Delete Your DNA and Eat a Steak
This month’s episode of “News You Can Use” on HealthcareNOWRadio features news from the month of May 2025
News You Can Use with your Hosts Dr Craig Joseph and Dr Nick van Terheyden
The show that gives you a quick insight into the latest news, twists, turns, and debacles going on in healthcare with my friend and co-host Craig Joseph, MD (@CraigJoseph), Chief Medical Officer at Nordic Consulting Partners, and myself, where every diagnosis comes with a side of humor. We hope you stay curious, stay engaged, and keep seeking the truth in healthcare in a world that thrives on information.
Buckle up as we dive into the ER of excitement, the ICU of irrationality, and the waiting room of wacky wisdom in this month’s show that features a review of:
- Medical Debt Conference
- CVS Health Aetna and the ACA
- The Omnibus Bill
- COVID-19 Vaccination Guideline Changes
- Genetic Data Sold
- USDA DRI Calculator
This month’s healthcare news is a rollercoaster of absurdity, heartbreak, and corporate greed—buckle up. We kicked things off with a deep dive into medical debt, a uniquely American nightmare. At a recent conference (hosted by the mysteriously named Lown Institute—pronunciation still pending), experts revealed that most of the world responded to “medical debt” with a collective “Huh?” Meanwhile, in the U.S., hospitals are drowning in financial chaos, patients are crushed by bills, and one organization’s heroic act was wiping out a 700 bill halting the wrecking of one individuals life.
Vaccines, Bills & Privacy Thrills
We revisit COVID’s (Like a Bad Sequel Nobody Wanted). Just when you thought it was safe to stop masking in your Uber, COVID vaccines are back in the headlines. Turns out, the U.S. has been the overzealous parent at the vaccine party, recommending shots for everyone while other countries focused on the elderly and chronically ill. Now, we’re finally catching up—maybe. Craig, ever the rationalist, admitted he was scandalized… until the data changed his mind. Shocking, right? Actual evidence influencing opinions? In this economy? Meanwhile, AI mergers and genetic data leaks (looking at you, 23andMe) remind us that privacy is a myth, and your DNA is probably being auctioned off to the highest bidder.
We note that CVS is ditching the ACA, in a move that shocked exactly no one. CVS, fresh off a 60% profit increase, decided to move Aetna out of the Affordable Care Act marketplace, leaving 17 million people scrambling for coverage. Meanwhile, the Omnibus Bill includes an option to let AI Run Wild: buried in this massive bill, Congress snuck in a “no AI oversight” clause, which, troublingly, ensures little accountability in the AI innovation space?
And in a rare wholesome moment, the USDA’s dietary calculator revealed we’re all protein-deficient. So go eat a steak (responsibly, of course). Until next time, folks—stay skeptical, stay fed, and maybe delete your 23andMe account before it’s too late, which it is now.
We hope you enjoy our take on the latest news and developments in healthcare and want to help you keep untangling the web of information, dodging the sensational pitfalls, and emerging victorious, albeit a little dizzy, on the other side. In the end, the stories we uncover and the discussions we ignite all shape the narrative of our shared future. We want to hear from you especially if you have topics covered or questions you’d like answered. You can reach out directly via the contact form on my website, or send a message on LinkedIn to Craig or me.
Until next week keep solving healthcare’s mysteries before they become your emergencies
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
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Raw Transcript
—
**Nick van Terheyden, MD:**
Welcome to the month of June. I’m Dr.
**Craig Joseph:**
Nick. And I’m Dr.
**Nick van Terheyden, MD:**
Craig. This week we’ll be dissecting the latest healthcare news, unraveling some of the latest twists and turns, and making some sense of the latest debacles.
**Craig Joseph:**
Just remember, life’s a lot like a breaking news story. Unpredictable, often absurd, and occasionally leaving you wondering if it’s all just a cosmic prank.
**Nick van Terheyden, MD:**
This week we take a look at your genetic data, which is now out in the wild if it wasn’t before. Some AI mergers. COVID vaccines re-emerges. It feels like we haven’t talked about that in a while.
