Health

A recent injury forced me to experience firsthand the dysfunction of the American healthcare system. After being sent through numerous referrals, I ultimately had to pay out of pocket because every specialist my primary care doctor referred me to was out of network. Even more frustrating was the wildly different prices for the exact same procedure: one testing site quoted me $1,400, another $500, and another just $398. Then there was the time lost traveling between doctor’s offices, labs, imaging centers, and surgical centers, each requiring a separate appointment. Even something as simple as getting medication meant another trip to the pharmacy. What should have been a straightforward process instead became an endless series of appointments, providers, and facilities. I have personally seen healthcare systems in other countries where diagnosis, testing, treatment, and even medication can all be provided under the same roof in a general hospital. So why does the U.S. healthcare system seem so fragmented and inefficient by comparison?

The truth is, America doesn’t really have just one healthcare system. There are employer plans, Medicare, Medicaid, Marketplace plans, hospital and pharmacy networks, deductibles, referrals, prior authorizations, and different rules for almost every insurer (Commonwealth Fund, 2026). The list seems endless. Even if a doctor says you need a test, your insurance company can still delay it. After treatment, you get separate bills from different providers, and a single coding mistake can mean your claim is denied. In 2024, administrative problems caused a quarter of in-network claim denials on HealthCare.gov plans (KFF, 2026). Many parts of the healthcare industry have profited from these inefficiencies and have little incentive to improve the system. The result is enormous administrative waste, higher costs, and a system in which patients often spend as much time navigating healthcare as receiving it.

The numbers make it clear: Americans pay more for healthcare than anyone else. In 2024, the US spent $5.3 trillion on healthcare, which is about $15,474 per person and 18% of the economy (CMS, 2026). Compared to other developed countries, the US spends about two and a half times more, but life expectancy here is still below average (OECD, 2025). In 2022, private insurance plans paid hospitals about 254% of what Medicare pays for the same services (RAND Corporation, 2024). Therefore, Americans are not getting more care than others; they are simply paying way more for everything.

Other wealthy nations show that universal care does not require one clear-cut model. England has a tax-funded NHS that is generally free for use (Commonwealth Fund, 2026). Germany uses regulated insurance funds, while the Netherlands uses private insurers but requires them to accept applicants and provide a standard package (Commonwealth Fund, 2026). Japan uses several insurance plans but imposes a uniform national fee schedule, and China covers more than 95% of its population through basic medical insurance (National Healthcare Security Administration, 2024). These systems still face shortages and waiting times, but patients are not normally required to investigate dozens of networks or risk financial ruin if they become sick.

So, if the American healthcare system is this inefficient and expensive, who is actually making the money? Large hospital systems can use their market power to negotiate higher prices with insurers (RAND Corporation, 2024). Brand-name drug manufacturers benefit from patent protections that limit competition (FDA, 2026). Insurers and pharmacy benefit managers profit from managing networks, claims, drug coverage, and rebates, while private-equity firms have increasingly bought medical practices and healthcare facilities in search of higher returns (HHS, 2024). The FTC has also warned that highly concentrated, vertically integrated PBMs may inflate drug costs and favor their own affiliated pharmacies (FTC, 2024).

So why doesn’t the government do more to protect patients? Illegal kickbacks and healthcare fraud do happen and are prosecuted (DOJ, 2025), but most industry influence is perfectly legal. It comes through lobbying, campaign contributions, and the revolving door between government and the healthcare industry. In 2024, pharmaceutical and health-product companies spent about $387 million lobbying the federal government, while hospital-related organizations spent another $116 million (Korostoff-Larsson et al., 2026). With so much money at stake, many powerful groups have a strong incentive to resist reforms that could lower prices or reduce their influence.

Healthcare should be designed around treating patients, not forcing them to navigate a maze of insurers, networks, facilities, and bills. The system can be fixed, but not through small reforms alone. It needs structural change. That means continuous basic coverage, simpler and standardized insurance rules, limits on prior authorization, lower prescription drug prices, tougher action against hospital monopolies, and equal payment rates so the same procedure does not cost more because a hospital owns the doctor’s office (MedPAC, 2022). Ultimately, no one seeking medical care should have to spend more time figuring out the healthcare system than actually receiving care.

