In a group text with fellow pediatricians, I received a message asking if anyone knew where a child could get a blood draw that was not the emergency room. The question came from a colleague on behalf of another physician friend. She was worried her son might be anemic because of how he looked pale and was unusually fatigued.
She had just switched jobs and her son was not covered yet …
Health insurance coverage loss threatens sick children
A new federal Health Care Advisory Committee has been announced to guide policy for Medicare, Medicaid, and other major health programs. Its mission is ambitious: improve outcomes, modernize care, and address the growing burden of chronic disease.
But there is a glaring omission. Not one independent, private practice physician, someone who manages chronic illness in the community every day, is represented. That is striking because at least one-quarter of all physicians …
Independent physicians are missing from health care policy
Key issues in California’s health care system highlight some structural problems that hit patients, doctors, and communities hard. These aren’t abstract policy debates; they are day-to-day realities in pain management, chronic care, and everyday practice. Core issues, which were pulled from the previously published articles, include but are not limited to:
How gold cards can drive California pain management reform
It is 2:17 a.m. in a crowded emergency room. A patient is rushed in. The patient is unconscious, unstable, and rapidly deteriorating. There is no time to obtain a detailed medical history, no opportunity for a careful discussion of risks, and obviously no time to seek consent. The doctor decides to take immediate action which saves the patient’s life. Weeks pass. The same doctor is served with a lawsuit.
At first …
Medical malpractice risks persist even after saving a life
An excerpt from Beyond Medicare For All: Cracking the Code of the Healthcare Affordability Crisis.
If our goal is high-quality, comprehensive, affordable health care for all, we must make health care less profitable. If health systems and corporations continue to control health care and their main goal is profit, health costs will continue to rise faster than the ability of society to pay, regardless of any reform efforts.
On the other …
A Medicare for All alternative that keeps insurers in
Let us be honest about what is really happening: Automation is coming for medicine, and equity is still waiting in line. Across hospital systems, medical schools, and conference stages, a profession is holding its breath. The question consuming medicine right now is not about patients. It is about survival. About whether artificial intelligence (AI) will hollow out what took decades to build, whether the clinical judgment earned through sleepless residencies …
Bridging the health equity gap with artificial intelligence
As California gears up for its gubernatorial primaries and debates, the familiar issues dominate the conversation: housing affordability, crime, taxes, and economic pressures. Health care surfaces, but rarely as a central priority with concrete, actionable solutions. Candidates offer broad strokes on affordability or protecting programs from federal changes, yet the crushing realities of escalating costs, physician shortages, regulatory burdens, and a system skewed against preventive, relationship-centered care receive little more …
California’s governor race is missing a health care plan
Travel time to get to an operating room (OR) has increased since 2010. In 2020, 44 percent of rural adults traveled for 60 minutes or longer to get to a place to receive surgery compared to approximately 37 percent in 2010.
Longer travel to receive surgery results in delayed treatment. Delayed treatment causes the development of more complicated cases, higher complication rates, and poorer outcomes for those who receive …
How mobile surgical units improve rural surgical access
The act of taking a deep breath is a simple, mindless reflex. However, for nearly 124,990 Americans this year, that same breath will become a reminder of a system that failed them. Currently, health care in the U.S. is viewed as a privilege, reserved for those who have the means to access it; it is no longer seen as a right. When it comes to lung cancer, our health …
Why lung cancer screening needs urgent policy reform
The current U.S. Secretary of Health and Human Services, Robert F. Kennedy Jr., has consistently captured public attention with his actions and rhetoric, but one aspect of his public health agenda that has received comparatively little scrutiny is his proposed reconceptualization of addiction treatment, undergirded by his support for and stated intent to emulate Patrignano. Patrignano is an addiction treatment program in Italy where people who use drugs (PWUD) participate …
Why Kennedy’s addiction treatment plan raises ethical concerns
“What is that?” I was sitting in the emergency room during my emergency medicine rotation, chatting with my attending when he had asked me what residency program I was in. I told him I was actually doing two: family medicine and preventive medicine. Family medicine he had heard of, but preventive medicine? Only a confused look. And he is not the only one. In medical school, there was no specialty …
Why the U.S. needs more preventive medicine and public health doctors
Recent federal cuts to how Medicare pays physicians are likely to deliver significant negative consequences to independent medical practices.