**Craig Joseph:**
We also dive into UnitedHealthcare and their problems, as well as CVS and Aetna saying goodbye.
**Nick van Terheyden, MD:**
Fathom. I to the ACA. But first off this week, I wanted to talk about the Medical Debt Conference that I attended in Washington DC this past week, and it was put on by the Lowne or Lowne Institute, so forgive me, Craig, can you correct me in the pronunciation of L-O-W-N, is that Lowne, Lowne, what do we- It’s one of those, I can commit. helpful as usual, okay, very helpful.
**Craig Joseph:**
If I knew, I still wouldn’t tell you, but I don’t know.
**Nick van Terheyden, MD:**
As I said, helpful as ever, I’m just calling it as it is.
**Craig Joseph:**
I’m here for you.
**Nick van Terheyden, MD:**
Yeah, as you always are. So, they put on a conference, it was a Medical Debt Conference, I actually posted something online on my blog, and then also on LinkedIn, that essentially tried to summarize, you know, key learning points. And a couple of things I wanted to do, really to call The Laun or Loan Institute, you know, it was just a great conference, it didn’t cost a lot of money, it was, you know, relatively inexpensive, at least, you know, the cost to me to attend, and they assembled this fantastic collection of folks all around various elements or aspects of this medical debt problem, and, you know, one of the outstanding comments or notes, notices that somebody highlighted was when they were comparing us to other countries, and, you know, they were trying to assess medical debt in comparison to the U.S. and other countries, and, you know, the vast majority of the world, when they asked that question, was, what do you mean, medical debt?
**Craig Joseph:**
How does that work?
**Nick van Terheyden, MD:**
Well, what is that, you know, and that even included countries that have some aspect of it, but, you know, even in places where they have They payment schemes, they have deductible plans, you know, there was some just basic, what I would call really intelligent thinking that, you know, I heard about. The resounding message throughout was that this was, you know, it’s just a pervasive problem, and if you haven’t experienced it, just wait. You know, there are so many challenges, and to be clear on both sides of this table, you know, with hospitals trying to do the right thing, but then when they set, you know, their financial assistance policies, sometimes they catch too many people, and then, you know, they can essentially go out of business. It was just a really informative, well-put-together conference that I came away learning a lot. If I was to summarize it, I think, you know, the resounding call repeatedly was back to . You know, it’s the price is stupid. But as I sort of summarized in my post, you know, get the data and show your work so that you can explain why this is just wrong. You need to bring communities with you because this impacts all sorts of different communities who can bring stories. And where they showed successes in places like New York, Colorado, they had people telling their story, their experience. I just attended a session just now. Two individuals shared their sort of personal challenges with denials. And, you know, when you’ve got ideas, share them with as many people as possible.
**Craig Joseph:**
Tell me about the storytelling. Is that just kind of folks talking about their problems or is this a way of explaining solutions or both?
**Nick van Terheyden, MD:**
It was both. I mean, I’ll give you one simple example. And, you know, this just sort of grounds you a little bit. You think about, I have to say that there was the presence of, you know, folks there, I forget the name of the company off the top of my head, but they, their, their principle is to essentially buy medical debt, pennies on the dollar, and then write it off. And the story that they told, and they actually have somebody working in the company that is gathering this all the time on an ongoing basis, an anthropologist that is on staff who goes out looking for this. And the story they told was a $700 debt that was so revolutionary for this mother of two children. You know, it was just such a personal story. And, you know, I know some people will listen to that and say, gosh, $700, you know, that’s the point. It’s how it’s impacting people in their sort of, their world. And this was a life changing event for this one woman who had $700 of debt wiped out by this organization. And you go, wow, couldn’t we do more of this? I mean, that’s not solving the problem, to be clear. You’re just, you know, you’re picking up the tail end of it. But, you know, it was delivering value. And it’s sort of, I don’t want to say tear jerking, because, you know, some of it made you angry, or at least it made me angry. But I think we need to be telling the stories, because that’s the way that people remember.
