As a family physician practicing in New Hampshire, I see the consequences of suffering every day: unresolved trauma, absent support systems and chronic disease that accumulates quietly until it lands in my exam room. I know what danger looks like. I see it in the patient who skips a follow-up because she cannot afford the copay. I see it in the man rationing his diabetes medication because his insurance denied coverage. I see it in prior authorization rejections stacking up on my desk. I see it in the mother who returned to work three weeks postpartum because she had no other choice, struggling to maintain breastfeeding and scrambling to find stable child care. The threat I worry about most is not Iran — it is our nation’s health.
Our political leaders spend enormous amounts of energy and taxpayer money on geopolitical adversaries thousands of miles away. Meanwhile, the real threat is already within our borders, and it is not immigrants. It lives in a health care system that is failing patients and failing physicians; clinician burnout is at all-time highs, costs are the highest in the world and our health outcomes lag behind every other wealthy nation. The same system reliably delivers profits for insurance companies, pharmaceutical corporations and hospital executives.
These misplaced priorities extend beyond cost and access. We are now seeing consequences in our collective immunity as well. In my practice I have increasingly difficult conversations with families about vaccines. Every week, I watch patients choose to opt out — not because the science has changed, but because public trust has been eroded. Endorsing misinformation is not just a political choice. It is a public health failure. Children are getting sick from illnesses we know how to prevent, and some have died. This is what happens when the science that has saved millions of lives and protected us from infectious disease for decades is ignored.
I write not only as a physician, but as a father. My partner and I are expecting our second child and building our family here in New Hampshire. To me, health is whether new parents can afford to stay home long enough to bond with their child and build a stable, nurturing home. It is whether a toddler has access to quality early education that shapes who they will become. It is whether a working family can afford child care without choosing between it and rent. These are not separate issues from our health care crisis; they are one and the same. New Hampshire launched a voluntary paid family leave program in 2023. After two years, it reached less than 3% of workers and less than 1% of employers. Voluntary programs without mandates do not close this gap. Voters from both parties support paid family leave. The will is there but the leadership to act on it is not.
As I prepare to take leave, I find myself thinking about the patients who cannot afford to make the same choice — those who will be back at work in three weeks, not 12. And according to the science on early attachment and brain development, even 12 weeks is too little. The evidence is clear: Paid parental leave reduces infant mortality, early childhood education produces lifetime gains in health and productivity and every dollar invested in a child’s first five years pays back many times over. We know this and yet we choose, year after year, to fund other priorities instead. Our nation’s long-term security depends on the health, stability and productivity of its population — and those are built in the first years of life, in stable homes and supportive communities, not on a battlefield.
Iran has not caused a single American to skip a colonoscopy. Iran did not bankrupt a family over the cost of treating cancer. Iran did not convince a parent to leave their child unvaccinated against whooping cough. Iran did not force a new parent back to work before their newborn’s first smile, or price a working family out of child care, or determine whether a child gets quality early education based on what their parents earn. We did all of that ourselves: through the policies we have chosen and a political culture that treats family health and stability as an individual’s responsibility rather than investments in our nation’s future.
Our families deserve better. We deserve leaders who are honest about vaccines, strengthen Medicaid, hold insurance and health care corporations accountable and recognize that investing in the health of young families is a national security strategy. The next time a politician speaks gravely about threats from abroad, ask what they have done to address the crisis in our homes, schools and exam rooms. Vote to keep us healthy, strong and secure here at home — because that is where the future of this nation will actually be decided.
Craig Betchart practices family medicine at Concord Hospital. He lives in Pembroke.