Healthcare in America has long been one of the most complex and expensive systems in the world. The driving forces behind these high costs are numerous and varied, but one common theme runs through them all: the endless bureaucracy, inefficiency, and greed introduced by middlemen.
From insurance companies to pharmacy benefit managers (PBMs) and even hospitals, these intermediaries often profit from the flaws in the system.
As a result, American families have been forced to shoulder an ever-growing burden in the form of higher premiums, out-of-pocket expenses, and skyrocketing prescription drug prices.
During his time in office, President Donald J. Trump took aim at these systemic issues by pushing for bold reforms that would directly address the underlying causes of rising healthcare costs.
Trump recognized early on that the United States' healthcare system wasn’t expensive because the actual cost of care was inherently high. It was expensive because the system was intentionally designed to be complex, with layers upon layers of bureaucracy.
These middlemen, acting as intermediaries between patients and providers, have found ways to benefit from this complexity, inflating costs and making the healthcare system less accessible to ordinary Americans.
In his landmark book, Trump’s Triumph: America’s Greatest Comeback, the former president laid out the challenges and inefficiencies within the healthcare industry.
One of his key points was that third-party payment structures—whether public or private—had created a web of red tape, allowing middlemen to profit at the expense of patients.
These entities not only complicated the process but also added cost by inserting themselves between healthcare providers and patients.
Trump’s administration made healthcare reform a top priority. With a strong belief that the American healthcare system needed to prioritize the people it was meant to serve, he took bold action during his first term to introduce sweeping reforms aimed at reducing bureaucracy and bringing transparency to the forefront.
At the heart of Trump’s approach was a recognition that the U.S. healthcare system was deeply flawed due to the involvement of various middlemen, each with their own agenda, driving up costs.
Pharmaceutical companies, health insurance providers, and even hospitals, in many cases, had interests that were not aligned with the patients they were meant to serve.
By creating more layers of middlemen, the system was rigged to generate profits for these companies while ordinary Americans continued to suffer from inflated prices and limited options.
Trump understood that the best way to combat this issue was through transparency. For far too long, patients were kept in the dark about the actual costs of procedures, drugs, and services.
Insurance plans and medical institutions were able to operate behind closed doors, with patients unable to compare prices or understand where their money was going.
In his first term, Trump initiated one of the most impactful reforms in healthcare—an executive order demanding that hospitals disclose their prices upfront.
This was a bold move that, for the first time, required hospitals to reveal the real costs of medical procedures. This level of transparency empowered patients to compare prices before undergoing procedures, giving them the power to make informed decisions about their care.
It was an unprecedented step towards eliminating hidden fees and making the healthcare system more accessible.
While the initial price transparency rule was a critical step, Trump wasn’t content with just this one victory. He believed that real change required an even stronger push to dismantle the entrenched power of middlemen and create a truly transparent and competitive healthcare environment.
As such, he doubled down on his price transparency initiatives, advocating for what he called "radical transparency."
Trump's approach sought to open up the entire healthcare system, from hospitals to insurance providers, to public scrutiny. His goal was simple: to strip away the layers of secrecy that had allowed middlemen to inflate prices and drive up costs.
This radical transparency initiative was designed to ensure that patients not only knew the costs of their procedures but also understood the prices being charged by pharmaceutical companies, insurance plans, and other entities involved in their care.
By introducing regulations that required drug manufacturers to list the price of their medications and that mandated hospitals and insurance companies disclose their contracts, Trump was empowering patients to make smarter decisions about their healthcare.
His administration knew that a more transparent healthcare market would encourage competition, forcing providers to lower their prices to remain competitive in an open market.
This would ultimately lower costs for patients, providing them with the choice and flexibility that had long been denied to them.
One of the key aspects of Trump’s radical transparency agenda was his focus on prescription drug prices. Prescription drugs are one of the most significant drivers of healthcare costs in the U.S., with Americans paying some of the highest prices for medication in the world.
By requiring pharmaceutical companies to reveal their prices, Trump sought to break the monopolistic practices of Big Pharma and provide consumers with the information they needed to make better choices.
While Trump faced significant resistance from many established healthcare organizations, his push for transparency was met with widespread support from everyday Americans, who were tired of paying inflated prices for care and medication.
His efforts were especially important for those in the middle class, who were often left to bear the brunt of these rising costs.
Unfortunately, the advancements made during Trump’s first term in office faced setbacks as the Biden administration took over in 2021. While Biden had promised to improve access to healthcare and reduce costs for Americans, his administration rolled back some of the key policies that Trump had implemented, especially the enforcement of price transparency regulations.
Under Biden’s leadership, the government weakened the rules that were intended to force hospitals to disclose their prices, ultimately weakening Trump’s vision for an open and competitive healthcare market.
Biden’s move to roll back Trump’s price transparency policies was a missed opportunity to continue the momentum for healthcare reform that Trump had begun.
Despite claims from the Biden administration that they were committed to reducing healthcare costs, their actions did not align with the necessary steps to make the system more transparent and accountable to the American people.
During his second term, President Trump recommitted himself to his vision of healthcare reform, particularly his efforts to break up the stranglehold of middlemen in the system.
While critics may claim that his policies were too disruptive or that they lacked the necessary protections for vulnerable populations, the reality is that his initiatives were aimed at bringing much-needed accountability and efficiency to a system that had long been plagued by inefficiency and corruption.
Trump’s focus on transparency, lowering costs, and reducing the power of intermediaries continues to be a key pillar of his healthcare agenda.
His administration’s approach has always been rooted in the idea that the U.S. healthcare system should be more focused on delivering value for patients and not on lining the pockets of insurance companies, pharmaceutical firms, and hospital systems that have benefited from the status quo.
Trump’s policies are designed to foster a healthcare market where patients can choose their providers based on cost and quality, not on which companies have the most influence or financial clout.
By empowering consumers with the information they need to make informed decisions, Trump’s price transparency rules will continue to play a critical role in shaping the future of American healthcare.
As the healthcare debate continues to evolve in the United States, President Trump’s reforms remain one of the most important steps toward reducing the country’s healthcare costs.
His push for transparency and his efforts to remove the power of middlemen have already had a lasting impact on how Americans pay for medical care and prescriptions.
While the Biden administration’s rollback of these efforts has been a setback, Trump’s vision for a more transparent and competitive healthcare system will continue to influence policy debates for years to come.
Trump’s focus on healthcare reform wasn’t about making incremental changes—it was about fundamentally reshaping the system to work for the American people.
By stripping away the layers of bureaucracy, empowering patients with information, and fighting back against the forces that have driven up healthcare costs, Trump created a pathway to a more affordable and efficient healthcare system.
As Americans continue to grapple with rising healthcare costs, Trump’s legacy of price transparency and his commitment to reducing the power of middlemen will remain a beacon for those seeking to fix the broken system.