**Craig Joseph:**
That’s the way that they understand. Yeah, agreed. Agreed. Agreed. I’m always amazed at the power of storytelling. People throw slides up or data. of, um, or it’s, it’s, I, it’s evidence, but just tell them a story, that sticks with you.
**Nick van Terheyden, MD:**
It does. It’s the things you remember. It’s the things that I, at least I remember. So anyway, big shout out to them, you know, super impressed. You know, hope they’ll do more of it. I hope people can learn. I know they recorded a lot of it, so hopefully it will be available. People can see it. So anyway, moving on, I’m, I, should I be surprised we’re talking about COVID again?
**Craig Joseph:**
I remember. Well, it’s, we’re a regular event for you and I for a considerable period of time. And then it dropped off a little bit, but yeah, we are again, there is a law that says you have to talk about COVID. If, if you have a podcast, is it in the omnibus bill? It’s, um, uh, I don’t know. It might only be in Vermont. It might only be in Vermont, to be honest, but, uh, still, I think we’re obligated. Yeah. The, the COVID vaccine, uh, traditionally it’s been since its creation, um, it’s been available to anyone for free. Right. And it’s been recommended.
**Nick van Terheyden, MD:**
I don’t know that it’s been free consistently.
**Craig Joseph:**
I think you had to have insurance, right? You might be right in the last year or two. Yeah, I’m sorry. Thank you for correcting me. But it had been, the government was paying, the government had been paying for it. But it certainly had been recommended for everyone six months and above annually. And that might be changing. And so with the changing of the guard, we have a new secretary. HHS and new leaders in the FDA and CDC and other various parts. And they’re reevaluating the recommendations for the COVID vaccine. And I have to say, I was not aware that the United States, in recommending it for everyone above age six months, was out of step with most of our industrialized peers, the vast majority of which only record. It for elderly folks, and so that age changed from, I think, 60 to 70, somewhere in between there.
**Nick van Terheyden, MD:**
Yeah, there was a lot of variability, right?
**Craig Joseph:**
Yeah, but was all old.
**Nick van Terheyden, MD:**
Crikey, that sounded terrible. it was all older people, or whatever the PC term for that is.
**Craig Joseph:**
No, no, I feel attacked.
**Nick van Terheyden, MD:**
People like you. want to say that.
**Craig Joseph:**
There you go. That’s the second time now I feel attacked. Everyone’s hearing it. They’ll all be called. All of you who are listening will be called for the lawsuit, and for not just for the elderly or older age folks, but also for people who have underlying medical problems like diabetes and heart disease and cancer and those kinds of things. Those are more traditionally around the world who COVID vaccines are recommended for, and it looks like that we are going to be, the U.S. is going to be moving in that direction. With a recommendation for those two populations. Elderly and people with chronic medical problems.
**Nick van Terheyden, MD:**
Right. And I think it was 65 and above and then chronic problems, correct?
**Craig Joseph:**
In the U.S., I think. But this is all based off of an editorial in the New England Journal. So the rulemaking or whatever it’s called hasn’t happened yet.
**Nick van Terheyden, MD:**
It’s not official, but certainly seems from the leadership that that’s the direction that we’re going in. It also included a town hall. Did you not manage to watch that YouTube?
**Craig Joseph:**
I did not watch the town hall. Was there anything? What did I miss?
**Nick van Terheyden, MD:**
A couple of talking heads, I think.
**Craig Joseph:**
OK, well, I read what the talking heads over the paper.
**Nick van Terheyden, MD:**
Yeah, I’m more efficient, more efficient reading it, too. Yeah. No, I agree. We’ve we’ve continued to adjust, although I, like you, was a little bit surprised. thought that we were more in line, but, you know, obviously not. Does seem to. It makes sense, you know, where you draw the line and, you know, what’s chronic conditions. But, you know, you’ve got to wonder why it stayed that way. I mean, I am questioning, how did we get to that point? Because normally we’re pretty good at sort of pulling back. Or maybe we’re not. Maybe we’re not.
