Conversations on Health: How We Get There - with Stephani Shelton

What will happen in the US if cases of a now contained virus – or a totally new one -  suddenly start multiplying by the millions? The CDC has drastically cut back on vaccine research as well as childhood vaccine recommendations. What diseases may come roaring back? Episode 40 drops on Tuesday January 20th with some answers from Daniel Jernigan, MD, MPH - one of the former top officials at the CDC. Links to the major podcast platforms and show notes on https://stephanishelton.com/conversations

It’s not exactly an episode – thus the A-40 label. It’s just me talking to you for a few minutes.  We had some last minute cancellations – which of course can happen as the holidays as well as the end of the business and financial year approach.  The historically long US government shut down also took its toll. On virtually everything.

So -- we will resume the usual episodes on the third Tuesday of January – the 20th to be precise - with Episode 40. Please check the podcast page on my website for guest and subject info; it will be there as soon as I know it – stephanishelton.com/conversations.  And while you’re there you may want to review the notes on Episode 37 and then the podcast itself  - the Emergency Update on Autism. You’ll get the actual scientific facts about autism – which Trump appointee and vaccine skeptic Robert F. Kennedy Jr. Is now trying irresponsibly to link to the one drug pregnant women can take to reduce dangerously high fevers – Tylenol. There’s an earlier and more detailed podcast on autism as well – Episode 34 – both with autism expert Amy Wetherby of Florida State University.

One of the subjects I hope to discuss during the coming year is what’s happened to the CDC and the FDA under RFK Jr. And the whole, once highly respected, scientifically factual, federal public health data base. And the government grant money which would normally be going to areas like cancer research and the virtually miracle-like mRNA base for everything from individualized cancer treatments to new vaccines for potential pandemics. Remember – smallpox was eradicated globally thanks to vaccines. And in the US the routine vaccination of children had virtually wiped out measles, polio and many other diseases. Now measles is coming back big time here. It’s a dangerous disease which can and is killing babies, children and even unvaccinated adults. And don’t forget Covid. It still makes a lot of people really sick and still kills a surprising number of them – and not just the very old and ill. Lots of people live their whole life in what we might call fragile health. Vulnerable to many diseases because their immune systems are suppressed by their diseases or by the drugs they take to control those diseases. I could go on a total rant about what RFK Jr. has done to the credibility of any US government report on any disease and what he and the unscientific people he’s appointed to key positions at the CDC and FDA are doing to the overall health and potential health outcomes of the American people. But I’ll leave that for the guests I hope to have in 2026 discussing this situation and where it’s taking us.

I don’t think a lot of people actually understand science. It’s not immutable, not unchangeable. It is called science precisely because as researchers and scientists keep testing what they know, they often learn something new which modifies specifics about a disease or a treatment or a procedure. And so what health professionals use as their guidelines often get rewritten by new discoveries. Which, i think, lots of us find confusing. And when you’re confused you tend to stop believing. In anything.

Of course none of us knows what 2026 will bring. Sadly it’s a pretty sure bet that many people on Obamacare health insurance now won’t be able to afford it after January first – unless there’s a small miracle in the few days left before Congress goes home for its holiday break. On the podcast – I hope to discuss that along with subjects like how venture capital contributes to drug, device and treatment breakthroughs. The extension of the 9-11 Fund for First Responders. And likely some personal stories which a lot of us can identify with. And in small, understandable chunks – i want to discuss more about how all health systems – hybrid like ours or totally government controlled like the rest of the world – will have to change in order to pay for expensive new treatments and the social care that virtually every health system seems to put on the back burner.

I want to thank all of you who have subscribed to this podcast and especially those who have stayed with me over these 3 years. Please tell your friends and colleagues about us. And if you have suggestions for episodes – please let me know. May 2026 bring you and yours health and happiness and the courage to follow your dreams.

