By George W. Chapman
Our fertility rate has been dropping steadily the last 50 years. We are now hovering around 1.8 births per woman. We need 2.1 to just maintain the current population. The administration has proffered a $1,000 baby incentive bonus. But any young adult will tell you that is totally inadequate when taking into account the unstable economy, inflation, spiking healthcare costs and a shaky job market, Cuts to Medicaid and SNAP don’t help the cause as those two programs cover four in 10 births.
Science Under Attack
Secretary of Health Robert Kennedy Jr. began by firing all the experts on the CDC vaccine committee and replacing them all with unqualified hand-picked vaccine skeptics that will fall in line with his various conspiracy theories and baseless claims. By a vote of 8-3 the committee ended a 34-year-old recommendation to inoculate newborns against hepatitis B. From 1991 to 2023, the hep B vaccine reduced infections from around 16,000 to just 7. (Sounds like it works.) Despite the overwhelming recommendations of the AMA, American Academy of Pediatrics and most, if not all epidemiologists, the committee still issued its recommendation not to protect infants from getting the hepatitis B infection. CDC hepatitis specialist Adam Langer was present to answer questions but was summarily rebuffed by the highly biased and predisposed committee. Insurers, realizing the health and cost benefit of the vaccine, will continue to cover the vaccine. Louisiana Republican Sen. Bill Cassidy, a physician, called Kennedy’s sham committee “totally discredited.” The AMA strongly urges the public to always consult with their physician when confused by CDC mandates and recommendations.
Drug Overdoses
There are about 100,000 drug overdoses a year in the U.S. (Not hundreds of thousands or millions a year as often overstated.) Lately cocaine deaths have been politicized. Cocaine accounts for 30% of all drug overdoses in a year, which is about 30,000. The majority of US overdoses are due to fentanyl and methamphetamines. Heroine, oxycodone, methadone, benzodiazepines, tramadol, antihistamines are culprits to lesser extents. To put overdoses in perspective, it is estimated 100,000 to 200,000 Americans die from illnesses related to pollution, linked to heart and lung disease, stroke, cancer and other conditions.
Lower Drug Prices
Despite all the hoopla on the news claiming drug prices will be reduced by “1,000 %” behind the scenes Medicare negotiators, authorized by the Inflation Reduction Act, are working on lowering the prices of 15 drugs including weight loss drugs. The lower prices will take effect January 2027. It is estimated that the out-of-pocket savings to Medicare beneficiaries will be in the neighborhood of $685 million. The savings to Medicare to purchase the 15 drugs will be in the billions. Prior to the Inflation Reduction Act, Medicare was literally prohibited from negotiating drug prices. While the cost savings are great news for Medicare beneficiaries, it does not impact anyone younger than 65 covered by employers or by insurance sold on the exchange. Thankfully, Humana and entrepreneur Mark Cuban’s Cost Plus Drugs are joining forces to lower the costs of drugs for everyone else. Commercial carriers say rising uncontrolled drug prices are the primary drive of higher premiums. The joint venture plans to bypass costly and ineffective pharmacy benefit managers and they may partner with Trump Rx.
ACA Does Not Stand Alone
As 2025 came to a close, health news was focused on the plight of 23 million people who could not afford their skyrocketing insurance if they lost their income-based tax subsidies per the Affordable Care Act. (As of this writing in December, their fate was still in the hands of Congress.) The news made it sound like skyrocketing premiums were unique to the ACA. They are not. Commercial insurance available on the exchanges is the same insurance available to employers. Employers may get lower premiums via group pricing, but their premiums are skyrocketing, too. So, to say the ACA particularly is “horrible/lousy” healthcare and needs “fixing” is purely political theater. Everyone’s premium is too expensive and that’s why employers subsidize employee premiums. The average annual premium for a family of four, via the ACA or employer, is a staggering $27,000. The ACA does not stand alone.
SNAP Benefits
Forty-two million Americans depend on the Supplemental Nutrition Assistance Program — or SNAP. Obviously, adequate nutrition is essential to good health. Unfortunately, it became a political football. Eligibility for SNAP benefits include work requirements. More than 98% of SNAP recipients are legitimate. Fraud is rare. Thirty-five percent of recipients are white, 25% are Black, 15% are Hispanic, 4% are Asian, 1% are American Indian. 20% are race unknown. Unfortunately, during the SNAP political maelstrom there were a lot of AI-generated videos perpetuating racial stereotypes and falsehoods about choosing not to work. AI experts saw indicators in the videos that prove they were AI-generated. Many news outlets were criticized for running the false videos. Most eventually dropped the videos after expert commentators pointed out the AI indicators.
2026 Medicare Premiums
Part B, covering physicians, will be $203 a month which is up $18 a month from 2025. There is no premium for Part A covering hospitals, as this was covered via payroll taxes. The inpatient deductible will be $1,736, up from $1,676, for the first 60 days. Days 61 through 90 have a $434 per day copay. High income earners will pay substantially more for Part B. skilled nursing facility-covered days 21-100 are at $210 a day.
George W. Chapman is a retired healthcare business consultant who worked exclusively with physicians, hospitals and healthcare organizations. He used to operate GW Chapman Consulting based in Syracuse.