A few months ago, I met a woman who had stopped speaking at dialysis. She had grown quiet, worn thin by the rhythm of a system that seemed to talk around her but never truly to her. When she finally spoke to me, it was not about her labs or transplant status. It was a whisper — “Do you think I’ll make it in time?”
In that moment, she wasn’t asking …
Why transplant equity requires more than access
Recently, The Hill published an op-ed purporting to be a measured critique of gender-affirming care for youth. In reality, it was a dangerous and misinformed piece of ideological propaganda cloaked in the language of academic concern and propped up by debunked claims and bad faith arguments.
Riffer, who has studied censorship, gender regulation, and the legislative targeting of LGBTQIA+ communities across the U.S., will say …
Ideology, not evidence, fuels the anti-trans agenda
Inland Southern California stands as one of the most diverse and rapidly growing regions in the United States. With a rich mix of cultures, ethnicities, and socioeconomic backgrounds, it also faces significant health disparities. From disproportionate rates of chronic diseases like diabetes and hypertension to barriers in accessing essential care, marginalized communities in the region continue to suffer the consequences of a health care system that often leaves them behind. …
Health equity in Inland Southern California requires urgent action
American medicine has mastered a perverse art: paying more to achieve less.
We call it “cost-cutting,” but it is a system of engineered backwardness. We underfund clinical staff, then spend fortunes on lawyers to defend the inevitable errors. We employ armies to process bills while insurers employ armies to deny them. We treat the eyes, the teeth, and the mind as optional accessories, as if they could be unbolted from the …
How American medicine profits from despair
Before I started medical school, I used to pass the same government hospital every day on my way to school. It was one of those places that offered “free treatment,” but even as a teenager, I could sense that the care was often just for the name. I remember going to school the next day at around 6:30 a.m., I saw a man sitting outside the hospital, the same man …
What I learned about health care by watching who gets left behind
The so-called “One Big Beautiful Bill” was passed by both houses of Congress and signed into law by the president on July 4, 2025. This bill will have a sweeping impact on the already declining health care landscape in America.
If you’ve been feeling a mix of confusion and frustration, you’re not alone. This isn’t just policy. This is your career, your practice, and your patients.
This bill brings the largest cuts …
How the One Big Beautiful Bill could reshape your medical career
You may have noticed the Supreme Court announced several crucial rulings on controversial topics. Buried in most coverage was a note that the Court upheld the legality of the U.S. Preventive Services Task Force (USPSTF).
Most folks have no clue what the USPSTF is or does. To people like me, it is crucial to advancing the early detection and prevention of cancer in the United States. For now, we can be …
Why the U.S. Preventive Services Task Force is essential to saving lives
An excerpt from Disease Detectives: True Stories of NYC Outbreaks.
Dr. Westyn Branch-Elliman contributed to this chapter.
There exist within NYC, communities that feel more like a small town than a perspiring slab of metropolis. People know and speak to their neighbors, greet each other warmly on the street, and watch over each other’s children. Single- and two-family brick homes with small, manicured lawns line quiet streets. There is usually one …
Brooklyn hepatitis C cluster reveals hidden dangers in outpatient clinics
Over the past several years, each time a periodic U.S. hospital closures report is released, the number failing financial stress tests and at extreme risk of closing rises. The number now approaches 800 nationwide.
Meanwhile, many project that the just-passed One Big Beautiful Bill will rapidly increase these closures and further degrade health care access for American citizens.
Touted reasons for accelerating hospital closures, especially impacting …
Why nearly 800 U.S. hospitals are at risk of shutting down
I recently spoke with close friends—both physicians—who admitted something quietly alarming: They’re not resisting change in health care. They’re just tired of constantly adapting while losing the essence of what brought them into medicine in the first place.
“I spend more time documenting than actually caring for my patients.”
“Every time I adjust to one system, a new one replaces it.”
These comments stayed with me—not as complaints, but as confessions. As a …
Innovation is moving too fast for health care workers to catch up
I understand that, in August, we will receive the prescription for the poor results of the recent Make America Healthy Again (MAHA) report focused on children’s health. As a pediatrician, I would like to offer some remedies for the child nutrition shortcomings identified in the report and provide feedback on other health concerns it raises.
