Health

Healthcare is changing fast. More and more often, patients are monitored not in hospital beds but in their own homes. What makes this possible? A combination of smart technology, secure networks, and thoughtful design — all bundled into what we call Remote Patient Monitoring (RPM).

The real engine behind this change is the Internet of Things (IoT). Tiny sensors, wearable devices, and connected platforms now let doctors see how their patients are doing in real time — even from hundreds of miles away. And that’s just scratching the surface.

Healthcare providers who partner with a reliable remote patient monitoring software development company can create systems that support personalized, proactive care — not just reactive treatments.

So, What Is IoT in Remote Patient Monitoring?

What Makes an IoT-Enabled RPM System Work?

1. The Devices Themselves

2. Reliable Data Transmission

3. A Secure Cloud Platform

4. Interfaces That Make Sense

The Value IoT Brings to Remote Monitoring

Timely Alerts and Earlier Interventions

Better Care Without Leaving Home

More Control for People with Chronic Illness

Cost and Time Savings

Where It’s Already Making a Difference

After Surgery

Supporting Aging in Place

Monitoring Pregnancies Remotely

Building Secure, Compliant, Scalable Systems

Looking Ahead: What’s Next for IoT and RPM?

Conclusion – Smart Devices, Smarter Care

Aid workers are also having to cope with a wave of cholera outbreaks in war-torn Sudan.

The World Food Programme (WFP) has said it is “shocked and alarmed” that its premises in southwestern Sudan have been hit by repeated shelling from the Rapid Support Forces (RSF), as the paramilitary group wages a brutal civil war, now in its third year, with the Sudanese army.

“Humanitarian staff, assets, operations and supplies should never be a target. This must stop now”, the United Nations body said on X on Thursday.

#Sudan pic.twitter.com/c4aXtS9zhY

— WFP Media (@WFP_Media) May 29, 2025

El-Fasher is the last major city held by the Sudanese army in the Darfur region. It has witnessed intense fighting between the army and RSF since May 2024, despite international warnings about the risks of violence in a city that serves as a key humanitarian hub for the five Darfur states.

For more than a year, the RSF has sought to wrest control of el-Fasher, located more than 800km (500 miles) southwest of the capital, Khartoum, from the army, launching regular attacks on the city and two major famine-hit camps for displaced people on its outskirts.

Adding to humanitarian woes on the ground, the Health Ministry in Khartoum state on Thursday reported 942 new cholera infections and 25 deaths the previous day, following 1,177 cases and 45 deaths the day before.

Aid workers say the scale of the cholera outbreak is deteriorating due to the near-total collapse of health services, with about 90 percent of hospitals in key war zones no longer operational.

Since August 2024, Sudan has reported more than 65,000 suspected cholera cases and at least 1,700 deaths across 12 of its 18 states. Khartoum alone has seen 7,700 cases and 185 deaths, including more than 1,000 infections in children under five, as it contends with more than two years of fighting between the army and the RSF.

Sudan’s army-backed government in Khartoum state announced earlier this month that all relief initiatives in the state must register with the Humanitarian Aid Commission (HAC), a government body that oversees humanitarian operations in Sudan.

Aid workers and activists are fearful these regulations will lead to a crackdown on local relief volunteers, exacerbating the catastrophic hunger crisis affecting 25 million people across the country.

The HAC was given expanded powers to register, monitor and, critics argue, crack down on local and Western aid groups by former leader Omar al-Bashir in 2006, according to aid groups, local relief volunteers and experts.

The army-backed government announced last week that it had dislodged RSF fighters from their last bases in Khartoum state, two months after retaking the heart of the capital from the paramilitaries.

The city, nonetheless, remains devastated with health and sanitation infrastructure barely functioning.

The RSF has been battling the SAF for control of Sudan since April 2023. The civil war has killed more than 20,000 people, uprooted 15 million and created what the UN considers the world’s worst humanitarian crisis.

This Morning host Craig Doyle made a personal announcement about his mum on Wednesday

This Morning star Craig Doyle received a heart-warming show of support from his co-host Rochelle Humes on Wednesday (May 28) as he shared news of his mother being in hospital.

On today’s episode of the popular ITV show, Craig and Rochelle delivered the latest updates from the UK and around the world.

Following a chat with Deirdre Sanders about the upcoming phone-in segment on in-law issues, Craig took a moment to send his best to his mum in hospital.

Deirdre said: “We’re here to help with any in-law problem,” prompting Craig to jest: “Don’t know what she’s talking about. My in-laws are perfect, morning Dorothy.”

Craig quickly added: “Can I say hello to my mum who’s in hospital. Hello mum, how are you? Have you got the sound up? Good girl,” reports Wales Online.

Rochelle chimed in with a warm message: “Hello mum! Hope you’re good. Love her.”

The duo were filling in for regular hosts Cat Deeley and Ben Shephard, who are taking a break during the half-term holiday. Earlier in the week, Paddy McGuinness and Alison Hammond had taken the reins.

At the beginning of today’s programme, Rochelle praised Craig for his achievement in last month’s London Marathon.

“You’re stuck with Craig and I today, sorry about that,” she said, before turning to Craig: “How are you? I’ve not seen you for a little while and we’ve got a lot to catch up on.

“Since I’ve last seen you, you’ve taken on a big challenge and absolutely nailed it… The London Marathon.”

A photo was then displayed showing Craig proudly posing with his medal, alongside EastEnders icon Adam Woodyatt and TV host Jenni Falconer.

“Ah fantastic! [Jenni] had to have her knee up because it was sweaty day, let’s just say,” Craig shared about the marathon experience.

“I haven’t done one in about 20 years and I thought I was the same as I was 20 years ago, I’m definitely not. It was really, really tough, so congratulations to all of you who finished the marathon… I was slow, I enjoyed it, the crowds were unbelievable.”

In other segments of today’s programme, Craig and Rochelle spoke to renowned opera singer Lesley Garrett, who revealed her private struggle with cancer.

Additionally, Race Across the World contestants Fin and Sioned stopped by the studio to discuss the latest developments in the popular BBC travel show, while Sharon Marshall delivered the latest soap news directly from the set of Emmerdale.

This Morning airs weekdays on ITV at 10am

Water treatment stations attacked by RSF can no longer provide clean water in Khartoum state, which reported 90 percent of the cases.

Sudan’s Ministry of Health has reported a spike in cholera cases in the war-torn country, with 2,700 infections and 172 deaths in the past week.

In a statement on Tuesday, the ministry said 90 percent of cases were reported in Khartoum state, where water and electricity supply have been severely disrupted in recent weeks by drone strikes blamed on the paramilitary Rapid Support Forces (RSF), at war with the army since April 2023.

Cases were also reported in the south, centre and north of the country.

Cholera is endemic to Sudan, but outbreaks have become far worse and more frequent since the war broke out, wrecking already fragile water and sanitation and health infrastructure.

Last Tuesday, the ministry said 51 people had died of cholera out of more than 2,300 reported cases over the past three weeks, 90 percent of them in Khartoum state.

The RSF this month launched drone strikes across Khartoum, including on three power stations, before being completely pushed out of their last holdout positions in the capital last week.

Water treatment stations out of service

The strikes knocked the electricity – and subsequently the local water network – out of service, according to Doctors Without Borders (MSF), forcing residents to turn to unsafe water sources.

“Water treatment stations no longer have electricity and cannot provide clean water from the Nile,” Slaymen Ammar, MSF’s medical coordinator in Khartoum, said in a statement.

Cholera, an acute diarrhoeal illness caused by ingesting contaminated water or food, can kill within hours if untreated. Yet, it is easily preventable and treatable when clean water, sanitation and timely medical care are available.

Sudan’s already fragile healthcare system has been pushed to the “breaking point” by the war, according to the World Health Organization.

Up to 90 percent of the country’s hospitals have at some point been forced to close because of the fighting, according to the doctors’ union, with health facilities regularly stormed, bombed and looted.

The war, now in its third year, has killed tens of thousands, displaced 13 million and created the world’s largest displacement and hunger crisis.

AUSTIN, Texas — Texas this year has been the center of the nation’s largest measles outbreak in more than two decades, as a mostly eradicated disease has sickened more than 700 in the state, sent dozens to hospitals and led to the death of two children who were unvaccinated.

But even as the outbreak slows, a bill approved by state lawmakers and sent to Republican Gov. Greg Abbott would make it significantly easier for parents to enroll their children in school without standard vaccinations for diseases such as measles, whooping cough, polio and hepatitis A and B.

Supporters say the bill streamlines an already legal exemption process that allows families to avoid vaccines for reasons of conscience, religious beliefs or medical reasons. It would let them download the required forms from a website instead of contacting state health officials and waiting for one to come in the mail.

The bill does not change which vaccines are required. However, critics say easing the exemption process opens a door to further outbreaks with potentially deadly results.

