Coleman Publishing
Broken Promises is an investigative nonfiction series examining how financial incentives, policy failures, and institutional power reshaped American healthcare — and what it will take to rebuild it around patients instead of profit. Created by Robert Coleman, a former VA Director of Clinical Pharmacy Services, the work spans a growing library of books and a three-part documentary trilogy, each following the same throughline from a single pharmacy receipt to the architecture of the entire system. The dream behind it is simple: a healthcare system Americans can actually trust.
These publications argue that meaningful healthcare reform requires confronting the financial incentives and policy failures shaping modern medicine. Together, they document systemic harm and outline practical pathways toward accountable, patient-centered care.
Browse by Subject
Broken Promises isn't one book — it's a growing body of investigation into how American healthcare works, why it costs what it does, and what the evidence says about fixing it. Start with a subject, or read the full overview first → Want the receipts behind every figure? Browse the annotated bibliography → Represent an organization, classroom, or newsroom? See what's here for you →
Every Source, Verified
Every GAO audit, JAMA study, and CDC report behind the numbers on this site — linked, verified, and organized by topic.
Browse the sources →Healthcare Costs
The evidence, in one place: drug pricing, insurance overhead, and consolidation — why the gap is prices, not how much care Americans use.
Read the research guide →Prescription Drugs
The hidden supply chain behind a prescription's price — manufacturers, middlemen, and the law that keeps Medicare from negotiating.
Read the research guide →Insurance & Financing
Denials, consolidation, private equity, and the financial machinery that came to matter more than the medicine it was built to support.
Read the research guide →Money & Power
Insurers, PBMs, hospital systems, and private equity each earn money at a different link in the chain — sourced and explained, actor by actor.
Read the research guide →Reform Failure
Six decades of legislation, expanded coverage, and unchanged cost trends — the structural reason incremental reform keeps getting absorbed.
Read the research guide →Single-Payer
What single-payer actually is, how it would be financed, the evidence for and against it, and the state-level bill already drafted.
See the policy case →Science & Public Health
How public trust in the CDC collapsed during COVID-19, and how the NIH, CDC, and HHS were reshaped in 2025 — two investigations, one crisis.
Read both investigations →Reform & Design
The design questions any replacement has to answer, and three proposals that try — Beyond Reform, Replace Don't Reform, and One Card, One Cure.
Read the research guide →The Full Investigation
From a single pharmacy receipt to the architecture of the entire system — the three-book investigation that started it all.
Start the trilogy →A documentary trilogy by Robert Coleman. Why do Americans pay more for healthcare than anyone else on earth — and get less certainty in return? The American Healthcare Investigation is a three-part documentary nonfiction trilogy that asks that question and follows the evidence wherever it leads, from a single pharmacy receipt to the architecture of the entire financing system built around American medicine. Each volume stands on its own. Together, they form a single continuous investigation, moving from discovery to understanding to design.
Read the full trilogy overview →
Book One · The American Healthcare Investigation
The Hidden Story Behind America's Prescription Drug Prices
Same pill, same factory, same company — a different price at every counter in America. A former VA pharmacy director follows a single prescription backward through manufacturers, hidden middlemen, and a twenty-year-old sentence in federal law and finds that another arm of the same government pays roughly half as much for the identical drug.
Book Two · The American Healthcare Investigation
How American Healthcare Became a Business
A routine diagnosis, delayed six weeks by an insurance review that had nothing to do with medicine, sends the investigation into the machinery behind American healthcare — denials, debt, consolidation, and the arrival of Wall Street — and asks how financing came to matter more than the care it was built to pay for.
Book Three · The American Healthcare Investigation
Designing the Future of American Healthcare Financing
If America were designing its healthcare financing system today, what would it build? The trilogy's final volume sets aside politics for design principles, studies what other nations have learned, and argues — carefully, and without naming a winner — that the honest answer is not another repair, but a new foundation.
Every elected official, every public servant, and every healthcare professional accepts a responsibility to serve the public interest.
Americans expect their leaders and healthcare institutions to protect their health, steward public resources wisely, and place the well-being of patients above political and financial interests. These are more than policy objectives—they are fundamental promises that define public service and the purpose of healthcare.
Yet millions of Americans experience a healthcare system that is increasingly expensive, complex, and difficult to navigate. We spend more on healthcare than any other nation, while patients continue to struggle with affordability, access, quality, and trust.
These realities raise an unavoidable question:
Have we drifted away from the promises that healthcare and public service were meant to uphold?
Broken Promises is my effort to explore that question.
Drawing on more than four decades of experience as a clinical pharmacist, healthcare executive, researcher, and educator, this website brings together research, books, audiobooks, video, and ongoing analysis examining how American healthcare arrived at this point, how financial and political interests influence the system, and what evidence tells us about the possibilities for meaningful reform.
This is not an effort to assign blame to one political party, ideology, or institution. It is an effort to understand the system, examine the evidence, ask difficult questions, and hold those entrusted with our healthcare accountable.
“Broken promises can be repaired—but only when they are first acknowledged.”
The goals of Broken Promises are straightforward:
Healthcare reform requires more than political slogans. It requires informed citizens, engaged professionals, credible evidence, ethical leadership, transparency, and accountability.
