrographs attributed to Gonda and described unequivocally as HTLV-III.  In another letter by Gallo, dated one day before he submitted his papers to Science, Gallo states, “It's extremely rare to find fresh cells [from AIDS patients] expressing the virus... cell culture seems to be necessary to induce virus,” a statement which raises the possibility he was working with a laboratory artifact. [9]  Included here are copies of these documents and links to the same. The very serious flaws they reveal in the preparation of the lead paper published in your journal in 1984 prompts our request that this paper be withdrawn. It appears that key experimental findings have been concealed. We further request that the three associated papers published on the same date also be withdrawn as they depend on the accuracy of this paper.  For the scientific record to be reliable, it is vital that papers shown to be flawed, or falsified be retracted. Because a very public record now exists showing that the Gallo papers drew unjustified conclusions, their withdrawal from Science is all the more important to maintain integrity. Future researchers must also understand they cannot rely on the 1984 Gallo papers for statements about HIV and AIDS, and all authors of papers that previously relied on this set of four papers should have the opportunity to consider whether their own conclusions are weakened by these revelations.      Gallo's handwritten revision, submitted without his colleague's knowledge despite multiple experiments that failed to support the new conclusion, was the sole foundation for the HIV=AIDS hypothesis. Had Science published the manuscript the way Popovic had typed it, there would be no AIDS “pandemic” - merely small clusters of people with AIDS. Without a viral hypothesis backing the development of expensive and deadly pharmaceuticals, would Fauci have allowed these patients to learn about the cure that existed all along?   Faced with a potential rebellion, Fauci marshaled the full resources under his control to squelch the publication of the investigations into Gallo and restrict any discussion of competing hypotheses in the scientific and mainstream press, which had been running virus-scare stories full-time since 1984. The effect was total, according to biochemist Dr. Kary Mullis, inventor of the polymerase chain reaction (PCR) procedure. In a 2009 interview, Mullis recalled his own shock when he attempted to unearth the experimental basis for the HIV=AIDS hypothesis. Despite his extensive inquiry into the literature, “there wasn't a scientific reference…[that] said ‘here's how come we know that HIV is the probable cause of AIDS.' There was nothing out there like that.”9 This yawning void at the core of HIV/AIDS “science" turned him into a strident critic of AIDS dogma - and those views made him persona non grata where the scientific press was concerned, suddenly unable to publish a single paper despite having won the Nobel Prize for his invention of the PCR test just weeks before.  10   DISSENT BECOMES “DENIAL”   While many of those who dissent from the orthodox HIV=AIDS view believe HIV plays a role in the development of AIDS, they point to lifestyle and other co-factors as being equally if not more important. Individuals who test positive for HIV can live for decades in perfect health - so long as they don't take AZT or the other toxic antivirals fast-tracked by Fauci's NIAID - but those who developed full-blown AIDS generally engaged in highly risky behaviors like extreme promiscuity and prodigious drug abuse, contracting STDs they took large quantities of antibiotics to treat, further running down their immune systems. While AIDS was largely portrayed as a “gay disease,” it was only the “fast track” gays, hooking up with dozens of partners nightly in sex marathons fueled by “poppers” (nitrate inhalants notorious for their own devastating effects on the immune system), who became sick. Kaposi's sarcoma, one of the original AIDS-defining conditions, was widespread among poppers-using gay men, but never appeared among IV drug users or hemophiliacs, the other two main risk groups during the early years of the epidemic. Even Robert Gallo himself, at a 1994 conference on poppers held by the National Institute on Drug Abuse, would admit that the previously-rare form of skin cancer surging among gay men was not primarily caused by HIV - and that it was immune stimulation, rather than suppression, that was likely responsible.11 Similarly, IV drug users are often riddled with opportunistic infections as their habit depresses the immune system and their focus on maintaining their addiction means that healthier habits - like good nutrition and even basic hygiene - fall by the wayside.    Supporting the call for revising the HIV=AIDS hypothesis to include co-factors is the fact that the mass heterosexual outbreaks long predicted by Fauci and his ilk in seemingly every country on Earth have failed to materialize, except - supposedly - in Africa, where the diagnostic standard for AIDS differs dramatically from those of the West. Given the prohibitively high cost of HIV testing for poor African nations, the WHO in 1985 crafted a diagnostic loophole that became known as the “Bangui definition,” allowing medical professionals to diagnose AIDS in the absence of a test using just clinical symptoms: high fever, persistent cough, at least 30 days of diarrhea, and the loss of 10% of one's body weight within two months. Often suffering from malnutrition and without access to clean drinking water, many of the inhabitants of sub-Saharan Africa fit the bill, especially when the WHO added tuberculosis to the list of AIDS-defining illnesses in 1993 - a move which may be responsible for as many as one half of African “AIDS” cases, according to journalist Christine Johnson. The WHO's former Chief of Global HIV Surveillance, James Chin, acknowledged their manipulation of statistics, but stressed that it was the entire AIDS industry - not just his organization - perpetrating the fraud. “There's the saying that, if you knew what sausages are made of, most people would hesitate to sort of eat them, because they wouldn't like what's in it. And if you knew how HIV/AIDS numbers are cooked, or made up, you would use them with extreme caution,” Chin told an interviewer in 2009.12   With infected numbers stubbornly remaining constant in the US despite Fauci's fearmongering projections of the looming heterosexually-transmitted plague, the CDC in 1993 broadened its definition of AIDS to include asymptomatic (that is, healthy) HIV-positive people with low T-cell counts - an absurd criteria given that an individual's T-cell count can fluctuate by hundreds within a single day. As a result, the number of “AIDS cases” in the US immediately doubled. Supervised by Fauci, the NIAID had been quietly piling on diseases into the “AIDS-related” category for years, bloating the list from just two conditions - pneumocystis carinii pneumonia and Kaposi's sarcoma - to 30 so fast it raised eyebrows among some of science's