The Trump 2.0 administration is 8-months into its MAGA agenda. Summer has passed. Schools are open. Congress is in session. Campaign 2026 is underway. The economy is slowing and public sentiment is dropping.
For U.S. healthcare, it’s more bad news than good. The challenges are unprecedented. Most organizations—hospitals, medical groups, drug and device makers, infomediaries and solution providers, insurers, et al—are defaulting to lower risk bets since the long-term for the health system is unclear.
The good news is that the health system in the U.S. is big, fragmented, complex, expensive (5% CAGR spending increases thru 2034) and slow to change. It is highly regulated at local, state and federal levels, labor intense (20 million) and capital-dependent (government funding, private investment)—a trifecta nightmare for operators and goldmine for private investors who time the system for shareholders effectively. And it operates opaquely: business practices are hidden from everyday users and bona-fide measures of its effectiveness not widely applied or accepted.
The bad news is its long-term sustainability in its current form is suspect and its short-term success is dependent on adapting to key tenets in Trump Healthcare 2.0:
- Trump Healthcare 2.0 is about reducing federal healthcare spending so federal deficits appear to be going down to voters in the mid-term election (November 3, 2026). Healthcare, which represents 27% of federal spending is an attractive target since a significant majority of all voters (especially MAGA Republicans) are dissatisfied with its performance and think is wasteful and inefficient. It views healthcare as a market where less government, more private innovation achieves more.
- The effect of One Big Beautiful Bill Act cuts to Medicaid and marketplace subsidies and imposition of Make America Healthy Again dogma in CMS, CDC, FDA and FCC are popular in the MAGA base while problematic to states, hospitals, physicians and insurers whose business practices and clinical accountability will be more closely scrutinized.
- The federal courts—SCOTUS, 13 circuit and 94 district courts– will support Trump Healthcare 2.0 policy changes in their decisions favoring state authority over federal rules, enabling White House executive orders and administrative actions against challenges and departmental directives that encourage competition, price transparency and cost reduction.
- The FTC and DOJ will pro-actively pursue actions that reverse/disable collusion, horizontal and vertical consolidation in each sector deemed to raise prices and lower choices for consumers.
In the administration’s posturing for the mid-term election November 3,2026, it’s assumed the economy and prices will be THE major issues to voters: healthcare affordability, housing costs and food prices will get heightened attention as a result. Thus, every healthcare organization board and leadership team should revisit short and long-term strategies, since traditional lag indicators re: utilization, regulations, structure, roles, responsibilities and funding are decreasingly predictive of the future.
Though every organization is different, there are 6 takeaways that merit particular attention as C suites and Boards re-evaluate strategies and timing:
- Monitor the entire economy. The healthcare is 18% of the GDP; 82% of commerce falls outside its domain. Appropriations for healthcare compete with education, defense and public safety and health; household spending for healthcare competes with housing, food and transportation costs. The healthcare dollar is not insulated from competing priorities. If, as expected, the economy slows due to slowdowns in the job market and in housing, and if cuts to marketplace subsidies are enacted, healthcare spending will quickly and significantly drop though utilization will increase.
- Follow clinical innovations carefully. Understand bench to bedside obstacles. The FDA will authorize 50-60 novel drugs and biologics and over 100 AI-enabled devices this year. Some will fundamentally alter care management processes; all will change costs and pricing. Those with short-term cost-reduction potential require consideration first. Given increased margin pressures, capital and operating budgets will reflect a more cautious and risk averse posture.
- Manage fixed costs (more) aggressively and creatively. Direct costs reduction is not enough. Facilities and administrative functions are fair game and for outsourcing, partnerships and risk sharing with suppliers, vendors, advisors and even competitors.
- Don’t underestimate price transparency. Prices matter. Consumers and regulator demand for price transparency from drugmakers, hospitals and insurers are inescapable. Justification and verification will be critical to trust and utilization.
- Navigate AI strategically. The pace and effectiveness of Ai-enabled solutions will define winners and losers in each segment. And private capital—investors, partners—will bring those solutions to market.
- Don’t discount public opinion. Consumer sentiment about the economy is low and dissatisfaction with the health system is high and increasing. Understanding root causes and initiating process improvement are starting points.
