MTT #101: From measles outbreaks to GLP-1 hype, the data every patient should know

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl examine a wide range of stories shaping American health. From new research on the lifesaving effects of health insurance to troubling vaccine policy changes in Washington, this episode offers an objective and insightful look at what’s working, what’s failing and what lies ahead.

The show opens with a study that functions as a natural experiment on health coverage. When the IRS sent letters warning uninsured Americans about Affordable Care Act penalties, researchers found a striking result: those who signed up for insurance had significantly lower mortality over the next two years. For Dr. Pearl, the takeaway is clear. As political battles over insurance subsidies begin, the stakes are measured in lives saved and lives lost.

From there, the hosts turn to the second round of Medicare drug price negotiations under the Inflation Reduction Act. Cuts as large as 85% will save billions of dollars, but Pearl warns that negotiating prices alone cannot fix America’s drug-pricing problem. The root issue, he notes, is the ability of manufacturers to extend monopolies for years through patent thickets, evergreening and litigation strategies that delay competition. Until those practices change, the United States will continue paying far more than any other nation.

Here are more pressing stories from this month’s episode of Medicine: The Truth:

• Expiring ACA subsidies: Enhanced marketplace subsidies for 24 million Americans are scheduled to sunset, threatening large premium hikes.
• Private insurance costs: Covering a family of four now averages $27,000 per year. Employers may shift even more of the burden onto employees.
• U.S. health spending vs peer nations: America spends nearly $14,000 per person on healthcare, far above any comparable nation, yet underinvests in preventing and managing chronic disease complications.
• Measles resurgence: Falling vaccination rates and permissive school exemptions have made measles endemic again, with outbreaks in multiple states.
• Biosimilars and insulin pricing: The FDA plans to streamline biosimilar approvals by focusing on molecular similarity rather than repeated clinical trials.
• COVID infections during pregnancy: A Massachusetts study of nearly 18,000 births found higher rates of neurodevelopmental diagnoses in children whose mothers had COVID while pregnant.
• Social media and mental health: In a small study, young adults who reduced daily social media use from two hours to 30 minutes saw sharp drops in anxiety and depression.
• Obesity trends and GLP-1s: New Gallup data show adult obesity declining slightly from 40% to 37% since 2022, with the largest gains among women ages 40 to 64 (a popular demographic for drugs like Ozempic).
• Estrogen therapy reconsidered: The FDA has removed its black box warning from estrogen-containing products after new evidence showed substantial cardiovascular, bone and cognitive benefits when started near menopause.

As the episode continues, Dr. Pearl highlights fascinating findings on peanut allergies and preterm birth disparities, looks at the likelihood of a severe flu season with the new H3N2 strain and a stern warning about the politicization of vaccine decisions.

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Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.

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