With the presidential election less than a week away, health care is not on the ballot, but who wins will certainly have an impact on the direction our health care system takes. In fact, the candidates’ respective approaches to health care appear diametrically opposed based on their past statements and records.

A President Kamala Harris would likely expand coverage to millions more people by expansion the Affordable Care Act and the expansion of Medicaid in all 50 states. It would also extend coverage protections to vulnerable populations that began during the pandemic followed by the Inflation Reduction Act.

A Harris administration would extend Medicare prescription drug price negotiations while limit out-of-pocket spending on medications to $2,000 per person per year. She promised to promote legislation that would limit the direct costs of insulin to $35 per month at all levels.

Of course, all of these measures cost money, and America is already spending more than 4,000 billion dollars per year on health care. And health coverage does not always translate into real care.

In contrast, a second Trump administration would focus on expanding competition and free market solutions. It would attempt to increase price transparency, which would promote competition.

He declared that he reduce Medicaid spendingwhich currently costs more than $600 billion per year, while preserving Medicare and Social Security. A second Trump administration would also likely focus on innovation and personalized health care solutions, increasing citizens’ investment in their own health, likely including more health savings account options.

The biggest change would probably be Trump Making America Healthy Again initiative, led by Robert F. Kennedy Jr., which would focus on pre-disease prevention by combating the obesity epidemic, promoting healthier diets, more exercise and declaring war on ultra-processed foods.

With more than 40 percent of Americans are now obese (up from 12 percent in the 1990s) because of empty calories and chemicals, a huge burden on our health care system in terms of chronic diseases that directly result, from high blood pressure to diabetes through diabetes. heart disease and stroke, cancer, sleep apnea, back pain and falls.

We spend more on health care than any other industrialized country, and in many areas we get less from it, including shorter life expectancy. As new, high-tech, personalized and expensive diagnostics and treatments emerge, we are already overwhelmed by the costs of existing tests and treatments.

What is the solution? Whether you agree with Harris’ expanded universal coverage or Trump’s highly personalized, market-based cutting-edge solutions, one thing is certain: We’re going to break the health care bank unless we let’s reach people before they get sick.

That’s why I support Make America Healthy Again and believe it should be bipartisan rather than just a campaign platform for Trump and the Republicans. Insurance companies may not like it if premiums go down if people live longer and healthier lives, but it would certainly be better for our economy if they did.

We need to find a way to limit ultra-processed foods, eat more fruits, vegetables and fiber, get more sleep and exercise.

Government subsidies will be well spent to put healthier foods back into classrooms and workplaces. I’ve always said that gym memberships should include tax breaks.

Additionally, a preventative medication like Lipitor to lower cholesterol or Ozempic to treat weight gain and diabetes is much cheaper in the long run than a heart stent or gastric bypass.

Making America healthy needs to happen before you even go to the doctor.

Marc Siegel, MD, is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a medical correspondent for Fox News and author of “COVID; The Politics of Fear and the Power of Science.”

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