Keen On

“It’s ultra stable. Health care doesn’t move. If you biopsied American health care in 2010 and again in 2026, no one could figure out which slide was which.” — Robert Pearl, MDBad news. The patient, I’m afraid, is ultra-stable. Robert Pearl, former CEO of Kaiser Permanente for eighteen years and author of ChatGPT MD, returns with the bleakest diagnosis we’ve heard all month. American healthcare, Dr Pearl says, is “ultra stable.” That might sound good. But it’s actually very very bad.If you biopsied American healthcare in 2010 and again in 2026, Pearl says, no clinician could tell the slides apart. Both were and are overpriced. Both underperforming. Hospitals still represent between 30-35% of expenses. Costs continue to rise at between 7-9% a year. There remain four hundred thousand misdiagnosis deaths annually. Burnout is stuck at 50%. The numbers haven’t moved in fifteen years.Meanwhile, a stealth revolution is already underway. 40% of Americans use generative AI every month for medical questions. 70-80% of