DJ Smithers

Thanks Shreya! All facilitated by my wonderful BI mentors! ☺️

A little announcement on the show today: It's our 29th birthday! 🎂

Inside the Trump Purge: Federal Workers Tell Their Stories Podcast Episode · The Daily · 02/19/2025 · 28m

I recommend this podcast, which includes interviews with fired federal workers. It does a good job capturing the personal cost of handing the government over to power-hungry sociopaths who don’t believe in competent governance.

podcasts.apple.com/us/podcast/t...

Yeah, these takes give away just how little someone understands about healthcare.

Nursing is a fundamentally human-centric role. Eg, inpatient they’re the most familiar with who patients are, what they typically look like, etc. They’re the eyes and ears for entire teams. That can’t be AI-ed.

FAA Employees Say Trump and Musk's Purge Is a 'Threat' to Air Safety Donald Trump and Elon Musk fired hundreds of Federal Aviation Administration employees. The administration argues it won’t affect air safety.

“There are currently four people remaining over there to do the work of 15 people. The danger to the national airspace can’t be understated."

"This is a very real threat to the American flying public.”

EXCLUSIVE ⤵️

Reading @chrislhayes.bsky.social’s The Sirens’ Call and @superwuster.bsky.social’s The Attention Merchants not to help me quit social media, but instead to have a higher brow inner monologue about why I should feel bad for being perpetually online

Cosplaying as a quiet mind by moving all tabs to the Reading List

It's a horrendous flu season. It's killing kids, it's killing adults. It's killing people who were perfectly healthy before and people who, like most Americans, have chronic illness. It costs NOTHING to keep existing resources available. Our government is spending money to make Americans sicker.

Had this exact disagreement with an attending the other day!

There should be a Things We Do For No Reason article on entirely avoiding (and counseling patients to entirely avoid) acetaminophen in cirrhosis…

In most people with cirrhosis, acetaminophen (up to 2g/day) is a safer analgesic than NSAIDs (kidneys, GI mucosa) or opioids (CNS function, gut motility)

Spreading the word from @shreyatrivedimd.bsky.social @ebtapper.bsky.social

1/ I am seeing a lot of comments on the slashing of NIH support along the lines of “universities should just spend their huge endowments.”

I’m the last person to cheer on the institutional stratification rising endowments have contributed to. But let me explain why this is not a solution.

Medicaid Work Requirements In Arkansas: Two-Year Impacts On Coverage, Employment, And Affordability Of Care - PubMed In June 2018 Arkansas became the first US state to implement work requirements in Medicaid, requiring adults ages 30-49 to work twenty hours a week, participate in "community engagement" activities, o...

Medicaid "work requirements" do not work. They are a form of administrative burden that reduces Medicaid's effectiveness at increasing the insured rate while increasing churn, which the knock-on effects of delayed and forgone care & medical debt www.ncbi.nlm.nih.gov/pubmed/32897...

News: Half of CDC "disease detectives" terminated. DOGE takes aim at US disease surveillance. Entire first-year class of the Epidemic Intelligence Service must be out by 5 p.m., sources say. Also: a major CDC contractor "just let go," and others may follow.

Major news:

Entire first-year class of the Epidemic Intelligence Service must be out by 5pm, sources say.

Also: a major CDC contractor "just let go." Others may follow.

This is an attack on our ability to detect outbreaks.

More, with quotes from CDC officials:
open.substack.com/pub/insideme...

If there’s a Disease X outbreak in the next four (or more?) years we literally will be flying blind, we just fired the people who would have tracked it

They are going to ignore court orders.

If they ignore court orders, the social contract is dead and buried, the constitution is no longer in effect.

It's a rubicon that cannot be uncrossed.

Here are some facts about "facilities and administrative" (F&A) costs, what we in the business call "indirects" and what Musk is calling "overhead" as he tries to convince Americans with being ok with cutting billions on dollars from medical and public health research at universities & hospitals

1/

1. Today the NIH director issued a new directive slashing overhead rates to 15%.

I want to provide some context on what that means and why it matters.

grants.nih.gov/grants/guide...

I'm not sure how to explain how financially devastating this will be for universities. This is, literally, catastrophic for universities and for science in the United States.

Draconian Medicaid Cuts Proposed in Idaho In one of many recent attacks on health care access, in Idaho’s House Bill 138, Rep.

It's hard to keep track of all the awfulness, but Idaho has introduced a massive attack on Medicaid, proposing the elimination of Medicaid expansion if they don't impose a work requirement, cap enrollment to 50k, and restrict benefits to being for only up to 3 years open.substack.com/pub/miranday...

And let's be clear that Medicare 'fraud' is largely done by health insurance companies (e.g. Medicare Advantage plans) and health care executives (e.g. Rick Scott). www.nytimes.com/2022/10/08/u...

CDC's Youth Risk Behavior Survey (YRBS) -- which, since 1990, has tracked high school students' behaviors that can influence health and social outcomes (like smoking, drug use, and dietary habits) -- is now offline

This is a big deal, y'all. Federal health websites are being stripped of content or removed in their entirety. Stick with this thread for a look at what's disappeared so far! 1/x

So cool! Really excited to watch this.

It’s true that there are health policy tradeoffs in many arenas. But one thing that is not a tradeoff is our decision, in the US, to punish the sick: Deductibles, copays, coinsurance, “medical debt”, medical bankruptcy are socially useless, socially harmful, policy decisions.

The Next Financial Crisis: Insurance Today on TAP: Increasing damage from fires, hurricanes, and floods will destabilize a lightly regulated industry—and spill over into broader financial markets.

"commissioners in climate disaster–prone states...have favored overly lenient regulation of insurers in terms of the adequacy of their loss reserves, in order to encourage them to keep providing insurance at all" prospect.org/blogs-and-ne...

House GOP Eyeing Cuts of Nearly One-Third in Projected Medicaid Spending House Republicans are considering deficit reductions of $5.5 trillion, which includes $2.3 trillion cuts in Medicaid… Cuts of this magnitude would put states at financial risk, forcing them to raise n...

$2.3 trillion in Medicaid spending cuts reportedly being considered by Republicans represents 31% of projected federal Medicaid spending over the next decade.

@robinr.bsky.social

www.kff.org/quick-take/h...

There are and will be many public health issues to defend in the coming years. We can all have an impact individually, and we can have a greater impact working together.

Hello BlueSky! We are a grassroots organization of thousands of public health professionals who are dedicated to sharing evidence-based public health science. We will post about our actions here and let you know how you can get involved. We look forward to interacting with you! Stay tuned.