Fixing Healthcare Podcast

The midterm elections are over. But for Americans struggling to afford medical care, the biggest questions remain unanswered.

Family health insurance premiums now average approximately $28,000 annually for employer-sponsored coverage, up 26% in five years. Workers are paying more in premiums, deductibles and out-of-pocket expenses, while millions of Americans are cutting back on basic necessities to afford the care they need.

In this episode of Medicine: The Truth, co-hosts Dr. Robert Pearl and Jeremy Corr examine the healthcare affordability crisis that helped shape the 2026 midterm elections, and the difficult choices awaiting the newly sworn-in Congress in January.

Dr. Pearl explores a striking contradiction in voter attitudes. Americans across party lines overwhelmingly agree that healthcare needs major reform. But they disagree sharply over government’s role, the merits of Medicare for All and how much choice they’re willing to surrender in exchange for lower costs. The challenge, Pearl explains, is that Americans want comprehensive coverage, affordable prices and freedom to choose their care.

Delivering all three has, so far, proven impossible.

While politicians debate solutions, the financial pressure continues. The hosts examine how rising medical expenses are affecting workers, why Americans pay far more than people in other wealthy nations despite worse outcomes, and what a recent analysis of common orthopedic procedures reveals about the value of medical interventions.

Also in this episode:

The 2026 Nobel Prize in Medicine: How three scientists pioneered optogenetics, a technique that uses light to activate or inhibit neurons.

AI’s growing clinical impact: New research associates AI-powered hospital alerts with lower inpatient mortality, while a pilot program involving Google’s AMIE chatbot finds promising results when AI interviews patients before primary care visits.

America’s worsening measles outbreak: With cases and deaths rising, Pearl warns about declining vaccination rates and the risks posed to infants who depend on herd immunity.

More Americans losing healthcare coverage: Why millions face disappearing insurance options, rising out-of-pocket expenses and the prospect of delaying necessary treatment.

The soaring cost of new medicines: A new analysis finds that roughly one-quarter of recently launched drugs carry net prices exceeding $500,000, intensifying disputes over access and affordability.

Listen to this episode of Medicine: The Truth for the latest medical headlines, scientific advances and a closer look at the affordability challenge confronting American healthcare.

* * *

Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post MTT #112: The votes are in. Will Congress finally tackle healthcare costs? appeared first on Fixing Healthcare.

American healthcare is approaching an economic reckoning. Or, better yet, a doomsday clock. Spending now exceeds $5.7 trillion annually, medical costs continue to climb and millions of families are struggling to afford care. Yet the people who may be best positioned to improve the system — physicians — are exhausted, overburdened and disengaged.

In this Unfiltered episode of Fixing Healthcare, Drs. Robert Pearl and Jonathan Fisher join cohost Jeremy Corr to confront a difficult question: How can doctors lead the changes healthcare urgently needs when so many are already struggling to get through the workday?

Dr. Pearl begins with the economic warning signs. Healthcare spending is projected to approach $9 trillion by 2034, while employers, insurers and government programs face growing financial pressure. He argues that continuing to raise prices, restrict coverage and shift costs to patients will only make matters worse.

The solution, he believes, requires physicians to take a more active role in redesigning care. That means preventing chronic disease, reducing avoidable hospitalizations, embracing new technologies and collaborating to improve clinical outcomes at lower costs.

Dr. Fisher agrees that medicine must change. But he questions how much more can reasonably be expected of clinicians who already lack sufficient time, resources and authority. Many physicians, he explains, are operating in survival mode. Asking them to assume leadership responsibilities without meaningful support risks accelerating the very burnout that threatens the profession.

Their discussion explores several questions facing American medicine:

Why are physicians increasingly reluctant to pursue leadership roles, and what would encourage greater participation?

How can clinicians collaborate to reduce costs without compromising patient care or increasing workloads?

What can healthcare leaders learn from advances in generative AI about teamwork, persistence and solving difficult problems?

Where is the line between motivating physicians to embrace change and pushing already exhausted professionals too far?

The conversation culminates in a sobering question from co-host Jeremy Corr: What happens if healthcare costs become so unsustainable that the system begins to break down?

Listen to this episode of Unfiltered for a candid discussion of healthcare’s economic future, the limits of physician resilience and the leadership necessary to prevent today’s problems from becoming tomorrow’s crisis.

HELPFUL RESOURCES

‘Just One Heart’ (Jonathan Fisher’s newest book)

‘ChatGPT, MD’ (Robert Pearl’s newest book)

Monthly Musings on American Healthcare (Robert Pearl’s newsletter)

* * *

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post FHC #233: Can physicians fix healthcare before the system breaks? appeared first on Fixing Healthcare.

