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A Proud Republican Who Faced Off A Party Leader. . .and Won!

By MIKE MAGEE

This past week, Trump’s posting of himself as The Pope surfaced once again David French’s classic Christmas, 2024, New York Times column titled “Why Are So Many Christians So Cruel?”

As I wrote at the time, “French and his wife and three children have experienced the cruelty first hand since he openly expressed his opposition to Donald Trump during the 2016 Presidential campaign. That resulted in threats to his entire family by white supremacists who especially targeted his adopted Ethiopian daughter. Ultimately, he was “cancelled” by his own denomination, the small (approximately 400,000 members), Calvinist “Presbyterian Church of America”.

Over the past week, American politicians of every stripe have debated what exactly was Trump’s motive in debasing the Papacy as Pope Francis was being laid to rest. Three main theories have emerged. 

1.      As a malignant narcissist, Trump could not bear the fact that Pope Francis was stealing his limelight.

2.      Trump was appealing to conservative Christian Evangelicals who are strongly opposed to the Papacy on theological grounds.

3.      Trump was appealing to conservative Catholics like New York Post columnist Charles Gasparino who says, “… we respect Trump more than the socialist Pope.” 

Of course, there likely are elements of truth in each of these. But I prefer to fall back on my New York City high school training and believe that this is the product of a dull witted school yard bully who thought this was funny. 

This is not to say he has the courage to claim ownership. (Obviously this doesn’t get posted without his approval.) No. He lies to your face, saying:

“I had nothing to do with it, Somebody made up a picture of me dressed like the pope, and they put it out on the internet. That’s not me that did it, I have no idea where it came from — maybe it was A.I. But I have no idea where it came from.” 

With his blessing, the image was posted at 10:29 PM on May 02, 2025 on his Truth Social account.

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Medicaid Should be Abolished. But Not Like This!

By MATTHEW HOLT

A long time ago in a different country, there was a landslide election from a population looking for change. And change they got. Americans had been campaigning for national health care since 1917. There had been failures in 1933 and 1946 and 1961. But in 1965 they got it. Sort of.

But a weird thing happened in the Congress. Out of the political sausage making came a plan that “Cared” for those over 65. While another plan came out that “Aid”ed the poor. (Stole that from the wonderful Adimika Arthur). Weirder still, the Medicare program was and is a Federally-funded program. The Medicaid program was a state-administered program, even though it was at least half funded by the Feds. 

That meant that Medicaid was always vulnerable to the whims of states. Of course many states already had demonstrated dismal records in how they treated their poorer and minority populations in the past (think slavery, Jim Crow, KKK, separate schools, drinking fountains, buses…you get the idea).

So while Medicare became the savior program for anyone who made it to 65, and later for those who were disabled or had kidney disease, Medicaid was a program for poor people that then got treated poorly. (Stole that from Jonathan Cohn). And right now in 2025 it is under severe threat yet again.

Before we get to that threat, it’s worth looking at the program. Medicaid has evolved and now covers most nursing home care (for “poor” seniors), care for the disabled, and even pays Medicare Part B premiums for people too poor to pay their own.  It also covers health insurance for poor people under 65 and in those states that accepted ACA Medicaid expansion, that’s a considerable number. Of course these are people under an imaginary line that makes them too poor to buy on the exchanges set up by the ACA. And usually Medicaid includes the CHIP program, an insurance program that covers poor children set up under Clinton in 1997.

This chart from the venerable KFF shows that while 75% of people on Medicaid are, poor, under 65, and not classified as disabled, 50% of the money goes to those who are not.

This all results in a bizarro world in which there is one Federal government program for people over 65 and the disabled, and then an entirely different state-based one, which spends 1/2 of its money on people who are over 65 and disabled and who are also in the Federal program. This is plain stupid and always has been.

Of course there is more to it than that.

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Welcome to the (U.S. Science) Apocalypse

By KIM BELLARD

I’m starting to feel like I’m beating a dead horse, having already written a couple times recently about the Trump Administration’s attacks on science, but the hits just keep on coming. Last Friday, for example, not only did the Administration’s proposed 2026 budget slash National Science Foundation (NSF) funding by over 50%, but Nature reported that the NSF was ceasing not only making new grants but also paying out on existing grants.

