Did I ever say, thanks for serving!? I should have, what has been happening has to be tough to watch.
Understandably, the evolution of the healthcare system has not gone well. I haven’t seen a doctor who has that much time in years. They are becoming fewer and farther between. (although I was lucky enough to get one of the good guys a couple years ago before he retired - I felt sorry for him as he read through the litany of really stupid questions, he was clearly not having a good time either).
I am just finishing up a short Substack series on how legislation since the 1980s (the Orphan Drug Act of 1983 and the Rare Diseases Act of 2002) created and codified the self-perpetuating "rare disease" industry that we now have. I didn’t get to Obamacare in this particular series, but laws that came out of the Obamacare era and then into other legislative actions in 2016 pretty much created the cabal that we now have that is "healthcare."
I think the corruption is at all levels, including the NGO that are shaping the protocols, insurance companies, and the federal governement particularly CMS Medicare. I wonder how many people realize that Genentech, Pfizer, et al. advise on the patient protocols for the cancer drugs they create. As a result, the protocols are often in the best interest of the pharmaceutical companies’ bottom lines. They are also the group putting out the literature on what to do when you have cancer through NCCN.org.
I’m not sure my series will ever go anywhere, but after going through a “rare,” “incurable” brain cancer and coming out the other end of it without destroying my body by following the lies about how to “manage” it, I feel compelled to ring my bell and share what I’ve learned. Not that my 30 Substack followers will find it all that interesting—but the information will be out there.
This was a while ago. Menopause has taken care of the situation. But many pharmacies have a contract with the drug companies, or at least so I was told.
Elimination of for profit healthcare and treating healthcare professionals like we do teachers and all other public employees is what should happen.
Making collage based on your ability, not ability to pay and graduating more doctors who have no debt but also make less would also make a huge difference.
Completely divorcing healthcare from your job needs to happen as well. . My daughter just got a huge pay bump, but has to wait 2 months for insurance to kick in. She has a serious health issue and changing all her providers is a nightmare. You shouldn't have to go through this when you change jobs.
The American system is a joke. The idea you can buy stock in a hospital or an insurance company is so morally bankrupt I can't fathom how we decided school is the taxpayers responsibility but healthcare isn't.
Working in cancer at a world-renowned facility, I tend to disagree. We see new drugs come out all the time and we are restricted to use them by insurance comapanies, unless it is a 4th or 5th line of therapy. But in the meantime, we have to give them toxic drugs in order for them to be able to receive the one that may actually work. One that will actually save their life. Or will it, because now they are pumped up with other medications that may have caused cancer in another part of the body. Insurance companies are playing God by dictating to the physicians, that know what's right for this patient, as to what they can and cannot use. I get the ones that may abuse the system, but what about the ones that are actually trying to save a life? Countless times I have had to spend hours on the phone advocating for a medication that I know is my patients best shot at living. Tell me honestly how many insurance companies actually look into a patient's health, really look into it, to see if it's needed before it is denied? 2 minutes? From what I understand the physicians that look at patient records are paid by how many they can deny in a day. Nationwide 20% of insurance claims are denied. And now reading this - The United States Files False Claims Act Complaint Against Three National Health Insurance Companies and Three Brokers Alleging Unlawful Kickbacks and Discrimination Against Disabled Americans, this was just filed May 1, 2025. I am tired of hearing the oh poor me's from the insurance companies, when I see claims denied daily for things that are desperately needed. Or a patient being told you can't have this treatment that will indeed save your life, until you have tried three others first, now they may kill you in the process, but sorry, this is our rule! JMHO!
1. NIH needs to change funding to be focused on finding cures. It is not doing that now. NIH budget this year alone is $49 BILLION dollars. NIH funds individual researchers who if successful get a patent and then a drug company makes an expensive drug to treat the symptoms. If no patent, no drug company interest then the research findings lie dormant in a huge database wasting the billions of dollars of taxpayer money. There is no priority list of disabling, chronic diseases costing trillions a year for NIH. There is often no published results to help the next researcher. Instead money is thrown across thousands of sites with no coordination to find the final answer, instead ALWAYS "more research is needed." Fund consortiums looking at root causes for cures yet not getting funded. See the 2024 lectures at AlzPi.org and NeuroImmune.org for root causes of dementia, mental illnesses, chronic diseases and fund them instead.
