Health

NY Times -  President Trump’s policy agenda would make deep cuts in government health plans and medical research, and, critics say, could also make finding a doctor more difficult. The Republicans’ major domestic policy bill restricts loans that students rely on to pursue professional graduate degrees, making the path to becoming a physician harder even as doctor shortages loom and the American population is graying.

The bill, which passed in the House last month and carries the president’s support, would cap direct federal unsubsidized loans at $150,000 — far less than the cost of obtaining a medical education — and phase out the Grad PLUS loans that help many students make up the difference.

Medicine, dentistry and osteopathic medicine are among the most expensive graduate programs.

Four years of medical education costs $286,454 at a public school, on average, and $390,848 at a private one, according to the Association of American Medical Colleges. Medical school graduates leave with an average debt of $212,341, the association found.

The price of a four-year program in osteopathic medicine is $297,881 at a public school, on average, and $371,403 at a private school, according to the American Association of Colleges of Osteopathic Medicine. The average indebtedness of their graduates is $259,196.

Axios - Public health experts and medical societies are raising alarm about the future of vaccines in the U.S. after HHS Secretary Robert F. Kennedy Jr. yesterday ousted all 17 members of the expert panel that advises the CDC on immunizations. HHS portrayed the unprecedented firing of the entire Advisory Committee for Immunization Practices as "restoring public trust" in vaccines. But it's expected to introduce anti-vaccine ideology to the panel and possibly lead to recommendations and policies that limit their availability.  "Unilaterally removing an entire panel of experts is reckless, shortsighted and severely harmful," Tina Tan, president of the Infectious Diseases Society of America, said in a statement.

"What scares me in all this is who's he going to bring in? Is he just going to bring in people like him, who are science denialists and conspiracy theorists and anti-vaccine activists?" said Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia and a member of a separate outside vaccine panel that has advised the FDA since 2018.  More here

NPR - U.S. drug-related deaths among young people are finally declining after a decade in which over 230,000 people under the age of 35 died from overdoses. In 2021, fentanyl and other drugs led to over 31,000 fatalities in this age group. By last year, that number had dropped significantly to approximately 16,690 fatal overdoses, according to provisional data from the CDC.  Researchers have a lot of theories behind the cause of this significant decline, including better health care, NPR’s Brian Mann says. Narcan, also known as naloxone, a medication that reverses fentanyl overdoses, is widely distributed. There is increasing evidence that young people are being more cautious and using fewer hard drugs that might be laced or contaminated with fentanyl. Mann says he hears concerns from experts and families that the Republican budget passed by the House would cut billions of dollars from Medicaid and public health and science agencies. The fear is that grants for fentanyl and other addiction programs will dry up, and this recovery would unravel.

NBC News - Health and Human Services Secretary Robert F. Kennedy Jr. took his most aggressive action yet to overhaul the nation’s vaccine policy, firing 17 members of an independent vaccine advisory committee at the CDC. Kennedy claimed in a Wall Street Journal editorial that the committee — which makes recommendations to the CDC about who should get certain vaccines, including the schedule for childhood vaccinations — has been “plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine.”

Members of the Advisory Committee on Immunization Practices, known more commonly as ACIP, undergo an extensive vetting process before being appointed and are required to disclose conflicts of interest and recuse themselves from voting on vaccines for which a conflict exists.

Former CDC officials and public health experts called Kennedy’s action concerning and said it would sow confusion. Richard Besser, the former acting director of the CDC, said in a statement that the firings “should erase any remaining doubt that he intends to impose his personal anti-vaccine agenda on the American people.” Full story

Time - Cancer is generally a disease of old age. But researchers are increasingly finding that certain types—including colon, breast, stomach, and pancreatic cancers—are hitting people younger than 50 far more commonly than they used to.

In a new report, published in the Annals of Internal Medicine, researchers at Vanderbilt University focus on a relatively rare cancer—appendiceal cancer, which occurs in the appendix—and found that its rates are also rising, especially among millennials.
 
Andreana Holowatyji, assistant professor of hematology and oncology at Vanderbilt University Medical Center, and her colleagues analyzed data from the National Cancer Institute’s Surveillance, Epidemiology and End Results program, a cancer registry that includes patients from 1975 to 2019. The scope of the dataset allowed them to look for generational differences in cancer rates. They specifically tracked appendix cancer, which for many years was misclassified as colorectal cancer since the appendix sits at the start of the large intestine....


In their analysis, which involved more than 4,800 people diagnosed with appendix cancer, rates of the cancer tripled among those born in 1980—and quadrupled among those born in 1985—compared to people born in 1945. Rates increased in every birth cohort after 1945. In that time, rates of appendectomies remained about the same, which the researchers say largely rules out the possibility that more cases were detected from appendectomies performed.

Steve Benen, MSNBC - I reached out to the nice folks at th]e Center on Budget and Policy Priorities and they referred me to the CBPP’s helpful breakdown of [Medicaid data]:


Roughly 16 million people by 2034 would lose health coverage and become uninsured because of the Medicaid cuts, the bill’s failure to extend enhanced premium tax credits for ACA marketplace coverage, and other harmful ACA marketplace changes, according to estimates from the Congressional Budget Office (CBO).

The Republicans’ Medicaid cuts alone, if implemented, would strip coverage from 7.8 million people. The same analysis added, however, that 4 million people would become uninsured due to cuts to Affordable Care Act marketplaces, and an additional 4.2 million people would lose their coverage because the Republicans’ package fails to extend the Biden-era subsidies (the premium tax credit enhancements) that made ACA plans far more affordable.