leading lights. Deeming the entire process “bizarre” and unprecedented, Kary Mullis wondered aloud why no one had called the AIDS establishment out: “There's something wrong here. And it's got to be financial.”13   Indeed, an early CDC public relations campaign was exposed by the Wall Street Journal in 1987 as having deliberately mischaracterized AIDS as a threat to the entire population so as to garner increased public and private funding for what was very much a niche issue, with the risk to average heterosexuals from a single act of sex “smaller than the risk of ever getting hit by lightning.” Ironically, the ads, which sought to humanize AIDS patients in an era when few Americans knew anyone with the disease and more than half the adult population thought infected people should be forced to carry cards warning of their status, could be seen as a reaction to the fear tactics deployed by Fauci early on.14   It's hard to tell where fraud ends and incompetence begins with Gallo's HIV antibody test. Much like Covid-19 would become a “pandemic of testing,” with murder victims and motorcycle crashes lumped into “Covid deaths” thanks to over-sensitized PCR tests that yielded as many as 90% false positives,15 HIV testing is fraught with false positives - and unlike with Covid-19, most people who hear they are HIV-positive still believe they are receiving a death sentence. Due to the difficulty of isolating HIV itself from human samples, the most common diagnostic tests, ELISA and the Western Blot, are designed to detect not the virus but antibodies to it, upending the traditional medical understanding that the presence of antibodies indicates only exposure - and often that the body has actually vanquished the pathogen. Patients are known to test positive for HIV antibodies in the absence of the virus due to at least 70 other conditions, including hepatitis, lupus, rheumatoid arthritis, syphilis, recent vaccination or even pregnancy. (https://www.chcfl.org/diseases-that-can-cause-a-false-positive-hiv-test/) Positive results are often followed up with a PCR “viral load” test, even though the inventor of the PCR technique Kary Mullis famously condemned its misuse as a tool for diagnosing infection. Packaging inserts for all three tests warn the user that they cannot be reliably used to diagnose HIV.16 The ELISA HIV antibody test explicitly states: “At present there is no recognized standard for establishing the presence and absence of HIV antibody in human blood.”17   That the public remains largely unaware of these and other massive holes in the supposedly airtight HIV=AIDS=DEATH paradigm is a testament to Fauci's multi-layered control of the press. Like the writers of the Great Barrington Declaration and other Covid-19 dissidents, scientists who question HIV/AIDS dogma have been brutally punished for their heresy, no matter how prestigious their prior standing in the field and no matter how much evidence they have for their own claims. In 1987, the year the FDA's approval of AZT made AIDS the most profitable epidemic yet (a dubious designation Covid-19 has since surpassed), Fauci made it clearer than ever that scientific inquiry and debate - the basis of the scientific method - would no longer be welcome in the American public health sector, eliminating retrovirologist Peter Duesberg, then one of the most prominent opponents of the HIV=AIDS hypothesis, from the scientific conversation with a professional disemboweling that would make a cartel hitman blush. Duesberg had just eviscerated Gallo's 1984 HIV paper with an article of his own in the journal Cancer Research, pointing out that retroviruses had never before been found to cause a single disease in humans - let alone 30 AIDS-defining diseases. Rather than allow Gallo or any of the other scientists in his camp to respond to the challenge, Fauci waged a scorched-earth campaign against Duesberg, who had until then been one of the most highly regarded researchers in his field. Every research grant he requested was denied; every media appearance was canceled or preempted. The University of California at Berkeley, unable to fully fire him due to tenure, took away his lab, his graduate students, and the rest of his funding. The few colleagues who dared speak up for him in public were also attacked, while enemies and opportunists were encouraged to slander Duesberg at the conferences he was barred from attending and in the journals that would no longer publish his replies. When Duesberg was summoned to the White House later that year by then-President Ronald Reagan to debate Fauci on the origins of AIDS, Fauci convinced the president to cancel, allegedly pulling rank on the Commander-in-Chief with an accusation that the “White House was interfering in scientific matters that belonged to the NIH and the Office of Science and Technology Assessment.” After seven years of this treatment, Duesberg was contacted by NIH official Stephen O'Brien and offered an escape from professional purgatory. He could have “everything back,” he was told, and shown a manuscript of a scientific paper - apparently commissioned by the editor of the journal Nature - “HIV Causes AIDS: Koch's Postulates Fulfilled” with his own name listed alongside O'Brien's as an author.18 His refusal to take the bribe effectively guaranteed the epithet “AIDS denier” will appear on his tombstone. The character assassination of Duesberg became a template that would be deployed to great effectiveness wherever Fauci encountered dissent - never debate, only demonize, deplatform and destroy.    Even Luc Montagnier, the real discoverer of HIV, soon found himself on the wrong side of the Fauci machine. With his 1990 declaration that “the HIV virus [by itself] is harmless and passive, a benign virus,” Montagnier began distancing himself from Gallo's fraud, effectively placing a target on his own back. In a 1995 interview, he elaborated: “four factors that have come together to account for the sudden epidemic [of AIDS]: HIV presence, immune hyper-activation, increased sexually transmitted disease incidence, sexual behavior changes and other behavioral changes” such as drug use, poor nutrition and stress - all of which he said had to occur “essentially simultaneously” for HIV to be transmitted, creating the modern epidemic. Like the professionals at the Tri-State Healing Center, Montagnier advocated for the use of antioxidants like vitamin C and N-acetyl cysteine, naming oxidative stress as a critical factor in the progression from HIV to AIDS.19 When Montagnier died in 2022, Fauci's media mouthpieces sneered that the scientist (who was awarded the Nobel Prize in 2008 for his discovery of HIV, despite his flagging faith in that discovery's significance) “started espousing views devoid of a scientific basis” in the late 2000s, leading him to be “shunned by the scientific community.”20 In a particularly egregious jab, the Washington Post's obit sings the praises of Robert Gallo, implying it was the American scientist who really should have won the Nobel for HIV, while dismissing as “

