Health Policy and Public Health

Physicians writing on KevinMD about policy as it reaches the exam room: prior authorization and the state and federal rules now written for it, scope of practice laws state by state, the CDC opioid guideline and what forced tapers did to patients, and public health from vaccination to the pandemic. Four maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words, Opioids: what physicians and pain patients say, in their own words, and Vaccines: what physicians say, in their own words.

October 3, 2026Oct 3, 2026

Imagine if we only treated lung cancer and never tackled smoking. Is that what we're doing with depression? We always ask people struggling with depression to reach out. But maybe we should also ask whether anyone is within reach. Every…

Imagine if we only treated lung cancer and never tackled smoking. Is that what we’re doing with depression? We always ask people struggling with depression to reach out. But maybe we should also ask whether anyone is within reach.

Every October, Depression Awareness Month urges us to recognize the symptoms and seek help. As a physician, I support that message. As a public health and preventive medicine practitioner, I also ask …

Health Policy

First Nations health care: Consultation is not control

Olumuyiwa Bamgbade, MD

October 2, 2026Oct 2, 2026

Canadian health organizations invite First Nations representatives to comment on services after budgets and priorities have already taken shape. Consultation can improve a proposal, but it offers limited influence when the decisions remain elsewhere. Health equity requires First Nations to…

For physicians, governance may seem distant from the examination room. Yet governance determines whether patients …

Health Policy

Climate anxiety in young people demands action in 2026

October 1, 2026Oct 1, 2026

As medical students who will inherit and treat the health consequences of climate change, we are witnessing how it reshapes the physical and emotional landscapes of our generation. These fears are actively shaping how an entire generation plans its future, from whether to have children to where to live and work. Across the country, young people are experiencing what researchers have termed eco-anxiety: chronic stress, fear for the …

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Health Policy

First Nations mental health care must not end at discharge

Olumuyiwa Bamgbade, MD

October 1, 2026Oct 1, 2026

An emergency department can stabilize a mental health crisis. It cannot, by itself, provide the relationships, housing, and continuing support that sustain recovery. For First Nations patients in Canada, we should promote mental health and substance use services that communities help govern, and patients can reach before, during, and after a crisis. For example, a patient receives instructions to arrange counseling, attend substance misuse therapy, and return if symptoms worsen. …

Health Policy

Coverage cuts strengthen the case for Medicare for All

Bruce A. Silverman, MD

September 30, 2026Sep 30, 2026

The One Big Beautiful Bill Act (OBBBA) lays bare a brutal truth about American health care: When coverage depends on politics, paperwork, employment status, and state budgets, people lose care, and some will die because of it. Cuts and administrative barriers to Medicaid, new hurdles for Affordable Care Act marketplace coverage, and continued failure to guarantee stable access to care all point in the same direction: Our fragmented system …

Conditions and Diseases

Physicians and the death penalty: There is no humane way

Ali Abdullah, RN

September 29, 2026Sep 29, 2026

"Do No Harm" is perhaps the most famous medical maxim. But reciting it is one thing; living by it is another. Sometimes, the question of "harm" is up for debate. Throughout history, physicians have lent their knowledge to all manner…

“Do No Harm” is perhaps the most famous medical maxim. But reciting it is one thing; living by it is another. Sometimes, the question of “harm” is up for debate. Throughout history, physicians have lent their knowledge to all manner of atrocities, warfare, torture, and mass sterilization, often justified under the supposedly noble pursuit of “reducing harm.”

Capital punishment or the death penalty is another instance of this dilemma. Doctors shouldn’t …

Physician

The insurance maze that single-payer health care would end

Ilana Slaff-Galatan, MD

September 27, 2026Sep 27, 2026

One day, my mother suddenly was unable to finish her sentences. She was admitted to the local hospital, where a CT and MRI revealed multiple lesions. Ultimately, she was diagnosed with a glioblastoma. The neurosurgeon told us she was too old to operate on and recommended hospice, adding that she was unlikely to live more than six months. At another hospital, she was offered radiation, chemotherapy, and infusions, as her …

Health Policy

Return or resign: the Pregnant Workers Fairness Act at work

Isabella Hower, MOT

September 26, 2026Sep 26, 2026

The first time I treated a newborn with the same congenital heart defect my unborn son was expected to have, I hesitated at the doorway. I couldn't stop picturing my own baby intubated and sedated, a fresh incision running the…

The first time I treated a newborn with the same congenital heart defect my unborn son was expected to have, I hesitated at the doorway. I couldn’t stop picturing my own baby intubated and sedated, a fresh incision running the length of his sternum.

I thought a terrifying fetal diagnosis would be the primary stressor of my pregnancy. I was wrong. The greatest obstacle wouldn’t come as a parent navigating her …

Health Policy

Kratom bans confuse the leaf with a semisynthetic opioid

Heidi Sykora, DNP

September 24, 2026Sep 24, 2026

Consider what happened in Walker County, Georgia, in the fall of 2025. Multiple middle schoolers became ill after eating gummies at school, though even the eventual headcount was never fully settled, with local reports ranging from three to five students. Emergency room physicians diagnosed a kratom overdose based on the clinical picture, and within hours the story was national: Kratom gummies had hospitalized children. Investigators collected one of the gummies …

Health Policy

Medicaid managed care and the case for mutual stewardship

Steven Merahn, MD

September 23, 2026Sep 23, 2026

Roughly half of American children receive their health care through Medicaid or CHIP. These programs were legislated to cover them, and the choice has been made (repeatedly, across decades and both parties) not to fund them at the level their…

