The Trump administration has a laudable goal: to make America healthy again. This would entail improving nutrition and care to address chronic diseases so Americans can live longer and healthier lives.
Unfortunately, despite spending more than other nations, having more advanced technologies, and having some of the world’s best caregivers, we are not able to take full advantage of these benefits because of the misaligned incentives that pervade our health-care ecosystem. In our system, providers and insurers often profit when patients require more treatment, not when they are and remain healthy.
Misalignment leads to several negative results. One example is the disparity in life expectancy that can be as high as 20 years between counties in the U.S. In California, wealthy counties like Marin have a life expectancy of 85 while a host of poorer rural counties generate far worse outcomes. Another effect of misalignment is inefficiency, leading to hundreds of billions in wasteful government spending and $150 billion in health-care administrative costs alone. Lack of alignment also precludes the technological integration that AI and massive amounts of data have brought to other industries. Finally, we saw the tragic effects of misalignment during the COVID-19 crisis, which exposed how unprepared our system was for a large-scale health emergency.
To fix these problems, we need health care that gives providers incentives to improve access and outcomes, making care more preventative and proactive. Getting this alignment will require improvements in both the public and private sectors. On the regulatory front, the General Catalyst Institute has just issued a white paper with specific policy recommendations that the Department of Health and Human Services can start implementing in the next nine months to get the government moving towards health-care transformation.
The recommendations call for more innovation that would lead to faster learning, which speeds up transformation. To do that, the government could develop regional health-care innovation “sandboxes” that will allow health-care experimentation at the local level. These sandboxes can be advanced through existing waiver authorities and help generate what is known as the flywheel effect: insights from system-wide efforts can help players evolve faster, while new applications drive additional system improvements. This continuous exchange builds momentum, making change easier and more sustainable.
Regulations also have to be changed so that patients can own their health data and share it across providers, rather than dealing with multiple medical portals that don’t communicate. Doctors and insurers need incentives to focus on prevention and proactive health management. The government needs to lower regulatory barriers that make it unreasonably hard for innovative companies to disrupt incumbent players that have zero incentive to cooperate with new entrants, and as a result, are not working in the best interests of the patient and consumer.
With such regulatory changes in place, the private sector could do even more to promote and accelerate change. No one company can bring about true transformation. Instead, we need an ecosystem of companies that can work together to help keep people healthy in an affordable way that is accessible to all. An innovative regional health ecosystem could incorporate new technologies like AI and use it to make the system more efficient, affordable, and effective.
Such an ecosystem could replicate and scale best practices, while reducing the burden on individual health systems to develop their own bespoke transformation assets. Different companies engaging in radical collaboration across an ecosystem can tackle different parts of the health-care challenge. For instance, if thousands of hospital systems used AI sepsis detection tools, they could identify warning signs hours earlier than usual, saving tens of thousands of lives and reducing costs by keeping patients out of intensive care.
One promising technology is an operating system designed specifically for health care. Just like DOS revolutionized personal computing by creating an accessible platform for users, a health-care operating system could break down data silos, allow for faster insights to identify more effective and efficient practices, and promote the adoption of those improved practices quickly and seamlessly.
Another promising application is a new health insurance interface to make health care benefit management simpler. This interface could make it easier for people to take their insurance with them when they change jobs so they feel less trapped in unsatisfying situations just for health care. Portability also means people could see the same doctors for years, rather than finding that their new insurance doesn’t cover their regular providers. Creating an ongoing relationship between patients and providers gives providers an incentive to care about long-term patient health.
When the new technologies prove their value, they can be adopted across the system. In this way, by 2030, we could have a blueprint for what works and then spend the next decade scaling the proven technologies across our entire health system.
The goal is a collaboration between the most advanced and promising technologies with caregivers who are directly treating patients. Each iteration can bring about better results, reducing unnecessary costs and improving access to all. Replicating this model across 10 to 15 regional platforms can allow the flywheel of intentionality and exploration to take our health system to the next level, to make health care accessible, proactive, and affordable, and truly fulfill the promise of making America healthy again.
