Hall of Famer D. Wayne Lukas has been hospitalized and will not return to training, family says

LOUISVILLE, Ky. — Hall of Fame horse racing trainer D. Wayne Lukas has been hospitalized and will not return to training, Churchill Downs announced Sunday after speaking with members of his family.
Lukas' family said the 89-year-old has battled a severe infection that has worsened and that he has declined an aggressive treatment plan to instead return home. His horses have been transferred to assistant trainer Sebastian 'Bas' Nicholl.

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Forbes

37 minutes ago

• Forbes

Price Controls On Doctors Are Costing Patients Dearly

Market Manipulation Just like the December 2024 continuing resolution, the current budget reconciliation bill fails to address the problem of Medicare reimbursing physicians at below market rates. Without a fix, the inevitable consequences will be worsening doctor shortages, declining healthcare quality, higher overall healthcare spending, and the accelerated loss of independent practices. Of course, how do we know that Medicare's payments to doctors are below their economic value? To start, Medicare's reimbursement rates have declined relative to both the cost of running a medical practice and inflation. Doctors consistently report that they lose money treating Medicare patients. A survey of doctors found that Medicare's low reimbursement rates (68%) are a primary threat to independent practices. As for inflation, it has grown 34.5% overall since January 2016 while the prices received by doctors have grown less than half as much - just 15.1%. This is not due to demand for healthcare declining – remember the huge number of aging Baby Boomers seeking health care – or a huge surge in the number of qualified doctors serving patients. In fact, the level of doctors serving patients today - 25.4 active physicians per 10,000 residents - is down from 2019 and has fallen back to 2009 levels. The problem is government setting prices at below market levels. And setting prices below market rates cause adverse consequences to our health, such as fewer doctors available to serve patients. This creates serious health risks for patients including longer wait times for appointments, less access to specialty care, shorter doctor visits, larger numbers of medical errors, and more misdiagnoses or missed diagnoses. These risks are more acute for people living in rural areas, who have a higher chance of living in areas deemed 'medical deserts' or regions that lack sufficient access to pharmacies, primary care providers, and hospitals. Medicare's uneconomical reimbursement system is also changing how patient care is delivered. For example, under the current reimbursement system, Medicare compensates hospitals more than independent physician offices for performing the same service. This incentivizes independent practices to merge with hospitals. Consolidating lower-cost physician practices into higher-cost hospital systems is driving up overall healthcare costs for patients and taxpayers and is reducing patient choice. Congress has acknowledged that there are serious consequences from government price controls, enacting legislation to raise provider payments by 2.9% for most of 2024. But these payments went back down on January 1, and the problem continues to plague the healthcare system. Fixing Medicare's flawed reimbursement policy should be a top priority for Congress. The more efficient reform comprehensively addresses Medicare's broader deficiencies by turning Medicare into a cash-based benefit system that funds health savings accounts (HSAs) for seniors. This direct payment option allows beneficiaries to receive their Medicare benefits in the same manner that they receive their Social Security benefits. At current spending levels, Medicare could give each beneficiary $15,150 annually to cover their insurance and healthcare costs. Under this system, patients and physicians, not bureaucrats, would take change and prices would reflect value. Providers would have to compete and would be incentivized to find new and better ways to expand value and reducing costs for patients. Fundamental reforms that establish well-functioning healthcare and health insurance markets will take time. Given this, Congress could act more immediately to index government payments to medical inflation and stop paying different reimbursement rates for the same services depending on where care is delivered. With more people aging, taxpayers will be spending more and more for Medicare and Medicaid. Unless Congress acts soon to stop Medicare's underpayment of physicians, it is patients who will ultimately pay the highest price with less access to doctors and specialists and longer wait times for life-saving care.

