Last week, the Trump administration took dead aim at the health system on multiple fronts:
Wednesday: The DOJ widened its attack on medical school admissions policies asserting the Yale School of Medicine discriminated against white and Asian applicants in favor of Hispanic and Black applicants despite (alleged) lower test scores. Previously, DOJ had challenged the UCLA Geffen School of Medicine and the administration promises others.
Also Wednesday, Vice President Vance announced a new Anti-Fraud Task Force aimed at Medicare, Medicaid and other health programs. Its initial target is Medicaid Fraud Control Units (MFCUs) in each state with special focus on autism care, at-home rehabilitation, non-emergency medical transports, and night supervision coverage. The administration is also withholding federal appropriations for state Medicaid programs beginning in MN and CA.
And CMS made 4 significant announcements through the week:
- May 12: Healthcare Advisory Committee first meeting: “The Committee will advise HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz on ways to improve how care is financed and delivered across Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace.”
- May 13: Electronic Prior Authorization early adopters: “The Centers for Medicare & Medicaid Services (CMS), through its Health Tech Ecosystem, is advancing its electronic prior authorization efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements. 29 healthcare organizations—including health systems, electronic health record developers, physician practices, networks, and digital health developers—have signed on as early adopters in this cross-sector effort.”
- May 13: Nationwide hospice/home health enrollment 6-month moratoria: “In coordination with Vice President JD Vance’s Anti-Fraud Task Force, the Centers for Medicare & Medicaid Services (CMS) is taking decisive action to protect Medicare beneficiaries and taxpayer dollars through implementation of a six-month, nationwide data-driven moratoria on new Medicare enrollment for hospices and home health agencies (HHAs). “
- May 15: 2027 ACA Exchange Final Rule: “The Centers for Medicare & Medicaid Services (CMS) issued a sweeping rule to strengthen oversight of the Affordable Care Act (ACA) Exchanges for plan year 2027 by lowering user fees, tightening eligibility verification, and giving states greater authority over plan oversight.”
These actions are consistent with the administration’s growing disdain for the healthcare industry as the mid-term election nears. Its gleeful rebuke of two-term Louisiana Republican Senator Bill Cassidy’s primary defeat Saturday a case in point: Cassidy chaired the Senate HELP committee and clashed with HHS Director RF Kennedy Jr. over MAHA initiatives like vaccine policies. A physician, he practiced gastroenterology with a specialty in hepatology (liver disease) before entering politics and was frequently differed with the administration’s health policies.
The administration’s antagonism toward the health system is understandable in the context of core beliefs held by its core MAGA voters:
- Economic: MAGA voters believe the $5.6 trillion U.S. health system is expensive, self-serving and rife with fraud. They support a private system, believing government intervention harmful and more regulation unnecessary. They believe government healthcare programs—Medicare and Medicaid—are necessary but inefficient and poorly run. The MAGA core opposes additional government spending on healthcare and sees many of its programs as ‘welfare’—especially Medicaid and CHIP.
- Political: Polling indicates the majority of Americans (including a super-majority of MAGA voters) believe the health system is fundamentally flawed and in need of significant improvement in affordability, accessibility and transparency. The majority of all voters believes corporatization in the health insurance, prescription drug and hospital sectors directly responsible for unnecessarily higher costs and lower quality, pay attention to executive compensation and consider fraud rampant across the system. The MAGA core share these views with the larger majority, blaming Democrats and the Affordable Care Act for fundamental flaws. And MAGA core antipathy toward healthcare is a significant factor in state politics where consolidation, Medicaid work requirements, abortion services, health cost containment councils, drug price controls and price transparency issues are top of mind to legislators and voters.
The industry is on the defensive. Insurers, hospitals, home care and prescription drug sectors are considered complicit in the system’s failings.
The industry’s aware, but to date, its defense of the status quo has been ineffective. Its primary response has been a blame game against offending sectors, over-regulation and macro-economic pressures while buying time even as voter discontent grows.
