“The United States…is like a golden retriever bounding through the forest, wagging it’s tail and knocking things over.”
Adm. James Starvidis, Former Supreme Allied Commander (Ret.) – in comments on CNN Live, February 16, 2026, related to the current approach of the United States in managing its European relationships…
“Let us not seek the Republican answer or the Democratic answer, but the right answer. Let us
not seek to fix the blame for the past. Let us accept our own responsibility for the future.”
John F. Kennedy, 35th President – United States of America
Opinions and Reflections
It’s Time To Come Together – On March 15th, Heather Cox Richardson offered up her daily Substack post with a commentary on Maine Joining the Union in 1860. I was not aware of the historical significance of Maine becoming a state and the political machinations that occurred over the state joining the Union. The southern states were in opposition to Maine joining the Union because it was a “free” state. It would have created a majority of federal legislators in the Senate with that perspective. We seem to be at a similar point in our legislature today although focused on a different set of issues. There are lessons to be learned in considering history for all of the lessons that could be applied today. When, “we the people” come together, we can make a difference.
Resonating Considerations - Project 1776 – I recently received an email from two financial analysts – Porter Stansberry and Luke Lango. I wanted to share it because their thesis truly resonated with all my readings and considerations over the last year. In essence, we are facing a dramatic, self-sustaining transformation of the way our nations, governments, companies, communities, and even our social relationships. The focus of the white paper was on how wealth was going to be created. And, while that’s an important consideration, the societal considerations are even more important. Specifically, I believe the greater issue is how the life we lead – as individuals and family – is going to be led!! And, by “life…created” I mean how we work, live, interact, and cooperate (or not) with our compadres, community, colleagues, friends, and even family. The message of the analysts is that we are moving very fast. These dynamics are creating a revolution in how society works. So, if we look at these changes in the context of revolutions, what we find is the following:
The rise and spread of Christianity took 3 centuries (1st – 3rd)
The Islamic Cultural and Economic Revolution, an additional 3 centuries (7th – 10th)
The Printing Revolution, 100 years (in the 15th century), which then fostered the Protestant Revolution and Scientific Revolutions (16th and 17th centuries)
The Industrial Revolution (18th and 19th centuries)
The Democratic Revolution (18th – 20th centuries) that fostered the evolution of human rights and served as the foundation for the Declaration of Independence in the USA
AND NOW…
The Digital Revolution is upon us!! And, the pace of change is accelerating. Consider these facts:
The radio took 38 years to reach 50 million users.
Television took 13 years.
The internet, 4 years.
ChatGPT hit 100 million users in 2 months.
We’ve come through revolutions before but the magnitude and pace were just a tad bit less dramatic. It’s clear that the current digital revolution is much more than provocative! In fact, the “pace” and “depth” of change have accelerated to the point where it has become exceptionally hard to “keep up” with the changes. Furthermore, the changes are altering the inner workings of life as we have known them over the centuries. Why?
Communication has shifted from local to global, anytime, all the time.
The intelligence of how we accomplish “work by workers” is being decoupled from the process of “completing work”.
Knowledge is distributed and disseminated through technology rather than people.
We’ve been through revolutions before – and, we’ve adapted. The challenge is before us! The question is whether we can pick up the pace and be flexible in our responses to this worldwide challenge. My advice? Let’s embrace and let’s adapt!
Books and Articles worth a Review…
American Heart Assn, American College of Cardiology, Plus 9 Others Issue New Guidance – In a joint release, the leading organizations involved in identifying ways for all of us to stay “heart healthy” released a new report in the past month in an effort to reduce the toll of cardiovascular disease, which is responsible for about one in three USA deaths. In releasing the guidance, Roger Blumenthal, MD, Chairman of the guideline group and a cardiologist at Johns Hopkins Medical School, opined that: “Eighty percent or more of cardiovascular disease is preventable.” So, the emphasis was on younger folks as well as us older (more gentile 😊) folks.
The new guideline starts with a focus on getting younger people to start with making sure they have a lifetime of lower LDL levels which would have a major effect on their health. He noted that: “Heart disease would go down markedly. We think we could cut heart attack and stroke rates down by half.” The new recommendations include starting by testing LDL cholesterol levels (i.e. “bad” cholesterol) even in childhood at around age 10. The recommendation, if followed, would identify one in 250 people with a genetic condition that leads to extremely high cholesterol levels. Treatment could then start immediately rather than happenstance identification of the problem down the road. The report also recommends that physicians start testing all other patients around ages 18 – 20 with repeat screenings every 5 years. It should be done more often for those with high LDL levels or other risk factors like diabetes. The intent is to have all individuals striving to have an LDL level below 100. And, if other risk factors are at play, below 70. And, if per chance, someone has had a heart attack or stroke, or is diagnosed with peripheral artery disease, the LDL needs to be even lower, below 55.
