Let’s be honest.
You have every reason to be skeptical. If I were you, I would be. In healthcare, the loudest voices often belong to people with something to protect—whether it’s their profession, their company, or their ideology.
But that’s exactly why I’m writing The Signal: to provide you with the best arguments in big debates in healthcare, and show them side-by-side so you can decide for yourself.
This is not about “politics” or giving equal weight to snake oil and facts. Instead, I want to get doctors, patients, and everyone in between out of their information bubbles. In order to do this, I am going to intentionally present a wide range of ideological views to ensure you are exposed to arguments from across the healthcare landscape on big questions of the day.
You don't have to look far for prime examples of tense debates. The UnitedHealthcare shooting. Private equity in healthcare. AI in medicine. Clinicians, policymakers, patients, startup founders, and investors all have different narratives that struggle to intersect.
The result?
A system where real problems get buried under competing agendas and incentives. And the best arguments never surface to those who are hungry for the truth. That's where The Signal comes in.
How I will do it.
I am creating this newsletter as an antidote to the noise. The Signal is about steelmanning arguments, not strawmanning them.
Whenever you get an email from me, here is what it will look like:
The Big Issue: you will get the core facts about a major issue in healthcare, stripped of hype, spin, and industry bias. The basic information in the most neutral language possible.
The Fault Line: most healthcare debates involve a fundamental question: should we centralize or decentralize? I will analyze each issue through this lens:
- Big Healthcare (Centralized): Health systems, insurers, pharma, policymakers—those advancing for scale, structure, and oversight.
- Small Healthcare (Decentralized) Clinicians, patients, startups, and local innovators—those pushing for flexibility, Hayekian autonomy, and ground-up change.
I will provide you with data and quotes from the strongest cases from these points of view, so you can actually engage with the best thinking.
How I See It: as an open-minded clinician, I’ll share my honest breakdown of where the arguments hold up, where they fall apart, and what actually matters. This is an act of transparency, so that you know a little more about where I stand and my thought-process.
And that’s it.
I will keep it concise, nuanced, and worth your time. No fluff, no endless scrolling—just clear, high-signal data and analysis to help you think better.
What The Signal Isn’t
I am not here to moderate your views or push an agenda. I am not going to bring you to the campfire to sing “kumbaya”, and pretend we all agree.
The Signal is about exposure, not coercion.
It’s about expanding the debate, not agreeing on the conclusion.
Where you decide to plant your flag is up to you—I just want to make sure you see the whole map before you begin climbing.
About Me.
My name is Keith Sakata, and I’ve spent my career at the crossroads of medicine, technology, and business—not by design, but by accident.
I have worked in academic medicine for a long time, so I have the tools, sources, and experience to analyze healthcare trends thoughtfully, and especially through the lens of patient-first care.
I have worked in venture capital and product building, learning from the brightest in Silicon Valley. Also, I have worked in homeless shelters and given mental healthcare to San Francisco’s most vulnerable.
I am deeply skeptical of both the ivory tower of academia and of the moral hazards in the pharmaceutical industry. Every now and then I strongly align with one perspective on an issue, but it’s relatively easy for me to oscillate between agreeing between these voices, and I often find myself somewhere in the middle.
I’ve also struggled with finding my place in medicine. When I left internal medicine at Stanford, I had no master plan—just a relentless curiosity about the ideas shaping healthcare’s future.
That curiosity led me to psychiatry, venture capital, community care, and technology. It also made one thing clear: I’m tired of echo chambers. I’m looking for something deeper and closer to the truth.
- Truth over tribalism.
- Curiosity over certainty.
- A scout mindset.
- Skepticism without cynicism.
- Personal accountability.
Who is this for?
The Signal is for people who know they are not getting the full story in healthcare.
If you’re tired of healthcare’s echo chambers, frustrated by hidden agendas, and looking for deeper, sharper thinking about medicine, policy, and innovation, this is your space.
If that sounds like what you’ve been missing, join me. Subscribe. Let’s dig deep past the noise and find the signal.