The U.S. has officially entered a new presidential term. Trump’s rapid-fire executive orders, RFK Jr.’s Senate confirmation as HHS secretary and Elon Musk’s early influence over government departments/budgets all indicate that healthcare is poised for major change. Last month, prior to Trump’s inauguration, I asked readers which healthcare outcomes seem most likely over the next four years. Here are the results:
My thoughts: The first weeks of President Trump’s administration have put healthcare front and center, and this survey reflects the concerns many Americans are experiencing. The top fears—reduced vaccine availability, rising out-of-pocket costs and fewer insured Americans—are likely tied to key figures in this administration’s policy reform efforts. Robert Kennedy Jr.’s history of unscientific vaccine skepticism fuels worries about public health protections, while Elon Musk’s aggressive push to cut government spending raises alarm over potential reductions in Medicaid, Medicare and other essential programs.
Meanwhile, optimism remains in short supply. Fewer than a third of respondents expect meaningful reforms to rein in drug prices, eliminate prior authorization hurdles or impose stricter regulations on unhealthy products like ultra-processed foods and alcohol. Despite political rhetoric, skepticism prevails about whether these long-standing issues will be addressed in any meaningful way.
The one bright spot? AI. Nearly two-thirds of respondents see an expanded role for artificial intelligence in medicine, and I share their hope. If GenAI is leveraged to improve diagnosis, personalize treatment and prevent chronic disease, it could drive down costs by keeping people healthier—a far better solution than restricting or delaying the care they need.
Thanks to all who voted! To participate in future surveys, and for access to timely news and opinion on American healthcare, sign up for my free (and ad-free) newsletter Monthly Musings on American Healthcare.
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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Check out Pearl’s newest book, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine with all profits going to Doctors Without Borders.
Thank you, Robbie, for this update. I haven’t seen you yet on MSBC but I’m glad you are there and I will look to listen to you. Keep up the good work fixing healthcare!