“If this bill becomes law, Texas is likely to see more illness, more death and higher health care costs for families and business,” Rekha Lakshmanan, chief strategy officer for Texas-based nonprofit Immunization Project, told state senators before the bill won final approval.

“The outbreak (in Texas) is not a coincidence. It is the canary in the coal mine screaming at the top of its lungs,” she said.

The exemption bill — as well as other bills passed by the Texas House on lawsuits against vaccine makers and removing immunization restrictions on organ transplants — are a snapshot of efforts across dozens of conservative states to question vaccines or roll back requirements.

At the national level, this wave has been buoyed by still-lingering pushback from the COVID-19 pandemic and the Trump administration’s embrace of Robert F. Kennedy Jr., who was one of the nation’s leading anti-vaccine advocates before being appointed secretary of the U.S. Health and Human Services Department.

The most recent federal data shows U.S. kindergarten vaccination rates have dipped since the pandemic — 92.7% in the 2023-24 school year compared to 95% before COVID-19 — and the proportion of children with exemptions rose to an all-time high. And last week, the “Make America Healthy Again” federal report on the nation’s health and wellness questioned the necessity of vaccine mandates for schoolkids.

The national Association of Immunization Managers, an organization of state and local immunization officials, has been tracking nearly 600 vaccine-related bills across the country in 2025, and the majority would not be considered pro-vaccine, said Brent Ewig, the group’s the group’s chief policy officer.

“We saw a spike in vaccine-related bills during the pandemic. The last few years it had been tapering off. With recent actions at the federal level, there has been a spike again,” Ewig said.

The Texas measles outbreak and vaccine requirements

Measles has been considered eliminated from the United States since 2000. The Texas outbreak started in late January in West Texas’ Mennonite communities that have been resistant to vaccines and distrustful of government intervention, and the highly contagious virus quickly jumped to other places with low vaccination rates.

Like many states, Texas requires children to obtain vaccines to protect against 11 diseases to attend public and private schools and child care centers. The state’s vaccination rates for the 2023-24 school year ranged between 93.78% for chicken pox to 95.78% for hepatitis B.

But parents can obtain exemptions for religious or personal reasons, or if a doctor determines it would not be safe because of a medical condition.

Exemption rates in Texas have been rising for nearly two decades, with a dramatic spike over the last five years. According to the Texas Department of Health Services, the agency received exemption requests for nearly 153,000 students in the 2023-2024 fiscal year, up from 136,000 the previous year and nearly double the 77,000 requested in 2019.

Texas’ vaccine rollback

The bill on vaccine exemption paperwork would make it easier for parents to obtain the needed form by letting them download it to a computer or smartphone. The current system where parents ask state health officials to mail a paper copy to their home can sometimes take weeks. The form would still need to be notarized before it is turned in to a school and a student is enrolled.

Advocates say the changes would help parents thread the bureaucratic process and get their children enrolled in school quicker.

“This bill is not about whether vaccines are good or bad, it’s about government efficiency and keeping kids in schools,” said Jackie Schlegal, founder of Texans for Medical Freedom, which advocates for “vaccine freedom of choice.”

Critics argue that simplifying the exemption form process makes it too easy for unvaccinated kids to enroll in a school, endangering the health of other kids and families.

“For years Texas has struck a delicate balance of parents’ right and public health and safety,” Lakshmanan said. “This bill is more than just a form … We can support parents without putting other families at risk.”

Still waiting for a Senate vote is a bill that would allow vaccine makers who advertise in Texas to be sued if their vaccine causes a person to be injured. That bill has been opposed by the Texas Association of Manufacturers.

The author of that bill is first-term state Rep. Shelley Luther, who was briefly jailed in 2020 for opening her Dallas salon in violation of governor’s emergency order during the pandemic. Abbott quickly weakened his enforcement of coronavirus safeguards and a court ordered her released.

Vertuno writes for the Associated Press.

Legislation likely to eventually pass as polls say 90 percent of French in favour of laws that give people with terminal diseases the right to die.

France’s lower house of parliament has approved a right-to-die bill in the first reading, taking an initial step in the lengthy process to pass legislation.

A total of 305 lawmakers in the National Assembly approved the legislation on Tuesday while 199 deputies voted against the bill to grant patients medical assistance to end their lives in defined circumstances.

The text has the backing of President Emmanuel Macron but is opposed by some conservative groups.

In a statement on X, Macron praised the approval of the bill as “an important step” on “the path of fraternity”.

“The National Assembly’s vote on legislation concerning the development of palliative care and assisted dying is an important step,” Macron posted. “With respect for sensitivities, doubts and hopes, the path of fraternity that I hoped for is gradually opening up.”

The legislation will be sent to the French Senate for further debate. Months could be required to schedule a definitive vote on the measure, given France’s long and complex parliamentary process. The National Assembly has the final say over the Senate.

The legislation is expected to eventually pass as polls indicated that more than 90 percent of French people are in favour of laws that give people with terminal diseases or going through interminable suffering the right to die.

The proposed measure defines assisted dying as allowing people to use lethal medication under certain conditions. They may take it themselves, or those whose physical conditions don’t allow them to do so alone would be able to get help from a doctor or nurse.

Strict conditions

To benefit, patients would need to be over 18, be French citizens or live in France.

A team of medical professionals would need to confirm that the patient has a grave and incurable illness “at an advanced or terminal stage”, is suffering from intolerable and untreatable pain, and is seeking lethal medication of their own free will.

Patients with severe psychiatric conditions and neurodegenerative disorders such as Alzheimer’s disease will not be eligible.

A person would initiate the request for lethal medication and confirm the request after a period of reflection.

If approved, a doctor would deliver a prescription for the lethal medication, which could be taken at home, a nursing home or a healthcare facility.

A 2023 report indicated that most French citizens back legalising end-of-life options, and opinion polls showed growing support over the past 20 years.

Initial discussions in parliament last year were abruptly interrupted by Macron’s decision to dissolve the National Assembly, plunging France into a months-long political crisis.

Chris Packham, 64, has opened up about his mental health battles and how he once ‘didn’t want to be on this planet any longer’, but his beloved pets gave him ‘purpose’

Chris Packham has poignantly disclosed that his pets provided him with ‘purpose’ during his lowest moments, confessing: “My dogs saved my life.”

The much-loved wildlife expert is set to grace our screens again on Monday, May 26, with the return of the beloved series Springwatch, where he will co-host with his long-time colleague Michaela Strachan.

Despite his cheerful television presence, the 64-year-old has spoken out about his struggles with mental health and a time when he “didn’t want to be on this planet any longer”.

In an intimate chat with Country Living, Chris, who rose to fame with the ’80s hit show The Really Wild Show, revealed: “My dogs saved my life.”

He elaborated: “I’ve been in some dark places. I was so miserable I didn’t want to be on this planet any longer, but my dogs took that choice away. They gave me the gift of purpose – and it’s the reason I’m still here,” reports Gloucestershire Live.

The devoted animal enthusiast expressed how his connection with his Poodles was so profound that he “couldn’t break it”.

He remarked: “I used to call my previous dogs ‘my joy grenades’. I’d let them off the lead, and they’d run for the sheer joy of running. It didn’t matter how miserable I was, that would always put a smile on my face.”

Diagnosed with Asperger’s Syndrome at the age of 44, Chris notes that individuals on the autism spectrum can often form even stronger bonds with dogs.

“I think it’s because we’re never judged. We are always accepted by that animal: the bonds are very tight,” he explained.

“Dogs offer us unconditional love. They are always pleased to see us. We trust them implicitly. I sleep with my dogs, we eat the same thing. I have an enormous responsibility and duty of care to make sure that my dogs are happy and healthy.”

Springwatch is celebrating its 20th year with a brand new segment called Springwatch Street, giving viewers a glimpse into the hidden lives of urban wildlife like foxes and swifts.

Ahead of the new series, Chris spoke about his relationship with co-host Michaela, saying: “We’re great friends. We know each other really well, so sometimes we may disagree about something, and the team may look at us and think, ‘Oh my goodness, the presenters have fallen out!’

“But we haven’t. We don’t get upset about those things. We don’t have to agree about everything. We just move on. So, the fact that we’re great, lifelong, trusted mates helps, but also that we work in very different ways in terms of way that we approach our job.”

Springwatch returns to BBC Two from Monday, May 26 at 8pm

*If you have been affected by this story, you can call the Samaritans for free on 116 123 or visit Samaritans

Israeli forces have killed more than a dozen Palestinian children in the Gaza Strip in the last 48 hours, while thousands more face the threat of imminent starvation amid a drastically deteriorating humanitarian crisis.

On Sunday, four-year-old Mohammed Yassine joined dozens of other children who have starved to death in recent days as the World Food Programme (WFP) warned that more than 70,000 children in Gaza face acute levels of malnutrition.

