“The world is intricately stitched together, boys. Every thread we pull, we will not know how it affects the design of things.” This is unlikely what President Trump said to his staff yesterday when he explained why he delayed the signing of an executive order to regulate the development of artificial intelligence. Instead, this bit of wisdom was delivered by the old-timer “Arn Peeples” – played by the actor W.H. (“Bill”) Macy (known best for his role in Fargo) – in the movie Train Dreams. This is a movie I can only watch on vacation because it is impossibly slow-paced. Because I am on vacation, I am also exploring slow-moving health policy in the One Thoughtful Paragraph below.
Other slow-moving activity in the news this week:
- U.S. Senate HELP Committee Chair Bill Cassidy’s (R-LA) primary election loss could slow efforts to fill key HHS leadership vacancies (e.g., FDA Commissioner, CDC Director, Surgeon General).
- CMS’ Healthcare Advisory Committee (HAC) got off to a slow start during its first public meeting on May 18, 2026. The group primarily focused on reviewing the HAC’s draft bylaws and initial six working groups. An op-ed co-authored by Dr. Shawn Martin, the CEO of the American Academy of Family Physicians (AAFP), and Dr. Sachin Jain, the CEO of SCAN Group and SCAN Health Plan, said the HAC will need to take specific actions beyond just establishing the committee if it intends to make substantive progress.
- Only 8 years and 4 months after the American Hospital Association (AHA), America’s Health Insurance Plans (AHIP), American Medical Association (AMA), American Pharmacists Association (APhA), Blue Cross Blue Shield Association (BCBSA) and the Medical Group Management Association (MGMA) announced a Consensus Statement outlining their shared commitment to industry-wide improvements to prior authorization processes, CMS named 29 organizations as “early adopters” of the Health Tech Ecosystem’s (HTE) electronic prior authorization requirements. The “early” adopters include providers (e.g., Cleveland Clinic, Providence, Sanford Health), EHRs (e.g., athenahealth, Epic, Oracle), networks (e.g., b.well Connected Health, eHealth Exchange), and payers (e.g., Cambia Health Solutions, Elevance, UnitedHealthcare).
We’re but children on this earth pulling bolts out of the Ferris wheel, thinking ourselves to be gods. This is a line in the award-winning film Train Dreams. It follows the life of a Pacific Northwest logger at the turn of the 20th Century as he participates in the harsh reality of creating the first railroad. The film is not funny. It is so slow-paced that it would not normally hold my attention. But you do not-normal things on vacation, so I am also reading the New York Times bestselling book “Abundance” – similarly focused on the harsh reality of regulating big new inventions. The book is a compilation of research showing how past regulatory schemes are screwing up our present state of affairs. Stories about medical science and ill-advised policymaking are cautionary tales, but one “this is how we should do it” lesson about ARPANET – the world’s first internet – got my attention. ARPANET, if you don’t know, was developed by the Department of Defense’s Advanced Research Projects Agency (DARPA). The Pentagon provided an unlimited budget (a slight exaggeration) to employ anyone in private-sector science and industry who could get this radical internet idea off the ground. It allowed open-ended innovation by the brightest minds to just dig in. To read that story during the week that President Trump almost, and then didn’t, issue a regulatory scheme for artificial intelligence is … unnerving. It is clear to me from my vacation spot that we are in the middle of another pivotal moment in our history of need-based ingenuity. To help make sure we are not just “pulling the bolts out of the Ferris wheel,” I’m going to need another vacation. For now, this is the only dialogue in Train Dreams that made me laugh:
Robert Grainier (the logger): Arn, do you think that the bad things that we do follow us through life?
Arn Peeples: I don’t know. I’ve seen bad men raised up and good men brought to their knees. I reckon if I could figure it out, I’d be sleeping next to someone a lot better-looking than you.
For now, if you’d like to figure out some of the legal and regulatory implications of AI Practicing Medicine, please join Maverick Health Policy and Goldsand Friedberg for a FREE webinar on May 27th at 3pm ET – register here.
