Welcome to Acute Condition.

I’ve had a lot of different jobs in health care. Hospital consulting, academic policy research, an almost-job at a VC firm, and now research and advocacy at a great nonprofit in DC.

One theme keeps recurring: most health care people are siloed in their specific spaces, which keeps them from actually changing the system. Stuck in medical school, consulting, or policy work, it’s easy to lose track of the larger health care narrative, the huge currents that underlie the work we all do. And for people not focused on health care during their day jobs, they lose track of the industry altogether, thinking it too complicated.

But there are real trends with historic implications happening right now. Hospitals are buying physician practices at a rate higher than ever before, and independent doctors are disappearing. Pharmaceuticals are increasingly controlled by just a few mass distributors, and fewer drugs are being pioneered by fewer R&D shops. Private equity discovered that health care can be lucrative if you control the right node, so firms are buying up diverse businesses (dermatology, ambulances, hearing aids) and driving up prices. Big Tech is quietly trying to get in the game, and whether or not that’s a success remains to be seen.

This newsletter aims to cover those stories and provide deeper analysis.

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