While I aim to get seven to eight hours of sleep on school nights, I usually end up with only five or six. On weekends, I try to catch up by sleeping eight to ten hours; however, instead of feeling well-rested, I often feel more tired than I do after my usual six. Strangely, on nights when I sleep only four hours, I sometimes experience a sudden burst of energy during the day. The inconsistency of these symptoms leaves me wondering why more sleep does not always translate to more energy.

Most guidance says teenagers and young adults should get about seven to nine hours of sleep each night, so my usual five hours is clearly not enough (CDC, 2024). Sleeping longer on weekends may ease short-term fatigue, but it can also disrupt the body’s sleep-wake cycle. The NHLBI recommends keeping weekend and weekday sleep schedules within about an hour of each other to prevent this shift (NHLBI, 2022). In addition, NIH research shows that weekend “catch-up sleep” does not fully reverse some metabolic disruptions caused by chronic sleep restriction (NIH, 2019). This helps explain why sleeping eight to ten hours on a weekend can still leave me feeling tired.

Another explanation is sleep inertia, the grogginess and mental fog that can occur immediately after waking (Hilditch et al., 2019). Research suggests that sleep inertia is more intense after sleep loss, and studies of restricted sleep show that cognitive performance sometimes remains impaired for more than an hour after waking (McHill et al., 2019). This suggests the issue may not be that I slept “too much,” but that I woke up during the wrong stage of sleep or at a time misaligned with my body clock. For students, this effect can be even worse because school schedules often clash with adolescents’ naturally delayed sleep cycles, which explains why I feel much more productive late at night (Crowley et al., 2018).

On the other hand, the sudden burst of energy after only four hours of sleep can be misleading. Feeling alert does not necessarily mean being well-rested. Research shows that the body naturally releases cortisol in the morning to help promote wakefulness, and sleep restriction has been linked to elevated stress hormones and increased physiological arousal later in the day (Andreadi et al., 2025). At the same time, studies on sleep deprivation indicate that attention, reaction time, and cognitive performance decline as sleep loss increases, even when a person can still push through and feel temporarily functional (Alhola & Polo-Kantola, 2007). That “energy” is often stress-induced alertness rather than real recovery.

If both too little sleep and oversleeping leave me feeling off, the real solution may be building a more consistent routine. Instead of relying on weekend catch-up, I should keep a regular wake-up time, gradually move my bedtime earlier, and limit weekend sleep-ins to about an hour past my usual schedule. The NHLBI also recommends avoiding bright light before bed, cutting off caffeine later in the day, and keeping naps short (NHLBI, 2022).

Changing a sleep habit will not be easy, especially as a student juggling schoolwork and a social life. But even small, consistent changes can help stabilize the body clock and boost energy, and I encourage other night owls like me to do the same. 

As we all know that U.S. pays much higher prices for prescription medicines than other developed countries, leaving many Americans with high out-of-pocket costs. Some even travel abroad, particularly to Canada or Mexico, to purchase cheaper medications. Despite decades of promises to reduce drug costs, Americans continue to pay high prices. A RAND comparison using 2022 data found U.S. prescription drug prices averaged 2.78 times those in 33 other countries, and brand‑name drugs averaged 4.22 times (RAND).

Recently, the Trump administration launched TrumpRx.gov, a government‑branded portal that displays discounted cash prices on a short list of brand‑name drugs and then redirects patients to manufacturer programs or pharmacy coupons (Reuters, Feb. 5). Reuters reports that the site is part of the administration’s “most‑favored nation” (MFN) pricing agreements with 16 major drugmakers, intended to push U.S. prices closer to those in other developed countries (White House).

Basically, TrumpRx functions like an MFN‑driven discount storefront: It lists posted cash prices for a limited set of brand-name drugs, including categories such as GLP‑1 diabetes/weight‑loss medicines and fertility medications, and then directs patients to where those discounted prices can actually be used (White House). However, it is not an insurance benefit. CBS reported the platform doesn’t accept insurance at launch, so purchases generally will not count toward deductibles and must be paid out of pocket (CBS News). Reuters also noted that only five manufacturers had posted products on day one, limiting its reach for now (Reuters).