When I feel I must share my thoughts and perspectives on a burning issue…
Disgusting! – In a recent newsletter by Heather Cox Richardson, she noted that the Trump family has been enriched by about $4 billion since the onset of President Trump’s most recent term. And, he just applied for “copyright” of his name and accoutrements associated with his name so that airports (several name changes in process), merch, and the like will provide payments to him and his family. The use of his position as President to enrich himself and his family is disgusting. It speaks to the totally narcissistic behavior that seems to have become the daily norm for this current White House. It’s sad when there are so many issues that need attention in our nation and in the world…
Information for your Consideration…
Hallelujah!!! US Cigarette Smoking Hits All-Time Low –The USA has finally hit an all-time (well, perhaps not “all-time”) low in cigarette smoking. When I was a kid growing up, I found my Dad’s smoking appalling. He cut our hair on a regular basis in the basement and always had a cigarette hanging out of his mouth. I found it disgusting. Then, in 1969 – when I started college – I tried a pipe but quickly moved to cigarettes. But I wasn’t alone! In fact, it was just over 40% of the American public that smoked – and there were no rules about when or where. However, my consumption grew over time, and I became an outlier. By 1983, I was puffing away on four packs of Marlboro Lights a day! Yes, 4 a day!!!
But then in the early 1980s, I developed some health problems (how stupid of me as a young physician). And, when walking with my best friend after dinner and talking about the problems (he was a physician as well, actually a pathologist – yikes!), I threw my pack into the garbage can on the street. As a result, I’ve become an ardent non-smoker now for 40+ years and wince every time I see a smoker. I share the story because I became very excited when I read about a newly published research study revealing that the number of smokers had dropped to less than 10% in 2024. It marks the first time the rate has dipped into nearly single digits. Again, hallelujah!!!
So, why the drop? It’s because of a decades-long public campaign by the government that started in 1964 when the surgeon general reported on the dangers of smoking. Since that time, a whole series of lifesaving initiatives have been started in addition to the public campaigns, including cigarette and tobacco taxes, smoking bans, and regular physician admonishments. Those efforts have prevented almost 4 million lung cancer deaths and chronic obstructive pulmonary disease among Americans. But, we still have a ways to go. The public health community has targeted a 6.1% adult smoking rate by 2030. Now, about those questions on vaccinations…
Trust The Healthcare Professionals…Spread The Word – The medical profession, via the American Medical Association and an increasing number of medical specialty societies, has developed the “Vaccine Integrity Project” to provide quality outcomes information on the use of vaccines. It’s been led by Michael Osterhoff, Ph.D., MPH, leader of the University of Minnesota Center for Infectious Disease Research and Policy. The work of the Center will include:
The Vaccine Integrity Project delivers transparent, science-based vaccine information by rapidly countering inaccurate or misleading information, synthesizing evidence, and translating research for decision-making.
The effort was put together through the collaborative organizing efforts of Osterhoff and the AMA as a response to the irresponsible information currently being promulgated by the US Department of Health and Human Services under the leadership of Secretary Robert F. Kennedy, Jr. Special thanks are extended to the folks in Minnesota, the AMA and the various specialty societies who are stepping up with ACCURATE information on vaccinations!!
Changing Behavior Of Consumers Due To Health Care Costs – In a recent report from
Academy Health, the behaviors we exhibit as a result of increasing health care costs is becoming an issue. Specifically, a recent Gallup poll revealed that the increasing cost of USA health care is creating a situation where citizens are making trade-offs on how, what and where they make ongoing life expenditures. In essence, about 1/3 of Americans are cutting back on basics like food, transportation, and utilities. And, where is the money headed? Of course, to pay for health care services by skipping meals (11%) and borrowing money (15%) or delaying prescriptions (15%). In fact, nearly 50% of the middle-income households and a significant portion of higher-income households noted that they have postponed big ticket items such as buying a home or having children – due to health care costs. Yikes! The worst situation is with uninsured individuals where 62% of such individuals report at least one financial sacrifice to cover medical costs.
Furthermore, the findings clearly point out that the affordability of health care is not purely a financial issue. It holds social, familial, and personal behavioral considerations as well by shaping how people live, plan, and prioritize their futures. For health services researchers, this highlights the need to better understand on how cost pressures influence health-seeking behavior, foregoing or delaying care, reducing medication adherence, and trade-offs between health and other essential needs. It also underscores the importance of studying financial strain beyond clinical settings, including its connections to mental health, stress, and worsening physical health outcomes.
