Health Policy

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.

When a health insurance denial leads to death

Timothy Lesaca, MD

Health Policy

June 23, 2026

For generations, the struggles between patients and health insurers have played out in the quiet corridors of bureaucracy and the echoing halls of the courts. When a claim is denied, the journey that follows is often a weary procession: appeals, reviews, complaints, and lawsuits. Even when an insurer is found at fault, the reckoning is almost always measured in a payment here, a penalty there, and maybe a sanction filed …

America on life support: A hospital social worker reflects

Kathleen Fitzgerald, LMSW

Health Policy

June 22, 2026

America feels like the ultimate noncompliant patient.

We stabilize her, patch the wounds, manage the crisis, discharge with recommendations, and within four to eight years she is right back in the ICU on another freedom tangent that destabilizes the entire body of democracy again. The cycle repeats endlessly. Reactive instead of preventive. Fragmented instead of coordinated. Profitable instead of sustainable.

And honestly? The same dysfunction reflected in the country is reflected in …

Environmental exposures and cancer: the missing question

Natalia Perez

Health Policy

June 20, 2026

I didn’t learn about environmental health disparities in a classroom. I saw them growing up in San Pedro Sula, Honduras. I remember neighborhoods built from scrap materials, homes close to industrial waste, and families who seemed to face illness more often than chance alone could explain. At the time, I didn’t question it. Now, as I prepare for a career in medicine, I find myself revisiting those memories with a …

The hidden tax driving up U.S. health care costs

Kayvan Haddadan, MD

Health Policy

June 16, 2026

Health care spending in the United States reached about 18 percent of GDP in 2024, totaling $5.3 trillion, or roughly $15,474 per person. That’s dramatically higher than peer countries, which average around 11 percent. Yet patient outcomes haven’t kept pace.

Two major, interconnected problems stand out: exploding administrative overhead that diverts money away from actual care, and a systemic preference for treating problems after they occur rather than …

The health care workforce crisis we keep ignoring

Narinder Singh Parhar, MD

Health Policy

June 15, 2026

American health care faces many challenges: rising costs, workforce shortages, an aging population, increasing chronic disease burden, and growing administrative complexity. Yet one of the most important health care crises receives far less attention than it deserves: the declining physical and emotional well-being of the health care workforce itself.

Physicians, nurses, respiratory therapists, pharmacists, physical therapists, and countless other health care professionals devote their careers to caring for others. Yet many …

The built environment is shaping our patients’ health

Karen Zhang

Health Policy

June 14, 2026

During my pediatrics rotation, I met a 13-year-old girl with obesity. She was trying to follow her doctor’s advice to eat healthier and exercise more, but it was tough: She lacked access to a gym, her neighborhood lacked sidewalks, and local traffic was fast and busy. It was not safe for her to walk or rollerblade alone, despite her motivation to be more active.

Her problem is a common one in …

From Pakistan to Indiana: climate change and patient health

Umayr R. Shaikh, MPH

Health Policy

June 14, 2026

I am a proud Pakistani Hoosier.

My father immigrated from Pakistan in 1992 in search of a better life than what was possible back home. After moving around for work in those early years, my parents settled outside Indianapolis when I was four years old, and Indiana has been home ever since. As I now pursue my medical education, I find myself thinking often about the two places that shaped me …

EMR errors get blamed on physicians, not systems

Dennis Hursh, Esq

Health Policy

June 13, 2026

I don’t think many physicians would disagree that EMR usability is a patient safety issue. And yet, health systems seem perfectly happy to place 100 percent of the blame for any glitches on physicians.

I was recently involved in a situation where a physician was being blamed for an obvious system error. The physician in question is an experienced and dedicated pediatrician, well known in the area for her compassion …

Health care consolidation is the biggest reform barrier

John E. McDonough, DPH, MPA

Health Policy

June 11, 2026

An excerpt from America’s Wrong Turn: US Health Care in the Neoliberal Era.

Let’s consider U.S. corporate consolidation and antitrust policy in the context of health and medical care sectors. Concentration, mergers, and acquisitions are vital parts of corporate strategy among all forms of health and medical firms, a phenomenon at every stage and level across our dizzyingly complex system. In this section, we examine insurers, hospitals, physicians, pharmaceuticals, and …

How Becerra and Hilton differ on California health care

Kayvan Haddadan, MD

Health Policy

June 11, 2026

This article tries to be unbiased and compares Xavier Becerra (Democrat, former U.S. HHS Secretary, California AG, and Congressman) and Steve Hilton (Republican, former Fox News host, British-born American conservative political commentator, author, entrepreneur, and former adviser) contrasting approaches to health care.

