Addressing America's $5 Trillion Healthcare Challenge Through a Systemic Approach

Published by Forbes on August 5, 2025, recent developments in the U.S. healthcare sector highlight significant shifts. From the enactment of the comprehensive One Big Beautiful Bill to CMS's new strategic initiatives, alongside executive orders targeting drug pricing and increased oversight of PBMs, Medicaid, and the 340B program, the landscape is rapidly evolving. While these actions may appear unrelated at first glance, they collectively signal a growing acknowledgment of a fundamental issue: the misaligned incentives that drive our healthcare system are fundamentally flawed. Addressing this requires more than minor adjustments. To genuinely improve health outcomes while reducing costs, a transformative business model must be adopted. This model should align stakeholder incentives, enhance transparency, and ensure accountability for the value delivered. Every component of the healthcare ecosystem—payers, providers, pharmacy benefit managers, and pharmaceutical companies—must operate within this restructured framework to create a cohesive and effective system.