**Craig Joseph:**
Yeah, I don’t know. I have to say when I first heard about it, I thought, scandalous. It’s scandalous. And, of course, that’s completely meaningless because we don’t know which way your scandal is thinking. But my scandalism, well, again, I’m a pediatrician and I always half joke that I haven’t met a vaccine that I didn’t like. like. Most of what I, you know, most of what I did as a pediatrician was prevent disease instead of treat disease. And most of the way I prevented the disease was with vaccine.
**Nick van Terheyden, MD:**
So, yeah, that’s a bit of whack-a-mole in that whole vaccine. In space with some individuals who keep coming at me with, you know, it causes infertility and a bunch of stuff. It does get a little bit wearing, I’ve got to be honest.
**Craig Joseph:**
One way is to not interact with some of those folks who are not to be convinced by data.
**Nick van Terheyden, MD:**
Yep, they will not be convinced by data.
**Craig Joseph:**
But this is, I mean, I know we’re kind of hammering home this point, but here I am responding to data, right? One of the data points that I was not aware of was that the U.S. is generally out of step in terms of recommendations for the COVID vaccine with most of our peers. And so that’s a much more reasonable direction than I thought it had been several months ago.
**Nick van Terheyden, MD:**
use these words together for you, but brilliant point.
**Craig Joseph:**
Yeah, this is what a rational person does, right? A rational person, when presented with evidence. That is contrary to their opinion, says, okay, I guess, I guess I was wrong.
**Nick van Terheyden, MD:**
Need to rethink. I need to rethink.
**Craig Joseph:**
If only, if only more of us would take this, yeah, take the side of, yeah, okay, here’s evidence, and that should, that should inform our thoughts.
**Nick van Terheyden, MD:**
Yes, we’ve, we’ve certainly seen our fair share of that. So, um, all right, have you been genetically profiled, Craig?
**Craig Joseph:**
I have, I have not been genetically, not, not in the way that I think you’re, we’re, we’re talking about. Um, I’ve, I’ve taken, I have had some genetic testing, but it’s purely focused and medical.
**Nick van Terheyden, MD:**
wasn’t like I was just interested in finding out some things. So you never signed up for 23andMe?
**Craig Joseph:**
That’s exactly what I’m telling you.
**Nick van Terheyden, MD:**
Okay. I never signed up for 23andMe. I was, I was in the early cohort when they were actually really sharing. Lots of information. got, you know, it was before they got a slap over the wrist from the, I think it was the FDA that said, no, not allowed, and had to pull it all back. But I got it. And I’ve gone a lot further than that. I’ve been fully, I’ve had a full, full exome sequence. So I’ve got all three billion pairs or whatever it is. And I continue to sort of refine that and post it into the research sites where you can check up to see what the latest news is. Always intriguing to me, but 23andMe was the sort of initial driver. But the news here is, well, they went into receivership. I think that wasn’t, that was a while back now. And being sold to Regeneron.
**Craig Joseph:**
Yes.
**Nick van Terheyden, MD:**
Hmm. No conflict of interest in the use of that data. Although I’ve heard lots of very warm statements. No problem there. We will protect your information, but I’ve to say I’m not convinced, and as I’ve posted elsewhere, I actually went through an extended period. It took me probably four to six weeks to eventually delete my data. Why, you ask?
**Craig Joseph:**
Why, I ask?
**Nick van Terheyden, MD:**
Oh, thanks for asking, Craig. It wasn’t that they wouldn’t delete the data, but I wanted to download it before, and there was this big list of data items, and it took them weeks for them to be available. I had to request them, and then I would get emails over the course of the next four to six weeks saying, oh, hey, we’ve got this piece of data now.
**Craig Joseph:**
You can download it.
**Nick van Terheyden, MD:**
So until that all happened, I wanted to save, and then once it happened, I deleted it, and then I got a confirmation, you know, type your name, inside leg measurement, all that kind of stuff to confirm you really wanted to delete. So I think my data is gone, so perhaps I’m lucky. You know, I don’t know.
**Craig Joseph:**
Well, you know, there are lots of privacy concerns with giving that information to a private company, and then that private company goes into bankruptcy, and yeah. So I think there were a lot of recommendations to delete those data points. So good on you.