YouTube video link:  https://youtu.be/UlTpOZzAMfw

Our neighbor and long-time friend Canada has been the subject of President Trump’s ire -and his tariffs - since he became President again in January. He’s even claimed Canadians would have “much better” health coverage if Canada were somehow to become the 51st US state. Actually, Canada - like almost all other industrialized countries - has a publicly funded, government run health care system. Which is somewhat similar to the UK’s venerable NHS. Which of course this podcast has looked at several times. Every Canadian in the country legally is covered. Although some fringe coverage can vary from province to province. Since there’s so much inaccurate information about the Canadian system floating around – I thought I’d try to set it all straight in a conversation with the extremely well-qualified Gregory P. Marchildon, CM, PhD, FCAH. He’s Professor Emeritus at the University of Toronto’s Institute of Health Policy, Management and Evaluation. And the Founding Director of the North American Observatory on Health Systems and Policies. Gregory Marchildon has worked as a lawyer, senior public servant, and consultant for numerous governments and international organizations. In recognition of his impact on both scholarship and public policy in Canada, he was made a member of the Order of Canada. He has written extensively on Canadian history and public policy. His most recent book is Tommy Douglas and the Quest for Medicare in Canada  published by the University of Toronto Press in 2025. I’m embarrassed at how much I didn’t know about the Canadian system – even with research – until I talked to Greg. I think you’ll learn a lot also..

YouTube Episode    https://youtu.be/_DxK-GUviPY

UPDATE -2/26 SEE END OF SHOW NOTES

As I record this – at the end of the second week in October 2025 – the US government is officially shut down. Senate and House Democrats are demanding negotiations with Republicans and President Trump to restore  major health care cuts to Medicaid and the Affordable Care Act marketplace subsidies for 2026. It’s expected that if these cuts aren’t restored – and restored quickly - insurance premiums will double or even triple. And millions of Americans who now have at least some basic health insurance will be unable to afford any. Many small, rural hospitals may have to close as well.

Which brings me to the overall state of the US healthcare “system” – such as it is. And my guest. Dr. Erica Rowe Urquhart. She’s a leading orthopedic surgeon who runs a private practice in New Jersey with her husband – who’s also a highly credentialed orthopedist. Dr. Urquhart has a PhD in molecular and cellular neuroscience and served her orthopedic surgery residency at New York’s renowned Hospital for Special Services. After 15 years in private practice Dr. Urquhart also got an MBA from Oxford’s Said Business School, so she could deal with the ever more complicated insurance issues we’ll be talking about – issues which often prevent even patients with “good” insurance from getting the medical procedures they need. Her book - The Invisible Hand Wielding the Scalpel - is just out. We cover a huge amount of ground in our conversation and I think you’ll identify with many of the issues we raise. As usual on this informal podcast, we use first names.

YouTube Episode link: https://youtu.be/YFuhwDcJxKU

https://drurquhart.com/

https://www.urquhartortho.com/

Channel link: @conversationsonhealthhowwe4827

UPDATE 1/16/26: Today, January 16th, the Lancet – a prestigious women’s health medical journal – published a review and meta-analysis of 60 studies about Tylenol (acetaminophen)and its potential effect when taken as recommended by pregnant women. The research found no association with autism, intellectual disability or ADHD

UPDATE 9/22/25; There was no real study released in late September, as expected, on a potential causal relationship between autism and Tylenol. Instead we got, basically, a rambling statement from President Trump (with HHS Secretary Robert F. Kennedy Jr.at his side) warning that pregnant women should ask their doctors before taking Tylenol. (Already a protocol). The President  – citing no evidence - told pregnant women  just “tough it out”.

I’m calling this an emergency update on autism – as we wait for the new causal studies authorized by Robert F. Kennedy Jr. – the Secretary of Health and Human Services. So far, according to a recent Reuters report,  researchers have submitted more than 100 proposals for RFK Jr’s 50 million dollar study of autism’s causes – essentially mining the CDC’s large data base. There’s a separate review in progress on vaccine safety as well as the relationship if any to autism. Secretary Kennedy originally made the unlikely  promise to have definitive findings by September – that’s this month  - but has now stretched that much further out.

Earlier this month Kennedy appeared before the Senate Finance Committee for what evolved into a highly contentious hearing. Mostly on vaccines, changes at the CDC  – and autism. There’s an excerpt in the podcast.

