Going to war has a cost. It always has. There are the lives lost, of course, but there are also fiscal and economic burdens and trade-offs, like the trade-offs between guns and butter. “Guns and butter” is an economic description from 1948 that highlights the trade-offs every government and population faces when it goes to war. How much will entering into this foreign conflict impede the general welfare at home?
Earlier this month, President Trump released a proposed budget that wildly expands funding for the Department of Defense while cutting $5 billion from the NIH and other domestic spending. During an event at the White House, he went further, saying we can’t afford Medicaid, Medicare, and day care because “we’re fighting wars.”
Guns and butter.
When wars erupt, it is difficult for a government to focus on both guns and butter. These tradeoffs are playing out in real time, even with the call for a 2-week ceasefire.
Why the U.S. Cannot Afford Butter
The Congressional Budget Office (CBO) estimates that the U.S. government has been spending roughly $1 billion per day on the conflict in Iran. The S&P 500 and the NASDAQ Composite were down nearly 10% in March, with the Dow Jones Industrial Average not far behind. Energy prices have been soaring too, and the money the government is shelling out for guns will add to the national debt, which already is close to $40 trillion. While oil prices fell and the stock market rallied this week following the ceasefire news, this may only be temporary.
According to Rep. David Schweikert’s (R-Ariz.) debt dashboard, the government has paid $253 billion in interest on the national debt over the last 12 months, or about $21 billion per month on average. The CBO predicts that net interest as a share of all government outlays will rise from 13.95% in fiscal year (FY) 2026 to 14.94% in FY 2028. The more money the government spends to service its debt, the less it will have for other priorities like infrastructure, education, and, of course, healthcare.
Into this environment came the GOP proposal in late March: cut up to $200 billion from healthcare to support ongoing war efforts and immigration enforcement.
Now, there is a legitimate conversation to be had about healthcare spending in the U.S. There are inefficiencies to address, incentives to realign, and costs to control, but using healthcare cuts as a mechanism to fund war will not lead to the types of well-thought out reforms we need. They will just lead to more human carnage.
Healthcare Spending Cuts Are a War on U.S. Patients
On its face, this proposal to cut up to $200 billion may look like fiscal pragmatism, but we cannot forget that, if enacted, these cuts would come on top of others. In one of the least productive and least popular congressional cycles in recent memory, lawmakers already eliminated roughly $1 trillion from healthcare spending while letting Affordable Care Act (ACA) subsidies expire. (The ACA move alone led to more than 1 million people losing health coverage.) The $1 trillion in cuts have already put pressure on state healthcare budgets, not to mention the more than 400 hospitals now at risk of closure.
Additional cuts would cause more pain. One proposal is to equalize reimbursement between hospital outpatient departments and physician offices, which has long been framed as a way to reduce costs, for example. Similarly, addressing Medicare Advantage “upcoding” has been positioned as a way to curb excess spending. There is also renewed interest in Medicaid restrictions, including limiting states’ ability to cover undocumented populations.
These policy options may be worthwhile, but not as a quick and blunt instrument to backfill war spending, especially since the downstream effects are predictable: coverage declines, reduced hospital and clinic revenues, and decreased access. Safety-net providers, particularly rural hospitals and clinics, are already operating on thin margins. If they face further financial strain, some will be forced to close. Others will cut services. Patients will delay care until they are sicker so physicians will have to tackle more complex and more expensive cases.
We have seen this before, but the difference now is that these domestic pressures will collide with a set of global factors that will make even common ailments harder to treat.
War Harms Healthcare Supply Chains
In addition to rising energy costs and falling stocks, the war in Iran has disrupted supply chains. The potential closure of the Strait of Hormuz alone has significant implications for pharmaceutical production and access. Disruptions do not stay localized; they ripple across manufacturing, pricing, and availability.
The risks run deep.
Jordan produces roughly half of the world’s amoxicillin oral suspension and a similar share of active pharmaceutical ingredients for etomidate, a commonly used anesthetic. Israel and Jordan together account for more than 70% of the active pharmaceutical ingredients for flumazenil, a drug used to reverse benzodiazepine effects.
Then there is helium. Helium is not something most patients think about, but it is essential for cooling MRI machines. Indeed, it is used in more than 95 million scans globally each year. Qatar alone produces about a third of the world’s helium, and attacks on production infrastructure are already raising concerns about supply disruptions.
War does not just cost taxpayers. It costs patients in the form of drug shortages, imaging delays, and rising costs. Make no mistake: this conflict has the potential to severely disrupt the healthcare industry, especially if the ceasefire is lifted.
The Tradeoffs Are Too Great
At the same time the U.S. is proposing further cuts to healthcare domestically and has already cut back aid to foreign governments, the effects of war have begun to impact those caught in the middle of the conflict.
Reports indicate that the war has blocked or severely restricted humanitarian access, worsening already fragile health conditions on the ground. Aid cut-offs raise the prospect of regional instability and lead to migration pressures, disease spread, and strain on international health systems.
Innovation will suffer too. Israel, Saudi Arabia, the United Arab Emirates, and Qatar are centers of innovation. Right now, basic operations — scheduling meetings, advancing partnerships — are being disrupted. Investment timelines are uncertain. Innovation does not stop during conflict, but it slows. And when it comes to health innovation, these delays matter.
The U.S. is considering financing a global conflict by pulling resources from a domestic system that is already under strain, while simultaneously exposing that system to new global supply risks.
When examined through a healthcare lens, the tradeoffs of this war are far too high. Let’s hope Iran and the Trump administration are serious about resolving this conflict and making the temporary ceasefire a permanent one.
Source link : https://www.medpagetoday.com/opinion/prescriptionsforabrokensystem/120701
Author :
Publish date : 2026-04-08 18:59:00
Copyright for syndicated content belongs to the linked Source.
