We are at a critical moment in health care—September of Year One of a new presidency that is moving at record speed. Our nation’s healthcare agencies are beginning to utilize artificial intelligence; pushing for transparency and reform; and are reshaping how research will affect patients for decades to come. Meanwhile, a bipartisan Congress is weighing consequential decisions on Medicaid, ACA insurance subsidies, and pharmacy benefit managers (PBM) reform.
With so much in flux, what is needed is a unifying framework that puts patients—not bureaucracies—at the center. That is why a growing number of innovators and leading economists are advancing a new initiative called “Most Favored Patient” (MFP). Unlike the actions of the most recent administration, MFP weaves together ideas with both bipartisan support and strong public backing. Its aim is simple but powerful: make Americans the world’s Most Favored Patients.
The New Pillars of Reform
At the heart of the MFP initiative is a framework of A.C.T.—Accountability, Competition, and Transparency. These principles are not abstract; they offer concrete steps that can both protect American patients and strengthen U.S. health care leadership globally.
Let’s look at each in turn:
Accountability. For decades, American patients have paid far more for brand-name drugs than patients in other wealthy nations. Countries such as Canada, Germany, and Australia tightly control drug prices, effectively shifting the costs of innovation onto Americans. That imbalance must end.
The fix is simple: a NATO-style framework where allies contribute their fair share toward medical innovation, pegged to an equal percentage of GDP. Just as President Trump pushed NATO countries to invest more in their own defense, the United States should insist that allies invest more in the biomedical breakthroughs that America creates and on which they depend.
Competition. COVID-19 exposed how dangerously dependent we are on China for active drug ingredients, generics and medical devices. That dependence is not only an economic problem; it is a national security threat. The MFP initiative calls for incentivizing more pharmaceutical and medical device manufacturing here in the United States, while strengthening protections for U.S. intellectual property abroad. Stronger supply chains mean secure access to medicines for patients—and more high-paying jobs at home.
Transparency is essential. Patients deserve to know what drives costs in the system—from the role of PBMs to hospital charges, so they can understand the true cost of prescription drugs. Clearer information empowers policymakers, providers, patients and families to make better choices, fosters competition and shines light on inefficiencies that drive up spending without improving care. In health care, sunlight isn’t just the best disinfectant—it’s the best cost control.
Harnessing the Bully Pulpit
Policy alone is not enough. The bully pulpit matters. We have seen it work: President Trump is working to lower the cost of drugs, successfully pressed for more biopharmaceutical investment in the US, called out greedy middlemen and has put pressure on allies for calling out how they force down the cost drugs and freeload off Americans. As Steve Forbes recently noted, “President Trump is proving to be the ultimate price control in healthcare. And he’s doing it without actually implementing such unnecessary measures [MFN price controls] —and he shouldn’t—thus avoiding the negative access and innovation-killing impacts they’d have on patients, families, innovators and workers.”
Patients win when leaders shine light on costs without stifling innovation.
A Unifying Vision
The Washington Health Innovation Council, which I founded three years ago as a hub of new thinking, is focused on these issues. This fall, we will engage elected and appointed officials on MFP’s three pillars. What unites us is not ideology or partisanship but commitment to basic truth: health care innovation exists to extend and improve American lives.
At its core, the Most Favored Patient initiative is about re-centering the system on the people it is supposed to serve. Accountability ensures fairness across borders. Competition safeguards our security and fuels progress. Transparency empowers patients to make informed choices.
The ultimate test of any reform is whether it makes Americans healthier, with longer lives and better quality of life. At a time when we scrutinize how we trade, manufacture and defend our allies, the principle should be just as clear in health care: America must lead, but our allies must carry their share of the burden. Only then will Americans truly become the world’s Most Favored Patients.
Jack Kalavritinos is the Founder of JK Strategies and the Washington Health Innovation Council and former senior HHS official in the Trump and Bush 43 Administrations.
