Why does 2026 mark an inflection year for American health?

In this episode, Robin Blackstone, MD, offers a spoken companion to her recent systems essay, explaining what has changed and why the current health system can no longer rely on delay, fragmentation, or diffuse responsibility.

Drawing on three converging forces—continuous advisory intelligence, upstream biological intervention, and unavoidable public accountability—this episode explores why new health system architecture is no longer optional, but necessary.

This is not a policy proposal or a technology pitch. It is a systems diagnosis of where American health stands as a new year begins.

Why does a hospital bill look nothing like a receipt?

Why do identical services cost wildly different amounts—sometimes in the same building?

In this episode of Doctor AI, Dr. Robin Blackstone unpacks the hidden architecture behind American medical pricing. Not the headlines. Not the politics. The machinery.

You’ll hear how billing codes replaced judgment, how committees—not markets—set prices, and how a system designed for accounting quietly came to govern care itself. This is the story of RVUs, CPT codes, negotiated rates, and the unintended consequences of turning medical work into units of volume rather than acts of care.

This episode is not about blaming clinicians or patients. It is about understanding how a pricing system built decades ago now shapes time, trust, access, and outcomes—and why real reform must start with how value is defined.

Clear. Uncomfortable. Necessary.

This episode examines why.

Rather than focusing on burnout or individual behavior, the discussion looks at the payment structures that shape modern medical work—and how efficiency gains are absorbed instead of released. What appears as acceleration is often the result of a system designed to reward volume, not relief.

This episode serves as the entry point to a larger series on how American medicine is paid, how physician work is valued, and where the costs of that system surface first.