As I head back to DC today, the FY26 federal budget is in suspense as the GOP-controlled Senate and House debate a final version to avoid a shutdown next week. Physicians, public health and state officials will digest last week’s ACIP vaccine advisory recommendations and issue their own directives and insurers will file their plan revisions for 2026. That’s what lawmakers and trade groups will be watching.
But at the kitchen tables in at least 40% of America’s households, unpaid healthcare bills from hospitals, labs, doctor offices and set-aside cash for over-the-counter remedies and prescription drug co-pays are on the agenda. Student loan payments, escalating costs for groceries, housing, rent and child care and an unstable employment market are squeezing families. Budgeting for healthcare is more problematic for them than anything else because price are not accessible and charges are not known until after services are performed.
Trump Healthcare 2.0 is not transformational: it is transactional. It aims to simplify the system and facilitate changes certain to disrupt the status quo. Its locus of control, is Main Street USA. not Pennsylvania Ave, in DC.
Paul
Sections in today’s report
- Quotables
- Corporate News
- Economy
- Hospitals
- Insurers
- Polling
- Prescription Drugs
- Public Health
Quotables
AEI on recursive AI: We’ve been here before—or at least we think we have. The machine age didn’t just give us steam engines—it produced child labor, dangerous urban factories, decades of worker agitation, and, out of that unrest, contributed to the rise of dangerous new ideologies like communism and fascism. Electrification remade cities but also displaced trades and reshaped social and economic rhythms. This is the pattern: change, uncertainty, social adaptation.
Most recently, robotic automation displaced millions of manufacturing workers, setting off new crises for non-college-educated workers in the US and abroad. Each leap forward solves problems and advances economic well-being, but also creates new, hard-to-predict frictions and challenges. So, it is likely to be in a world of recursive AI, which belongs in the lineage of transformational change, but with a critical difference: pace. Steam engines, electricity, and even the Internet, all took decades to diffuse fully. Recursive AI could collapse diffusion into years, leaving us precious little time to come to terms with it
The Coming Acceleration | American Enterprise Institute – AEI
On physician quality ratings usefulness: “The holy grail of quality ratings should be both specific—reflecting the clinician’s specialty or subspecialty—and rich, drawing on detailed insights from patient experiences and peer feedback. Such ratings must go beyond process metrics to capture real-world outcomes, communication, and trust.
There is a lot at stake in getting this right. As more organizations race to build and publish physician ratings, our health care system must ensure these ratings themselves meet high standards of validity, specificity, and relevance—so that families can make truly informed choices with confidence when it matters most.”
How Do We Choose Doctors? Patient, Parent, And Professional Perspectives | Health Affairs
Burda on compensation in healthcare relative to inflation: “Economists say one measure of the health of an industry is compensation. Are the people who work in the industry getting paid more or less than they were before? If it’s more, how much more (or less) than the change in the cost of living? That makes sense to me. Let’s compare compensation changes in healthcare according to various industry reports with the Consumer Price Index — better known as inflation — for 2024. According to the U.S. Bureau of Labor Statistics, it was 2.9% in 2024…. (after summarizing findings of 9 healthcare compensation reports) better to work in healthcare where almost all the compensation increases across industry sectors rose faster than inflation last year.
So, if compensation is one measure of an industry’s health, I’d say, based on the evidence, the healthcare industry is pretty healthy despite all coughing, sniffing and complaining. It’s why the Healthcare Industrial Complex is so difficult to uproot. Too many people make too much money to want to change anything for consumers. That’s why we need a customer resolution in healthcare now more than ever.”
4sightHealth.Burda_Healthcare_Compensation_Reports.9_16_25.pdf
Axios on Medicaid cuts: “Republicans’ sweeping Medicaid overhaul has left a lot of the heavy lifting to governors and state health officials as the program launches the biggest package of changes in its 60-year history…States working with hospitals, clinics and other providers will have to do more with less as they face about $1 trillion in program cuts and the likelihood of 10 million or more newly uninsured people from new work rules and other changes.
While the GOP views Medicaid as a waste-riddled program that’s due for a shakeup, the cuts will force painful tradeoffs at the local level as health systems also struggle with inflation, higher labor costs and rising medical costs….
