Robert F. Kennedy Jr., President-elect Donald Trump’s pick to lead the Department of Health and Human Services, said before the election that Trump tasked him with “end(ing) the chronic disease epidemic in this country” and delivering “measurable results in the diminishment of chronic disease within two years.” RFK vowed that he would.

As an emergency physician, I support the new administration’s commitment to reducing chronic disease. An estimated 129 million Americans suffer from at least one major chronic condition, such as heart disease, diabetes or cancer. These long-term conditions require ongoing care and limit daily activities, but they are often preventable through lifestyle changes.

While the “Make America Healthy Again” agenda remains largely undefined, it highlights prevention and nutrition as central strategies. But improving our diets can only do so much. To truly improve our ability to prevent chronic diseases and manage chronic conditions, we must secure universal health coverage.

All people in the United States, regardless of their economic status, should have access to the full range of essential quality health services they need — prevention, treatment, rehabilitation and palliative care — when and where they need them.

We are far from this goal. The U.S. Centers for Disease Control and Prevention (CDC) reports that approximately 27 million Americans are currently uninsured. Even those with insurance frequently struggle to obtain the health care they need. In 2023, Commonwealth Fund, an independent health care research organization, found 43% of working-age adults with employer-sponsored insurance reported difficulty covering their health care costs.

How would universal coverage help the Trump administration reach its goal? Take hypertension, for example. Commonly known as high blood pressure, hypertension is a chronic condition where the force of blood against artery walls is consistently too high. Risk factors include increased age, genetic predisposition, obesity, physical inactivity, high-salt diets and excessive alcohol consumption.

This preventable and treatable condition affects more than 100 million Americans and is a major risk factor for cardiovascular diseases, the nation’s leading cause of death. Hypertension is often called a “silent killer” because it typically develops without noticeable symptoms. A study published in the Journal of the American Medical Association in 2024 found that more than half of U.S. adults aged 18 years or older with uncontrolled hypertension were unaware they had the condition.

Jerome M. Adams, Trump’s surgeon general during his first administration, issued a comprehensive Call to Action to Control Hypertension in 2020. The report found that many individuals with hypertension do not receive adequate care due to financial barriers, such as insufficient health insurance, high deductibles and copayments, or limited access to health care services.

Regular health screenings for all Americans, either through a primary care doctor or targeted public health initiatives, could help identify hypertension early, alerting patients to timely lifestyle adjustments or treatments that could help them avoid serious complications such as strokes or heart attacks. A CDC simulation model projected that insurance expansions could lead to approximately 63,000 fewer strokes and 95,000 fewer deaths from heart disease by 2050.

Universal coverage would also help reduce the risks of hypertension after diagnosis. Today, many individuals diagnosed with hypertension skip essential medications. A Commonwealth Fund survey released in November found that up to one-third of people with chronic conditions like heart failure and diabetes say they skip medication doses or don’t fill their prescriptions because of the cost.

There are many ways that the United States could achieve universal health care. It could involve expanding existing programs like Medicare, creating a new national health insurance system or enhancing the current Affordable Care Act framework.

However it is accomplished, universal health care coverage would ensure that all Americans have access to essential health services, including regular blood pressure checks and affordable antihypertensive medications.

Critics of universal health care often cite concerns about wait times and care quality, but countries with universal coverage consistently achieve better health outcomes and financial protection.

It’s time for the United States to join other high-income nations in providing comprehensive health coverage to all its citizens. If the future Secretary of Health and Human Services could achieve this goal, he would not only address chronic diseases more effectively but also alleviate the strain on emergency departments and improve the overall health of our nation.

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Dr. Cristiana Baloescu is an emergency physician and assistant professor at Yale School of Medicine. She is a Public Voices fellow of Yale and The OpEd Project. This column was produced for Progressive Perspectives, a project of The Progressive magazine, and distributed by Tribune News Service.

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