The Leaking US Health Care Aqueduct — A Cartoon
- T Michael White MD FACP
- Dec 11, 2024
- 1 min read
By Ibrahim I Ghobrial MD MRCP FACP
“Should you find yourself in a chronically leaking boat, energy devoted to changing vessels is likely to be more productive than energy devoted to patching leaks.” - Warren Buffett
Monday, December 9, 2024
Dear Mr. President, Honorable Members of Congress and Distinguished Staff and Fine Citizens,
The following sketch depicts the perspective of patients and physicians (many who are patients too). Resources are pumped into the system, but because of chaotic inefficiency (leakage), little makes it to the tap (to the point of care).

We (patients and physicians) implore you to please find a way forward to dramatic change to realize compassionate, safe, timely efficient, effective, equitable (just), patient-centered care (C-STEEEP) for all.
Respectfully submitted,
Ibrahim I Ghobrial MD MRCP FACP
Pittsburgh
Copy to: We The People at fixingushealthcare.com

Yes, a picture is worth...
Thank you (again) Dr. Ghobrial.
What a tremendous illustration of a complex set of issues! And these are just the tip of the iceberg. Probably the most important message of all, though, of this cartoon is that the patients bear the brunt of all of the inefficiencies and inequities of our healthcare 'system,' ironically ending up sacrificing their health in the process. Unfortunately, it also illustrates the difficulty of 'fixing' these issues, as they are all interdependent, and addressing one can have unpredictable effects on the others. Great job, Dr. Ghobrial, capturing so much of what we're talking about in a single illustration!