My take:
U.S. healthcare’s future is uncertain because its major players are not coordinated in a meaningful response to its systemic issues. It’s easier for hospitals to blame insurers and economic conditions for higher labor costs and inadequate reimbursement. It’s easier for insurers to blame hospitals and drug companies for high costs and it’s easier for elected officials to cut programs in the name of fraud and waste than address underlying need.
As the mid-term election nears and anxiety about affordability dominates voter attention, healthcare’s role in federal, state and local economies and affordability will be front and center. The attention the industry gets will be unflattering. MAGA voters will welcome it.
Paul
P.S. The “quotables” section in today’s report is especially rich in views pertinent to the industry’s future.
Resources in addition to citations below
Trump Nemesis Sen. Bill Cassidy Defeated in GOP Primary – WSJ
CMS healthcare fraud push draws caution from hospitals, insurers – Modern Healthcare
He Was Convicted for Defrauding the Government. Now Medicaid Pays His Wife Millions.
With a Friend in Trump, the Tobacco Industry Secures a Lucrative Win – The New York Times
UnitedHealth’s Optum Rx to shift PBM model in transparency push – Modern Healthcare
Inflation Soared to 3.8% in April, Driven by Gasoline Prices – WSJ
U.S. Schools Face a Crisis as the Number of Children Drops – The New York Times
Sections in today’s report
- Quotables
- Economy
- Hospitals
- Physicians
- Polling
- Prescription Drugs
- Public Health
Quotables
Pearl on health system transformation: “In the 1960s, the United States accelerated its space program out of fear of falling behind the Soviets. Today, private companies are investing billions in space because the financial upside is enormous.
In both cases, leaders didn’t take on extraordinary risk simply because it was the right thing to do. Instead, moonshots of the past have happened for two reasons: great fear or great reward.
Healthcare may now be approaching a similar point. A recent Gallup survey found that 61% of U.S. adults worry “a great deal” about the availability and affordability of care, surpassing the economy as the nation’s top concern for the first time in over a decade.
Patients, employers and public programs are feeling the strain of rising premiums and drug prices. The frustration is real. Voter anger is mounting. The question is whether the upcoming midterms will scare elected officials into attempting a healthcare moonshot. “
Monthly Musings on Healthcare, Robert Pearl, MD May 2026 app.flashissue.com/newsletters/fe98994a1e12fe15bc46d1e73fc4f186a11eccd4
Bill Cassidy on La. Senate primary loss Saturday “When you participate in democracy, sometimes it doesn’t turn out the way you want it to. But you don’t pout. You don’t whine. You don’t claim that an election was stolen from you. And if someone doesn’t understand that and attempts to control others through using the levers of power, they’re about serving themselves, they’re not about serving us. And that person is not qualified to be a leader.”
Cassidy Loses Senate Primary in Louisiana, as Trump Vanquishes G.O.P. Foe – The New York Times
Frist on built environment and healthcare: “For decades, healthcare has treated nature and the built environment as external variables. Increasingly, science suggests they are part of the healthcare system itself.
The future of public health may depend not only on what happens inside hospitals, but also on what happens outside them — in the roads we design, the air we breathe, the water we protect, and the ecosystems we choose to preserve.”
The Overlooked Connections Between Infrastructure, Nature and Public Health
Rodney on system focus: “People don’t take proactive action on their health because they don’t think the data pertains to them. It’s abstract. It’s someone else’s risk profile. But when you hand someone their own genomic data, their own biomarkers, their own inflammatory profile, people act. Knowing changes behavior.
And here’s a signal of hope: Americans want this. 65% of consumers want a system built around prevention, not treatment (PwC/Harris). 69% would pay to know their biological age. We’ve entered what I’ve been calling the era of the “Medical Main Character” — where people want to be protagonists of their own health story, not passengers…. the guessing era of healthcare is ending. The knowing era is beginning. The science is catching up to the demand. And the headlines are completely missing it…”
(13) Cancer in 2035: The Golden Age Nobody’s Talking About
Rosiak on Medicaid fraud: “288 “home health” companies operating out of just 7 mostly empty buildings. They have billed taxpayers over $250 MILLION from 2018-2024, according to long-secret government payment data made public by DOGE. Offices are totally vacant, or unoccupied with signs proclaiming “out to lunch,” but stacks of months-old mail prove nobody has been in for a long time. Meanwhile these Medicaid home health businesses, many founded and operated by immigrants, are billing the government for non-medical services like “companionship” and “conversation.” With explosive growth in billing and little oversight, this shocking investigative series reveals how weak rules in Ohio’s expanded Medicaid program allowed massive waste and abuse. Families, taxpayers, and real patients lose out.”
