Health policy

3,339 articles · Since 2007

Physicians writing on KevinMD about the rules they practice under: prior authorization and the algorithms now deciding it, gold card laws, scope of practice and who may practice without supervision, Medicare and Medicaid, the Affordable Care Act, drug pricing, rationing that is done and not named, and the policies that decide which patients get care. 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, Race and medicine: what physicians say, in their own words, and Medical ethics: what physicians say, in their own words.

Latest articles

Can health plans afford to ignore tobacco harm reduction?

Edward Anselm, MD

October 10, 2026Oct 10, 2026

Health insurance companies have always been ambivalent about treatment of cigarette smokers. Tobacco-related disease accounts for roughly 8 percent of U.S. medical spending, while smoking cessation is among the most cost-effective interventions in medicine. Yet the economics look different from the perspective of an individual insurer. Treatment of tobacco use generates costs today, while many of the savings from avoiding hospitalizations, and preventing cancer and other tobacco-related diseases, accrue years …

What would Dolly do about universal health care?

Alisa Berger, MD

October 9, 2026Oct 9, 2026

The passing of Dolly Parton was a gut punch to those like me assuming she still had many years left to spread kindness on this earth. It was incredible to see how she touched so many hearts well beyond U.S. borders. I got tears in my eyes watching Britain’s King’s Guard play “9 to 5” in her memory. Though her beaming smile may be gone, her eternal optimism remains. We …

Workplace violence in health care needs a national standard

Isabella Hower, MOT

October 8, 2026Oct 8, 2026

My foot slid on something wet as I entered the medical/surgical unit. Glancing down, I wondered vaguely who had spilled cranberry juice before registering the red droplets for what they were: blood. I looked over my shoulder and froze. A…

My foot slid on something wet as I entered the medical/surgical unit. Glancing down, I wondered vaguely who had spilled cranberry juice before registering the red droplets for what they were: blood.

I looked over my shoulder and froze. A patient stood in the deserted hallway, blood streaking his arm from where he appeared to have ripped out an IV. A pair of bandage scissors hung loosely in his hand.

I ran …

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How Medicare Advantage prior authorization delays care

Adam Lee

October 8, 2026Oct 8, 20262

Medicare Advantage has become one of the most important parts of the American health care system. Designed as a privately administered alternative to traditional Medicare, the program allows insurers to manage coverage for older adults while receiving payments from the federal government. Supporters argue that Medicare Advantage can reduce unnecessary spending while giving seniors access to benefits that traditional Medicare may not fully provide.

Yet recent scrutiny has raised a more …

Pharmacy benefit managers and the price no one can see

Matt Hasan, PhD

October 7, 2026Oct 7, 2026

A physician writes a prescription believing the clinical decision has been made. In reality, another decision-making process is just beginning. Between the prescription and the patient sits an increasingly powerful infrastructure of pharmacy benefit managers, insurers, formularies, rebate agreements, pharmacy…

A physician writes a prescription believing the clinical decision has been made. In reality, another decision-making process is just beginning.

Between the prescription and the patient sits an increasingly powerful infrastructure of pharmacy benefit managers, insurers, formularies, rebate agreements, pharmacy networks, prior authorization rules, and specialty pharmacies. Most physicians see only fragments of this system. Patients usually understand even less.

The result is a peculiar form of American medicine: The person making …

A letter to Congress: Repeal the Controlled Substances Act

Richard A. Lawhern, PhD

October 7, 2026Oct 7, 2026

I write as a health care educator and author with thirty years of research experience and over three hundred papers published as author or co-author, several of them widely cited. In that role, I see thousands of emails and social media postings every month from people whose lives are being destroyed by misdirected and frequently outright fraudulent U.S. public health policy on treatment of pain and addiction. The …

Nursing home ratings hide what the federal record shows

Shawn Redd

October 5, 2026Oct 5, 2026

When a patient asks where to go for a knee replacement, a colonoscopy, or their mother's rehab stay, they have usually already looked. Not at the federal record. At the stars. Here is what the stars do not show. Our…

When a patient asks where to go for a knee replacement, a colonoscopy, or their mother’s rehab stay, they have usually already looked. Not at the federal record. At the stars.

