Transcript of Dr. Mehmet Oz on Fixing American Healthcare + Fraud | Live from Davos

All right, everybody. Welcome back. It's all in at Davos. My bestie, David Sacks, is here. We're having a great time. We're here.

Can you guys catch this in the background? Oh my God. It's amazing. It's stunning. This is the Davos experience.

It looks real. I know.

It looks like a green screen from here because it's just so picturesque.

It's literally like a postcard. It's not green screen.

It's a real deal.

We'll look over the ledge here. What you'll see is all of the virtue signaling ESG DEI executives. It's emanating from this entire area, and they put solar over every single building here. None of it's plugged in. It's just for esthetics. But we're really excited, David and I, to do a bunch of interviews here. Wow. Today, we've got a great one for you, and we're going to talk about health, and we're going to talk about the healthcare system with none other than Dr. Mamedaz. You're the administrator now for CMS. You've gone from being America's doctor, dare I say, to being a civil servant like my friend David Sacks. Why did you choose, really, height of your power's career to go into public service like this?

I'm in the change business. You guys are as well. If you're in the change business and the project you're pursuing is not making a significant change, then you want to move on to something else that could make the impact you desire. And especially in health care, we don't have the luxury of fooling around for years of our lives pursuing interests that don't result in meaningfully changing the quality of life, but also the opportunity that the American people will have. I loved being a TV host. Did it for 13 years. I love practicing surgery, which I've done my whole life till recently. This is the best job I've ever had. And it's the best job I've had because of the people that I get to work with, but also because you truly do get to make the change that I desire. I think a lot of folks, the reason they watch the podcast is they want to change stuff, too. I encourage everybody to take some big swings, and you'll break things once in a while. But if you want to be able to change meaningfully the infrastructure, whatever is bothering you, you got to go at a full speed.

And this administration offers us a unique opportunity to do that.

It is interesting, David. You were used to going at a pretty fast pace as well. And then I think our expectation was, Hey, you get into public service. It's going to be about consensus building, and it's going to take a lot of time. Say what you will about Trump. Some people might not agree with every policy, but he ships. He's like a founder who ships and ships products. To look fast. That's also been your experience.

He's hard to keep up with. He moves incredibly fast, and it makes him really fun to work for because he wants to get things done. Every day, he wants to get things done. There's a sense of urgency. Yeah. You'll be in a meeting with the President in the oval office, and you'll tell him about a problem. His first instinct is to pick up the phone and call and fix it right then and there. He does that meeting after meeting, hour after hour, day after day, week after week. When you compound that desire to get things done, and he acts on right there, it has a huge impact.

He seems to get great pleasure in bringing together, especially in this administration, which I think is distinctly different than the first. First administration, he was new to politics, and he brought in a lot of career politicians that I think maybe people told him were the right people. This time, he has explicitly gone and looked for people with expertise who are proven winners in the field, yourself included.

He wants us to carry the water. I think, across the different parts of the administration. He wants individuals that don't have to rely on the President to tell the story all the time because so much of the narrative that is reflected in the media is just completely off. I'm not even saying that they're doing it on purpose. They literally don't understand some of the secondary tertiary impacts of the decisions you're making. And it's our job to, therefore, tell not just the media, but the American people what we're trying to do. And that's especially important if you're unorthodox in how you govern. And this is a fundamentally important reality, at least at CMS. David, I don't know how it is in the developing AI where there probably wasn't a rule book before anyway. But at healthcare, there have been doctors since the dawn of... But since humans left Africa 50,000 years ago, there were doctors in the encampment. And so there is a way of doing things. And in government, that exists as well. But it's not always the right way to do things. So for example, we have the ability to make laws. Every part of the administration pretty much can.

We get Congress to do stuff. It doesn't always turn out the way you want it to turn out, and it takes a lot of time. And then negotiated final result sometimes fall short. You have rulemaking, second big area, which is administrative entities like ours can write the rules that everyone has to follow. We're going to pay you this much. We're not going to let these people do that anymore. It does take some time, and it's prone to law fare. By that, I mean, the people you're regulating, if they don't like what you're saying, they can sue you and they can stop you. And in this administration, if the other party doesn't like what you're doing, even if it's the best thing, we had a rule that would reduce fraud, but the blue cities didn't They didn't like it because it was coming from someone they didn't like, the President. So they enjoyed it, and that's now caught up in court. Now, we'll win, but it could take years. So that's the second big way. You make laws, you pass rules. The third way, which historically government has not used, I don't think as effectively as possible This president, because he's a great negotiator, is able to push us in ways that historically not been done, is to just use the power to convene.

