Dr. Mehmet Oz on Fixing American Healthcare + Fraud | Live from Davos
These notes were generated by AI and may contain inaccuracies.
Interview at Davos with Dr. Mehmet Oz, CMS administrator. Hosts note the picturesque Davos setting with solar panels on buildings for aesthetics only. Dr. Oz transitioned from TV host (13 years) and surgery to CMS for greater impact in healthcare change.
I'm in the change business... this is the best job I've ever had because you truly do get to make the change that I desire.
Encourages taking big swings to change infrastructure. Trump administration enables fast action.
Trump moves fast, ships product quickly, creates urgency. In Oval Office meetings, his first instinct is to pick up the phone and fix problems immediately. This administration selects proven experts like Dr. Oz, not career politicians. Leaders must tell the story to media and public due to misunderstandings of impacts.
Three ways to make change:
- Make laws through Congress (slow, compromised results).
- Rulemaking (takes time, prone to lawfare; e.g., fraud-reducing rule enjoined by blue cities, now in court).
- Power to convene: Bring parties together for safe harbor discussions, underused historically. Trump excels as negotiator.
Addresses US paying 10x more for same drugs as Canada/Europe. Trump directs convening drug companies with pressure (rules/projects as leverage) but without harming innovation. US spends 1% of GDP (8% of healthcare spending) on drugs vs. Europe's 0.3%.
Don't hurt the innovative nature of pharmaceuticals... take some of the fat out of it. Pull it back and give it to the American people.
Fairness analogy to NATO burden-sharing. Negotiations ongoing; Britain agreed. Europeans get drugs later, lower cancer survival rates.
Lower drug prices enable access, e.g., getting average American to work one year longer = $3 trillion to economy. Gets them closer to Medicare, addresses financial crises. US spends twice as much as universal healthcare countries but gets faster/better access for life-threatening issues.
Everyone should have access, but payment method key to avoid restrictions like in socialized systems (6-12+ month waits). Americans prioritize timely care over just affordability.
Canadians come to US for urgent treatment; few Americans go to Canada. Some US medical tourism for cosmetic, dental, elective procedures, stem cells (still regulatory process in US).
AI/tech ready for big shifts. Subsidize top entrepreneurs building apps for conditions like diabetes to attract investors.
Studies (Harvard/MIT) show LLMs give better advice than average GP, better bedside manner, preferred by patients. LLMs outperform on board exams, more patient/repetitive.
Hybrid approach: AI does busywork/paperwork, feeds key info to doctors for human connection (50% cortex for reading faces).
Shortage of GPs (US 2-3x below Europe per capita); med students prefer high-pay specialties due to debt (even at tuition-free Columbia).
Patients use consumer AI (ChatGPT, Grok) with blood panels/PDFs for self-diagnosis/research. Doctors use specialized tools with journal citations.
Trend: Self-directed healthcare (Function Health, Superpower, Whoop blood labs, Aura, Apple Watch, HLEP, POVA 3D scans, Nico/Daniel X $300 full body scan). 80/20 rule: If 20% adopt, improves all medicine.
Concern for Medicaid patients (vulnerable, government insurance): 2x more likely to cancel appointments than Medicare patients due to jobs, transportation, flexibility.
AI democratizes: Puts labs/info in accessible form. <50% Medicare patients use free annual wellness exam. Non-attenders think they're healthier but objectively sicker.
600 companies pledged interoperability/data transparency. Deputize people for self-care, changing doctor incentives (e.g., ambient info collection).
As a physician, I'm telling you, it helps us to have patients pushing us to pay attention.
50% of what a doctor tells the patient is forgotten before the patient leaves the office. When your kid asks what happened with the doctor, you don't remember because you're nervous and anxious. The doctor spoke quickly and used big words. Breaking that down makes information flow easily, involving more stakeholders, with the patient as the ultimate stakeholder.
Medical records have been hijacked by medical record companies and hidden. Those companies are now saying they get it. The president is serious about sharing data and will come after them if they don't. Pharma companies, when challenged on most favored nation pricing for charging several times more for the same products, admitted they knew the day would come. They negotiated because they believe the president would act. Don't throw away that power—don't beg for forgiveness, push for action and make things happen.
