Rising health care costs, Ebola outbreak, Gen Z: Morning Rounds

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Good morning, folks. This is Allison, in for Theresa today.

I have to say, the recent news on the presidential fitness test sent me down memory lane. I remember the “sit and reach” exam, and I know my schools had climbing ropes, but I don’t think we were actually allowed to climb them because they were afraid we’d fall and hurt ourselves. Do any other millennial Morning Rounds readers remember what activities they did in the test? Send your recollections to [email protected].

Now, onto today’s news.

Secret shopper finds disturbing GLP-1 prescribing practices online 

It seems that these days, everybody wants to get their hands on the GLP-1 medications semaglutide and tirzepatide. But a recent secret shopper study — remember those? — showed that the prescription process can often fall far short of clinical standards.

Katie Palmer reports on a new study published Monday in the Journal of the American Medical Association, detailing one researcher’s efforts to get a weight loss drug prescription at 49 different telehealth sites. The results disturbed multiple weight loss physicians. One in five sites didn’t inquire about a patient’s weight loss goals. Nearly half didn’t ask about eating disorders. And on a handful of telehealth platforms, there was no direct contact with a clinician before getting a prescription.

Physicians are calling for regulatory bodies to enforce clinical care standards. Read more about the study results here.

Astronomical costs threaten employer-based health insurance 

Bob Herman is coming in hot with a three-peat — a multipart series, that is, into the soaring costs of and misbehavior with employer-sponsored health benefits.

Health insurance premiums are rising across the country, thanks to high prices for hospitals, doctors, and prescription drugs and more intensive care. As a result, employer-sponsored health insurance is becoming so expensive that some companies are giving up. The percentage of working-age adults who get their health coverage from a job is dropping, going from 67% in 1998 to about 60%. Herman heard from some of the people directly impacted by this decision.

He also highlights a case in New Jersey, where whistleblower complaints pushed Horizon Blue Cross Blue Shield to pay a $100 million settlement to wipe away allegations that it knowingly overpaid hospitals and doctors and fraudulently won its state contract.

It’s an expansive series that deserves your attention. Access all of the articles here.

Ebola outbreak exposes a fractured outbreak response system 

Ebola has once again cropped up in Uganda and the Democratic Republic of the Congo. We’ve contained the disease before. But what if, this time around, the threat is not only that we cannot contain its spread, but that the outbreak never ends?

In a new First Opinion piece, humanitarians Ivan Buendia Gayton and Eric D. Perakslis examine how the methods of containing past outbreaks may not apply this time around. Whereas previous outbreaks have occurred in small villages, the current wave of Ebola is spreading in one of the densest areas of population in Africa. Some of our frontlines of defense against disease spread — the World Health Organization and Centers for Disease Control and Prevention — are operating at greatly reduced capacity. And highly specialized treatment facilities in the U.S. remain unutilized.

The risk of all this is that Ebola becomes endemic, continually threatening millions in Central Africa while periodically casting sparks into the rest of the world. Once that future arrives, the authors argue, containment will become a recurring expense and control will be impossible. Read more.

Remembering a legendary virus researcher

C.J. Peters, a legendary figure in the world of finding and studying viruses that pose threats to people, died on July 4. Peters’ knowledge was prodigious, and his style was unique. He had the personality of a cowboy, but one who favored Hawaiian-print shirts.

One of my first encounters with Peters, a phone interview, was about Ebola (I think; it was a long time ago) and how some people contract it by eating bats. I was horrified and asked why people would eat bats. His answer was gentle schooling: “You live in a world with too much protein.” In 2018, I interviewed him at length in his home in Galveston, Texas, where he told me so many jaw-dropping tales of his times in the field that I struggled to know what to cut. I hope the ensuing profile — found here — captured his essence.

Peters has been in declining health for years, so I didn’t reach out to ask his thoughts about the current administration’s approach to trying to keep people infected with Ebola — or even at risk of being infected — from coming to the U.S., including American citizens. I already knew his views: “Fences don’t keep viruses out,” he told me in 2018.

Peters was a singular figure, operating in vastly different times. We won’t see his kind again, but we were lucky as heck to have him. RIP. — Helen Branswell

The Gen Z doctors are our future 

Can Gen Z physicians entering the workforce fill the gaps left by retiring practitioners and burnout? Even if they can, will they be welcomed into a field?

Health care executive Frantz Berthaud grapples with these questions in a new First Opinion essay. The desperate need for new clinicians is at odds with how leaders actually talk about the younger generation, deeming them “soft” and too focused in the wrong areas. Recounting a recent experience getting care, Berthaud argues that Gen Z actually has a thing or two to teach health care leaders. Read more.

What we’re reading

• An autism breakthrough, or an illusion? The fight over assisted spelling, New York Times
• Decline of Ph.D. admissions could imperil a ‘generation of new talent,’ New York Times
•  Vertex acquires Crinetics Pharmaceuticals for $10 billion as biotech M&A booms, STAT