Then this week, at an event called “Choose Europe for Science,” European leaders announced a 500 million euro ($566 million) program to attract scientists. It wasn’t specifically targeted at U.S. scientists, but the context was pretty clear.

Sudip Parikh, chief executive officer of the American Association for the Advancement of Science, called the proposed budget cuts “a crisis, just a catastrophe for U.S. science.” Even if Congress doesn’t go along with such draconian cuts and grant approval resumes, Dr. Parikh warns: “That’s created this paralysis that I think is hurting us already.” 

One NSF staffer fears: “This country’s status as the global leader in science and innovation is seemingly hanging by a thread at this point.”

Nature obtained an internal NSF April 30 email that told staff members “stop awarding all funding actions until further notice.” Researchers can continue to spend money they’ve already received but new money for those existing or for new grants are frozen “until further notice.” Staff members had already been told to screen grant proposals for “topics or activities that may not be in alignment with agency priorities.”

NPR reports that some 344 previously approved grants were terminated as a result, as they “were not aligned with agency priorities.” One staffer told Nature that the policy had the potential for “Orwellian overreach,” and another warned: “They are butchering the gold standard merit review process that was established at NSF over decades.” Yet another staffer told Samantha Michaels of Mother Jones that the freeze is “a slow-moving apocalypse…In effect, every NSF grant right now is canceled.”

No wonder that NSF’s director, Sethuraman Panchanathan, resigned last week, simply saying: “I believe I have done all I can.” 

If you think, oh, who cares? We still have plenty of innovative private companies investing in research, so who needs the government to fund research, then you might want to consider this: new research from American University estimates that even a 25% drop in federal support for R&D would reduce the U.S. GDP by 3.8% in the long term. And these aren’t one-time hits. “It is going to be a decline forever,” said Ignacio González, one of the study’s authors. “The U.S. economy is going to be smaller.”  

If you don’t believe AU, then maybe you’ll believe the Federal Reserve Bank of Dallas, which estimates that government investments in research and development accounted for at least a fifth of U.S. productivity growth since World War II. “If you look at a long period of time, a lot of our increase in living standards seems to be coming from public investment in scientific research,” Andrew Fieldhouse, a Texas A&M economist and an author of the Dallas Fed study, told The New York Times. “The rates of return are just really high.”

It’s no wonder, then, that European leaders see an opportunity.

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League Connect Digital Summit is WEDNESDAY

It’s Matthew Holt and I am looking forward to MC-ing the #LeagueConnectDigitalSummit THIS Wednesday May 7.

This one-day virtual event brings together leaders across health care, tech, and consumer experience to explore what it really takes to deliver personalized, digital-first, AI-powered care. I’ll be guiding the day’s key transitions and themes. There’s also strategy & implementation tracks with the likes of Google, Highmark Health, Accenture, Amwell, Deloitte, SCAN, Gainwell Technologies Health, and startups like SimpliFed, Healthily, Linus Health and so many more.

Join me and League for a FREE day of conversations, connection, and actionable insights that move health care forward. 

Oh, yes and Moneyball, The Blind Side and Liar’s Poker author Michael Lewis is the keynote.

Register here

Glen Tullman, Transcarent

A couple of weeks back Transcarent completed its $630m acquisition of Accolade. But CEO Glen Tullman calls it a merger for a reason because Accolade brings people, products and clients that Transcarent didn’t have. Glen got in deep about Transcarent’s new product set in terms of its AI fueled navigation, primary care, weight management, cancer care and partnerships. Where is it going in terms of more with employers (yes!), Medicare (not yet) and aggressive expansion of services? And what can employers and their employees expect in terms of improving customer service from the health care system? Glen and his team have a big vision, big capital backing, and he is definitely intending to move the needle on care access, quality and cost.–Matthew Holt

Dr. Google Starts Sharing Regular Folks’ Advice As Chatbots Loom

By MICHAEL MILLENSON

“Dr. Google,” the nickname for the search engine that answers hundreds of millions of health questions every day, has begun including advice from the general public in some of its answers. The “What People Suggest” feature, presented as a response to user demand, comes at a pivotal point for traditional web search amid the growing popularity of artificial intelligence-enabled chatbots such as ChatGPT.