At the same time, rising costs and reductions in public coverage – such as Medicaid cuts – are opportunities that deserve further study how policy changes affect affordability and access across different populations. It’s also clear that research to examine variation across income groups, insurance status, and states to better understand those who are most impacted and why is also another important area of research. More broadly, these trends raise critical questions about downstream effects on the health system, including increased emergency care use, higher long-term costs, and widening inequities, all of which position affordability as a central issue for both research and policy moving forward.
RFK, Jr. Dismissing Important And Valued DHHS Capabilities!! – Everyone with an interest in health care must read the following information, which was prepared and released by Academy Health, a very reliable academically-oriented organization:
The U.S. Preventive Services Task Force (USPSTF) is an independent, volunteer group made up of 16 national experts across behavioral health, internal medicine, pediatrics, nursing, family medicine, geriatrics, obstetrics and gynecology. These experts serve to advance the task force’s mission to “improve the health of people nationwide by making evidence-based recommendations about clinical preventive services and health promotion.” In addition to this, the members’ recommendations also influence insurance coverage. The task force has been an instrumental component of our preventative care system since 1984. Now, doctors fear having been abandoned by the U.S. Department of Health and Human Services (HHS).
The USPSTF meets three times a year in March, July, and November; however, the group has not met since March 2025. Without convening, there are potential threats to the Affordable Care Act’s (ACA) no-cost prevention care mandate, as the task force offers recommendations to services with a Grade A or B that insurance plans cover. Without up-to-date, evidence-based guidance from the task force, there is a potential for health disparities to worsen. The meetings have not been directly cancelled, but instead, members have been told that the meetings will be rescheduled without a tentative date. This group of experts offer recommendations around STI testing, cancer screenings, mental health concerns in primary care, medications, and more, to help reduce disease and to ensure coverage for preventative care services.
Postponing the meetings without following up with tentative meeting dates could hinder updates to preventative care recommendations that doctors rely on to assist in guiding patient care. Additionally, since the task force has not been able to meet in a year, they were not able to submit their annual report to Congress. This yearly report is used to help grant decision making for the National Institutes of Health and to outline gaps in research. Doctors have expressed concern about postponement being a larger warning that the HHS plans to erode and restructure the task force, like other federal advisory groups.
In addition, as of March 2026, the U.S. Supreme Court issued a 6-3 decision upholding the constitutionality of the U.S. Preventive Services Task Force (USPSTF) appointment process, protecting no-cost coverage for recommended preventive services (e.g., cancer screenings, HIV PrEP) under the Affordable Care Act (ACA), per SCOTUS Blog and American Medical Association. While the legal structure is secured, the task force will likely face potential logistical, staffing, and political challenges to its operations, according to CNN. This is very important, since experts warn that changes in the composition of the task force as well as its operational support will have the ability to impact millions of Americans.
Trust The Healthcare Professionals…Spread The Word – The medical profession via the American Medical Association and an increasing number of medical specialty societies have developed the “Vaccine Integrity Project” to provide quality outcomes information on the use of vaccines. It’s been led by Michael Osterhoff, Ph.D., MPH, leader of the University of Minnesota Center for Infectious Disease Research and Policy. The work of the Center will include: The Vaccine Integrity Project delivers transparent, science-based vaccine information by rapidly countering inaccurate or misleading information, synthesizing evidence, and translating research for decision-making. The effort was put together through the collaborative organizing efforts of Osterhoff and the AMA as a response to the irresponsible information currently being promulgated by the US Department of Health and Human Services under the leadership of Secretary Robert F. Kennedy, Jr. Special thanks are extended to the folks in Minnesota, the AMA and the various specialty societies who are stepping up with ACCURATE information on vaccinations!!
Perspectives and realities emerging in the transformational AI space….
Consumer Focused Copilot Health Unveiled By Microsoft & Amazon – Amazon’s first major step into the health care world was the purchase of One Medical, a one-stop primary care-oriented medical service. It was the first major step and it was a face-to-face model of care delivery. Now, it’s moving toward virtual consultations with the launch of Health AI on a broad scale. Under the new program, eligible USA-based Amazon Prime members who use Health AI will gain access to five free direct-message care consultations with a One Medical provider for more than 30 common conditions. These consultations are initially focused on the “basics” in primary care, such as allergies, cold and flu, acid reflux, straight-forward infections such as pink eye and urinary, anti-aging skin care, and hair loss, among others. Individuals who seek the care will be eligible to receive 5 free virtual consultations as part of an introductory offer from Amazon.
