top of page

It was my honor to give a presentation titled "The US Healthcare System: Can We Do Better?" this month at The Bur Oak Foundation, an independent, non-partisan, non-profit educational foundation dedicated to serving the academic community of the University of Michigan. I thank my hosts for the opportunity to present on a topic that means so much to me personally, the fact that healthcare today has lost its soul - its sense of humanity. The nature of healthcare has become transactional and impersonal. As a result, the current state of U.S. healthcare is dire. Costs are astronomical and patient outcome and satisfaction are low. Healthcare has become transactional by emphasizing coding, procedures and tests over relationships and conversations. To fix healthcare, we need to start with simplicity, incentives and culture. We can do that by prioritizing primary care, reforming end-of-life care and limiting insurance interference with clinical decision making while making long-term investments in nutrition and education. To watch the presentation, scroll to the bottom of this page or access it directly here on YouTube.





The Milbank Memorial Fund is a wealth of information on US primary care. In particular, they have completed numerous studies on the importance and value of primary care. In addition, each year for the last several years, Milbank has issued a national scorecard on the state of primary care in the US. Unfortunately, these scorecards document a steady decline in primary care investment at a time when those resources have never been more important.


This quote from the report summarizes the issue:


”This combination of worsening primary care access and sicker patients has created a vicious cycle. Patients are driven to use more expensive services like emergency rooms, which raise healthcare costs and premiums, further reducing affordability and access. At the same time, overall healthcare spending continues to rise faster than economic indicators, while the crumbling primary care infrastructure receives only a small portion of these dollars.”


To be more specific, in 2022 US healthcare spending on primary care was under 5%. Other countries with advanced health systems and much better health outcomes spend on average 14% of health expenditures on primary care. Even more depressing is the fact Medicare only spends 3.4% of its funds on primary care.


Hopefully, the new administration will embrace these common sense facts and focus on improving primary care. Several options for that investment are possible. Go to www.thejourneys-end.org for more details.



This Wall Street Journal article powerfully portrays how trust has declined in healthcare. This sad outcome is the consequence of the ever growing burden of bureaucracy in the form of regulations and misaligned economic incentives interfering with the doctor patient relationship.


Our nation needs to wake up and acknowledge that perhaps health reform is as important as the Ukrainian War or peace in the Middle East. What we need is major change - not expanded ACOs or more value based care. Two key elements to that reform are:

  1. Simplicity - healthcare is too complex

  2. Restoring the patient physician relationship


For more information on these reform options go to www.thejourneys-end.org






Get in Touch

  • Linkedin

Thank you for your message!

bottom of page