It was just after 7 PM when Linda realized she couldn’t do it alone anymore. Her mother, Eleanor, a once-independent retired schoolteacher, had begun to struggle with the simplest tasks—making breakfast, taking medication on time, even getting dressed. Linda had a full-time job, two children, and a mortgage to worry about. Assisted living was out of the question—too expensive, too impersonal. So, she turned to what seemed like the only option left: an in-home care agency. The first quote? $6,500 a month—just for basic assistance.
Eleanor is not alone. Across the United States, millions of seniors, individuals with disabilities, and people recovering from surgeries or illnesses are caught in the same trap: needing help at home but unable to afford the staggering costs. Many require assistance with every day, non-medical tasks like transportation to doctor’s appointments, grocery shopping, housekeeping, meal preparation, and companionship to fight loneliness. For family members, juggling these responsibilities alongside work and personal commitments can be overwhelming, often leading to burnout and stress.
With the inauguration of President Trump and the appointment of a new Secretary of Health, there is fresh momentum to address what has long been a failing system — one that spends more than any other developed country while delivering subpar results. The President has long championed innovative, efficient solutions that cut through red tape, and his administration is now poised to deliver on that promise in the healthcare sector.
A System Straining Under Its Own Weight
The numbers paint a grim picture. The U.S. spends nearly 18% of its GDP on healthcare —by far the highest in the world. Despite this, Americans experience worse health outcomes than their counterparts in Canada, Germany, or the United Kingdom. A recent study found that 20-30% of healthcare spending is wasteful, amounting to between $600 billion and $1.45 trillion annually.
Much of this inefficiency stems from an overreliance on profit-driven insurance companies that have little incentive to lower costs. Americans routinely pay exorbitant prices for services that should be affordable, with insurers adding layers of bureaucracy that drive up costs while delivering little added value. According to a Kaiser Family Foundation survey, half of U.S. adults struggle to afford healthcare, and one in four skip necessary treatment because of cost concerns.
While Medicare Advantage plans are available and marketed as an all-in-one solution, they often fail to deliver the services necessary to help seniors and people with disabilities live independently at home. Research shows that Medicare Advantage beneficiaries receive fewer home health visits and have worse outcomes compared to those on traditional optinos. Many of these plans limit coverage for essential home care, impose burdensome prior authorization requirements, and restrict access to in-network providers, making it difficult for seniors to receive the assistance they need when they need most. Instead of providing flexible, person-centered care, these plans often add more layers of inefficiency to an already overburdened system.
Dr. Sarah Whitman, a geriatric care expert at Johns Hopkins University, underscores this issue:
“Medicare Advantage plans often look great on paper but can be incredibly restrictive when it comes to real-world care. Many seniors and their families struggle with denied claims, bureaucratic delays, and limited access to caregivers who can provide essential services like transportation, light housekeeping, or simply companionship. The current system does not adequately support aging in place.”
A New Model: Community-Driven Care
In response to these challenges, a growing movement is advocating for a different approach — one that leans on technology to connect people needing care with caregivers in their own communities – often neighbors or local providers. Canada has already seen success with this model. Tuktu Care, a platform that links seniors and those with disabilities to local freelance caregivers, has proven that community-powered solutions can make care more affordable, more personal, and more widely available.
Rustam Sengupta, the founder of Tuktu, explains the platform’s impact:
“By creating direct linkages between supply and demand using technology, we’ve proven that the costs of at-home care can be significantly reduced. This model ensures that the money paid for care is earned by local community members, not large corporations.
Tuktu, now expanding into the U.S (www.tuktu.us), uses smart matchmaking to connect people like Eleanor with trusted local providers who offer help at a fraction of the cost of traditional agencies. Rather than relying on institutional care or expensive agencies, it allows communities to take care of their own.
Dr. Jonathan Meyer, a healthcare economist at Stanford University, echoes the potential of this shift:
“Tech-powered platforms are revolutionizing healthcare by removing unnecessary intermediaries and creating direct, cost-efficient solutions. The President’s push for greater transparency and efficiency aligns perfectly with these innovations, which can deliver higher-quality care at lower costs.”
A More Efficient and Affordable Future
Community-powered care aligns with President Trump’s call for greater efficiency and transparency in healthcare spending. His administration has already signaled its intent to reduce the role of bureaucratic middlemen in healthcare transactions, and care platforms fit seamlessly into this vision. These innovations embody the kind of smart, market-driven solutions that the President has consistently championed—leveraging technology to reduce costs while improving service quality.
Anecdotes like Linda’s illustrate why these matters. Through Tuktu, Linda was able to find Sarah, a local college student who needed flexible work. For $20 an hour—far below agency rates — Sarah helps Eleanor with grocery shopping, light housekeeping, and companionship. Eleanor remains in her home, Linda avoids financial ruin, and Sarah earns an income. Everyone benefits.
Compare this to the insurance-driven model, where administrative overhead and corporate markups inflate costs while delivering no additional value. The current system not only fails to cover everyone, but even those with coverage often receive inadequate services. Community-based platforms like Tuktu cut through these inefficiencies, ensuring that money spent on care goes directly to caregivers—not insurance executives or agency middlemen.
A New Mandate for Change
With the newly appointed Secretary of Health’s mandate to make care cheaper and more efficient, solutions like community-driven platforms offer a roadmap forward. By leveraging digital solutions to connect caregivers with those in need, the U.S. could dramatically reduce costs while improving access and quality.
The question is no longer whether change is needed, it is how quickly we can implement it. The current system is unsustainable, draining families financially while failing to deliver high-quality care. The future of care must be rooted in local communities, empowered by technology, and free from the unnecessary burdens imposed by a bloated and profit-driven insurance model.
President Trump has promised to put efficiency at the heart of his administration’s healthcare reforms. Embracing community-driven platforms may be his best bet.