The $1 Billion Medicaid Scam Hiding in Plain Sight
MedPage on HHS Vacancies: “When the week began, several senior positions at HHS were already sitting empty.
There was no Senate-confirmed U.S. surgeon general. The head of the NIH was doubling as the acting head of the CDC. The FDA lacked a permanent vaccine chief after that official was ousted for a second time in a year.
Then on Tuesday Marty Makary, MD, MPH, resigned as head of the FDA, leaving another major health agency with only an acting commissioner. Makary’s departure widens a leadership gap that has plagued HHS throughout Health Secretary Robert F. Kennedy Jr.’s tenure.
Across a vast and multilayered government, in which many leadership positions must be confirmed by a Senate that shares only a narrow partisan majority with the administration, it’s typical for some roles to remain unfilled or be occupied by interim leaders. But critics say the level of upheaval in the current HHS is unusual and the lack of scientific expertise among its leadership is concerning.”
Makary’s Resignation Expands Leadership Void at Health Department | MedPage Today
Ravi, Keith on state cost controls: “As patients are confronted with rising health care costs, many may choose to forgo or delay critical care. Despite the United States spending more in health care than any other country, nearly half of American adults’ express difficulty in affording care. Higher prices for hospital care contribute to this affordability crisis and are in part driven by hospital anti-competitive behavior, such as market consolidation and lopsided contract terms. Ultimately, higher health care costs, including hospital costs, are borne by patients, employers, and taxpayers—and serve as barriers to care that can result in poorer health outcomes and greater income inequality.
To help limit health care costs, eight states—California, Connecticut, Delaware, Massachusetts, New Jersey, Oregon, Rhode Island, and Washington—have implemented health care cost-growth benchmarks… While cost-growth benchmarks have had mixed results to date and faced some criticism for being “largely insufficient to contain spending growth” based on existing state experiences, several other states have signaled interest in enacting cost-growth benchmark legislation.”
New York Times on population education: “Something troubling is happening in U.S. education.
Almost everywhere in America, students are performing worse than their peers were 10 years ago, according to new, district-level test score data released Wednesday by the Educational Opportunity Project at Stanford.
Compared with a decade earlier, reading scores were down last year in 83% of school districts where data was available. Math scores were down in 70%. The declines have affected both rich and poor districts, and crossed racial and geographic divides.”
Why U.S. Test Scores Are in a ‘Generation-Long Decline’ – The New York Times
Axios on marketplace coverage: “Sweeping changes that congressional Republicans made to the Affordable Care Act and Medicaid are starting to take effect, fueling an election-year blame game over coverage losses.
Driving the news: The changes are hitting home, with about 1.2 million fewer people signed up for ACA coverage compared with a year ago, following Congress’ refusal to extend enhanced subsidies.
By the numbers: Wakely Consulting Group found that 14% of enrollees did not pay their first ACA premium in January. It estimated that 2026 enrollment will end up being 17% to 26% lower than last year.
Insurers in some states are reporting drops in enrollment as high as 20% to 30%, while other states are stepping in to offer additional financial help to limit the losses, according to an insurance industry source.”
Axios Vitals May 12, 2026
Sussman on decreasing fertility rates: “The collective reluctance to procreate is perhaps most glaring in the Nordic countries… The same downward trend held in the United States, where births have fallen by about 23% since 2007, despite high rates of immigration until last year. Births have also been declining in East Asian countries, even though governments in the region have thrown buckets of money at the problem. And in France, despite its longstanding pronatalist policies.
This is not simply a matter of affordability, the buzzword so often invoked to explain why people are choosing to have smaller families. Government support for parents can help, but overall, people are having fewer children both in countries that offer very little and in those renowned for their generous family benefits; moreover, the trend holds among those who are struggling to make ends meet and among those who, like the Riveras, have advanced degrees and salaried jobs. What unites these disparate cultures, policy environments and demographics, researchers are now realizing, is young people’s inescapable and crushing sense that the future is too uncertain for the lifelong commitment of parenthood. Call it the vibes theory of demographic decline.”
