Reimagine Healthcare

What would happen if employers stopped providing health insurance? Imagine a small manufacturing company in Grants Pass with 18 employees. For years, the owner has offered health insurance, even as premiums climbed and each renewal season forced the same difficult tradeoffs: raise employee costs, increase deductibles, delay hiring, or absorb the hit. Now imagine the company stops offering insuranc...

Trust in American institutions has collapsed. Trust in physicians and hospitals fell sharply after 2020. Trust in federal government remains near historic lows. Public confidence in agencies, media, and national political institutions has weakened across the political spectrum. But one pattern keeps showing up in the data: Americans still trust local institutions far more than national ones. In th...

Southern Oregon’s provider shortage cannot be solved by one hospital, one insurer, one employer, one university, or one government agency acting alone. That is the central argument of this third and final episode in the Reimagine Healthcare series on Southern Oregon’s provider shortage. In the first episode, Noah Volz explained why the shortage is persistent, compounding, and structural. Jackson a...

Southern Oregon’s provider shortage is not just a recruitment problem. It is a structural problem — shaped by healthcare costs, housing costs, wildfire insurance risk, burnout, and the lack of a community-level mechanism to act collectively. In the last episode, we mapped the problem. Jackson and Josephine counties have fewer primary care providers than they need, behavioral health waits can stret...

Southern Oregon does not just need more doctors. It needs a structural response to a provider shortage that has been building for years. In this first episode of a three-part Reimagine Healthcare series, Noah Volz examines the healthcare provider shortage in Jackson and Josephine counties — not as an abstract workforce issue, but as a compounding regional crisis affecting patients, employers, hosp...

Value-based care was supposed to fix one of the biggest problems in American healthcare: the system gets paid for activity, not necessarily outcomes. Instead of rewarding more visits, more tests, and more procedures, value-based care promised to reward better results: healthier patients, fewer complications, better coordination, and less unnecessary care. But has it actually changed the system? In...

Most people think they pay for their own health insurance. But that is usually not true — at least not fully. In this episode of Reimagine Healthcare , Noah Volz breaks down one of the most important and least understood facts in American healthcare: almost everyone receives public support for healthcare, but some subsidies are visible while others are hidden. Medicaid and Medicare are obvious gov...

Can you really “shop around” for healthcare? For most people in Southern Oregon, the answer is no. In this episode of Reimagine Healthcare , Noah Volz breaks down one of the most misleading ideas in American health policy: the belief that healthcare works like a normal market. A real market requires clear prices, meaningful competition, time to compare options, and the ability to walk away. Health...

Why does medicine sometimes stay stuck on outdated ideas, even when better evidence is available? In this final episode of the Blind Spots in Medicine series, Noah Volz looks beneath the individual examples — appendicitis, peanut allergy, antibiotics, and the microbiome — and asks a deeper question: How are doctors trained to think? This episode explores how medical education can reward memorizati...

Antibiotics are one of the greatest tools in medical history. They save lives. They have saved millions of lives. If you have bacterial meningitis, sepsis, worsening pneumonia, or a serious skin infection, you want antibiotics quickly. But what happens when a life-saving tool becomes normalized, overused, and prescribed in situations where the benefit is small, uncertain, or nonexistent? In this e...

How can a medical recommendation that harms people survive for years inside one of the most educated, evidence-focused professions in the world? In this episode of Reimagine Healthcare , Noah Volz begins a three-part series on what Dr. Marty Makary calls blind spots in medicine — the places where healthcare gets stuck on ideas that are incomplete, outdated, or wrong. This is not an anti-doctor epi...

America spends more on healthcare than any other wealthy country in the world — roughly twice as much per person as comparable nations. And yet Americans, on average, die younger. So what is going on? In this episode of Reimagine Healthcare , Noah Volz breaks down one of the most uncomfortable paradoxes in American healthcare: the United States has extraordinary rescue medicine, advanced hospitals...

