“Everyone should have ready access to all necessary medical, hospital, and related services.”
That’s a quote that might have emerged from the most recent healthcare policy debates. But its source is actually President Harry Truman. In November 1945, roughly three months after the official end of World War II and barely seven months after stepping into the presidency after the death of Franklin Roosevelt, Truman delivered a Special Message to the Congress Recommending a Comprehensive Health Program, clarifying that what he was advocating for was not socialized medicine.
“We are a rich nation and can afford many things,” Truman said in his message. “But ill-health, which can be prevented or cured, is one thing we cannot afford.”
It would take two decades and three presidencies before a national health insurance plan was implemented; this one focused on healthcare for the elderly. On July 30, 1965, President Lyndon Johnson traveled to Independence, Missouri, to sign the bill that launched Medicare and to present healthcare cards to its first two recipients: Harry Truman and his wife, Bess.
For nearly a century, presidents have proposed big, bold policies to shape our access to healthcare. In a recent blog, I discussed the 2025 Budget Reconciliation Act (the so-called “One Big Beautiful Bill Act”) and how its impact on health savings account (HSA) eligible services could create significant opportunities for entrepreneurs and healthcare investors.
There’s also a specific impact on Medicare that is critical to understand. The 2025 Act will reduce support for people with Low-Income Subsidy (LIS) coverage. An estimated 40 percent of Medicare beneficiaries receive LIS as part of a cost-sharing plan with Medicare Part D designed to make prescription drugs more affordable. The Act also makes it more challenging to implement improvements to Medicare Savings Programs (MSPs), which help lower-income Medicare enrollees cover premiums and out-of-pocket expenses. These are changes that will affect an estimated 1.3 million people.
Build Something Better
We can certainly have a thoughtful, informed debate about the necessity of, or the impact of, the anticipated hundreds of billions of dollars in cuts to Medicare spending. But let’s recognize that legislation like this can also create an opportunity to evaluate where we are and seize opportunities to do certain things better.
We’re facing a physician shortage in this country, with estimates suggesting it will reach 86,000 in 10 years, meaning we need to act rapidly to identify how to support and sustain the doctors already providing care, inspire others to enter the profession, and train them well when they do.
The 2025 Act delivers a one-time 2.5 percent increase to the Medicare Physician Fee Schedule for 2026, a response to the gap between physician practice costs and Medicare payments. As the number of physicians practicing medicine dwindles, we need to make sure that those doctors don’t reduce the number of Medicare patients they see or abandon seeing any Medicare patients at all. My hope is that the legislative effort to address physician payment will spark a deeper discussion about moving our focus from volume to outcomes and to identifying strategies that will support care providers operating in rural areas.
Rather than trying to relitigate legislation, I’m advocating for an effort to accelerate the adoption of the proven care models that are delivering better outcomes at lower cost. A renewed focus on outcome-based and value-based care. Shared savings plans. Broad access to primary care and an expansion of the primary-care-led team model.
These are nonpartisan approaches. They’re also proven to deliver better healthcare outcomes.
Towards the end of his presidency, Harry Truman described the health of the American people as “one of our basic national resources…as important to the welfare of our country as our land, our water, and our minerals.” The first Medicare enrollee understood the importance of providing cost-effective, quality healthcare as a national imperative.
It’s good to challenge longstanding assumptions about how best to do this by being curious and approaching established norms with a sense of innovation and inspiration. Leaders of healthcare organizations can change our direction through compassion, gratitude, and finding time for reflection to cut through the noise and distractions and truly focus on leading.
We Can Do Even More
This moment in Medicare’s evolution calls for a different kind of leadership. Mindful leadership begins with silence and reflection, the discipline to step back from the noise, remove obstacles, and see clearly what will truly serve patients and providers. It advances through compassion, recognizing that durable reform is built on trust, collaboration, and a shared commitment to better outcomes. And it is sustained by gratitude, the perspective that renews resilience and keeps leaders focused on purpose rather than politics.
When healthcare executives and policymakers operate within this ethical framework of loving kindness, innovation becomes intentional, strategy becomes sharper, and decisions are guided not only by economics but by values. At this pivot point, we have an opportunity to adjust the system and elevate how we lead it.