Cost-cutting is not a plan—it’s a reaction. It often ignores the fact that spending exists to solve a real problem. The policy in place may be expensive and ineffective, but simply cutting or trimming it doesn’t make the problem go away—it just ensures we’ll solve it badly again in the future. The real issue isn’t the cost; it’s that the policy itself is unaffordable or unsustainable.

Take healthcare, for example. We’re not spending too much because people want to overpay for insulin, lab tests, or routine doctor visits—we’re spending too much because the system is built on inefficiencies, middlemen, and outdated pricing structures. Slashing budgets won’t fix that. Instead, we need to focus on radical cost reductions that make healthcare affordable without compromising access or innovation.

For millions of Americans, this isn’t theoretical—it’s the difference between affording life-saving insulin or rationing it. It’s the choice between getting a critical lab test or skipping it because it costs too much.

Here are some of the biggest cost drivers that need immediate reform—and the savings if we fix them. While exact savings depend on implementation and market factors, estimates suggest that addressing these inefficiencies could lead to substantial reductions in healthcare costs. Here’s how much we might save in each area:

Vaccines – A $1 MMR vaccine could save $10B+ annually by eliminating cost barriers for routine immunizations.

Insulin – Bringing costs down from $300–$500 per month to $10 per month could save $20B+ per year for diabetics.

Routine Lab Work – Lowering $50–$200 blood tests to $10 per test could save $50B+ annually by making diagnostics affordable.

At-Home Testing – Affordable self-testing for glucose, cholesterol, and infections could cut unnecessary doctor visits and save $10B+ annually.

Telehealth & Retail Clinics – Expanding $30 virtual visits and walk-in care could save $30B+ per year by reducing ER and hospital reliance.

Wearables & Remote Monitoring – Cost-effective tools for chronic disease management could save $10B+ annually by preventing expensive hospital stays.

In total, these six reforms could reduce U.S. healthcare costs by $120B per year—without cutting access to care.

So, we can’t just cut costs—we need to fix the system. The U.S. didn’t slash vaccine research spending to lower COVID costs—it funded Operation Warp Speed, accelerating development and delivering life-saving vaccines faster and cheaper than the traditional system ever could. Operation Warp Speed cost $18B—but it saved the U.S. economy $1.2T by accelerating reopening, preventing hospitalizations, and reducing sick days.

Here’s how we do it without distorting the free market:

Fund open-source research & competitive grants → Instead of propping up select companies, support innovation that lowers costs for everyone (e.g., generic insulin, vaccine development).

Challenge-based prizes (X-Prize model) → Reward breakthroughs that achieve cost reductions, like $10 lab tests or affordable at-home diagnostics.

Fast-track FDA approval for cost-saving innovations → Cut red tape on proven, safe alternatives that make healthcare cheaper and more accessible.

Allow Medicare/Medicaid to negotiate prices → Break price-gouging in routine treatments while still fostering competition.

Use market incentives instead of permanent subsidies → Encourage providers to deliver affordable care without creating dependency on government spending.

The question isn’t whether we can afford to fix healthcare—it’s whether we can afford not to. What do you think? Where should we start?