Medicaid typically accounts for about 30% of a state’s budget each year. Spending goes up during tough economic times, and states are required to cover a set of mandatory benefits.
The biggest changes from the law will arrive in 2027. But states have already started planning for how they’ll implement work requirements, decide who’s eligible more frequently and cope with new restrictions on how they draw down federal funds. They’ll also be competing for $50 billion in rural health funding that Congress added to the law — a sum that’s been widely criticized as inadequate.”
Medicaid overhaul shifts tough choices to states
Corporate News of Significance to Healthcare from Last week’s Business News
- 5 companies that could hit $4 trillion in market cap: Nvidia and Microsoft hit the $4 trillion market cap milestone over the summer. Apple, Google, Amazon may join.Apple, Google and Amazon could hit $4 trillion market cap next
- Democrats in Congress are proposing legislation that would bar health insurers from buying medical practices through their subsidiaries and require them to separate their insurance and provider businesses. The bill is aimed at UnitedHealth Group. Democrats introduce bill that would force UnitedHealth breakup| STAT
- “Oracle just dropped a number so absurd it looked like a government budget line item: $455 billion in signed obligations, up 359% from last year. Wall Street spat out its coffee, the stock had its best day since 1992, and for one surreal afternoon…Ellison’s reinvention is built on substations and signatures, not software magic. Investors now talk about Oracle less like a cloud company and more like a utility with a console — one whose marquee tenant may or may not be OpenAI. The risks are real: one whale account, billions in capex, and a utility grid that may or may not keep up. But for now, Ellison has pulled off the rarest pivot in tech: not dazzling people into loving him, but boring them into needing him. “Quartz’s Shannon Carroll has more on the mogul who plugged back into relevance. Fed cuts to the chase
- Nvidia has agreed to buy a $5 billion stake (4%) in Intel, confirms the New York Times(Sept. 18), offering a major boost to its struggling rival while signaling the central role artificial intelligence (AI) is playing in reshaping the chip industry. The two companies will collaborate on chips for personal computers and data centers that combine Intel’s central processing units with Nvidia’s graphics processing units.
- Cigna’s $3.5 billion investment in Shields Health Solutions expands its presence in the specialty pharmacy market. Walgreens Boots Alliance broke out Shields Health Solutions into a standalone company in a transaction with private equity firm Sycamore Partners last month.
Economy
McKinsey on consumer sentiment: “Optimism has been steadily declining since November 2024. While pessimism has shown more volatility, it too has experienced a recent drop. Together, these shifts have driven net sentiment—the gap between optimism and pessimism—to a level 35% below its peak in November last year. Consumer optimism has been steadily declining since November 2024. While pessimism has shown more volatility, it too has experienced a recent drop. “
An update on US consumer sentiment | McKinsey
FICO score dropping: “The average FICO® Score decreased two points to 715 since 2024 due to increases in utilization and delinquency, including the resumption of student loan delinquency reporting. While the national average score dipped one point since April 2021, the median score rose five points since then due to a broadening of the score distribution…
The recent K-shaped economy has led to financial stress for some borrowers impacted by affordability concerns stemming from inflation and higher interest rates, while others have benefited from increases in their stock market portfolios and home price appreciation. Additionally, increased education and awareness of the importance of credit scores have helped consumers understand what they need to do to more effectively manage their credit.”
WSJ on Interest Rate Cut: “Whatever probability you put on recession a few weeks ago, it should be lower now that the Federal Reserve has cut interest rates.
The cut was just a quarter percentage point, to a range of 4% to 4.25%. Still, the mere fact of the cut and the likelihood of more to come show that the Fed is now prioritizing growth in a way that makes a recession much less likely.
Markets anticipated this.
Economic growth through the first half of this year had been sluggish. Then on Aug. 1 came news that job growth had slowed to a crawl as hiring dried up, the sort of thing that often comes at the start of a recession. Fresh jobs data on Sept. 5 painted an even more dismal picture, with the unemployment rate drifting up to 4.3%.
