WHAT’S NEXT IN HEALTHCARE
Join us for an exclusive event on early cancer detection and prevention featuring Dr. Elizabeth O’Donnell, MD, MPH of the Dana-Farber Cancer Institute.
DATE: Tuesday, July 15, 2025
TIME: Registration 8:30 a.m. | Start 9:00 a.m. | Close 11:00 a.m.
LOCATION: Smith Family Room – Floor 16, Dana Building, 44 Binney St., Boston, MA 02215
Parking is available under the Yawkey Building.
SPACE IS LIMITED: Please email Vana Tomines at vana@wellworthadvisors.com to request attendance.
Few understand the U.S. healthcare system like Dr. David Shulkin. The former Secretary of Veterans Affairs has led major hospitals, shaped policy at the highest level, and worked to modernize care delivery across both public and private systems. In a recent conversation with Wellworth, Dr. Shulkin shared his insights on where American healthcare is headed — and why now is the time for families to pay close attention.
Q: You’ve said the healthcare system is under increasing pressure. What changes should families be watching?
Shulkin: We’re seeing a significant shift in insurance coverage — though it’s flying under the radar. Due to changes in Medicaid eligibility, work requirements, and cuts to enrollment assistance, 10 to 15 million people may lose their coverage. Add that to those who’ve already lost insurance, and we’re talking about 20 million Americans uninsured.
This doesn’t just affect those individuals — it affects all of us. Hospitals will be forced to provide more uncompensated care. Emergency rooms will be more crowded. Wait times will go up. And quality may suffer.
Q: And even for those who do have insurance?
Shulkin: Most people don’t really understand their health plans. One in three Americans can’t explain their coverage. Many are shocked when they try to access care and are hit with massive out-of-pocket costs — sometimes $6,000 to $10,000 before insurance even kicks in.
That’s especially true for Marketplace and Medicare Advantage plans. People think they’re covered at institutions like Mayo Clinic — until they find out they’re not.
Q: What about staffing? We keep hearing about shortages.
Shulkin: They’re real. We have projected shortages of over 120,000 doctors and 200,000 nurses in the next decade. But those forecasts may be off. Why? Artificial intelligence. AI is already being used by people as a first point of care —mental health advice, symptom checkers, even image analysis. In the near future, AI will help manage chronic illness, triage patients, and handle administrative overload. That won’t eliminate the need for clinicians — but it will change the staffing landscape.
Q: How did you address this while running the VA?
Shulkin: We expanded telehealth and remote patient monitoring to reach veterans in rural areas. We also gave advanced practice nurses and pharmacists the ability to work at the top of their licenses. That took pressure off physicians and improved access without compromising care.
Q: Let’s talk about cost. Why does it keep going up — and can anything stop it?
Shulkin: Healthcare has always outpaced inflation. That’s because we’re living longer, and we want access to cutting-edge treatments — biologics, gene therapies, personalized medicine. It’s extraordinary science, but it’s expensive. AI could help reduce some administrative costs, but historically, technology in healthcare hasn’t lowered spending. If anything, it has accelerated it.
Q: So what’s the impact on families?
Shulkin: Healthcare is becoming a bigger share of household budgets. If people want access to the best care, they’ll need to plan for it — especially later in life. And those with limited-network insurance plans should understand the tradeoffs: lower premiums often mean fewer options.
Q: What about long-term care? That’s something many of our clients are starting to think about.
Shulkin: We need to move away from facility-based care as the default. Most people want to stay at home. With better models of care, remote monitoring, and — soon — personalized robotics, we can make that happen. In the VA, I pushed for home-based care not only because it’s what people want, but because it prevents Medicaid spend-down and eases the burden on government programs.
Q: It seems like consumers are being asked to make more complex decisions, with less transparency.
Shulkin: Exactly. In most areas of life, you know what something costs and how good it is before you buy it. In healthcare, that’s still rare. We’re starting to see new transparency laws and digital tools — but we have a long way to go.
Final thoughts?
Shulkin: The biggest changes in healthcare aren’t coming from sweeping reforms. They’re coming in the fine print — quiet policy tweaks, technological shifts, new payment models. If you don’t understand what’s happening, you’re not alone. But staying informed is the first step toward protecting your access and getting the care you deserve.
At Wellworth, we help families and family offices navigate these very issues — choosing the right coverage, finding top-tier care, and anticipating how changes in policy, demographics, and technology will shape tomorrow’s decisions.