Introducing The Remedy

I find myself launching a second newsletter (forgive me and please sign up)

Questioning the last 20 years of health policy

I recently had the delightful experience of going on the podcast Organized Money with Matt Stoller and David Dayen. We talked about the low rate increase that the Trump administration proposed for Medicare Advantage for 2027, and what that might mean for the Medicare Advantage program.

Part of the fun was saying what I think about health policy, something I haven’t written many newsletters about because I find that health policy conversations (1) often turn far too wonky to be interesting, and (2) tend to tread the same tired paths. The Organized Money conversation was fun because we jumped way outside the path. Forget talking about site-neutral payments (which are important!), we talked about whether the neoliberal worldview — the assumptions that led to value-based care, Medicare Advantage, and high-deductible health plans — is now being questioned among health policy thinkers.

I started Acute Condition in 2020 and its audience reflects the different facets of the industry I’ve written about: policy, health tech, global competition in pharmaceuticals. Because each of these audiences comes to my newsletter for different reasons and represents different parts of the healthcare industry, I’ve always tried to walk a fine line between having an opinion and being overly political.

That said, I think health policy is at a particularly interesting crossroads right now. Is the neoliberal paradigm being questioned? I think it is. The system that the last 20+ years of health policy build is worthy of questioning; the system is increasingly more of a financial game and less of an actual health delivery system. Even more interesting: if you’ve ever had the enjoyable (but lengthy) experience of reading Paul Starr’s The Social Transformation of American Medicine, published in 1982, he more or less predicted all of this.

At the same time, what’s next in American health policy seems to be locked in the brains and academic papers of policy wonks who want to debate in mind-numbing detail. And if I have anything to contribute, it’s my love of explaining things in written form.

Explaining how the future will be shaped

This brings me to the main point of this newsletter: I’m starting another Substack, which I’m calling The Remedy, explicitly focused on the health policy debates that I think are shaping the next era of American healthcare. My goal is to go a layer deeper than the repeal Obamacare/Medicare-for-all duality that have dominated the political conversations over the last few election cycles — I think that dichotomy is basically dead anyway. The Affordable Care Act is here to stay, and Medicare-for-all in its original form has lost a lot of steam. At the same time, I don’t want to bore you with information you can find elsewhere.

I intend for most of my pieces to be detailed interviews with experts (see Santi Ruiz’s newsletter Statecraft for my inspiration there), and some of them to be more in-depth posts about themes that I’m seeing. I’ll also be keeping Acute Condition going with a regular cadence, and I might cross-post.

I don’t want to over-promise and under-deliver; I suspect this new newsletter will take shape as I go, as Acute Condition has.

I hope you’ll follow along!