Yet since that first bad jobs report, the S&P 500 has risen 6%. That’s partly over enthusiasm about artificial intelligence. But AI can’t explain why the Russell 2000 index of small stocks has risen even more, by 11%. Those companies are more sensitive to the ups and downs of the economic cycle, suggesting that investors expect a pickup in consumer and business spending.
This isn’t because weak job growth is good for spending, but because investors correctly figured the Fed would shift priorities from inflation to jobs. As expectations of rate cuts grew, the benchmark 10-year Treasury note’s yield tumbled from 4.4% to just above 4%, and the two-year yield fell even more…”
The Fed Rolls Back Recession Risk – WSJ
Bank of America: Fund manager outlook: Highlights:
- Of the 196 fund managers surveyed, 67% see the Federal Reserve engineering a soft landing; 77% of fund managers, however, expect to see stagflation.
- 48% think AI stocks are not in a bubble, and 35% said companies should increase their capital expenditure, striking given that the Magnificent 7 companies alone are set to spend over $350 billion on AI.
- A record 58% of those surveyed say stocks are overvalued.
- 67% of respondents have 0% of their portfolios committed to crypto.
Stocks could rally another 50% in two years, BofA says
New York Times on College Educated Unemployed: When the federal government released its August employment numbers on Sept. 5, the overall unemployment rate was still relatively low, at just over 4%. But underneath was a concerning statistic: The portion of unemployed people who have been out of work for more than six months, which is considered “long-term,” rose to its highest share in over three years — to nearly 26%.
But just as surprising as the rise in long-term unemployment is the subset of workers who are increasingly driving it: the college educated. The fraction of long-term unemployed people with a college degree has grown from about one-fifth a decade ago to about one-third today… The problem has worsened over the past year or two after easing temporarily.
Economists cite a number of reasons for this trend. There are simply more college graduates today than there were 10 years ago, and the job market for people without college degrees improved, reducing their share of long-term unemployed.
But employers also appear to have less need for college-educated workers, driven by technological change, automation and, most recently, President Trump’s cuts to federal workers and funding, which have disproportionately affected the college educated
Employers’ need for college-educated workers appears to have slowed during the past decade or two, according to several studies by economists. Even before ChatGPT was released, applications like accounting software and earlier forms of artificial intelligence used in fields like finance and merchandise planning rendered some skilled workers obsolete. Data from Indeed, the job-seeking platform, shows that the portion of job advertisements requiring a college degree has dropped about 6% since 2019.”
The Long-Term Unemployed Today? College Grads. – The New York Times
Pitchbook on Economy: Venture Capital investing: “A dichotomy is developing across nearly all aspects of the VC landscape. Unicorns are launching IPOs at the fastest rate since 2021, but exits remain stunted. Large funds continue to dominate new commitments, yet fundraising is tracking for an eight-year low. For every slice of data in VC there is a line in the sand creating separate realities…
- Inflation continues to cool, albeit at a slower pace, as CPI has yet to reach the Fed’s 2% target.
- Measures of consumer sentiment have trended lower in 2025.
- Employers are likely shifting to a “low hire, low fire” mindset to keep overhead low but avoid the pain of the labor shortages seen in the post-pandemic era.
- Exit counts and values are recovering from their 2024 slump with trailing 6-month totals surpassing short-term trends but remaining suppressed compared with long-term trends.
- The weak IPO market and sluggish M&A activity are driving a difficult liquidity landscape for investors.
- Capital is increasingly concentrated among a handful of large platforms. The top 10 funds have accounted for 42.9% of commitments YTD, while emerging managers continue to face friction despite stabilizing after the ZIRP era.
- Compared with recent sectoral cycles, the scale of investment in AI is unprecedented…The 10 largest deals represent 41.2% of all VC activity.
- Within AI, horizontal platforms dominate deal value, far outpacing vertical applications and autonomous machines even as deal counts in those segments accelerate.
- High entry prices reshape venture outcomes: Early-stage deals carry higher risk but also greater upside, while in Series D+ deals, outcomes converge toward the median and exit hurdles become exceptionally large.
Q3 2025 Quantitative Perspectives: A Fork in the Road
WSJ on employment: “The number of Americans who newly filed for unemployment benefits declined sharply last week…returning the figures to the previous trend after a large spike the week before.