WSJ on nurse practitioners: “These days, heading to the doctor’s office often doesn’t involve a doctor. At least not directly. Instead, nurse practitioners have become major gap fillers, growing their ranks by 60% to 461,000 between 2019 and 2025, data from the American Association of Nurse Practitioners show.
Physician assistants who can fill similar roles are also in high demand, as are other non-MD health providers. They are all part of a broader trend to push basic care beyond the doctor’s office. In many states, for example, pharmacists now prescribe medications such as contraceptives and flu treatments.
This shift has sparked some controversy: Doctors’ groups say there is danger in deploying people who don’t undergo the rigor of medical school and residency to do unsupervised doctor-level work. These groups have tried to stop states from changing rules to widen the market for NPs and PAs, as the other professions are known.
But the graying population frequently demands more care than doctors can provide. The number of doctors the U.S. can add a year is limited by available residency slots, and many newly minted MDs often bypass primary care in favor of higher-paying specialties. The U.S. is currently facing a shortage of 16,000 primary-care physicians, according to an analysis by the nonprofit KFF, which researches healthcare policy, and projections show the shortage is likely to dramatically worsen.
Healthcare workers such as NPs and PAs often plug these holes. And they can be money-savers.
Nurse practitioners make an average income of $132,000 a year, according to federal data. That is a lucrative step-up from registered nurses, who make an average $98,000, but also far below the $257,000 average for primary-care doctors…
Meanwhile, Peterson’s two-year nurse practitioner program cost around $50,000, a fraction of what she would have spent on medical school. By contrast, the average medical-school graduate leaves with $207,000 in debt. The less-grueling training made it easier to plan and raise a family, said Peterson, who like most NPs received her bachelor of science in nursing before going on to get her advanced degree.
Patients in rural areas, in particular, have come to rely on nurse practitioners. According to federal data, 66% of rural Medicare recipients say they see a nurse practitioner or physician assistant for some or all of their medical care, compared with the 54% of urban residents who say the same. “
Nurse Practitioner Is Now the Hottest Job in Healthcare – WSJ
Economy
BLS: CPI for April: The Consumer Price Index (All items) rose 3.8% in the 12 months through April, up from 3.3% in March and the highest since 2023. On a monthly basis, CPI gained 0.6%, slowing from the 0.9% increase in March, the first full month of the war.
Core CPI, which excludes food and energy prices, was more benign even as it continued to accelerate. The gauge advanced 2.8% in the year ending in April–up from 2.6% in March. For the month, it increased 0.4%, up from the 0.2% gain in March.
Energy accounted for more than 40% of CPI’s monthly rise, even as prices rose more slowly than in March, the government said. Energy costs surged roughly 4% after an 11% gain the prior month. Food prices also soared in April: Grocery prices rose 0.5%, while dining out costs gained 0.7%. Both are the biggest monthly surges since the end of 2025.
The medical care index decreased 0.1% in April, after falling 0.2% in March. The index for hospital services decreased 0.3% over the month. Conversely, the physicians’ services index increased 0.6% over the month while the prescription drugs index was unchanged in April.
| 4/25 v 4/26 | |
| All Items | +3.8% |
| All items less food & energy | +3.3% |
| Medical care commodities | -0.5% |
| Medical care services | +3.2% |
| Physician Services | +2.6% |
| Hospital Services | +5.5% |
Note: Healthcare accounts for 8.34% of the CPI (physicians 1.67%, hospitals 2.17%, commodities 1.45%, other) vs shelter 35.32%, food 13.56%, energy 7.09%
CPI Home : U.S. Bureau of Labor Statistics
Goldman Sachs on economic outlook: “We see three reasons why the 10-week closure of the Strait of Hormuz has hurt global growth only moderately so far. First, oil prices have not risen as much as expected… Second, physical shortages in areas such as jet fuel have so far been met with relatively painless forms of demand destruction…Third, fiscal policy, the AI boom, and—with a brief interruption in March—financial conditions have been supportive all year. Under our baseline assumption of a gradual Strait reopening that starts soon and finishes in late June, we see Brent prices stable in the near term and edging down to $90/barrel by year-end. However, the risks remain tilted toward more adverse outcomes, higher oil prices, and greater economic damage.”