So I’m bringing back Dr. Amy Wetherby - one of the top US autism experts - for this emergency update. To set you straight on the facts. The science. What we know now about autism’s causes – which is quite a lot. And how early intervention can change an autistic child’s life. Dr. Wetherby was my guest last June on Episode 34. Here’s the link to that much longer and more detailed podcast. https://youtu.be/5EMedABGCrU

Amy Wetherby is a Distinguished Research Professor in the Department of Clinical Sciences and Director of the Autism Institute in the College of Medicine at Florida State University. She’s also a Fellow of the American Speech-Language-Hearing Association with over 45 years of clinical experience and the Executive Director of the FSU Center for Autism and Related Disabilities. Amy is also co-developer of the websites Autism Navigator and Baby Navigator - which can provide a huge amount of help to the parents and teachers of autistic children. This update was recorded September 12, 2025. I’ll add to these notes if something coming out of HHS or the CDC substantially  changes anything we discussed.  

Autism Navigator now has a new menu of diagnostic services: https://autismnavigator.com/diagnosis-get-started-now/

The Society for Developmental and Behavioral Pediatrics (statement)

YouTube video link:  https://youtu.be/0RTTN5Yh4lc

Channel link: @conversationsonhealthhowwe4827

The cornerstone of any healthcare system is the general practitioner or GP. In the US we’ve renamed the GP to the rather cold sounding “primary care doctor”. Perhaps because so few of us still have that old multi-year connection with our doctor or perhaps because of the way our huge health insurance companies function. In the last podcast – Episode 35 - we talked about the UK’s still ailing health system – the NHS – a year after the Labor Government took over. Not much change yet but a recently released 10 year plan envisions most standard health care centralized in neighborhoods at the GP level. Including the mushrooming varieties of medical imaging.

This doesn’t sound particularly revolutionary – especially if you live in the Czech Republic. Health care there still revolves around the general practitioner.

So we’re going to meet a long time GP in this episode – who also teaches and is involved in many international health care projects.

In addition to his MD, Dr. Bohumil Seifert also holds a PhD and is an Associate Professor at the Institute of General Practice, First Faculty of Medicine at Charles University.  He headed that department for 14 years - until 2023. Dr. Seifert now spends half his time practicing in central Prague – the Czech Republic’s capital. The rest of his time is spent in international activities and research, much of it for the World Health Organization and WONCA - the World Organization of Family Doctors. We used first names in this interview – as is my custom on this podcast.      

YouTube Episode Link:    

Dr. David Marx Episode #1  https://youtu.be/io3rVfvYgj4

The United Kingdom’s National Health Service was founded in 1948 and is considered the mother of all government run health care systems - with Sweden’s slightly later plan for universal coverage just behind. We’ve profiled both systems on this podcast series. But we’re going back to take another look at the NHS --almost exactly one year after labor won a huge parliamentary victory. And the new Prime Minister Sir Keir Starmer and his new Secretary for Health and Social Care Wes Streeting declared the NHS was “broken” and promised to fix it.

All health systems are having trouble adjusting to rising costs and demographic changes but perhaps the faltering NHS has gotten the most notoriety. Health care waiting lists as long as 2 years, doctor shortages and strikes, no hospital beds available for emergency patients – it’s a very long list. Under the government’s recent “Spending Review” – somewhat like the annual US budget outline – the NHS got the lion’s share of the available money – along with the military. And a 10 year plan emphasizes moving to neighborhood health centers for most healthcare instead of it being hospital-based. But what about immediate help for people?  Are there any improvements in this first year?

For the answers – I went back to the UK’s David Hunter - who explained how the UK system works in Episode11. He’s Emeritus Professor of Health Policy and Management at the Population Health Sciences Institute, Newcastle University and also Emeritus Professor at Durham University. His long list of endeavors also includes the recent addition of board member at “Ways to Wellness”.  Which tries to reduce health inequalities. As you watch or listen - you’ll notice a lot of similarities to the US right now. Think Elon Musk’s DOGE and its abrupt firing of so many health policy related government workers. And of course our unending debate about taxation.

