Thank you and happy holidays

I am pleased to report readership grew 27% this year. Here's are the top ten most read stories.

Dear Readers,

A year ago, I decided to cut back my postings to an average of about once a week. The idea was to write more incisively and in-depth rather than simply responding to the events of the day.

I am pleased to report that readers responded well. My free and paid subscriber base grew 27% over the past year, with the largest increases coming in the final two months of the year after the election. A warm welcome to all my new readers.

Health care will likely become a major focal point in 2025, unlike during the election season when the media largely ignored what a Trump victory with Republican control of Congress might entail. I plan to continue working through these turbulent times.

But I can’t do it without your help. To keep up with the news, I am a paid subscriber to numerous paywalled publications. There are the usual office expenses. Unlike most substacks, I do not keep any of my articles behind a paywall. I would like to continue that policy, but only 5% of my subscribers are paid.

So, time for my yearly plea. If you can find it in your heart and wallet to support this work, please consider becoming a paid subscriber by clicking on this link:

And, if you think you know folks who might be interested in keeping up with an informed critique of contemporary health care-related events (and a few other subjects from time to time), please forward this email to them.

Happy New Year everyone! Here are the top ten most-read articles of 2024, in descending order:

1. RFK, Jr. at HHS

An unserious man would be a figurehead a HHS, giving industry free rein to further reduce regulations that ensure our food is safe and new drugs and devices are effective. (11/14)

2. Paul Krugman, pragmatic Keynesian, leaving the Times

When writing about health care, the Nobel Prize-winning economist wanted single-payer but defended Obamacare. (12/6)

3. The limits of Incrementalism

Only bold solutions that solve health care’s enduring problems of access and cost can put the U.S. on the road to better health. (11/4)

4. One other good idea from RFK Jr.: Boost primary care

While public health advocates are mobilizing to thwart the anti-vaxxer's confirmation, his acolytes want to revamp physician pay to boost primary care. It's long overdue. (12/11)

5. The contrarian addiction

Dr. Marty Makary, Trump's nominee to head the Food and Drug Administration, hunts for evidence in studies that should never pass muster at the agency he hopes to head. (12/5)

6. Kennedy/Oz as champions of public health?

Not when Medicare, Medicaid and the ACA are under assault. Their verbal attacks on the food industry, while entirely justified, provide no guidance as to what will happen if they gain Senate approval. (11/11)

7. Anatomy of a policy failure

How high-deductible health insurance plans, touted by free marketeers, caused the medical debt crisis and degraded public health. (5/15)

8. An extremist agenda for health

Project 2025's architect would severely restrict the government's ability to protect the nation's health. The one exception? Abortion and reproductive health. Then it steps in big time. (9/4)

9. America's Not-So-Hidden Public Health Crises

The new year is a good time to issue a report card on the health status of the American people. On every front, I marked the box that says "needs improvement." (1/5)

10. A plan to end unaffordable out-of-pocket costs

Put a cap on it that is based on household income. It's doable if we put providers on a budget. (12/12)

Half Dome, Yosemite National Park, September 2024