The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.
More than a dozen billionaires have made major donations to colleges that host the nation’s elite basketball programs. Among them are Nike’s founder, a Walmart heiress, and the owner of the Dallas Cowboys. Several of the powerhouse teams bankrolled by billionaires are favored to win in the first March Madness round starting Thursday.
Considering the sports entertainment industry is estimated to be worth $2 trillion, it’s no surprise America’s ultrawealthy are eager to throw money at the nation’s storied college athletics programs.
There is a healthy list of more than a dozen billionaires who are bankrolling the schools in this year’s March Madness tournament. Some of these high-net-worth individuals are household names, while others have amassed their fortunes away from the spotlight.
Some of the most recognizable names making major donations to March Madness schools include Nike founder Phil Knight, Walmart heir Nancy Walton Laurie, and Dallas Cowboys owner Jerry Jones. This trio alone is worth a whopping $62.2 billion.
But there are more than a dozen other high-profile CEOs and executives who have invested big bucks into March Madness schools, either because it’s their alma mater or they have a geographic or family connection to the team. And it pays to have a strong basketball team. In fiscal 2023, the NCAA reported a record $1.29 billion in revenue—largely from the survive-and-advance March Madness tournament. Plus, the tournament is expected to award hundreds of millions of dollars to participating schools.
Fortune has compiled a sampling of billionaire donors to schools participating in the March Madness tournament this year. Note, this list is not exhaustive.
Phil Knight
Knight was once a college athlete himself—a runner on the University of Oregon’s track team in the 1950s while he earned his bachelor’s degree in accounting. The 87-year-old Nike founder has shared his $33.5 billion fortune with his alma mater, making several major donations over the years to the school’s academic and athletic programs. In all, his donations to Oregon have totaled more than $1 billion.
Knight made two separate $500 million donations to Oregon for science-related academics and in 2007 he and his wife announced a $100 million gift to found the UO Athletics Legacy Fund to help support all athletic programs at the university.
Oregon will face off with Liberty University on Friday at 10:10 p.m. EST and are favored to win.
Nancy Walton Laurie
Walton Laurie is an heiress of the family that created Walmart, the world’s largest retailer with more than $680 billion in fiscal 2025 revenue. Apart from the Walton family, her personal net worth is currently estimated at $12.5 billion.
Walton Laurie, the youngest daughter of Walmart cofounder Bud Walton, donated $25 million with her husband Bill Laurie in 2001 for a new basketball arena at the University of Missouri. The arena was originally named Paige Sports Arena after their daughter.
Mizzou plays Drake University at 7:35 p.m. EST on Thursday and are favored to win.
Jerry Jones
This University of Arkansas alum played for the Razorbacks football team in the 1960s and went on to become a successful oil businessman and the longtime owner of the Dallas Cowboys. The football dynasty is currently worth about $10 billion. Jones’ current estimated net worth is more than $16 billion.
In 2015, Jones donated $10.65 million to Arkansas’ athletic program, which he credited for his success in business.
“I would not be where I am today without those life lessons learned as a student-athlete at the University of Arkansas,” Jones said in a statement at the time.
Arkansas will play the Kansas Jayhawks on Thursday at 7:10 p.m. EST. Kansas is expected to beat Arkansas.
He also reportedly helped the University of Michigan fund a name, image, and likeness sports package to poach quarterback recruit Bryce Underwood from Louisiana State University to Michigan in November 2024.
While Ellison, 80, didn’t have a prior connection to the Wolverines, his 33-year-old wife, Jolin, is a Michigan alum.
The Wolverines play UC San Diego at 10 p.m. EST Thursday and are favored to win.
Daniel Gilbert
Gilbert cofounded mortgage behemoth Rocket Companies, which has a current market cap of nearly $30 billion. He’s worth an estimated $31.3 billion, making him the 57th-richest man in the world today. Gilbert also owns the NBA’s Cleveland Cavaliers.