Chronic disease rates among children are mentioned first in the report. Authors point to …
How pediatricians can address the health problems raised in the MAHA child health report
Rising costs are dominating kitchen table conversations across the country, and health care is no exception. In response, federal and state regulators have introduced a range of proposals to curb spending and improve efficiencies—some thoughtful, others deeply flawed. As a former emergency medicine physician and now a health care executive with over three decades of experience, I’ve seen what works and what doesn’t. If we’re serious about cost control, we …
How reforming insurance, drug prices, and prevention can cut health care costs
Imagine going to a restaurant where, instead of being charged separately for your appetizer, main course, and dessert, you pay a fixed price for the entire meal. That’s the idea behind a bundled payment plan in health care. Instead of billing patients and insurers for every individual test, treatment, or doctor’s visit during a medical episode—like a knee replacement—providers receive a single, comprehensive payment for all services related to a …
Bundled payments in Medicare: Will fixed pricing reshape surgery costs?
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As lawmakers debate cuts to Medicaid and restrictions on care for undocumented immigrants, the question isn’t just what America covers—it’s who.
Proposals like the No Medicaid for Illegal Immigrants Act of 2025, and related attempts to embed its provisions in the One Big Beautiful Bill Act, aim to block federal funding for Medicaid services to undocumented families. Some state plans go further, threatening to remove children from CHIP if …
Who gets to be well in America: Immigrant health is on the line
Brick-and-mortar stores must deal with online competition. Even health clinics face disruption from telemedicine. Yet optometrists have special protection in South Carolina.
When a telehealth company invented a safe and effective way for doctors to renew vision prescriptions remotely, political insiders rallied in Columbia to ban the service in South Carolina. Now, nine years later, the state-sponsored favoritism could end.
The South Carolina Supreme Court, which already rejected an attempt to …
Online eye exams spark legal battle over health care access
President Trump signed into law the One Big Beautiful Bill Act (H.R. 1)—a 1,000+ page legislative thunderclap that had just cleared Congress, reshaping the landscape of American domestic policy as fireworks lit the sky. Branded as a domestic reset—heavy on tax cuts, defense expansion, and deregulation—it was not sold as a health care bill. But for those of us on the front lines of medicine, particularly in rural America, make …
The One Big Beautiful Bill and the fragile heart of rural health care
Health care leaders don’t have a vision problem. We have an execution problem.
Over the last two decades, I’ve seen countless strategic plans crafted with care, insight, and bold ambition. Mission statements get refreshed. Core values are realigned. Retreats are held. Vision decks are created and shared from the C-suite to the frontlines. And yet — within weeks — most of those plans fade into the background.
The problem isn’t poor leadership …
Why health care leaders fail at execution—and how to fix it
I have a great doctor. I’ve enjoyed his approach to providing care so much that I was greatly distressed when, at my last visit, he told me he was thinking of retiring early. While I consider myself fortunate to have a positive and dependable relationship with my doctor, fewer people now relate to that sentiment than before.
Gallup recently reported that America’s trust in professionals has declined, with overall trust …
Healing the doctor-patient relationship by attacking administrative inefficiencies
In an age where bold language dominates headlines, it can be easy to overlook the real-world effects of complex legislation. But this is not just a matter of political branding. The proposed One Big Beautiful Bill Act has implications that, based on current research, could lead to substantial and preventable harm to public health.
As a fourth-year medical student with a background in public health, I’ve spent years studying how health …
The hidden health risks in the One Big Beautiful Bill Act
As a surgery resident, I see the long shadow of poor public health every day — whether it’s a diabetic foot infection that’s gone too long without care or a hypertensive crisis that never should’ve happened. That’s why the proposed restructuring of the CDC and other federal health agencies is not just administrative news to me — it’s personal.
The argument for reform often leans on efficiency: Reduce bureaucracy, streamline oversight, …
The CDC’s restructuring: Where is the voice of health care in the room?
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