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Seven Questions Before You Vote · Doctor AI: Rebuilding Trust in American Healthcare

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  This is Robin Blackstone from American Health Radio, bringing
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  you another of our special articles for the midterm elections.
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  Monday, we clarified the definitions about the issues that matter to your
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  health, and yesterday on Tuesday, we
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  published a state-by-state breakdown of how that will matter
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  in the state where you live.
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  Today, we are asking questions.
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  First, the questions you ask yourself, and then the same questions you ask of those
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  who are seeking your vote in the midterms.
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  This is as good a way as I know to understand who you are aligned
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  with and may want to support, at least on the topic of health.
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  Seven questions about health to ask yourself and anyone who wants your vote.
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  Ask them, write down the answer.
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  If it's an adjective, you have your answer
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  The image today is the, FDNY Fireboat Salute from New York Harbor, July 4th,
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  2026, the 250th anniversary of the United States, photographed by this author
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  Wednesday, October twenty-eighth, six days before election day.
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  Early voting is already open in many states, including New York.
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  Your state's dates and your polling place are on your state
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  page at robinblackstone.com, your state, and at vote.gov.
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  One of the privileges the Constitution gives us is the right, and I would
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  say the obligation, to question the people who represent us.
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  To do that well, you need the language, which is why Monday was definitions.
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  Yesterday, you got your own state, who holds the offices that shape your
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  health, from governor and medical board to insurance commissioner and Congress,
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  and who and what is on your ballot.
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  Today, I want to arm you with the questions and the reasons behind them.
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  Why questions?
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  Because the people on your ballot will spend this week telling you what
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  they believe about healthcare, and almost none of it will be checkable.
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  A question is different.
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  A question has an answer, or it doesn't, and you can hear which.
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  In the years I spent taking care of people, I learned that the most
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  useful thing in the room is usually the plainest question asked and then
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  left alone while the other pe-- person decides whether and how to answer it
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  These are seven.
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  They are written for a governor's race, but six of the seven work on anyone,
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  a legislator, a member of Congress, an attorney general, someone already
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  in office, the person in charge of health benefits at your company.
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  The links to the offices and their staff are on your state's page
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  at robinblackstone.com/yourstate.
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  That's the part where you fill in which one-- which state you're in.
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  They are also questions you might want to ask yourself.
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  Your own answers tell you where you stand and why, and how it compares to
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  the people you're evaluating for office.
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  The questions take no side.
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  Each one, each is one a Republican, a Democrat, an independent, or
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  you could answer well or badly.
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  Both below each is why it matters and what a real answer sounds like.
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  At the end, there are two things to do with them.
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  Number one, answer them yourself in the poll at the end of this piece.
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  Number two, ask the people who want your vote and tell us what
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  they said in the second form.
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  We publish the results without your name attached.
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  One, should I need a doctor's permission to use an AI tool for my own health?
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  Why it matters?
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  Today, anyone can ask an AI tool about his or her own symptoms, his or
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  her own lab results, his or her own medications, and get a useful answer.
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  The Medical Board's National Federation is now drafting model
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  rules on AI use with limited or no direct physician supervision.
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  In a committee with no members of the public in it, and your state's
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  board, appointed by the governor, will decide whether to adopt them.
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  The question is whether a doctor must stand between you and the answer.
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  Some will say this is a question of free speech, others of safety.
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  Both deserve a direct answer.
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  A real answer says yes or no, and then says who decides.
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  "I'd appoint board members who believe people can think about
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  their own health," is an answer.
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  "No, and here is the board I'd appoint to write the rules," is also an answer.
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  "We need to be careful with AI," is not an answer because it is neither.
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  Question number two, will you publish every year two figures?
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  How many people in our state have no insurance coverage, and how many were
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  seriously harmed by a wrong diagnosis?
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  Why it matters.
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  The Census publishes your state's uninsured figure every September, so a
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  governor should be able to say it from memory and name next year's target.
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  No state publishes a count of people seriously harmed by a diagnostic error.
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  By one published national estimate, that is about seven hundred and ninety-five
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  thousand Americans a year who die or are permanently disabled by the medical system
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  You cannot fix what you refuse to count.
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  A real answer is yes to both numbers and a date.
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  We'll look into it is not an answer.
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  Question number three, will you erase the medical debt hospitals
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  will never collect, as North Carolina did at no cost to the state?
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  Why it matters?
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  Most medical debt is never collected.
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  It sits on credit reports and on families taking the place
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  of a home or an education, and it hangs over people for years.
