The third pharmacy turned him away. My patient had already driven across Northern Michigan in search of his life-saving cancer medication. The first pharmacy was out of stock. The second was out too. At the third, he was told they hadn’t received a shipment in weeks.

On the other end of this crisis are the physicians. We spend our late evening hours calling store after store, a desperate game of pharmacy roulette, just to find the one with that last bottle of medicine.

Today, there are 223 active drug shortages in America. Chemotherapy drugs routinely go on backorder while intravenous pain medications have disappeared across hospitals. Patients are rationing insulin due to their pharmacies being short on supply. Out of sheer desperation, my patients have checked into the hospital just to get the medications they need. It is disheartening to witness, but this has become the new reality of American medicine.

Our medicine cabinets have become mercy to a fragile global supply chain. We no longer manufacture the bulk of our essential drugs at home. Instead, we’ve outsourced our health to overseas facilities, turning a trade vulnerability into a public health liability. Four out of ten key starting materials used to make our medications come from China alone. Even worse, more than 80 percent of active pharmaceutical ingredients are manufactured abroad. In an era of escalating geopolitical volatility, where the disruption in the Strait of Hormuz could soon domino into shortages here at home, we have handed our adversaries the “kill switch” for our most essential medicines.

The economics are also precarious. Affordable generics are the backbone of our health care system, but 40 percent are made by single manufacturers. When production becomes difficult or margins shrink, drug makers either reduce output or exit the market altogether. As a result, the average national drug shortage lasts between 1.5 and 4.5 years.

In early April, the White House issued an executive order employing tariffs to incentivize drug makers to shift their production to American shores. It’s a move the administration claims will help address the crisis of shortages. Yet, the order includes a significant carve-out: It exempts generic products. Generics make up 90 percent of prescriptions filled in the U.S. today and account for nearly all of our most critical shortages.

We know the majority of generics originate overseas, but we have almost no visibility into the multi-step process it takes to transform raw ingredients into packaged pills. As a result, our hospitals, pharmacies, and regulators lack the real-time data to detect an impending shortage before the shelf is already empty.

Economic penalties miss the mark on solving the crux of the problem: We are flying blind. To meaningfully end drug shortages, we first need better visibility into the current system we depend upon. This is why Congress must pass the Mapping America’s Pharmaceutical Supply (MAPS) Act.

The bipartisan MAPS Act would pull back the curtain on this opaque industry. It would require the Department of Health and Human Services to map the entire supply chain from raw ingredients to final pill. Just as I need an X-ray to see a fracture, our government needs the tools to pinpoint bottlenecks in real time and foresee future supply chain collapses. This visibility will create early warning systems, allowing hospitals and pharmacies time to adjust before patients feel a major impact.

Long term, the MAPS Act will provide the data and intelligence necessary to ensure onshoring efforts are strategic rather than scattered. While there is growth in domestic manufacturing, most of these projects focus on high-margin biologics and blockbuster drugs. If our goal is national security, we must focus on the essential generic medications (pain medications, chemotherapies, and critical antibiotics) that form the backbone of clinical practice. Without a strategic approach, we risk becoming a nation skilled at producing the world’s most advanced therapies yet unable to secure the basic medicines that Americans rely on every day.

Ultimately, the burden of drug shortages falls on my patients and those who care for them. Doctors rewrite prescriptions again and again. Pharmacists call suppliers with no clear answers. Patients and caregivers travel from pharmacy to pharmacy. When my patient was forced to drive across the state looking for his medication, he wasn’t thinking about supply chains or geopolitics. He was just trying to survive the day.

As a country, we should no longer gamble with our national medicine cabinet. The status quo is a threat to my patients’ health and our nation’s health security. Congress must pass the MAPS Act, so we can start building a medicine supply chain resilient for generations to come.

Anmol Gupta is an internal medicine-pediatrics resident.