This week, lawmakers reached a bipartisan agreement on the latest HHS appropriations bill that is a critical step forward in funding essential health programs for the year ahead.

To be a Prepared Patient (and Consumer), it is important to know where the winds are blowing with regard to health care. There has been mounting pressure on the Trump Administration to propose solutions to our health care crisis and so the White House released their plan. In this newsletter, I will break it down but first, some background for the problem of U.S. health care.

Recently I had an ophthalmology appointment. During the week before the appointment, I got a text and an email encouraging me to "sign in" electronically before the appointment. I dutifully completed the paperwork, submitted photos of my insurance card as directed and paid my co-pay. I did this immediately upon receipt of the notification, four days before my scheduled appointment.

Over the past year, the Trump administration dismantled the core functions of HHS and closed USAID, eliminating health as an effective tool of "soft power" and more importantly leading to many thousands of deaths across the globe. Moreover, Congress passed consequential legislation, "the One Big Beautiful Bill" (OBBBA), that will have ugly consequences for millions of people.

A physician colleague recently told me that increasingly she is seeing patients turning 65 years old seeking care for the first time in their adult life as they qualify for Medicare. These people have gone without care for decades and present with chronic conditions such as diabetes, heart disease and kidney disease. The opportunity for prevention or mitigation has passed. Health care coverage matters.

As Congress departs Washington without voting to extend the Affordable Care Act (ACA) marketplace premium subsidies, millions of Americans are heading toward a preventable affordability cliff.

The United States has one of the most advanced medical systems in the world and one of the most dysfunctional. Costs keep rising, families and employers feel increasingly squeezed, hospitals and physician practices are struggling with mounds of administrative paperwork and declining revenue, and the policy debate has become polarized and oversimplified. But meaningful reform requires understanding a core truth: our health system is not simply expensive; it is structurally fragmented, economically distorted, and historically accidental.

During my pediatrics training, I took care of a teenage boy with sickle cell disease in the pediatric intensive care unit. He was suffering from Acute Chest Syndrome, a condition where misshapen "sickle" blood cells clog up the capillaries in the lungs. These blockages cause infarcts (damage) to lung tissue, preventing the lungs from doing their job of air exchange.

There's been a lot of chatter about price transparency as a way to lower health care costs. Price transparency is a good thing, but as a way to lower health care costs? Hold on! Health care is not a commodity like other items you buy. Yes, we should have price transparency. For those patients who are able, comparing prices is a good thing. However, price transparency will not lower costs. It's because of basic economics.

Have you seen the assertions that the ACA is the cause of rising healthcare costs? Let's get real - U.S. healthcare costs have consistently grown faster than inflation and have been rising for decades, long before the ACA was implemented in 2010. Do not believe the rhetoric that the Affordable Care Act is the cause of escalating healthcare costs. As with most issues that don't fit well with political rhetoric, it's complex.

Families who I cared for in the ER convinced me that waiting for top‑down changes in our health system is a luxury patients cannot afford. We can reclaim power now, before illness strikes and financial debt mounts. For those who have already been impacted, we can reduce the likelihood that similar incidents will occur again. This is why I wrote "The Prepared Patient: Your Guide to Surviving the Healthcare System".

Abstract: Quality measures are used for a variety of purposes in health care, including clinical care improvement, regulation, accreditation, public reporting, surveillance, and maintenance of certification.