The US government can bring people together who would not normally talk. They can give safe hardware industry to come together and discuss problems that historically they would shy away from.

What's the great example of that? I'm wondering if it's the drug companies who… They have something to lose because President Trump has been very clear, Hey, I want these prices lowered. Why are we the sucker at the poker table? We're paying 10 times what Canada is paying. Is that the best example in your experience?

It's a great example. Most Favored Nation drug pricing, it specifically addresses the problem you outlined, which is we just pay a bunch more for the exact same product made the same factory, often in America, than our counterparts do here in Europe. So the President says, We need to change that. So he says, Go talk to drug companies, create some opportunities for risk for them, make some rules, create some projects that if we were to act on them, would really hurt them. A little pressure. A little pressure. Build the crowbars and the baseball bats. Okay. Cut some trees down, hone the wood, but don't use them. And he very specifically said, Do not hurt the innovative nature of pharmaceuticals. They are important to our nation. They save lives. We want to have the most innovative industries in the world because that's where the opportunities are to differentiate ourselves. It's also part of our national destiny. Be the best. So don't hurt the industry, but take some of the fat out of it. Pull it back and give it to the American people. Plus, it's the fair way of doing things. And metaphorically, when you think about NATO and the President saying to NATO countries, We're all in it together to protect ourselves against external threats.

You guys got to put up more money. We'll put up more, but proportionately more. It's got to be fair. They all did that pretty much, with one or two exceptions. He did the same thing with pharmaceuticals. He said, There's an external threat, which is Russia or foreign governments. There's internal threats, like cancer. We want everyone to chip in. We pay in the United States 0. 8% of our GDP towards pharmaceutical products. 0.

8%. 0. 8%. Almost 1% of our GDP goes to drugs. That's not the healthcare system, which I think is 17%. Right. 1% of it, a full 6% of our healthcare goes just directly to the drug company. We want- That's what's with your math is.

It's quite impressive. Yeah, thank you. I only bring this up because the percentages make a difference here. 0. 8%. It comes from us playing Black Jack. That's actually the calculator. I know.

No, it comes from us playing Black Jack and poker together. I've lost a lot of- I'm playing two outers over here. I've lost a lot of money to this guy, and I don't play him in chess anymore. Bend, but don't break. You want them to bend a little bit, be reasonable, but you don't want to break the industry.

As a doctor- Let's see upshot of this because you hear this term affordability a lot. So the average American is going to pay less for their drug prices.

We're going to pay less. The Europeans, we are telling all the countries, we're in the middle of these discussions. We've just gotten the British to say yes, and other countries are talking to us about the fact that they pay 0. 3 So less than half of what we pay percent-wise is being spent by them. And they get away with it because their people don't realize that if you get cancer, more advanced cancer is in Europe, your survival rates are way below the US. And if you don't get access to the drugs, which they don't for several years on average, that we get in the US, yes, you can get it for cheaper, but your people are paying a price. And this is the most important message that I'm going to deliver today. The most important message is, don't think about health care like an expense. Think of it as an investment because if I can get The average American to work one year longer because they got them a medication at a better price, they didn't turn away at the drug store, or because we're able to do something else, correct? Morbilities. Missing work. The Mahan, the movement.

We'll talk about all this. But if you can get the average American to work one year longer, that is worth $3 trillion to the US economy. It's massive. So we need to get people feeling their best, feeling that they have agency over their future with confidence that they're going to make a difference in the world. So they want to keep trying to do it at the workplace. And that extra one year, which gets them closer to Medicare, by the way, also helps deal with other financial crises that we're facing as a nation. So this is the way to think about it the right way. Get the actual cost of care down. Don't just pay more money into the system. Get the actual The cost of care down so the money we're spending gets us more value.

We're spending twice as much as these other countries who have universal health care. Now, you did point out that they get things later. We have a better system, but we pay through the notes for it. That would be an accurate way of describing the current state of affairs?

Precisely stated, yes. Okay.

How do we get every American health care? Because I believe a lot of the tension we have comes from a fear from people maybe who are not as well off as the people on the pod right now, and they live with that fear. We don't live with that fear. We know if we need to get health care, we're going to figure it out. We'll be able to pay for it out of pocket or insurance will pay for it. But there are people who go bankrupt because of this. You believe in universal health care, I would assume, as a doctor?

I want everyone to have access to health care. But how we pay for it is the defining issue here. How do you keep the system incentivized to take care of you? If I tell everybody in America that you have health care, and then I tell the doctors, Give them health care, but they don't deal with the financial costs, then you all of a sudden start to restrict the access to care. You can get the health care like you do in socialized medicine countries. You just have to wait six months or a year or longer, or you don't get the care at all. When you start having that discussion with Americans, they say, Wait, wait, wait. Hold on, Yes, of course I want to get the health care for an affordable price. But the question, the fundamental question is, how long till I actually get the care?