Related: The growing dominance of a handful of giant stocks in major indexes doesn’t automatically make markets more volatile or suggest that companies are overvalued—but it does create underappreciated risks for investors…”The weight of the top 10 stocks in the S&P 500 has risen sharply over the past decade: They now account for 36.5% (up from 18.5% in 2015) of the index by market capitalization.”
Financial Times on Climate for Private Equity Deals: “Private equity dealmaking slowed sharply in early 2026, underscoring a more cautious market tone. Buyout volumes dropped 36% quarter over quarter to $172 billion, the Financial Times reports, as geopolitical tensions and uncertainty around AI’s impact weigh on investor confidence. Firms are holding off on deals, particularly in the software industry, where executives fear AI will disrupt business models. Several industry leaders expect these concerns to further dampen investment appetite, reinforcing a broader shift toward selectivity and delayed deployment.”
Financial Times https://www.ft.com/content
Men in the workforce: “The American labor market is tilting away from men. Over the past year, nearly all net job growth has come from healthcare and social assistance, a sector with a dearth of men. Sectors with heavily male workforces have been losing jobs. The post pandemic period has seen an influx of women in their prime working years into employment. The share of men working has flatlined.
Friday, the Labor Department reported the overall unemployment rate stayed steady at 4.3%. Unemployment rates for men and for women weren’t all that different from each other—4.4% vs 4.2%, respectively—just as they weren’t before the pandemic…
Among men age 16 and over, the employment-to-population ratio was 64.1% in April. That compared with an average of 66.6% in 2019, and 70.9% in the 1990s. A lot of that decline can be explained by an aging population: There are a lot more male retirees than there used to be.
The share of women working has always been lower than men, but it has held up much better despite an aging population. Women’s employment-to-population ratio came to 54.5% in April, a bit below its 2019 and 1990s averages.”
Men Are Losing Out in the Changing Job Market – WSJ
WSJ on MBA programs: “One of America’s most expensive graduate degrees is going on sale. More business schools are giving steep discounts on tuition that can save students up to 50%, or tens of thousands of dollars a year.
Applications to U.S. business schools slumped last fall, and many international students, worried about tighter visa restrictions, are opting for schools closer to home…
The number of graduate students in management who received financial assistance has been soaring. A decade ago, it was 48% and in 2025 it was 62%, according to the Graduate Management Admission Council, a nonprofit that tracks application trends.
Merit-based scholarships for business-school students is also on the rise, GMAC data shows, at 47% of incoming students last year, up from 32% a decade earlier.”
There Is a Fire Sale on M.B.A.s – WSJ
New York Federal Reserve Report on Student Loan Default: “Millions of borrowers are defaulting on their student loans, and they are nearly 40 years old on average. That is nearly 2½ years older than the profile of a student-loan defaulter before the pandemic… Borrowers 50 and older are now at higher risk of default than younger borrowers.
Since a pandemic-era pause on student-loan repayments ended in 2023, the federal government has been pushing people to start repaying their loans. In the fourth quarter of last year, those who failed to restart payments began defaulting, meaning they hit 270 days past due on their payments. The New York Fed estimated that more than 3.5 million people defaulted between October and March.
Nearly 40% of those with auto loans are past due, 56% with at least one credit card are past due and 20% with a mortgage are past due. Loan delinquencies have been broadly trending higher.”
The Average Student-Loan Defaulter Is Nearly 40 Years Old – WSJ
Hospitals
KLAS: Epic increases EHR market share: Smaller health systems and midsize standalone hospitals drove the increase, with the vendor adding nearly 50 customers from these categories. Epic in 2025 expanded its acute-care hospital market share to 44%, compared with 42% the previous year. The company added 18,679 acute-care beds last year, growing its market share to 57% compared with 55% in 2024.
