Ep. 77: What's broken in health care, with Marschall Runge, M.D., Ph.D.

Marschall Runge, M.D., Ph.D., dean of the University of Michigan Medical School, CEO of Michigan Medicine and author of The Great Healthcare Disruption, joins the show to dissect exactly what's broken in U.S. health care — and what we can do to fix it.

Also, don't miss our previous episodes on what AI can (and can't) do for prior authorizations, our special report on 60 years of Medicare, physician struggles and why physicians are suing RFK Jr.

Music Credits:
Moonlit Walk by Buurd - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Overview (00:00:00) Dr. Runge and the hosts introduce the episode’s focus: challenges and dysfunctions in the U.S. health care system.

What’s Broken in U.S. Health care? (00:01:20) Discussion of patient frustrations: appointment delays, rising drug prices, insurance confusion and system complexity.

Retailers in Health care: Why Didn’t It Work? (00:02:22) Exploring why Walmart, Amazon and others struggled to deliver primary care and the issue of fragmented medical records.

Primary Care Challenges (00:06:08) Examining the importance of primary care, low physician numbers, burnout and why fewer medical students choose this path.

Practice Management Tip: Patient Care Online (00:09:30) Brief segment promoting Patient Care Online as a resource for clinical information.

AI in Medicine: Promise and Limitations (00:09:49) How AI is being used for note-taking, scheduling and efficiency; its current benefits and limitations in health care.

Health care Equity and Access (00:14:06) Concerns about technology access disparities between urban and rural/low-income areas; discussion of universal health care models.

History and Impact of HMOs and Capitation (00:17:31) Reflection on HMOs, capitation, and their effects on primary care and health care delivery in the U.S.

U.S. Health Outcomes and Prevention (00:19:07) U.S. ranking in healthy life expectancy, rising chronic diseases and the need for better prevention and health management.

Practice Management Minute: Staffing Metrics (00:19:55) Tips for medical practices on when to add staff, based on wait times, overtime and labor costs.

Health care Innovation and Drug Development (00:21:04) U.S. leadership in medical innovation, new weight loss and genetic therapies and the challenge of high drug costs.

Healthy Aging and Lifestyle Factors (00:24:16) Key lifestyle factors for healthy aging: sleep, fitness, community and policy approaches to promote healthy choices.

Misinformation in Medicine (00:26:43) Concerns about health misinformation on social media and the need for better health education in schools.

Conclusion and Farewell (00:28:46) Closing remarks, thanks to the guest and information on subscribing to the podcast.