In 2023, the U.S. federal government spent a staggering $1.5 trillion on healthcare, yet Americans are becoming unhealthier by key measures like obesity, maternal mortality, and life expectancy. This unsustainable trajectory not only undermines public health but threatens the fiscal future, with healthcare spending growing faster than the economy and consuming nearly 30% of the federal budget. Despite challenges, the path forward lies in incentivizing innovation, reforming payment structures, liberating healthcare data, and reducing fraud. By fostering a competitive, entrepreneurial healthcare system and embracing cutting-edge technologies like AI, the U.S. has the potential to improve health outcomes while controlling costs and ensuring a brighter, healthier future.
The rapid evolution of warfare has exposed critical gaps in US capabilities. Conducting ground offensives over complex terrain, and protecting the troops who carry them out, will both be dramatically different missions in 2030. Over the first quarter of the century, from the GWOT’s infantry campaigns to today’s increasingly autonomous combat, ground operations have meant constant and intensifying danger to the warfighter. From 2006-2021, 44% of US forces killed in action were caused by improvised explosive devices (IEDs). Avoiding IEDs often forces tactical vehicles off-road, multiplying the risk of accidents. From 2010-2019, the U.S. Army and Marine Corps reported 896 tactical vehicle accidents, many involving fatalities. Today, ground forces are even further exposed with the rise of unmanned aerial and ground vehicles and distributed sensors, and asymmetric conflict is shifting ground operations to the most difficult terrain.
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