Newsletters

The system asks people to coordinate information, decisions, and next steps while they may be sick, worried, or caring for someone else.

Before deciding to go uninsured for a year, The Prepared Patient understands the costs, protections, and options that could change their mind.

A Practical way to look beyond the monthly premium and choose coverage that fits your life. I cover this in more detail in "The Prepared Patient: Your Guide to Surviving the Health Care System".

A practical checklist for choosing 2027 coverage while there is still time to compare plans, costs, and care needs.

"Producing Health” treats supply, prices, and patient effort as economic inputs. But a health system patients cannot afford, reach, or navigate cannot turn capacity into better health.

The 2026 numbers on America's coverage divide, and where to get care if you are on the wrong side of it

If you have visited a doctor in the past few years, there is a good chance you have been treated under a payment model you have never heard of. It is called value-based care, and it quietly shapes how your doctor is paid, how your care is coordinated, and sometimes which tests and treatments you are offered. As I argue throughout The Prepared Patient, the people who fare best in our health care system are the ones who understand how it works behind the scenes. This edition of The Prepared Patient newsletter is your plain-language guide to value-based care: what it is, who it affects, and what to watch for.

Health insurance premiums rise every year. That is not news. What is different now is the pace. Health costs are climbing much faster than inflation and wages, the gap will widen again in 2027, and families are already being priced out of coverage and care. This is not sustainable.

It’s astonishing that approximately 80% of medical bills contain at least one error.  When patients formally appeal a denial, a large share of those denials get reversed. Depending on the type of denial, anywhere from a third to more than 80% are overturned. For appealed prior-authorization denials in Medicare Advantage, the overturn rate topped 83%.

A physician friend told me about a recent visit that stayed with her. A patient sat down, pulled out her phone, and explained that before coming in she had typed her symptoms into an AI chatbot. She arrived with a printed list of questions, a few possible explanations, and several treatment options she wanted to talk through. A decade ago, my friend said, she might have braced herself. That day she felt something closer to hope.

Here is a number that should give you pause. Only 12% of U.S. adults have proficient health literacy. That figure comes from the National Assessment of Adult Literacy, and the broader research has barely budged since that assessment. Put another way, nearly 9 out of 10 American adults lack the skills to fully understand and act on the health information thrown at them every day.

Why women are turning to TikTok for perimenopause and menopause answers is a symptom of a deeper problem, and how to protect yourself in the in-between.

In the wealthiest country on earth, in the year 2026, giving birth remains a leading cause of death for women, and if she is Black, the risk is more than triple. We know the problem, time to take evidence-based solutions to scale.

Healthcare AI is having its gold rush moment. Funding is pouring in, pilots are multiplying, and every week brings another startup promising to fix documentation, triage, diagnosis, or revenue cycle. But walk through enough of these companies and a familiar pattern emerges.

When was the last time 73% of Republicans, Democrats, and Independents agreed on anything?

According to recent polling, that share of American voters across all three groups now believes the U.S. health care system needs major change or a complete rebuild.

Nobody Chose to Get Sick. So Why Are We Acting Like They Did?

When a 42-year-old mother of three gets a breast cancer diagnosis, did she choose that? When a 28-year-old is doubled over with inflammatory bowel disease, is that a lifestyle failure?

When a TV Drama Tells the Truth

Some stories land harder than others. In a recent episode of The Pitt, a drama set inside a Pittsburgh emergency department, two patient storylines unfold quietly alongside each other. Neither ends in a dramatic courtroom revelation or a heroic last-minute save. Both end with something more unsettling: the system simply failing people who needed it.

The Prepared Patient believes knowledge is the foundation of good health. Being prepared means walking into your doctor's office ready to have a real conversation. Few topics deserve that kind of preparation more than vaccines.

Headlines regularly proclaim that AI chatbots will soon render physicians obsolete. A closer examination of what physicians actually do and what it would take to automate that work responsibly tells a more complicated story.

My search for a board-certified primary care physician exposed a larger problem: physician shortages, concierge barriers, and a system that is making equitable access harder to sustain.

Why a knee replacement costs $15,000 in one zip code and $80,000 in another, and what we can actually do about it.

What Every Patient Needs to Know in 2026

The most sweeping overhaul of American health care in a generation isn’t coming. It’s already here. From Medicaid work mandates to ACA premium shock to narrowed Medicare drug negotiations, the rules that govern your coverage and your costs are being rewritten.

Healthcare is one of the leading causes of personal bankruptcy in the United States and yet most of us spend more time picking a Netflix subscription than choosing our health insurance plan. That has to change.

Healthcare in 2026 is breaking household budgets, and we know exactly why. Do we have the political will to fix this mess? Knowing where the high costs are coming from is one step to being a Prepared Patient.

Across America, millions have made or are making an impossible choice: pay premiums they can't afford, or keep coverage they can't use.

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.