The Big Story: All trees, no forest — yet
“This potential for minimalist or maximalist policymaking is the reality across nearly every realm of health care.”
By Tim Stewart and David Jarrard
3-minute read
Wasting no time after being inaugurated on Monday, President Trump’s blitzkrieg of executive orders in his first week has government and business leaders reeling, grinding some parts of the federal government to a halt and making many shout “WTF?!” It’s clear that Trump 2.0 is considerably more organized than the first go-round (at least for one week) and is executing on a plan that has been in the works for years.
The WSJ calls it “shock therapy.” Trade associations, law firms and cable news are full of people working to translate the orders, calculate the consequences, strategize how to play them or affect them or, in some cases, outright resist them. Executive teams are huddled around conference tables trying to pull together the strands of these actions and determine the immediate and extended operational and cultural impacts to their organizations.
If anyone says they confidently know what all this means, doubt them.
In what will certainly be the first of a storm of legal challenges to the sweeps of the president’s pen, Monday’s action to end birthright citizenship was blocked by a judge on Thursday. While the deluge of executive orders is a loud statement of intent, those plans will continue to change shape as they run into legal and bureaucratic reality.
In healthcare, industry leaders are ending this week (and beginning this era) with a stack of initiatives worth their worry and careful consideration. On the list:
- Immigration actions: The administration’s plans for pursuing undocumented immigrants will be coming through providers’ doors, impacting not only patients but also members of that critical workforce. Hospitals will be particularly affected.
- DEI: Health systems everywhere are now facing this question: “How do we continue doing work that fulfills our responsibility to our communities and engages our people without putting a target on our organization?”
- Brain Freeze: Withdrawal from the World Health Organization and its valuable data stream will have ramifications for public health broadly and many researchers in the U.S. The freeze on activity from federal entities like the CDC and NIH has clear short-term effects for scientists and researchers, and less clear bigger-picture impacts for funding research and clinical missions.
- Medicare and Medicaid: Longer term – but certainly no less consequential – are the potential ramifications for Medicare and Medicaid and other government programs. These could cap expenditures, reduce payment rates and affect established federal work requirements.
Quite a list. And around the corner next week, aspiring Health and Human Services Secretary Robert F. Kennedy appears before his Senate confirmation.
What to do now as a healthcare leader?
- Don’t respond to the shock therapy with panic or awe. President Trump considers himself a dealmaker, and it may be useful to view these initial efforts as a first offer. Just as it’s unlikely the U.S. will buy Greenland, some of the other projects circulating here likely will not bear fruit. Others will take time to wind their way through the regulatory and, possibly, judicial process.
- Separate the wheat from the chaff. Activate your kitchen cabinet. Legal, policy and communications experts. Board leaders. Tap your associations. What’s real? What matters and requires your action today? What’s hyperbole and please-join-my-outrage?
- Understand and recommit to your mission of care. Once again, test yourself. What do you believe and what do you do? Say that. Share that.
- Don’t let your colleagues panic, either. What changes today? What doesn’t? What are the commitments our team members need to hear from us?
- As we say, don’t dance to somebody else’s music. Providers have great political power when they choose to wield it. There’s much to doubt here…but don’t doubt your resilience.
Whether you’re supportive of the Trump 2.0 agenda or terrified by it, one thing that we know for sure from the last 10 years is that this president comes with his own social media-amplified Wall of Sound. This is the time for leaders who can separate signal from noise and guide their organizations – and the healthcare industry – through significant moments and challenges by focusing on what really matters.
Contributors: Emme Nelson Baxter, Isaac Squyres, David Shifrin
Image Credit: Drew Do