Broken Promises is intended to be a resource for that work.
Whether you are a patient, healthcare professional, researcher, educator, policymaker, student, journalist, advocate, or simply someone who wants to understand American healthcare better, you are invited to explore the evidence, question the status quo, and participate in the conversation.
Real reform begins with understanding.
It continues with informed discussion.
And ultimately, it depends on people deciding that healthcare can—and should—work better.
“Healthcare belongs to the American people. Together, we can reclaim its purpose.”
Kindle eBook · 2026
COVID-19 and the Cost of Certainty
In spring 2025, 77% of American adults trusted the CDC's health recommendations. One year later, 50% did. Broken Trust investigates what that 27-point collapse actually measured — and argues that institutions and their critics failed the same way, for the same reason: both claimed more certainty than they possessed.
"Confidence is a claim about the world. Certainty is a claim about oneself."
Kindle eBook · 2026
The Crisis Inside NIH, CDC, and HHS
Three children died of measles in the United States in 2025 — a disease eliminated here twenty-five years ago, preventable by a vaccine that has existed since 1963. When Science Became Political is an investigation into how that became possible. Robert Coleman, a retired clinical pharmacist with forty years in medicine, documents the leadership, the claims, the firings, the cancelled research, and the consequences already on the record. Every significant statement is sourced. The book states plainly where the evidence is contested, and where it is not.
"The evidence is not merely a warning about the future. It is a description of the present."
Kindle eBook · 2025 · Companion to Unnecessary Deaths
The urgent companion volume to the original investigation, built around the five converging failures driving preventable American mortality today:
"This book is that autopsy. And it is a warning."
Get it on Kindle →
Kindle eBook · 2026 · Companion to Hostile Takeover
The U.S. spends 17.7% of GDP on healthcare — about $15,000 per person per year — and has the lowest life expectancy in the G7, with an estimated 68,000 preventable deaths a year. Medical debt is the number one cause of personal bankruptcy. This is not dysfunction. It is the design.
A twelve-chapter citizen's guide to what actually went wrong with American healthcare — and what will fix it. It shows, with numbers, why every incremental reform of the past fifty years has been absorbed by the same extraction layer sitting between patients and care. Inside:
Not the same book as the trilogy's Beyond Reform — how the two relate.
"The problem isn't complexity. It's control."
Kindle eBook
Three in ten Americans skip a prescription because they cannot afford it, and the United States pays two to three times more per person on prescription drugs than any other wealthy country. Rigged at the Counter explains why.
Former VA Director of Clinical Pharmacy Services Robert Coleman traces the machinery behind American drug pricing — the single sentence in a 2003 law that bars Medicare from negotiating, the pharmacy benefit managers who quietly keep the rebate money, and the reason a $7,000-a-month biologic in a U.S. pharmacy costs $1,400 in the United Kingdom. Drawing on the federal law that lets the VA pay 54% less than Medicare for the same medicines, Coleman shows what fair pricing looks like when Washington is willing to bargain — and lays out six levers any Congress could pull to close the gap.
The instability in American healthcare is structural, not accidental. These works investigate the systematic transformation of care delivery into financial products — and identify pathways toward restoration.
How Wall Street and Congress Took Over Healthcare — and How We Can Take It Back
Available as eBook, Audiobook, and serialized Substack edition. Not the same book as the trilogy's Behind the System — how the two relate.
A data-driven investigation into preventable harm within American healthcare systems
Substack Analysis: weekly serialized chapters and healthcare policy breakdowns.
A practical blueprint for citizen-led healthcare reform
Describes a practical three-phase reform plan, the Washington Health Trust — a drafted state-level prototype designed to end denial-driven insurance practices and cut administrative waste. This legislative bill is again before the Washington state legislature in early 2026, building on decades of single-payer advocacy.
Video content exploring healthcare policy analysis, structural reform, and book discussions — policy breakdowns, deep dives, and structural reform analysis.
Every factual claim on this site and in these books is sourced — to government data, peer-reviewed research, court records, or other primary sources. Where a figure is a model or projection rather than an observed count, we say so, and report the range rather than a single headline number. If you believe a citation has been misrepresented, tell us — we want to know. See every source, verified and linked, in the annotated bibliography →
Forty years in medicine, sixteen of them as Director of Clinical Pharmacy Services at the VA Palo Alto Health Care System. He writes as an investigator, not an advocate.
Four decades of service within the United States Department of Veterans Affairs, working directly within federal healthcare systems as practitioner, researcher, and reformer. Director, Clinical Pharmacy Service at Palo Alto VA for 16 years.
Extensive peer-reviewed publication history spanning infectious disease, pharmacokinetics, anticoagulation therapy, and medical informatics. Academic contributions available via Google Scholar.
Evolution from frontline clinical practitioner to system-level critic, examining the financial architecture and policy incentives that transformed American healthcare delivery.
"Reform begins with structural understanding."
Represent a policy organization, publication, or classroom? See how to use this research →
As Heard on Code WACK!
Two recent Code WACK! segments drawn from the investigation — on drug pricing, and on how insurance denials actually work.
Questions about the research, speaking engagements, or reform collaboration — reach out directly.
Prefer email? Reach out directly at bob.w.coleman@gmail.com