When Warren Buffett, the most successful capitalist of the past century, calls punitive tariffs “a big mistake” that can become “an act of war,” Washington ought to listen.

Speaking recently at Berkshire Hathaway’s annual meeting, the 94-year-old “Oracle of Omaha” stressed that prosperity is not a zero-sum game and that weaponizing commerce leaves America poorer and less secure. His warning echoes a bipartisan tradition, going back to former President Dwight Eisenhower, that open markets, not barriers, sustain American strength.

Buffett spoke as the United States imposes its toughest tariff regime in decades. Since April 5, every import pays a 10% baseline duty. Chinese goods now face a 30% charge, the baseline plus a 20% surcharge, after a 90-day truce pared April’s 145% spike. Canada and Mexico confront roughly 35% on most items not listed in the United States-Mexico-Canada Agreement, reflecting the baseline plus a 25% emergency add-on.

Economic warning lights are flashing. Our gross domestic product contracted 0.3% in the first quarter, the first decline since 2022, after firms front-loaded shipments and then hit the brakes. Consumer confidence is down, factory orders are soft and a Bloomberg economist panel now pegs the 12-month recession risk at 45%.

Tariffs hit daily life hardest in health care, where even a bottleneck echoes for months. Higher duties on drugs and supplies inflate costs for hospitals and pharmacies. Levies on imported chemicals, glass vials, syringes, packaging and electronic sensors add price pressure at every step. A generic blood-pressure pill that cost $12 last spring now rings up near $15, almost a 25% jump once wholesalers layer on tariff expenses.

These increases snowball, particularly for the roughly 45% of Marin County residents who rely on Medicare or Medi-Cal. Medi-Cal, serving more than 56,000 residents, is squeezed as supply costs climb. Every tariff-driven hike drains resources from provider networks, straining thin margins and limiting access. Primary-care offices in Novato and Mill Valley say they are renegotiating contracts mid-year just to cover rising supply bills.

Hospitals and clinics, already stretched by post-pandemic labor shortages, feel the pinch. The American Hospital Association estimates medical-supply expenses jumped $6.6 billion nationwide last year, driven in part by tariff pass-throughs. Costs for intravenous tubing, diagnostic catheters and single-use sensors keep rising, forcing administrators to choose between absorbing losses and raising premiums or copays.

At the pharmacy counter, pain is immediate. The Ernst & Young accounting firm projects a 25% drug tariff could add $51 billion a year to U.S. prescription spending, about a 13% hike at the register. For Marin’s 54,000 Medicare beneficiaries on fixed incomes, even a few extra dollars per refill can disrupt adherence and worsen outcomes.

The Berkshire Hathaway multinational conglomerate holding company illustrates the broader toll. Subsidiaries from railroads to retailers list tariffs and chaos among their top risks. The conglomerate now holds a record $347 billion in cash and has trimmed flagship stakes like Apple, which is hardly a vote of confidence. When America’s long-term investor parks money on the sidelines, policymakers should take heed.

History offers sober lessons. From the spiral caused by the Smoot-Hawley Tariff Act of 1930 to the surcharge implemented by then-President Richard Nixon in 1971, blanket protectionism has reliably produced higher prices, slower growth and frayed alliances. Today’s duties jeopardize supply chains for medical devices, semiconductors, and clean-energy gear while eroding U.S. clout in global standard-setting bodies.

The following list includes tips for a better, healthier path forward:

• Negotiate, don’t dictate: Craft targeted deals on subsidies and intellectual property theft instead of blanket levies.

• Invest at home: Strengthen workforce training and health-care infrastructure, as well as research and development, so firms out-innovate rather than out-tariff rivals.

• Reengage allies: Restore comprehensive trade pacts, such as a revised Trans-Pacific Partnership, that raise labor, environmental and health standards.

• Modernize rules: Lead World Trade Organization updates on digital commerce, state-owned enterprises, climate policy and essential medical-supply trade.

Trade has long powered American prosperity; tariffs are a political sugar high. Marin families already confronting steeper pharmacy bills, higher care costs and tighter Medi-Cal networks feel the damage firsthand. Policymakers must pivot quickly. Otherwise, today’s temporary discomfort will congeal into structural economic and health-care harm that is vastly harder and costlier to undo.

Michael Skolnik, of San Rafael, is faculty and academic director of the Executive Healthcare MBA at Dominican University.