The pledge event at the White House involved Dr. Oz, Amy Gleason, and Secretary Kennedy. The law gives patients the right to their own medical records, but in practice, they don't get them due to HIPAA regulations and proprietary formats from health record storage companies. Patients don't know how to access the data or what to do with it. The pledge gets 600 companies to agree to share health records with other medical companies.
AI is the magic glue, excelling at reading data from different formats and translating it without needing a perfect API. Dump unstructured data in, and it works. People are integrating Eight Sleep data, Whoop data, blood panels into major AI systems, taking pictures of supplements or drinks to ask about impacts on sleep. This realizes the promise of owning medical data in a usable format via chat interfaces.
It's technological obscurification—proprietary formats create a moat. AI decodes it, making it usable for interaction.
Some states are trying to ban AI in therapy, but in rural areas without psychiatrists or psychiatric care, AI provides a baseline service. Version one may have hallucinations but improves yearly. Banning it leaves people with nothing.
AI is coming to every neighborhood—engage it, don't run. Encourage governors to go full bore but do it right. Allow professionals to function at the height of their license. Use pharmacists better—70,000 pharmacists, 95% of Americans live within five miles of a pharmacy, unlike hospitals.
AI enables pharmacists and doctors to function at a higher level. 60 million Americans in rural America lack mental health services. Vets commit suicide at high rates, more than lost in war, due to lack of access, many in rural areas. Park Avenue psychiatrists won't practice at $800/hour in the North Slope of Alaska in winter.
$50 billion investment in rural healthcare via the Rural Health Transformation Fund from the working families tax cut legislation—largest ever, allocated by end of year. Governors must make a difference; most plans include AI to rightsize the system.
Micro hospitals like ADU units for grandma or Airbnb—startups building rooms with central services, nurse practitioners, telemedicine to bring care without giant hospitals. Micro clinics provide top-tier care.
AI-supported robots do ultrasounds in Alabama without OBs. Drones deliver prescriptions to North Slope of Alaska without roads. Vending machines for smart medication dispensing—happening in other countries, should happen in America.
$50 billion enables innovation in rural areas, foundational to the nation. States now talk differently about AI and technology with abundant resources.
By administration's end, dramatically change how Americans work with healthcare information: blocking and tackling like making medical record companies share data, forcing health information systems to share elegantly at fair prices, seeding with money, making it safe to invest. 600 companies invested, including major AI firms, foundational tech, surgeons.
Entrepreneurs reticent in education, housing, healthcare—most regulated/government-controlled. Direct-to-consumer investments work; government lacks runway. Open for business—work with industry, private sector has better ideas. CMS had nine engineers among 6,500 employees and 40,000 contractors (16 basis points). Cobalt-based infrastructure from 1970s.
Cut $3 billion in costs. Fired a company that built $200 million system with no usable code—they admitted underperforming, no accountability.
Four years ago, Tim Ferriss and Kevin Rose used diabetes drug Ozempic off-label for visceral fat loss. Speaker went from 213 lbs to 172 lbs, formerly marathon runner at 165-170 lbs.
GLP-1 drugs impact heart disease, kidney failure, liver disease, dementia—all linked to obesity. President Trump made these drugs available to all: prices drop from $1,200 cash pay to $200 starting, pills at $150 (first FDA-approved this month). Launch Trump RX next week for affordable cash pay.
Every Medicare patient gets $50 co-pay, Medicaid for nothing—those who need it most. Saves taxpayer money within two years by reducing hypertension, diabetes, downstream illnesses. Over half of healthcare spending on obesity-driven chronic illnesses (knees, autoimmune, cancer).
Internal modeling shows drops. Agreed prices with Novo Nordisk and Eli Lilly. Currently, top zip codes for weight loss drugs: Upper East Side Manhattan (vain, affluent), then LA. Vulnerable rural populations have 9-year shorter life expectancy.
GLP-1s from poisonous venom hacking appetite system. Tip of iceberg—address appetite, addiction (addictive behavior drops). Newer drugs more effective. Pills reduce wastage, exact dosing, lower price for scale.
