RealClearHealth Articles

Healthcare has things exactly backwards. Normally, when you spend more money, you expect to get more product, service, or value in some form. But in the U.S. healthcare system, Washington keeps spending more (of our money), and we keep getting less ... care. The latest example is a new set of rules just announced by CMS that govern accountable care organizations and change the metrics and compliance requirements by which they are judged (and funded). The cost of these new regulations is not included in the CMS announcement. It is certain to be substantial, likely in billions, both...

Sixty years ago, renowned psychologist and thinker Abraham Maslow warned about a common cognitive bias in science: “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.”   The Drug Enforcement Agency would be wise to ponder this wisdom before going through with its July 1, 2026 announcement of its “intent to temporarily place 7-hydroxymitragynine (7-OH) and three related substances into Schedule I of the Controlled Substances Act (CSA).” This isn't the first time Washington has considered this approach....

The Trump administration recently announced charges against 455 defendants, including 90 doctors and other healthcare professionals, in connection with more than $6.5 billion in alleged healthcare fraud. This is a form of national organized crime, with both taxpayers and patients bearing the financial loss. As a healthcare broker who has spent a lifetime working in this industry, I found it encouraging to see investigators finally targeting what is likely one of the biggest drivers of inflated medical costs in the United States. The scale of the operation was unprecedented. It spanned 56...

I often say that my entire professional career has been in drugs and money. I’ve been a licensed pharmacist for more than 50 years and a bank president for almost 30. In both pharmacy and banking, compounding can be good and very bad. For your money, compounded interest on investments can make you rich, but compounded interest on credit cards can bury you in debt. For your drugs, compounding done properly can save your life, but when done wrong can kill you. The moral of the story is when compounding goes bad—either in drugs or money—it could end in your financial or actual...

Many hospitals are destabilizing small businesses across America by exploiting a little-known federal charity care program to drive healthcare costs up.The 340B Drug Pricing Program was supposed to help safety-net hospitals serve vulnerable patients by letting them buy prescription medicines at a discount. But because hospitals are not actually obligated to pass those savings on, many use the program to bill patients -- and their employer-provided insurance plans -- at enormous markups to generate profit.These tactics are already driving small employers' costs to untenable levels. Small...

America has a health care affordability problem. Families feel it not only in premiums and deductibles, but also in how costs can affect access to care, the quality of that care, and the success of the health outcomes. And there is a growing fear that the doctor they want may not be taking new patients and the nearest hospital may not always be there when they need it.   Understanding how to address these concerns of Americans is not a simple task. Yet, too often, government offers quick fixes or a simple policy response to remedy a problem. Even if it has an impact on the problem...

The FDA’s upcoming Pharmacy Compounding Advisory Committee meeting on unapproved peptides is about more than a handful of substances under review. At stake is whether our regulatory system will still enforce the line between unproven, experimental treatments and proven medicines – or let one be mistaken for the other. Researchers are investigating various peptides for a range of conditions, from wound healing to metabolic and neurological disorders. That work deserves support. But innovation and potential promise are not the same as scientific proof, and research into possible...

Low-income Americans are being squeezed by rising health care costs, and the Trump economy isn’t making things any easier on families who are trying to afford basics like housing, groceries, and gas, which recently approached an all-time high. Prescription drugs only make up a portion of overall healthcare spending, but their high cost is a pain point for many. For years, Consumer Action has supported legislation and other efforts to lower drug prices, including the Affordable and Safe Prescription Drug Importation Act to allow importation of low-cost drugs from...

The next great competition between the United States and China won’t be decided only in artificial-intelligence labs or semiconductor fabrication plants. It may instead be won in pharmaceutical laboratories, clinical trial networks, and advanced manufacturing facilities. The nation that discovers, develops, and manufactures tomorrow's medicines will gain far more than commercial success. It will command investment, attract scientific talent, strengthen national security, and provide better healthcare for its citizens. China understands this. For more than a decade, Beijing has treated...

Every FDA Commissioner inherits unfinished business. Scientific advances continue whether regulators are ready for them or not, and every new Commissioner must decide whether the Agency will merely keep pace or help shape the future of medicine. Kyle Diamantas' first public statement as Acting FDA Commissioner suggests he understands that challenge. His policy statement, An Enduring Mission in a New Era: The FDA Public Health Pillars, does more than outline administrative priorities. It recognizes that FDA's responsibilities now extend well beyond reviewing individual drug applications. The...

