Is Health Care a Right? Trinity Health CEO weighs in

Newsweek

20-06-2025

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What happens to a society that starts viewing health care as a privilege, not a right?
I posed that question to Mike Slubowski, president and CEO of Trinity Health, on Tuesday. We had been discussing Trinity Health's decision to take a vocal stance on proposed Medicaid cuts, alongside other large Catholic health systems.
"This isn't a political issue for us," Slubowski told me. "It's our mission."
Catholic social teachings speak to the common good, he continued. In a just society, everyone should have access to a fundamental level of health care services.
This belief is foundational to every nurse, physician and hospital executive that I've spoken to (or at least, that's what they've told me). When someone comes into the emergency department, staff will do everything in their power to save them—regardless of the patient's ability to pay. When a stranger needs a doctor on a plane, doctors are inclined to stand up, even if they're off-duty. Earlier this year, Dr. Brendan Carr, CEO of Mount Sinai, told me of the delicate balance hospitals must strike between survival and sacrifice: "We make lots and lots of decisions that are terrible business decisions on purpose, because it's tethered to our mission."
Regardless of politics, I'd gamble that most Americans agree with this mission in practice. When our children receive rare diagnoses, many of us would be relieved to learn that financial assistance is available for a novel, expensive treatment. When our parents need emergency surgery, many of us would be grateful to not have to scramble for a credit card first.
Indeed, the majority of Americans want Medicaid funding to either remain about the same or increase. That's true of Democrats, Republicans, independents, Trump voters and Harris voters, according to a recent survey from KFF.
But Americans are also frustrated by high health care costs and a perceived lack of price transparency. Many felt their trust in medical institutions fracture during the COVID-19 pandemic. For some, those cracks have only widened with time and increasingly political messaging. (Check this week's report from the conservative consumer advocacy organization Consumers' Research, which accused Cleveland Clinic, Vanderbilt University Medical Center and three other academic health systems of misappropriating government resources to prop up a "woke" agenda.)
All of this to say, for many voters, health care is confusing, frustrating and somewhat opaque: not unlike politics itself.
Senator Joni Ernst of Iowa made headlines earlier this month when, in response to questions from constituents about Medicaid cuts, she remarked, "We all are going to die."
Well, yes. But when I asked Slubowski what happens when a society starts behaving that way—when it views health care as a privilege, not a right—he focused more on the principles of the "common good." We can't prevent all deaths, but we can prevent some. In doing so, health care systems help preserve social order in times of chaos.
He pointed to health systems' actions during the COVID-19 pandemic: shutting down elective services, pouring all of their resources into caring for critical patients and protecting staff members from infection.
"You can't do that kind of thing without a well-developed health system that is also focused on public health," Slubowski said.
If Medicaid cuts come to fruition, health care leaders have testified that access will decline, the cost of uncompensated care will rise, and hospitals will not be able to reinvest in their facilities, staff and communities. Slubowski echoed these concerns.
"In my view, it's sort of like a downward spiral," he said. "In my view, the health system would not be prepared for another type of pandemic."
Slubowski reminded me that our population is rapidly aging; a new type of pandemic is already on the horizon.
Read on to the Pulse Check section for more of my interview with Trinity Health's CEO. And if you have thoughts to share on today's edition, I'd love to hear them. Email me at [e-mail].
Essential Reading
Tensions are mounting amid ICE's mass deportation efforts—and this week, health care entered the national conversation. On Tuesday, advisers to Health Secretary Robert F. Kennedy Jr. ordered CMS officials to transfer Medicaid data to immigration enforcement personnel at the Department of Homeland Security. California Governor Gavin Newsom questioned the order's legality.
Meanwhile, California hospitals and mobile clinics have been reporting immigration raids on their premises, according to CalMatters. One health system estimated that a third of medical appointments were canceled this week, purportedly because immigrant patients are afraid to attend them.
A new KFF report highlighted immigrants' role in the health care workforce. One in six hospital workers are immigrants, per the research foundation.
A second state has formally replaced the "physician assistant" title with "physician associate." Maine's legislature enacted the law on Monday, joining Oregon, which made the switch in April 2024. The AAPA has been advocating for states to adopt this change, saying it better reflects PAs' leadership roles and responsibilities in the modern health care system.
The former COO and CFO of Loretto Hospital in Chicago has been charged for allegedly submitting false COVID-19 testing claims to the government and seeking approximately $900 million in reimbursements for more than 1 million fake patients. Anosh Amed faces nearly two dozen charges for the scheme, which took place in 2021 and also involved laboratory leadership, according to an indictment that was unsealed Tuesday and reported by Block Club Chicago.
One health care company took home the gold in Newsweek's inaugural AI Impact Awards. Every Cure, which uses AI to find repurposing opportunities for existing drugs, was voted as the overall winner by a panel of cross-industry experts. View the full list of winners here.
Pulse Check
Mike Slubowski is the president and CEO of Trinity Health, one of the nation's largest nonprofit health systems spanning 26 states with a network of 93 hospitals. This week, I connected with Slubowski to discuss the expected impact of proposed Medicaid cuts.
For context, Trinity serves 875,000 Medicaid patients each year. If that enrollment is slashed by the predicted 12 percent, it would result in 105,000 fewer patients across the system.
As it stands, Medicaid payments fall short of covering the system's costs by $500 million each year. The proposed cuts would add an annual loss of $600 million to that shortfall, according to data the health system shared with me.
Here's what Slubowski told me during our Pulse Check.
Editor's Note: Some responses have been edited for length and clarity.
Mike Slubowski is the president and CEO of Trinity Health.
Mike Slubowski is the president and CEO of Trinity Health.
Trinity Health
