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.

Why the U.S. health care system is failing patients and physicians

John C. Hagan III, MD

Health Policy

January 18, 2026

United States (U.S.) health care, once a citadel of innovation and quality, has sadly devolved into a complex, frustrating, and frequently inaccessible system. It is so disorganized and inefficient it might not even meet the definition of a “system.” U.S. health care fails to address the needs and expectations of patients on many occasions and in many ways. For most of my career, I have considered U.S. health care the …

Putting health back into insurance: the case for tobacco cessation

Edward Anselm, MD

Health Policy

January 17, 2026

As major public health agencies such as the Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), and state health departments face reductions in scope and resources, a unique opportunity arises for health insurers to take a leading role in improving public health, while also enhancing their own reputations and financial sustainability.

Consider tobacco use, the leading cause of preventable death in the United States, …

Retail health care vs. employer DPC: Preparing for 2026 policy shifts

Dana Y. Lujan, MBA

Health Policy

January 16, 2026

Recent federal policy discussions have introduced a framework that would place health care affordability dollars into individual-controlled accounts rather than routing them through insurers or employer benefit plans. Still at the framework stage and requiring legislative action, the architecture being explored signals a potential shift in how health care purchasing power flows through the system.

Whether or not this specific framework advances, the direction of travel is clear. Health care …

Ecovillages and organic agriculture: a scenario for global climate restoration

David K. Cundiff, MD

Health Policy

January 10, 2026

Eight years ago, motivated by concern for my six grandchildren and future generations, I began a systematic study of climate change through the assessment reports of the Intergovernmental Panel on Climate Change (IPCC). That work led me to focus on a central omission in mainstream climate modeling: The failure to model global conversion to exclusively organic agriculture.

In 2024, the preprint journal SSRN published my scenario to reduce net projected greenhouse …

How environmental justice and health disparities connect to climate change

Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta

Health Policy

January 10, 2026

Environmental justice, health disparities, and climate change are deeply interconnected, with climate change acting as a threat multiplier that exacerbates existing health inequities, particularly among marginalized and underserved communities. Environmental justice refers to equitable and meaningful involvement in environmental policies, regardless of income, race, etc. Historically marginalized communities of color, the low-income population, and indigenous people are disproportionately exposed to ongoing as well as historical environmental policies. Health disparities arise …

Examining the rural divide in pediatric health care

James Bianchi

Health Policy

January 9, 2026

A vacant expression covered the face of a 14-year-old boy who lay almost lifeless in a hospital bed, completely unaware of the frantic hustle that surrounded him. Once an extraordinary student-athlete, intracerebral hemorrhage unjustly robbed him of his robust character. This was my most significant interaction with a patient. I knew him not as the student-athlete, nor the boy from neurosurgery, but as my youngest brother. With limited access to …

Mobile dentistry: a structural redesign for public health

Rida Ghani

Health Policy

January 8, 2026

Canada prides itself on having a strong public health system, yet we continue to treat oral health as optional. Dental disease occupies a peculiar niche in health care: scientifically essential, yet structurally marginalized. We know that chronic gum inflammation is linked to heart disease, stroke, diabetes complications, and even adverse pregnancy outcomes. Yet it remains largely detached from how we think about preventing chronic illness.

This disconnect isn’t caused by a …

Accountable care cooperatives: a 2026 vision for U.S. health care

David K. Cundiff, MD

Health Policy

January 7, 2026

As of January 1, 2026, the American health care system is in crisis. People can no longer afford their health insurance premiums or even to afford to pay for any health insurance. Recently, a 62-year-old self-employed friend of mine saw his premiums increased tenfold in a single cycle. I am lucky that I am over 65 and have Medicare insurance as well as a pension from my employment. Millions of …

Geography as destiny: the truth about U.S. life expectancy disparities

Arthur Lazarus, MD, MBA

Health Policy

January 5, 2026

Every New Year arrives with its familiar rituals. We raise a glass, make a resolution, and offer a toast to things we hope will be different this time around: better habits, better balance, better health. We say “I’ll drink to that” as shorthand for optimism, an easy affirmation that the future is still negotiable and a longer life is possible.

Then along comes a map.

Student loan cuts for health professionals

Naa Asheley Ashitey

Health Policy

December 30, 2025

I want to make something clear from the very beginning, because this point often gets lost when taking this perspective on this topic.

