The number of Medicare enrollees is projected to rise over the next few years as the baby boomer population ages. More than 2 million Illinoisans are currently enrolled in the federal health care program, according to Healthinsurance.org,

The Office-Based Facility Association, a coalition of practitioners, is calling for a change in what they view as an ineffective and unfair pricing structure of the Medicare Physician Fee schedule.

Jason McKitrick, executive director of the association, said other payers linking themselves to Medicare is one of the issues.

"When you've got ongoing cuts to Medicare, that means you've likely got ancillary cuts going on with the private side, with the Medicaid side, etc.," McKitrick explained. "It's the Centers for Medicare and Medicaid Services, CMS, ultimately, that's the agency and the federal government that sets the rates for the Medicare Physician Fee Schedule."

The association pointed out the current fee schedule addresses doctor's fees only, not the costly and necessary supplies and equipment needed for their practices. According to the Centers for Medicare and Medicaid Services data, there are 300 office-based services under the fee schedule for which Medicare reimbursement is less than the direct costs, before even considering other costs like overhead and physician work.

Dr. Sreenivas Reddy, a vascular interventional radiologist in Hinsdale, said in addition to seeing patients, he has to monitor overhead expenses such as office space and employee salaries, both affected by inflation. Not having the proper medical equipment and supplies, he added, limits his ability to perform specialized procedures and forces patients to seek care elsewhere.

"That makes these patients go to the hospital-based facilities," Reddy noted. "We have to close our offices and try to join these hospital-based models. They would love to come to the office, get the procedure done in one or two hours, versus it takes like a whole day in the hospital setting."

Reddy emphasized physicians' reimbursement, based on the current physician pay schedule, has been on the downtrend for the last five years. The group has further concerns about a decrease in the number of private practices causing more medical deserts for interventional radiology, cardiology, vascular surgery, radiation and oncology care.

By Grace Hussain for Sentient.
Broadcast version by Zamone Perez for Maryland News Connection reporting for the Sentient-Public News Service Collaboration

When the Trump Administration takes office in January, Robert F. Kennedy Jr. - an avid fan of raw dairy and the nominee for Secretary of Health and Human Services - has signaled that he plans on boosting access to raw milk. Reportedly, he's even reached out to the CEO of one of his favorite raw milk brands to work with the administration to expand access to raw milk nationally. But in a time of avian flu, what are the health implications of more people drinking raw milk?

The short answer: not great.

Currently, it's illegal to sell raw milk under federal law, meaning it can't be sold across state lines. But there are state laws governing whether the beverage can be sold within each state. Several states, including Florida and Louisiana, have laws explicitly barring raw milk sold for human consumption, but still have loopholes in the laws, allowing people to buy it for their pets.

When milk is pasteurized, it's heated to 161F (ultra-pasteurized requires heating at 280F for a slightly shorter amount of time), and then rapidly cooled in order to kill off harmful bacteria. While it's not a foolproof process, the risk of consuming raw milk is hundreds of times greater than drinking pasteurized milk. Let's take a look at the risks of its popularity growing.

The Health Risks of Drinking Raw Milk

Consuming raw milk has been linked to numerous health issues, including different types of infections, and even bird flu. More people drinking raw milk could lead to an increase in sickness or death from bacteria harbored in untreated milk. "Some of the illnesses are pretty nasty," Martin Wiedmann, who specializes in food safety and science at Cornell, tells Sentient.

Wiedmann is no stranger to raw milk's appeal. "I grew up on raw milk. I'm not a foam out of the mouth, don't drink raw milk, person," he tells Sentient. But the worst risks are severe, he says. Wiedmann points specifically to listeria and Guillain-Barré syndrome, both of which can be deadly. In the case of listeria, about 20 percent of those infected die. With Guillain-Barré syndrome, "your body makes antibodies against your own nerves," he says. "It can be super nasty."

