ABOUT THE AUTHOR: John Adams, a retired U.S. Army brigadier general, is president of Guardian Six Consulting and former deputy U.S. military representative to NATO’s Military Committee. He worked with military representatives of NATO and Partnership for Peace member nations to develop policy recommendations for the political authorities of the alliance, and helped coordinate the transfer of authority in Afghanistan from U.S. to NATO control. He has a master’s degree in Strategic Studies from the U.S. Army War College and has completed the US/Russia Flag Officers’ Program at Harvard University.

During my years in uniform, national security was never an abstract concept. It was measured in readiness, resilience and the ability to sustain operations under pressure. We planned for disrupted supply lines, hostile actors and unforeseen crises because failure to do so cost lives. That same discipline should guide how we think about health care — and it should inform how we approach the Commerce Department’s recent decision to open a Section 232 investigation into medical devices.

Section 232 exists to protect national security. That purpose is legitimate. But it must be applied with strategic clarity. Health care security is national security. A nation that cannot equip its hospitals, protect its clinicians, or deliver lifesaving care in a crisis is not secure — no matter how many tanks or missiles it possesses.

There is a strong case for strengthening domestic medical manufacturing. The pandemic exposed dangerous dependencies on foreign supply chains, some of them tied to geopolitical competitors. Rewarding domestic manufacturers, incentivizing production in the United States, and penalizing bad actors — particularly those linked to foreign adversaries who manipulate markets or weaponize supply chains — are all defensible national security objectives.

But broad, indiscriminate tariffs on medical devices and supplies are not strategy. They are blunt instruments — and in this domain, blunt force risks collateral damage to patients, hospitals and readiness itself.

In military planning, we distinguish between long-term force development and near-term operational risk. You do not degrade current readiness in pursuit of future capacity. Yet sweeping Section 232 tariffs would do exactly that: impose immediate costs and disruptions on the health care system while domestic manufacturing capacity — if it comes at all — takes years to scale.

American patients will bear the direct consequences of tariff-driven cost increases, but the burden will fall most heavily on those with the least flexibility and the greatest medical need. Seniors living on fixed incomes are particularly vulnerable. Higher costs for diagnostic equipment, implantable devices and chronic disease technologies translate into higher premiums, increased cost-sharing and delayed access to care. For older Americans managing heart disease, diabetes or cancer, delays in imaging, procedures or device replacement are not inconveniences — they are risks to life and independence.

Veterans face a parallel threat. Many rely on the Veterans Health Administration for complex, technology-intensive care. If tariffs raise the cost of advanced imaging systems, surgical robotics, prosthetics, or monitoring devices, procurement decisions may increasingly favor lower-cost, lower-capability options. That outcome would undermine the standard of care available to those who have already borne the cost of national defense. A policy justified in the name of national security should not degrade the care delivered to the men and women who secured it.

Rural patients are at even greater risk. Rural communities already contend with limited provider availability, long travel distances and aging infrastructure. When the cost of medical equipment rises, access narrows first in these settings. Delayed upgrades to imaging machines, fewer available ventilators, or reduced inventories of essential consumables can mean longer waits, missed diagnoses, or the need to travel hours for treatment. In emergencies — strokes, heart attacks, traumatic injuries — those delays can be fatal.

From a security standpoint, these outcomes weaken national resilience. A health care system that leaves seniors, veterans and rural Americans with diminished access to timely, advanced care is a system less prepared for crisis, less trusted by the public, and less capable of sustaining the nation through emergencies. Protecting health care security means protecting the patients who depend on it most — not pricing them out of care through blunt trade measures that ignore real-world consequences.

The United States health care system, like the modern military, relies on complex global supply chains. Many advanced medical devices are assembled from components sourced across allied nations. Disrupting those supply chains without viable alternatives risks slowing innovation, delaying care, and reducing access to lifesaving technologies. In defense terms, it creates single points of failure.

There are also direct implications for government-run systems. Department of Veterans Affairs facilities rely heavily on imported medical devices and supplies. Tariffs that raise costs may force procurement decisions that prioritize price over performance, leaving veterans with less-advanced care. That should be unacceptable to anyone who claims national security as their justification.

If the goal is to strengthen America’s medical manufacturing base, then the tools should reflect that mission: incentivizing domestic production, streamlined regulation, and targeted action against genuinely hostile actors. Those are instruments of strategy. Broad Section 232 tariffs on medical devices are not.

National security is not served by weakening the health of the nation. Health care resilience underwrites economic strength, military readiness and crisis response. We should not sacrifice today’s patient care in the name of tomorrow’s capacity — especially when smarter, more targeted policies are available.