Here is what the stars do not show. Our analysis of Centers for Medicare & Medicaid Services records found that 46 percent of U.S. nursing homes carry at least one federal civil money penalty on the current enforcement record, and …

Access to interventional psychiatry should not end downtown

Ravi Singareddy, MD

October 5, 2026Oct 5, 2026

A standard course of repetitive transcranial magnetic stimulation (TMS) for depression means coming to the clinic five days a week for four to six weeks, roughly 20 to 36 sessions. That is because response depends mainly on the number of…

Esketamine (Spravato) carries a different but equally demanding logistical load. Under its FDA safety program, known as a Risk Evaluation and Mitigation Strategy (REMS), each …

Voting and health outcomes: the cycle doctors ignore

Jacob Player, MD, MPH

October 4, 2026Oct 4, 2026

Poor health can negatively impact any and all aspects of our lives, often discouraging us from participating fully in activities we otherwise would. It shouldn't be surprising, then, that those with worse health are also less likely to vote, or…

Poor health can negatively impact any and all aspects of our lives, often discouraging us from participating fully in activities we otherwise would. It shouldn’t be surprising, then, that those with worse health are also less likely to vote, or that voter participation is inversely associated with time spent in inpatient care. And while we may accept this at face value, the downstream consequences of this are often …

Lancaster County measles outbreak exposes a crisis of trust

Arthur Lazarus, MD, MBA

October 4, 2026Oct 4, 2026

For ten years, I lived with my family, 45 minutes from the rolling clover fields and dairy farms of Lancaster County, Pennsylvania, iconic markers of a world defined by quiet tradition. Yet in the fall of 2026, this peaceful landscape has become a dark microcosm of modern medicine’s greatest crisis: the weaponization of politics, the spread of bad-faith disinformation, and the collapse of public trust in the medical profession.

As Pennsylvania …

Why milk banks in emergencies must plan like blood banks

Sharron Bransburg-Zabary, PhD

October 4, 2026Oct 4, 2026

As more families depend on human milk banks to meet the vital health and nutritional needs of babies, these facilities should implement emergency response plans, similar to those in blood and tissue banks and other critical medical services. Human milk is a lifesaving resource for preterm, low-birth-weight, and critically ill infants, with the World Health Organization recommending pasteurized donor milk for babies who are unable to receive their …

3 ways communities can ease the loneliness epidemic

Tista S. Ghosh, MD, MPH

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 …

The developmental pediatrician shortage is about to deepen

Ronald L. Lindsay, MD

October 3, 2026Oct 3, 2026

A recent Guardian article described a troubling reality unfolding across England: Nearly 1 million people are waiting for ADHD assessments, approximately 295,000 are awaiting autism evaluations, and some National Health Service (NHS) regions have imposed minimum waiting periods of two years before patients can even be assessed. “Two-year waiting times highlight NHS struggle with rise in ADHD and autism awareness” reported that overwhelmed health systems are struggling to keep …

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 …

How an AI tool explained Ruan v. United States to doctors

Richard A. Lawhern, PhD

October 2, 2026Oct 2, 2026

As a health care educator with three decades of experience in research and hundreds of published papers, I have written at some length both on KevinMD and in clinical journals, concerning the dangers of artificial intelligence in medicine. I have also recently written about the profound differences between meanings of the term “Red Flag” in legal versus clinical contexts. Moreover, I have declared that predictive algorithms on …

Climate anxiety in young people demands action in 2026

Gauri Gurumurthy & Preston Dang & Rohini Kambhampati

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 …

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. …

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 …

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 …

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 …

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