As well as causing starvation deaths, Israel has intensified its bombardment and ground offensive in Gaza, killing some 600 people in nearly a week.

A strike on a tent housing displaced people in central Gaza killed a mother and her children in the central city of Deir el-Balah, according to Al-Aqsa Hospital, while a child was killed when his family’s tent was struck with a drone in Bani Suheila, east of Khan Younis, the Palestinian news agency Wafa reported.

A strike in the Jabaliya area of northern Gaza killed at least five, including two women and a child, according to Gaza’s Health Ministry.

Eleven-year-old Yaqeen Hammad, a popular social media influencer, and nine of Dr Alaa Amir al-Najjar’s 10 children were also killed in separate Israeli air raids. Al-Najjar’s remaining child, 11-year-old Adam, is in critical condition in an intensive care unit.

The attacks come amid an Israeli blockade for almost three months that has choked off access to essential food, fuel, and medical supplies. Aid agencies warn that thousands of children are now at risk of death from starvation.

Children account for 31 percent of Palestinians confirmed killed during Israel’s 19 months of war on Gaza, according to the Ministry of Health in Gaza. This figure excludes deaths that have been reported but for which the victims remain unidentified, suggesting the real toll is higher.

A report commissioned by the United Nations also highlighted Israel’s disproportionate violence against children through targeting densely populated areas, with repeated air raids on residential buildings contributing to the rising child death toll.

At least 22 Palestinians were killed in Israeli attacks across the Gaza Strip since dawn on Sunday, according to Al Jazeera Arabic.

Below are some of the children killed in Israeli attacks:

Yaqeen Hammad

Known for her smile and volunteer work in Gaza, Yaqeen Hammad was killed after Israel shelled al-Baraka in Deir el-Balah, northern Gaza, on Friday night.

The 11-year-old influencer and her older brother, Mohamed Hammad, delivered food, toys and clothing to displaced families, the Palestine Chronicle reports. She also played an active role in the Ouena collective – a Gaza-based nonprofit group dedicated to aid and humanitarian relief.

Messages of grief and tributes from activists, Yaqeen’s followers and journalists poured in after news of her death spread online.

“Her body may be gone, but her impact remains a beacon of humanity,” wrote Mahmoud Bassam, a photojournalist in Gaza.

“Instead of being at school and enjoying her childhood, she was active on Instagram and participating in campaigns to help others in Gaza. No words. Absolutely no words,” another tribute read on X.

Mohammed Yassine

Activists and Palestinian platforms shared on social media painful scenes of Mohammed Yassine on a hospital bed.

Appearing in a video, holding Yassine’s body, Mahmoud Basal of Gaza’s Civil Defence said: “Mohammed Yassine died from hunger, a direct result of the occupation’s prevention of food and medical aid from entering Gaza.”

“Mohammed was not the first child, and the fear has become a certainty that he won’t be the last,” Basal added.

Dr Alaa al-Najjar’s nine children

An Israeli attack on the home of al-Najjar on Friday killed nine of her children and critically injured 11-year-old Adam.

Sidar, Luqman, Sadin, Reval, Ruslan, Jubran, Eve, Rakan and Yahya  – aged between seven months and 12 years – all died in the attack, Gaza’s Government Media Office said.

Al-Najjar is a paediatrician at the southern city’s Nasser Hospital, where her husband is receiving care after being critically injured in the attack.

“It is unbelievable,” said Ahmad al-Farra, head of the hospital’s paediatrics department, of the attack’s impact.

“You can’t imagine the shock that [al-Najjar] had when she heard about that [attack]. But up until now, she is trying to be near her son and her husband to survive.”

A Medicaid bill pushed by Republicans proposes significant cuts to the health insurance programme for lower-income Americans. But United States President Donald Trump has claimed the legislation would change Medicaid in ways that only combat “waste, fraud and abuse”, a phrase he repeated seven times over a couple of minutes.

“We’re not doing any cutting of anything meaningful,” the Republican president said. “The only thing we’re cutting is waste, fraud and abuse. … We’re not changing Medicaid, and we’re not changing Medicare, and we’re not changing Social Security.”

The House of Representatives passed the bill on Thursday, and it now moves to the Senate, where it could be changed. The House version doesn’t directly target Social Security or Medicare. But it changes Medicaid, including in ways that align with Republican priorities.

Congress’s nonpartisan Congressional Budget Office has projected that at least 8.6 million people will lose coverage because of the changes.

“Relatively little of the bill is clearly related to trying to reduce fraud or error,” said Leighton Ku, director of George Washington University’s Center for Health Policy Research. “There are some minor provisions about things like looking for dead people who are enrolled or checking addresses. But the major provisions are not fraud, waste or error by any means. They’re things that reflect policy preferences of the Republican architects.”

Robin Rudowitz, vice president and director of the Program on Medicaid and the Uninsured at the health policy research group KFF, agreed that the scope of the bill’s changes go further than Trump said. “The magnitude of the federal spending reductions and resulting coverage loss go well beyond rooting out fraud and abuse,” she said.

The bill’s key provisions could be removed before the final votes and enactment while others may be added.

The White House did not respond to an inquiry for this fact check.

How the federal government defines waste, fraud and abuse

The Centers for Medicare and Medicaid Services, the federal agency that runs Medicaid, offers official definitions for these three terms:

• Fraud: “When someone knowingly deceives, conceals, or misrepresents to obtain money or property from any health care benefit program. Medicare or Medicaid fraud is considered a criminal act.”
• Waste: “Overusing services or other practices that directly or indirectly result in unnecessary costs to any health care benefit program. Examples of waste are conducting excessive office visits, prescribing more medications than necessary, and ordering excessive laboratory tests.”
• Abuse: “When health care providers or suppliers perform actions that directly or indirectly result in unnecessary costs to any health care benefit program. Abuse includes any practice that doesn’t provide patients with medically necessary services or meet professionally recognised standards,” such as overbilling or misusing billing codes.

Some bill provisions can be described as targeting waste, fraud and abuse

One provision in the bill requires states to confirm recipients’ Medicaid eligibility at least every six months rather than every year under current law. Another would set stricter requirements for verifying enrollees’ addresses and other information.

Such efforts could save expenditures on ineligible people and could be classified as a waste-prevention measure.

Other provisions are more ideological than focused on waste, fraud and abuse

Several of the bill’s highest-profile provisions are driven more by ideology – differences in how expansive the programme should be and what types of people should benefit.

One of these provisions involves people in the US without documentation.

Because it’s already against the law to spend federal Medicaid funds on undocumented people, the bill takes a different approach: It seeks to make it harder for states to exclusively rely on state funds to cover immigrants in the US. Currently, 14 states and the District of Columbia cover children regardless of their immigration status, and seven states plus Washington, DC, cover at least some adults living in the US without documents too.

For these states, the bill reduces the federal government’s share of Medicaid payments from 90 percent to 80 percent.

In other words, if a state wants to keep covering undocumented people, it will face a cut in the federal reimbursement rate for the coverage of US citizens, not just immigrants in the country without documents. Budgetary pressures in these states could mean that some citizens also lose some of their benefits or all of their Medicaid coverage.

Another provision involves work requirements. The bill would require individuals aged 19 to 64 receiving Medicaid under the Affordable Care Act expansion, which was passed during former President Barack Obama’s Democratic administration, to be working or participating in qualifying activities (such as having a disability, being a caretaker for family members or attending school) for at least 80 hours per month.

Research has found that the vast majority of people who would be required to work under similar requirements are already employed or have a qualifying exemption — yet many get thrown off Medicaid because they fail to keep up with the mandatory paperwork.

“Work requirements are not about waste, fraud, and abuse. They are fundamentally changing the rules of who is eligible for the programme, and they are adding an immense set of bureaucratic obstacles and red tape for eligible people to keep coverage,” said Benjamin D Sommers, a professor of healthcare economics and medicine at Harvard University’s TH Chan School of Public Health and Harvard Medical School.

A KFF analysis in March found that fraud occurs in Medicare and Medicaid mostly by providers. “There are checks on fraud, waste, and abuse at both the federal and the state levels,” KFF wrote.

Another bill provision bans Medicaid funds spent on nonprofit organisations primarily engaged in family planning or reproductive services, which would affect Planned Parenthood and other organisations that provide abortions.

Finally, at least two provisions focus on saving money. One would require, for the first time, that states impose $35 copays for many types of care. The other would limit retroactive coverage after applying for Medicaid to one month before application, down from 90 days. These provisions don’t specify how they’d root out waste, fraud and abuse.

“The ‘Medicaid savings’ in this bill are primarily from reducing programme enrolment,” Sommers said.

Our ruling

Trump said the House bill is “not changing Medicaid,” only cutting “waste, fraud and abuse”.

The legislation includes provisions that could improve the detection of beneficiaries who aren’t eligible for coverage.

