Michael Fine
As seen in:
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Articles by Michael Fine
Dr. Michael Fine: What’s crazy about tuberculosis in 2026
I had the opportunity to attend a valuable and important lecture on tuberculosis (TB), given by a real expert who has just joined our medical community, an expert who exhibited tremendous kindness and grace as they gave their presentation. Few Americans think much about TB anymore – most of us think about it as a disease of the past, a disease of old romantic poets and teeming slums, one that seems irrelevant to our daily life.
Ninth Circuit Leaves Core California Emissions Disclosures in Place
On November 9, 2026, the U.S. Court of Appeals for the Ninth Circuit in United States of America Chamber of Commerce et al. v. Sanchez et al., No. 25-5327 (9th Cir. Nov. 9, 2026) declined to block SB 253’s Scope 1 and Scope 2 emissions disclosure requirements but held that its Scope 3 disclosure requirements and SB 261’s climate-related financial risk reporting requirements likely violated the First Amendment.
Ninth Circuit Leaves Core California Emissions Disclosures in Place
On November 9, 2026, the U.S. Court of Appeals for the Ninth Circuit in United States of America Chamber of Commerce et al. v. Sanchez et al., No. 25-5327 (9th Cir. Nov. 9, 2026) declined to block SB 253’s Scope 1 and Scope 2 emissions disclosure requirements but held that its Scope 3 disclosure requirements and SB 261’s climate-related financial risk reporting requirements likely violated the First Amendment.
Dr. Michael Fine: What’s crazy about health care in the Governor’s race
So it’s that time again. Too many campaign commercials and appearances. Not enough substance. Healthcare turns out to be important for any governor to know and know well, although I’ve never met one who does. Healthcare, via Medicaid, consumes more than 30 percent of Rhode Island’s budget. It’s also the largest sector of the state’s economy and the sector that employs the most people, so we might want a governor who knows healthcare inside and out.
The War Against People – a short story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What’s crazy about Medicaid Part D
It’s Medicare reenrollment time again, which means everyone with Medicare gets to look at how much they’ll spend, what they get and the choices that are available to them for the next year. The money, of course, is crazy. Everybody pays at least $202 a month but higher income people pay more, with a cost that tops out at $689 a month (but tops out at $689 a month for incomes above $750,000 a year, even for incomes in the millions or billions.) There are copays and deductibles on top of all that.
Dr. Michael Fine: What’s crazy about health insurance isn’t just what it costs
Now we have the numbers. The cost of health insurance in Rhode Island is going up again. Health Insurance for small employers is going up an average of 3.8 percent; for individuals, bought through HealthSource RI, an average of 12.4 percent; and for large employers, insurance is going up 9.5 percent.
The Dean’s Life: A short story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
The Dean’s Lie: A short story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What’s crazy about hospitals and billing redux
From the You Can’t Make This Stuff Up But It Makes Your Skin Crawl Department. A friend in Texas, with newly diagnosed breast cancer, had to be scheduled for bilateral mastectomies. All quite traumatic and scary. As part of the process, she needed a preparatory procedure. She’s a doctor – she knows the “system” (so-called) as well as anyone, and she has world class insurance. Insurance with copays and deductibles to be sure, but still excellent insurance from a nationally known company.
Nurses Transforming Healthcare completes mission, advances work with Primary Care for All Americans
After five years of educating, advocating, and piloting a new vision for healthcare, Nurses Transforming Healthcare (NTH) has reached an important milestone: the organization has successfully fulfilled the purpose for which it was created. NTH was established to advance a vision of healthcare that recognizes healthcare as an essential service rather than a profit center, while elevating the importance of strong, community-based primary care.
Dr. Michael Fine: What’s crazy about who we lost in August
Ed Ehlinger, M.D. Wendell Berry, and Dolly Parton. These are three people whose lives made a difference to us and to me and to your health, three people we lost in August. Ed Ehlinger was a doctor who trained in both internal medicine and pediatrics, and who practiced public health. We met while he was the Director of the Minnesota Department of Public Health, a position he held for six years. He was a wild and sometimes goofy guy.