While TrumpRx may help people who need an out‑of‑pocket option most, like uninsured patients, people with high deductibles, and those whose plans simply will not cover a drug (CBS News),  it can also mislead because an insured patient may pay more by going cash, and that spending will not count toward out-of-pocket protections (Reuters). The drug list itself raises concerns as well, since STAT found that about half of the listed brand drugs already have generic versions that are usually cheaper (STAT). 

To make this policy more effective and transparent,  I propose three steps TrumpRx should take. First, list generic alternatives and typical insurance copays alongside the cash price. Second, add clear warnings that paying cash will not count toward the deductible or out‑of‑pocket limits. Third, publish data showing who actually saves and who does not, so the program can be adjusted accordingly.

Overall, I think this initiative by the Trump administration is a big step toward making essential medicines more affordable and accessible to Americans, and I hope that soon no one has to travel abroad just to afford the prescriptions they need.

We all know that too much sugar can have adverse effects on our health, ranging from diabetes to fatty liver disease, but is it true that some sugars are worse than others? An article in the holiday issue of The Economist says otherwise. 

What struck me most in the article is that it tries to disprove a very specific myth: the “natural sugar” belief. It argues that whether a label says “raw sugar”, “honey”, “agave”, or “maple syrup”, the sweetness usually comes down to the same basic chemistry, glucose and fructose, so swapping one for another doesn’t make much difference. (The Economist, 2025) Instead, it says the reality is more about how you consume sugar. Liquid sugars are absorbed quickly; fruit juice behaves like sugar, separated from its fiber “packaging”; and pairing sugar with fiber, protein, and fat helps slow absorption and blunts blood sugar spikes. 

The article is largely right on the “natural vs refined” point. The WHO definition of free sugars includes not only sugars added during manufacturing or cooking, but also sugars naturally present in honey, syrups, fruit juices, and fruit-juice concentrates. WHO recommends keeping free sugars below 10% of total energy and suggests aiming below 5% for additional benefit. (World Health Organization, 2015) The American Heart Association makes the same practical point in plainer language: “added sugar is added sugar no matter what it is called,” and it gives concrete daily limits of 25 g/day for women and 36 g/day for men. (American Heart Association, 2024) Harvard Health likewise notes that differences in the glucose–fructose ratio across table sugar, HFCS, and many “natural” sweeteners have little impact on metabolic health. (Harvard Health Publishing, 2023)

So while the article is largely right at the molecular level, its headline claim that “the type of sugar won’t make any difference” looks less convincing once you look at how sugar is actually delivered. A 2025 dose–response meta-analysis pooling prospective cohorts found that each additional daily serving of sugar-sweetened beverages was linked to a 25% higher risk of type 2 diabetes, and each additional serving of fruit juice to about a 5% higher risk, both graded as moderate certainty. Meanwhile, total sugar and sucrose showed inverse associations at around 20 g/day, and added sugar and fructose were essentially null. (Della Corte et al., 2025) The 2025 U.S. Dietary Guidelines Advisory Committee’s systematic review lands in the same place on beverages: sugar-sweetened drink consumption “may be associated” with a higher risk of type 2 diabetes. (Giovannucci et al., 2024) In other words, it’s not that honey is bad and coconut sugar is good; it’s that liquid sugar behaves differently enough that the risk signal is stronger and more consistent. 

At the biochemical level, fructose is where the claim that “some sugars are worse” becomes reasonable, even when calories are held constant. Fructose produces a lower immediate glycemic response than pure glucose because it is metabolized largely in the liver, but that simply shifts the metabolic load. (Malik & Hu, 2015) In a randomized controlled trial in healthy men, fructose and sucrose-sweetened beverages (80 g/day for 7 weeks) roughly doubled basal hepatic fat synthesis compared with controls, whereas the same amount of glucose did not. (Geidl-Flueck et al., 2021) On the gut side, the article’s point about bloating is also real for some people: incomplete fructose absorption can lead to fermentation in the colon and symptoms like gas and bloating. (Biesiekierski, 2014) This evidence undermines the article’s claim that the type of sugar doesn’t matter and suggests that high intakes of fructose-rich sweeteners, including high-fructose corn syrup in many sweets, especially carbonated sodas, contribute to rising rates of fatty liver disease. 