**Nick van Terheyden, MD:**
Lucky me.
**Craig Joseph:**
Why don’t you email them to me, and then I’ll keep them for safe.
**Nick van Terheyden, MD:**
I will definitely blow up your email if you want me to do that.
**Craig Joseph:**
I want every pair, if you would.
**Nick van Terheyden, MD:**
Every pair, all three billion. It is a lot of data. I think the download is at least 700 megabytes. Wow. Now, this isn’t 23andMe, this is the full XO, but yeah, it’s a lot. Anyway, moving on, the omnibus bill is sort of a little bit contextual. I’m I’m I’m sure. I’m not to call it that. know it’s called some other things. Anything you noticed in that that stuck out for you?
**Craig Joseph:**
Well, there are – this is changing. Obviously, it’s changing very frequently, so we don’t really know where it’s going to end up.
**Nick van Terheyden, MD:**
But yeah, there’s some major, major cuts to Medicaid.
**Craig Joseph:**
I think that’s the biggest, biggest thing. So tens of millions of people, as it is now, will lose their health insurance. And again, to clarify for folks, Medicaid covers some young people with specific medical problems and the poor, and Medicare covers the elderly.
**Nick van Terheyden, MD:**
I was always taught – well, I was going to say always taught – I only learned fairly recently from one of my children because I always find it very difficult.
**Craig Joseph:**
Well, I didn’t grow up with it, so I get confused between the two, but Medicare for grey hair. Oh, that’s very nice.
**Nick van Terheyden, MD:**
Isn’t that clever?
**Craig Joseph:**
I had never I’ve heard that before, but that does help me growing up with it. I kind of have heard that before, but yeah. So Medicare, it’s hard to a lot of politicians are afraid to touch that because those are the people that vote a lot. Apparently told I’m just, I’m no political scientist.
**Nick van Terheyden, MD:**
CVS was not, not, not, not terrified to touch it. They’ve, they announced that they’re pulling out of the Affordable Care Act marketplace in 2026, they’re pulling Aetna out. That leaves about 17 million people who are searching for healthcare coverage, which just seems, hmm, a little bit mean, got to say. Well, is it, it might be because they’re struggling financially, Dr. Nick. I, it’s funny you should mention that. Really?
**Craig Joseph:**
Yeah.
**Nick van Terheyden, MD:**
Yeah. They, they happen to announce their quarterly profits at the same time, which increased by a small 60%. 100% increase in profit margin, 1.8 billion, I believe the number was.
**Craig Joseph:**
Wow, 60 isn’t 6-0.
**Nick van Terheyden, MD:**
6-0.
**Craig Joseph:**
Wow, that’s a big increase.
**Nick van Terheyden, MD:**
Yeah, so that wasn’t it. But anyway, I’m going to call out one thing in that omnibus bill. If you haven’t heard about it, I’d be surprised, but the AI oversight, the ruling that has essentially said no AI oversight. Yeah, this was slipped in as one of these, I don’t know, pork rinds or something they call them. I’m just confused by these terms.
**Craig Joseph:**
Pork rinds.
**Nick van Terheyden, MD:**
Yes. And it mandates that there will be no oversight, and it removes any of the state’s abilities to do that. Like, you know, California, who have said that, you know, to be rolled in, if you’re using AI to deny care or to do something, you have to actually declare it. You’ve got to show your work, that kind of thing. All gone. All And he is. What has that got to do with the bill?
**Craig Joseph:**
Well, it’s got nothing to do with the bill, but that’s how, you know, legislation is done. We stick little things in other, I mean, how many pages? There’s thousands of pages. They’re going to stick some things in there. It’s interesting, you know, the pros of, the folks who are against these kinds of AI laws say that it will slow down our forward progress. It’s an innovation. And the folks that are for these kinds of laws think that AI is going to kill us. I might be overgeneralizing both of those sides. In fact, I’m sure I am. But yeah, it’s interesting. It’ll be interesting if it remains, if that gets into the final bill, and if so, if it changes its form. Ten years does seem like a lot of time. Of course, the government, you know, we can pass a law next year. Take So, no promises for the future, Dr.
