I would have never guessed that someday I’d be writing a blog about tariffs. I do remember President Trump during his campaign talked about how unfair other countries tariffs were, but I didn’t imagine how he would approach changing them. As a champion of the free market, I’ve always been against anything that built barriers to the free exchange of goods and services. The President was of this thinking in his first term when he helped close a free trade agreement between the U.S., Canada, and Mexico. I believe that the tariffs imposed by other countries are just a way for them to make quick profits because of manufacturing, geological or political advantages. This approach is not conducive to long term efficiency and doesn’t promote price competition. I hoped that when President Trump won the election, he would institute structured and meaningful steps toward eliminating these inefficient and damaging tariffs. 

Last week I attended the yearly American Society on Aging conference. I’ve agone to this conference for years and have always found it a great place to stay in touch with those who serve older Americans. The theme of this year’s conference was ageism and culture, focusing on identifying and eliminating ageism in all our dealings. It certainly was an honorable theme but, as you might imagine there was a palatable anxiety given the uncertainty that has enveloped our healthcare institutions as they react to the first 90 plus days of the new administration. There were people who had seen valued colleagues who took early retirement, lost their jobs to a reduction in force (RIF), had their whole office dissolved or absorbed into another office or were fearful of losing the funding or grants for their office. There were businesses that were fearful that big changes would make their future plans obsolete. The concern was evident and often took over the discussions in many panels and seminars, but surprisingly it didn’t seem to cause a paralysis of action. From what I saw, even in this time of uncertainty, support for older Americans stands pretty solid, both now and in the future.

I have written many times about the “pill penalty” that is part of the Inflation Reduction Act (IRA). In fact, I’ve written about it at least 8 times. Here is one blog that explains the details of why this policy in the IRA needs to be changed. One of the most egregious parts of this penalty is it reduces the exclusivity period (for small molecule medicines, the pills we are used to taking) to 9 years as opposed to large molecule medicines (biologic drugs that are injected, usually at a doctor’s office) which are allowed an acceptable 13 years of exclusivity.

When I was in high school and driving the first car I owned I very quickly became aware of the price of a gallon of gas. I still remember what it cost because it seemed to stay constant throughout those high school years at 32.9 cents a gallon. I certainly didn’t know what economic forces were in play that determined that price. I did know that periodically they had “gas wars” that would drive the gas down to 16 cents a gallon, but they were very short-lived.

As I look back at our country’s infancy, I’m amazed at how smart those early leaders were. They realized how important some basic rights and governing organizations were to the growing colonies and then to our young country. They quickly established the rule of law that allowed us to feel safe both physically and financially. Benjamin Franklin understood the importance of a secure method of communication by establishing the post office even before the Declaration of Independence was signed. The early leaders recognized how important patents were and wrote it into the Constitution.

I remember the first time I drove a car with a backup camera. I rented a car for five days and quickly became very comfortable and impressed with how useful the camera was and how it helped me feel safe as I backed up and parked. The first time I drove my car after I returned home, I was amazed at how I instinctively looked at the dashboard when I backed up, searching for the backup camera screen that my car still didn’t have. In just five days, I had grown used to this new technology that was effective, efficient, and made my life easier and safer. I think that the same thing happened during the pandemic with telehealth.

One of the most important jobs our lawmakers have is to judiciously spend the precious tax dollars we send them each year. They need this money for important things – a military to keep us safe in the world and for law enforcement to keep us safe in our neighborhoods, for Social Security and Medicare so we could have some money and healthcare when we retire, for Medicaid and other programs for those that have fallen on hard times. There are many other things that our government spends money on, but I thought I’d list a few that I think are very important and deserve our tax money.

Last Tuesday, the Speaker of the House, Mike Johnson, asked President Trump to address a joint session of Congress. Since the President has only been in office for two months, it wasn’t a regular State of the Union speech, but the President wouldn’t pass up the opportunity to give a speech to Congress, members of the Supreme Court, Cabinet members, military leaders, and you and me.

There are two interconnected themes that are the focus of this month: National Nutrition Month and World Obesity Day. National Nutrition Month is an annual campaign of the Academy of Nutrition and Dietetics, and their theme this year is "Food Connects Us," emphasizing the role of food in bringing people together socially, economically, and culturally. World Obesity Day, March 4th, is organized by the World Obesity Federation, which collaborates with the World Health Organization and other global partners.