As you can imagine, once they gain experience with the basics, the intent is to offer broader, expanded coverage for virtual consultations. It’s not surprising, and it’s just the first step… But wait!! There’s more. For non-Prime individuals who want a care offering, there’s an introductory offer of out-of-pocket, pay-per-visit of $29 for a virtual visit with an Amazon One Medical provider – both virtual and real. In the near-term, expect “add-on” services such as dietary advice, exercise recommendations, and other “healthy” support advice. And, how does this interact with the existing primary care providers? I couldn’t get a clear answer…
ChatGPT – The New GoTo Health Care Information Consumer Resource – As of early January, 2026, roughly 1.5 – 2.0 million questions each week are sent as queries to ChatGPT related to health insurance. But, that’s not all folks!! It’s also becoming the go-to for health information on all sorts of problems. If you thought insurance was a big issue, consider this:
§ More than 40 million people query ChatGPT with healthcare questions every day. It’s a message from consumers! Consumers are clearly shifting many of their questions away from traditional sources to the chatbot.
§ Furthermore, nearly 7 of 10 health-related conversations with ChatGPT occur outside of typical clinical hours (much better than the local hospital emergency waiting room). So, it’s clear that consumers are seeking information outside of access to their providers.
§ If you consider the data across the globe, more than 5% of ChatGPT messages are about healthcare = “billions of messages” according to OpenAI.
Ideas and thoughts on how care delivery can be transformed…
Musings from a foodie…
Sometimes I feel like I’ve become a member of the local Rotary Club and one of my jobs is to support local business! And, I do with friends and colleagues who don’t live in Maine. But, for my blog, I’ve always had listings of various places around the nation and the world. But, I’ve been home for a while now. So, I decided to – once again – share a note with my readers on a local gem that is located right here in Kittery, Maine – my adopted hometown. It’s…
Robert’s Maine Grill [⭐⭐⭐⭐⭐⭐]. It’s not a white tablecloth, fancy silverware, poofy-do kind of place, but the preparation on their seafood is among the best I’ve ever had – and the oyster bar at the entrance is always a delight. The oysters come from various farms located up and down the coast of Maine – each with a discernible taste that is uh-la-la.
The restaurant is just off of Route 1 on “Mall Road” in the midst of the outlet malls that bring shoppers from all over the Northeast to Kittery every week. You can’t miss it since it’s located near a bay that extends up to the highway, is an iconic blue-grey building, and there are always lots of cars located in the parking lot!! It’s clearly a sign of quality.
You’ll have your choice of multiple fish as well as lobster rolls. I personally prefer the haddock (YES!!), another local fish, and sometimes the cod (Also, a YES!!). Their prep by the cooks in the kitchen is always perfect! The batter is light, not heavy. And, don’t forget, fish is a healthy source of protein. Plus, it’s always “fresh” at Robert’s. They’ve never disappointed me on this count. I would also definitely recommend oysters as a starter, and the haddock chowder is very worthy of a taste as well. Or, at minimum – perhaps a dip into your partner’s bowl 😊.
And, finally, for dessert, you MUST have the blueberry pie made with Maine blueberries. They are not those “big blue jobs” from places down south (like New Jersey and others) but, instead, those small, pea-sized berries that exude tastiness served with some local vanilla ice cream and it’s to die for… Need I say more? If you get close to Kittery, make your reservations and head to Robert’s. It’s worth the visit.
By the way, there are lots of other options on the menu. You can check it out by going to the Robert’s Maine Grill website or Facebook page. And, if you don’t have Google Maps or Waze, check out this map as a resource for finding this culinary jewel that we treasure here in Maine, which also serves up the very best authentic New England seafood.
The ongoing saga…
The Great – This too shall pass if “WE THE PEOPLE” keep calm and carry on (= a British phrase adopted during WWII) that we should adopt as well during these turbulent times.
The Good – Finally, the U.S. Supreme Court is appropriately stepping up to the Trump Administration.
The Bad – I pulled out my “peace necklace” as a quiet sign of protest for yet another senseless war that will go nowhere when we have so many other resources by engaging the world community in working with the USA to solve global problems…
The Ugly – Robert F. Kennedy, Jr.’s attempt to de-science the incredible abilities we’ve developed at the U.S. Department of Health and Human Services during my lifetime. It was – and will again at some point post-Kennedy’s tenure – be the world’s best resource of solid information on immunizations and other notable healthcare information.
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