Why do Americans often pay far more for the same prescription drugs than people in other wealthy countries? In this episode of Reimagine Healthcare , Noah Volz breaks down one of the most distorted parts of the American healthcare system: prescription drug pricing. The episode starts with a simple image: a tube of toothpaste with both ends open. Countries like Canada, the United Kingdom, Germany,...

American healthcare now costs more than $5 trillion a year — nearly one-fifth of the entire U.S. economy. But where does all that money actually come from? And where does it go? In this first episode of a new Reimagine Healthcare series, Noah Volz breaks down the money machine behind American healthcare in plain English. Households, employers, the federal government, and state governments all help...

What would it take to prevent Alzheimer’s before it becomes obvious? In this third and final episode of our series on women’s brain health and Alzheimer’s disease, Noah Volz looks at the system Southern Oregon would need to build if it took prevention seriously. The numbers are sobering. The lifetime cost of dementia care is estimated at more than $400,000 per person, and much of that burden falls...

Carol is 54, hikes the Siskiyous on weekends, and has been forgetting words mid-sentence for two years. Her doctor ran the standard tests, found nothing, and told her it's just part of getting older. Her doctor is probably wrong. This is the first episode in a three-part series on Alzheimer's disease in women — drawing on the research of Dr. Lisa Mosconi, director of the Women's Brain Initiative a...

Kathleen's labs had been normal for three years. She was on medication. She was still disappearing. This final episode of the thyroid series follows Kathleen through the six months after her extended labs changed everything — and makes a direct case for what Southern Oregon's healthcare infrastructure needs to build so that her story becomes the rule, not a lucky accident. What produced Kathleen's...

Your labs came back normal. You're still exhausted. And here's the part nobody tells you: the test your doctor used to make that call may not have been accurate enough to know. Episode two of the thyroid series gets specific. After last week's episode on why the standard TSH-and-T4 framework misses most of the biological story, this episode is about the labs — what should actually be measured, why...

You've been told your thyroid labs are normal. You're on medication. And you're still exhausted, still foggy, still canceling the life you used to have. Nobody can explain why. For somewhere between ten and fifteen percent of people being treated for hypothyroidism right now, that is exactly what's happening. This episode is the first in a three-part series investigating the gap between what the s...

What if the solution to Southern Oregon’s healthcare affordability crisis already existed—and was working in markets just like ours? In this final episode of the series, we break down the most promising strategy for reducing healthcare costs in Southern Oregon: employer purchasing alliances. Across the country, groups of employers are joining forces to negotiate better healthcare pricing, implemen...

Why does the same family pay thousands more for healthcare in Southern Oregon than they would in Portland, Eugene, or Boise? In this episode, we expose the hidden market forces driving Southern Oregon’s healthcare affordability crisis—and why the problem goes far beyond deductibles and insurance design. Because this isn’t just bad luck. It’s not overuse. And it’s not because patients are making po...

In this episode, we follow a real-world Southern Oregon family through an ordinary year of healthcare expenses—and reveal how a “normal” employer-sponsored insurance plan quietly creates financial instability, delayed care, and impossible household decisions. They have jobs. They have insurance. They are doing everything right. And yet by year’s end, nearly one quarter of their income goes to heal...

After previous episodes exposing how medical debt destroys credit, housing stability, workforce productivity, and long-term health outcomes, this episode shifts from diagnosis to solutions. Because the truth is simple: medical debt is not inevitable—it is a design flaw. And communities across the country are proving it can be fixed. In this episode, we break down the evidence-based strategies that...

Most business owners in Southern Oregon have no idea their employees' medical debt is showing up on their own bottom line. Absenteeism. Turnover. Delayed workers' comp claims. Higher insurance premiums. It adds up to over half a million dollars annually for a 100-employee firm — all traced back to $72,000 in total employee medical debt. In this episode, Noah Volz breaks down the hidden business co...

One ER visit. One $3,800 bill you couldn't pay. And then — for the next seven years — every financial transaction in your life gets more expensive. That's the credit cascade. And the math is brutal. This is Episode 3 of the Medical Debt series, and it's the one that will make you angry. A 67-point credit score drop from medical debt doesn't just affect your ability to rent an apartment. It costs y...