An academic journal may offer some positivity to US health policy—an optimism scarce amid Trump administration’s layoffs, funding cuts, and ideology-based research assessments. A recent issue of Health Affairs Scholar proposes that the healthcare conversation can change if academics “think bigger” and policymakers invest more in their communities.
According to Dr. Victor Roy, a family physician and health and political economy project director at the New School in New York City, the public’s reaction to the murder of the United HealthCare CEO shows that people are fed up and looking for larger-scale solutions. He believes there are visceral feelings around these issues and that ideas on the scale of challenges can lead to meaningful changes.
Health policy has become a crucial point for the MAGA right, as the Trump administration launches a campaign that has significantly altered public health institutions. In a few weeks in office, the administration has removed information on women and minority groups from government health websites, reviewed billions in scientific grant applications for conformity, and appointed Robert F Kennedy Jr as the nation’s top health leader. Additionally, the US plans to leave the World Health Organization.
Congressional Republicans have also suggested major cuts to Medicaid to fund tax cuts for the wealthy. Despite the challenges, the US spends more on healthcare than almost any other country but has some of the worst outcomes amongst developed democracies, making it a global outlier for its lack of universal healthcare.
Don’t tinker at the edges, Roy suggests. Instead, look for upstream solutions to health issues. Examine successful programs in cities and states, such as the Philadelphia Joy Bank, Connecticut’s “baby bonds,” and the American Economic Liberties Project’s “Break Up Big Medicine” initiative.
Other proposals in the journal issue include home care cooperatives for home care workers, reinvesting in public hospitals and public pharmaceutical production, and providing social insurance for times when people cannot work. Katharyn A. Phillips, the editor-in-chief of Health Affairs Scholar, says these approaches prioritize investment in patients, communities, healthcare clinicians, and workers, which could lead to meaningful changes in health policy.
Source: https://www.theguardian.com/us-news/2025/mar/22/us-healthcare-trump