The new feature, currently available only to U.S. mobile users, is populated with content culled, analyzed and filtered from online discussions at sites such as Reddit, Quora and X. Though Google says the information will be “credible and relevant,” an obvious concern is whether an algorithm whose raw material is online opinion could end up as a global super-spreader of misinformation that’s wrong or even dangerous. What happens if someone is searching for alternative treatments for cancer or wondering whether vitamin A can prevent measles?

In a wide-ranging interview, I posed those and other questions to Dr. Michael Howell, Google’s chief clinical officer. Howell explained why Google initiated the feature and how the company intends to ensure its helpfulness and accuracy. Although he framed the feature within the context of the company’s long-standing mission to “organize the world’s information and make it universally accessible and useful,” the increasing competitive pressure on Google Search in the artificial intelligence era, particularly for a topic that generates billions of dollars in Search-related revenue from sponsored links and ads, hovered inescapably in the background.

Weeding Out Harm

Howell joined Google in 2017 from University of Chicago Medicine, where he served as chief quality officer. Before that, he was a rising star at the Harvard system thanks to his work as both researcher and front-lines leader in using the science of health care delivery to improve care quality and safety. When Howell speaks of consumer searches related to chronic conditions like diabetes and asthma or more serious issues such as blood clots in the lung – he’s a pulmonologist and intensivist – he does so with the passion of a patient care veteran and someone who’s served as a resource when illness strikes friends and family.

“People want authoritative information, but they also want the lived experience of other people,” Howell said. “We want to help them find that information as easily as possible.”

He added, “It’s a mistake to say that the only thing we should do to help people find high-quality information is to weed out misinformation. Think about making a garden. If all you did was weed things, you’d have a patch of dirt.”

That’s true, but it’s also true that if you do a poor job of weeding, the weeds that remain can harm or even kill your plants. And the stakes involved in weeding out bad health information and helping good advice flourish are far higher than in horticulture.

Google’s weeder wielding work starts with digging out those who shouldn’t see the feature in the first place. Even for U.S. mobile users, the target of the initial rollout, not every query will prompt a What People Suggest response. The information has to be judged helpful and safe.

If someone’s looking for answers about a heart attack, for example, the feature doesn’t trigger, since it could be an emergency situation.

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Tom Knight, HealthcareDiversion.org

Tom Knight is the Chairman of HealthcareDiversion.org, a nonprofit that is trying to educate about the topic of drug theft from facilities. This happens both because medical professionals are addicts (and victims themselves) and also because of organized crime and resale. The consequences are awful, with patients receiving water instead of analgesic drugs, getting infections and often dying. And of course there’s a lot of liability and problems for those facilities when these issues are found out. What’s worse is that this problem is rampant. Tom has built a database to show just the tip of the iceberg of the problem. So come on a journey to a terrible health care problem you’ve never thought of that almost certainly affects you–Matthew Holt

To Beat Parkinson’s, You Must Stand on Your Head

By WOJCIECH WASILEWSKI

Dear Reader, if you’re looking for something soft and easy, please buy a different book. This one isn’t here to comfort you — it’s here to shake your lazy world, to shock you, to drag you out of the same lethargy I was trapped in for years after being diagnosed. If you feel anger, rebellion, or even a surge of motivation while reading, then it was worth writing this book, each and every hour. Parkinson’s isn’t polite — and I won’t be either. This is my war manifesto against Parkinson’s.

Throughout this book, I use the word “Parkinson” as shorthand for Parkinson’s disease, not as a reference to James Parkinson, the doctor who first described it. If that feels like an oversimplification — I apologize. But trust me, it’s the least important thing here.

People today are searching for real stories — not textbook definitions, sterile medical jargon, or sugar-coated tales of suffering. You won’t find any of that here. What you’ll find instead is something far more valuable: the truth. Raw, unfiltered, sometimes brutal, sometimes even vulgar. Why? Because that’s what this disease really is. That’s the kind of relentless fight you’ll need if you don’t want Parkinson’s to steal your life, piece by piece. I’m not afraid of that fight — and this is exactly what this book is about. I want you to stop being afraid and to believe you can get into this fight too.

This is not a scientific book. I’m not a doctor. I don’t have a PhD. I’m not an “expert” who appears on morning TV. I’m just a patient — like you. Someone who heard the diagnosis and, instead of quietly accepting it and waiting for the end, chose to fight back. And the most important part? After years of struggle, I’m living proof that it can be done. This isn’t theory — it’s my sweat, my pain, my setbacks, and my comebacks. If you want to read the story of someone who curses Parkinson’s out loud every day and refuses to let it win — you’re in the right place.

