Healthcare and Research Infrastructure
The US healthcare system is largely a mix of private and public provision. In 2020, total healthcare spending was about $4.1 trillion.
The US leads globally in research infrastructure. In 2023, the National Institutes of Health (NIH) had a budget of around $48 billion, making it the largest single public funder of biomedical and behavioral research globally. Under the National NIH budget proposals of the Donald Trump administration, the agency's funding was targeted for deep cuts, with plans including a reduction of approximately 40% (around $18 billion) in the FY 2026 budget. In addition, the NIH cancelled or froze more than $2 billion in grants by early 2025 and cut indirect cost reimbursement rates for institutions from roughly 27% to 30%, down to 15%.
The US hosts several powerhouse life sciences research centers driving innovation. At the federal core is the NIH in Bethesda, Maryland, a 27-institute biomedical engine that invests tens of billions annually across areas from genomics and neuroscience to infectious disease. In Boston, Massachusetts General Hospital and Brigham and Women's Hospital, both Harvard-affiliated, run two of the world's largest hospital-based research programs. Houston's MD Anderson Cancer Center is a leader in oncology research, while Oak Ridge National Laboratory contributes at the interface of biology, computation and biomanufacturing, leveraging supercomputing for bioenergy and systems biology.