This episode was shot, recorded and edited in Prague, Czech Republic before Labor released its 10 year plan to “fundamentally rewire” the NHS.

https://www.bbc.co.uk/programmes/l00578wn

https://www.waystowellness.org.uk/

Episode 11: David Hunter on the NHS: https://youtu.be/jqrNfpxSayA

Episode 18 – Catharina Barkman – Sweden #1:  https://youtu.be/Y4pTu_XcSqA

Episode 19 – Catharina Barkman – Sweden #2:  https://youtu.be/2vdA41ckoVA

What do we actually know about autism? Not enough according to Robert F. Kennedy Jr. – the Health and Human Services Secretary.  He’s promised an initial 50 million dollars for his plan to find out what exactly causes autism. With an unusually short turnaround for research proposals . Remember Kennedy first promised he’d have all the answers by September but then extended that to March and now it appears by the funding guidelines it will be a year or more. Still much faster than research norms.

Many health experts fear HHS will just cherry pick the answers RFK Jr. has pushed for years - including the long-debunked idea vaccines cause autism. The reality is there is already a solid base of data about autism’s cause. And some very successful methods to greatly improve a child’s ability to overcome it.

When I decided to do this episode on autism – i didn’t have to look far to find  one of the top experts in the country – Amy Wetherby, PhD. She just happens to be my cousin. Amy is a Distinguished Research Professor in the Department of Clinical Sciences and Director of the Autism Institute in the College of Medicine at Florida State University. She’s also a Fellow of the American Speech-Language-Hearing Association with over 45 years of clinical experience and the Executive Director of the FSU Center for Autism and Related Disabilities. Amy has served on the National Academy of Sciences Committee for Educational Interventions for Children with Autism and her list of credits and activities goes on and on. She is also co-developer of the websites Autism Navigator  and Baby Navigator for parents and teachers which we discuss extensively on the podcast.

This interview was recorded in early June of 2025; if there are major updates from RFK Jr. – I’ll add them to the show notes also. I learned so much from my conversation with Amy Wetherby – I hope you will also.

The podcast is also available on YouTube:

https://youtu.be/5EMedABGCrU

It’s no secret our population is aging fast. According to the US  Census Bureau, 10,000 Baby Boomers hit that 65 landmark year each day. In fact 2025 is predicted to be “peak 65” demographically – with more than 11,000 Boomers crossing the daily line. Unfortunately as we age – more of us develop dementia and Alzheimer’s – with most of the associated costs paid by Medicare. It’s estimated that for Alzheimer’s care alone – costs are as much as 2.8 times higher than for other seniors.

So Medicare has begun an experimental program called Guide. Partnering with some private, digitally oriented companies to create better dementia outcomes -  both personally for older people and their caretakers and financially for Medicare.

One of those companies is Tembo Health – founded and run by Dr. Anurag Gupta. He’s a practicing emergency physician with both an MBA and an additional degree and board certification in Clinical Infomatics. And lots and lots of real world experience at top rated hospitals.

The concept of public-private partnering in healthcare isn’t new; but it’s certainly not every venture capitalist- financed start-up which hopes to make its mark with dementia care. So here’s my really useful conversation with Dr. Anurag Gupta:

https://www.tembo.health/

https://www.cms.gov/priorities/innovation/innovation-models/guide

YouTube Episode link: https://youtu.be/3Dw1rnp8Rc0

Most of you know something about the opioid crisis. It’s considered one of the most devastating public health catastrophes of our time.

Just to summarize briefly – the first wave of deaths began in the mid 1990s when Purdue Pharma’s newly approved pain drug OxyContin was pushed to doctors. Purdue had lied to the FDA, saying OxyContin was less addictive than other opioids. It was, actually, even more addictive. Then came the wave of deaths from many of those addicts switching to “street” heroin. And then, as we all know, came the synthetic opioid fentanyl. 2024 figures aren’t yet finalized but even though there has been a decline in deaths - the US continues to have the highest rate in the world.

With that as the background – I just had a very illuminating discussion with Dr. Arun Gupta. He started as an internist.  But ultimately, he got so upset about the plight of his addicted patients in his mostly rural Michigan practice that he became a specialized addiction doctor. Then he wrote a book laying out the history of opioids and what needs to be done to help patients recover.  This is a conversation I don’t think you want to miss.

Note: all episodes are also available in video form on YouTube

https://thepreventableepidemicbook.com/ (website is being updated)

https://entrepreneursecho.com/usas-most-compassionate-medical-leader-advocating-access-to-addiction-treatment-nationwide/

https://www.samhsa.gov/substance-use/treatment/overdose-prevention/opioid-overdose-reversal   (NARCAN etc.)