President Donald Trump faces many problems left by the outgoing Biden administration. One of them is the world’s most expensive health-care system, as millions of Americans struggle to access timely, quality care. In 2024, the nation spent an astonishing $4.9 trillion on health care – more than the entire GDP of Japan.
Much of this money never reached doctors or hospitals. Instead, it was consumed by bureaucracy, unnecessary regulations, and compliance activities. We must fundamentally rethink how to allocate resources to save money and improve care.
The solution isn’t more funding; it’s defunding the bloated system and empowering patients, something that Trump should consider to empower patients with better, affordable care.
The problem lies in inefficiency. The U.S. spends far more on health care per capita than other developed nations. In 2023, Americans spent an average of $12,742 per person on health care. Compare that to Israel ($3,469), the United Kingdom ($5,867), or even Switzerland ($9,044).
The difference isn’t due to better outcomes or superior care – it’s because American health-care dollars are being diverted into an inefficient system.
A large portion of U.S. health-care spending goes to what can be described as BURRDEN: bureaucracy, unnecessary rules and regulations, directives, enforcement, and noncompliance activities. Research suggests that these non-clinical activities consume 31% to 50% of U.S. health-care spending. That means between $1.52 trillion and $2.45 trillion annually could be saved or redirected toward actual care.
Envision a scenario where patients – not bureaucracies – control these resources. If employees receive the $23,968 as part of the compensation their employers currently spend on health insurance, they can make their health-care decisions. These funds are currently directed toward insurance companies but could be returned to workers, empowering them to shop for care directly.
Giving consumers control over their health-care dollars could restore market forces to the system, driving down prices and improving service quality.
The evidence supporting patient empowerment is compelling. When patients pay directly for care, providers must compete for their business by offering better prices and higher-quality services. This dynamic can already be seen in direct-pay surgery centers and cash-only primary care practices.
At the Surgery Center of Oklahoma, for instance, patients can see the total cost of procedures upfront. This is generally a fraction of what traditional, insurance-based hospitals charge. Transparency and competition create savings while simultaneously improving quality.
Critics argue that patients lack the knowledge to make complex medical decisions. However, the same could be said for hiring a lawyer or choosing a car mechanic, yet consumers navigate these markets daily. Empowering patients doesn’t mean abandoning them; it means providing tools like transparent pricing and quality data to help them make informed choices.
For example, health savings accounts (HSAs) could be expanded and more flexible. This would allow families to save tax-free for medical expenses and spend those funds as they see fit, including on insurance policies they want, instead of being limited to what Washington allows.
Defunding the health-care system doesn’t mean cutting care. It means cutting the inefficiencies that inflate costs and hinder access. We could achieve substantial savings by streamlining regulations and reducing administrative waste while improving the patient experience. Elon Musk’s Department of Government Efficiency, or DOGE, can make history by tackling health-care reform as its priority. Starting with health-care offers wins for finances and people.
Without reform, health-care spending will continue to rise, draining public funds and household budgets. Meanwhile, millions of Americans will remain stuck in a system prioritizing paperwork over patients. By defunding the bloated bureaucracy and empowering individuals, we can create a system that delivers better outcomes at a fraction of the cost.
It’s time to give Americans what they deserve: affordable, accessible health care that puts their needs first.