**Nick van Terheyden, MD:**
Nick. You seem to simplify government, I’m just going to say, but okay.
**Craig Joseph:**
I do.
**Nick van Terheyden, MD:**
Oh, we’ll just pass the law room.
**Craig Joseph:**
Yeah, it’s just that stuff. Yeah, it’s totally possible. I learned that from a chief medical information officer once who was getting a lot of slack, or no slack at all actually, getting a lot of flack for configuring the electronic health record in such a way that it followed the bylaws. And a surgeon was very upset, and the CMIO replied in a very packed ICU, Doctor, all you need to do is change the bylaws and we’ll configure the technology to support that change. And that’s all you need to do. And in fact, he said, he promised that if the bylaws were changed within one hour of that change, he personally would change the configuration of the EHR. And the guy said, that’s all I have to do is just change this bylaw. He that’s all you have to do, and then he went to the doors of the ICU and, you know, pressed the button so that the doors opened, and the surgeon yells out, again, across this crowded ICU, what are the chances of me changing the bylaw?
**Nick van Terheyden, MD:**
And he turns around, he looks at me and goes, zero. Yeah, right.
**Craig Joseph:**
And just as he said zero, the doors closed. It was a dramatic moment. That is how I feel about, yeah, all we have to do in government is just change the law.
**Nick van Terheyden, MD:**
It’s no big deal. Oh, that’s, yes. I was going to ask, knowing what you know about EHR configuration, how likely is it that somebody could do that within an hour? of course, the punchline to all of this is, yeah, try changing the bylaw.
**Craig Joseph:**
It doesn’t matter. I can promise you anything, because I know that that bylaw is not going to get changed.
**Nick van Terheyden, MD:**
So, I don’t know.
**Craig Joseph:**
I don’t know.
**Nick van Terheyden, MD:**
Yeah.
**Craig Joseph:**
We’ll see. We’ll see what happens with the AI.
**Nick van Terheyden, MD:**
All right. And then closing out, I came across this USDA DRI. That’s Dietary Reference Intakes Calculator, I will put a link in the show notes, it was just, I want to say just an interesting sort of, you know, custom, it’s a custom calculation for what you need in your dietary makeup. The big thing is the protein. We are dreadfully under-recommending the amount of protein, this, you know, pyramid of foodstuffs, which, you know, every time I open a book seems to be ridiculed for, you know, how it arrived and some of the vested interests. I thought it was actually quite interesting. In my particular instance, 63 grams, I think the 0.8 per kilo, which, yes, everybody… Rushing to convert, that’s helpful for you, is it?
**Craig Joseph:**
You know how many kilos you are? I don’t, off the top of my head, know how many kilos I Do you know what a kilo is?
**Nick van Terheyden, MD:**
I do.
**Craig Joseph:**
And I used to be very good at converting from one to the other.
**Nick van Terheyden, MD:**
Oh, I actually could buy that. As a pediatrician, I could buy that because it was probably all in grams and kilos for those little babies, right?
**Craig Joseph:**
Yeah. Yeah. Well, yes. Yeah. It’s interesting just going to this website, this DRI calculator, I think you can just Google it, to see exactly for your height and weight what you should be getting.
**Nick van Terheyden, MD:**
Yeah. There’s a few variables, how active you are, but I think the overriding message is we’re not getting enough protein, trying to get enough in, but without killing yourself on too many calories. Just, you know, a little bit more custom approach to what we should and should not be eating, which, you know, I think. Is what we really need in all of this. You know, that’s been the struggle that we’re sort of trying to do all of this in a way that is giving folks just, you know, broad advice. It’s not exactly right. But anyway, well, unfortunately, we find ourselves at the end of yet another episode. We’ve explored some health care mysteries. We’ve explored many of Craig’s mysteries.
**Craig Joseph:**
Sure.
**Nick van Terheyden, MD:**
And, uh, that was before they became your emergency.
**Craig Joseph:**
So until next time, I’m Dr. Nick. I am Dr. Craig. The recording has stopped.