Being denied is something they live with. They complain about their universal health care. We complain about not having universal health care.

What are the two or three? The thing I would look at is the flow of patients who seek treatment internationally. I hear lots of stories about Canadians coming to the US to get treatment because they don't want to wait two years.

To get the latest treatment.

Not just the latest, to get some procedure because they could be dead in two years. So they come here. I don't hear any Americans talking about going to Canada to get treated.

We actually do have a number of examples of that in surgeries and treatments that you have to pay for out of pocket Cosmetic, dental, people are going, and this has become tourism, and there are people who do change locations. Yes, this is a trend.

For electing procedures, you mentioned cosmetic surgery. That's definitely a trend. Also, there's some procedures that we don't do in America. Themselves. Some cells. There We're still going through the regulatory process. But the bigger issue really is the one David's raising, which is most Americans complain that the healthcare system is broken. Almost none would leave the country to get top-tier healthcare for a life-threatening problem. We have this It's a bizarre opportunity. I do think it's an opportunity. How do we make the top-tier healthcare available to folks who need it, but do it at a price that is sustainable? That's where I think your specialty area comes into play. Before this administration, I think because we didn't have the right technologies to promise convincingly that we could do this, there was a hesitancy to make big shifts. We're taking big swings because we think AI is ready. We think the tech transformation that could happen in healthcare is worth subsidizing. By that, I mean making possible for top-tier entrepreneurs who are building apps that can help you deal with the medical crisis that you're dealing with, their diabetes. We can put money into the system to make that worth you doing so you can get investors to support you, you can get a fair evaluation.

So technology to lower the price Obviously, that's a huge win. Let me ask you the difficult question. As a doctor, there have been studies that came out recently that not only do LLMs currently give better advice than the average general practitioner, they have better bedside manner. The customers or the patients enjoy the LLM more than they enjoyed a GP.

Where did you see that? I haven't seen that.

This is a study that came out of either Harvard or MIT. I'll put it in the show notes, but this is a pretty ground-breaking. What are your thoughts if When you were going to a new society, is this idea that you have to go to the GP, they ask you a bunch of questions, then they go on their medical text, figure out what their advice is, is that the best modality or would it be better for the calm and cold, for an ankle sprain to do what most Americans without insurance are doing or people who are self-directed, they go on a large language model. It says, Here's how you deal with these issues, and they do it themselves, and they can take care of a couple of things. Wouldn't it be better to just have them do this stuff and then decide if they should go see their GP?

I think there's a hybrid of that that derisks it a little bit. Early on, there are definitely problems with hallucination and the like that Americans will be very intolerant to. We actually understand of a human being who has an MD degree makes a mistake. We think AI is perfect and are completely intoler. They've been a minor transgression. What you said earlier is true, and these studies have been done several times now. The large language models do better on board exams. So With general knowledge, they're better than a doctor. They're more patient than a doctor. If you talk to an AI-informed avatar, they'll answer the same 10 questions on diabetes all day long and not get bored. Talk to a general practitioner after they've talked to 10 patients with diabetes who've asked the same 10 questions, you get a little terse in your responses. That's just human nature. I don't want to answer the same question every time, but that's what patients need you to do. I think we have the opportunity, and we looked at some of these models. In fact, John Dore brought a bunch of very thoughtful entrepreneurs into the building to talk about the possibility of us taking the average general practitioner and making them five times, maybe even 10 times more efficient.

Now, here's the big deal. There are not enough GPs in America. We probably need 2-3 times more just to keep up with Europe. It's just per capita. Way below because my son just finished medical school. There aren't many kids in medical school at Columbia where he went who are going to become GPs. They all want to be ophthalmologists and orthopedic surgeons because they pay a lot more.

And they got big loans for their degrees.

Yeah, and they're in debt. They're in debt. And this is even Columbia is free. If you don't have money, you don't have to pay tuition at Columbia. They did that so that kids would go into general practice and hasn't had the desired impact yet. But the broader question is, how do we allow AI to play a role as this transition period happens so people feel confident? One way of doing it is to allow it to do most of the work. Then, especially with the Genetic AI, take the paperwork out of it, the busy work out of it, and feed the doctor the key information. What's the most important thing I do as a doctor? I look at you in the eyes and I read you, and I try to connect with you. 50% of our cortex, of our higher cognitive function, 50% of it is to read your face. We're hardwired to be social animals, to understand this subtle little… David's bored. You're not. I got to change the pace. I got to get back to him. He's doing card calculations in his head.