Though The Economist is right to dismiss the wellness-marketing fantasy that “natural” sugars are categorically healthier, the data also show that sugar risk isn’t flat; how and where you consume it matters. Sugary drinks, in particular, stand out as a consistent problem, with a 2025 Nature Medicine analysis estimating 2.2 million new type 2 diabetes cases and 1.2 million new cardiovascular cases in 2020 attributable to sugar-sweetened beverages globally. (Lara-Castor et al., 2025) As someone with a sweet tooth, I will cut down on soda and juice and replace them with whole fruit. But my dessert after dinner? That will be hard to give up.

Learning about the circulatory system and cholesterol’s role in heart disease in Biology class drew my attention to an article titled “Re-thinking cholesterol” in The Economist. 

I expected the article to be a refresher on the usual LDL (“bad”) and HDL (“good”) model. Instead, it argues that cholesterol isn’t really a two‑box diagram at all. Cholesterol molecules travel inside lipoprotein particles, and those particles form an ecosystem of sizes and types that behave differently in artery walls (The Economist, 2025). The article suggests that risk depends less on “LDL bad, HDL good” and more on which particles are present and how many of the dangerous ones you have, adding complexity to our understanding of heart disease. 

Two risks that are “hidden” stood out: First is lipoprotein(a), or Lp(a), which is an LDL‑like particle with an extra protein (apo(a)) that appears to add clotting and inflammatory risk. Lp(a) levels are mainly genetic, barely move with lifestyle, and aren’t included in routine cholesterol panels unless you request the test. 

The second “hidden” risk the article highlights is remnant cholesterol, which are leftover, triglyceride-rich particles that can be packed with cholesterol even after they have carried and delivered the necessary fats (The Economist, 2025). What surprised me is that newer genetic and metabolic research suggests these remnants may be more damaging per particle than standard LDL. A 2024 analysis estimated that triglyceride-rich lipoprotein (TRL)/remnant particles are about four times more atherogenic per particle than LDL (Björnson et al., 2024). 

The article explains that many of the particles that actually get trapped in artery walls share a surface protein called apolipoprotein B (apoB) and crucially, each atherogenic particle carries one apoB molecule (The Economist, 2025). That means an apoB blood test is basically a headcount of the cholesterol-carrying particles most likely to cause plaque. Major medical groups increasingly agree that apoB can capture risk more accurately than LDL-cholesterol alone in some people (De Oliveira-Gomes et al., 2024).

What changed my understanding is why LDL-C can be misleading, depending on the person. Two people can have the same LDL-cholesterol, but one person might be carrying that cholesterol in many smaller particles (higher apoB), while the other has fewer particles carrying more cholesterol each (lower apoB). The Economist even says a substantial number of people can look “fine” on LDL-C but still have high apoB and therefore a higher risk. Peer-reviewed work backs up the broader point: discordance between LDL-C and apoB happens often enough that measuring apoB can reclassify risk, especially in people with high triglycerides, insulin resistance, obesity, or diabetes (where particle number can run high even if LDL-C isn’t). 

I think the Economist does a strong job of translating a complicated shift in lipid science into a simple mental model: atherosclerosis is more about how many apoB particles hit the arterial wall than how much cholesterol is floating around. It also highlights two “blind spots” (Lp(a) and remnants) that a standard lipid panel can miss.

However, there are two places to be cautious about. First, the new “particle” framing doesn’t erase the basics: lowering LDL (and apoB) still matters because randomized trials show LDL-lowering therapies reduce heart attacks and strokes, and the “very high HDL is bad” idea can be misunderstood as “HDL causes harm” since very high HDL can reflect confounding factors (like heavy alcohol intake or certain medical conditions), so it’s safer to treat HDL-C as a clue rather than a target.