Yahoo

42 minutes ago

• Yahoo

Mom of 8 with Stage 3 Breast Cancer Breaks Down in Tears After Unexpected Call From School Nurse (Exclusive)

Misty De La Cruz is a mother of eight who is battling an aggressive form of breast cancer Since her diagnosis in 2024, the 43-year-old has been open about her health struggles with her family, and especially with her children De La Cruz was heartbroken after she received an unexpected call from the elementary school nurse regarding her younger sonMisty De La Cruz was diagnosed with stage 3 triple-negative breast cancer in September 2024 after discovering a lump during one of her monthly self-exams. In May 2025, the Maryland-based mother of eight received an unexpected call from her son's elementary school. Over the phone, a nurse explained that the 10-year-old was frequently exhausted during school hours, telling the staff he's afraid to fall asleep most nights in fear that his mom might pass away overnight. De La Cruz filmed her emotional reaction to the heartbreaking phone call on TikTok, amassing over 3 million views. De La Cruz, who is battling the side effects of treatment while trying to maintain a stable family, says the emotional toll cancer takes extends far beyond the physical. For her, it's not just about surviving, it's about holding together a household deeply affected by fear and uncertainty. 'As a parent you try to be strong for your children, but they watch you slowly change into someone completely different,' De La Cruz tells PEOPLE exclusively. After her diagnosis, the 43-year-old sat down with her older children and was honest about what she was facing. It took a bit more time to have that conversation with her younger son. When she finally did, De La Cruz spoke with him one-on-one, gently explaining what cancer is and how it would impact both her health and their daily lives. 'He was crying, and the only thing he asked was if I was going to die,' she recalls. 'I tried to reassure him that the doctors were going to do the best that they could do to make sure that that didn't happen. But ultimately, there is never a promise from anyone, but I was gonna fight as hard as I could.' As months pass by, De La Cruz can no longer manage simple tasks she once took for granted. For example, standing in the kitchen to cook meals for her family is now a struggle. Chemotherapy has taken a serious toll on her body, and she often has negative reactions to the treatment and feels the side effects almost immediately. 'You lose all sense of humility or embarrassment because there are days when you can't even wash yourself and need assistance,' she explains. 'The debilitating pain from the neuropathy makes it impossible to even stand up at times. The bone and muscle pain from the injections made me need to use a walker at 42 years old because I couldn't even stand up on my own.' Working to cover basic expenses is also difficult, but even more heartbreaking is not being able to take care of her younger children when they're sick. She also has to miss her kids' activities because her weak immune system makes even a minor illness potentially life-threatening. 'You just feel helpless and useless and a burden all at the same time,' she candidly tells PEOPLE. While her children's schools were informed early on about her illness and have offered unwavering support, receiving a call from the elementary school nurse left her in tears. "It's one of those calls no parent wants to receive,' De La Cruz says. 'The feeling is gut-wrenching. It's almost like someone knocked the wind out of you, and you really don't know how to react to it. All I could do was cry.' When her son got home from school, she made sure they talked and decided that therapy was the best route for him. 'I allow my son to ask all of the questions he wants to ask, and I answer them honestly. I don't believe in tiptoeing around something or masking what the situation really is,' she reveals. 'We've had open discussions about my chances of survival as well as how it's going to change our lives on a daily basis.' Yet, no matter how sensitively she approaches the topic, De La Cruz still senses that her children worry about losing her. 'It doesn't take away the fear and a child's eyes as they watch the person who's always been the strongest in the household become the weakest,' she admits. De La Cruz has told each of her children that if they ever felt the need to talk to a professional, she would gladly arrange it. When it comes to creating small moments of normalcy around the house, De La Cruz says sticking to a routine helps a lot. 'No matter how sick I am, every Sunday our family has a Sunday dinner,' she reveals. 'Usually, I'm the one to do all the cooking, but we've had to improvise.' She's had to rely on her children more than ever, especially in the kitchen, as she can no longer stand for more than a few minutes at a time. Nevertheless, cooking together brings them joy. What she's learned through cancer is this: be honest with your children. Let them feel what they feel— anger, sadness, confusion. 'Everyone grieves differently,' she says, 'and this is a grieving process. You won't be the person you were before cancer.' Never miss a story — sign up for to stay up-to-date on the best of what PEOPLE has to offer​​, from celebrity news to compelling human interest stories. One of the hardest but most important lessons was learning to accept help. As someone deeply independent, leaning on others felt unnatural at first. But she came to understand that "it doesn't mean you're weak… It just means you're human – and even the strongest humans need help.' She wants others to know that the financial toll is real and often hidden. 'A lot of people fail to understand that just because you physically survive cancer, it doesn't mean that you emotionally mentally or financially survive it,' she emphasizes. 'I had to create a GoFundMe to attempt to not lose our home due to the unbelievable cost of trying to survive.' Her advice to others facing this journey is to speak openly, accept support, and don't be ashamed to ask for help. Survival isn't just about your body – it's about your whole life. And healing takes time. Read the original article on People