American healthcare keeps getting more expensive. Insurers respond by restricting access, employers cut benefits and patients pay more out of pocket. Yet the underlying problem remains: chronic diseases continue to drive much of the nation’s medical spending.

In this episode of Diving Deep, co-hosts Dr. Robert Pearl and Jeremy Corr explore two technological advances that could help break this cycle. One is already changing how millions of Americans manage their weight. The other could transform how physicians and patients manage chronic disease.

Together, Pearl argues, GLP-1 medications and generative AI offer a new path toward better health and more affordable care.

Two innovations, one goal: preventing costly complications

Pearl begins with a striking figure: Americans now spend more than $5.7 trillion annually on healthcare, with chronic diseases accounting for much of the expense. Five major conditions (obesity, diabetes, cardiovascular disease, cancer and dementia) are associated with more than $1.3 trillion in annual medical costs.

Rather than continuing to shift these expenses among insurers, employers and patients, Pearl argues that medicine should focus on preventing the complications that generate them.

GLP-1 medications offer one way forward. By helping patients lose substantial weight, these drugs can also reduce the risk of diabetes and other obesity-related conditions. Clinical trials demonstrate benefits that extend well beyond the number on the scale.

But prevention alone isn’t enough. Millions of Americans already live with hypertension, diabetes and heart failure. Despite effective treatments, many struggle to control their conditions because medical care still revolves around brief office visits every few months.

Pearl explains how GenAI agents, connected to home-monitoring devices, could change that. Rather than waiting until a patient’s next appointment, AI could analyze daily blood-pressure readings, glucose levels and weight changes, identify worsening conditions and alert clinicians when treatment needs adjusting.

The result would be more continuous care, fewer preventable complications and potentially billions in savings. Making that vision possible, however, would require lower drug prices, compatible monitoring technology and payment models that reward keeping patients healthy.

What a troubling AI experiment reveals about medicine’s future

The second half of the episode explores a very different development: an OpenAI experiment in which AI agents unexpectedly began working together to solve complex cybersecurity challenges.

According to Pearl, roughly 1,200 agents established their own means of communication, exchanged more than 70,000 messages and files, and coordinated activities beyond what researchers had anticipated. Some subsequently accessed systems at Hugging Face without authorization.

The experiment raised serious questions about how to control increasingly capable AI. But Pearl sees another implication that deserves equal attention: what if similarly coordinated agents could work on behalf of patients?

Imagine having an entire team of AI agents continuously analyzing your medical history, medications, test results and wearable data. Working alongside clinicians, they could identify problems earlier, assist with difficult diagnoses and provide medical guidance when doctors’ offices are closed.

Pearl describes three possibilities: a 24/7 entry point for patients seeking medical advice, personalized guidance during hospital stays and continuous monitoring for people with chronic illnesses. These applications go far beyond the administrative tasks that dominate much of today’s medical AI adoption. They would require physicians to reconsider how much clinical responsibility can be shared with technology.

Ultimately, both discussions arrive at the same destination: America will not solve its healthcare affordability crisis by restricting care. It will do so by keeping people healthier and treating problems before they become life-threatening.

Listen to this episode of Diving Deep to explore how GLP-1 medications, GenAI agents and new approaches to medical care could make that future possible.

Helpful links:

OpenAI’s Latest Experiment Should Change How Doctors And Patients Use GenAI (Forbes)

How GLP-1s And GenAI Can Solve Healthcare’s Affordability Crisis (Forbes)

Monthly Musings on American Healthcare (RobertPearlMD.com)

* * *

Dr. Robert Pearl is the author of ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post FHC #232: Can GLP-1s & GenAI solve healthcare’s affordability crisis? appeared first on Fixing Healthcare.

Dean Ornish’s life was saved by meaning, connection and lifestyle change. Then he spent 50 years proving those same forces can save others.

In this episode of Fixing Healthcare, Dr. Robert Pearl and Jeremy Corr welcome Dr. Dean Ornish, professor of medicine at the University of California, San Francisco (UCSF), and one of the most influential figures in lifestyle medicine.

Across his career, Ornish has shown that comprehensive lifestyle changes can help prevent and even reverse major chronic diseases, including heart disease, prostate cancer and, most recently, early-stage Alzheimer’s disease.

But this conversation begins somewhere more personal.

