FHC #204: Why healthcare chaos didn’t lead to change & what comes next

This Diving Deep episode with Dr. Robert Pearl and Jeremy Corr looks at U.S. healthcare across three time horizons: past, present and future.

The hosts use 2025 as a case study in disruption without reform, 2026 as a year of mounting pressure and near-term transition, and the coming decade as a period when generative AI will fundamentally reshape how medicine is practiced.

Looking back at 2025

Dr. Pearl argues that despite political upheaval, executive orders, agency shakeups and constant headlines, American healthcare ended the year largely unchanged. Just more expensive and less trusted. He walks through five domains where chaos dominated but improvement failed to materialize. The throughline? Intense disruption produced little structural change in care delivery, affordability or outcomes.

Turning to 2026

The conversation shifts from stagnation to pressure. Pearl identifies two forces that make inaction increasingly risky: the midterm elections and accelerating healthcare costs. He outlines how that pressure is likely to shape behavior across the system — not through sweeping reform, but through targeted, politically visible moves.

Looking further ahead

Pearl describes how generative AI could alter medicine at a profound level, especially through the convergence of AI and surgical robotics. He argues that autonomous surgery, once the realm of science fiction, is now technologically plausible and could upend long-standing hierarchies between cognitive and procedural specialties.

Helpful links

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.