2. Medical schools, oversight agencies should insist on competency. Teach and test updated information on the most misdiagnosed diseases, disabling diseases and costly diseases ROOT CAUSES and stya current. Now outdated information is taught and a flood of basic science concepts is thrown in with no attempt to tell how this is useful for a clinician.
3. Nurses need to use their skills and not be wasting time due to our system of taking the patients meds away. Patients should take their own pills. They do this 99% of their lives. An initial check of what meds they take needs done on arrival as many of the problems patients have is polypharmacy. Then nurses would have the time to be in the rooms to help patients and physicians instead of always passing meds. Med errors are too likely in a hectic, overworked hospital. Nursing home patients would benefit from stopping a lot of their meds.
4. CDC/HHS is outdated in many of their publications and funding There has been millions of dollars wasted just as with NIH. They need to have a priority list of diseases and fund accordingly. Patient advocates need to be given much of the money instead as they will use it wisely.
A question? How many additional deaths was that ceo responsible for, if it was your daughter, your infant baby, mother or grandmother, should businessmen be allowed to take life through their policies while physicians are helpless accomplices?
I would like to see commentators such as yourself discontinue with the perfunctory politically correct virtue signalling of criticizing Brian Thompson's killer. We don't mourn Osama Bin Laden's death. Let's not pretend we care about Thompson's death. He was a scumbag. Plain and simple.
No, intelligent person can state how the addition of business CEO’s to the field of medicine has helped patient care. The million-dollar salaries are taken directly from direct patient care and therefore the CEO must limit, medicine, care and services to protect their salaries.
The goals of CEOs is opposite True Physicians.
1. businessmen take an oath to protect profits ---physicians take an oath to protect patients
2. businessmen take an oath to protect the stockholders ---physicians take an oath to protect the baby holders: parents/grandparents
3. businessmen see numbers --- physicians see patients
4. businessmen try to save money --- physicians try to save lives
Independent Physician Association (IPA)
Recommend - physicians only work 3-4 days for a CEO/Hospital/Insurance company or business-run clinics in order to regain their voice to advocate for patients.
SALARIED PHYSICIANS HAVE NO VOICE, THEIR WORDS MUST BE CLEARED THROUGH THE CEO OR CMO OR MEDICAL DIRECTOR
CEO’s benefit politicians running for a political office.
What about the lives lost caused by the CEO. In all honesty CEO’s run medicine and salaried physicians are voiceless and fearful when it comes to protecting and fighting for patients because their pay check is on the line. The goal of a ceo is to deny and protect their salary.
CEO’s have no role in leading the field of medicine!!!
Physicians return to your first love which are the patients.
My writing is an explanation as to why USA does not have some form of National healthcare system, and why America is alone in this in the entire industrialized Western world. I stated historical fact that the American Medical Association (and physicians) are primarily responsible for our sad situation. Those are my primary contentions and are easily verifiable facts. I was not primarily addressing American physician incomes/salaries in my original writing. However, it is also true that America physicians incomes are greater than that of physician incomes/salaries employed in National healthcare systems, even though such physicians are sill in the top tier of their nation’s earners. In a personal note, I’ve been a licensed healthcare professional for 40+ years and know many “salaried” practicing physicians, none of whom make less than $270, 000 annually and on top of that, most get bonuses for how “efficiently” or cheaply they treat patients (meaning many patients do not get the care they need because the doc wants a bonus). I know their salaries because I see the budgets. I also know many, many physicians whose income is well over $1million/annually. But, it’s in American physician’s nature to poor mouth. As for USA salaries that have come no where close to keeping up with inflation, that’s the situation that applies to the average and low income wage earners, whose salaries have stagnated since the 1970s.
VP this RN appreciates your evidence based analysis of this very complicated and nuanced problem. I am still working at 64 in the outpatient end of life setting and the waste that I see before the patient comes onto service leaves me speechless. I could say a lot more but I will leave it at that.
I nominate Dr Prasad to lead HHS into reform -- it is also clear that it's the entire systemic mess, not just insurance companies, and like cancer, it needs a radical solution...
Did I ever say, thanks for serving!? I should have, what has been happening has to be tough to watch.