The Equinox – a Short Story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What’s crazy about COVID and flu vaccines in 2026
I got a Pfizer COVID vaccine last night from Walgreens. And no, RFK Jr, I didn’t die. I didn’t feel a thing, and I feel fine now. No magnetic particles are letting extraterrestrials control my thoughts from space, at least not as far as I can tell. We are in the late summer COVID spike, so likely 10-15 percent of us will get COVID this summer, but few of us are at much risk from it.
Dr. Michael Fine: What’s crazy about COVID and flu vaccines in 2026
1:15 5 hours ago Grandpa With Dementia Goes Viral As Amateur Photography Gets Attention It Deserves | Happily Happily • 5h A beloved grandpa who spent his adult life traveling the world, taking amazing amateur photographs of animals and landscapes along the way, is finally getting the recognition he deserves, thanks to the help of his granddaughter. 87-year-old Clyde Elmore recently started struggling with dementia, which has seen him forget where he took some of his stunning images.
Dr. Michael Fine: What’s crazy about Dr. Fauci and helicopters?
This week the US Senate Homeland Security Committee voted to hold Tony Fauci in contempt of Congress for pleading the Fifth when he testified before the committee. What a mess. At one level, this is embarrassing to me because it represents a very public brawl between two physicians – Senator (and Doctor) Rand Paul, who is an ophthalmologist and the son of a obstetrician-gynecologist, and Dr. Tony Fauci, who is an internist, infectious disease specialist and immunologist.
A Short Story by Michael Fine: “Now Vern Has a Groundhog in the HAVAHART Trap”
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: Why it’s crazy we don’t have community paramedicine everywhere in Rhode Island
One of the things driving health care cost increases in the US is the way people use emergency rooms for routine medical care. Between 40 and 88 percent of all emergency room visits are for diseases and conditions that don’t require hospitalization – for colds and sore throats and simple sprains, headaches and back pain. The cost difference is outrageous. A same-day visit to a primary care clinician runs between $100 and $170. The average cost for an emergency room visit is between $2400 and $2800.
Dr. Michael Fine: What’s crazy about health care in Lithuania
I’ve just returned from a brief research trip to Lithuania, which wasn’t focused on health care. But while I was there, I had the opportunity to discuss the Lithuanian health care system with a colleague who runs the district health center of a small Lithuanian city. I learned that Lithuania, like most of Europe and the developing world, has a single national compulsory insurance fund, so everyone has a way to pay for health care. Working people contribute from their wages or income.
Rhode Island Weather for June 29, 2026
On Monday, June 29, 2026, in Rhode Island, look for a mostly sunny and very pleasant summer day with comfortable warmth and low humidity. WEATHER NOTE: Starting Thursday serious heat and humidity is expected to come in and stay for a few days – with heat humidity indexes in the low 100s. Morning starts nice and cool with lows in the low-to-mid 60s under partly to mostly clear skies.
Business Monday: The 4th of July and Marketing – Bob Salvas
by Bob Salvas, contributing writer One of the challenges in marketing and business development is getting your message noticed and remembered in a world where there is an overabundance of communication going on. How do you break through the clutter? It may be helpful to understand more about how people process information. Have you ever tried just to memorize some random information? It can be challenging. One way to make it easier is to use schema-based learning.
Rhode Island said “No Thanks” to The Great American State Fair. Why?
All 50 states and six U.S. territories were offered exhibit space at the national 250th birthday exposition. Rhode Island’s booth was built, marked “RI” — and left dark, locked and unstaffed. All 50 states and six U.S. territories were invited to the Great American State Fair in Washington, D.C., to showcase their culture, history and industries.
Man Loses Cellphone in Italy: A Short Story By Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What’s crazy about decent medical care
I ran into my friend Bert last night and we got to talking. “I hear you guys talking about medical care, about how it is for-profit and lots of people are using it to make too much money on the backs of communities,” he said. “But my care is great. I go to Oak Street. I see a nurse practitioner. She’s great. She takes all the time I need with me. She explains things. And you know me. I have lots of questions. If I need to see a specialist, they set it up.
