109. United States Health Care ꟷ Hot Mess, Canary, Wolf and Solution
- Dec 14, 2025
- 4 min read
Fixing United States Health Care - Letters to the File
Part I. The Hot Mess
Part II. The Solution
by
T Michael White MD FACP
The Realization of Universal Access to ABC-STEEEP
(Affordable, Basic, Compassionate - Safe, Timely, Efficient, Effective, Equitable/Just, Patient-Centered Care)
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109. United States Health Care ꟷ Hot Mess, Canary, Wolf and Solution
“Man is to man either a god or a wolf.”
Desiderius Erasmus
The WhiteHouse on the Belleair Bluff
Thursday, December 11, 2025
A letter to the file…
It is past time to submit an opinion piece to the Tampa Bay Times…
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United States Health Care ꟷ Hot Mess, Canary, Wolf and Solution
“Man is to man either a god or a wolf.”
Desiderius Erasmus
As an academic, administrative, clinical physician and patient (humbly excelling in each regard), I serve as a canary in our United States health care mine. Near terminally distressed, I sound the alarm ꟷ a hungry health care wolf is at our door. A chaotic health care cataclysm is upon us. Our wellbeing and that of our near and dear and our trailing generations is in jeopardy.
What does this ravenous beast look like? No sheep clothing here…
The well-employed couple with employer-sponsored health care are trying to raise a
family. Despite paying $13,000 in annual premiums, they have paid an additional
$18,000 out-of-pocket three years in a row. ‘Insured,’ their finances are in shambles.
The 68-year-old professional, eligible for Medicare, is beyond ready to retire. He
cannot. He must work to maintain his increasingly expensive employer-sponsored
health care until his 62-year-old uninsured wife qualifies for Medicare. All other options are fiscally unrealistic.
The young couple struggling paycheck to paycheck is uninsured. They each work two jobs each designed to be less than 30 hours per week (so their employers can avoid offering them health care insurance). Despite subsidies, Affordable Care Act premiums and deductibles are beyond their reach.
The mid-career superstar (with need for health care) is locked into an
unstimulating/geographically unsatisfactory position because of fear of losing employer- sponsored health care.
The uninsured single-mother housekeeper and her child are now living in their car.
Illness related expenses eroded their already tenuous food and housing securities.
Hospital and community securities are being impacted. Some argue our health care
debacle is even placing our national economy and national security at risk .
Each day, as a canary in the health care mine, I confront (very little) good and (very
much, ever increasing) bad health care news.
Good news: although burdened with administrative hassles, our well-trained physicians, nurses and support staffs (our Better Angels) and our fine hospitals consistently stand ready to provide magnificent state-of-the-art care.
Good news: there is consensus among our fine citizens that our fine country must offer eligible residents infrastructure that provides universal access to affordable, basic, compassionate, safe, timely, efficient, effective, equitable (just), patient-centered care (ABC-STEEEP). This access must be provided by an efficient, planned single payor/multiple provider system that is funded by personal and corporate income tax. Bad news: every preceding word represents a pipe dream.
Good news: some are positioned for magnificent care: members of congress; the
multimillionaire/billionaire club; and Medicare recipients protected by enough personal wealth to address ever increasing premiums, co-pays and co-insurance. Bad news: the latter group 1) is shrinking, 2) has begun to avoid or delay care because of expense and 3) increasingly worries that their Medicare protection will be withdrawn.
Bad news: for the best of the rest (employer-sponsored insured, Affordable Care Act
insured, etc.,) health insurance has become a sham paradox ꟷ insured when well, uninsured when ill. While healthy, premiums are now unaffordable. When significant illness or accident intervene, co-pays, co-insurance, deductibles and annual out-of-pocket maximums erode personal and family education, employment, finance, food, health, housing and transportation securities. The circumstance for the significantly ill uninsured is beyond comprehension. There is no good news.
Surely the leadership of this fine country, aware of chaos, is taking dead aim at resolving this hot mess. It is not. Band aids, finger pointing, hypocrisy and lip service reign. Sadly, the root cause ꟷ health care in this country is a non-system that has been allowed to callously (abuse, duplication, fraud, greed) evolve into an unaffordable hot mess ꟷ is neither acknowledged nor being addressed.
Is there a solution? Yes. Our decent, virtuous country must acknowledge however well-intentioned errors and start anew. Designed and implemented single payer/multiple regional provider infrastructure, funded by personal and corporate taxpayer dollars, that provides eligible residents universal access to ABC-STEEEP is required. Each provider will demonstrate a track record of efficiency, quality, patient satisfaction and safety. Ascendant, award-winning, regional 5-Star Medicare Advantage Plans will serve as paradigms. Fine examples already exist in our own Hillsborough and Pinellas Counties. How do we get from here to there? Courageous, enlightened, altruistic national leadership should be the answer. Good luck with that ꟷ in 2025 they just do not have the goods. Telling ourselves the unvarnished truth ꟷ a chaotic, catastrophic, cataclysmic (a Pearl Harbor) breakdown in health care that puts our food, health, housing and self-esteem securities (our wellbeing) in jeopardy is already upon us ꟷ is the answer.
Truth told and crisis confronted, dramatic action will follow ꟷ it’s our American way.
(750 words)
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Dr. Mike, your submission worthy, submit (yesterday).
Respectfully submitted with fondest personal regards,
Dr. Mike
You may leave an anonymous comment without username and email ꟷ please do. Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as this draft and subsequent chapters will be significantly enhanced.
Dr. Mike
Letters to the File ꟷ Part II
101. Introduction to Part II ꟷ The Solution
102. The United States Health Care System ꟷ Enabling Legislation
103. The United States Health Care System ꟷ View From Space
104. My (Unique and Very Personal) United States Health Care ꟷ Getting Started
105. My Semi-annual Primary Care Team Visit
106. The United States Health Care System ꟷ My Contract
107. ‘Medicide’ ꟷ Failure to Make Whitefish Bay (A Fiction)
108A. P/CEO Charley Price’s Prologue ꟷ We Must Start Anew!
108B. The Enabling Cataclysm ꟷ A Fiction?
108C. Dr. Dana Kellis’ Epilogue ꟷ A Single Payer (not a single provider) System
109. United States Health Care ꟷ Hot Mess, Canary, Wolf and Solution
(more to follow)
We can see ourselves and our community members in Dr. White's examples. This issue should not be ignored. Thanks for leading the discussion for bettering our healthcare system.