Becerra emphasizes government-led expansion of access, protections against federal rollbacks, cost controls via regulation and purchasing power, and a long-term vision for universal coverage. Hilton focuses on reducing government …

The direct primary care HSA rule did not fix access

Dana Y. Lujan, MBA

Health Policy

June 11, 2026

In a few weeks, the direct care community will celebrate the one-year anniversary of getting what it had been asking for. By the end of the first quarter, before the rule had been in effect for a single full billing cycle, it was already clear that the more consequential effect was not affordability. It was market design. As I wrote in January, when tax-advantaged dollars enter a care model, they …

RFK’s HHS cuts leave the U.S. open to a bioweapon attack

Harry Severance, MD

Health Policy

June 8, 2026

Both during and since the COVID-19 pandemic, multiple theorists and pundits have postulated that COVID-19 was being developed as a bioweapon, and was mistakenly (or purposely) released from a containment lab, purportedly in China. Other researchers say no. But, either way, the effects upon our country, our society, our health care delivery (with emergency departments and hospitals overwhelmed, while many clinics were forced to shut down), our …

Fragmented care is the gap digital health left open

Robert Nieves, JD, MBA, MPA, RN

Health Policy

June 6, 2026

One of the unintended consequences of digital health is that we became extraordinarily good at collecting information without spending nearly enough time teaching clinicians how to use it together.

For years, health care informatics focused largely on documentation itself. We trained clinicians to click, complete, reconcile, acknowledge, and navigate increasingly complex systems. Conversations emerged around reducing clicks, decreasing documentation burden, and improving workflow efficiency. Those things matter.

But somewhere along the way, …

End-of-life decision-making is never a solo act

Chinmeri Nwuba

Health Policy

June 5, 2026

Technological and biomedical advancements are undeniable blessings in today’s health sector. These advancements have improved life-prolonging technologies. So, clinicians can often sustain biological life long after meaningful recovery is unlikely. Consequently, there is a subtle shift happening in modern medicine, where we are no longer asking whether we can keep people alive but who gets to decide when not to.

This shift becomes clearer when viewed through Ronald Dworkin’s distinction between …

Neonatal care in humanitarian crises is conditional

Maddie Beans

Health Policy

June 4, 2026

Neonatal survival depends on continuity that modern health systems often assume as stable. Thermoregulation, oxygen delivery, infection control, trained clinical staffing, and reliable electricity must function together as an integrated system. When that system is intact, care follows a predictable sequence from delivery through stabilization and escalation when needed. When it is disrupted, survival becomes conditional rather than assured.

In Gaza and Lebanon, ongoing humanitarian conditions have placed neonatal services under …

Insurance consolidation is a patient safety problem

American Society of Anesthesiologists

Health Policy

June 4, 2026

Imagine a physician who has been practicing anesthesiology for 20 years. She is skilled, board-certified, well-liked, and respected by her team. She now works more hours than she did 10 years ago, covers more call, cares for sicker patients, and manages an …

Health care affordability is now a moral crisis

Narinder Singh Parhar, MD

Health Policy

June 4, 2026

“If gravity pulls everything down, why are my health insurance premiums and co-payments skyrocketing?”

The question sounds humorous, but beneath the humor lies frustration shared by millions of Americans. Health care spending in the United States continues to rise year after year. Medical technology has advanced dramatically. We have better imaging, more sophisticated procedures, and an ever-expanding list of medications. Yet many patients are finding health care increasingly difficult to afford. …

U.S. drug shortages threaten national health security

Anmol Gupta, MD, MPP

Health Policy

June 4, 2026

The third pharmacy turned him away. My patient had already driven across Northern Michigan in search of his life-saving cancer medication. The first pharmacy was out of stock. The second was out too. At the third, he was told they hadn’t received a shipment in weeks.

On the other end of this crisis are the physicians. We spend our late evening hours calling store after store, a desperate game of pharmacy …

The real reason value-based care has not delivered

Jeanne Cohen

Health Policy

June 3, 2026

It has been 20 years since the term “value-based care” (VBC) entered the health care lexicon.

VBC was supposed to transform health care. It promised to move the system away from fee-for-service (FFS), a model that rewards volume over outcomes, toward a future defined by prevention, efficiency, better patient results, reduced waste, and lower costs. Two decades later, that promise remains largely unfulfilled. Despite years of pilots, policy pushes, and payment …

RFK’s food pyramid is a win for industry, not health

Martha Rosenberg

Health Policy

May 27, 2026

When Robert Kennedy Jr. (RFK) was confirmed as HHS director last February, overseeing the CDC, NIH, CMS, and FDA, many worried that modern medicines would become unavailable or scarce.

Instead, industry has received unexpected windfalls and green lights from the new policies. Exhibit A: the exoneration of hormone replacement therapy (HRT) from its well-documented links to cancer and cardiovascular effects. The “timing theories” at Wake Forest that helped turn HRT on …

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