Oracle Health saw a decline in market share for the third year in a row, with most of its departing customers leaving for its competitor Epic. Oracle’s market share of acute-care hospitals was 22% in 2025, compared with 23% the year before. It lost 14,676 acute-care beds in 2025, bringing its market share down to 20% from 22%.
Meditech’s 2025 market share of acute-care hospitals and acute-care beds stayed largely flat from 2024 at 15% and 13%, respectively. The company lost 1,015 beds in 2025.
KLAS Research https://klasresearch.com/report/2026-best-in-klas-awards-software-and-services
Physicians
Kaiser Permanente Report: Physician Exiting profession: “A sample of clinically inactive physicians drawn from American Medical Association Physician Professional Data™ completed a survey between May and June 2024, with questions assessing demographics, education, clinical training, and reasons for leaving clinical practice. In addition to standard descriptive statistics, gender differences were also explored. Results:
Among the 971 respondents included in the analysis, the majority (63.9%) identified as women, the mean age was 45.8 years, and 11.0% had never practiced after graduate medical education. The physicians who left practice reported “hassle factor” (44.7%) and “too stressful” (44.5%) as prime motivators for their departure. Physicians who were women were more likely than men to have exited due to needing to care for family members (7.9% vs 0.6%, P < .001) or children (21.3% vs 4.2%, P < .001). The mean age of physicians who left clinical practice was 48.1 years, 9 years younger than observed in a similar cohort in 2008.”
Why Have All the Doctors Gone? Insights Into Early Clinical Departure Among Physicians in the United States: A National Survey https://www.thepermanentejournal.org/doi/10.7812/TPP/25.219
PAI-Avalere: Key Findings about Physician Employment Trends 2018-2025
82.0% physicians were employed by hospitals or corporate entities such as private equity firms or health insurers as of January 1, 2026.
- 7% of physicians were employed by hospitals; 22.3% were employed by corporate entities.
- The percentage of employed physicians grew by 5.6% from 2024-2026, largely due to hospitals.
253,000 additional physicians became employees of hospitals or corporate entities from January 2018 to January 2026; 48,100 additional physicians were employed between 2024 and 2026.
- 181,200 additional physicians became hospital employees over the eight-year period: 44,000 from 2024-2026.
- 71,800 additional physicians became corporate employees over the eight-year period.
Corporate physician employment leveled off in 2023-2025 but hit a new peak in 2026.
- 152,200 fewer physicians were operating independently over the eight-year period: 23,900 of the shift occurred from 2024-2026.
Hospitals and other corporate entities acquired 85,000 additional physician practices from 2018-2026, totaling 157,200 (63.9%). Almost 13,900 practices were acquired from 2024-2026, increasing by 9.7%. Corporate ownership (33.2%) continued to outweigh hospital ownership (30.6%).
- Hospitals acquired 32,800 additional physician practices over the eight-year period: 5,800 of these acquisitions occurred from 2024-2026.
- Corporate entities acquired 52,300 additional physician practices over the eight-year period: Only 8,000 acquisitions occurred from 2024-2026, moderating from January 2022.
20260424_PAI Physician Employment Acquisition Trends_Summary_vFINAL.docx
Polling
CNN Poll on costs of living: “CNN’s poll, conducted by SSRS, finds a surge in people naming high prices and the cost of living as the top economic problem facing their family. Strong majorities are pessimistic about the economy as a whole — almost 7 in 10 believe a recession is likely in the next year — and about their own ability to cover expenses and make purchases.
Those negative feelings about the economy, with major political implications for the midterms, reflect the strain across economic, generational and partisan lines on Americans’ everyday lives. Many people are trimming their grocery lists and cutting back spending on extras, and few feel comfortably able to save…
A widening wealth gap in the United States has insulated the overall economy from a downturn. …But averages don’t tell the full story: Middle-income and lower-income Americans’ wages stopped outpacing inflation last year. That’s left many Americans in a sour mood about their financial prospects.”
Cost of living: 76% of Americans say their biggest financial problem is higher prices | CNN Politics
Harris Thought Leadership Practice Toxic Boss Survey: Based on online survey results from 1,334 employed U.S. adults:
- 6 out of 10 workers said they currently have a toxic boss. Meanwhile, 70% say they’ve had a toxic boss at some point in their career. This rises to 75% for LGBTQIA+ workers.