Health Affairs' Senior Deputy Editor Rob Lott interviews Jihye Han of Brigham and Women's Hospital and Harvard University on her recent paper that takes a closer look at the regulatory treatments for first-in-class drugs and how those differ between the US and Europe.Order the March 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.

Health Affairs' Jeff Byers invites Victor Dzau of the National Academy of Medicine to the program to discuss the 2025 Vital Directions paper package and what major takeaways could be found to inform the incoming administration for the future of health care.Join a live recording of A Health Podyssey on March 12 featuring Rob Lott and Yashaswini Singh discussing her recent paper on the effect of private equity on physician turnover.  Register for the live taping here.Related Links:Podcast: Don Berwick on How to Fix US Health Care (A Health Podyssey)Vital Directions for Health & Health Care: Priorities for 2025 Webinar (National Academy of Medicine)Vital Directions For Health And Health Care: Priorities For 2025 (Health Affairs)Updating US Public Health For Healthier Communities (Health Affairs)Artificial Intelligence In Health And Health Care: Priorities For Action (Health Affairs)

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Zirui Song of Harvard University and Massachusetts General Hospital on his recent paper that explores how private equity acquisition impacts hospital costs and utilization and what variations were seen throughout 2005–19. Order the February 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.

Dave becomes acquainted with Dr. Kim Byas, who, among his several current endeavors, including Vice President of Community Engagement and Impact at The Center for Health Affairs, is a member of the Conscious Leadership Guild. In the course of this conversation, Kim introduces the concept of the origin story. Each of us has one, yet to inform and grow our practices, we can become more aware of this unique personal resource. Journaling is one way of doing so. 

