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May 26, 2025 23 mins

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You’ve never voted for them. You’ve probably never even heard of them. But a small group of just 16 volunteer clinicians meets three times a year—and they decide what medical screenings your doctor recommends, and what your insurance will actually pay for. No big deal, right?

In this episode of the Shameless Care Podcast, Robert and Anna pull back the curtain on one of the most quietly powerful forces in American healthcare: The United States Preventive Services Task Force (USPSTF). Think of it as the Justice League of public health… if the Justice League had no capes, no budget, and way more paperwork.

You’ll learn:

  • Why the USPSTF was created in 1984 (yes, the same year as Ghostbusters, Purple Rain, and, well… 1984).
  • How their grades (A, B, C, D, and I) determine whether insurance companies must pay for a test.
  • Why a “C” might cost you hundreds, but an “A” is totally free.
  • How the Affordable Care Act gave them real power—without making them part of the government.
  • Why some preventive care (like STI testing for straight men) gets ignored altogether.

We’ll also get into the wild world of STI screening recommendations—because nothing says “fun Friday night” like a chlamydia debate. Did you know that the USPSTF doesn’t recommend routine gonorrhea or chlamydia screening for men at all? Meanwhile, women under 25? Automatically screened, every year. Equal opportunity, this is not.

Anna breaks down the Task Force’s controversial guidance on herpes testing (spoiler: it’s a no), and Robert rants about why the phrase “full panel” STI test is dangerously misleading.

We’ll also cover:

  • Why men skipping STI tests is bad science (and worse math).
  • What “Grade I” means (spoiler: “I have no clue”).
  • How healthcare is really different for proactive, sex-positive people.
  • Why your “free” colonoscopy wasn’t just a gift from Blue Cross.

Oh—and don’t miss our Shameless Dirty Joke of the Week, some very good news from the NHS about a gonorrhea vaccine, and a quick look at how the USPSTF decides what’s worth testing… and what’s just noise.

This episode is for anyone who’s ever wondered why their insurance won’t pay for something, why their STI test missed half the infections, or how a tiny group of super-nerds became the most influential people in American preventive medicine.

We’re not here to fearmonger. We’re not here to sell you anything. We’re just here to give you the real talk on sexual health, without shame, without fluff—and with a few laughs along the way.

Welcome to the Shameless Care Podcast.

Let’s get into it.


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