Sunjay Shah

Radiation Oncologist working in a suburb of Philadelphia. UNC grad. Love to travel and explore the world. Peleton enthusiast.

[Dustin @r0ck3t23]

Elon Musk just defended America better than every politician in Washington combined.

Musk: “After World War 2, the US could have basically taken over the world and any country. Like we got nukes, nobody else got nukes. We don’t even have to lose soldiers. Which country do you want?”

One nation on earth held a weapon nobody else had.

Total dominance. Zero competition. No risk of retaliation.

Every empire in history that held that kind of advantage used it.

Rome. The Mongols. The British. The Ottomans.

They conquered until they collapsed.

America had a bigger advantage than all of them combined.

And it rebuilt the countries it just defeated.

Musk: “The United States actually helped rebuild countries. So it helped rebuild Europe, it helped rebuild Japan. This is very unusual behavior, almost unprecedented.”

Almost unprecedented?

It had never happened before. Not once in 5,000 years of recorded history.

The Marshall Plan wasn’t foreign aid.

It was the most radical act of restraint any superpower ever committed.

America turned its enemies into allies. Turned rubble into economies. Turned surrender into partnership.

Germany went from ashes to the economic engine of Europe in a generation.

Japan went from unconditional surrender to the third largest economy on earth.

Three years after the war, America was flying food into Berlin.

A city in the heart of the nation that just tried to destroy it.

That’s not policy.

That’s a civilization deciding what it is at the exact moment it has the power to be anything.

You’re being told a story right now.

That America is the villain of history.

You hear it everywhere. Media. Universities. Social platforms.

Musk: “There’s always like, well America’s done bad things. Well of course America’s done bad things, but one needs to look at the whole track record.”

Every nation on earth has dark chapters. Every single one.

The difference is what a country does when nobody can stop it.

And when nobody could stop America, it fed its enemies and rebuilt their cities.

Musk: “The history of China suggests that China is not acquisitive. Meaning they’re not going to go out and invade a whole bunch of countries.”

Probably right.

China has historically built walls, not fleets.

But the real question isn’t about borders anymore.

We’re approaching a moment that mirrors 1945 in ways nobody has fully processed yet.

AI is going to give a handful of people a power advantage that makes nuclear monopoly look quaint.

If someone is going to hold that kind of power, who do you want it to be?

The country that conquered when it could? Or the one that rebuilt when it didn’t have to?

Every alliance. Every trade route. Every economy.

Billions lifted out of poverty.

All of it traces back to one act of restraint that had never been done before.

And carries no guarantee of being repeated.

The most powerful thing America ever did wasn’t building the bomb.

It was what it didn’t do after.

[Sunjay Shah @sunjay_shah]

@5_utr @GirvigianMD Very interesting work. What do you think your data implies about the future demand for radiation oncologists?

[Handre @Handre]

LASIK eye surgery cost $2,200 per eye in 2000. Today it's around $1,000 per eye despite 24 years of inflation. Meanwhile, an MRI that cost $1,200 in 2000 now costs $3,000+. The difference? LASIK operates in a free market with no insurance interference and minimal regulation.

When patients pay directly, providers must compete on price and quality. LASIK clinics advertise prices, offer financing, and constantly improve technology to attract customers. Compare this to hospital procedures where prices are hidden, patients never see bills, and insurance companies negotiate opaque rates that somehow always increase faster than inflation.

Cosmetic surgery follows the same pattern. Breast augmentation, rhinoplasty, and other elective procedures have become more affordable and safer over decades. Surgeons invest in better techniques and equipment because they must satisfy paying customers, not insurance bureaucrats or hospital administrators focused on maximizing reimbursements.

The lesson is clear: remove third-party payment systems and excessive regulation, and you get Austrian economics in action. Prices fall, quality rises, and innovation accelerates. Healthcare costs aren't rising because of aging populations or new technology—they're rising because we've destroyed the price mechanism that makes markets work.

[Eric Topol @EricTopol]

The time of day for cancer immunotherapy is associated with major outcomes. Early is better. Results from a randomized trial of lung cancer, backs up the importance of our circadian rhythm and immune system
https://t.co/bHqUZ3U83O

[Neil Floch MD @NeilFlochMD]

The one point that the general public must understand is that the cost of medicine, the rise of hospitals systems, and the fall of private practice has occurred largely because government has allowed hospital systems to be paid a “facility fee” that independent physicians cannot collect. https://t.co/UpPIXwLbn3

[PDBrown @PDBrownOnc]

🚨🚨Randomized Trial Spine SBRT Target Tumor only vs.Tumor+ Elective Coverage 🚨
↑↑tumor control with Elective Target coverage

[Sunjay Shah @sunjay_shah]

@dr_alimuhammad @_ShankarSiva 40Gy in 5 fx is not isoeffective to the other doses; more like 20Gy x1.
Do we have data that is a sufficient dose? If so, why not decrease the 1 and 3 fraction total doses?