In the week through Sept. 13, jobless claims filings fell to 231,000, down from an upwardly revised 264,000 a week earlier…
Unemployment claims have been trending higher over the past month, culminating in an outsize jump in last week’s numbers. Part of that increase was due a rise in claims filed in Texas, which one report said included a flurry of fraudulent claims.
Still, there is broader evidence that the labor market is weakening across the country. Over the past three months, the economy has added fewer than 30,000 jobs a month on average, down from a rate well above 100,000 a month earlier this year. Unemployment remains modest but ticked higher to 4.3% in August.
U.S. Jobless Claims Fell Last Week – WSJ
Commerce Department Report: Housing: Key takeaways from the Commerce Department’s report released last Wednesday:
- Housing starts, a gauge of new residential construction, fell to 1.307 million in August from a marginally upwardly revised 1.429 million in July. Economists polled by The Wall Street Journal anticipated a higher 1.37 million starts. Starts were 6.0% lower than a year earlier.
- Residential permits, another measure of trends in housing construction, dropped to 1.312 million, from an upwardly revised 1.362 million in July. Economists expected 1.37 million.
- The decline in housing starts comes as builders’ sentiment held steady this month, the National Association of Home Builders said Tuesday.
Housing Starts Declined More Than Expected in August – WSJ
Hospitals
Fierce Healthcare on House Ways and Means hearing about nonprofit hospitals: “Nonprofit hospitals weathered a broadside of criticism on their use of tax benefits and exploitation of “anticompetitive” regulations and policies during a Tuesday afternoon House Ways and Means Oversight Subcommittee hearing. Testimonies given to the Republican-led committee covered a broad swath of grievances with limited or conditional support for tax-exempt hospitals…
Academics specializing in economics and health policy research, meanwhile, highlighted for the subcommittee their work estimating over $37 billion in annual tax-exemption benefits and urban hospitals double-dipping into rural hospital designations.
Both of these groups of witnesses were in agreement that the current community benefit reporting requirements for nonprofit hospitals are insufficient. Nonprofits don’t have a clear definition of a community benefit under statute, they said, and no requirements to spell out specific spending items in mandatory IRS forms means there’s limited measurable evidence of organizations’ positive outcomes for their communities.
Almost across the board, the Republicans agreed with the accusations of misdirected spending and backed increased transparency and reporting requirements as a fix.
The American Hospital Association (AHA), in a statement submitted to the subcommittee, pointed to recent data it released outlining nearly $150 billion in total community benefit reported by nonprofit hospitals to the IRS in 2022—a tally the industry’s critics typically pan for including spending on areas like medical research and training for which hospitals are often compensated. The AHA’s statement argued that keeping those requirements flexible is essential and that limiting the measurements to direct financial assistance misses hospitals’ work in tailoring their expenditures to the needs of their communities.
“Any suggestion that the IRS should both define and evaluate community benefit clearly misses the point,” the hospital lobby wrote. “Community benefit can only be fairly judged by those in the community for which the benefits accrue.”
Nonprofit hospitals’ community benefits face lawmaker scrutiny
Insurers
American Community Survey: Coverage: “The national rate of uninsured hit 8.2% in 2024, up from 7.9% in 2023. The uninsured rate for all ages increased in 18 states and the District of Columbia and declined in two states from 2023 to 2024; for adults, it rose in 17 states and declined in 3 states between 2023 and 2024. Nine states currently have a total uninsured rate (including children) of over 10%. In 2024, the uninsured rate ranged from a low of 2.8% in Massachusetts to a high of 16.7% in Texas.”
Health Insurance Coverage by State: 2023 and 2024
CBO: ACA Subsidy Extension cost analysis: Per the Congressional Budget Office analysis, extending’ subsidies for ACA health plans permanent would cost about $350B over a decade.
“The expiration of the enhanced credits will affect many middle-income Marketplace enrollees as well those with low incomes, some of whom could see major out-of-pocket premium increases. With the enhanced tax credits, enrollees earning over 400% of poverty ($106,600 for a family of three in 2026) will not spend more than 8.5% of their incomes on out-of-pocket premiums for benchmark plans. Without the enhanced tax credits, these same enrollees will experience a “double whammy” in cost increases, not only losing all financial assistance available through the premium tax credits but also needing to cover the premium increases Marketplace insurers are planning for next year.”