How do you foresee Medicaid cuts impacting Trinity Health's financial stability and long-term strategy?
You can't cut billions from Medicaid and not affect people in the health of communities. Up to 10 million people losing coverage as a result of this is going to be devastating for our communities.
We know when people don't have access to care, they forego preventive care and they end up in the emergency departments, which are already overflowing. It results in more costly care and interventions.
Our calculations just on the House version—not all the stuff the Senate is now considering, which are even maybe more onerous for us—we estimate an [annual] impact of $600 million to our budget once implementation happens over the next couple of years.
As a faith-based, not-for-profit health system, we don't set goals to earn big margins or profits. In fact, this year, we've been running at three-tenths-of-a-percent operating margin. If we were living large, three percent would be the maximum [operating margin] that we believe we would need to reinvest in our future. So we don't set high aspirations.
But right now, we're barely above break-even. And so you can think about the impact of $600 million [lost], and what it's going to do for our communities. About 20 percent of our patients are on Medicaid—up to 25 percent in some of the communities that we serve.
That's a significant share. Specifically, what sort of ripple effect would this have on your ability to sustain your workforce and the services you offer?
Clearly, we're going to have to make decisions about services, locations, administrative support costs, some of our work on community health and wellbeing that's proactive instead of reactive. We have a lot of difficult decisions.
Even before these cuts, every year, the increases in Medicare and Medicaid payments—and even the commercial payers that push back—are far below inflation. Medical cost inflation right now with supplies, medical device suppliers, wages and salaries...there's a gap every year that we have to close of over $1 billion dollars between revenue and cost. Imagine adding $600 million onto that gap every year that we have to close. It's substantial.
Are there past policy or funding shifts that health systems can draw on to inform their response here?
Not at this magnitude. I want to emphasize: revenue increases are below inflation. Proposed Medicare, Medicaid increases in payment are below inflation levels. The commercial payers are reluctant to do increases. And frankly, the employers [that sponsor employees' insurance coverage] know that they are subsidizing federal and state underpayment as it is, and they can't withstand more cost.
So, you know, we're in a bit of a vise over this whole situation. There have been a lot of statements about, "Well, all we're focusing on is able-bodied adults, and we're getting rid of waste, fraud and abuse." But we have financial counselors that sit with people every day to try to help them qualify for Medicaid or other coverage. We know that there is not that level of waste, fraud and abuse in the program. There are very rigorous regulations and rules about who can be covered and how they can be covered, and we just don't see that this is an elimination of simple "waste, fraud and abuse" of the system.
C-Suite Shuffles
Amazon Health Services is reorganizing, simplifying the business into six units called "pillars," CNBC reported. The move comes after a recent string of leadership departures, including former Amazon Vice President of Healthcare Aaron Martin and Chief Medical Officer Dr. Sunita Mishra, and former Chief Medical Officer of Amazon Pharmacy Dr. Vin Gupta.
Internal Amazon and One Medical leaders were appointed to helm each new pillar, which are as follows: (1) One Medical Clinical Care Delivery, (2) One Medical Clinical Operations and Performance, (3) AHS Strategic Growth and Network Development, (4) AHS Store, Tech and Marketing, (5) AHS Compliance and (6) AHS Pharmacy Services.
Gary Herbst is retiring as CEO of Kaweah Health after 34 years with the Visalia, California-based health system. His departure is effective June 30, 2026, and the health system's board of directors will launch a nationwide search for his successor as early as July.
Wisp, the women's telehealth company, has appointed former White House physician Dr. Jennifer Peña to serve as its chief medical officer. Her resume also includes the CMO title at Nurx, K Health and Vault Health.
Executive Edge
Dr. Inderpreet Dhillon is the senior medical director at Grow Therapy and previously helmed the mental health virtual care department at the Permanente Medical Group. As both an organizational leader and a psychiatrist—who still sees patients—he's well-acquainted with the challenges facing today's physicians and health care executives.
This week, I connected with Dhillon to learn how he prioritizes wellness for himself and his colleagues as a mental health professional. He emphasized the importance of being a good listener, leading with empathy and modeling vulnerability—qualities derived from a difficult lesson he learned himself:
If you push yourself too hard, "the outcomes are not good, personally and professionally. A little over four years ago, I was working 40 to 60 hours a week, went back to school to get my MBA, and my twin girls were six at that point. I'm juggling that responsibility of being a father, having big administrative responsibilities, going to school, managing patient care—and I had a massive heart attack in my early forties.
"I remember lying down in bed at the cardiac ICU, and it was funny: there was a cemetery across the street, and that's what my view was. And I'm like, 'I'm here, but I could have been there.'
"There were a couple of realizations. What is most important for me? Of course, work is important for me because I chose this profession and I chose to be in a leadership role to bring the systemic change which I believe needs to happen. Kids are important to me. Family is important to me. So my first realization was, hey, I need to balance this better. The second realization was, I am not Superman. I feel most humans have this perception that nothing bad is going to ever happen to them, until it actually happens to them. Sometimes life comes and punches you smack in your face, and it's a wakeup call.
"I openly share this experience with my teams, with my colleagues...that bad things can happen to you, physically and mentally, if you do not slow down and understand what your priorities are, the workload you're carrying, the things you're juggling. Sharing that doesn't make me any weaker. Actually, it makes me more real and human for my team and my colleagues.
"These are important lessons, right? Not everybody has to learn them the hard way. Let's say that these are things which can be prevented and can be prevented if the culture is the right culture, if there is enough safety in the [organization], if the leaders are modeling those behaviors themselves."
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