The fall of American medicine

It’s a sunny day and poppies are popping. Tempting to go outside to taste the air, listen to the colors of spring, and smell the warmth.

But I have a deadline, and certain responsibilities come with the bathrobe and Lone Ranger mask.

I’ve been told that my grandfather’s normal day went like this:

1. Breakfast served by the cook

2. See a few patients in his office which was attached to his house

3. See his hospitalized patients.

4. Lunch

5. Have the stable-hand hitch the horse to his carriage and make some house calls.

6. Dinner with family, served by the cook.

7. Play cards with friends.

Grandpa died while dad was in high school. Lung cancer. Grandpa smoked. Syphilis was so widespread that America’s most famous physician, William Osler, told med school graduates “know syphilis and you will know medicine.” Pneumonia was often a death sentence, giving rise to the expression, “You’ll catch your death of pneumonia.”

U.S. life expectancy at the turn of the century was 47.

My father was in med school in New York when he developed pneumonia. The professors offered him a chance to survive — a new drug called “antibiotic,” a product of medical research. The sharp reader will have concluded that he survived.

He focused on delivering babies — 6,000 before he retired. His first delivery was heralded by a farmer who knocked on his door in a snowstorm. Dad drove, slipping tires and slapping windshield wipers, to the farmer’s house and helped the farmer’s wife deliver.

For all the years I lived at home, dinner was all of us hungry kids and our patient mom waiting for dad to show up. Finally, we could sit down to eat. Then the phone rings and dad’s gone again.

He used medical research findings to treat infections and improve obstetric methods. Syphilis became treatable by penicillin. He also sponsored and funded multi-casualty exercises on our sprawling lawn, practicing response to an atomic bomb attack.

Half the hospital staff attended. We all took radioactive fallout seriously, even tho we didn’t understand it realistically. Antibiotics, medical research and public health infrastructure led to an increased life expectancy of 69 in the 1960s.

I recall getting a smallpox vaccine as a kid (drop of fluid on the skin followed by pin-pricks). Also recall that mom wouldn’t let us go to the beach in summer from fear of polio.

Dad had taken me with him to the hospital once, where I saw a child-sized iron lung. The arrival of the brand-new polio vaccine caused widespread excitement, and I joined a line of other kids at the local fire station to get my dose. The beach became available again. The iron lung disappeared.

During my career, my goal with patients was to prevent hospitalization. My goal in public health was to prevent community outbreaks. Traditional skills were augmented by medical research such as:

1. Treating drug-resistant infections.
2. Anti-viral drugs (flu, Covid, others)
3. Syphilis control (shameless plug — my book, “A Greater
Pox,” on the history of this disease is in the Mariposa Library).
4. Engineering immune cells in the body.
5. Robotic surgery.
6. The genetics of cancer.
7. Origins of Alzheimer’s disease.
8. Mapping the chemistry of cancer cells and finding ways to
control it.
9. Finding new drugs to treat pain without addicting opioids.
10. Exploring benefits of stem cells.
11. Studying head trauma in athletes.
12. Improved, targeted chemotherapy.

U.S. life expectancy rose to 76 in the 2000s. America was the world leader in medical research and public health.

* ** * *

Now, into this medical infrastructure, superior in scientific research and (some) clinical care, creeps greed. In the U.S., several healthcare associated organizations operate on a for-profit basis. Primary among these are insurance companies which realize gigantic profits and decide whether or not to pay for your medical tests, procedures and medications.

My Lone Ranger mask has not obscured this gigantic rip-off of your premium payments and health-directed tax dollars. ‘Nuff said. By now, almost all of you have personal experience with this dysfunctional method of paying for healthcare.

But many of the organizations that actually provide the care are also greed-mills. For example, the CEO of HCA Healthcare is currently paid $26, 456,606. The four administrative people beneath him suck out from the company’s billings (which should be providing care to patients) an additional $32,761,000. (Becker’s Hospital Review March 13.)

In spite of our technological and research superiority, this insurance and healthcare system dysfunction has been occurring as our health outcome measures have dropped.

