In a strong Op-Ed in the New York Times, Dr. Zack Cooper of Yale’s Health Care Affordability Lab points out simple, straightforward stesp that would help reduce out-of-control health care insurance costs.
NYT: When Health Insurance Costs $10,000 Per Person, It’s Time for Reform
Health Care Affordability Lab at Yale
AI Summary: “Health Care Premiums Are Going Up, Again. Here’s What We Can Do Now.”
Author: Zack Cooper, Director of the Health Care Affordability Lab at Yale University
Published: November 3, 2026, The New York Times, Opinion
Central Argument
America’s health care costs are spiraling upward, but meaningful relief does not necessarily require a sweeping overhaul of the entire health care system. Instead, Zack Cooper argues that a series of relatively small, targeted reforms could collectively save hundreds of billions of dollars annually without sacrificing the quality of care.
Cooper believes that politicians devote too much attention to comprehensive proposals, such as Medicare for All, while overlooking practical reforms that could deliver substantial savings much sooner.
The Growing Health Care Crisis
Health insurance is becoming increasingly unaffordable for American families. Cooper highlights several alarming figures:
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13%: The average increase in individual-market insurance premiums for 2027, following a 26% increase the previous year.
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10%: The expected increase in employer-sponsored health coverage costs.
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$10,000: The projected annual employer-sponsored coverage cost per person, exceeding this amount.
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$5.5 trillion: The approximate annual size of America’s health care system.
These rising costs discourage people from seeking necessary medical treatment, strain household budgets, and contribute to the federal government’s mounting fiscal problems.
A Different Approach: Fix the Leaks
Cooper argues that America’s health care system is not one unified structure but a collection of overlapping systems, including Medicare, Medicaid, private insurance, and veterans’ health care.
Each contains inefficiencies, excessive charges, unnecessary administrative expenses, and practices that benefit powerful financial interests.
Rather than replacing the entire system, Cooper proposes identifying and correcting these individual problems.
Researchers at Yale’s Health Care Affordability Lab have identified 23 evidence-based reforms that could save as much as $400 billion annually, approximately 8% of total American health care spending.
Examples of Practical Reforms
Cooper identifies several opportunities for reducing costs.
1. Combining insurance markets
Most states maintain separate insurance markets for individuals and small businesses. Combining these markets could reduce administrative expenses and create larger insurance pools. Researchers estimate this could save households approximately $500 annually and the federal government more than $8 billion.
2. Increasing childhood flu vaccinations
Making flu vaccinations more convenient, including through pharmacies, could reduce illness, doctor visits, and emergency room treatment. Increasing vaccination among children ages two through five could save approximately $500 million annually.
3. Regulating hospital prices
Hospitals frequently negotiate dramatically different prices with insurance companies for similar services. Better regulation of these negotiated prices could reduce excessive spending.
4. Encouraging competition in prescription drugs
Certain agreements between brand-name and generic pharmaceutical manufacturers delay the introduction of less expensive medicines. Eliminating these anticompetitive practices could lower prescription drug costs.
5. Reducing fraud
Strengthening oversight of fraudulent medical billing, particularly in home health care, could recover substantial amounts of wasted money.
Why These Reforms Face Resistance
Cooper identifies a fundamental political problem: The financial waste in American health care is often someone else’s income.
Hospitals, pharmaceutical manufacturers, insurers, and other businesses have powerful lobbying organizations protecting their financial interests.
By contrast, there is no equally powerful political constituency advocating for greater efficiency.
Furthermore, incremental reforms rarely capture public enthusiasm. Politicians prefer promoting ambitious transformations rather than discussing technical changes to insurance regulations or billing procedures.
Consequently, even reforms that could save billions of dollars face considerable opposition.
The Role of Comprehensive Reform
Cooper does not reject large-scale health care reform. In fact, he favors eventually allowing Americans to buy into Medicare.
However, he believes such changes are politically unlikely before 2028 and would take additional years to implement.
He also observes that comprehensive reform would not eliminate difficult decisions about prices, payments, and financial incentives. Those decisions would still have to be made under any new system.
Implementing smaller reforms now would provide immediate financial benefits while building the political experience necessary for more ambitious changes later.
Conclusion
Cooper’s essential message is that Americans should not have to wait for a political revolution to obtain more affordable health care.
By addressing inefficiencies, excessive profits, anticompetitive behavior, and administrative waste individually, policymakers could generate enormous savings.
His argument is both economic and political: Real health care reform may be achieved not through one dramatic transformation, but through dozens of practical improvements that collectively produce transformative results.
An Important Implication
One particularly significant aspect of Cooper’s argument is his recognition that excessive health care spending is not simply the consequence of an inefficient system. It is also the product of financial incentives that reward inefficiency.
This raises an important ethical question: When practices that increase medical costs also generate income for powerful institutions, how can public policy put patients’ welfare ahead of financial interests?
That question could provide an especially productive starting point for a broader discussion of health care as a moral responsibility rather than simply an economic commodity.
Source: Zack Cooper, The New York Times, November 3, 2026. The article was also republished in the Salt Lake Tribune on November 4.
