I picked up one of my favorite shirts at the White House. I love that place, and I love what the Trump administration has done and continues to do. It makes me think about continuity, about practical people who get results, and about the kind of energy we need in the states. I’m excited about Vivek Ramaswamy in Ohio. The race is competitive—recent polls have shown leads within the margin of error and prediction markets have favored his opponent more strongly—but I look at the internals, the trajectory, and the opportunity, and I believe he can win. Assuming that path, Ohio has a unique chance to lead the country on something that matters more to ordinary families than almost anything else: the crushing cost of healthcare, starting with cancer treatments.
I’ve been thinking about this for years. Friends have faced cancer. I’ve watched the bills, the delays, the sense that the system is designed more to manage disease than to fix people. The way for Republicans to win on healthcare in 2028 is not another tax credit or block grant that sounds like accounting. It is a concrete story: we cut the price of the most expensive treatments by attacking the cost-plus culture that has defined medicine the same way it once defined aerospace. We make advanced care available faster and cheaper. We fix people.
SpaceX is the right frame. Elon Musk and his team did not invent rockets. They applied vertical integration, rapid iteration, and a ruthless attack on cost-plus assumptions that had been baked into the industry for decades. NASA’s Shuttle delivered payload to low Earth orbit at something like $54,500 per kilogram. Falcon 9 brought that down toward $2,720 per kilogram—an order-of-magnitude improvement driven by reusability, in-house manufacturing of critical components, and a culture that squeezed suppliers and eliminated layers of markup. Roughly 80 percent of Falcon hardware was built in-house at Hawthorne. The “idiot index”—raw materials representing only a tiny fraction of final cost—forced first-principles thinking. That is the model. Cancer care is stuck in the opposite posture: academic timelines, slow FDA pathways, venture capital that demands multi-year runways before it moves, and pricing that treats every new therapy as a custom, high-margin product.
Ohio already has the raw material. Two weeks ago the James Cancer Center at Ohio State published a Phase 1 trial in Blood Cancer Discovery. Researchers tested a point-of-care manufactured trispecific CAR-T product targeting CD19, CD20, and CD22, enhanced with an OX40 costimulatory domain. Sixteen patients (median age 64) who had already burned through a median of three prior therapies received the cells. In the B-cell non-Hodgkin lymphoma subset, the complete response rate was 83 percent. There was no severe cytokine release syndrome and no neurotoxicity. Median vein-to-vein time was about seven days. That is not incremental. That is the kind of result that can rewrite parts of the treatment algorithm when it scales.
Around the same time, Ohio State licensed next-generation dual-payload antibody-drug conjugate technology to BiFormyx BioPharma. The company is moving its headquarters to Columbus and is targeting an Investigational New Drug filing in early 2028 for programs aimed at aggressive solid tumors such as triple-negative breast cancer. The entrepreneurs are not hypothetical. They are already in the state, building on James Center infrastructure that no pure startup can match.
A Ramaswamy administration would not need to invent cancer research. It would need to do three practical things. First, treat the James Center and Cincinnati Children’s as anchor tenants the way SpaceX treated Hawthorne—build the surrounding ecosystem of suppliers, manufacturers, and trial capacity around them instead of scattering small grants. Second, compress the state’s role in clinical trial siting and IRB approvals so Ohio becomes the fastest place in America to run a first-in-human study. A state-level regulatory sandbox that allows expanded access for therapies that have cleared Phase 1 while the national FDA process continues would put desperate patients on a plane to Columbus instead of Europe or Mexico. That builds both the clinical data and the political testimony at the same time. Third, use the governor’s office and the congressional delegation to push FDA pathway reform specifically for cell and gene therapies, while launching a manufacturing initiative so advanced therapies are built here. That sounds like jobs. It is jobs. It also happens to cure people.
The honest political caveat is that a pure “cure for cancer” message carries risk. Joe Biden’s moonshot language ran into the reality that many trials exist but the system is slow and expensive. Pharma has incentives to protect high-margin models. The safer, stronger 2028 pitch is not “we cured cancer.” It is “we cut the price by a large fraction and made advanced care available in county hospitals.” Direct medical costs of cancer care were already estimated above $200 billion annually and are projected to climb further; oncology drug spending alone is on a path toward hundreds of billions more by 2030. Families feel the $200 syringe and the six-figure episode. A SpaceX-style attack on the manufacturing and process costs of CAR-T and next-generation ADCs—point-of-care production, standardized platforms, elimination of custom-build markups—turns that into a diner-table number a voter in Dayton can understand.
