Forbes March 27, 2023
Robert Pearl, M.D.

In healthcare, as in life, people devote a lot of time and attention to the way things should be. They’d be better off focusing on what actually could be.

As an example, 57% to 70% of American voters believe our nation “should” adopt a single-payer healthcare system like Medicare For All. Likewise, public health advocates insist that more of the nation’s $4 trillion healthcare budget “should” be spent on combating the social determinants of health: things like housing insecurity, low-wage jobs and other socioeconomic stresses. Neither of these ideas will happen, nor will dozens of positive healthcare solutions that “should” happen.

When the things that should happen don’t, there’s always a reason. In healthcare, the biggest roadblock to change is...

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