“Avoidable Deaths” in the U.S. measured 368.6 per 100,000 people in the most recent data. Those numbers in France and Germany are much lower — 161.5 and 167.8 respectively.

In previous articles I’ve detailed the abysmal health outcome measurements the U.S. has. We are already seeing a drop in life expectancy measures as well.

Now, into this medical mess of greed creeps — moral failure. The current administration and RF Kennedy have seriously weakened both medical research and our ability to prevent both disease in individuals and outbreaks in our communities.

Specifics:

1. Trump withdrew the U.S. from the World Health Organization and its vast knowledge of potential epidemics. (The White House.)

2. The “Big Beautiful (yet another werd intended to obscure the truth) Bill” attacked medical research by cutting grant funding to research institutions. Some 7,800 such grants were denied, frozen or killed including 5,844 grants already funded. (Nature, Jan. 20, 2026.)

The number of new grants funded were reduced by 24 percent. Most of these grants came from the National Institutes of Health (NIH). NIH funding went from $48 billion in 2925 to $27.5 billion in 2026. (Brookings.) Lawsuits and judges have been modifying these numbers, but the administration’s intent is clear.

3. Rural hospitals are under attack. The B.B.B. reduced reimbursement to these hospitals by $137 billion over the coming decade. There was an outcry. The admin provided $50 billion — a one-time payment far short of the projected loss. (Washington Post)

So far, over 195 rural hospitals in the U.S. have closed or been converted to other facilities. (Sheps Center for Health Services Research.)

4. Both medicare and medicaid (MediCal in this state) are being negatively impacted. Deductibles, co-insurance and premium costs for Medicare are all rising from 2025 levels. (Center for Medicare and Medicaid Services.) Medicaid funding will fall 14 percent over the next decade, taking insurance from 7.5 million Americans. (Kaiser Family Foundation.)

5. Trust in public health and vaccines was attacked during the first Trump administration. RFK has undermined this trust even further. Congress and the administration are starving the CDC — once among the world’s most respected public health organizations. The CDC budget in 2024 was $9.263 billion. In 2026, it’s $4.320 billion.

6. Amid this financial mayhem targeting medical research, public health, your Medicare and Medicaid and rural hospitals, funding of our military stands out grotesquely. Our military is already the most heavily funded in the world. It makes up 35.5 percent of all military spending in the world. It uses up 3.4 percent of our Gross Domestic Product (most countries not currently at war have lower percentage GDP figures, even China, which is second in absolute dollars spent).

In 2024, our military received $874 billion of your tax dollars. Yet currently the number is $1,000 billion and they’re going to Congress to request even more.

Here are a couple of interesting developments. For those suffering from paralysis due to spinal cord trauma, a futuristic remedy is now available. There is a brain chip which can be implanted and, when your brain says “move my hand,” a prosthetic hand grabs what you want. This is now commercially available.

Guess which U.S. research facility developed this breakthrough? Answer: none. It comes from China. (WIRED and Nature.)

Number 2: Relief for rural hospitals! Dr. Oz and not-a-doctor RFK have a plan: AI nurses. Will alleviate the physician and nurse shortage in rural areas! Do not require salary or benefits like health insurance or retirement accounts! (Washington Post)

Also, they do not exist.

So the score is: China 1

U.S.: 0

To me, this destruction of America’s prime position in medical research and mediocre position in providing healthcare mimics the fall of the Roman Empire. But it’s more than simple greed and political power play.

It’s a gigantic moral failure. To fund the over-bloated Military Industrial Complex (Eisenhower’s term) at the expense of the taxpayers’ healthcare, protection from public health threats and rural healthcare institutions is a monstrous choice.

Only we taxpayers and voting citizens can correct this.

You know what to do.

Dr. Charles Mosher, M.D., M.P.H., was Mariposa’s county health officer from 1988-2014. Prior to his work at Mariposa County, Mosher served in the Peace Corps, worked for the state of Georgia and served for 11 years with the Merced County Health Department. He can be reached at author@greaterstory.com.