Leapfrog broken systems—don't fix today's pipes if future has none. Unshore production, hire American workers, stay innovative. Same day as most favored nation event, executive order on childhood cancer—20 children survived due to U.S. technologies unavailable elsewhere.
Need better visibility via technology/audits. Audits check spreadsheets but not input legitimacy without site visits—states block them.
Federal law mandates voter registration signup with welfare programs like SNAP, Medicaid—recruits voters getting free services, skewing demographics (no equivalent at NRA events).
Unions in California sign up home health care workers/personal care services. Shifted economy to services family used to provide (driving to doctor, post-hospital care, groceries, landlord negotiation)—government pays, enabling fraud.
Consumer out-of-pocket has incentive for value; government payment lacks it. Minnesota: Somali community exploited no oversight.
Adage: only morons get caught—steal $5 million in Medicare/Medicaid, 18 months jail.
20 times more durable medical equipment providers (wheelchairs, knee braces) in South Florida than McDonald's—all Cuban, fly back to Cuba with millions.
7 times more hospice in California than 5-7 years ago—not matching deaths. Hospice survival rate 100% (designed for cancer patients dying within 6 months)—government pays fully.
Foreign governments/gangs involved: Russian-Armenian gangs in LA, $15 billion bust, escape to Russia. Story: hospice owner building mansion; plumber, carpenter also own hospices. Hospital doctor offers $1,000/month for referrals; board members own hospices.
Corruption from organized crime poisons system if tolerated.
Solutions: fraud war room, moratorium on new providers for some services, stop Medicaid payments if states fail fiduciary duty (states administer Medicaid).
At CMS, payments will be stopped on behalf of taxpayers if providers aren't taking care of the money. Whistleblower laws allow reporting fraud with a percentage of recovered funds. The administration now encourages reporting fraud, dramatically increasing reports. Government workers, many Democrats, joined to do their jobs but were told to ignore fraud and focus on enrollment. Failing to address fraud will destroy Medicaid. Medicaid protects children at the dawn of life (53% born into poverty), seniors at twilight, and those living in shadows, as Hubert Humphrey said. Every great society cares for the vulnerable. Organized crime stealing from federal programs kills them. Falsely enrolling kids in autism programs blocks real autistic children from care.
Young millennial and Gen Z parents with two jobs can't access childcare because dollars are stolen. Socialists in cities like California and New York want to seize assets and raise taxes before fixing fraud, like pouring water into a leaky bucket. Gavin Newsom at Davos encouraged European leaders to defy President Trump. California has massive fraud; an iceberg image shows Minnesota as the tip, but California, the fourth largest economy, is huge. Newsom vetoed audits—someone who vetoes audits doesn't want to get caught, like a criminal. Banning audits is to government spending what banning voter ID is to elections: you ban the fraud-catching tool unless you want fraud.
California's $350 billion budget doubled in the last decade, three times per capita, 2.5 times inflation rate, yet runs a huge deficit, driving job creators out with asset seizure proposals. Clamping down on fraud would fill the budget hole. LA County alone has $3.5 billion fraud in hospice and home health care—10% of all U.S. home healthcare expense. Improving the system restores confidence. Governors unwilling to act have ulterior motives. This president and American people won't tolerate it.
Elon Musk asked to review Twitter (now X) bills after purchase; company hemorrhaged cash. Tons of unused software subscriptions on credit cards. Elon canceled all cards. Software companies backchanneled, begging payment despite software never installed—deranged fraud at scale. In government, no private sector profit motive means fraud metastasizes to 20-30%, hundreds of billions. A YouTuber exposed empty Minnesota daycare centers (Learning Centers) receiving millions each—dozens in one program, one state. Sophisticated, politically connected groups, often foreign nationals or government-backed. Easy entry with bought beneficiary numbers.
Low-hanging fruit: cut payments, require attestation with driver's license and passport, random office visits or Zoom calls. Cancel credit cards, force reverification. Zero baseline budgeting with recurring autopay lacking codes. Lina Khan rule: cancel subscriptions as easily as signing up. Newspapers make cancellation hard, claiming fraud prevention despite easy online signup. Require in-person pickup with photos of services provided.