Forbes

an hour ago

• Forbes

5 Timely Ideas To Improve Medicare Advantage

WASHINGTON, DC - MARCH 14: Dr. Mehmet Oz, arrives for his confirmation hearing with the Senate ... More Finance Committee in the Dirksen Senate Office Building on March 14, 2025 in Washington, DC. Oz is U.S. President Donald Trump's nominee to be administrator of the Centers for Medicare and Medicaid Services. (Photo by) In April, Dr. Mehmet Oz became Administrator of the Centers for Medicare & Medicaid Services (CMS). While his appointment generated a buzz, it is the work ahead that truly matters, especially when it comes to Medicare Advantage (MA), the program that provides care to about 33 million people, or 54 percent of the Medicare population. Though MA is poised to provide the best outcomes for the most Americans, the program is also ripe for reform, and there are several critical areas Oz could focus on to drive meaningful improvement. Here are five: 1. Pilot Multiyear Enrollment in Plans. MA plans looking to make investments in prevention and effective treatment face a conundrum: people under our care drop out of our plans on an annual basis. One way to fix this is to move away from annual enrollment and create options for people to enroll in plans for several years at a time. Dr. Oz has called for 'shifting the paradigm for health care from a system that focuses on sick care to one that fosters prevention, wellness, and chronic disease management.' Multiyear enrollment would provide the necessary incentives to achieve this worthy goal because you can't really invest in improving health in 1-year increments. 2. Standardize Plan Benefits. Plans should be competing based on excellence and their proven abilities to drive outcomes, not edge benefits and giveaways like cash rebates. By adopting standardized plan benefits and requiring them to address genuine health needs, CMS could ensure that when consumers choose plans on the basis of plan quality and health outcomes—which should be the most important metric in their decision-making process. 3. Reform Broker Commissions. Lately, there's been a lot of talk about reforming the way MA brokers are compensated. Last year, CMS issued a rule capping broker compensation, but that rule was blocked by a judge before it took effect. And recently, the Department of Justice alleged in a lawsuit that insurers were paying kickbacks to brokers in return for steering beneficiaries toward their plans. Amid these developments, we too rarely discuss ways to encourage brokers to steer people toward higher-quality plans. It's time to align broker commissions with plan ratings. Under this approach, a broker who enrolls a client in a higher-rated plan would receive a larger commission than one who steers a client toward a lower-rated plan. CMS estimates that last year almost 38% of MA enrollment was in plans with fewer than four stars. We owe it to plan members to create a system that provides their brokers with every incentive to help them choose plans of the highest quality. 4. Reform the Broker Industry to Focus More on Clinical Support. While we'refocusing on brokers, let's also provide them with incentives to use their expertise more expansively to improve health. I've spoken to brokers who help clients find care and navigate medical bureaucracies, locate the best prices on medications, and even connect them with life-saving social services. Brokers earn renewal fees when their clients sign up annually for MA plans. Those renewal fees should be earned by annually providing clients with care navigation and other health services that drive positive clinical outcomes. Brokers who don't offer such services should receive reduced renewal fees—or maybe not continue to serve seniors at all. Either way, it's worth noting how many outstanding brokers already do this work and are among the most trusted members of their communities—exactly the kind of behaviors that should be rewarded. 5. Incentivize Integration Between Health Plans and Provider Organizations. There's a lot of friction in our healthcare system, especially between health plans and provider organizations. Plans allege providers drive up costs with unnecessary procedures, tests and prescription medications; providers say plans are inflexible and stand in the way of appropriate patient care. It's beyond time to change the dynamic between these two groups. Many have already discovered that the best way to do this is to enter into global capitation arrangements by which providers receive a fee to manage all of a plan member's healthcare expenses. The benefit of these arrangements is that they encourage each group to focus on what they do best: payers manage risk while providers make decisions about direct care. The best of these arrangements are true partnerships in which payers and providers transparently design products together that play to both groups' strengths with an orientation toward improving outcomes. Going forward, it would be in patients' interests for CMS to offer a standardized framework for payers and providers to collaborate in this way. The appointment of a new CMS Administrator presents a unique opportunity to enact substantial and lasting changes. That's certainly the case with Dr. Mehmet Oz. By focusing on these five key areas, he can help unleash the full potential of Medicare Advantage, benefiting older adults across the country.