Policy

The hidden cost of health care: How rising debt threatens your access to care

Policy
March 21, 2025

Before a discussion of entitlements and welfare programs is started, a primer on the fiscal situation of the country seems appropriate. Service on the national debt is now second only to Social Security as a government expenditure. The debt is now about $36 trillion. Government revenues are 18 percent of GDP. Spending is 25 percent of GDP. Seventy-six percent of spending has been mandatory, leaving 24 percent as discretionary. The …

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When state legislators are given the opportunity, they vote overwhelmingly for doctor autonomy in pain treatment

Policy
March 20, 2025

As I have written elsewhere, the United States is now embroiled in a highly contentious debate concerning the causes of the so-called “opioid crisis.” Prescribing guidelines updated in 2022 by the Centers for Disease Control and Prevention (CDC) and Veterans Administration (VA) have become the basis for continuing scientifically unsupported restrictions on patient access to long-term prescription opioid therapy. Doctors …

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10 ways health care leaders sabotage their own success—and how to stop

Policy
March 15, 2025

As a former health care executive, I have witnessed many leaders at all levels sabotage their own success. Most of it was unintentional but rather the result of a failure to learn from those who have gone before. Many in the health care industry are promoted into leadership roles without the benefit of leadership or management training and are then left to their own devices to learn “on the job,” …

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Why Quebec’s health care model could change Canada’s system for good

Policy
March 11, 2025

Health care systems worldwide are grappling with access, efficiency, and sustainability challenges. In Canada, the debate over public versus private care is especially charged, and nowhere is this more evident than in Quebec. The province has the highest number of physicians practicing outside the public system in the country—yet they still account for only 2 percent of all doctors. Instead of vilifying these professionals, policymakers should be asking: What lessons …

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The truth about FEMA: a lifeline in disaster response

Policy
March 2, 2025

We heard of Hurricane Irma only a handful of days before it smacked straight through 5th Avenue in my hometown. The predicted storm paths sent the hurricane sweeping through Miami—across the coast. When the storm path shifted, it was almost too late for my family to evacuate. Its 180 mph winds and 10–15 foot storm surge were catastrophic, costing the lives of 84 people.

It was the coordinated response of the …

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The deadly impact of the U.S. anti-abortion funding policy

Policy
March 1, 2025

As first-year medical students, we are taught to always prioritize patients over politics. However, our research in maternal health has shown us that the two are dangerously intertwined, with political decisions directly impacting the provision of health care not just domestically but around the globe.

On January 24, only four days into his second term, President Trump reinstated “Protecting Life in Global …

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Chainsaw politics may cut deeply into the fabric of health care

Policy
February 28, 2025

Federal downsizing, while touted as a means to streamline operations and eliminate bureaucratic waste, has significant and often detrimental consequences for the U.S. health care system. Two documents shed light on this issue from complementary perspectives. The first, a U.S. Office of Management and Budget-Office of Personnel Management (OMB-OPM) memorandum outlines an aggressive workforce optimization initiative designed to reduce federal staffing and cut costs. The …

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Curbing health care costs: 3 reforms for a more efficient system

Policy
February 21, 2025

The United States health care system is plagued by inefficiencies that drive up costs and limit access to care. The Department of Government Efficiency has a crucial role to play in addressing this challenge. As a physician, I often strive to practice cost-conscious care whenever possible. Three common-sense broad reforms—repealing Certificate of Need (CON) laws, implementing universal physician licensing, and advocating for site-neutral payment reform—offer significant opportunities to reduce health …

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Are you protecting your career? 5 essential questions about your NP liability insurance

Policy
February 17, 2025

The Doctors Company

A nurse practitioner (NP) in urgent care saw a patient with a severe headache following a fall. Initial testing and symptoms suggested a concussion, leading to discharge. However, when the patient’s worsening condition later revealed an elevated white blood cell count, they were rushed for further evaluation—but it was too late. The patient succumbed to bacterial meningitis. …

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To boost primary care physician pay, Congress should change funding requirements for Medicaid state-directed payments

Policy
February 15, 2025

Introduction

It is no secret that the U.S. medical system fails to treat all patients equally. Those with Medicaid often lack access to the same primary care and subspecialty clinics as those with Medicare or private insurance and face longer wait times. Medicaid is jointly funded by the states and federal government. The solution is to increase Medicaid reimbursement. Of course, in my home state, Texas, …

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Murder, vitriol, and hidden costs: inside the health insurance industry’s biggest battles

Policy
February 6, 2025

With the murder of the UnitedHealthcare CEO, many have expressed vitriol towards the insurance industry.