Understandably, the evolution of the healthcare system has not gone well. I haven’t seen a doctor who has that much time in years. They are becoming fewer and farther between. (although I was lucky enough to get one of the good guys a couple years ago before he retired - I felt sorry for him as he read through the litany of really stupid questions, he was clearly not having a good time either).
I am just finishing up a short Substack series on how legislation since the 1980s (the Orphan Drug Act of 1983 and the Rare Diseases Act of 2002) created and codified the self-perpetuating "rare disease" industry that we now have. I didn’t get to Obamacare in this particular series, but laws that came out of the Obamacare era and then into other legislative actions in 2016 pretty much created the cabal that we now have that is "healthcare."
I think the corruption is at all levels, including the NGO that are shaping the protocols, insurance companies, and the federal governement particularly CMS Medicare. I wonder how many people realize that Genentech, Pfizer, et al. advise on the patient protocols for the cancer drugs they create. As a result, the protocols are often in the best interest of the pharmaceutical companies’ bottom lines. They are also the group putting out the literature on what to do when you have cancer through NCCN.org.
I’m not sure my series will ever go anywhere, but after going through a “rare,” “incurable” brain cancer and coming out the other end of it without destroying my body by following the lies about how to “manage” it, I feel compelled to ring my bell and share what I’ve learned. Not that my 30 Substack followers will find it all that interesting—but the information will be out there.
This was a while ago. Menopause has taken care of the situation. But many pharmacies have a contract with the drug companies, or at least so I was told.
Elimination of for profit healthcare and treating healthcare professionals like we do teachers and all other public employees is what should happen.
Making collage based on your ability, not ability to pay and graduating more doctors who have no debt but also make less would also make a huge difference.
Completely divorcing healthcare from your job needs to happen as well. . My daughter just got a huge pay bump, but has to wait 2 months for insurance to kick in. She has a serious health issue and changing all her providers is a nightmare. You shouldn't have to go through this when you change jobs.
The American system is a joke. The idea you can buy stock in a hospital or an insurance company is so morally bankrupt I can't fathom how we decided school is the taxpayers responsibility but healthcare isn't.
Working in cancer at a world-renowned facility, I tend to disagree. We see new drugs come out all the time and we are restricted to use them by insurance comapanies, unless it is a 4th or 5th line of therapy. But in the meantime, we have to give them toxic drugs in order for them to be able to receive the one that may actually work. One that will actually save their life. Or will it, because now they are pumped up with other medications that may have caused cancer in another part of the body. Insurance companies are playing God by dictating to the physicians, that know what's right for this patient, as to what they can and cannot use. I get the ones that may abuse the system, but what about the ones that are actually trying to save a life? Countless times I have had to spend hours on the phone advocating for a medication that I know is my patients best shot at living. Tell me honestly how many insurance companies actually look into a patient's health, really look into it, to see if it's needed before it is denied? 2 minutes? From what I understand the physicians that look at patient records are paid by how many they can deny in a day. Nationwide 20% of insurance claims are denied. And now reading this - The United States Files False Claims Act Complaint Against Three National Health Insurance Companies and Three Brokers Alleging Unlawful Kickbacks and Discrimination Against Disabled Americans, this was just filed May 1, 2025. I am tired of hearing the oh poor me's from the insurance companies, when I see claims denied daily for things that are desperately needed. Or a patient being told you can't have this treatment that will indeed save your life, until you have tried three others first, now they may kill you in the process, but sorry, this is our rule! JMHO!
A few very quick fixes would make a huge impact.
1. NIH needs to change funding to be focused on finding cures. It is not doing that now. NIH budget this year alone is $49 BILLION dollars. NIH funds individual researchers who if successful get a patent and then a drug company makes an expensive drug to treat the symptoms. If no patent, no drug company interest then the research findings lie dormant in a huge database wasting the billions of dollars of taxpayer money. There is no priority list of disabling, chronic diseases costing trillions a year for NIH. There is often no published results to help the next researcher. Instead money is thrown across thousands of sites with no coordination to find the final answer, instead ALWAYS "more research is needed." Fund consortiums looking at root causes for cures yet not getting funded. See the 2024 lectures at AlzPi.org and NeuroImmune.org for root causes of dementia, mental illnesses, chronic diseases and fund them instead.