Ornish describes becoming suicidally depressed at 19 and discovering, through illness, spiritual teaching and acts of service, that healing begins when people reconnect with meaning, purpose and one another. That experience shaped his life’s work and gave him a radically different view of medicine. Drugs and surgery can be lifesaving in a crisis, he says, but they often bypass the deeper causes of disease.

From there, the conversation moves into the science behind his approach. Ornish explains how diet, exercise, stress reduction and love and support can affect gene expression, inflammation, telomeres, loneliness, chronic disease and survival. Ideas once dismissed as “touchy-feely,” he says, are now supported by decades of peer-reviewed research.

Pearl and Ornish also discuss generative AI, where both see promise and limits. AI can deliver knowledge at extraordinary speed, but Ornish emphasizes that information is not the whole story. Medicine still needs presence, listening, compassion and the kind of human connection that helps people feel seen and accepted.

In his closing reflection, Pearl connects Ornish’s work to the future of healthcare affordability. The nation will not fix healthcare by cutting back, he says. It will improve outcomes and lower costs by keeping people healthier, preventing chronic disease complications and aligning incentives around better care.

Dean Ornish has spent his career showing that health is not driven by one input alone. It is multimodal: shaped by food, movement, stress, love, purpose, connection, biology and belief. This episode is a reminder that healing is not only about adding more medical interventions. Sometimes it begins by helping people stop disturbing what they already have.

Helpful links:

Dr. Dean Ornish (website)

Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases (Dean’s book)

ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine (Robert’s book)

* * *

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post FHC #231: Dean Ornish on lifestyle medicine, loneliness and hope appeared first on Fixing Healthcare.

Fixing Healthcare is revisiting a Diving Deep episode that feels even more important today than when it first aired in November 2023.

At the time, ChatGPT had been available to the public for just one year. Generative AI was still widely viewed as a fascinating but unreliable tool, impressive in some settings and error-prone in others. Many clinicians saw it as a novelty. Some saw it as a threat. Few fully grasped how quickly the technology would advance or how profoundly it might reshape the relationship between doctors and patients.

Nearly three years later, that early vision already feels outdated. We’ve already surpassed the vision of generative AI helping patients prepare for office visits and ask better questions. The next generation of AI agents are proving capable of helping provide care between visits: monitoring chronic disease, identifying early signs of heart failure, flagging postoperative wound infections, answering medication questions and alerting doctors when a patient’s condition begins to worsen. Instead of centering care almost entirely around the doctor’s office, these tools could extend medical expertise into the home, 24/7.

When the episode was released, many people worried that generative AI was not powerful enough to solve clinical problems. Now, some worry that it has become too powerful and may pose existential risks. Across the nation, health systems, technology companies and policymakers are debating how far these tools should go, how quickly they should be adopted and who should guide their use.

That makes this replay especially timely. In this episode, co-hosts Dr. Robert Pearl and Jeremy Corr return to two connected problems: the high cost of American healthcare and the potential for generative AI to give patients more knowledge, agency and control.

The first half of the conversation focuses on “skimping,” a term Pearl uses for the many ways healthcare organizations constrain costs by giving patients less care, less access or fewer resources while still charging more. He compares it to buying a box of cereal at the same price, only to discover there are fewer flakes inside. In healthcare, however, the consequences are far more serious.

The second half of the episode turns to generative AI and the future of the doctor-patient relationship. Pearl argues that, when used correctly, generative AI could make medicine more collaborative. Instead of relying entirely on brief office visits, patients could use AI to better understand their conditions, evaluate treatment options, track symptoms and participate more actively in decisions. Doctors, meanwhile, could benefit from patients arriving better informed and more prepared.

That idea was provocative in 2023. Today, it is becoming increasingly practical. Generative AI systems have grown more capable, more conversational and more widely used. The tools available now are far beyond what existed when this episode first aired.

And as Pearl has argued in his book ChatGPT, MD, the exponential growth of AI means that capabilities can double quickly. If a technology doubles in power each year, then after five years it is not five times stronger. It is 32 times stronger.

That mathematical reality gives this episode its new relevance. The conversation is both a look back at early optimism about generative AI in medicine and a reminder that even bold predictions can prove conservative when a technology advances exponentially.

Listen again to this early Diving Deep conversation and consider how much has changed since November 2023—and how much more may change in the next two years.

HELPFUL LINKS

How America Skimps On Healthcare (Forbes)

How Generative AI Will Upend The Doctor-Patient Relationship (Forbes)

Monthly Musings on American Healthcare (Robert Pearl’s newsletter)

* * *

Dr. Robert Pearl is the author of ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post FHC #230: Flashback to healthcare skimping and AI-powered patients appeared first on Fixing Healthcare.