But other provisions would change Medicaid to align with Trump’s ideology and Republican priorities. The bill would incentivise states to stop using their own funds to cover undocumented people in the US; it requires people to work or do other approved activities to secure benefits; and it bans Medicaid payments to nonprofits such as Planned Parenthood, which provide abortions among other services.

Other changes aim to cut expenses, including the imposition of copays and a shorter window for retroactive coverage. Those provisions don’t specify how they’d cut waste, fraud or abuse.

We rate the statement false.

Across Los Angeles, the Inland Empire and the Coachella Valley, one community health center is extending its services to immigrant patients in their homes after realizing that people were skipping critical medical appointments because they’ve become too afraid to venture out.

St. John’s Community Health, one of the largest nonprofit community healthcare providers in Los Angeles County that caters to low-income and working-class residents, launched a home visitation program in March after learning that patients were missing routine and urgent care appointments because they feared being taken in by U.S. Immigration and Customs Enforcement agents.

St. John’s, which offers services through a network of clinics and mobile units across the region, estimates that at least 25,000 of its patients are undocumented, and about a third of them suffer from chronic conditions, including diabetes and hypertension, which require routine checkups. But these patients were missing tests to monitor their blood sugar and blood pressure, as well as appointments to pick up prescription refills.

Earlier this year, the health center began surveying patients and found that hundreds were canceling appointments “solely due to fear of being apprehended by ICE.”

President Trump came into his second term promising the largest deportation effort in U.S. history, initially focusing his rhetoric on undocumented immigrants who had committed violent crimes. But shortly after he took office, his administration said they considered anyone in the country without authorization to be a criminal.

In the months since, the new administration has used a variety of tactics to sow fear in immigrant communities. The Department of Homeland Security has launched an ad campaign urging people in the country without authorization to leave or risk being rounded up and deported. Immigration agents are showing up at Home Depots and inside courtrooms, in search of people in the U.S. without authorization. Increasingly, immigrants who are detained are being whisked away and deported to their home countries — or, in some cases, nations where they have no ties — without time for packing or family goodbyes.

The Trump administration in January rescinded a policy that once shielded sensitive locations such as hospitals, churches and schools from immigration-related arrests.

In response to the survey results, St. John’s launched the Health Care Without Fear program in an effort to reach patients who are afraid to leave their homes. Jim Mangia, chief executive and president of St. John’s, said in a statement that healthcare providers should implement policies to ensure all patients, regardless of immigration status, have access to care.

“Healthcare is a human right — we will not allow fear to stand in the way of that,” he said.

Bukola Olusanya, a nurse practitioner and the regional medical director at St. John’s, said one woman reported not having left her home in three months. She said she knows of other patients with chronic conditions who aren’t leaving their house to exercise, which could exacerbate their illness. Even some immigrants in the U.S. legally are expressing reservations, given news stories about the government accusing people of crimes and deporting them without due process.

Olusanya said waiting for people to come back in for medical care on their own felt like too great a risk, given how quickly their conditions could deteriorate. “It could be a complication that’s going to make them get a disability that’s going to last a lifetime, and they become so much more dependent, or they have to use more resources,” she said. “So why not prevent that?”

On a recent Thursday at St. John’s Avalon Clinic in South L.A., Olusanya prepared to head to the home of a patient who lived about 30 minutes away. The Avalon Clinic serves a large population of homeless patients and has a street team that frequently uses a van filled with medical equipment. The van is proving useful for home visits.

Olusanya spent about 30 minutes preparing for the 3 p.m. appointment, assembling equipment to draw blood, collect a urine sample and check the patient’s vitals and glucose levels. She said she has conducted physical exams in bedrooms and living rooms, depending on the patient’s housing situation and privacy.

She recalled a similar drop in patient visits during Trump’s first administration when he also vowed mass deportations. Back then, she said, the staff at St. John’s held drills to prepare for potential federal raids, linking arms in a human chain to block the clinic entrance.

But this time around, she said, the fear is more palpable. “You feel it; it’s very thick,” she said.

While telehealth is an option for some patients, many need in-person care. St. John’s sends a team of three or four staff members to make the house calls, she said, and are generally welcomed with a mix of relief and gratitude that makes it worthwhile.

“They’re very happy like, ‘Oh, my God, St. John’s can do this. I’m so grateful,’ ” she said. “So it means a lot.”

A growing coalition of HIV prevention organizations, health experts and Democrats in Congress are sounding the alarm over sweeping Trump administration cuts to HIV/AIDS prevention and surveillance programs nationally, warning they will reverse years of progress combating the disease and cause spikes in new cases — especially in California and among the LGBTQ+ community.

In a letter addressed Friday to Health and Human Services Secretary Robert F. Kennedy Jr., Rep. Laura Friedman (D-Glendale) and 22 of her House colleagues demanded the release of HIV funding allocated by Congress but withheld by the Trump administration. They cited estimates from the Foundation for AIDS Research, known as amfAR, that the cuts could lead to 143,000 additional HIV infections nationwide and 127,000 additional deaths from AIDS-related causes within five years.

Friedman said the effects would be felt in communities small and large across the country but that California would be hit the hardest. She said L.A. County — which stands to lose nearly $20 million in annual federal HIV prevention funding — is being forced to terminate contracts with 39 providers and could see as many as 650 new cases per year as a result.

According to amfAR, that would mark a huge increase, pushing the total number of new infections per year in the county to roughly 2,000.

“South L.A. and communities across California are already feeling the devastating impacts of these withheld HIV prevention funds. These cuts aren’t just numbers — they’re shuttered clinics, canceled programs, and lives lost,” Friedman said in a statement to The Times.

As one example, she said, the Los Angeles LGBT Center — which is headquartered in her district — would likely have to eliminate a range of services including HIV testing, STD screening, community education and assistance for patients using pre-exposure prophylaxis, or PrEP, a medicine taken by pill or shot that can greatly reduce a person’s risk of becoming infected from sex or injection drug use.

A list reviewed by The Times of L.A. County providers facing funding cuts included large and small organizations and medical institutions in a diverse set of communities, from major hospitals and nonprofits to small clinics. The list was provided by a source on the condition of anonymity in order to be candid about the funding of organizations that have not all publicly announced the cuts.

The affected organizations serve a host of communities that already struggle with relatively high rates of HIV infection, including low-income, Spanish speaking, Black and brown and LGBTQ+ communities.

According to L.A. County, the Trump administration’s budget blueprint eliminates or reduces a number of congressionally authorized public health programs, including funding cuts to the domestic HIV prevention program and the Ryan White program, which supports critical care and treatment services for uninsured and underinsured people living with HIV.

The county said the cuts would have “an immediate and long-lasting impact” on community health.

Dozens of organizations and hospitals, such as Children’s Hospital of Los Angeles, are bracing for the disruption and potential vacuum of preventative services they’ve been providing to the community since the 1980s, according to Claudia Borzutzky, the hospital’s Chief of Adolescent and Young Adult Medicine.

Borzutzky said without the funding, programs that provide screening, education, patient navigation and community outreach — especially for at-risk adolescents and young adults — will evaporate. So, too, will free services that help patients enroll in insurance and access HIV prevention medications.

Patients who “face a variety of health barriers” and are often stigmatized will bear the brunt, she said, losing the “role models [and] peer educators that they can relate to and help [them] build confidence to come into a doctor’s office and seek testing and treatment.”

“We are having to sunset these programs really, really quickly, which impacts our patients and staff in really dramatic ways,” she said.

Answers to queries sent to other southern California health departments suggested they are trying to figure out how to cope with budget shortfalls, too. Health officials from Kern, San Bernardino and Riverside counties all said the situation is uncertain, and that they don’t yet know how they will respond.

Friedman and her colleagues — including fellow California representatives Nancy Pelosi, Judy Chu, Gilbert Cisneros Jr., Robert Garcia, Sam Liccardo, Kevin Mullin, Mark Takano, Derek Tran and George Whitesides — said they were concerned not only about funding for programs nationwide being cut, but also about the wholesale dismantling or defunding of important divisions working on HIV prevention within the federal government.

They questioned in their letter staffing cuts to the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention at the U.S. Centers for Disease Control and Prevention, as well as “the reported elimination” of the Division of HIV Prevention within that center.

In addition to demanding the release of funds already allocated by Congress, the representatives called on Kennedy — and Dr. Debra Houry, deputy director of the CDC — to better communicate the status of ongoing grant funding, and to release “a list of personnel within CDC who can provide timely responses” when those groups to whom Congress had already allocated funding have questions moving forward.

“Although Congress has appropriated funding for HIV prevention in Fiscal Year 2025, several grant recipients have failed to receive adequate communication from CDC regarding the status of their awards,” Friedman and her colleagues wrote. “This ambiguity has caused health departments across the country to pre-emptively terminate HIV and STD prevention contracts with local organizations due to an anticipated lack of funding.”

The letter is just the latest challenge to the Trump administration’s sweeping cuts to federal agencies and to federal funding allocated by Congress to organizations around the country.