The Inflation Reduction Act (IRA) was probably President Biden’s most important piece of legislation passed during his four years. It contained many different parts but, as is always the case, my ultimate focus in this blog will be on how it impacts our healthcare. I will only describe its effect on other parts of the healthcare business and their possible reaction to further clarify how it will ultimately affect you and me. I will also try to predict how the new administration might impact the implementation of the IRA.

There’s been a lot of talk for the last few years about how the government’s rules, regulations, and legislation will, or already have, slowed the discovery of new medicines. I’ve written a lot about the Inflation Reduction Act (IRA) and how I believe the price-setting policies will limit innovation. As is always the case, both sides of the question wade in with their own evaluation of the impact of the IRA on innovation, with some saying there will be little impact.

For the past few years, in February, I’ve written many blogs highlighting American Heart Month. I wrote a blog about getting back to taking care of yourself and your heart a year into the pandemic and one explaining what heart-healthy meant. I wrote a blog about the seven key health factors and behaviors that increase risks for heart attacks and strokes called “Life’s Simple 7”. Another blog discussed recognizing the signs of a heart attack. These were all great blogs . . . ok, maybe just adequately written, but each one passed on some really good information.

Vaccines were in the news a lot last week and were centered around the confirmation hearings concerning President Trump’s nomination of Robert F. Kennedy Jr. as Secretary of Health and Human Services (HHS). The hearings were conducted by the Senate Finance Committee and the Senate Health, Education, Labor, and Pensions (HELP) Committee. There were many questions about Mr. Kennedy’s stance on vaccines, and all of the old controversies, myths, and theories once again were in the news. It seemed that vaccines have become intertwined with politics and our freedoms, and I thought it would be important that I take a shot at separating the political rhetoric from these lifesaving medicines.

Almost every January I do a blog on Glaucoma since it is National Glaucoma Awareness Month. I do this because of the stealthy way glaucoma can rob older Americans of their sight. They use the word awareness in the title because the way that we combat this sight-robbing disease is by being aware of the danger and by getting tested. There’s no magic cure for glaucoma, but there are medicines, eye drops, and even surgery that can slow the progression of the disease and help you maintain your sight.

The nonpartisan senior healthcare advocacy group issued the following statement in response to the Centers for Medicare and Medicaid Services (CMS) announcement for an additional 15 drugs selected for Medicare Drug Price Negotiations under the Inflation Reduction Act (IRA).

In the past, I’ve talked a lot about the nuances of policies that affect Medicare, which is only natural since Medicare is a part of the lives of over 60 million older Americans. One of the challenges I face is trying to extract the rhetoric that seems to permeate any proposed changes to Medicare and then explain the impact these changes could have on our healthcare. It’s also difficult to separate fact from fiction in these days of social media influencers and conspiracy theories. We’ve all been notified, on smartphones, our PCs, by email, etc., of some huge problem with Medicare or parts of our healthcare.

Every year, in the first part of January, the Consumer Electronics Show (CES) is held in Las Vegas. It has been going on for more than 57 years and this year attracted 138,000+ attendees. It is the showplace for unveiling the latest in consumer technology and what the future looks like for computer hardware, electronics, and software. This is the third year I have visited the show, and each year, I am absolutely astounded by what technology can do now and what it has the power to do when it comes to making us healthier and enjoy longer lives in the future.

2025 sounds to me like a year far in the future, not the year I’m living in right now. It reminds me of when I woke up one New Year's morning and realized that I was now living in the same year that George Orwell wrote about in his novel Nineteen Eighty-Four, a novel that I had read 20 years earlier. I don’t want to be overdramatic, but 2025 may turn out to be a year that we look back on and recognize as the start of a new direction in our country’s history.

The last election was a stark continuance of the polarized status of our politics and even our country. Both sides disagree on fundamental issues, and at times, it appears there is no attempt to even listen to the other side. This is the environment we find ourselves in, and with one party having won the majority in the House and the Senate, as well as capturing the White House, it looks like this polarization is going to be magnified. As we look forward to 2025, from a healthcare perspective, it’s easy to think that any compromise or bipartisan solutions may be out of the question.