Michael Doring Connelly

America’s healthcare crisis is not caused by one bad policy or one failing program. The system is breaking because it is built on incentives that undermine affordability, coordination, and quality. When you look across the major failures — rising costs, fragmented care, clinician burnout, unnecessary utilization, fraud, and overwhelming administrative burden — a single pattern emerges: these are symptoms of a fundamental design flaw. Affordability Is the Breaking Point ACA pr

In U.S. healthcare, payor mix and service mix—not posted “prices”—determine whether hospitals and physicians stay financially viable. Payor Mix: The Real Driver Different insurers pay providers wildly different margins: Medicare: ~90% of costs (negative margin) Medicaid: ~70% of costs (even more negative) Uninsured: ~25% of costs (catastrophically negative) If a provider relied solely on these groups, it would go out of business. Because prices cannot be negotiated with gover

The latest KFF Employer Health Benefits Survey shows the average U.S. family premium has soared past $27,000 a year. That’s the cost of a new car—just to stay insured. The recent government shutdown over ACA subsidies misses the real issue. Americans across the board—whether covered by ACA, Medicare, or employer plans—can no longer afford healthcare. The crisis isn’t who pays the bill; it’s why the bill is so high. We know the causes:  • Overtreatment and waste.  • Fragmente

“Hospices owned by private equity firms yield higher profit margins and spend fewer dollars on direct patient care," a new study in Health Affairs found. For the study, researchers examined revenue and expense data among providers using four types of ownership models: PE-backed, publicly traded companies, other for-profit entities, and nonprofits. PE-owned agencies reported the highest profits and lowest spending on patient care.  "Our findings suggest that PE-owned hospice

Both renal dialysis and primary care provide critical services, but the magnitude of their benefits is vastly different. Dialysis serves...

The guidelines insurers use to deny claims are fundamentally different from those developed by clinical specialty societies. This...

Dr. Pearl’s recent post  predicting a “massive healthcare crisis” is right on point. He offers compelling evidence of the crisis’s...

A response to Anna Eisenberg’s “Deep Dive” Eisenberg’s six-part Deep Dive  into the U.S. healthcare system is a well-researched and...

The recent New England Journal of Medicine article, “ Defining Health Care Corporatization ,” provides a valuable historical overview of...

This opinion piece , titled Medicaid Is Overdue for a Big Beautiful Overhaul, calls for a significant reform of Medicaid and argues that...

Three decades ago, there were no healthcare companies in the top 25 of the Fortune 500. Today eight of the top 25 are healthcare...

Felice J. Freyer’s May 8 article in the Boston Globe  calls out that Americans’ trust in medicine is declining but that doctors can still...

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...

The Milbank Memorial Fund is a wealth of information on US primary care. In particular, they have completed numerous studies on the...

This Wall Street Journal article powerfully portrays how trust has declined in healthcare. This sad outcome is the consequence of the...

Why isn’t the Medicare hospice benefit more accessible given it improves patient care and saves billions annually for tax payers? We...

Yet another powerful article demonstrates that Primary Care (PC) in the US is underpaid and facing a massive shortage - creating a...

A recent New England Journal of Medicine article discusses Medicare’s new regulatory efforts to improve primary care physician...

The Commonwealth Fund released a study comparing primary care in the United States to other industrialized countries. Primary care needs...

This editorial opinion by the Wall Street Journal regarding the murder of United Healthcare CEO Brian Thompson misses the point. The...