Through a series of executive orders and with the help of his billionaire adviser Elon Musk’s “Department of Government Efficiency” and other agency heads, Trump in the first months of his second term has radically altered the federal government’s footprint, laying off thousands of federal workers and attempting to claw back trillions of dollars in federal spending — to be reallocated to projects more aligned with his political agenda, or used to pay for tax cuts that Democrats and independent reviewers have said will disproportionately help wealthy Americans.

California Atty. Gen. Rob Bonta’s office has repeatedly sued the Trump administration over such moves, including cuts and layoffs within Health and Human Services broadly and cuts to grants intended to make states more resistant to infectious disease specifically — calling them unwise, legally unjustifiable and a threat to the health of average Americans.

LGBTQ+ organizations also have sued the Trump administration over orders to preclude health and other organizations from spending federal funding on diversity, equity and inclusion programs geared toward LGBTQ+ populations, including programs designed to decrease new HIV infections and increase healthy management of the disease among transgender people and other vulnerable groups.

“The orders seek to erase transgender people from public life; dismantle diversity, equity, inclusion, and accessibility initiatives; and strip funding from nonprofits providing life-saving health care, housing, and support services,” said Jose Abrigo, the HIV Project Director of Lambda Legal, in a statement. The legal group has filed a number of lawsuits challenging the Trump administration cuts, including one on behalf of the San Francisco AIDS Foundation and other nonprofits.

Trump has defended his cuts to the federal government as necessary to implement his agenda. He and his agency leaders have consistently said that the cuts target waste, fraud and abuse in the government, and that average Americans will be better served following the reshuffling.

Kennedy has consistently defended the changes within Health and Human Services, as well. Agency spokespeople have said the substantial cuts would help it focus on Kennedy’s priorities of “ending America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins.”

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy has said. “This Department will do more — a lot more — at a lower cost to the taxpayer.”

Kennedy has repeatedly spread misinformation about HIV and AIDS in the past, including by giving credence to the false claim that HIV does not cause AIDS.

As recently as June 2023, Kennedy told a reporter for New York Magazine that there “are much better candidates than H.I.V. for what causes AIDS,” and he has previously suggested that environmental toxins and “poppers” — an inhalant drug popular in the gay community — could be causes of AIDS instead.

None of that is supported by science or medicine. Studies from around the world have proven the link between HIV and AIDS, and found it — not drug use or sexual behavior — to be the only common factor in AIDS cases.

Officials in L.A. County said they remained hopeful that the Trump administration would reverse course after considering the effects of the cuts — and the “detrimental impacts on the health and well-being of residents and workers across” the county if they are allowed to stand.

For Miley Cyrus, an “extremely excruciating” pain preceded “Something Beautiful.”

The pop star and Disney channel alumna this week spoke candidly about her mental, emotional and physical health, unveiling that she powered through a “medical emergency” during her live “New Year’s Eve Party” TV special three years ago. The Grammy-winning “Flowers” musician said she suffered an ovarian cyst rupture.

“We didn’t know exactly what was going on, but it was pretty traumatic, ’cause it was extremely excruciating,” she told DJ and Apple Music interviewer Zane Lowe in a far-ranging conversation published Wednesday. “I did the show anyways.”

The “Wrecking Ball” and “Party in the U.S.A” singer, 32, rang in 2023 for NBC, co-hosting her “Miley’s New Year’s Eve Party” with godmother and music icon Dolly Parton. During the special, produced by “Saturday Night Live” boss Lorne Michaels, Cyrus performed live, taking the stage alongside Parton, Paris Hilton, Sia and Fletcher. Latto, Rae Sremmurd and Liily were also among the musical acts who joined the New Year’s celebration.

Cyrus, who said she couldn’t pass up an opportunity to work with both Michaels and Parton, told Lowe the holiday gig “was really hard on me” and did not go into further detail about the health scare. Ovarian cysts are fluid-filled sacs found in an ovary or on its surface. Cysts are common and can often be harmless and cause little to no discomfort, but larger cysts can bring about symptoms including pelvic pain, abdominal pressure and bloating, according to the Mayo Clinic. Cysts can “become twisted or burst open,” causing “pain and bleeding inside the pelvis.”

The “Hannah Montana” star also opened up about a polyp on her vocal cords, which makes live performances feel like “running a marathon with the weights on,” and her sobriety journey. Cyrus has been in the public eye since childhood and in recent years has spoken about her struggles with addiction. In December 2020, she told Rolling Stone about her drug and alcohol use and how the young, drug-related deaths of artists including Amy Winehouse, Janis Joplin and Jimi Hendrix prompted her to “pull my[self] together before I’m 27.”

For Cyrus, sobriety hasn’t always been a straightforward path, but this week she said “sobriety is … like my God.”

“I need it. I live for [it]. It’s changed my entire life,” she said before acknowledging there was a moment she “fell apart” in recent years. “I was so close to who’s sitting here right now but … [life] had more lessons for me.”

Cyrus, who won her first career Grammy for “Flowers” in 2024, is on the verge of a new, theatrical and fashionable era. Her ninth studio album, “Something Beautiful” is due May 30 and will be accompanied by a film in June.

“This era marks another bold artistic evolution for Miley, blending music and film into an immersive experience,” according to an announcement shared to her Instagram page.

“Something Beautiful,” Cyrus said in the Apple Music chat, “ couldn’t [be] any more personal to me.”

She added: “Every single string, sound… sequin, strand of hair, eye lash has been considered and created not only something that I love but something that I’m excited to share with [fans.]”

On Oct. 29, 2022, the universe told Dr. Casey Means her fate lay in Los Angeles.

President Trump’s new pick for surgeon general wrote in her popular online newsletter of her epiphany, which came during a dawn hike among the cadmium-colored California oaks and flames of wild mustard flower painting the Topanga Canyon: “You must move to LA. This is where your partner is!’”

Los Angeles has been a Shangri-La for health-seekers since its Gold Rush days as the sanitarium capital of the United States.

Today, it’s the epicenter of America’s $480-billion wellness industry, where gym-fluencers, plant-medicine gurus and celebrity physicians trade health secrets and discount codes across their blue-check Instagram pages and chart-topping podcasts.

But by earning Trump’s nod, Means, 37, has ascended to a new level of power, bringing her singular focus on metabolic dysfunction as the root of ill health and her unorthodox beliefs about psilocybin therapy and the perils of vaccines to the White House.

The surgeon general is the country’s first physician, and the foremost authority on American medicine. Means’ central philosophy — that illness “is a result of the choices you make” — puts her in lockstep with Health and Human Services Secretary Robert F. Kennedy Jr. and in opposition to generations of U.S. public health officials.

Means declined to comment. But interviews with friends and her public writings track a metamorphosis since her move to L.A., from a med-tech entrepreneur and emerging wellness guru to the new face of Trump’s “Make America Healthy Again” movement, or MAHA for short.

If confirmed, America’s next top doctor will bring another unconventional addition to the surgeon general’s uniform: a baby bump. Friends told The Times Means and her husband, Brian Nickerson, are expecting a baby this fall.

“[The pregnancy] will definitely empower her,” said Dr. Darshan Shah, a popular longevity expert and longtime friend of Means. “It might create even more of a sense of urgency.”

On this, both supporters and critics agree. Fertility is a primal obsession of the MAHA movement, and a unifying policy priority among otherwise heterodox MAGA figureheads from Elon Musk to JD Vance. In this worldview, motherhood itself is a credential.

“She’s going to say, ‘I’m a mom, and the reason why you can trust me is I’m a mom,’” said Jessica Malaty Rivera, an infectious disease epidemiologist and an outspoken critic of Means.

Mothers have long been the standard-bearers for Kennedy’s wellness crusade. “MAHA moms” flanked him at the White House during a roundtable in March, where they filmed themselves struggling to pronounce common food additives. Many flocked to Trump after the president vowed to put Kennedy in charge of the nation’s healthcare.

Deena Metzger at her Topanga home. Metzger is a poet, novelist, essayist, storyteller, teacher, healer and medicine woman who has taught and counseled for over fifty years.

(Al Seib/For The Times)

“It’s such a radical change that’s required [in medicine],” said the writer and healer Deena Metzger, 88, whom Means has called one of her “spiritual guides.” “It’s wildly exciting that she might be surgeon general, because she’s really thinking about health.”

Her outsider status gives her a clear-eyed perspective, her supporters say.

“The answer to our metabolic dysfunction is through lifestyle,” said Dr. Sara Szal Gottfried, an OBGYN and longtime friend of Means. “Seventy percent of our healthcare costs are due to lifestyle choices, and that’s where she starts.”

Means’ 2024 bestseller “Good Energy” touts much the same message: Simple individual changes could make most people healthy, but the medical system profits by keeping them sick.