He donated $15 million to Michigan State University in 2016 to be used toward the school’s basketball program. Both he and his wife, Jennifer, attended Michigan State, and said at the time the school had “played a large role in both of our lives.”
Michigan State faces off against Bryant University on Friday at 10 p.m. EST. The Michigan State Spartans are expected to win.
Sarah Blackburn was one of many who jumped in on the hype to get a full-body MRI. The test as a preventative screening tool has been gaining popularity in recent years. Many already healthy individuals take the scan hoping to be reassured that nothing is out of the ordinary. But Blackburn had quite the opposite experience.
“I had a full-body MRI just for fun. No symptoms whatsoever,” Blackburn says in a viral TikTok video about her experience earlier this year. “Now I am scheduled to have an organ removed in two weeks.”
Blackburn decided to take Prenuvo’s $2,500 full-body MRI in Houston—the fast-growing company has been expanding across the U.S. after launching in Vancouver in 2018. While the scan is not a replacement for recommended routine screenings like mammograms and pap smears at your doctor’s office, the company claims its 60-minute test is an early detection and preventive health tool, scanning for hundreds of conditions and “silent killers like aneurysms,” according to the site. But for many, it’s just more data to store away because often, there is nothing to act on, which was the case with me when, as part of a story, I underwent a Prenuvo full-body MRI last year.
“I was so excited to get my results. I don’t know what I thought we were going to find. Now, looking back, I was just so certain that this was going to give me peace of mind and that they were not going to find anything serious,” Blackburn says.
After the scan, people receive a report that outlines each organ of the body and any informational or important findings. “I was treating it like a spa day. I was so excited, and taking pictures in my little scrubs,” Blackburn shares on TikTok. “It did kind of feel like a spa day, until it didn’t.”
Four days after her scan around 8:30 p.m., Blackburn was alerted that her results were ready. She posted screenshots of the results in her video.
“I went into a full blown panic attack,” she says. Marked in red letters under the circulatory system category, the words “important finding” sat. She had a splenic artery aneurysm, according to the report.
The finding’s description noted that while “the majority of splenic artery aneurysms are incidental findings … if a splenic artery aneurysm ruptures, there is a one in three mortality rate.”
“It was a really dark and hard two months, where I was spiraling and freaking out and seeing a lot of doctors and pretty much treating my body like glass because I had no idea about this,” Blackburn shares. “I literally felt like a ticking time bomb was found inside my body.”
After months of deliberation, Blackburn decided to get her spleen removed, and tells People that she had, in fact, had a lesion on a 2020 ultrasound that she had never learned about. “Read your radiology reports,” Blackburn told People. “I did not read it. I just thought, ‘Okay, I’m going to get told everything that needs attention.’ But, that was not the case.” A follow-up CT scan after the Prenuvo results found two anyeurums in her splenic artery.
While in some cases the full-body scans can uncover an important finding, it can also cause undue anxiety about things that are still in the range of normal, Dr. Matthew Davenport, the William Martel Collegiate professor of radiology and service chief and vice chair in the Department of Radiology at Michigan Medicine, previously told Fortune.
“Knowing is not always to your advantage if what you learn doesn’t have a clear pathway. Sometimes when you learn a piece of information, you can be misdirected as to the importance of it,” he told Fortune. “You can learn something about yourself, but it can actually increase your uncertainty.”
Often, people may go down unnecessary rabbit holes and additional testing, he adds.
But for Blackburn, the scan caused her to act—and was, in fact, incredibly useful for her health. “I will be starting the journey of life without a spleen, which I think is going to be okay. It’s going to be better than having to live in fear of having a ruptured aneurism,” she says in the video.
Still, she says she has mixed feelings about recommending the scans to others, especially those who have severe health anxiety.
“I feel grateful,” Blackburn says. “I am happy that I know about this and had the chance to decide what I wanted to do moving forward, but … for the people who already have existing health anxiety I truly don’t know if I can recommend it.”
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