Day one is not a task force. It is one connector with no ego and a mandate: get the founder, the family office, the hospital executive, and one skeptical journalist in a room every month. I know people who would make powerful patient testimony—friends who have lived the system. Put one of them on camera early. The three-month runway is to assemble the core group, file the sandbox concept, and open conversations with the Trump administration for continuity on FDA reform. The durability beyond any single administration is the real prize. Healthcare is the issue that does not care about team colors. Every cycle Republicans are asked what they will do, and the answer has usually been accounting. “We fix the thing that costs you more than your mortgage” is a different animal. It turns a defensive issue into an offensive one and gives the party a story about results rather than a man.
I have said for years that the person who can talk to anyone, get the money people and the operators in a room, and handle the public relations against the entrenched interests is more valuable than another PhD on staff. That is the SpaceX culture applied to medicine. Ohio can lead it. The technology is further along than most people realize. The politics have been the bottleneck. A friendly administration that treats this like a campaign—speed, visibility, manufacturing, and patient stories—can change the cost structure of healthcare by making advanced treatments practical instead of perpetually expensive.
If you are interested in the kind of first-principles thinking that produced The Gunfighter’s Guide to Business, this is the same mindset applied to the largest cost problem in American life. Ohio has the anchors. A Ramaswamy administration can put the right people in the rooms. The rest is execution.
Footnotes
1. Ohio governor race polling and prediction markets as of late October 2026 (Cleveland.com, State of the Odds / Kalshi-Polymarket data).
2. Vasu S, et al. Safety and Clinical Outcomes of a First-in-Human Trial of Point-of-Care Manufactured Trispecific CAR T Cells Targeting CD19, CD20, and CD22. Blood Cancer Discovery. 2026;7(5). DOI: 10.1158/2643-3230.BCD-26-0186. OSUCCC–James lead.
3. CancerNetwork summary of the same trial: 83% complete responses in the B-NHL subset; no severe CRS or neurotoxicity.
4. Ohio State licensing of next-generation dual-payload ADC technology to BiFormyx BioPharma (October 2026 announcement); IND target early 2028.
5. AACR Cancer Progress Report 2026 and related estimates of direct cancer care costs exceeding $200 billion (2020 baseline figures, ongoing growth).
6. Milliman analysis of oncology drug spending trajectory toward $400 billion by 2030.
7. NASA Shuttle ~$54,500/kg vs. Falcon 9 ~$2,720/kg (various aerospace analyses, including Harry Jones / NASA Ames references); SpaceX vertical integration figures from company and independent reporting.
8. JAMA Oncology viewpoint on rising median monthly launch prices for systemic therapies (2023–2025 data).
Selected Bibliography
• Vasu S, Denlinger N, Song NJ, et al. “Safety and Clinical Outcomes of a First-in-Human Trial of Point-of-Care Manufactured Trispecific CAR T Cells Targeting CD19, CD20, and CD22.” Blood Cancer Discovery 7, no. 5 (2026).
• American Association for Cancer Research. Cancer Progress Report 2026.
• Milliman. “The oncology drug landscape: Spend trends, market dynamics, and the road to 2030” (2026).
• Shah C. “Rethinking Value in Cancer Care in the US.” JAMA Oncology (October 2026).
• Ohio State University Office of Enterprise for Research, Innovation and Knowledge. Licensing announcements for BiFormyx BioPharma dual-payload ADC platform (2025–2026).
• SpaceX and independent analyses of Falcon 9 reusability and vertical integration (Hawthorne manufacturing, cost-per-kilogram comparisons versus Shuttle).
• Peterson-KFF Health System Tracker and related national health expenditure data.
• American Cancer Society and National Cancer Institute studies on cancer-attributable medical costs by phase of care.
Rich Hoffman
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About the Author: Rich Hoffman
Rich Hoffman is an author, political consultant, and strategic advisor based in Cincinnati, Ohio, and the creator of The Politics of Heaven—a unique framework that connects biblical theology, ancient history, and modern power structures to explain how moral alignment and spiritual forces shape global events. Blending real-world political experience with deep research into archaeology, UFO phenomena, and suppressed historical narratives, Hoffman offers compelling commentary on topics ranging from ancient civilizations and the Dead Sea Scrolls to modern populist movements, paranormal continuity, and leadership strategy in chaotic environments. As the author of The Gunfighter’s Guide to Business and the forthcoming Politics of Heaven, he brings a grounded yet provocative voice to media discussions, supported by firsthand experiences and a cross-disciplinary approach that bridges science, history, and theology. For interviews, speaking engagements, or expert analysis, visit richhoffmanbooks.com or contact directly by email at rhoffman@richhoffmanbooks.com. If you’ve seen the movie, Disclosure Day and want to talk about it and the implications of Presidnet Trump’s UAP disclosures, let me know and we can bring some color to your coverage. https://richhoffmanbooks.com/media-inquiries-broadcast-topics-and-contact-info/?frame-nonce=ad51e7ecba I do have a firsthand UFO encounter to discuss.
