The term “core competency” was coined by management experts C.K. Prahalad and Gary Hamel in their influential 1990 article titled “The core competence of the corporation,” published in the Harvard Business Review. Prahalad and Hamel defined core competencies as the unique capabilities or advantages that a company possesses, which are critical to its ability to achieve competitive advantage and long-term success. These competencies are not just about the skills or technologies themselves but are the collective learning and coordination across various business units that allow a company to deliver unique value to customers.
On average, a company typically possesses between three to five core competencies. For example, Sony’s core competency in imaging and sensing technologies has been crucial in the development of high-quality camera sensors used in smartphones and professional cameras. Apple’s core competency in design and user experience has been central to the success of products like the iPhone and Apple Watch. Honda’s expertise in engine design and manufacturing has enabled it to excel not only in the automotive industry but also in producing motorcycles and power equipment. These competencies are integral to the company’s ability to innovate and adapt, providing a sustainable competitive edge in the marketplace.
The concept of “core competency” is generally applied to a company or business—not to a country. But let’s think in broader terms. What about the United States? America’s core competencies are often highlighted by its significant strengths in various sectors, which contribute to its global influence and leadership. One of the primary areas of excellence is innovation and technology. The United States is home to leading technology companies and research institutions that drive advancements in fields such as information technology, biotechnology, and aerospace. This innovation is supported by a robust ecosystem of entrepreneurship and business, characterized by a strong entrepreneurial culture and a legal and financial system that encourages innovation and development.
Higher education and research are also pivotal components of America’s core competencies. American universities are renowned for their quality of education and research output, attracting students and scholars from around the world. This educational prowess feeds into the country’s ability to innovate and adapt, further bolstering its technological advancements. Additionally, the U.S. exerts significant cultural influence through its entertainment industry, including film, music, and television, which shapes trends and popular culture globally.
The United States also maintains a formidable military power, with one of the most advanced and powerful military forces in the world, providing strategic influence and defense capabilities. Economically, the U.S. benefits from a highly diversified economy that includes a wide range of industries from agriculture and manufacturing to services and technology. Rich in natural resources such as oil, natural gas, minerals, and agricultural land, the U.S. leverages these assets to strengthen its economic position. Furthermore, as a leading global power, the U.S. plays a crucial role in international diplomacy, trade, and governance, influencing global policies and agreements.
However, when it comes to health care, the United States faces significant challenges that prevent it from being universally recognized as having a core competency in this area. While the U.S. is a leader in medical research, innovation, and technology, the health care system as a whole is marked by critical issues. Access and coverage remain problematic, as the system does not provide universal coverage, leaving many Americans uninsured or underinsured and limiting access to necessary health care services.
The cost of health care in the U.S. is among the highest in the world, yet health outcomes do not always reflect the level of spending, indicating systemic inefficiencies. Compared to other developed nations, the U.S. often ranks lower on key health indicators such as life expectancy and infant mortality. Moreover, the health care system is highly complex and fragmented, with a mix of public and private payers and providers that can lead to disparities in care. Significant inequities in health outcomes and access to care based on socioeconomic status, race, and geography further highlight the challenges within the system.
So, while the United States excels in certain aspects of health care, such as cutting-edge medical research and the development of new treatments and technologies, system-wide issues hinder the recognition of health care as a core competency on a broad scale.
My question is: What aspects of Trump’s trade wars with other nations will improve our broken health care system? In the long run—and I stress the long run—tariffs may bolster the economy. But that still leaves most other core competencies untouched—ones that could use a proverbial shot in the arm. As for health care, which I consider mission critical, it’s not even on Trump’s radar. Not only that, but tariffs will not repair broken health systems. They will only make them worse.
Tariffs will hurt the U.S. health care system by increasing the cost of imported medical supplies, equipment, and pharmaceuticals. Many of these products are sourced from global supply chains, and higher tariffs could lead to increased costs for health care providers, which may be passed on to patients in the form of higher health care expenses. Furthermore, tariffs will cause disruptions in the availability of essential medical products.
Tariffs could conceivably incentivize domestic production of medical goods, potentially leading to a more robust local manufacturing sector. This could enhance supply chain resilience and reduce dependency on foreign goods and products. However, the transition to increased domestic production will take years and, in the interim, could result in unsustainable supply shortages or increased costs.
The U.S. health care system is on the brink of collapse. Trump’s dangerous domestic policies and unfathomable purge of federal health care workers, coupled with unqualified hires in leadership positions, have pushed it there. Now he wants tariffs imposed on our trading partners. I’m less concerned about a trade war than I am about the extinction of health care as we know it.
Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of several books on narrative medicine, including Medicine on Fire: A Narrative Travelogue and Story Treasures: Medical Essays and Insights in the Narrative Tradition.