The much-touted DOGE (Department of Government Efficiency) found $9 billion of government waste, fraud, and abuse. Congress implemented their recommended cuts in the Rescissions Act of 2025 (H.R. 4). This waste reduction represents 0.13% of the U.S. 2024 federal budget and 0.024% of the national debt.
DOGE scoured federal spending to find $9 billion to cut and missed (or ignored) a wasteful federal expenditure of more than $2 trillion, healthcare, representing 35% of the 2024 federal budget!
Their single task was to improve federal dollar efficiency, meaning to maximize dollars that produce what Americans want and need, and to minimize taxpayer dollars that are expended unnecessarily, wastefully, inefficiently. In healthcare, Americans need care, not insurance, not promises of care, and not job creation unless the workers are care providers.
In 2024, the U.S. expended $4.8 trillion on its healthcare system. At least half, $2.4 trillion, paid for BURRDEN – Bureaucracy, Unnecessary Rules and Regulations, Directives, Enforcement, and Non-compliance activities like review and oversight.
The Affordable Care Act (ACA, colloquially Obamacare) cost $1.76 trillion. Most of the cost went to infrastructure, not patient care, such as funding an ACA Health Insurance Exchange (HIE) in every state and District of Columbia. (One author, Dr. Waldman, was a Director of the New Mexico HIE.) ACA BURRDEN was so expensive that then President Obama had to take $716 billion from funds for senior care out of the Medicare Trust to defray the costs.
The public seems unaware that BURRDEN is very costly. Legislators certainly do not elevate this expense, paid to grateful bureaucrats, to public awareness. As Congress passes each new healthcare act, more BURRDEN is created and more non-clinical healthcare workers – those who provide no care – must be paid by taxpayers.
Between 1970 and 2020, the number of U.S. physicians doubled, i.e., increased 100 percent. Over the same fifty years, the number of non-clinical healthcare workers –bureaucrats or administrators of all types – increased by more than 4,400 percent! The is 44 non-care givers for every one care giver: salaries, benefits, offices, equipment, and generous pensions all paid by taxpayers. Anthony Fauci’s annual pension at retirement was $414,000, more than the salary of the U.S. President.
Since care is the desired result of healthcare spending, and $2.4 trillion provided no care, that money was spent inefficiently, wastefully.
DOGE should have remembered the Willie Sutton rule. When asked why he robbed banks, Sutton replied, “Because that’s where the money is.” If DOGE had followed Sutton’s wisdom, they could have reduced government wasteful spending by $2.4 trillion, 35.5% of last year’s budget, rather than a paltry $9 billion (0.13%.)
Deane Waldman, M.D., MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of Center for Healthcare Policy at Texas Public Policy Foundation; former Director of New Mexico Health Insurance Exchange; and author of 13 books, including the latest with Dr. Vance Ginn, “Empower Patients–Two Doctors’ Cure for Healthcare.” Follow him on X.com @DrDeaneW or contact via www.deanewaldman.com.