2. Medical schools, oversight agencies should insist on competency. Teach and test updated information on the most misdiagnosed diseases, disabling diseases and costly diseases ROOT CAUSES and stya current. Now outdated information is taught and a flood of basic science concepts is thrown in with no attempt to tell how this is useful for a clinician.
3. Nurses need to use their skills and not be wasting time due to our system of taking the patients meds away. Patients should take their own pills. They do this 99% of their lives. An initial check of what meds they take needs done on arrival as many of the problems patients have is polypharmacy. Then nurses would have the time to be in the rooms to help patients and physicians instead of always passing meds. Med errors are too likely in a hectic, overworked hospital. Nursing home patients would benefit from stopping a lot of their meds.
4. CDC/HHS is outdated in many of their publications and funding There has been millions of dollars wasted just as with NIH. They need to have a priority list of diseases and fund accordingly. Patient advocates need to be given much of the money instead as they will use it wisely.
A question? How many additional deaths was that ceo responsible for, if it was your daughter, your infant baby, mother or grandmother, should businessmen be allowed to take life through their policies while physicians are helpless accomplices?
I would like to see commentators such as yourself discontinue with the perfunctory politically correct virtue signalling of criticizing Brian Thompson's killer. We don't mourn Osama Bin Laden's death. Let's not pretend we care about Thompson's death. He was a scumbag. Plain and simple.
No, intelligent person can state how the addition of business CEO’s to the field of medicine has helped patient care. The million-dollar salaries are taken directly from direct patient care and therefore the CEO must limit, medicine, care and services to protect their salaries.
The goals of CEOs is opposite True Physicians.
1. businessmen take an oath to protect profits ---physicians take an oath to protect patients
2. businessmen take an oath to protect the stockholders ---physicians take an oath to protect the baby holders: parents/grandparents
3. businessmen see numbers --- physicians see patients
4. businessmen try to save money --- physicians try to save lives
Independent Physician Association (IPA)
Recommend - physicians only work 3-4 days for a CEO/Hospital/Insurance company or business-run clinics in order to regain their voice to advocate for patients.
SALARIED PHYSICIANS HAVE NO VOICE, THEIR WORDS MUST BE CLEARED THROUGH THE CEO OR CMO OR MEDICAL DIRECTOR
CEO’s benefit politicians running for a political office.
What about the lives lost caused by the CEO. In all honesty CEO’s run medicine and salaried physicians are voiceless and fearful when it comes to protecting and fighting for patients because their pay check is on the line. The goal of a ceo is to deny and protect their salary.
CEO’s have no role in leading the field of medicine!!!
Physicians return to your first love which are the patients.
My writing is an explanation as to why USA does not have some form of National healthcare system, and why America is alone in this in the entire industrialized Western world. I stated historical fact that the American Medical Association (and physicians) are primarily responsible for our sad situation. Those are my primary contentions and are easily verifiable facts. I was not primarily addressing American physician incomes/salaries in my original writing. However, it is also true that America physicians incomes are greater than that of physician incomes/salaries employed in National healthcare systems, even though such physicians are sill in the top tier of their nation’s earners. In a personal note, I’ve been a licensed healthcare professional for 40+ years and know many “salaried” practicing physicians, none of whom make less than $270, 000 annually and on top of that, most get bonuses for how “efficiently” or cheaply they treat patients (meaning many patients do not get the care they need because the doc wants a bonus). I know their salaries because I see the budgets. I also know many, many physicians whose income is well over $1million/annually. But, it’s in American physician’s nature to poor mouth. As for USA salaries that have come no where close to keeping up with inflation, that’s the situation that applies to the average and low income wage earners, whose salaries have stagnated since the 1970s.
Is MANGIOE a Health Care Revolutionary?
Those of us that oppose the death penalty can't accept assassinations as a solution.
He is a psychotic murderer regardless os what anyone thinks of the victim.
VP this RN appreciates your evidence based analysis of this very complicated and nuanced problem. I am still working at 64 in the outpatient end of life setting and the waste that I see before the patient comes onto service leaves me speechless. I could say a lot more but I will leave it at that.
we have the largest medical library for medical students.
that can train all of Latin America.
or any Spanish speaking student.
I nominate Dr Prasad to lead HHS into reform -- it is also clear that it's the entire systemic mess, not just insurance companies, and like cancer, it needs a radical solution...