Having worked in non-profit health care all my life, I decided in 2018 to switch to the “dark side,” or the insurance industry, out of curiosity. What is it that they do, and how are they doing it? I thought knowing would make me a better health care worker when I returned.

As a registered nurse case …

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My totally wrong expert predictions for health care in 2025

Policy
January 27, 2025

January

In a blistering commentary, the American Medical Association’s flagship journal, JAMA, condemns the corrosive effect on patient care of the profit-seeking practices of health insurers. Separately, the organization announces that it’s selling the 13 journals in its JAMA Network to a private equity firm for $375 million “in order to enhance our mission of promoting the betterment of public health.”

February

Quickly following up on a campaign pledge to slash the federal …

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10 transformative ideas to redesign a broken health care system: a doctor’s perspective for a more efficient, cost-effective and patient-focused system

Policy
January 25, 2025

The U.S. health care system is an inefficient maze of bureaucracy, redundancies, and waste. As a practicing physician, I see firsthand how these inefficiencies frustrate both providers and patients, inflate costs, and undermine the quality of care. If we are serious about transforming health care into a system that works for everyone, we need bold, outside-the-box solutions. Here are just some of the most glaring inefficiencies I see that could …

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Humanity’s crossroads: peace or nuclear war?

Policy
January 25, 2025

“We are here to make a choice between the quick and the dead …”

With these solemn words, Bernard Baruch, a trusted advisor to U.S. presidents, addressed the United Nations (UN) Atomic Energy Commission in June 1946. Less than a year had passed since the bombings of Hiroshima and Nagasaki, and the world stood at a crossroads. Baruch’s message was clear: humanity could either embrace the hope of global peace …

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The HEARTS Act: Empowering schools to save lives

Policy
January 23, 2025

Every year, sudden cardiac arrest (SCA) claims the lives of thousands of students and student-athletes in the United States, making it one of the leading causes of death. The condition is particularly insidious as it often strikes without warning, leaving schools and communities grappling with preventable tragedies. While student-athletes are at a higher risk due to the physical demands of sports, SCA can affect any student, highlighting the urgent need …

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Why health systems must renegotiate contracts to survive

Policy
January 22, 2025

Providers must stop subsidizing payors’ profit margins. Consider UnitedHealthcare, which boasts a 6 percent margin on revenue (equivalent to $22 billion), while hospitals manage a slim 3 percent margin, and physician practices often struggle to stay financially viable. This imbalance underscores the urgent need for hospitals, health systems, and physicians to negotiate rates that not only cover their costs but also generate margins sufficient to offer competitive salaries and reinvest …

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States have the power to influence health care

Policy
January 19, 2025

Individual states in the United States can significantly shape key health care areas through policy.

In early 2024, a KKF analysis indicated that Americans collectively held around $220 billion in medical debt.

North Carolina has one of the highest percentages of adults facing medical debt, at 13.4 percent. On July 1, 2024, North Carolina Governor Roy Cooper and the North Carolina Department of Health and Human Services (NCDHHS) …

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Why the opioid crisis and youth mental health demand urgent parity reforms in 2025

Policy
January 16, 2025

At the beginning of 2024, the nation continued to experience the impact of three declared public health emergencies with significant behavioral health implications: COVID-19, Mpox, and the opioid crisis. At the same time, three major national associations continued to highlight what they first described in 2021 as a “youth mental health crisis.” As we enter 2025, emergency declarations for two of these — Mpox and COVID-19 — have …

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Pay for performance and shared savings are good, but they’re not the solution

Policy
January 9, 2025

Think about every health care reform effort we’ve been working on for the last decade or two, including accountable care organizations (ACOs) and the value-based purchasing models from CMS. The vast majority of them use one or both of the following strategies in an attempt to financially reward providers for delivering higher value (it’s like they’ve realized that financial incentives need to be fixed!):

  • Quality bonuses: For providers who deliver …

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Fostering health care innovation through federal policy: a case for direct primary care

Policy
January 5, 2025

Abstract

The United States health care system faces escalating costs, access disparities, and significant physician burnout. Direct primary care (DPC) offers a transformative approach by emphasizing patient-centered care, price transparency, and reduced administrative burdens. Yet, federal policy reforms are necessary to scale this model nationally. This article outlines actionable federal policy recommendations, identifying how mechanisms like agency rulemaking and budget reconciliation can be used to drive adoption, expand access, and empower …

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