The Future of Healthcare

The Future of Healthcare Bothers Me

An honest look at where the system is headed — and why I'm worried about my grandkids.

Here's something most people don't realize: we already have a form of socialized medicine in the United States. When your insurance premiums go up to cover costs generated by other people, that's socialized medicine by definition. We just don't call it that.

What people usually mean when they say "socialized medicine" is government-run healthcare. And we're closer to that than most people think. Every year, the government tells physicians more about what they can do and what they can charge for it. They set the reimbursement rates, and insurance companies follow — if it's good enough for Medicare, it becomes the floor for everyone.

Some states have already moved further down this road. Oregon operates with a formal prioritized list of what the state will and won't cover. Missouri hasn't gone that far yet, but the trajectory is visible.

Name One Federal Program That Works

The loudest argument for expanding government's role in healthcare is Medicare for All. And before anyone makes that case, I'd ask them to answer a straightforward question: name one federal program that's a documented success.

The post office? No. Amtrak? No. Medicare itself? It's heading toward insolvency. Social Security? Same story. Medicaid? Not financially sustainable at current trajectory.

I'm not saying this to score political points. I'm saying it because I've seen up close how the federal government runs a healthcare system — through my experience with the VA. There are good doctors within that system. But the administrative structure around them is, in my honest assessment, broken. The idea of bringing that model to all Americans concerns me deeply.

The People I'm Worried About

Here's the thing: I'm not particularly worried about my own healthcare future. I have no plans to retire. I intend to practice medicine well into my 80s if I'm able — I won't voluntarily surrender my license. And frankly, I believe I take good care of people. I plan to keep doing it for as long as I can.

What does concern me is what my grandchildren are going to inherit. This country is spending significantly more than it takes in, and the debt isn't going to be paid off. The healthcare math gets harder every year. The people who will be left to deal with the consequences of decisions being made right now are young — and they don't have a vote in any of this yet.

That's where my concern actually lives. Not in what happens in my lifetime. In theirs.

The Data Problem

There's one more piece of this that bothers me: the growing access to personal health data through digital systems.

I'll be honest — I don't fully understand how these systems work, and that's precisely why I'm suspicious of them. When something is more sophisticated than my ability to audit it, I don't automatically trust that it's being managed in my patients' interest. Health data is enormously valuable to a lot of parties — insurance companies, pharmaceutical companies, employers — and the regulations protecting it haven't kept pace with the technology collecting it.

I don't have a clean solution to offer here. I just think it's worth being aware that your health information is increasingly out of your direct control, and the downstream consequences of that aren't fully understood yet.

What Stays the Same

None of this changes what happens in my exam room. Patients come in, I listen, I troubleshoot, I apply 40 years of experience to whatever they're dealing with, and I try to help them get better. The system around that can be as complicated and broken as it wants to be.

The work itself is still worth doing.

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