Nurses, physician assistants, occupational therapists, physical therapists, medical assistants, and every allied-health professional are indispensable to our health care system. They are professionals whose expertise saves lives, keeps clinics running, and provides the continuity of care that physicians alone cannot sustain. Their work is rigorous, their training is …

Why lab monkey escapes demand transparency

Mikalah Singer, JD

Health Policy

December 30, 2025

A laboratory transport truck crashed in Mississippi last month resulting in eight monkeys escaping, seven of whom were shot and killed after surviving the initial crash. Tragedies like this happen too often. Over the past two decades, there have been more than 15 publicly reported lab monkey escapes, both during transportation and directly from labs, including from the California, Southwest, and Oregon National Primate Research …

The political selectivity of medical freedom: a double standard

Arthur Lazarus, MD, MBA

Health Policy

December 22, 2025

I’ve been thinking about “choice” a lot lately, not the rich, ethically grounded version we teach in medical school, rooted in autonomy, informed consent, and shared decision-making, but a thinner, more selective version now circulating in political and legal discourse. The kind that sounds principled until you read the fine print.

The message goes like this: You may choose, just make sure you choose correctly.

It’s the literary equivalent of Animal Farm: …

Understanding alternative drug funding programs

Martha Rosenberg

Health Policy

December 20, 2025

As elected officials and citizens brace for the possible expiration of federal subsidies for health insurance premiums, many wonder if there are alternatives to the confusing rebate/copay/deductible/premium drug coverage word salad (see: PSAOs, GPOs, NADACs, ASOs, MLRs, AWPs, WACs, U&Cs, MACs, BERs, GERs, DFERs, GDRs, NDCs, DIRs, and ERISAs).

Just because patients don’t understand the opaque layers/players behind the drug procurement affordability crisis, doesn’t mean that lawmakers do, say experts (which …

The impact of policy cuts on ableism in health care

Ashna Shome, MD

Health Policy

December 19, 2025

I am a disabled doctor. Being in residency, where many of my peers are young and able-bodied, I entered medicine with extensive experience on the other side of the examination table. I also entered medicine wanting to emulate the best of the care I received, and minimize the worst.

Over time, I have met more and more doctors like me who struggle with temporary or permanent disability. I see how systems …

Accountable care cooperatives: a community-owned health care fix

David K. Cundiff, MD

Health Policy

December 13, 2025

After the longest government shutdown in U.S. history (one triggered by battles over health care funding) the core issue remains unresolved. Neither political party has produced a durable solution. The Centers for Medicare and Medicaid Services (CMS) projects U.S. health care spending will reach nearly $9 trillion by 2035, consuming 20 percent to 22 percent of GDP. The Congressional Budget Office projects that without significant changes in policy, …

Why U.S. health care costs so much

Ruhi Saldanha

Health Policy

December 12, 2025

The U.S. has the lowest health care quality ranking compared to other high-income countries. According to the Centers for Medicare and Medicaid Services (CMS), the U.S. spent approximately $4.9 trillion on health care in 2023. This means that almost one out of every five dollars spent in the U.S. goes towards health services. Despite this high spending, the U.S. consistently has a lower life expectancy compared …

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Why U.S. health care costs so much

Why the expiration of ACA enhanced subsidies threatens health care access

Sandya Venugopal, MD and Tina Bharani, MD

Health Policy

December 12, 2025

Just over 40 days into the longest government shutdown in American history, the rope snapped. The enhanced premium tax credits that kept 22 million Americans insured will expire on December 31, 2025. Premiums are soaring, protections are vanishing, and the safety net is unraveling. Americans are already reeling from gutted SNAP benefits. Now they’re losing health care coverage too. The Congress has made it clear that the most vulnerable are …

Why extending ACA subsidies is crucial for health care access

Curt Dill, MD

Health Policy

December 11, 2025

When Americans decide something is right, political inertia does not prevent us from acting, and now is the time for health care. Before the Affordable Care Act (ACA), 60 percent of Americans had employer-sponsored coverage, 20 percent relied on public programs, and the remaining 20 percent had to obtain insurance on their own, a difficult task because the individual market was unsustainable. But the ACA stabilized these issues by expanding …

Medicare payment is failing rural health

Saravanan Kasthuri, MD

Health Policy

December 5, 2025

Ten years ago, I quit my job and started a solo office-based practice in rural Washington. I serve patients like Mr. G, an elderly gentleman who drove over 70 miles through mountain passes and rural highways to receive care for gangrene of his foot, as nearby hospitals were either too full or too far away. But Medicare’s broken payment system is endangering practices like mine, quietly dismantling access to affordable …

Did the CDC just dismantle vaccine safety clarity?

Ronald L. Lindsay, MD

Health Policy

November 22, 2025

“Vaccines do not cause autism.” That statement once anchored public health. The CDC just dismantled it, quietly, strategically, and dangerously.

Presumption reversed, justice subverted

Attorney Lindsey Halligan didn’t misspeak when she claimed James Comey must prove his innocence beyond a reasonable doubt to a Virginia grand jury. She exposed the new doctrine: guilt by accusation, innocence by loyalty. Then she staged a procedural ambush. She bypassed the full grand jury entirely. She …

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