Dr. Michael Fine: What’s crazy about sending a 102-year-old home from rehab on a Friday
A 102-year-old man I know is likely to be sent home from rehab today. This 102-year-old man lives in another state. Until three weeks ago, he was driving, playing tennis, and living in his own home. Over the last few months, he developed leg swelling and then shortness of breath, likely the result of some heart failure and some disturbances in the heart’s rhythm, which put him in the hospital for about a week.
Man on a Motorcycle with a Cougar Riding on the Back: A Short Story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What’s crazy about Hantavirus and Ebola
Hantavirus on a ship, spreading person to person. Ebola spreading in the Democratic Republic of Congo and in Uganda. 13 cases of Hantavirus, with three deaths. Over a thousand known cases of Ebola, with 17 confirmed and about 240 suspected deaths. What’s the world coming to? Is this the Zombie Apocalypse? My first advice is to calm down. Excellent public health work appears to have contained the outbreak of Hantavirus by quarantining exposed people.
Dr. Micheal Fine: What’s crazy about firing the Commissioner of FDA
So the saga aka circus in health care in Washington continues. This week Marty Makary MD, the Commissioner of the FDA, resigned/was fired by RFK,Jr. and the Trump administration. I didn’t know Dr. Makary but I have colleagues who do. We once presented at the same conference and were in a room together, but I don’t have much of a sense of him as a person.
Dr. Michael Fine: What’s crazy about dental cleanings and prevention Original
I’m a big fan of prevention, understanding that everyone dies of something, and not all health problems are preventable. That said, it’s crazy how our fears about illness and death overwhelm our better judgment from time to time, and how people with a service to sell sometimes let their ambition get in front of the science, even when it is just an ambition to prevent every illness and disease. Take dental cleanings, an arena in which I am a patient, not an expert.
Is Hope an Illusion That Lets Us Tolerate the Destruction of Who and What We Are? – A short story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What’s crazy about what insurance companies want – and a little about our politics
I was asked to look at a few bills about primary care that were presented this week for hearing in the legislature. One of these bills allows physicians to charge administrative or operational fees to support their overhead. Another allows physicians to charge optional fees for non-covered services.
Dr. Michael Fine: A new med school at URI is a crazy good opportunity
Some friends and colleagues from Brown University Health are arguing that Rhode Island doesn’t need a new medical school at URI – and that such a new medical school won’t help address Rhode Island’s primary care physician supply crisis. One part of that is true. If you dropped a medical school from outer space into Rhode Island, that by itself won’t change the number of primary care physicians in Rhode Island.
The Use of Force: a Short Story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
The Use of Force: a Short Story by Michael Fine
Read more short stories by Michael Fine, go here: https://2×8.ea2.myftpupload.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Michele Gallagher: A spotlight on modern-day women who are unearthing Revolutionary history
“Behind the Lines: Unsung Women of the American Revolution”was a full-weekend lecture series held in mid-March in Portsmouth, hosted by the Brigade of the American Revolution and sponsored by the Debra Najecki Endowment at Portsmouth Friends Church. The conference brought together dozens of authors and historians to highlight the crucial, often overlooked roles women played in the fight for independence—as spies, soldiers, diplomats, poets, and strategists.
Dr. Michael Fine: What’s crazy about hospitals and money
It’s budget time again at the Statehouse. I’m hearing that Rhode Island’s hospitals are asking the legislature for money. Again. This happens every year, and usually the hospitals tell us about a crisis that provides a very good reason for those hospitals to get another $100 million of our tax dollars. This year the crisis is the number of people who are losing health insurance because of the loss of federal subsidies that supported lower premiums for people who buy insurance through HealthSourceRI.
Dr. Michael Fine: What's crazy about blood
As you may have read, the Rhode Island Blood Center has put out a call for blood donations – and it is extremely important that you donate if you can. Lives literally depend on these donations, for which there is no effective substitute. AI can’t donate. You can. Please consider it. That said, understanding how much blood costs, and why, may help us understand why all our health care is so damned expensive. First fact – all blood starts out free. All the blood in the United States is donated.
