Official Washington still is struggling to understand and adapt to the populist wave that carried Donald Trump to the White House. Anger and denial linger still, emotions rooted in the social and economic chasm between Trump voters and the political class.

What does this mean for health? The first fight is already shaping up, of course, over Obamacare. The way forward falls on President-Elect Trump, his presumptive HHS Secretary Tom Price (R-GA) and the GOP-controlled Congress to make good on his campaign promise of replacing Obamacare with “something terrific.” This won’t be easy, and the latest reports are that the can might be kicked down the road a few years.

Responding to populist frustrations will require policymakers to recognize that long-held policy assumptions may no longer apply in a rapidly changing economy. These include:

• The link between jobs and coverage. How workers – and seniors — get coverage will evolve.

• The broken link between “health” and health insurance. Regulators will at some point give insurers room to innovate, permitting new forms of coverage that promote health and offer new ways to finance care for chronic conditions.

• The broken link between premium and risk. A health promotion approach will require restoring this link, allowing insurers to encourage and reward healthy behaviors.

• New technology. Technology will one day penetrate the health care regulatory encrustation and dispel the lingering paternalism that regards consumers as incapable of making informed choices about their medical care.

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