Bird flu represents another risk to consuming raw milk. California recently declared a state of emergency in response to bird flu spreading via dairy. While pasteurization kills the bacteria responsible for the disease, drinking infected raw milk can spread the disease, with confirmed cases of avian flu in cats and mice who were given raw milk.

It's still unclear whether humans can contract the disease from consuming infected raw milk. But California, the largest dairy producer in the country, is one of several states that allows the sale of raw milk for human consumption.

Why Do Some People Still Drink Raw Milk?

One of the main reasons people consume raw milk is because of the perceived health benefits. But the Food and Drug Administration has stated that most raw milk health claims are false.

For Dennis D'Amico, a microbiologist focused on dairy safety at the University of Connecticut, the health benefits of consuming raw milk are overstated. "The fat content is not going to change. The protein content is not going to change. The mineral content is not going to change," he tells Sentient. "You do see some minor decreases in a few of the vitamins [with pasteurization], but most of the nutrition field or the food science field would argue that it's relatively insignificant in the scheme of things."

Wiedmann agrees, pointing specifically to vitamin C, which is destroyed through pasteurization. "You're not gonna get enough vitamin C through milk," so the health benefits of pasteurization outweigh the loss, he says.

How Bacteria Gets Into Milk

Bacteria can get into milk either from the cow or from the environment. The cow herself could be infected with salmonella, or another disease causing bacteria. In that case, "the outside of the animal could be sterile, everything involved in the rest of the process could be sterile, but the milk is already contaminated," cautions D'Amico. Another animal-based route of contamination happens when bacteria from the environment gets into the cow's teat, causing an infection called mastitis.

While it's possible to minimize bacteria in the environment, it's impossible to eliminate it. "The risk is always there," says Wiedmann. "A cow in a [factory farm] poops, just like a cow in a pasture would."

Diversified production systems that raise chickens in addition to cows, for example, introduce additional risk. "If your chickens carry salmonella, the risk of those chickens contaminating the raw milk also becomes bigger," Wiedmann says, challenging the assumption that milk produced by small or organic farms is a safe option.

The Problem of Misinformation About Raw Milk

Raw milk is a flashy issue whose proponents go against settled science, says D'Amico. "The idea that unpasteurized milk can cause illness has been around forever," he says, pointing to the drop in foodborne illnesses that followed the widespread implementation of pasteurization. In the eyes of public health experts and regulatory officials, "the problem's been solved."

But misinformation about raw milk continues to spread. "You have proponents that have a much bigger story to tell [using] anecdotal evidence, and there's just so much more to it," says D'Amico. And that story is "much more romantic and attractive." Based on his experience, many people drinking and supporting raw milk are also skeptics of other widely accepted health advancements, like vaccines. He points specifically to COVID-19 as driving the trend toward science skepticism.

Google searches for "raw milk" significantly increased toward the end of 2021, the height of the pandemic, and have trended upwards since. The increase in searches may have reflected a rising perception that raw milk offers protection against sickness, with some even mistakenly believing it could act as a form of passive immunity to COVID-19 instead of vaccination. A few years beforehand, in 2014, survey data revealed that 67.9 percent of raw milk drinkers didn't trust recommendations from state health officials.

During the pandemic, mis- and disinformation proliferated at an alarming rate, leading the World Health Organization to declare an "infodemic" - an overabundance of information, both accurate and inaccurate - alongside the pandemic. The infodemic provided the perfect environment to incubate skepticism about science.

Is Raw Milk a Personal Freedom Issue?

Despite the public health risks of raw milk, for both D'Amico and Wiedmann, the issue ultimately comes down to personal choice, even if that choice can have consequences.

Both agree that there are two main reasons for limiting raw milk consumption: burden on the healthcare system, and unknowing consumption. The more people who engage in risky behaviors - like smoking cigarettes or drinking raw milk - and get sick, the greater the burden on the healthcare system and hospitals, and thus taxpayers and the wider public, says D'Amico. The public health burden of raw milk consumption is likely to increase with the beverage's growing popularity.