“Moms (and families) will not stand anymore for a country that profits massively off kids getting chronically sick,” Means posted on X on Jan. 30. “Nothing can stop the frustration that is leading to this movement.”

Critics say that elides a more complex reality.

“This is what we call terrain theory — it’s the inverse of germ theory,” said Rivera, the epidemiologist. “Terrain theory has a very deeply racist and kind of eugenic origin, in which certain people got sick and certain people didn’t.”

She and others point out that Means is being elevated at the same time the administration guts public health infrastructure, slashing staff and research funding and aiming to cut billions more from public safety net programs.

“MAHA is why we are defunding the [Centers for Disease Control and Prevention and National Institutes of Health],” Rivera said. “Thirteen million people could be uninsured because of [Medicaid cuts].”

But trust in those institutions — and in physicians generally — has tanked in the past five years, surveys show.

The blurring of personal pathos and professional authority at a moment of crisis for institutional medicine is central to MAHA’s influence and power, public health experts say. They point to the movement’s broad appeal from cerulean Santa Monica to crimson Gaines County, Texas, as evidence that health skepticism transcends political lines.

“[MAHA] has sucked in a lot of my blue friends and turned them purple,” Rivera said. “I have people doing the mental gymnastics of ‘I’m not MAGA, I’m just MAHA.’ I’m like, ‘I don’t think you realize those two things are one thing now.’”

Means’ own celebrity is similarly vast, uniting Americans fed up with what they see as a sclerotic and corrupt medical system.

Her opposition to California’s stringent childhood vaccine mandates, enthusiasm for magic mushrooms, and obsession with all things “clean” and “natural” have endeared her to everyone from raw milk fans to anti-vaxxers to boosters of Luigi Mangione, the accused killer of a healthcare chief executive who regularly receives fan mail while awaiting trial in Brooklyn’s Metropolitan Detention Center.

“We’ve never had anyone in that role [of surgeon general] who almost anyone knew who they were,” Dr. Joel Warsh, a Studio City pediatrician and fellow MAHA luminary, whose book on vaccines “Between a Shot and a Hard Place” came out this week. “We know the public loves her.”

That adoration may yet outshine concerns over Means’ medical qualifications — despite her elite education, she left just months before the end of her residency as an ear, nose and throat surgeon at Oregon Health & Science University. Her Oregon medical license is current but inactive and her experience in public health policy is limited.

And while the nominee vigorously defends the brand partnerships that often bookend her newsletters and social media posts, others see the dark side of L.A. influence in the practice.

“L.A. is its own universe when it comes to wellness,” Rivera said. “You can convince anybody to buy a $19 strawberry at Erewhon and say it’s worth it, the same way you can sell people colonics and detox cleanses and all kinds of wellness smoke and mirrors.”

Means made her name as CEO of a subscription health tracking service whose distinguishing feature is blood sugar monitoring for non-diabetics — a practice she touts across several chapters of her book. Her newsletter readers are regularly offered 20% off $1.50-per-pill probiotics or individually packaged matcha mix promising “radiant skin” for its drinkers.

More recently, she’s partnered with WeNatal, a bespoke prenatal vitamin company whose flagship product contains almost the same essential molecules as the brands offered through Medicaid — the insurance half of pregnant Californians use. Taking it daily from conception to birth would cost close to $600.

“So many of the companies that she supports, so many of the companies selling snake oil have some connection to or presence in Los Angeles,” Rivera went on. “It is the mecca for that kind of stuff.”

Even some in the doctor’s inner circle have misgivings about the world of influence that launched her, and the administration she’s poised to join.

Deena Metzger is at the center of a web of influence surgeon general nominee Dr. Casey Means found when she moved to L.A.

(Al Seib / For The Times)

“I’m not sure the obsession with wellness is really about wellness,” Metzger said, her husky Gentle Boy lying at her feet in her home in Topanga. “There’s wellness, which is maybe even a social fabrication, and there’s health.”

The writer and breast cancer survivor has spent decades convening doctors and other healers on this mountaintop as part of her ReVisioning Medicine councils, probing the question posed variously by Soviet writer Mikhail Bulgakov and American humanitarian Dr. Paul Farmer, Jewish philosopher-physician Moses ben Maimon and fictional heartthrob Dr. Robby on “The Pitt”: Can we create a medicine that does no harm?

“How do you believe in that? Or associate with it?” she wondered about the MAHA movement her friend had helped to birth. “But If she’s there and she has power to do things, it will be good for us.”

While mainstream medical authorities and wellness gurus agree that pesticides, plastics and ultraprocessed foods harm public health, they diverge on how much weight to give MAHA’s preferred targets and how to enact policy prescriptions that actually affect them.

“We have people forming a social movement around beef tallow — let’s get that focused on alcohol reduction, tobacco reduction,” said Dr. Jon-Patrick Allem, an expert in social media and health communication. “I don’t disagree with reducing ultraprocessed foods. I don’t disagree with removing dyes from foods. But are these the main drivers of chronic disease?”

In one case, a person suffered permanent brain damage because of a delayed transfer, The Guardian newspaper reported.

UnitedHealth has allegedly secretly paid nursing homes to reduce hospital transfers — the latest accusations in a series of woes facing the health insurance giant.

The alleged action, first reported by The Guardian newspaper on Wednesday, was part of a series of cost-cutting tactics that have saved the company millions, but at times, risked residents’ health, the publication showed, citing an investigation.

The story, which cites thousands of documents and firsthand accounts of more than 20 former employees of the healthcare company and nursing homes, says that the insurance giant sent its own medical teams to nursing homes to push the cost-cutting measures. As a result, patients who urgently needed medical care did not receive it, including one person who now lives with permanent brain damage after a delayed transfer.

The allegations add to the litany of negatives that have hurt UnitedHealth in the last several months, following a massive cyberattack at its Change Healthcare unit, reports of criminal and civil investigations into the company’s practices, including one for Medicare fraud and the abrupt departure of CEO Andrew Witty last week.

UnitedHealth said in response to the story, “The US Department of Justice investigated these allegations, interviewed witnesses, and obtained thousands of documents that demonstrated the significant factual inaccuracies in the allegations.”

The company also said that the DOJ “declined to pursue the matter”.

Wall Street responds 

Shares have stumbled all year, losing more than 39 percent compared with a 0.6 percent decrease for the Dow. As of noon ET (16:00 GMT), the stock is down more than 3.6 percent.

“The news is only seemingly getting worse for UnitedHealth,” said Sahak Manuelian, managing director, global equity trading at Wedbush Securities.

HSBC downgraded the stock to “reduce” from “hold,” and cut the price target to a street-low of $270.

The brokerage said higher medical costs, pressure on drug pricing and its pharmacy benefit management unit, OptumRx, and a potential Medicaid funding cut can upset the company’s recovery journey.

Suddenly, it’s 2024 all over again.

Once more we’re litigating Joe Biden’s catatonic debate performance, his lumbering gait, his moth-eaten memory and his selfish delusion he deserved a second term in the White House while shuffling through his ninth decade on earth.

Biden’s abrupt announcement he faces an advanced form of prostate cancer has only served to increase speculation over what the president’s inner circle knew, and when they knew it.

“Original Sin,” a book by journalists Jake Tapper and Alex Thompson, published this week, is chock-full of anecdotes illustrating the lengths to which Biden’s family and palace guard worked to shield his mental and physical lapses from voters.

John Robert Greene is not at all surprised.

“It’s old news, hiding presidential illness,” said Greene, who’s written a shelf full of books on presidents and the presidency. “I can’t think of too many … who’ve been the picture of health.”

Before we go further, let’s state for the record this in no way condones the actions of Biden and his political enablers. To be clear, let’s repeat it in capital letters: WHAT BIDEN AND HIS HANDLERS DID WAS WRONG.

But, as Greene states, it was not unprecedented or terribly unusual. History abounds with examples of presidential maladies being minimized, or kept secret.

Grover Cleveland underwent surgery for oral cancer on a yacht in New York Harbor to keep his condition from being widely known. Woodrow Wilson suffered a debilitating stroke, a fact covered up by his wife and confidants, who exercised extraordinary power in his stead.

Franklin D. Roosevelt and John F. Kennedy both suffered serious, chronic ailments that were kept well away from the public eye.

Those surrounding Ronald Reagan downplayed his injuries after a 1981 assassination attempt, and the Trump administration misled the public about the seriousness of the president’s condition after he was diagnosed with COVID-19 a month before the 2020 election.

The capacity to misdirect, in Biden’s case, or mislead, as happened under Trump, illustrates one of the magical features of the White House: the ability of a president to conceal himself in plain sight.

“When you’re in the presidency, there is nothing that you can’t hide for awhile,” Greene, an emeritus history professor at Cazenovia College, said from his home in upstate New York. “You’ve got everything at your disposal to live a completely hidden double life, if you want. Everything from the Secret Service to the bubble of the White House.”