If you want to hear the voice of someone who tests every possible method to claw back one more day of normal life from this disease, someone who isn’t afraid to speak the truth and take risks — this book is for you. This is my declaration of war on Parkinson’s. And if you’re ready to join me in this fight — come on board. Because to live well with Parkinson’s, you have to completely change your lifestyle. That’s exactly what this book is about.

PARKINSON’S AFFECTS THE YOUNG

I’m talking to you — the person who typed into Google: “Parkinson’s and physical activity,” “diet and Parkinson’s,” “how to stop Parkinson’s,” “can you recover from Parkinson’s,” or “can young people get Parkinson’s.” If you’ve landed here, you’re searching for answers. I’m no miracle worker. I don’t have magic pills or secret formulas. I do have something better though — real strategies that work for me. Not just for me.

This isn’t an academic thesis. This is a battle guide. A survival manual. It’s about resisting this disease, outsmarting it, slowing it down, exhausting it. It’s about clawing back one more day of normal life — and doing it all over again tomorrow.

You know what annoys me the most? That the majority of people still think Parkinson’s is a disease of old men sitting on benches outside their apartment buildings. That’s just not true. More and more young people — people who should have their whole lives ahead of them — are being diagnosed. And then what? Fear. Panic. The crushing feeling that everything is over. Doctors rarely have time to explain what’s really going on. And the internet? It hits you with nightmare scenarios — videos of people shaking so violently they can’t even lift a spoon. Nevertheless, that’s not the full truth about Parkinson’s.

For younger people, Parkinson’s is a completely different fight — a different tempo, a different pressure, a different kind of war. They are the ones who this book is for. For people in their 30s, 40s, and 50s, with families, careers, dreams, and plans — all of which Parkinson’s is trying to rip away. We don’t have to let it happen. We can fight back.

WORDS OF CRITICISM FOR THE CRITICS

I can already hear the noise — the mocking, the scoffing, the eye-rolling. Critics saying there’s no scientific proof, that maybe something did work for me but won’t work for anyone else, that it’s all clichés and empty words. Maybe my Parkinson’s is ‘defective,’ they’ll say. Or maybe I don’t even have it. Or I just got lucky and ended up with the soft version — you know, Parkinson’s Lite.

To all the critics who will claim that nothing in this book works, I have only one thing to say: Keep on clucking.

When I first decided to fight Parkinson’s, my condition was declining fast. I had muscle rigidity. I could barely walk. My left arm didn’t swing. I felt that heavy-leg fatigue, and my tremors were intense. I passed out twice — both times collapsing in the bathroom. Then I underwent the FUS procedure, and it significantly reduced the tremor in my left hand. That was the moment I realized I had to change my life. And so began a slow but powerful transformation.

I HAVEN’T WON THE WAR

Let’s be clear, dear Reader: I haven’t won the war against Parkinson’s — not even close. Writing this book, after working full-time as an analyst for eight hours a day, takes a toll on me. Sitting at the computer for hours temporarily worsens my symptoms. Just this morning, I woke up in pain — arms, legs, back, everything.

And what did I do? First I went for a light three-kilometer run. Next I took a freezing cold shower. Then I had a healthy breakfast. These simple steps and just like that — my body came back to life.

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Bloom is Off the Rose at UnitedHealth Group

By JEFF GOLDSMITH

A Forty Year Growth Saga is Coming to an End

After market close Wednesday April 16, UnitedHealth Group reported its First Quarter 2025 earnings. UNH missed their expected 1Q earnings by 9 cents a share, but the firm also lowered its full year 2025 earnings estimate by 12%. On Thursday opening, investors reacted with an unbridled fury, and stripped UNH of more than a hundred billion in market capitalization in a matter of hours. In the glare of hindsight, UNH was priced for perfection at a pre-crash trailing Price Earnings ratio of 38, six points higher than Amazon and eight points higher than Microsoft, which might account for the savagery of the correction.

