November 21, 2024
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Morning Rounds Writer and Podcast Producer

Good morning, I'm back! And I can barely believe all the news that happened while I was away. On vacation, my biggest concern was a broken milkshake machine at a highway McDonald's. Why are they always broken??

(Addendum: Editors know things! Mine just sent me this story in the Verge about an update to the "right to repair" issues that have long plagued McDonald's franchise owners and their machines.)

exclusive

RFK Jr. explores a GOP proposal to overturn how doctors are paid

People close to Robert F. Kennedy Jr. are exploring a proposal that would reduce the role of the American Medical Association in determining what Medicare pays for medical services, four sources familiar with the process told STAT’s Rachel Cohrs Zhang. The AMA runs a panel of doctors that make recommendations to Medicare about how much services should cost. The proposal, which is still in early stages, would wrest this influence away from the main physician lobby. 

It’s not a new idea — such proposals have been periodically raised by Republicans for the past two decades, but haven’t ever been implemented. RFK Jr., who is President-elect Trump’s pick for Secretary of Health and Human Services, has decried the influence of big business in health care. He’s also sparred with the AMA in the past over his views on vaccines.

Read the scoop from Rachel. And in other RFK Jr. news, don't miss the Pharmalot View from STAT's Ed Silverman on how trying to unravel the relationship between the FDA and industry could actually Make America Sick Again.


one big number

23%

That’s the percentage of U.S. adults under age 65 who had health insurance all year in 2024, but were considered underinsured — meaning the coverage didn’t actually give them access to affordable health care, based on their income and out-of-pocket costs and premiums. The statistic comes from a nationally representative survey from the Commonwealth Fund. Nearly three in 10 working-age adults had medical debt, the report also found, with rates highest among those who were underinsured. Two-thirds of underinsured people got their health coverage from their employers. 

“Having health insurance doesn’t always mean access to affordable, timely care,” Joseph Betancourt, a physician and president of the Commonwealth Fund, said in a media briefing yesterday. The rate of people who are uninsured is at a “historic low,” Betancourt said, but still “too many Americans are struggling to afford the care they need.” If you want to get into the nitty gritty of hospitals and health care costs, make sure to subscribe to Bob Herman’s weekly Health Care Inc. newsletter.


social media

Science Twitter migrates to Bluesky

A decade ago, science was entering its “extremely online era,” as STAT’s Katie Palmer puts it. Academics who were traditionally siloed in niche fields were gaining unprecedented followings on Twitter. Now, Twitter is called X, and many of those scientists are leaving the site for Bluesky, a similar social media platform founded by former Twitter CEO Jack Dorsey. It’s hard to say exactly how many people have made the switch, but overall accounts on Bluesky surpassed 20 million this week, including many of X’s top-followed science, medicine, and health policy accounts. 

“Folks have said we need to stay [on X] because if we all leave, then it's all going to be misinformation,” microbiologist and research sleuth Elisabeth Bik told Katie. “But at some point, the pendulum swung the other way.” Read more about who’s making moves, who isn’t, and what it means for science communication going forward.



science

Needles are out, squid jets are in

IBRAHIM CHALHOUB/AFP via Getty Images 

Figuring out the best way to deliver drugs to patients involves weighing tradeoffs. Methods like IVs are great at getting a medication into someone’s blood stream, but require both time and a trained clinician. Pills and other oral methods are easier to use, but don’t always work as well. Now a group of bioengineers hopes to shake up the cast of drug delivery options with a device that draws inspiration from squids, octopuses, and other sea creatures.    

The blueberry-sized device can be swallowed to deliver orally drugs that would normally have to be injected through a needle. It then uses jets, modeled after the organs that squids and other cephalopods use to propel themselves through the water and to release ink, to eject drugs into the tissue lining the digestive tract. It’s an innovative idea for the simple goal of making it easier for patients to receive medication. STAT’s Anil Oza has more on the device and the results so far.  


reproductive health

Study shows: Endometriosis tied to earlier deaths

A growing body of evidence has shown that endometriosis (where tissue like that from the inside of the uterus grows on its outside) and uterine fibroids are linked to an increased risk of long-term chronic disease. A study published yesterday in The BMJ provides evidence for a more extreme potential link: Among more than 110,000 cisgender women, endometriosis was associated with a 31% higher risk of death before age 70, primarily driven by gynecological cancers. Uterine fibroids were also associated with higher risk of death specifically from gynecological cancers. 

Researchers analyzed data from nurses who participated in a survey study that ran from 1989- 2019. Participants were between the ages of 25 and 42 at the beginning of the study, and every couple years reported diagnoses of endometriosis or uterine fibroids. The authors noted that most participants were white, but believed that the large population and long-term results were still useful. 


across the pond

U.K. says cheerio to disposable vapes

The U.K. is moving to ban disposable vapes starting next summer, STAT’s Drew Joseph reports from London. It’s part of a broader policy push that will prevent anyone who is currently age 15 or younger from ever being able to buy tobacco products, with the aim of creating what the government has dubbed a “smoke-free U.K.” 

The phaseout is stronger action than anything we’ve seen here in the U.S., where thousands of vapes are widely available even though the vast majority are technically illegal, not having received the regulatory authorization that any e-cigarettes for purchase are meant to have. It’s an example of how the two countries have diverged in their approaches to e-cigarettes — and their views of the threats and potential benefits that accompany the products. Read more from Drew.


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What we're reading

  • Trump promises clean tap water. Will he clean up 'forever chemicals?' New York Times

  • It took years for my Black son to be diagnosed with cystic fibrosis. Then it happened to my family again, STAT
  • What happened to Nashville's Center for Reproductive Health? The Cut
  • Don’t expect RFK Jr. and Dr. Oz to get much done on prevention and wellness, STAT

Thanks for reading! More tomorrow,