If DOGE Really Wants To Make the Government More Efficient, It Should Start With Health Care Fraud | Opinion

President Donald Trump and Elon Musk's new Department of Government Efficiency (DOGE) has recently captured media attention for a variety of controversial spending cuts. The Department has taken to social media to boast of obscure savings like $500,000 on media subscriptions at NASA or $3 million on real estate leases. If DOGE wants to make a more substantial impact on the government's bottom line, all while genuinely increasing efficiency as opposed to merely allocating money to policy preferences, the Department should target fraud, waste, and abuse in the government's major areas of contracting—health care and defense. This would save orders of magnitude more than those media and real estate line items, while also deterring billions more in future fraud.

The government health care programs, headlined by Medicare and Medicaid, have staggering budgets. Medicare and Medicaid alone account for nearly $2 trillion of government expenditures annually, with total health care spending approaching $5 trillion, or $15,000 for every American. Given those numbers, even a relatively low rate of fraud costs a great deal.

Estimates of improper payments (including payments resulting from fraud, negligence, and mistake) by these federally backed health care program ranges into the hundreds of millions. A recent Wall Street Journal analysis of the Medicare Advantage program, a privatized version of Medicare that covers roughly half of Medicare's beneficiaries, found $50 billion in suspect payments in that sub-program alone. That's roughly the entire budget of U.S. Agency for International Development (USAID), an agency that has recently been reported to be on DOGE's chopping block.

We'd know. As lawyers who represent whistleblowers, our clients have aided the government in recovering hundreds of millions lost to health care fraud. Under a law called the False Claims Act, private individuals can sue government contractors, including those that work with and bill Medicare and Medicaid. Since the law was revamped in 1986, it has been used to recover $54 billion lost to fraud by the Department of Health and Human Services (HHS).

The expertise that DOGE, and Musk, bring is also uniquely suited for detecting (and later, hopefully deterring) health care fraud. It's been widely reported that DOGE has been using AI tools to uncover wasteful spending. Health care data is a perfect application of those tools. Because health care is a generally objective, data-heavy environment, current AI models can do some of their best pattern recognition to spot likely fraud.

Another common area of fraud against the government, and the reason the False Claims Act became law at all, is defense contracting. The law was first passed in 1863, amid the American civil war, partially in reaction to war profiteers selling the Union Army sickly mules as healthy cavalry horses, sawdust as sugar or flour, and glued-together rags as crisp new uniforms. The 1986 amendments which revamped and modernized the law stemmed from the same fount.

Since then, the law has proven effective, recovering over $7 billion in fraud against the department of defense.

Government contractor fraud is prevalent, wasteful, and inefficient. It's the low hanging fruit where DOGE should start, and where the department, with its unique expertise, is likely to get the most bang from its buck.

Max Voldman and Hallie Noecker are whistleblower attorneys at Whistleblower Partners LLP.

The views expressed in this article are the writers' own.