Each new year brings fresh promises of healthcare reform: new technologies, policy proposals, pricing models and delivery innovations. Yet for patients, clinicians and health system leaders alike, progress often feels uneven and unpredictable. As 2026 began, I asked readers to step back and consider the healthcare system as a whole. Here are the results:
My thoughts: Several responses stand out. On the first question, readers are split between two poles: nearly half expect American medicine to remain largely unchanged in 2026, while a third anticipate major deterioration. Taken together, these views suggest a shared skepticism that healthcare’s incumbents (doctors, hospitals, insurers and drug companies) will drive meaningful transformation on their own. For those expecting decline, the concern appears less about clinical care itself and more about the risk that actions by federal agencies (including the CDC and FDA) could exacerbate existing problems rather than resolve them.
Responses to the second question reveal a more striking consensus. Nearly two-thirds of readers believe that any meaningful change in 2026 is most likely to come from technology, including AI and digital health tools. That result is notable given how recently (within the past year, even) skepticism toward generative AI dominated public and professional debate. While the survey did not ask respondents to distinguish between beneficial and harmful disruption, I believe the meaningful change will benefit rather than harm patients and providers alike.
Thanks to those who voted! To participate in future surveys, and for access to timely news and opinion on American healthcare, sign up for my free (and ad-free) newsletter Monthly Musings on American Healthcare.