- 47% say their boss’s bad behavior is stressing them out, burning them out, or causing their mental health to slide downhill.
- 66% say they’ve responded to toxic bosses by trying to meet their demands — working on weekends and on days off.
- 53% have gone to therapy over their toxic boss.
- 73% of workers have pushed back against a toxic boss.
6 in 10 workers say they have a toxic boss, study finds – Fast Company
Gallup on value of education: “Only one in four adults without a college degree (25%) believe most people can access a quality, affordable education. This is the lowest level recorded since 2022 and a drop of 10 points in just two years. Even so, nearly three in four adults without a degree (73%) say earning a credential is just as important today as it was 20 years ago.
The 2026 State of Higher Education Study surveyed more than 14,000 adults without a degree or who are working toward one, nearly 6,000 college graduates, and 2,000 employers. Across all three groups, the research shows a growing gap. Americans still believe higher education is worth it, but more people are questioning whether they can afford it.”
Gallup-Lumina State of Higher Education
Prescription Drugs
NYT on pancreatic cancer drug: “Pancreatic cancer is one of the most dire diagnoses in medicine. There are few available treatments, and they do little to help. For decades, experimental drugs flopped in trials. Many researchers believed the biological obstacles could not be surmounted.
In what seems the blink of an eye, all that has changed. A drug nearing regulatory approval, daraxonrasib, is the first to substantially extend the lives of patients with pancreatic cancer. It works by targeting a cellular protein that fuels not just nearly all pancreatic tumors, but also many lung and colon cancers. Those three are the leading causes of cancer deaths.
Now, some scientists predict that the approach could wind up being the most significant advance in cancer treatment in 15 years, since the arrival of immunotherapy.
The long scientific journey that led to the drug is a triumph of both public and private research funding, succeeding only after decades of false starts and dashed hopes — and the unraveling of conventional wisdom that turned out to be completely wrong.”
How an ‘Impossible’ Idea Led to a Pancreatic Cancer Breakthrough – The New York Times
Study: MFN Pricing for GLP-1s in Medicare:: “For this economic evaluation, we used a nationally representative, validated Diabetes, Obesity, Cardiovascular Disease microsimulation model.2 We estimated that 30 million Medicare Part D beneficiaries, including both current and those aging into eligibility, would meet clinical criteria for obesity treatment (body mass index [BMI; calculated as weight in kilograms divided by height in meters squared], ≥30; or ≥27 with 1 or more comorbidity).1 Individuals with diabetes or cardiovascular disease (CVD), who are already covered for GLP-1RAs in Medicare, were excluded from this analysis. Our estimates suggest that the reduced MFN price of GLP-1RAs and accompanying coverage for obesity treatment in Medicare will likely increase drug spending, with only partial offsets from downstream health care savings. Although our model did not project achieving net savings at announced MFN prices of $245 per month over 10 years, cost neutrality could be achievable at substantially lower prices (eg, $150/mo). Higher long-term adherence increases cumulative net spending because weight loss benefits plateau while medication costs persist. Most GLP-1RAs expenditures also accrue beyond the initiation year as maintenance therapy. These projections suggest that alternative strategies to sustain weight loss and cardiometabolic benefits may warrant evaluation, including dose or frequency reduction, transition to lower-cost pharmacotherapies, and structured behavioral or nutrition programs.5 However, pragmatic trials are needed to determine the effectiveness of alternative weight maintenance strategies.
Policy uncertainty remains substantial. The legal authority to implement MFN pricing and its interaction with the Inflation Reduction Act’s Medicare Maximum Fair Price (MFP) framework remain unresolved. MFN prices, anticipated in 2026, may supersede the scheduled MFP for semaglutide ($274/mo) in 2027, but litigation or administrative revisions are possible. Moreover, the durability of the MFN policy depends on manufacturer responses, global pricing dynamics, and opaque international rebates.
