Public Health & Policy

Understanding alternative drug funding programs

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 economic case for investing in tobacco cessation

Edward Anselm, MD

Conditions

December 16, 2025

Despite decades of progress in reducing the prevalence of cigarette smoking, tobacco use remains a leading cause of preventable death and disease, and a significant driver of health care costs in the United States. Smoking cessation therapy is consistently ranked among the most cost-effective clinical preventive services and is considered to be “the gold standard of health care cost-effectiveness.” Yet, delivery of evidence-based treatment …

Accountable care cooperatives: a community-owned health care fix

David K. Cundiff, MD

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

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

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

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 …

Modern eugenics: the quiet return of a dangerous ideology

Arthur Lazarus, MD, MBA

Physician

December 8, 2025

I’m not paranoid. And I don’t believe in conspiracy theories. But as a physician who has spent decades watching the pendulum of medical ethics swing back and forth, I can’t ignore the pattern emerging across public health and politics today. Some of what I’m seeing looks uncomfortably familiar. It looks like eugenics, not the caricature of white coats and calipers, but the quieter, policy-driven, values-encoded version that shaped America a …

A lawyer’s essential checklist for physician side hustles [PODCAST]

The Podcast by KevinMD

Podcast

December 5, 2025

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Licensed attorney Anu Murthy discusses her article, “A lawyer’s guide to physician side gigs.” Anu details why the pandemic caused an explosion in physician side gigs (from telehealth to passion projects) and …

The devaluation of physicians in health care

Allan Dobzyniak, MD

Physician

December 5, 2025

It is remarkable that treatises, white papers, editorials, and articles on the cost of health care are consistent with ignoring the essence of care, and they are lacking in physician commentary. Insurance is not health care, and there can be no health care without doctors. Simply stated, in the end after all the intermediaries have claimed their pound of flesh for myriad services that most often provide little to no …

How immigrant physicians solved a U.S. crisis

Eram Alam, PhD

Conditions

November 24, 2025

In the decades following the passage of the Hart-Celler Immigration and Nationality Act of 1965, the face of American medicine irrevocably changed. This bill expedited the rapid entry of physicians from post-colonial Asian nations into the U.S. in significant numbers. In this migratory flow, South Asian physicians, in …

Did the CDC just dismantle vaccine safety clarity?

Ronald L. Lindsay, MD

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 …

Why we need to expand Medicaid

Mona Bascetta

Education

November 20, 2025

When I began PA school, I faced an unexpected financial hurdle: I no longer qualified for employer-sponsored health insurance, and although at the time, I didn’t meet the requirements for Medicaid, I did qualify for subsidized health coverage through the marketplace. However, even with subsidies, the monthly premiums and out-of-pocket costs were still a financial strain. To afford health care and cover basic living expenses, I had to continue working …

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Why we need to expand Medicaid

How culturally compassionate care builds trust and saves lives [PODCAST]

The Podcast by KevinMD

Podcast

November 19, 2025

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Public health professional Nishat Uddin discusses her article “Why culturally compassionate care matters for South Asian communities.” Nishat explains why South Asians, one of the fastest-growing U.S. populations, face disproportionate rates of …

Medicine’s silence on RFK Jr. [PODCAST]

The Podcast by KevinMD

Podcast

November 16, 2025

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Diagnostic radiologist Rakesh A. Shah discusses his article “A critique of medicine’s response to RFK Jr.” Rakesh argues that major physician organizations have failed in their duty to protect public health by …

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Medicine’s silence on RFK Jr. [PODCAST]

A new vision for modern, humane clinics

Miguel Villagra, MD

Physician

November 16, 2025

This is an invitation to clinicians and health leaders to shape the next decade of care: more precise, more connected, more human. The tools are here. The leadership is you.

The quiet nudge

If you’ve felt that steady tug that health care could be so much better, you’re not alone, and you’re not wrong. We’re investing more than ever, but patients still meet friction at the exact moment they need ease. That …

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A new vision for modern, humane clinics

Why medical organizations must end their silence

Marilyn Uzdavines, JD & Vijay Rajput, MD

Policy

November 14, 2025

Professional medical organizations, such as the American Medical Association (AMA), American Hospital Association (AHA), and American College of Physicians (ACP), do more than set policy. They are custodians of medicine’s ethical core, defenders of science, and guardians of public trust. Yet, at critical moments, these organizations too often fall back on a strategy of silence. That silence is not neutral. It carries real consequences.

Mixed messages, missed voices

Consider a recent example. …

The flaw in the ACA’s physician ownership ban

Luis Tumialán, MD

Policy

November 14, 2025

“The most expensive piece of medical equipment is a doctor’s pen. And, as a rule, hospital executives don’t own the pen caps. Doctors do.” Dr. Atul Gawande, an endocrine surgeon practicing at Brigham’s Women and Children Hospital in Boston, Massachusetts, wrote those words in the June 1, 2009, edition of the New Yorker in an article entitled, “The Cost Conundrum.” In that article, Dr. Gawande compared health care expenditures …

Deaths in custody highlight crisis in Philly prisons

Kendall Major, MD, Tommy Gautier, MD, Alyssa Lambrecht, DO, and Elle Saine, MD

Policy

November 12, 2025

The Kensington community is still reeling after the deaths of Amanda Cahill and Joey Gabor, who both died in custody shortly after being arrested during the area’s controversial narcotics sweeps at the end of 2024. While we don’t know the details behind these deaths, they are alarming and depict the vulnerability of those incarcerated with substance use disorder. We as physicians working to curtail the opioid epidemic must advocate for …

Why ACA subsidies aren’t the main issue

Andrew Murphy, MD

Policy

November 10, 2025

As a physician with decades of experience, I have watched health care in this country change from a patient-centered calling into a profit-driven corporate enterprise. Much of the current political rhetoric surrounding the Affordable Care Act (ACA) conveniently ignores the real structural issues that drive up premiums and reduce access for ordinary Americans.

The recent claim that, if Republicans “get their way” and ACA tax credits expire, insurance costs will skyrocket …

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Why ACA subsidies aren’t the main issue

Are we scared of the wrong environmental toxins?

M. Bennet Broner, PhD

Conditions

November 1, 2025

Like you, I receive many emails concerning environmental toxins. Many of their claims are based on conjecture rather than scientific evidence and are delivered in a panicked manner, implying that you or a family member is doomed if you do not act quickly. It is especially annoying that they often target minor issues rather than major ones. For example, they have emphasized the danger of artificial sweeteners. However, if one …

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