Bearman Gonzalo, Nori Priya
Division of Infectious Diseases, Virginia Commonwealth University Health, Richmond, Virginia, USA.
Division of Infectious Diseases, Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA.
Open Forum Infect Dis. 2025 Jul 25;12(8):ofaf443. doi: 10.1093/ofid/ofaf443. eCollection 2025 Aug.
Executive order-driven federal cuts and workforce contractions have immediately threatened health outcomes. These actions are broadly destructive, unfolding alongside ongoing, multistate outbreaks and deaths from vaccine-preventable illnesses. Furthermore, proposed steep cuts to Medicaid and the Affordable Care Act will have dire consequences for millions of Americans if passed into law. Given the urgency of collectively devastating federal actions, all healthcare providers must adapt, regardless of job role. Immediate societal harm through a loss of healthcare coverage and support of basic needs (eg, food stamps), erosion of pandemic preparedness, and loss of scientific expertise are just a few anticipated harms. Ultimately, increased downstream healthcare spending on a sicker society may ensue. While federal actions have "flooded the zone," the infectious diseases workforce can actively R.I.S.E. (Recommit, Innovate, Speak Up, Evaluate) by recommitting to the most relevant issues impacting our patients, exercising our professional voices, and upholding our values.
行政命令驱动的联邦预算削减和劳动力缩减立即威胁到了健康结果。这些行动具有广泛的破坏性，与正在进行的多州疫情爆发以及可通过疫苗预防的疾病导致的死亡同时出现。此外，如果削减医疗补助和《平价医疗法案》的提议法案通过成为法律，将对数百万美国人产生可怕后果。鉴于联邦政府这些具有集体毁灭性行动的紧迫性，所有医疗保健提供者无论其工作岗位如何都必须做出调整。因医保覆盖范围丧失和基本需求（如食品券）支持缺失而造成的直接社会危害、大流行防范能力的削弱以及科学专业知识的流失，只是一些预期的危害。最终，可能会导致在病情更严重的社会中医疗保健支出增加。虽然联邦政府的行动已经“淹没了这个领域”，但传染病领域的工作人员可以通过重新致力于影响我们患者的最相关问题、发出我们的专业声音并坚守我们的价值观，积极地“奋起应对”（重新承诺、创新、大声疾呼、评估）。
