If Donald Trump and Elon Musk want a bold win for Americans, they should champion the creation of a PayPal for health care administration. The current fragmented system exists primarily to protect big insurance companies from competition. The rest of us pay with our time, our health, and sometimes our lives.

Forty-seven year-old Kathleen Valentini’s leg, hip, and pelvis were amputated after the MRI her physician requested to diagnose the cause of her pain—it turned out to be cancer—was denied. The appeals process was too slow. By the time she got the MRI, the cancer had spread too far for chemotherapy.

To order an MRI, care teams like Kathleen’s have to find the insurer’s requirements and submit documents by fax or an online form. If the request is denied, they have to call the insurer to spell out the patient’s policy number. Then the insurance company, or their third-party administrator, starts the process on their end. That people, rather than computers, move information is a reason it took over a month to approve the appeal for the MRI.

Fortunately, there is a well-known solution. Most industries have solved similar problems with digital transaction systems like PayPal. When you buy something online, digital systems check your state’s tax rate, check for fraud, and email you a tracking number. When you search for a home loan, digital systems use your credit score and current interest rates to let you choose between combinations of monthly payments and loan durations.

Bringing health care systems into the digital age could reduce administration costs by over 60 percent, according to research in which we participated. This would save over $1 trillion per year of the $1.6 trillion that Americans spend on billing and insurance. That’s an average of $6,000 for each of the 160 million Americans with employer-sponsored health insurance.

Reducing the complexity of health insurance is a bipartisan priority. President Donald Trump recently signed an executive order to improve enforcement of rules requiring insurers and hospitals to post their negotiated prices in a machine-readable format. Mike Braun and Bernie Sanders, two of the most and least conservative members of the Senate, are co-sponsors of a bill to expand these rules and impose additional data sharing standards. These efforts require the disclosure of prices obscured by our broken system. Our proposal is to modernize the system.

There are three main challenges—standardizing health insurance contracts, creating a digital transaction system, and ensuring that health insurance companies use it.

The 320,000 U.S. health plans must be standardized into a format that can be administered by computers, not by people making phone calls. Our research suggests this may be easier than it seems. Our proof-of-concept tool encodes the state-specific prior-authorization rules of four large insurers into a surprisingly simple digital contract. Much of the work, translating hundreds of pages of written rules into code, could be done by large language models that interpret written medical data better than physicians.

A public-private partnership must create digital systems to administer the standardized contracts. Home mortgages show how a federal agency can coordinate private efforts. Before 1971, every state, bank, and loan officer set its own terms for home loans. Fannie Mae and Freddie Mac, which were publicly traded for-profit companies chartered by Congress, led the effort to standardize mortgage contracts. They created the system that today processes over 90 percent of home loans as uniform mortgages.

The biggest challenge is ensuring the participation of the large health insurers for which the system would save billions. They remain vociferous opponents of changing an incredibly profitable system. They claim that state-specific regulations make standardization impossible and that it would hurt consumers.

Nobel Prize-winning economists and our research suggest another explanation. Insurers preserve the complexity and fragmentation of the current system as a moat against competition. This accords with growing insurer profits failing to attract new competitors. Absent competition, innovation presents more risks than benefits.

Insurance companies will fight to preserve the status quo just as pharmaceutical companies fought to maintain a ban on Medicare negotiating drug prices or to keep charging 10 times as much for insulin in the U.S. as in other countries. But change is possible. After 20 years, the Inflation Reduction Act ended Medicare’s most egregious overpayments and brought down the cost of insulin.

Kathleen Valentini died the year after her request for an MRI was denied, killed by cancer that could have been caught earlier. We all pay a steep price. The delays caused by health care’s complex administrative processes lead to blindness, paralysis, and death. It’s an anti-system overdue for fundamental change.

David Scheinker, Kevin Schulman, and Stefanos Zenios study and teach health care operations, policy, administration, and innovation at Stanford’s Schools of Engineering, Medicine, and Business.

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