The amount of U.S. spending on healthcare reached four and a half trillion dollars in 2022, or about $14,000 per person. Despite such massive spending, many aspects of American healthcare are marred by problems. There’s the shortage of primary care doctors. An emphasis on treating disease rather than promoting long-term health. Locally, doctors can make more in neighboring Massachusetts and Connecticut than they can in Rhode Island. And the state’s hospitals are overly dependent on Medicare and Medicaid, rather than the more lucrative reimbursement paid by private insurers. This adds up to a series of complicated challenges, if not a worsening crisis. State government has started making some efforts to respond, but these remain at an early stage. So what will it take to put healthcare in Rhode Island on a better footing? Does the state have too many hospitals? And is it possible to create a system more responsive to everyday people than insurance companies and healthcare executives? This week on Political Roundtable, I’m going in-depth with author, community activist and former state Health Director Dr. Michael Fine.

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