America has a shortage of healthcare workers, and patients are paying the price. Many communities, especially in rural areas, do not have enough doctors, registered nurses (RNs), and advanced practice registered nurses (APRNs) to meet basic healthcare needs. Providers cluster in urban markets while rural communities are left with too few options. Interstate licensure compacts can help fix that. By making it easier for qualified clinicians to practice across state lines, especially through telemedicine, compacts bring care to patients instead of pretending thousands of providers will suddenly...

For decades, the message to Americans who smoked was essentially simple: quit or suffer the consequences. That message reflected the urgency of the cigarette epidemic, and the lack of alternative nicotine products available to smokers. The good news is that the marketplace, driven by innovation and science, has changed. While cigarette smoking has declined to historic lows, modern nicotine products, such as nicotine pouches and heated tobacco products, provide much better options for the legal-age adult smoker. Of course, a clear understanding of the options available is critical to making...

Scott Pelley’s extraordinary juvenile meltdown over being fired from Sixty Minutes, recalled a moment in my life when I was facing the meat grinder that most “guests” on the program dreaded. As one of the first generation of healthcare economists, in 1985 I had been lifted out of a comfortable slot on the faculty at Johns Hopkins where I had been writing about the economics of health care.  I had a particular focus on the rapacious behavior of hospitals in the early days of Medicare and Medicaid when they were doing everything possible to inflate the costs of care...

This month, the Office of the United States Trade Representative (USTR) took an important and long-overdue step by launching a Section 301 investigation into Germany’s pharmaceutical pricing policies. The move sends a clear message: the United States will no longer tolerate wealthy foreign governments shifting the costs of medical innovation onto American patients. American biopharmaceutical innovation has delivered some of the most significant medical breakthroughs in modern history. But the global system that supports this innovation is deeply unbalanced, leaving American patients to...

Germany claims to be one of America's closest allies. Yet it just doubled down on a policy that would weaken one of America's most economically and strategically important industries -- and help China gain a chokehold over the development of and access to the free world's medicine supply.The Trump administration recently took an important first step toward addressing that threat. Late last month [JUNE 18], it launched a Section 301 investigation into the German government's persistent underpayment for innovative medicines -- many of which are developed right here in the United States. The...

Washington has spent years debating health care costs without confronting the biggest one. The single largest driver of America's health spending problem is hospitals. Not only does Washington largely ignore this fact, but government policies actively encourage these rising costs. Since 2000, hospital service prices have climbed 281 percent – three times overall inflation and double wage growth. No other major sector, including the obvious ones like college tuition, childcare, and housing, has outpaced hospital care. While national conversations leave many assuming our biggest problem...

Every day, providers see firsthand how coverage and access decisions shape whether patients with rheumatoid arthritis can continue treatments that control their disease or spiral into avoidable pain and disease progression. Earlier this year, I shared these perspectives with policymakers during a CMS session on the Medicare Drug Price Negotiation Program under the Inflation Reduction Act, an important step toward aligning policy with patient care. In my practice, some patients are deeply engaged, while others feel overwhelmed by a complex system. That complexity was echoed in...

Healthcare ranges from routine to complex, but in many states, doctors who could be focused on more complex care still spend valuable time treating patients with routine problems. Meanwhile, patients wait weeks for an appointment for what could have been done in half an hour, or worse for a diagnosis that was needed urgently. Letting pharmacists treat straightforward conditions, like the flu, alleviates the bottleneck for urgent or complex needs while making care more convenient for patients. Many states only authorize pharmacists to provide a narrow set of services, and in many others,...

The pharmaceutical landscape is on the cusp of a revolutionary transition from standard GLP-1 weight-loss injections to highly complex, next-generation therapeutics. However, a familiar and dangerous threat looms over this scientific breakthrough: the rise of "bottom-feeder" compounders exploiting regulatory loopholes to sell unapproved, untested, and potentially lethal knockoffs. The gravity of this threat was laid bare in briefing documents released ahead of the FDA's Pharmacy Compounding Advisory Committee (PCAC) meeting scheduled for July 23–24, 2026, where agency...