Solving Healthcare’s Math Problem

Douglas A. Koekkoek, MD


Jan 2, 2026


Healthcare Administration Leadership & Management Journal


Volume 4, Issue 1, Pages 23-25


https://doi.org/10.55834/halmj.5967981206


Abstract

U.S. healthcare faces a financial crisis as expenses outpace reimbursements, threatening system sustainability. The COVID-19 pandemic depleted reserves while labor costs surged. Traditional efficiency measures are exhausted, and an aging population with chronic disease burdens the system further. Seven transformative strategies are proposed: promoting healthy behaviors to reduce chronic disease; minimizing futile end-of-life care; implementing coordinated care models for chronically ill patients; simplifying reimbursement systems; shifting from fee-for-service to outcome-based payment; creating vertically integrated healthcare systems; and redirecting care to lower-cost settings. Strong leadership and fundamental restructuring — rather than simply increasing reimbursements — are essential to avert healthcare system collapse and ensure accessible, quality care.




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