Unlike cigarettes, milk is widely consumed, and raw milk can be difficult to differentiate from pasteurized milk. "You have raw milk in your fridge. Your kids have their friends over. They drink milk. Those kids have no idea they're drinking raw milk. Their parents have no idea that their kids drink raw milk when they're over at someone's house. They get sick. Those kids are not making a choice," says Wiedmann.

When children are infected, they're at especially high risk of getting very sick, says D'Amico. "What we often see in these raw milk cases, is not only are children being infected, but they're also being affected with much more severe infections, kidney failure, death and things like that," he says.

The Bottom Line

While consuming raw milk may be seen as a personal choice, it's not exactly a decision that affects only the individual. As the popularity of raw milk potentially rises, so does the risk of dangerous bacteria proliferating. The spread of misinformation around raw milk only adds to the danger, increasing the likelihood of widespread outbreaks. If the trend continues unchecked, it could place significant strain on healthcare systems and public health resources.


Grace Hussain wrote this article for Sentient.


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They may offer people a legitimate way to convert cash into cryptocurrency but crypto ATMs are also popular with scammers.

Washington had the highest rate of reported impostor scams in the country in 2023, according to the Federal Trade Commission. The Spokane City Council recently passed a resolution supporting more state regulations for the crypto ATMs, including limits on how much money can be withdrawn daily.

Det. Tim Schwering of the Spokane Police Department, said his office is receiving two or three calls a day about crypto ATM scams.

"$50,000 is very common in losses," Schwering pointed out. "You know, $100,000, $200,000 in losses, entire life savings wiped out from these types of scams."

Schwering noted most of the scams center around fake romantic relationships or bogus investment opportunities. He added most of the scammers are based in countries with no diplomatic relationships with the U.S. law enforcement. Even if he can find the money in countries like China, Russia or North Korea, he cannot get it back.

Schwering emphasized investment scams can be especially hard to recognize because scammers will allow victims to withdraw some money after making it look like their investment has grown on a fake website. Once victims feel secure they can withdraw their supposed "earnings," the con escalates. The FBI estimates Americans were robbed of close to $6 billion in 2023 through crypto-related scams.

"When you're making that kind of money, you can put money into building websites that are, they look like, legitimate investment websites," Schwering explained.

Schwering is working with the Washington State Department of Financial Institutions on legislation to limit the amount of money someone can deposit into a crypto ATM to $1,000 a day. He said it will not solve the problem but could help mitigate the potential losses.


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South Dakota is among the states with the highest percentage of residents carrying medical debt but a new federal rule announced this week could ease some of the pressure when they apply for loans.

The Consumer Financial Protection Bureau has finalized a rule stating credit agencies cannot share a person's medical debt history with a lending institution requesting credit information. The only debt details that can be relayed to determine a person's creditworthiness are mortgages, car loans, credit cards and similar activity.

Patricia Kelmar, senior director of health care campaigns for the U.S. Public Interest Research Group, said groups like hers had long pushed for this move.

"Medical debt is not really indicative of somebody's ability or desire to pay back a loan," Kelmar pointed out. "Oftentimes people are in a situation where they get a bad medical diagnosis, or they've been in a car accident. Suddenly they have a lot of medical bills."

According to the Peterson-KFF Health System Tracker, nearly 18% of South Dakota adults report having medical debt. The national average is 8%. Some credit agencies already exclude medical debt in loan situations.

Kelmar acknowledged the incoming Trump administration could seek to reverse this rule change, as some advisers have said they want to do away with the Consumer Financial Protection Bureau altogether.

Pushback is also expected from debt collection firms. Kelmar emphasized skeptics should know keeping medical debt out of the equation is good for the overall economy.

"The long arm of medical debt can really hurt people's financial future and their ability to get better," Kelmar contended.

For example, she noted a person emerging from a medical scare might need a new car to rejoin the workforce but the sudden health care debt they incurred might get in the way. The new rule will be effective 60 days after it's published in the Federal Register.


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