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

RFK Jr. explores a GOP proposal to overturn how doctors are paidPeople 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 number23%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.

chemistryMystery water pollutant revealed (don’t panic)Water systems use chlorine to kill pathogens that cause disease. But chlorine reacts with bits of natural matter in water to form compounds that are associated with cancers, miscarriage, and low birth weight. So the EPA in 1998 enacted a rule that led many water systems to switch to using chloramines to disinfect water instead, avoiding those toxic byproducts. It turns out that chloramine disinfection creates a different set of disinfection byproducts — one of which has been known to exist for 40 years, yet its identity remained a mystery. In a Science study published yesterday, a team of scientists identified Cl–N–NO2– , or chloronitramide anion, as the mystery compound. They also found it in U.S. drinking water samples at toxicologically relevant concentrations. Though the compound looks similar to others that are toxic, the exact toxicity of the compound has yet to be studied.But do not panic: While we don’t know exactly how worried we should be about chloronitramide anion’s health effects, we do know that disinfecting water prevents diseases like cholera and dysentery, which are both deadly. It will take federal support to fund NIH and EPA toxicology studies that will tell us what levels of chloronitramide anion are safe, what alternatives are available, and whether household activated carbon water filters can indeed remove the compound from water, as the researchers suspect.