Making U.S. medical manufacturing last.
I work on the demand side of domestic medical supply: the trade rules, federal procurement and reimbursement policy that decide whether American production lines keep running.
Positions
All 6 briefs-
Demand
Orders, not grants.
Why capital grants produced factories but not a domestic PPE industry, and why multi-year offtake is the instrument that works.
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Trade
Finish the Section 232 investigation.
The national-security trade investigation into PPE opened in September 2025. A determination paired with offtake would give U.S. producers something they can finance.
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Trade
Tariffs that close the market.
China-only duties shifted glove imports to Malaysia and Vietnam. Origin-neutral measures are what change where gloves are made.
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Reimbursement
Pay hospitals to buy American.
Hospitals choose PPE on price. A Medicare payment adjustment for domestically made gloves, gowns and respirators changes that math where purchasing decisions are made.
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Procurement
Publish the demand signal.
The hardest part of building domestic capacity was never the engineering. It was not knowing what the government would need in eighteen months. A published, recurring forecast changes that.
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Preparedness
Rotate the stockpile.
Pay domestic makers to keep surge capacity warm, rotate inventory through commercial channels so nothing expires on a shelf, and back it with multi-year commitments.
The problem, in four facts
The United States uses about 120 billion nitrile exam gloves a year and makes roughly 1 percent of them.
Source and contextAbout $850 million in federal awards went to eight domestic glove and rubber ventures after COVID. The plants could be built; committed customers never came.
Source and contextA domestic glove costs roughly twice the imported price, and Asian producers are still adding capacity.
Orders, not grantsIn 2026 Medicare asked whether to extend the premium it already pays for domestic N95 respirators to gloves and gowns, about a nickel a glove: policy aimed at demand rather than supply.
Pay hospitals to buy American
Recent writing
All 15 pieces-
The Nickel-a-Glove Question: Medicare Is Finally Asking the Right Thing About American-Made PPE
Inside the July 2026 outpatient payment rule, CMS asks whether Medicare should pay hospitals extra for domestic gloves, gowns and respirators. What the question gets right, and what it still misses.
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Uncle Sam’s Shopping Spree: How Centralizing Purchases Could Change Your Next Doctor’s Visit
Imagine the U.S. government as the world’s biggest shopper, spending billions each year on everything from computers to, yes, even the nitrile gloves your doctor wears.
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How Tariffs on Critical Imports Strengthen National Security
In a recent interview with CNBC, Jamie Dimon, CEO of JPMorgan Chase, addressed the lingering controversy over tariffs enacted during President Trump’s administration by bluntly advising everyone…
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A Fond Farewell and a Warm Welcome: Looking Back and Moving Forward
As one era comes to a close and another begins, it’s time to reflect on the impressive achievements of the outgoing ASPR (Assistant Secretary for Preparedness and Response) and their dedicated…
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