The Centers for Medicare and Medicaid Services’ (CMS) final rule for the 2026 Medicare Physician Fee Schedule imposes a dramatic reduction in payment rates for medical services performed in hospital settings by independent clinicians.
The payment reduction fails to account for the true resource costs incurred by independent physician practices, creating an …
Medicare practice expense cuts will hurt patients
In one health care organization, a provider was reviewed and cleared through routine payment integrity processes. Months later, that same provider became the subject of a fraud investigation, based on patterns that had been present all along. Both reviews were technically correct within their scope. But together, they revealed something more concerning: The system itself was not aligned. Health care organizations invest heavily in payment integrity (PI) and special investigations …
Why health care fraud detection requires payment integrity alignment
I first met Ramon in the aftermath of Hurricane Katrina when I was moonlighting in local ERs and assisting wherever needed. New Orleans has a long-standing historical and economic connection to Honduras, primarily through the banana trade and shipping routes linking Honduran ports to New Orleans. These routes facilitated both commerce and migration between the two. Ramon, whose family has deep roots in both Honduras and New Orleans, arrived here …
Preparing for Medicaid cuts and the imperial health boomerang
You were told physician-owned hospitals were finished. That the 2010 legislation closing them out of Medicare was permanent. That if you wanted to own something, your options were a direct primary care practice, a concierge model, or a slow negotiation with the health system already employing half your colleagues. The hospital. The thing you actually trained to practice in. That was off the table.
It may not be anymore. But the …
Physician-owned hospitals get a narrow CMS opening
In recent months, a heated debate has emerged about the credibility of major medical journals such as the New England Journal of Medicine, the Journal of the American Medical Association, and The Lancet. Critics, including United States Health and Human Services Secretary Robert F. Kennedy Junior, have argued that these journals are compromised by pharmaceutical industry influence and therefore cannot be trusted. At first glance, the claim may sound extreme. …
Evaluating the credibility of major medical journals today
Rural health clinics (RHCs) are Medicaid-funded community-based interventions that significantly improve maternal health in rural areas by increasing access to care. A study done in Egypt, an extremely rural country, showed that community clinics for rural health provided evidence-based interventions that have drastically lowered complication rates during pregnancy. Complications during pregnancy dropped from 38.1 percent to 15.1 percent, and postpartum complications from 81.7 percent to 7.0 percent. Although these solutions …
How rural health care access impacts maternal mortality
One hundred million Americans carry medical debt. Research published in JAMA Network Open found that medical debt is associated with higher mortality across every leading cause of death, including suicide. A national study in the Journal of Clinical Psychiatry found that people carrying debt burden are more than three times as likely to attempt suicide. Sixteen percent of suicides in this country involve a financial crisis. I do not write …
The hidden toll of medical debt on patient health and survival
KevinMD recently published a paper describing the horrible impacts of health care lobbying in the U.S. This article assesses how effective the lobbyists have been in misdirecting four key legislators on health care-related committees of the U.S. House of Representatives and Senate.
As we will shortly discover, these highly influential lawmakers have parts of their story right. They also have parts desperately wrong, in ways that are destroying American medicine …
How health care lobbying distorts the U.S. opioid crisis
I’ve recently been forced to make painful and difficult choices that impact my personal life as well as my small business because this Congress has been unwilling to renew tax credits that used to significantly lower the cost of my health insurance. My husband and I are both self-employed entrepreneurs. We don’t have access to corporate health plans and the substantial cost sharing that employers typically …
How expiring ACA enhanced premium tax credits hurt business
Get free updates delivered free to your inbox.