However, that choice, and the confines it creates, defines the real-world conditions …

Medications

The conflict of interest that discloses as nothing

Martha Rosenberg

September 23, 2026Sep 23, 2026

With 66 percent of U.S. adults, some 131 million people, now taking prescription drugs, and with Medicare drug spending running into the hundreds of billions, it is worth asking how the pharmaceutical industry came to occupy so central a place…

The FDA announced this month that it is hiring more than 2,000 employees, rebuilding after reductions …

Conditions and Diseases

Underage online gambling needs more than a checkbox

Kayvan Haddadan, MD

September 22, 2026Sep 22, 2026

Gambling as a recreational activity continues to expand, driven by the constant availability of online platforms. Sports betting, casino-style games, and real-time micro-betting are now accessible on smartphones at any hour, turning what was once occasional into a continuous presence…

Gambling disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth …

Health Policy

AI in prior authorization: 3 contract questions for 2027

Matt Hasan, PhD

September 22, 2026Sep 22, 2026

Health systems are buying software that assembles a prior authorization packet from the chart, files it, and chases status. Health plans are buying software that reads the same packet, scores medical necessity against internal rules, and routes a yes or a request for more information. Vendors on both sides advertise essentially the same promise: Artificial intelligence will fix prior authorization.

That is only half true. What is arriving is a dual-use …

Conditions and Diseases

A poem about political division and the will to begin again

Michele Luckenbaugh

September 18, 2026Sep 18, 2026

I watch the world spinning faster than I can follow, a wheel thrown down a hill with no one reaching for the brake. Decisions made in haste, words fired like arrows, people stepping over the rights of others as though…

I watch the world spinning faster
than I can follow,
a wheel thrown down a hill
with no one reaching for the brake.

Decisions made in haste,
words fired like arrows,
people stepping over the rights of others
as though compassion
has become an inconvenience.

Where is the moral compass
we once carried inside our hearts?

Somewhere above us,
a man sits upon his golden throne,
surrounded by wealth
and power and influence,
and maybe he thinks he can
control the world.

The people below think,
“If he …

Physician

Can physicians and organized labor stand together?

Sameen Farooq, MD

September 15, 2026Sep 15, 2026

Our cultural ethos has revolved around the paragons of "hard work" and so much so that now our health leaders are suggesting that "healthy" Americans work longer to delay retirement to stimulate the economy. In the words of Dr. Oz,…

Our cultural ethos has revolved around the paragons of “hard work” and so much so that now our health leaders are suggesting that “healthy” Americans work longer to delay retirement to stimulate the economy. In the words of Dr. Oz, “If Americans could stay healthy enough to work just one additional year or start working earlier in their lives, it would increase the GDP of our nation by trillions …

Health Policy

Local news and public health: the segment viewers missed

Ronald L. Lindsay, MD

September 9, 2026Sep 9, 2026

Local news has always been a mirror: imperfect, sometimes distorted, but still a reflection of what a community believes matters. In Jacksonville, that mirror has become increasingly fogged. Last night, it reflected almost nothing of public value. For nearly twenty…

For nearly twenty minutes, English-speaking viewers watched the demolition of an empty indoor mall, a structure long abandoned except for a megachurch occupying the old Belk store. The anchors narrated the fall of drywall, …

Podcast

Why value-based care hasn’t lowered your medical bills [PODCAST]

The Podcast by KevinMD

September 8, 2026Sep 8, 2026

Everyone agrees health care should reward better outcomes at lower cost. So why hasn't it happened? The answer isn't payment models or policy. It comes down to the everyday choices individual clinicians make, and whether anyone can actually see them.…

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Everyone agrees health care should reward better outcomes at lower cost. So why hasn’t it happened? The answer isn’t payment models or policy. It comes down to the everyday choices individual clinicians make, and whether anyone can actually see them. Jeanne Cohen, a health care analytics founder and CEO, argues that …

Health Policy

Why a broken health care system keeps getting worse

Peter R. Kowey, MD

September 8, 2026Sep 8, 2026

"We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering." Elisabeth Kubler-Ross Over the course of my career,…

“We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering.” Elisabeth Kubler-Ross

Over the course of my career, I have witnessed an inexorable decline in the quality of medical care that we, as physicians, render to our patients. There is a myriad of reasons for this sad development, some …

Health Policy

Physician advocacy is a duty, not a political choice

Sean Gallagher, MD

September 7, 2026Sep 7, 2026

Christopher Nolan's The Odyssey was more than just a tale about a man's long journey home. It is ultimately a warning about what happens when society abandons its shared obligations. I found his modern interpretation helpful for framing a recent…

Christopher Nolan’s The Odyssey was more than just a tale about a man’s long journey home. It is ultimately a warning about what happens when society abandons its shared obligations. I found his modern interpretation helpful for framing a recent shift in attitudes toward public health and medicine.

In the film, the actions of the Greeks at Troy violated one of their wider society’s most foundational social norms: Zeus’ Law. It …

Health Policy

Prior authorization automation has an arithmetic problem

JJ Martin Quesada

September 6, 2026Sep 6, 2026

Wael Khouli wrote here on July 26 that AI will not replace physician advisors, volume will. He is right, and his argument applies elsewhere in the clinic to the people who build prior authorizations. I build this kind of software and have seen automation rescue teams as much as I have seen careless implementations bury them. The difference comes down to the quality of existing data, workflows, and knowing …

Health Policy and Public Health

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