Greene likened the Neoclassical mansion at 1600 Pennsylvania Ave. to a giant fish bowl — one that is painted from the inside. It’s highly visible, but you can’t really see what’s happening in the interior.

That deflates the notion there was some grand media conspiracy to prop Biden up. (Sorry, haters.)

Yes, detractors will say it was plain as the dawning day that Biden was demented, diminished and obviously not up to the job of the presidency. Today, Trump’s critics say the same sort of thing about him; from their armchairs, they even deliver quite specific diagnoses: He suffers dementia, or Alzheimer’s or Parkinson’s disease.

That doesn’t make it so.

“It’s a very politicized process. People see what they want to see,” said Jacob Appel, a professor of psychiatry and medical education at the Icahn School of Medicine in New York City, who’s writing a book on presidential health.

“You can watch videotapes of Ronald Reagan in 1987,” Appel said, “and, depending on your view of him. you can see him as sharp and funny as ever, or being on the cusp of dementia.” (Five years after leaving the White House, Reagan — then 83 — announced he was in the early stages of Alzheimer’s disease.)

To an uncomfortable degree, those covering the White House — and, by extension, the public they serve — are forced to rely on whatever the White House chooses to reveal.

“I don’t have subpoena power,” Tapper told The Times’ Stephen Battaglio, saying he would have eagerly published the details contained in his new book had sources been willing to come forth while Biden was still in power. “We were just lied to over and over again.”

It hasn’t always been that way.

In September 1955, during his first term, President Dwight D. Eisenhower suffered a heart attack while on a golf vacation in Denver. “”It was sudden,” said Jim Newton, an Eisenhower biographer. “One minute he’s fine and the next minute he was flat on his back, quite literally.”

The details surrounding Eisenhower’s immediate treatment remain a mystery, though Newton suggests that may have had more do with protecting his personal physician, who misdiagnosed the heart attack as a bout of indigestion, than a purposeful attempt to mislead the public.

From then on, the White House was forthcoming — offering daily reports on what Eisenhower ate, his blood pressure, the results of various tests — to a point that it embarrassed the president. (Among the information released was an accounting of Ike’s bowel movements.)

“They were self-consciously transparent,” Newton said. “The White House looked to the Wilson example as something not to emulate.”

Less than 14 months later, Eisenhower had sufficiently recovered — and voters had enough faith in his well-being — that he won his second term in a landslide.

But that 70-year-old example is a notable exception.

As long as there are White House staffers, campaign advisers, political strategists and family members, presidents will be surrounded by people with an incentive to downplay, minimize or obfuscate any physical or mental maladies they face while in office.

All we can do is wait — years, decades — for the truth to come out. And, in the meantime, hope for the best.

Statement from Biden’s office comes after US President Donald Trump expressed doubt over timing of diagnosis.

Former United States President Joe Biden was not diagnosed with prostate cancer before last week, and received his “last known” blood test for the disease more than a decade ago, his office has said.

The Biden camp’s statement on Tuesday came as critics, including current President Donald Trump, stoked scepticism over the timing of the diagnosis, which has reanimated questions about whether the former president misled the public about his health while in office.

“President Biden’s last known PSA was in 2014,” Biden’s office said in the brief statement, referring to the prostate-specific antigen test used to detect prostate cancer.

“Prior to Friday, President Biden had never been diagnosed with prostate cancer.”

On Monday, Trump said he was “surprised” that the public had not been notified about Biden’s diagnosis “a long time ago”.

“Why did it take so long? This takes a long time. It can take years to get this level of danger,” Trump told reporters at the White House, referring to the advanced nature of Biden’s cancer.

“Somebody is not telling the facts, and that’s a big problem,” Trump said.

Biden’s office said on Sunday that the former president had, two days earlier, been diagnosed with prostate cancer that had spread to his bones.

Biden’s office said his cancer had score of 9 under the Gleason classification system, which grades prostate cancer from 6 to 10, indicating it is among the most aggressive kinds.

While some doctors have expressed doubt that Biden, 82, was not diagnosed earlier given his access to the best medical care, others have noted that screening is generally not recommended for men of his age and that some cancers do not show up in tests.

The US Centers for Disease Control and Prevention and other medical bodies do not recommend regular screening for prostate cancer for men over 70 due to the quality of life issues that can result from unnecessary treatment.

“It is entirely reasonable, albeit sad, that even a person of President Biden’s position may present with a new diagnosis of prostate cancer that is metastatic at his age,” Adam Weiner, an urologic surgeon at Cedars-Sinai Medical Center in Los Angeles, told Al Jazeera.

“Since President Biden is now 82, it is entirely possible he was screened for prostate cancer up to the recommended age and his newly diagnosed prostate cancer first occurred sometime since then,” Weiner said.

Nick James, an expert in prostate cancer at The Institute of Cancer Research in London, said the Biden camp’s account of the diagnosis was “plausible even if a bit unusual”, as certain cancers with a low PSA production can be missed in blood tests.

“It’s one of the drawbacks of PSA testing is that it can miss such tumours. Likewise, prostate MRI, the other test he might have had, also has a false negative rate,” James told Al Jazeera.

Biden’s age and health were major concerns for voters during his presidency and re-election campaign, which the former president abandoned following a disastrous debate performance against Trump in June.

Critics have accused Biden and his team of covering up the extent of his mental and physical decline while in office.

On Tuesday, CNN anchor Jake Tapper and Axios correspondent Alex Thompson released a new book, Original Sin, detailing the Biden camp’s alleged efforts to conceal his deterioration.

The book includes numerous accounts of Biden’s alleged decline, including an incident in which the then-president was said to have not been able to recognise Hollywood actor George Clooney at a 2024 fundraiser.

Accord aims to prevent repeat of disjointed response and international disarray that surrounded COVID-19 pandemic.

Members of the World Health Organization (WHO) have adopted an agreement intended to improve preparedness for future pandemics, but the absence of the United States casts doubt on the treaty’s effectiveness.

After three years of negotiations, the legally binding pact was adopted by the World Health Assembly in Geneva on Tuesday. WHO member countries welcomed its passing with applause.

The accord aims to prevent a repeat of the disjointed response and international disarray that surrounded the COVID-19 pandemic by improving coordination, surveillance and access to medicines during any future pandemics.

“It’s an historic day,” WHO chief Tedros Adhanom Ghebreyesus said after the vote.

The agreement’s text was finalised last month after multiple rounds of tense negotiations.

“The world is safer today thanks to the leadership, collaboration and commitment of our member states to adopt the historic WHO Pandemic Agreement,” Tedros said in a statement.

“The agreement is a victory for public health, science and multilateral action. It will ensure we, collectively, can better protect the world from future pandemic threats. It is also a recognition by the international community that our citizens, societies and economies must not be left vulnerable to again suffer losses like those endured during COVID-19,” he added.

The agreement aims to better detect and combat pandemics by focusing on greater international coordination and surveillance and more equitable access to vaccines and treatments.

The negotiations grew tense amid disagreements between wealthy and developing countries with the latter feeling cut off from access to vaccines during the COVID-19 pandemic.

Dr Esperance Luvindao, Namibia’s health minister and chairwoman of a committee that paved the way for the agreement’s adoption, said COVID-19 inflicted huge costs “on lives, livelihoods and economies”.

“We, as sovereign states, have resolved to join hands as one world together, so we can protect our children, elders, front-line health workers and all others from the next pandemic,” Luvindao added. “It is our duty and responsibility to humanity.”

Effective without US support?

The US, traditionally the WHO’s top donor, was not part of the final stages of the agreement process after the Trump administration announced the US pullout from the WHO and funding for the agency in January.

US Health and Human Services Secretary Robert F Kennedy Jr slammed the WHO as “moribund” during the annual assembly.

“I urge the world’s health ministers and the WHO to take our withdrawal from the organisation as a wake-up call,” he said in a video shown at the meeting in Geneva. “We’ve already been in contact with like-minded countries, and we encourage others to consider joining us.”

Kennedy accused the WHO of failing to learn from the lessons of the pandemic.

“It has doubled down with the pandemic agreement, which will lock in all of the dysfunction of the WHO pandemic response. … We’re not going to participate in that,” he said.

The treaty’s effectiveness will face doubts without the US, which poured billions into ensuring pharmaceutical companies develop COVID-19 vaccines quickly. Countries face no penalties if they ignore it, a common issue in international law.

Countries have until May 2026 to thrash out the details of the agreement’s pathogen access and benefit-sharing (PABS) mechanism.

The PABS mechanism deals with sharing access to pathogens with pandemic potential and then sharing the benefits derived from them, such as vaccines, tests and treatments.

Once the PABS system is finalised, countries can then ratify the agreement. Once 60 do so, the treaty will then enter into force.

Public spending cuts across six African countries have resulted in the incomes of health and education workers falling by up to 50 percent in five years, leaving them struggling to make ends meet, according to international NGO ActionAid.

