Our 2025 Think Tank plan is partly enacted. Thank you, Sec. Kennedy, and all who made this possible. Simple Question: What If Healthcare Made More Money When Americans Became Healthier?
by James Lyons-Weiler, PhD, Popular Rationalism, ©2026
(Nov. 8, 2026) — The Kennedy–Oz Medicare reforms begin to correct the incentives that reward treating illness over preventing it. An IPAK-EDU think tank developed a broader blueprint for giving Americans greater control over their healthcare dollars, rewarding measurable health improvement, and building a financially sustainable system in which everyone benefits when patients become healthier.
I thank Murray Sabrin, Antony Sammeroff and others who participated in the think tank for doing their part. Let’s see to it that America becomes healthier, wealthier, and wise.
HHS Officially Recognizes: That Which You Underwrite Grows
On November 4, 2026, Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz announced a series of Medicare reforms that begin confronting one of the most consequential defects in American healthcare financing: the system has developed extraordinarily sophisticated mechanisms for paying doctors, hospitals, and insurers to manage illness, but far less effective mechanisms for avoiding perverse incentives and rewarding them when patients become healthier and require less medical care.
The announcement represents a meaningful change in federal reimbursement policy. CMS is expanding payment pathways for prevention, health coaching, smoking cessation, behavioral health services, and coordinated primary care while modifying the financial incentives governing Accountable Care Organizations (ACOs). The agency is also addressing overlapping payments, correcting reimbursement loopholes, and allowing approved care organizations to reduce or eliminate certain patient cost-sharing obligations beginning in 2027.
Kennedy summarized the objective:
“Medicare should reward clinicians for keeping people healthy.”
Spot on. That which you underwrite grows.
For generations, American healthcare financing has rewarded the delivery of medical services with extraordinary precision. We have billing codes for diagnoses, consultations, laboratory tests, imaging, procedures, hospital admissions, and treatment of complications. We have established elaborate reimbursement schedules and administrative systems that determine which services qualify for payment and how much each provider receives. Yet the system remains comparatively poorly equipped to reward a physician who prevents a patient from developing the condition that would have generated those billable encounters.
A patient who develops type 2 diabetes may generate years of revenue through medication management, laboratory monitoring, specialist consultations, and treatment of complications. A patient whose physician helps prevent diabetes may generate far less revenue, even when the intervention produces greater health benefits and reduces future expenditures. The physician who succeeds in preventing illness may save the healthcare system money without receiving an appropriate share of the value created.
This contradiction does not require physicians to act against their patients’ interests. Most physicians want their patients to become healthier. The problem lies in the financial structure surrounding clinical practice. Hospitals depend on revenue from services delivered. Insurers manage claims and utilization. Healthcare organizations allocate resources toward activities that support their financial survival. Investors respond to the expected returns from treatments, technologies, and service delivery.
When financial success depends more reliably on treating disease than preventing it, the system naturally develops greater capacity to treat disease.
The Kennedy–Oz reforms begin changing those incentives. Their importance, however, becomes clearer when we examine the larger transformation that remains possible.
Read the rest here.
Leave a Reply