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Senior Editor Kathleen Haddad back to the program to discuss two recent reports exploring the impacts of private equity on the US health care system. Health Affairs published an ahead-of-print article from Michelle S. Rockwell and coauthors exploring demographic variation in COVID-19-associated outpatient hydroxychloroquine and ivermectin use and spending throughout the public health emergency. Also, join a live recording of A Health Podyssey on March 12 featuring Rob Lott and Yashaswini Singh discussing her recent paper on the effect of private equity on physician turnover.  Register for the live taping here.Related Articles:HHS Releases Report on Consolidation and Private Equity (PE) in Health Care MarketsFTC retains stricter merger guidelines under Trump (Healthcare Dive)REPORT: Profits Over Patients: The Harmful Effects of Private Equity on the U.S. Health Care SystemREPORT: HHS Consolidation in Health Care Markets RFI Response  Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews J. Michael McWilliams of Harvard Medical School and Brigham and Women's Hospital on his recent paper that explores opportunities for the use of patient health survey data for risk adjustment to limit distortionary coding incentives in Medicare. Order the January 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Mark Fendrick of The University of Michigan's Center for Value-Based Insurance Design (VBID) to discuss the recent announcement from CMS that the Medicare Advantage VBID model would be ending after 2025, and what the future holds for VBID moving forward with the new Trump administration. Check out a recently released Health Policy brief from Nathaniel Tran and Gilbert Gonzales exploring LGBTQI+ policies.Join Health Affairs on February 25 for an exclusive Insider virtual event featuring Stacie Dusetzina and Laura Tollen discussing HHS's announcement of the 15 additional drugs selected for Medicare drug price negotiations, including weight-loss drugs such as Ozempic and Wegovy.Also, join a live recording of A Health Podyssey on March 12 featuring Rob Lott and Yashaswini Singh discussing her recent paper on the effect of private equity on physician turnover.  Register for the live taping here. Related Articles:The End Of The MA Value-Based Insurance Design Model: What Next? (Health Affairs Forefront)V-BID X: Creating A Value-Based Insurance Design Plan For The Exchange Market (Health Affairs Forefront)Medicare Advantage Value-Based Insurance Design (VBID) Model to End after Calendar Year 2025 (CMS) Subscribe to UnitedHealthcare's Community & State newsletter.

On this episode of DGTL Voices, I interview Dr. George Kikano, the Executive Vice President for Health Affairs and Dean of the College of Medicine at Central Michigan University. Dr. Kikano shares his journey from growing up in Lebanon during the Civil War to becoming a leader in healthcare education. The conversation covers the importance of purpose in life, the role of technology in medical training, and the challenges and rewards of building a new medical school. 

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Jennifer Wolff of John Hopkins University about her recent paper that explores the increasing number of family caregivers that are assisting older US adults, including adults with dementia. Order the February 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Kinika Young of The Leukemia & Lymphoma Society to the program to discuss a recent final rule/advisory issued by the Consumer Financial Protection Bureau barring medical debt from US credit reports and how this rule will impact the scope of medical debt in the US today.  Check out a recently released Health Policy brief from Nathaniel Tran and Gilbert Gonzales exploring how public debates and enactments of both pro- and anti-LGBTQI+ policies affect LGBTQI+ populations in the places where they live, learn, work, play, and age.Also, join Health Affairs on February 25 for an exclusive Insider virtual event featuring Stacie Dusetzina and Laura Tollen discussing HHS's announcement of the 15 additional drugs selected for Medicare drug price negotiations, including weight-loss drugs such as Ozempic and Wegovy.Related Articles:New Federal Guidance Puts Medical Debt Collectors On Notice (Health Affairs Forefront)Consumer advisory: Pause and review your rights when you hear from a medical debt collector (CFPB)Nearly 1 in 2 Patients with Medical Debt Feel "Trapped," New Poll from Leading Health Care Orgs Find (Leukemia & Lymphoma Society) Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Senior Deputy Editor Rob Lott interviews Don Berwick of the Institute for Healthcare Improvement about his paper as part of the Vital Directions for Health and Health Care: Priorities for 2025 package that proposes strategies for how health care in the US could be transformed.Order the February 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Senior Editor Ellen Bayer to the program to examine the US Food & Drug Administration's most recent work on food and nutrition policy, as well as what was done in the final days of the Biden administration and where things stand today.Health Affairs will be releasing a theme issue focusing on Food, Nutrition, & Health in April 2025.Next week, Health Affairs will be releasing their February 2025 issue that will feature a health policy road map for a new US administration. The papers featured in this road map have been published ahead-of-print. Order your copy today. Related Articles:FDA Finalizes Updated “Healthy” Nutrient Content ClaimFront-of-Package Nutrition LabelingPresident Trump Enacts Regulatory Freeze and Halts Public Communications for Federal Agencies (The National Law Review) Subscribe to UnitedHealthcare's Community & State newsletter.

Health Affairs' Senior Deputy Editor Rob Lott interviews Paige Nong of the University of Minnesota about her recent paper that evaluates and explores the current use of artificial intelligence and predictive models in US hospitals.Order the January 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.