The Human Cost of Public Sector Cuts in Africa report published on Tuesday found that 97 percent of the healthcare workers it surveyed in Ethiopia, Ghana, Kenya, Liberia, Malawi and Nigeria could not cover their basic needs like food and rent with their wages.

The International Monetary Fund (IMF) is to blame for these countries’ failing public systems, the report said, as the agency advises governments to significantly cut public spending to pay back foreign debt. As the debt crisis rapidly worsens across the Global South, more than three-quarters of all low-income countries in the world are spending more on debt servicing than healthcare.

“The debt crisis and the IMF’s insistence on cuts to public services in favour of foreign debt repayments have severely hindered investments in healthcare and education across Africa. For example, in 2024, Nigeria allocated only 4% of its national revenue to health, while a staggering 20.1% went toward repaying foreign debt,” said ActionAid Nigeria’s Country Director Andrew Mamedu.

The report highlighted how insufficient budgets in the healthcare system had resulted in chronic shortages and a decline in the quality of service.

Women also appear to be disproportionally affected.

“In the past month, I have witnessed four women giving birth at home due to unaffordable hospital fees. The community is forced to seek vaccines and immunisation in private hospitals since they are not available in public hospitals. Our [local] health services are limited in terms of catering for pregnant and lactating women,” said a healthcare worker from Kenya, who  ActionAid identified only as Maria.

Medicines for malaria – which remains a leading cause of death across the African continent, especially in young children and pregnant women – are now 10 times more expensive at private facilities, the NGO said. Millions don’t have access to lifesaving healthcare due to long travel distances, rising fees and a medical workforce shortage.

“Malaria is an epidemic in our area [because medication is now beyond the reach of many]. Five years ago, we could buy [antimalarial medication] for 50 birrs ($0.4), but now it costs more than 500 birr ($4) in private health centres,” a community member from Muyakela Kebele in Ethiopia, identified only as Marym, told ActionAid.

‘Delivering quality education is nearly impossible’

The situation is equally dire in education, as budget cuts have led to failing public education systems crippled by rising costs, a shortage of learning materials and overcrowded classrooms.

Teachers report being overwhelmed by overcrowded classrooms, with some having to manage more than 200 students. In addition, about 87 percent of teachers said they lacked basic classroom materials, with 73 percent saying they paid for the materials themselves.

Meanwhile, teachers’ wages have been gradually falling, with 84 percent reporting a 10-15 percent drop in their income over the past five years.

“I often struggle to put enough food on the table,” said a teacher from Liberia, identified as Kasor.

Four of the six countries included in the report are spending less than the recommended one-fifth of their national budget on education, according to the UNESCO Institute for Statistics.

“I now believe teaching is the least valued profession. With over 200 students in my class and inadequate teaching and learning materials, delivering quality education is nearly impossible,” said a primary school teacher in Malawi’s Rumphi District, identified as Maluwa.

Action Aid said its report shows that the consequences of IMF-endorsed policies are far-reaching. Healthcare workers and educators are severely limited in the work they can do, which has direct consequences on the quality of services they can provide, it said.

“The debt crisis and drive for austerity is amplified for countries in the Global South and low-income countries, especially due to an unfair global economic system held in place by outdated institutions, such as the IMF,” said Roos Saalbrink, the global economic justice lead at ActionAid International. “This means the burden of debt falls on those most marginalised – once again. This must end.”

A HEALTH food brand has urgently recalled one of its popular snacks over E.coli fears with a “do not eat” warning issued to shoppers.

Grape Tree is recalling Raw Unsalted Macadamia Nuts because Shiga toxin-producing E.coli has been found in one of its batches.

The recall affects 250g packs of the nuts which have a best before date of July 11, 2026.

The store is warning customers who have bought the affected batch, which has a batch code of G41 5 101 250610, not to eat them.

A spokesperson for Grape Tree says: “If you have bought Raw Unsalted Macadamia Nuts 250g as detailed above, do not eat them.

“Instead, check if you have bought the affected batch code.

“You can do this by taking a picture of this notice or writing down the batch code/best before date for reference at home.

“Return the product to the store for a full refund (with or without a receipt).”

The Food Standards Agency also shared the product recall notice, adding that it is England, Wales and Scotland specific.

A spokesperson said: “If you have bought the above product do not eat it. Instead return it to the store from where it was bought for a full refund.

“For more information, please email [email protected].”

It comes after Lidl recently told shoppers not to eat one of its savoury snacks over fears it could contain salmonella.

The discount supermarket urgently recalled its Sol & Mar Chicharricos BBQ Pork Scratchings after the problem was found.

The recall affected 100g packets of the pork scratchings with best before dates ranging from August 5, 2025 through to August 12, 2025.

Former United States President Joe Biden’s cancer diagnosis has rekindled questions about whether he deceived the public about his health while in office, with his successor, Donald Trump, adding his voice to those suggesting a coverup.

Speaking to reporters at the White House on Monday, President Trump cast doubt on the timing of Biden’s advanced cancer diagnosis amid renewed scrutiny of the former president’s physical and mental fitness during his tenure.

“I’m surprised that the public wasn’t notified a long time ago,” Trump told reporters at the White House.

“Why did it take so long? This takes a long time, it can take years to get this level of danger,” Trump added.

“So, look, it’s a very sad situation, I feel very badly about it. And I think people should try and find out what happened.”

Trump also said that the doctors who had examined Biden while in office were “not telling the facts”.

“That’s a big problem,” he said.

Biden’s office said in a statement on Sunday that the former president was diagnosed with an aggressive form of prostate cancer that had spread to his bones.

The statement said Biden was diagnosed on Friday after experiencing “increasing urinary symptoms” and that he and his family were reviewing treatment options.

Doctors graded Biden’s cancer with a score of 9 under the Gleason classification system, according to the statement, indicating it is among the most aggressive kinds.

Late-stage prostate cancer has an average five-year survival rate of 28 percent, according to Johns Hopkins Medicine.

Biden earlier on Monday expressed gratitude to well-wishers for their words of support and encouragement.

“Cancer touches us all,” Biden wrote on social media.

“Like so many of you, Jill and I have learned that we are strongest in the broken places. Thank you for lifting us up with love and support.”

Cancer touches us all. Like so many of you, Jill and I have learned that we are strongest in the broken places. Thank you for lifting us up with love and support. pic.twitter.com/oSS1vGIiwU

— Joe Biden (@JoeBiden) May 19, 2025

The news of Biden’s cancer diagnosis came as the former president’s health was already under renewed scrutiny ahead of the publication of a new book detailing the alleged coverup of his physical and mental deterioration by his inner circle.

Original Sin, written by CNN anchor Jake Tapper and Axios correspondent Alex Thompson, contains various damning accounts of Biden’s alleged decline, including an incident in which the then-president was reportedly unable to recognise Hollywood actor George Clooney at a 2024 fundraiser.

In his comments on Biden’s diagnosis on Monday, Trump drew a link between the former president’s cancer and the alleged concealment of his mental acuity.

“If you take a look, it’s the same doctor that said Joe was cognitively fine, there was nothing wrong with him,” Trump said.

“There are things going on that the public wasn’t informed of, and I think somebody is going to have to speak to his doctor,” he added.

Some doctors have publicly questioned the account of Biden’s cancer diagnosis provided by his office, pointing out that such advanced cancer would have had to progress over a period of years.

“For even with the most aggressive form, it is a 5-7 year journey without treatment before it becomes metastatic,” Steven Quay, a pathologist who is the chief executive of biopharmaceutical company Atossa Therapeutics, said in a post on X.

“Meaning, it would be malpractice for this patient to show up and be first diagnosed with metastatic disease in May 2025. It is highly likely he was carrying a diagnosis of prostate cancer throughout his White House tenure and the American people were uninformed.”

Howard P Forman, a professor of radiology at Yale University, said it was “inconceivable” that Biden’s cancer was not detected before he left office, as it would have been picked up by a blood test known as a prostate-specific antigen (PSA) test.

“Gleason grade 9 would have had an elevated PSA level for some time before this diagnosis. And he must have had a PSA test numerous times before. This is odd,” Forman said in a post on X.

However, Daniel W Lin, a prostate cancer expert at UW Medicine in Washington state, said that while Biden has “very likely” had cancer for years, it is possible he was not given a PSA test.

“There are screening controversies with the use of PSA, and many medical groups do not recommend PSA testing after 70 or 75 years of age, although others recommend based on life expectancy or state of health rather than age cut-points,” Lin told Al Jazeera.

Lin said it was also possible that Biden has a rarer form of cancer that is not detectable by the test.

“This situation is less common, but not considered overly rare. Additionally, when this situation occurs, it is more common in high-grade cancers, such as former President Biden’s case,” he said.

“Playing the odds, he does not fall into this category, however, it can definitely occur.”