Government Shutdown Ripples Through Health Care Sector

Summary

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Bloomberg Businessweek Podcast Summary

Episode: Government Shutdown Ripples Through Health Care Sector
Date: November 7, 2025
Hosts: Carol Massar & Tim Stenovec
Guest: Dr. Susan Blumenthal, Former Assistant U.S. Surgeon General; First Deputy Assistant Secretary for Women’s Health

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Episode Overview

This episode of Bloomberg Businessweek delves into how the recent U.S. Government shutdown is impacting the health care sector, with a spotlight on women’s health. Dr. Susan Blumenthal joins to provide frontline insights on policy, economics, research equity, and technological advances shaping the future of women's health. The discussion also covers the evolution of breast cancer detection and current innovations at the intersection of technology and women's medicine.

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Key Discussion Points & Insights

1. The Government Shutdown’s Impact on Health Care

[02:12–03:57]

• Insurance Coverage at Risk:
  Dr. Blumenthal stresses the magnitude:

  “We now have the lowest rate of uninsured people in history, 8%. However, if ... the tax credits for the marketplaces are not extended, then we have 24 million people at risk of paying twice as much for their premiums. A rise of 116% and ... an estimated 4 million could go uninsured. That’s just not acceptable in the United States.” (Dr. Blumenthal, 02:32)

• Ripple Effect for Small Businesses:

  “99% of businesses in America are small businesses. ... 10 million ... have the owners and the employees rely on the Affordable Care Act premiums, these tax credits. So ... this could be a huge increase in premiums for these small businesses and ... could affect their economic well being.” (Dr. Blumenthal, 02:49)

• Policy Stakes:
  Dr. Blumenthal makes clear the shutdown is “not just about government paychecks, but about the lifeline of health care for millions.” The uncertainty affects both coverage and the health sector economy.

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2. The Evolution of Women’s Health Advocacy & Research

[03:57–05:38]

• Historical Exclusion:

  “When I started, there were no women’s health reports or conferences. Women were not in the ... clinical trials.” (Dr. Blumenthal, 04:15)

• Landmark Changes in the 1990s:
  As the inaugural Deputy Assistant Secretary for Women’s Health, Dr. Blumenthal led efforts to include women and minorities in clinical trials:

  “Today at the NIH, 52% of all clinical trial participants are women. However, NIH supported studies are only 10% of all clinical trials. So we have a long way to go.” (Dr. Blumenthal, 04:34)

• Neglected Diseases:
  She highlights overlooked issues: autoimmune diseases (80% occur in women) and different disease profiles, like heart disease’s unique symptoms in women.

  “We need to train physicians to be sensitive to those differences and to develop treatments that may be somewhat different for them.” (Dr. Blumenthal, 05:19)

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3. Breakthroughs in Breast Cancer Detection

[05:38–07:58]

• Limits of Traditional Mammography:
  Mammography, “a 40-year-old technology” in the 1990s, had significant flaws, missing 20% of cancers.

• Cross-Industry Innovation:
  Dr. Blumenthal recounts a memorable collaboration:

  “If we can see the surface of Mars with a Hubble telescope... why can’t we better detect small lesions in women’s breasts?” (Dr. Blumenthal, 06:05)
  By tapping tools from NASA, CIA, and DOD, she catalyzed advances:
  “We put our nation’s top radiologists together with their top imaging scientists. And out of that came digital mammography, ... computer assisted diagnosis, ... and 3D medical imaging.” (Dr. Blumenthal, 06:23)

• Results and Optimism:

  “We have seen a remarkable decline in death from breast cancer since 1990 of 44%. ... With the 21st century tools like AI ... I'm very hopeful that we will bring those death rates down even more.” (Dr. Blumenthal, 07:35)
  Early detection boosts five-year survival to 95%.

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4. Current & Future Innovations in Women’s Health

[07:58–08:40]

• Technology Advancements:
  At MIT Media Lab, Dr. Blumenthal and team are working on an “ultrasound patch you can put in a bra ... remotely monitored for dense breast tissue.”

• Midlife & Menopause Research:

  “We want to look at women in midlife, looking at menopause and new interventions there to make sure that the bonus years of life we’ve gained ... are truly better years of life, productive years of life, healthy years of life.” (Dr. Blumenthal, 08:20)

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Notable Quotes & Memorable Moments

• “The first wealth is health.” (Dr. Blumenthal quoting Emerson, 02:13)

• “We put our nation’s top radiologists together with their top imaging scientists. And out of that came digital mammography ... we got a peace dividend out of our national investment in defense. And I say what better investment could there be than to save the lives of women everywhere?” (Dr. Blumenthal, 06:23)

• “If you find breast cancer early, there’s a 95% five-year survival rate. So we can cure this disease.” (Dr. Blumenthal, 07:49)

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Timestamps for Important Segments

• [02:12] — Dr. Blumenthal on government shutdown’s impact on health care and insurance
• [03:57] — Reflections on the evolution of women’s health research and clinical trial equity
• [05:48] — Advances in breast cancer detection and use of cross-sector technology
• [07:58] — Present and future innovations: wearable ultrasound and menopause research

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Conclusion

This episode offers both a high-level and deeply human perspective on how federal policy directly affects health care access, with a special focus on women’s health. Dr. Susan Blumenthal’s firsthand experience and advocacy over decades illuminate the critical gains made—and the urgent challenges that remain—at the intersection of policy, technology, and equity.

For those interested in health policy, technological innovation, and women’s advocacy, this episode is insightful and inspiring.