Note: In July, the nonpartisan Congressional Budget Office estimated 10 million people will become uninsured and the healthcare industry will lose $1.1 trillion as a result of the Big Beautiful Bill Act signed July 4 by President Trump.
Calculating Marketplace Enrollees’ Possible Cost Increases (KFF)
Study: Medicaid cut impact on hospitals in Medicaid expansion states: The Commonwealth Fund analysis found that hospitals in the 41 expansion states could see their operating margins decrease by 0.4 to 0.5 percentage point, or a drop of -11.7% to -13.3%. Hardest hit: safety-net and rural hospitals.
Commonwealth fund www.commonwealthfund.org
Polling
NORC-U of Chicago: Opinions about country direction: The nationwide poll of 1183 US adults was conducted September 11-15, 2025:
“Since June, the share of adults who say the country is on the wrong track increased 13 percentage points from 62% to 75%. The shift occurred primarily among Republicans. In June, 29% of Republicans said the country was heading in the wrong direction. That number is now 51%. The vast majority of Democrats have felt the country is headed in the wrong direction since Donald Trump won the election in 2024.
Among Republicans, there are notable differences by age and gender: those under 45 are more likely than older Republicans (61% vs 43%) to say the country is off track, and Republican women are more likely than men (60% vs 43%) to share that view.”
Pessimism about the direction of the country is growing among Republicans – AP-NORC September 19, 2025
Wash U survey: Opinions about mental health access: “Rates of mental health conditions are increasing, yet only about one-half of people with a mental health condition and less than one-quarter with a substance use disorder (SUD) received treatment in 2023. We conducted a national internet-based survey of US adults (January 17 to February 12, 2025) through Qualtrics…Results:
Of 1442 participants, 849 (58.9%) were female, and 292 (20.3%) had annual household income less than $25 000. In unadjusted weighted estimates, 72.64% supported policies to expand access to community services, and most participants supported policies to expand access to peer-led services. We found no evidence that levels of support differed between Republicans and Democrats.”
EBRI Report: Worker access to mental health services: Per the Employee Benefits Research Institute survey of 3100 U.S. workers between the ages of 20 and 74:
- More than one in four workers (27%) reported they or someone on their health plan has a mental health condition. These individuals were more likely to be between 25 and 54 years old, more often married with children, and more often employed at smaller firms.
- People are struggling to get care – especially mental health care.
- Emergency room use is high: Nearly two-thirds (62%) of respondents with a mental health condition visited the ER in the past six months. They were 50% more likely than those who did not report a mental health condition to use emergency care, twice as likely to visit the emergency department three times, and four times as likely to visit four times in a six-month period.
- Anxiety, depression, ADHD are most common: Anxiety (17%), depression, (11%) and attention-deficit/hyperactivity disorder (ADHD) (8%) were the most frequently reported conditions.
– https://www.ebri.org/employeespathforwardreport.)
Prescription Drugs
Study: Efficacy of 25 mg dose of oral semaglutide: U of Chicago researchers conducted a 71-week, double-blind, randomized, placebo-controlled trial conducted at 22 sites in four countries involving 205 persons without diabetes who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 30 or higher or a BMI of 27 or higher with at least one obesity-related complication. Results:
A total of 205 participants were randomly assigned to receive oral semaglutide, and 102 to receive placebo. The estimated mean change in body weight from baseline to week 64 was −13.6% in the oral semaglutide group and −2.2% in the placebo group (estimated difference, −11.4 percentage points; 95% confidence interval, −13.9 to −9.0; P<0.001). Participants in the oral semaglutide group were significantly more likely than those in the placebo group to have body-weight reductions of 5% or more, 10% or more, 15% or more, and 20% or more (P<0.001 for all comparisons) and to have an improved IWQOL-Lite-CT Physical Function score (P<0.001). Gastrointestinal adverse events were more common with oral semaglutide than with placebo (74.0% vs. 42.2%).