A major limitation is that our estimates exclude costs associated with additional clinical visits and laboratory monitoring often needed during GLP-1RAs initiation and follow-up,6 which would further increase net spending and lower the drug price at which cost neutrality might be achieved. More evidence is needed on the effects of GLP-1RAs on health care utilization, particularly among obesity-only populations using second-generation GLP-1RAs.”
Public Health
WHO declares ebola public health emergency: “The World Health Organization declared late Saturday that the spread of the Ebola virus in the Democratic Republic of Congo and Uganda was a global health emergency, a day after Africa’s leading public health authority first announced an outbreak in a province in northeastern Congo linked to dozens of suspected deaths.
By Saturday, cases had also been confirmed in Kinshasa, Congo, and in Kampala, Uganda, the capital cities of each country, the W.H.O. said. In Congo’s Ituri Province, where the outbreak was first identified, 246 suspected cases and 80 deaths attributed to the virus had been reported, although only eight cases had been definitively linked to the virus through laboratory testing.
The spread of the outbreak to the capitals of Congo and Uganda could pose a challenge for public health workers because infectious diseases can spread more rapidly in dense urban settings. Ebola is transmitted through direct contact with the bodily fluids of an infected person, putting family members and caregivers at particular risk.”
W.H.O. Declares Ebola Outbreak a Global Health Emergency – The New York Times
CDC: Overdoes deaths: Drug overdose deaths declined almost 14% nationwide in 2025, falling in almost every state, according to provisional data the CDC released yesterday.
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.
Pew Research on suicide: “May is Mental Health Awareness Month, a time to elevate the needs of the millions of Americans who have a mental health condition. The term refers to a wide range of conditions that affect mood, thinking, and behavior, which can cause distress and problems functioning in social, work, and family activities. This year, the awareness month arrives with sobering news: The U.S. mortality data published by the Centers for Disease Control and Prevention (CDC) revealed that suicide has replaced COVID-19 as the country’s 10th leading cause of death.
Almost 49,000 people died by suicide in 2024, the most recent year for which data is available. That year, an additional 14.3 million adults (age 18 and older) seriously thought about suicide, 4.6 million adults made a suicide plan, and 2.2 million attempted suicide. An estimated 2.8 million adolescents (ages 12 to 17) had serious thoughts of suicide, made suicide plans, or attempted suicide.”
CDC on flu vaccination rates in post-acute care: Flu vaccination rates are higher for nursing home residents than they are for the healthcare professionals caring for them, the CDC’s latest report indicates. The CDC found that across facility types, nursing home residents were less likely to be vaccinated than similarly aged people in the general population (75.6%). Medicaid-certified facilities were the only exception, with vaccination rates resembling those of the same age. Meanwhile, healthcare professionals caring for residents had even lower vaccination rates (45.4%), although independent practitioners, students, trainees, and volunteers reported comparatively higher rates. Overall, healthcare professionals in nursing home settings were less likely to be vaccinated than those in acute care settings (80.7%), suggesting that targeted education for nursing home staff and their residents may be an important lever for protecting this vulnerable population.
MMWR April 23, 2026 https://www.cdc.gov/mmwr/volumes/75/wr
Stat on alcoholism: “It is a drug that kills nearly 500 Americans every day, and causes more deaths in a typical year than every infectious disease combined…
Of 178,000 deaths that occur each year from alcohol, roughly one-third are from causes like car crashes and alcohol poisoning. The rest are from cancer, heart disease, liver failure, and other chronic conditions that result from sustained heavy drinking. As far as drugs are concerned, alcohol’s toll is only outpaced by the prolonged damage of tobacco.
But though the U.S. has dramatically cut tobacco use, it has never made a serious effort to curb alcohol-related harms other than in the infamous era of Prohibition. Over twice as many Americans consumed alcohol in 2024 than used tobacco products, federal estimates suggest.
Alcohol is a leading preventable cause of cancer similar to obesity and tobacco. Researchers have estimated that if Americans who drink consumed only one alcoholic beverage per day, it could avert 17,450 cases of cancer each year. Addressing problem drinking is one of the best ways to save more lives for less money, according to the World Health Organization.”
The Deadliest Drug: STAT examines America’s hidden alcohol epidemic | STAT