[Sunjay Shah @sunjay_shah]

@DrewMoghanaki @AltorkiNasser @TobiasFinazzi @Mat_Guc @IsaOpitz @NitinOhri3 @dramycummings @SalmaJabbour1 @HornLeora @JieDengMDPhD @AKesarwala Why not treat the nodes with XRT as well? Maybe 5Gy x5?

[The Wall Street Journal @WSJ]

Author Malcolm Gladwell explains why he thinks driverless cars will fail in urban centers—and why he ran circles (literally) around a Waymo vehicle.

[Yuan James Rao @yuanjamesrao]

I emphasize to students that is a miracle of modern medicine that some prostate, lung, and other cancers often be cured non-invasively with radiation in 5 or fewer treatments (SBRT), and often with excellent safety. Most people and MDs don't know! #radonc

[Sunjay Shah @sunjay_shah]

@WSJ That’s idiotic. Making NYC livable for younger employees will help financial firms recruit better talent. They need to see the larger picture.

[Daniel E Spratt @DrSpratticus]

X-torial: Cleaning up the misinformation about @JoeBiden and #ProstateCancer that I am reading everywhere.

The purpose of this is to provide education from someone who treats and studies PCa for a living, lead the USA @NCCN PCa guidelines, hold leadership in @NRGonc @theNCI @US_FDA and dedicated my career to help men and their families suffering from PCa

@nytimes @WSJ @FoxNews @CNN @NBCNews @Reuters @ASCO @PCFnews @DeptofDefense

[Jon Strasser @StrasserMD]

Great meeting with Rep. Sarah McBride at @ASTRO_org #AdvocacyDay2025. We need your support for #ROCR!

[Sunjay Shah @sunjay_shah]

@FareedZakaria Your reasoned and methodical approach makes you an excellent commentator and a predictable mediocre negotiator. Trump’s unpredictability is a real strength.

[Dutch Rojas @DutchRojas]

𝗬𝗼𝘂’𝗿𝗲 𝗽𝗮𝘆𝗶𝗻𝗴 $𝟮,𝟮𝟬𝟬 𝗺𝗼𝗻𝘁𝗵𝗹𝘆 𝗳𝗼𝗿 𝗮 𝗳𝗮𝗺𝗶𝗹𝘆 𝗵𝗲𝗮𝗹𝘁𝗵 𝗽𝗹𝗮𝗻 𝘁𝗵𝗮𝘁 𝗰𝗮𝗻’𝘁 𝗲𝘃𝗲𝗻 𝗰𝗼𝘃𝗲𝗿 𝗮𝗻 𝘂𝗿𝗴𝗲𝗻𝘁 𝗰𝗮𝗿𝗲 𝘃𝗶𝘀𝗶𝘁.

Meanwhile, non-profit health systems are accumulating billions, tax-free, and driving up prices for everyone.

Since the ACA, more Americans have been insured, but what about affordability?

It’s gotten worse.

Here’s why:
Massive non-profit health systems — not scrappy rural hospitals, but billion-dollar empires — have weaponized a financial system that makes healthcare more expensive for everyone while protecting their power.

How they did it:

Tax Immunity:
No federal, state, or property taxes — they expand while contributing almost nothing to their communities.

Government Subsidies Turned Profit Centers: Programs like 340B and DSH were meant to help vulnerable patients. Instead, they boost operating margins.

Market Domination:
Health systems consolidation wipes out independent doctors and small clinics, killing competition and increasing prices.

Emotional Branding:
“Mission-driven” messaging and university partnerships create a halo effect that hides corporate behavior.

The result?

* Higher premiums
* Higher deductibles
* Fewer independent choices
* Bloated healthcare bureaucracies
* Billions in surplus operating margins for “non-profit” systems

Non-profit health systems aren’t broken charities.
They’re powerful corporate machines and your wallet is funding their expansion.

The premium death spiral will only continue until we demand competition, transparency, and accountability.

#HealthcareReform #InsurancePremiums #NonProfitHealthSystems #HealthcareCosts #PolicyChange #ACA #WakeUpCall


[Dutch Rojas @DutchRojas]

Physical therapy at a health system: $330
Same visit at an independent PT clinic: $95

There are 400 million PT visits every year.

We don’t have a cost problem.
We have a cartel problem.

#healthcare

[ACC Network @accnetwork]

UNC fans walking into work this morning

[Amer. Urol. Assn. @AmerUrological]

An amazing conversation between @shahsohan208 and @SarahEMcBride during our Hill Day visit.

#AUASummit25

[Sunjay Shah @sunjay_shah]

@ChampionofStars @NIH @POTUS @realDonaldTrump @DOGE @elonmusk @AlanDersh @JonathanTurley @RobertKennedyJr @SpeakerJohnson @JDVance @HHSGov How do you think they got that way?

[Sunjay Shah @sunjay_shah]

@YashBShah @PennUrology @pennsurgery @JEFFUrology Congratulations!