oOver the past few years, pressure has been on the US healthcare system. This includes issues related to hospital staffing, as well as financial and operational challenges that have led to the closure of many healthcare facilities and reducing critical services such as emergency situations and obstetric care.
On a daily basis, many of the nation's largest healthcare systems announce major deficits or cut costs. For example, Brigham (MGB), one of the nation's leading health systems, recently reported an operating loss of $72 million in 2024 despite a focus on cost management. (Responses include layoffs of about 1,500 employees or about 2% of their workforce.) Many other large health systems, such as Vanderbilt, Yale New Haven Health, University of Pennsylvania Health System, and Orlando Health, were affected by similar cost issues and had to fire people or reduce their services. The most vulnerable levels of health supply include rural facilities. A February Chartis review reported that 432 rural hospitals were at risk of closing in 2025.
At the moment, healthcare faces yet another obstacle: tariffs. President Trump's announcement of increased tariffs on imports into the US is going to undermine an already vulnerable health care system. Many of the supplies patients and hospitals rely on to drive safely are imported, including basic and necessary supplies such as supply of medicines, gloves, gowns and IVs. Not only does tariffs increase the price of these products, they also add astronomical costs to the patients we care for.
Read more: Trump doubles trade war and threatens China with more tariffs
One of the biggest costs affecting healthcare is medicine. A significant portion of active pharmaceutical ingredients (APIs) and completed drugs are manufactured overseas, with a significant proportion of APIs coming from India and China, and suffering a significant increase in tariffs. A significant proportion of the finished medicines that can be used are manufactured overseas. India accounts for 48%, China 13%, and Europe accounts for another 7%.
A 2022 survey by Avalere Health shows that even completed drugs produced in the country are made with imported APIs, with estimates estimated to be above 30%. The final result is a price increase that will be passed on to not only the pharmacy benefits manager (PBM), but also to patients and their families. Consumers are ultimately sufferers, and high out-of-pocket costs lead to inability to fully meet some skip doses or prescriptions.
Many other everyday supplies that are essential to the functioning of hospitals are manufactured overseas and are affected by increased tariffs. For example, surgical gloves, one of the most commonly used products to provide patient care, brings us foreign dependence. US healthcare facilities rely entirely on foreign suppliers for less than 1% of the gloves produced domestically. In fact, Malaysia accounts for 60% of the world's nitrile gloves production.
Intravenous catheters are another important aspect of patient care and the mainstay of modern medicine, manufactured primarily outside North America, with China and India as the leaders. Surgical masks, which were extremely important during and after the pandemic, are symbolic of the vulnerable international medical device chains that hospitals rely on. The mask is one of the leading durable medical devices (DMEs) that were not readily available in the US and became an important product as Covid-19 ignited in early 2020. Several US companies intervened to manufacture disposable surgical masks. But even that major initiative has also allowed them to generate fractions to meet our demand.
Hospitals spend billions of dollars on key equipment and technology each year, and while most of them are manufactured outside the US, they have to pay for the incredible financial stress on the entire healthcare system. Equipment such as ventilation devices, anesthesia machines, X-ray devices, state-of-the-art CT and MRI scanners are all manufactured or parts from overseas. An estimated increase in the cost of such equipment from 20-30% could be a major blow to the vast majority of hospitals and clinics in the US, as well as overseas. Deferring or delaying such spending to save money can have a negative impact on patient care. This includes the inability to diagnose life-changing or threatening conditions in a timely and accurate way using imaging modalities essential for emergency care and trauma care.
Our leaders need to address this major issue. Because it can have a major impact or collapse on our health system. It is important to invest in rebuilding a robust domestic supply chain for pharmaceuticals, but it is also important to focus on rebuilding the US pharmaceutical industry, which was a global leader for decades, but it will take time. Yes, we need to reform and renovate such facilities so that the US can manufacture drugs effectively and efficiently, reducing costs and foreign reliance on the global supply chain. However, we must also acknowledge that sharing medical resources with other countries provides opportunities to source products, APIs and other DMEs that are lacking in the US, and also provides opportunities to promote cooperation and cooperation to save lives.
Above all, our elected leaders face tariff problems on medical supplies and need to act to reduce such increases as the health system cannot afford it jointly. Our health system is not equipped to absorb the enormous and burden of such increased costs.