California has highest tax rates, proposes novel unconstitutional taxes needing enforcement before wringing out fraud. State auditors are allies; Minnesota auditor tried raising fraud issues but ignored. HHS workers shuttled or escorted out for speaking up. Ethical people leave or stay quiet. Growing up in Hungary, Thomas Peterffy knew everyone lied and knew he knew—corrupts everything. Good people weeded out; remaining don't care, aren't good, or complicit. Misaligned values fixed in working families tax cut legislation, aligning president with governors, closing legalized money-laundering saving $5.4 trillion in Medicaid alone—turning America into one massive healthcare system with a small country attached.
Without bold action, next generation inherits train wreck. Hypocrisy: leaders like Mandami and Newsom promise more services without audits or fraud fights. Newsom's 2022 Medi-Cal for all including illegal aliens created budget hole. President refused federal reimbursement. SEIU union upset over funding cuts. Most Americans oppose universal healthcare for illegal aliens. If providing it, audit to prevent abuse—but Newsom vetoes audits. Federal government pays, so no incentive for states to audit.
Illegal immigrants in California get free dental/vision unlike Medicare recipients. Taxpayers from poor states like New Mexico subsidize wealthy California. When federal payments for illegal immigrants stopped, California shifted to state funds. Audit found $1.5 billion wrongly charged to feds—not even argued. California now pays itself, forcing seriousness. Poor states shouldn't subsidize fourth largest economy.
Country of immigrants: support legal immigration, close border—election decider. Incentives matter: remove free healthcare, jobs to deter illegal entry. No reason to pay coyotes $5-25k or risk crossing. Free U.S. healthcare worth $30k per illegal immigrant family—major immigration pull. Can't deport 10 million legally (200 years). Remove incentives: free housing, food, healthcare. Show me incentive, I'll show outcome—like war on drugs.
San Francisco fentanyl for $5-10/hit due to no policing; free $800/month housing draws homeless from other states, worsening suffering via homeless industrial complex.
Trump considers cannabis rescheduling like Canada. Fentanyl: 9-12 overdoses/day peak in San Francisco; methamphetamine. Good substance use disorder meds exist but programs inaccessible. Miami's Mayor Suarez cut homelessness 90% by arresting for public urination, diverting to rehab (4-6 tries needed). Free showers/food enables; expect bad outcomes. Kensington, Philadelphia (tranq drug causes ulcers): users livid when revived from OD—ruins high/escape, pain so bad some seek death.
'Minnesota nice' doesn't mean allowing public health rape. Love means tough actions gaining respect. Parents of addicted adult children beg: arrest and lock up as last resort—not harassment, true compassion. Faculty lounge pontificating from tweed jackets ignores this. Intelligence aids self-deception. Trump's appeal: cuts BS, defies common sense. We don't have to accept it.
Calling it homelessness means you're trying to solve the wrong thing. Putting a junkie in a home—they have plenty of homes to go to. It's nothing to do with that. I've used the term junkies because I grew up in New York in the 70s and 80s and that's what we call people addicted to smack. It's not derogatory. It's an indication of just how bad that disease is.
After two hours of discussion, the host wraps up with Dr. Oz, noting his tips and energy.
Dr. Oz first reached out during the transition because he's intensely interested in AI and was looking for names of AI experts in Silicon Valley to build his advisory panel. Impressed right away with the energy, knowledge, and passion. He really cares about improving health outcomes for all Americans. We're very lucky to have him in this administration—from the president on down. The country is lucky; he could be doing many different things but cares about this job.
I wanted to have you speak to us on the pods. Kind of long overdue.
You're very kind to have me on. I've enjoyed it. Big fan obviously of your work in part because you brought a sense of clarity to many of the issues you discussed.
Dr. Oz thanks David for using his ability to get people together—the power to convene is remarkably effective. He's demystified a lot, allowing the administration to embrace AI and technology in general.
God bless you.
Great. Thank you. Thanks for being here.
We'll see you next time on All-in at Davos. I'm going all in.
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