HJBR Jan/Feb 2026

FIGHTING FOR CARE 14 JAN / FEB 2026 I  HEALTHCARE JOURNAL OF BATON ROUGE   podcast about the hidden crisis of moral injury among American healthcare work- ers. 22 Diljeet Singh, MD, an integrative gynecologic oncologist and president of Physicians for a National Health Program (PNHP), explained howwhat’s often labeled as “burnout”among healthcare profession- als is actually a deeper, systemic crisis that harms both physicians and patients, and is getting worse under our profit-driven healthcare system. Moral injury is a term that comes from the military. It describes the injury suf- fered by members when they’re forced to do something that goes against their moral center. Similarly, doctors and other health- care professionals — just like all those who shared with us unsolicited horror stories — suffer moral injury when they’re forced to go against their moral compass. These impossible situations happen when finan- cial concerns, not clinical judgment, deter- mine what kind of care a patient receives. As with members of the military, medical workers often feel betrayed by the system and their leaders. Singh also discussed a project to study moral injury that she’s been leading with the Robert Wood Johnson Foundation. I wasn’t surprised to hear her tell host Brenda Gaz- zar how healthcare workers who partici- pated felt comfortable sharing their sto- ries for the research project because the anonymity provided them protection from blowback at work. All along our journey, medical professionals of all stripes told us how much InHumana needed to exist, because they were forced to suffer in silence from what we now know is moral injury. During an October 2025 phone call with Singh, she told me how patients can suffer moral injury as a result of distrust, stem- ming from the fact that nothing you tell your doctor today is guaranteed to remain confidential. Unlike conversations with an attorney or confessions to a priest, things you disclose to your physician can be used against you in the future. This means folks aren’t always willing to provide accurate information about their behaviors and med- ical history, leading to lower quality health- care for untold patients. Singh also explained to me how some physicians add to the moral injury cri- sis by contributing to the growing level of distrust patients have for medical profes- sionals. How? By willingly creating con- flicts of interest between what’s best for the patient and what’s best for the doctor’s net worth. Patients increasingly feel obligated to research treatments to determine if they medically need to undergo them, or if their doctors are recommending certain proce- dures simply because they get some sort of kickback from them. This is a sad side effect of practicing medicine in an economic jungle. The Lown Institute, a nonpartisan think tank advocating for better patient care, recently published a report revealing how U.S. hospitals performedmore than 200,000 unnecessary back surgeries on Medicare patients in a three-year span, costing tax- payers more than $1.9 billion, and inflicting physical injury on patients. 23 “Complica- tions of spinal fusion occur in up to 18% of patients and include infection, blood clots, stroke, pneumonia, heart and lung prob- lems, and even death,” the report noted. According to their website, the Lown Institute believes that, “In a health system that works, patients receive all the care they need and none that they do not, while clini- cians take great satisfaction in their roles. Our society grows stronger, more stable, and more productive. “But the industrialization of health care has disrupted the healing relationship between clinicians and patients. Profits have been prioritized over healing. Too often, our systemnot only fails to heal, but creates new suffering.” 24 Sadly, there are many in the pro- economic-jungle-medicine crowd who are using the Lown Institute’s noble efforts as justification for employing AI to inflict untold moral harm on all Medicare beneficiaries. My take on that crowd’s argument is, “If the human doctors can’t police themselves with regard to overtreatment, let’s useAI to do it for them.” This is the argument propping upWISeR. Humanity’s most altruistic endeavor is forced to operate in an economic jungle, yet people are constantly surprised by how adversarial the system is. Moral injury will continue to erode the human infrastructure of our for-profit healthcare system. Ameri- can healthcare workers will continue to get worn down and chewed up by the machin- ery, caught between intractable contradic- tions in an inherently cruel system. Sadly, as long as opportunities exist to profit from the misery of human beings, exploitation will persist. n REFERENCES 1 Medicare appeals like my mom’s are usually pri- vate rather than public. Out of concern for her protected health information, we have not pub- lished the full documents and the audio provided to us from OMHA from the appeal hearings. 2 Barrows et al. v. Humana, Inc., Healthcare Liti- gation Tracker, O’Neill Institute for National and Global Health Law Georgetown University Law Center, https://litigationtracker.law.georgetown . edu/litigation/barrows-et-al-v-humana-inc/. 3 Estate of Gene B. Lokken et al. v. UnitedHealth Group, Inc. et al., Healthcare Litigation Tracker, O’Neill Institute for National and Global Health Law Georgetown University Law Center, https:// litigationtracker.law.georgetown.edu/litigation/ estate-of-gene-b-lokken-the-et-al-v-united- health-group-inc-et-al/. 4 “Quality Improvement Programs,” Centers for Medicare & Medicaid Services, n.d., https://www. cms.gov/medicare/quality/quality-improvement- organizations. 5 “Chapter 8: Coverage of Extended Care (SNF) Services Under Hospital Insurance,” Medicare Benefit Policy Manual, Centers for Medicare & Medicaid Services, October 5, 2023, https://www. cms.gov/regulations-and-guidance/guidance/ manuals/downloads/bp102c08pdf.pdf. 6 Medicare appeals like my mom’s are usually pri- vate rather than public. Out of concern for her protected health information, we have not pub- lished the full documents and the audio provided to us from OMHA from the appeal hearings, but we did post this audio snippet from the hearing: https://www.youtube.com/watch?v=SWtIYIL0jIo. 7 Medicare appeals like my mom’s are usually private rather than public. Out of concern for