Definitive answers to the question–what is happening to United’s sprawling mass of businesses–are impossible because the company is an $400 billion black box. The main United businesses–health insurance, care delivery, pharmacy benefits management and business intelligence/services–are so intertwined with one another that only United CFO John Rex and a few other senior managers actually know from whence United’s earnings actually flow. What follows is some speculation on the root causes of United’s earnings problem.

First, a major driver of the last two decades of United’s earnings growth has been using a big chunk of its astonishing monthly cash flow (which was approaching $3 billion a month) buying other companies. This party might be over. United has historically spent about half their accumulated wealth on dividends and share buybacks, that is, paying off shareholders to remain shareholders.

However, a big and undisclosed contributor to UNH earnings growth has been acquisitions, which have occurred in a nearly unbroken string for forty years. From 2019 to 2023, United spent an astonishing $118 billion buying other companies, nearly all of which ended up in Optum. Thanks to great discipline by UNH Executive Chair Stephen Hemsley and CFO-now-President John Rex, United almost invariably bought profitable firms in transactions that were accretive to earnings.

United appears to be running out of accretive transactions. With the dearth of major new transactions, United’s $81+ billion horde of cash and short term investments (larger than Exxon Mobil) is likely to plump up yet more. This will cause folks to wonder why United is raising their rates to employers or shaking down providers for deeper discounts when they are sitting on a growing mountain of cash.

United cannot buy more health insurers (both CIGNA and Humana been for sale for years) because federal antitrust enforcers will stop them. There are no more accretive risk-bearing physician group deals. Hospitals presently employ more than a third of practicing physicians in the US (a very unhappy state affairs for both parties). But these hospital acquisitions have limited the universe of available physician transactions for United.

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Pope Francis Links to Scalia on Due Process: The Case Made by a Skadden Litigator

By MIKE MAGEE 

The Pope’s passing interrupted an epic battle between Trump and the rest of the civilized world over whether America remains a society “under the law.” Critical to the rule of law is the principle of “Due Process,” as described in not one, but two Amendments to our Constitution. 

The Fifth Amendment states that no inhabitant shall be “deprived of life, liberty or property without due process of law.” 

The Fourteenth Amendment, ratified after the Civil War and Emancipation, uses the same eleven words, called the “Due Process Clause,” to describe a legal obligation of all states. 

In arrogantly ignoring any pretense of “Due Process” last week by deporting accused (but not proven) alleged gang member Kilmar Abrego Garcia to an El Salvador top security prison along with 220 others, and ignoring a court order to return the planes while still in flight, Trump basically thumbed his nose at America’s legal system. This was a bridge too far, even for some of his political supporters in Congress. 

With that case still in litigation, the Administration tried to repeat the publicity stunt with another group of accused aliens this past weekend and was slapped down by the Supreme Court in an unanimous decision. 

What Trump is learning the hard way is that without “Due Process” the law profession might as well hang up its shingle. Trump thought he had Chief Justice Roberts in his pocket when he purposefully allowed himself to be caught on a hot mic as he passed the Chief Justice on his way to deliver the 2025 State of the Union Address. His words for the camera, “Thank you again. Thank you again. Won’t forget it.”  were intended to signal to the world, He owes me big time, and I own him. 

A common “Due Process” thread connecting these two current events (the Pope’s death and the illegal deportation of Kilmar Albrego Garcia)  includes another Supreme Court Justice – Antonio Scalia. Catholic and trained by Jesuits, he shared a common lineage with Pope Francis, the first Jesuit ever to lead the Catholic Church. Other Justices also share this Jesuit educational parentage including Clarence Thomas, Brett Kavanaugh, and Neil Gorsuch. 

But Francis and Antonin have a second historical connection. Pope Francis, the day before the 2025 State of the Union address, publicly labeled the immigration policies of the incoming President and Vice President, “a disgrace.” More recently, the Vatican spoke out in opposition to last weeks El Salvador imprisonments. Part of criticism tracks back to the lack of “Due Process.” 

Glaringly obvious today, this was just one arm of an aggressive Project 2025 campaign against America’s Legal Profession. By late March, multiple DC based law firms pledged allegiance to the Trump Administration to avoid being barred from entering Federal buildings to represent their clients. Some members of the targeted firms resisted. For example, Skadden associate, Rachel Cohen, resigned from her firm in protest, stating, “It does just all come around to, is this industry going to be silent when the president operates outside the balance of the law, or is it not?” 

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