Transcript

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Right now, we wanted to dig into time now for BusinessWeek women's health segment, where we focus on key issues in developing technologies impacting both the present and future of women's health around the world. We're joined today by Dr. Susan Blumenthal. She's a former Assistant US Surgeon General and the first ever Deputy Assistant secretary for Women's health. Right now, she's a visiting professor at the MIT Media Lab in Washington. Dr. Blumenthal, thank you so much for joining us today. We wanted to talk, of course, about your work in women's health care, but we also wanted to take a moment to discuss what's going on with the US Government shutdown. What's been the impact? What have you been hearing on the ground?

[Dr. Susan Blumenthal]

Well, I think the impact is having a tremendous, you know, concern for for health. As the great poet Emerson once said, the first wealth is health, and that's the foundation of a healthy life. You know, before the Affordable Care act, there were 50 million uninsured Americans. A person went bankrupt every 30 seconds in the United States, thanks to the Affordable Care act, we now have the lowest rate of uninsured people in history, 8%. However, if with a shutdown in place and if the tax credits for the marketplaces are not extended, then we have 24 million people at risk of, of paying twice as much for their premiums. A rise of 116% and, you know, an estimated 4 million could go uninsured. That's just not acceptable in the United States. It's also has a tremendous economic impact because 99% of businesses in America are small businesses. That's 35 million small businesses in America. And 10 million of those small businesses, you know, have the owners and the employees rely on the Affordable Care act premiums, these tax credits. So that means that, you know, this could be a huge increase in premiums for these small businesses and, and could affect their economic well being. It means that 450,000 small businesses would become ineligible for those tax credits.

[Interviewer/Co-host]

Yeah.

[Dr. Susan Blumenthal]

If, if the, if they're not extended. And that's what the shutdown is all about. And why it's so difficult is, you know, this health care question is really on the table.

[Interviewer/Co-host]

Yeah. A lot of uncertainty around what the next steps are for the shutdown. But I want to focus on your experience. You've been at the forefront of Women's Health for 30 years, serving under four U.S. presidents. What was the landscape like for women's health and women's health research back when you started in government?

[Dr. Susan Blumenthal]

Well, when I started, there were no women's health reports or conferences. Women were not in the, in the clinical trials. So our work was to expose those inequities in the early 1990s. And then in 1993, I was appointed the first Deputy Assistant Secretary for Women's health. You know, we then built infrastructure for women's health in all of the governments. At nih, cdc, fda, women's health offices were there. We made sure that women and minorities were included in the clinical trials. Today at the NIH, 52% of all clinical trial participants are women. However, NIH supported studies are only 10% of all clinical trials. So we have a long way to go. And there are many issues that affect women that have not been studied adequately, like autoimmune diseases. 80% of autoimmune diseases occur in women. These are diseases like diabetes, type 1, Sjogren's disease, lupus, scleroderma. And so we need to focus more on those illnesses and diseases that disproportionately affect women and women and diseases that affect women differently, like heart disease. Many people don't know that heart disease is the number one killer of women, but the Symptoms may present differently. So we need to train physicians to be sensitive to those differences and to develop treatments that may be somewhat different for them.

[Interviewer/Host]

Well, last month, October was breast cancer awareness month. Can you talk to us a bit about your work on this disease in particular in terms of improving early detection?

[Dr. Susan Blumenthal]

Absolutely. Well, one out of eight women will develop breast cancer in their lifetimes. It is the most common cancer for women next to skin cancer, but, you know, we need to find it early. And mammography, When I was working in the 90s in this area, mammography was a 40 year old technology. Then it's now a 70 year old technology, but 40 year old technology. Three out of four lesions it found were benign and it missed 20% of cancer. So I thought, if we can see the surface of the Mars with a Hubble telescope and see missiles 20,000 miles away in distant skies, why can't we better detect small lesions in women's breasts right here on Earth? Here's what I did. I called the director of the CIA, the head of NASA, generals at the DOD who worked in research, and I asked them if they had imaging technology that we could apply to finding breast cancer early. And they said they did. And we put our nation's top radiologists together with their top imaging scientists. And out of that came digital mammography, because then mammography was an X ray. So digital mammography, computer assisted diagnosis, which was one of the very first applications of AI, artificial intelligence to health and 3D medical imaging. And so we got a peace dividend out of our national investment in defense. And I say what better investment could there be than to save the lives of women everywhere? As a result of these improvements in early detection of breast cancer and also better treatments, we have seen a remarkable decline in death from breast cancer since 1990 of 44%. So again, with the 21st century tools like AI and new technologies that are being applied to the fight against breast cancer, I'm very hopeful that we will bring those death rates down even more. So and if you find breast cancer early, there's a 95%, five year survival rate. So we can cure this disease.

[Interviewer/Co-host]

Dr. Blumenthal, in just about 30 seconds, what are some of the top kind of initiatives that are top of mind or areas of research that you're paying attention to? Again, just about 30 seconds.

[Dr. Susan Blumenthal]

Well, again, at the MIT Media Lab, we're focusing on a breast patch, an ultrasound patch that you can put in a bra and it can be remotely monitored for dense breast tissue. Ultrasound is a very important new technology to use. And also we want to look at women in midlife, looking at menopause and new interventions there to make sure that the bonus years of life we've gained in this century are truly better years of life, productive years of life, healthy years of life. Thank you for the opportunity of joining me today.

[Interviewer/Host]

Thanks so much for joining us. Of course. That's Dr. Susan Blumenthal, former Assistant US Surgeon General and the first ever Deputy Assistant Secretary for Women's Health.

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