Health care expenses that arise from largely nonclinical functions, such as coding and billing and administration, cost the US health care system almost $1 trillion annually. Michael Chernew, PhD, from Harvard Medical School Department of Health Care Policy, and David Cutler, PhD, from Harvard University Department of Economics, join JAMA Associate Editor Karen Joynt Maddox, MD, MPH, from Washington University School of Medicine to discuss some basic fixes and simplifications that could reduce administrative spending by an estimated $265 billion.