Healthcare & The Titanic

Have you heard, there’s a healthcare crisis in America? We spend 20% of our precious GDP trying to stay well (or get well) yet one-third of what we spend (7% of GDP) is wasted on treatments that are ineffective and/or on conditions that have been misdiagnosed. Now add to that the unnecessary tests and procedures occasioned by the practice of Tort First defensive medicine and it’s not a pretty picture. 

But at least we have a system that delivers the best available healthcare to every resident, equally and on demand, that always delivers a warm and caring healthcare experience, and that treats every patient at all times with the dignity and respect they deserve; right?

Not so much! When I walk into a Morton’s Steakhouse I know I’m going to spend a lot of money, but I also know I’m likely to have a very rewarding experience. Can I say the same when I walk into a doctor’s office or a hospital ER?

Ok, so none of this is news to you after all! But not to worry: our best minds are working to make things better, much better. Problem is, they have been doing so since the dawn of the healthcare crisis (c. 1985)…and that makes a note I recently found in my in-box (1/8/2026) especially troubling: 

“OpenAI on Wednesday announced ChatGPT Health, which will allow users to securely connect their medical records and wellness apps to the artificial intelligence chatbot. ChatGPT Health is not intended for diagnosis and treatment…”

New Flash: We have been in the process of ‘allowing users to securely connect their medical records and wellness apps’ for more than 25 years. It was a signature project of George W. Bush’s presidency. And to what end?

During the last quarter century there has been an explosion in healthcare technology encompassing surgical procedures, pharmacology, diagnostics, etc. and yet, unless you happen to be the direct beneficiary of one of these advances, who thinks that everyday healthcare is better now than it was 25 years ago? 

As many doctors will attest, it is almost impossible to practice medicine today. Patients are not so much treated as they are managed...managed according to insurance carrier protocols, industry best practices, regulatory checklists, and the need to defend potential malpractice litigation down the road.

And if that’s not enough, we now have the poorly understood and grossly misapplied provisions of HIPPA, erecting unnecessary (and unintended) barriers between healthcare professionals. To whatever extent we do practice medicine, we often do so in the dark. 

Of course we know where the fault lies, don’t we? Insurance company red tape, PBM price gouging, government over-regulation and paperwork, the legal system! And no doubt, each of these can be problematic and does contribute in its own way to lapses in patient care. Besides, we would rather blame others for our problems than look in a mirror. 

But that’s ok because our politicians have the answer, don’t they? The trouble is, they have too many answers. Some say we need more competition among insurance carriers and healthcare providers, some say more consumerism and patient accountability, some more emphasis on public health, wellness, prevention and primary care. 

Most say we’d be OK if we were more like England, Canada, or Germany, even though those systems are arguably even more troubled than ours (though I will grant you, they are cheaper – folks get less care, but they pay less for it – I guess that’s something: Morton’s opens its first drive thru).   

Things don’t have to be this way. ‘We have the technology’ to make things better, much better (there’s even ‘an app for that’), but we choose not to deploy it. It’s called Artificial Intelligence (AI) and it has the potential to turn healthcare upside down…and in short order. 

But there’s nothing we fear more than a solution to our problems. Imagine the angst in the Climate Community if we discovered cheap, abundant, clean energy! The advantage to being as old as I am, at the time that I am, is that I have seen technologies that were bound to change the world come…and go: VHS, MTV, Blockbuster, Fax, AOL, etc. 

(Remember when we said, “I can’t imagine how we did business before we had fax;” well, when was the last time someone sent you a fax?) Take a message to Sam Altman (OpenAI): “You can’t save the Titanic by rearranging the deck chairs. You have to change course.” 

TV crime shows notwithstanding, people are not bad. No one wants the healthcare system to fail. But doctors, lawyers, payers, and regulators all have vested interests in the current ‘infrastructure’ and that puts them squarely at odds with progress.

We love to put lipstick on pigs; what we can’t see can’t hurt us (as long as we don’t smell it). The rollout of ChatGPT Health, at least as advertised, is the moral equivalent of waving a fan and calling it air conditioning. 

It doesn’t help; actually, it hurts! It creates the impression that our problems can be solved easily and ‘on the cheap’ and that we’re actually addressing them. It soaks up attention and resources that might otherwise have been directed toward implementing a real solution. 

And we have a pretty good idea what that solution is. OpenAI is right to think that AI is the future of healthcare, but they are apparently reluctant to deploy it. For example, 80% of the tasks performed in a  Primary Care practice could be done as well or better by AI, freeing the physician to do what she does best: observe, classify, diagnose, prescribe, and evaluate.

On the specialist level, an extensive study (Harvard Medical et al.) has shown that AI is 4 times better at diagnosing complex health conditions than a team of seasoned, board certified physicians.  Incredible…but true! 

We have the technology to transform healthcare here and now and across the planet; we just need the will to deploy it and we will begin to build that will only once we stop moving furniture.

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Honoré Daumier’s The Hypochondriac (c. 1830s) humorously depicts a man obsessively worried about his health while the doctor appears indifferent, highlighting both the patient’s anxiety and the physician’s detachment. The painting serves as a satirical critique of medical negligence and the social dynamics between doctors and patients in 19th-century France.