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  North Carolina erased more than six point five billion dollars of it by
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  making debt relief a condition of the Medicaid payments its hospital wanted.
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  Arizona and Illinois each erased more than one billion through a nonprofit partner.
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  Many hospitals are nonprofits.
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  This could be part of their obligation to the community.
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  This is a decision a governor can make.
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  The real answer says, "Yes, and here is the mechanism," or, "No,
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  and here's what I'd do instead."
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  Medical debt is a real problem is not an answer.
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  Question number four, who will you appoint to the medical board?
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  How long do they serve?
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  What share of them will be members of the public?
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  And does the board look like the people it licenses and the people it serves?
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  Why it matters?
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  The board licenses doctors and is about to write the rules on AI.
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  In most states, the governor appoints it.
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  Whether there is a member of the public at that table, someone whose job is not
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  medicine, decides whose interests are in the room when the rules are written.
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  Most boards today have a few public members among ten or fifteen physicians.
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  A real answer names the share and the kind of person.
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  The follow-up is what the current board looks like.
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  Question number five, will the people in this state keep their coverage next year?
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  How many exactly?
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  Why it matters?
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  The Congressional Budget Office estimates the twenty twenty-five reconciliation law
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  and the lapse of the enhanced marketplace credits add about fourteen million people
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  to the uninsured by twenty thirty-four.
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  Your state's share depends on decisions your governor and legislature make
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  this year, whether to expand Medicaid, how to run eligibility checks, whether
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  to backfill lost federal money.
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  Anyone who wants to run the state should know the number.
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  The real answer is a number and a plan.
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  Nobody will lose coverage is not an answer because the arithmetic says otherwise.
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  My plan covers everyone is not an answer either because it comes
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  befo-- it comes be-- unless it comes with the number and the money
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  Question number six.
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  What may a nurse, a pharmacist, or software do here without
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  a physician's signature?
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  Why it matters.
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  State law decides what ch-- what each kind of clinician may do on their own.
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  Every signature the law requires that is not about safety is a
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  fee paid in money or in waiting.
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  This is where access to care is actually set, and it is set in your
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  legislature, not in the plan structure.
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  A real answer names a specific change or defends the status quo on the evidence.
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  We should let providers practice at the top of their license is
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  a slogan until it names which license and what they practice.
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  Number seven, if I move to the next state with the same
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  insurance card, what do I lose?
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  What would you change so that I don't?
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  Why it matters.
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  The words on your insurance plan do not change at the state line.
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  But what it covers, who may treat you, and whether you qualify for help
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  if you lose your job, those all do.
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  A child's therapy, a telehealth visit, a Medicaid application,
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  each is decided state by state.
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  Texarkana, for instance, is one town with the state line drawn down
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  the middle of it, and the odds of being uninsured are nearly twice
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  as high on one of those two sides.
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  A real answer admits the gap exists and names one thing the candidate
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  could change and would change.
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  Pretending the state line does not matter is not an answer.
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  How states collaborate around this could be
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  What to do with them?
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  Answer them your f-- self first.
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  The seven questions are a poll at robinblackstone.com/sevenquestions.
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  It takes two minutes.
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  Friday, I publish the results by state with no names, and I'll
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  also publish my results on Friday.
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  Then ask your state page at robinblackstone.com/arizona/texas/missouri
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  has the official pages to reach your governor, your state legislatures--
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  lators, and your members of Congress.
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  And your state's election site lists every candidate on your ballot.
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  Ask one question, write down the answer, put it in the second form on the same
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  page, who you asked, which question, what they said, and whether they answered it.
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  Friday, I publish what the people who want our votes said when asked
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  office by office without party labels and without your name.
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  That is the whole method.
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  A question asked and answer recorded.
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  It is how medicine is supposed to work, and it is how a vote is supposed to work.
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  If the answer is an adjective, you already have your answer.
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  Where I stand.
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  I am not a member of either party.
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  This is not a paid announcement, and I am not raising money, and
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  nobody is paying me to write this.
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  I'm a surgeon with conflicts of interest like everyone in this field.
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  I founded the companies and the charity that carry this work
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  forward, and I write books about it.
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  None of them profit from how you vote.
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  Tomorrow, Thursday, five gifts the public has already paid for and
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  who can give them by Christmas.
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  If this is useful, forward it to one person who votes.
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  Vote your health, already paid for, first opinion.
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  This is Robin Blackstone, robinblackstone.com/sevenquestions.
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  Thank you for listening