Average tax refunds are reportedly up 10% this year, but easing Americans’ distrust of how Uncle Sam spends the money it keeps is not disappearing anytime soon. According to 2025 polling from the Cato Institute, the average adult believes that 59 cents of every federal tax dollar is “wasted” — up from 38 cents in 1986.
That’s why recent investigations to uncover Medicaid fraud in states ranging from Blue California to Red Florida are resonating with voters. When program spending on autism therapy, for example, is accelerating by hundreds of millions of dollars in certain states, something is up, and more rigorous oversight is clearly needed.
In this type of environment, the urge to slash and burn government budgets is enticing. When federal health-related spending stretches into the trillions of dollars, it’s prudent for a taxpayer to wonder what other waste could be lurking beneath the surface. But Washington should be careful not to throw the baby out with the bathwater. Smart investments in public health pay out sizable dividends.
TRUMP IS QUIETLY SOLVING AMERICA’S HEALTHCARE CRISIS. HERE’S HOW
While Medicaid is currently in the spotlight, the National Institutes of Health has been a favorite punching bag for Republicans since the COVID-19 pandemic — and for good reason. Some within the agency arguably misled Americans as transparency took a back seat to political expediency in 2020 and 2021.
What began as a nonscientifically based dictate about face masks snowballed into murky explanations for social distancing rules, drawn-out school closures, and preventive care that greatly undermined the credibility of government health advice. A desire for retribution is partly why a proposal to cut the NIH’s budget by 40% was (unsuccessfully) floated last year.
Holding officials accountable matters, but past missteps should not put public health progress on life support. The NIH helps to deliver real health benefits that quietly save people’s lives.
The agency’s research supports medical breakthroughs that are revolutionizing cancer treatment and cardiovascular care. The work has transformed HIV from a fatal diagnosis to a manageable disease and has helped map the human genome to unlock a new era of precision medicine. Though difficult to quantify, NIH research has undoubtedly saved millions of American lives.
However, these innovations don’t happen in a vacuum. They are only possible because of the partnership between the government and private sector — both coming to the table with unique strengths that depend on the other.
To understand the dynamic, it’s helpful to compare the study of physics to that of engineering. The former discipline instills general, conceptual knowledge that informs the application of the latter. Still, a grasp of both physics and engineering is needed to build a bridge.
Similarly, the NIH helps to create the building blocks for health innovations. Private industry then runs with the science — spending more than double the NIH’s budget on further research and development — to get it over the finish line in the form of treatments, therapies, and vaccines. For a single new medicine, this process can cost companies upwards of $2 billion and take more than a decade.
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The complementary relationship is why plans to significantly defund the NIH are unpopular among both Republicans and Democrats in Congress. In fact, a bipartisan group of lawmakers recently approved an increase to the agency’s budget. That same bipartisan zeal should also apply to fostering a robust private medicine economy, or else little of the NIH science will translate to realized health benefits.
As more of the public receives refunds from the IRS, many will wonder what Uncle Sam is doing with the rest of the money — and rightfully so. The federal budget is overgrown and long overdue for a haircut, but continuing to support a robust health research ecosystem is one investment worth every penny.
Dr. Tom Price served as the 23rd U.S. Secretary of Health and Human Services and is a former member of Congress from Georgia.