What Causes Autism: A fictional short story by Michael Fine
Read more short stories by Michael Fine, go here: https://rinewstoday.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What's crazy about paying for medical school
Before I describe the incredible cost of medical school, I want to mention how I paid for my medical education. I didn’t. You did, and I am very grateful for that. Like about 1800 other American medical students in 1979, I was lucky enough to get a National Health Corps Scholarship, which paid my tuition, gave me money for books, and gave me $550 a month (about $2600 today) to live on.
Dr. Michael Fine: What’s crazy about tetting into medical school. Part 1. - What's Up Newp
Ok. We are somewhere between 50,000 and 300,000 doctors short. Probably more, given our current approach to immigration, because 25 percent of all doctors in the US come from other countries – because we don’t send enough of our own students to medical school. Instead, we import our doctors from elsewhere, from places who need them more than we do.
The Prince of the Apple Towns: A short story by Michael Fine
Read more short stories by Michael Fine, go here: https://rinewstoday.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What's crazy about keeping Roger Williams and Fatima Hospitals alive?
We are now seeing the predictable twisting in the wind as our state leadership struggles with what to do about Roger Williams and Fatima Hospitals, which are bankrupt. Nobody in state government likes to see hospitals close, in part because people work at hospitals and those people vote, and their unions have lobbying power.
Dr. Michael Fine: What's crazy about medicine
This week’s column is about two apparently unrelated events: my re-reading of The Citadel, by AJ Cronin, a classic novel/tearjerker about a British General Practitioner, written in 1937, and the new nutrition guidelines from HHS put forward by RFK Jr. There is a common thread, I promise, which is that medicine and health are not the same: that what we want is health but what we do is medicine, and that’s crazy, because health requires us to eat well and exercise, to spend time with people we...
Somehow - A short story by Michael Fine
Read more short stories by Michael Fine, go here: https://rinewstoday.com/dr-michael-fine/ Michael Fine, MD is currently Health Policy Advisor in Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc.
Dr. Michael Fine: What's crazy about the work we ask healthcare workers to do
I spent the last few weeks studying and taking tests so I can continue my Board Certification (in Family Medicine). Physicians and other health care workers are licensed by the State of Rhode Island and must pay a hefty fee for that privilege, as well as show evidence that we have studied the new developments in medicine and in our specialty. Physicians must complete a three-to-five-year residency and pass a certifying examination in order to become Board Certified.
Dr. Michael Fine: What’s crazy about the Hepatitis B Vaccine and SNAP
This has been two weeks of particular craziness in health care, in which everyone, on all sides, did their level best at missing the boat. First, our friends at CDC’s Advisory Committee on Immunization Practices went ahead and changed the recommendation for Hepatitis B vaccine for newborns, a crazy change if ever there was one.
Words Will Never Hurt Me, a short story by Michael Fine
Words Will Never Hurt Me By Michael Fine © 2025 by Michael Fine This is a work of fiction. Names, characters, businesses, places, events, locales, and incidents are either the products of the author’s imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental. “Stop blaming Trump,” Jeffery said as he rolled over in bed. “Government depends on the consent of the governed.” It was early fall.
Dr. Michael Fine: What's crazy about vaccines and RFK Jr., redux
First, now is the time to get a flu shot if you haven’t gotten one already. Flu is spreading in some southern and western states. Holiday travel will bring it here. Don’t delay. That said, I got the bill for the COVID-19 shot I had last month. Or rather, I got a record of the bill my insurance company got and paid. The nice retail pharmacy where I got the shot billed $249.99 for the vaccine and for giving me the jab.
Dr. Michael Fine: What's crazy about vaccines and RFK Jr., redux - What's Up Newp
5 hours ago HARTFORD, Conn. (AP) — Approximately $3.6 billion in delayed funding for the Low Income Home Energy Assistance Program, or LIHEAP, was released Friday to states and tribes, according to the National Energy Assistance Directors Association. The federal funding for LIHEAP, which helps millions of …
Ninth Circuit Enjoins Enforcement of California Climate Disclosure Law SB 261 | JD Supra
On November 18, 2025, the U.S. Court of Appeals for the Ninth Circuit granted an injunction blocking enforcement of SB 261, the California law requiring certain companies to biennially report their climate-related financial risks, just weeks ahead of the January 1, 2026 reporting deadline.
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