One of the boldest and most consistent themes in President Donald J. Trumps healthcare agenda is his determination to reduce the role and power of middlemen.From insurance companies to pharmacy benefit managers (PBMs) and even hospitals these intermediaries profit from the inefficiencies of our bloated health system. The result is higher costs for American families. As I explain in my new book, "Trumps Triumph: Americas Greatest Comeback," the U.S. healthcare system isnt expensive just because care is costly. Its expensive because the system is complex by design. The third-party payment structure, whether public or private, adds layers of bureaucracy. This opens the door for middlemen to offer supposed solutions that serve their own bottom lines not patients. Its a vicious cycle: more rules lead to more middlemen, which lead to even more rules, red tape, and rising costs.President Trump understood this and he took action.TRUMP'S HEALTHCARE ORDER WILL HELP FIX HEALTHCARE FOR EVERYONEIn his first term, he issued a groundbreaking executive order on price transparency. For the first time, hospitals were required to disclose the real cost of procedures, enabling patients to compare prices before receiving care. While the Biden administration weakened enforcement, Trump doubled down in his second term with an even stronger push for what he called "radical transparency."Radical transparency is the antidote to healthcares worst inefficiencies. When patients and employers can see wide price differences for the same procedures even within the same hospital system the games played behind the scenes get exposed. These inflated prices often have little to do with quality and everything to do with how well insurers negotiate or how many middlemen take a cut.The same is true for prescription drugs. PBMs giant corporations that control which drugs are covered and at what cost use their market power to inflate prices. Three PBMs control 80 percent of the market. Theyre often subsidiaries of major insurers, forming vertically integrated monopolies. New data from the Pacific Research Institute shows that most PBMs skim more money off high-cost prescriptions than European countries charge. Its no wonder Americans are paying more.Hospitals play a role as well. Many exploit a well-intentioned federal program known as 340B, which allows them to purchase drugs at steep discounts. Instead of passing the savings to patients, they bill insurers full price and pocket the difference. The program was meant to expand care for low-income patients, but theres little oversight to ensure this happens.President Trumps recent executive order on drug pricing targets this broken system. By creating a pathway for manufacturers to sell directly to patients, health plans, pharmacies, and clinics without the markup hes offering a way to bypass the middlemen. This isnt theory its already working. When insulin makers launched direct-to-consumer programs, they sold the same drug at one-fourth the price patients were paying through insurance while still making a profit. Thats the power of real market competition without a single government price control.This stands in sharp contrast to the Lefts top-down vision. Whether its price controls, centralized purchasing, or government-run insurance, the lefts answer is always more bureaucracy. But more bureaucracy means more complexity and more room for middlemen to thrive.Perhaps the most visionary part of President Trumps health care agenda is his call to Make America Healthy Again. For decades, weve operated a "sick care" system focused on treating illness after it strikes. Trumps approach is different. It emphasizes prevention, lifestyle, and personal responsibility turning Americans from passive recipients into active participants in their own health.CLICK HERE FOR MORE FOX NEWS OPINIONIn this model, the governments role isnt to run the system but to create an environment in which patients and doctors can lead with access to better tools, more transparency, and useful information. That means clearer labeling for ultra-processed foods, ensuring gold standard scientific data free of conflicts of interest, and addressing environmental factors that contribute to chronic disease. These kinds of structural reforms empower people to make informed choices and live healthier lives without mandates or micromanagement.Its a model that eliminates the ultimate middleman: the system itself.CLICK HERE FOR MORE FOX NEWS OPINIONPresident Trumps leadership has laid the groundwork for a transparent, patient-centered, free-market healthcare system. But the job isnt done. Congress should join him in continuing this fight not just to lower costs, but to restore power to the American people.America deserves a healthcare system that benefits Americans not industry middlemen.