In medicine, new discoveries constantly reshape our understanding of diseases, especially heart disease, one of the leading causes of death. The goal of preventing this disease ultimately boils down to recognizing risk early enough to prevent plaque from building in the first place.

One day after swim practice, I saw a parent guiding her son, who was about my age, carefully toward the pool. Out of curiosity, I asked my swim club manager about him and learned that he had a lifelong neurological condition and was here for aquatic therapy treatment. The manager told me that our club offers a special needs program called “Footprints.” However, because insurance often does not cover these types of therapies, most parents cannot afford to bring their disabled children with conditions such as cerebral palsy, severe autism, or traumatic brain injuries for the consistent aquatic treatment they need. This exposes a major policy failure in our healthcare system: America claims to offer world-class medical care, yet many children with complex disabilities receive only a fraction of the therapy their doctors prescribe.

The evidence is hidden in the insurance plan documents that few people ever read. Georgia’s Essential Health Benefits benchmark, for instance, caps outpatient physical and occupational therapy at twenty visits combined per year and sets a separate twenty-visit limit for speech therapy—numbers that evaporate by spring break if a doctor orders two or three sessions a week (Georgia Office of Insurance, 2025). Even when caps are not the immediate barrier, the infamous “plateau” clause is: Aetna’s national medical policy declares physical therapy “not medically necessary” once a patient’s condition is neither regressing nor improving, effectively halting coverage the moment progress slows (Aetna Medical Policy, 2025). For kids whose timelines stretch across years, that plateau comes early and often. Families who cannot handle steep out-of-pocket bills turn to Medicaid, where the Early and Periodic Screening, Diagnostic, and Treatment benefit flips the script by mandating coverage for any service that will “correct or ameliorate” a child’s condition, with no hard visit caps or cost sharing (CMS, 2014). Yet eligibility depends on income thresholds or long waiver waitlists, leaving many middle-income households stranded between skimpy private coverage and a public program they cannot reach.

Growing scientific evidence shows that aquatic therapy has a positive effect on individuals with special needs, yet it remains out of reach for many families due to insurance barriers. A 2025 systematic review found that aquatic exercise produced clinically meaningful gains in gross motor function for children with cerebral palsy, matching—sometimes surpassing—land-based programs (Pauluka et al., 2025). Warm water reduces gravity’s pull so stiff muscles can move, while hydrostatic pressure offers uniform deep-pressure input that calms the nervous system and eases spasticity. A 2021 mixed-methods study found quantifiable improvements in social competence, sensory regulation, and overall quality of life for children on the autism spectrum after only twelve weeks of aquatic sessions (Güeita-Rodríguez et al., 2021). However, insurers routinely classify aquatic sessions together as therapy under generic codes, and/or view them as non-evidence-based recreational experiences instead of therapeutic programs. 

Fixing this mismatch is not rocket science. Federal regulators could adopt Medicaid’s medical-necessity standard for private plans, clarifying that therapies preventing deterioration qualify for coverage. Congress could anchor private plans to a realistic national floor for habilitative therapy, such as one hundred combined visits per year for qualifying diagnoses, to ensure benefits do not vanish by mid-semester. The American Medical Association and the Centers for Medicare & Medicaid Services could establish a dedicated billing code for aquatic therapy tied to its true clinical value, giving hospitals and community pools a sustainable path to expand programs. If we enforce parity laws, prohibiting stricter limits on developmental therapies than on post-surgical rehabilitation, we can put a stop to the absurd situation where autism services face tighter caps than an ACL recovery plan.

Until those changes happen, kids with special needs will continue to struggle with limited access to essential therapies. A healthcare system committed to evidence-based practice should never force families to choose between mortgage payments and getting their child the therapy they need to thrive. To help address and bring awareness to this problem, I have taken the initiative to organize a pull-up contest at my swim club this summer to raise funds for the “Footprints” program, which will provide free aquatic therapy to children with special needs who otherwise could not afford it.