Oral semaglutide at a dose of 25 mg once daily resulted in a greater mean reduction in body weight than placebo in participants with overweight or obesity. (Funded by Novo Nordisk; OASIS 4 ClinicalTrials.gov number, NCT05564117.)
STAT: U.K. drug companies standoff with regulators: The U.K.’s life sciences ecosystem is reeling as AstraZeneca, Merck, Eli Lilly, and Sanofi collectively pause billions in planned R&D investments. They cite an inhospitable business climate and collapsing drug pricing talks with the National Health Service,
Two reasons why the U.K. is no longer a destination for pharma investment | STAT
Public Health
Study: Mortality trends for non-communicable diseases (NCD): Researchers analyzed quantify how much NCD mortality changed from 2010 to 2019 in 185 countries. Findings:
“From 2010 to 2019, the probability of dying from an NCD between birth and age 80 years decreased in 152 (82%) of 185 countries for females and in 147 (79%) countries for males; it increased in the remaining 33 (18%) countries for females and 38 (21%) countries for males… NCD mortality declined in all high-income western countries, with Denmark experiencing the largest decline for both sexes and the USA experiencing the smallest decline… Circulatory diseases were the greatest contributors to declines in NCD mortality from 2010 to 2019 in most countries, with some cancers (eg, stomach and colorectal cancers for both sexes, cervical and breast cancers for females, and lung and prostate cancers for males) also contributing towards lower NCD mortality in 2019 than in 2010 in many countries.
From 2010 to 2019, NCD mortality declined in four of every five countries in the world. These improvements were not as large as the preceding decade for most countries, driven by smaller declines in mortality from multiple NCDs.”
Note: The probability of dying from a non-communicable disease actually increased for U.S. adults ages 20 to 45.
New York Times on Supplemental Nutrition Assistance Program (SNAP): “President Trump’s sweeping domestic policy law fundamentally alters how food stamps are funded, leaving states to bear some of the cost for the first time in six decades.
The move all but ensures that states across the country will adopt a patchwork of policies for a crucial aspect of the social safety net. Whether they can find the money in their budgets — estimated, in some cases, to surpass a billion dollars — will have wide-ranging, and likely uneven, consequences for some 42 million people who participate in the.
Some states warn that the entire program is at risk of being eliminated if legislatures cannot come up with their share. Others are weighing whether to impose additional state taxes or cut costs elsewhere in their budgets. And some are considering imposing barriers that will all but certainly reduce the number of recipients on their rolls.
Under the new law, states are required to cover 5% to 15% of food stamp benefits beginning in 2028 if their error rate in administering benefits exceeds 6%. Higher error rates result in higher cost shares, though the states with the highest rates are given more time to comply. Based on rates from the 2024 fiscal year, all but eight states would be required to pay for benefits.
Altogether, the Congressional Budget Office estimated that states would contribute about $35 billion toward benefits from 2028 to 2034. Coupled with another provision increasing states’ portion of administrative expenses from 50%to 75%, two-thirds of states will have their share of annual SNAP costs increase by $100 million or more, based on the latest error rates, according to one estimate...”
States Grapple With Fundamental Change in Food Stamps – The New York Times
Study: Association between BMI and cancer screenings: “Given the disproportionate increase in obesity severity and its known health disparities, we examined whether worsening obesity severity is associated with lower cancer screening rates.” Results:
“This cross-sectional study found that severe obesity was associated with a lower prevalence of some guideline-recommended cancer screenings. While mammography prevalence also declined with increases in BMI, the difference was not significant, which is concerning with rapid rises in severe obesity. In contrast, comparable or slightly higher screening rates were associated with BMI 30.0 to 39.9 vs the reference, possibly due to greater health care engagement with fewer barriers (eg, mobility limitations, inadequate equipment, weight stigma) than observed with severe obesity. The quality of some tests, particularly mammography, may also decline with greater body size due to technical limitations, further discouraging participation. The association of FOBT with increased BMI possibly reflects the accessibility of home-based testing, though reliance on FOBT alone is concerning without follow-up colonoscopy…These findings highlight the need for targeted, equity-focused strategies to improve cancer screening access among individuals with obesity.
