Making America Healthy Again (Really)

What a year this has been.

When President Trump graded his economic policies, he gave America’s economy an A++++. I’m not an economist — that’s not my lane. But I am a consumer, and this grade is consistent with a man who claims to have decreased drug prices by 400–600%. Until drug companies start sending me cheques when I pick up prescriptions, I believe neither claim.

I am a surgeon and a patient. As 2025 comes to a close, I can give America’s health a grade. According to HHS Secretary RFK Jr., his mandate was to make America Healthy Again.

He gets a failing grade.

This year brought more medical debt, lower-quality care, worsening physician shortages, and less access to healthcare. A weakened federal safety net and financial harm followed, leading to the closure of crucial hospitals. Policy changes delivered suffering with striking disregard.

Every year, I make resolutions: personal goals to become a better version of myself. These are my resolutions for America. Because regardless of how I feel about Secretary Kennedy, if he succeeds, we all benefit.

How to Make America Healthy Again (Really)

1. Expand and Strengthen Healthcare Coverage

The Crisis: Nearly 140 million Americans have faced financial hardship due to medical expenses. We collectively owe $220 billion in medical debt.

What We Need

• Reverse at least $1 trillion in Medicaid cuts and end work requirements that could affect the coverage of 36 million Americans.
• Permanently extend enhanced premium tax credits beyond 2025, so 4.2 million people retain their marketplace health coverage.
• Establish a new public insurance option that directly competes with private insurers to create more affordable choices.
• Expand Medicaid in all states to cover individuals up to 138% of the federal poverty level.
• Reinstate the CFPB medical debt rule, removing medical debt from credit reports.
• Cap out-of-pocket costs for all insurance plans.
• Automatically enroll eligible individuals in financial assistance programs to ensure no one misses out due to paperwork barriers.

2. Stabilize and Support Safety-Net Hospitals

The Crisis: Rural hospitals operate at a median margin of 1.0%. Nearly half run at a loss. 432 are vulnerable to closure. Create a Rural Hospital Stabilization Fund with direct federal financial support specifically earmarked for rural hospitals at risk of closing.

• Increase Medicaid reimbursement rates to match the actual costs of care.
• Expand protections under the 340B drug pricing program.
• Provide infrastructure grants for hospital modernization.
• Reward hospitals serving high proportions of the vulnerable population. Implement federal oversight and approval for private equity companies acquiring hospitals, modeled after Massachusetts regulations, to prevent destabilizing closures.
• Prohibit surprise billing and predatory debt collection.
• Ban facility fees for tele-health and off-campus care.

3. Address the Physician Shortage

The Crisis: We face a projected shortage of up to 86,000 physicians by 2036. The 1997 Balanced Budget Act capped residency training positions — a cap we still haven’t lifted.

What We Need

• Pass the Resident Physician Shortage Reduction Act to add 14,000+ Medicare GME positions.
• Prioritize GME funding for primary care, mental health, and rural specialties.
• Expand loan forgiveness programs for physicians serving underserved areas.
• Support Teaching Health Centers training residents in community settings. Abolish the proposed $100,000 H-1B visa fee for international medical graduates (IMGs), who represent 25% of US physicians and more in some regions.
• Expand the Conrad 30 program (a US federal initiative that allows IMGs on J-1 visas to waive the mandatory two-year return to their home countries, enabling them to stay and practice medicine in underserved US areas with physician shortages).
• Create permanent residency pathways for physicians serving shortage areas.
• Improve licensure reciprocity across state lines.

4. Restore Evidence-Based Public Health Policies

What We’ve Lost:

• Universal hepatitis B birth dose recommendations (which prevented 500,000+ childhood infections and 90,100 deaths).
• Water fluoridation (projected to prevent 25.4 million additional cavities in children over five years).
• 1,400 CDC workers and the entire Division of Oral Health.
• 20,000 HHS employees (a 20% workforce reduction).

Restore evidence-based, life-saving programs.

• Rebuild CDC capacity and restore scientific advisory committees with qualified experts.
• Fund state and local health departments (which have lost 56,000 jobs since 2008).
• Create a permanent public health workforce for emergencies.

5. Address Social Determinants of Health

Food and Nutrition: While Kennedy’s food dye initiative shows awareness, we need more decisive action:

• Mandate removal of harmful additives with clear timelines (not suggestions).
• Expand SNAP benefits rather than cutting them.
• Fund school meal programs with nutritious, minimally processed options.
• Tax ultra-processed foods and subsidize whole foods.
• Require clear labeling of ultra-processed foods and additives.

Economic Security:

• Fund affordable housing initiatives.
• Raise the minimum wage to reduce health-damaging economic stress.
• Expand the earned income tax credit.
• Provide paid sick leave and family medical leave nationally.

6. Maternal and Child Health Protection

The Crisis: 27 rural labor and delivery units closed or plan to close in 2025 alone. That’s 116 closures since 2020. Rural maternity care is in crisis. More women and babies will die unnecessarily until we act. Allocate federal funding specifically to sustain and expand rural maternity care services in critical areas where access is threatened.

• Extend postpartum Medicaid coverage to 12 months in all states.
• Fund midwifery and birth center programs where hospitals close OB units.
• Provide transportation assistance for pregnant women in rural areas.
• Expand tele-health for prenatal care with proper reimbursement.

7. Mental Health and Substance Use Services

• Achieve true mental health parity by enforcing existing laws.
• Expand certified community behavioral health clinics nationwide.
• Fund opioid treatment programs and harm reduction services.
• Integrate mental health into primary care settings.
• Create crisis response teams as alternatives to police for mental health emergencies.

8. Pharmaceutical Pricing Reform

• Allow Medicare to negotiate prices for all drugs, not just a limited list.
• Cap insulin prices at $35 for all Americans, not just Medicare beneficiaries.
• Import lower-cost drugs from Canada and other countries with safety standards.
• Limit drug price increases to inflation rates.
• Increase generic drug competition by preventing pay-for-delay agreements.

9. Health Equity and Disparities

CMS introduced a health equity benchmark in 2025, rewarding organizations that serve low-income populations. Build on this:

• Mandate health equity data collection across all programs.
• Fund community health workers who understand local populations.
• Expand culturally competent care training requirements.
• Address environmental justice by reducing pollution in disadvantaged communities.
• Fund language access services for limited English proficiency populations.

10. Prevention and Early Intervention

• Fund comprehensive screening programs for preventable diseases.
• Restore and expand childhood vaccination programs based on evidence.
• Support school-based health centers in underserved areas.
• Create mobile health units for rural and remote populations.
• Invest in early childhood interventions that prevent chronic disease.

Measurement and Accountability

• Establish clear health outcome targets (reduce maternal mortality, increase life expectancy, reduce disparities).
• Require annual reporting on progress toward health equity goals.
• Fund independent research on policy effectiveness.
• Create stakeholder advisory boards that include patients, community advocates, and frontline workers.

The Bottom Line

Genuinely making America healthy again requires investing in healthcare infrastructure, not dismantling it.

The current trajectory moves in precisely the wrong direction: cutting Medicaid by $1+ trillion, imposing $100,000 visa fees on foreign doctors, weakening vaccine recommendations, eliminating fluoridation, and gutting public health agencies.

True health requires:

• Universal access to affordable care.
• An adequate supply of healthcare workers.
• Strong safety-net for vulnerable populations.
• Evidence-based public health policies.
• Investment in prevention and social determinants.
• Protection from medical bankruptcy.

These policies tackle the root causes of America’s health crisis, avoiding ideologically driven cuts that worsen suffering, deaths, and disparities.

Together, we can make New Year’s 2026 something to celebrate.