In fairness to David, he was out till 1: 00 AM. They dragged him to four meetings. I was in bed at night. I have good sleep health. I got my Whoop. I got my sleep score. I am a pillow princess like you, Dr. Oz. I hear that you're extreme about your sleep.

I'm a good sleep. My wife is a world-class sleeper. She brings her own pillows.

Your wife is delightful, by the way. I did an hour interview with Lisa before you even got on stage here. I was like, Wow, she's impressive.

To build on this point, I think it's interesting. I think we're going to get smarter doctors and smarter patients, and they're each going to use their own version of AI. What patients are going to use is a consumer product, ChatGPT, Grok, and so forth. What's interesting, I think, is when they can dump in their blood panels because AI is so good at reading PDF, just unstructured data. You dump all your stuff in it. You ask for a diagnosis, you get smarter, you can research your own condition. You're not wasting, frankly, the doctor's time by asking basic questions.

You're a consumer. You're a better customer. You're a better customer.

You're more educated. Then the doctors, they can use ChatGPT or what have you, but actually, they're using much more specialized tools, the ones I've seen. They will give you a citation directly to a medical journal. That you can bring to your doctor. Because that's very important to doctors. So you know it's not hallucinating. Just getting the answer from a chatbot.

It's like, Oh, that was on Joe Rogan's podcast.

You need to know what the source is.

Which is fine. If you get information from Joe and then you want to get a source to a respected medical journal. Let me ask you about this trend. This is self-directed health care. There's function health doing blood labs, superpower. Whoop just started offering them, Aura, Apple Watch, 8 Sleep. I'm an investor in that one, full disclosure. It's doing great. These things are now putting all that data together and starting to tell you your health span, your actual age versus your health age. I don't know what that metric is. But people are now measuring things and getting some knowledge of this and then going to a GP. The problem I'm having is, and I'm not price sensitive, I could get any concierge doctor I want. There's very few doctors who want to work like this at the moment. That's something's got to change. But what do you think of this new group of people who are doing self-directed health care, doing two blood labs a year, putting it into a database, Prunova with the 3D scans, Niko, Daniel X, new company doing a $300 full body scan. All of this, is this going to be the paradigm shift?

Eighty-twenty rule. If 20% of Americans do what you're saying and they will, it will make all of medicine function better. I'm actually concerned about the other end of the spectrum. Tell me. The people who don't go to their doctors. Medicaid patients are twice as likely, Medicaid is the folks who are vulnerable, who have made less money. They're getting government health insurance. Medicare is-That is our universal health care. That's where we need help. The chance of a Medicaid patient who doesn't pay for their health care because they don't have the means to do it, the chance of them canceling their doctor's appointment is twice that of a Medicare patient. It's hard to take care of them. Now, they have two jobs. They'll get fired if they leave the job early. They don't have the flexibility of moving their calendar around. They don't have transportation. There's lots of reasons they don't show. But if I can't get health care to them, that's a major crisis for us. The real opportunity for AI is democratizing health care. See, you guys are already smart. You just listed off top of your head a dozen companies all doing great work.

Most people have no idea these companies exist or what they do exist. If I can put into AI my labs and I don't know much about health care, I can get information sent to me in a way that I can process it, and at the time, I'm ready to hear it. Now, I'll give you one more data point that might be useful. All Medicare patients, all seniors over 65, all of them are given a free wellness exam every year. What percentage of people take their free medical exam with a doctor? Less than 5%. No, it's not that bad. It's less than 50%. Less than 5%, okay. But most people don't do it. It's there. Part of the reason we think that's happening is you don't prioritize it. Here's the more important data point. People who They actually see their doctor think they're sicker, but they're actually much healthier than people who don't see their doctor because ignorance is bliss. People who don't go to their doctor or seek any health advice think that they're doing great, and actually, objectively, they're doing much worse. We have an opportunity to democratize this by saying, Okay, I'm going to meet you where you are.

You don't care about going to see a doctor, even though it's free, it's yours. In this new health tech ecosystem we're building out with Amy Gleason, who also ran Doge, helping to roll this all out, we're making it easier for every tech company to participate. 600 companies have signed a pledge agreeing to interoperability data transparency and to build these tools for the American people to be able to use them. Now, once I deputize you to be better equipped to take care of yourself, you change the system. Because when you ask a doctor a question, the first time you're the only patient, they don't pay attention. The second patient who asks the same question, we change. As a physician, I'm telling you, it helps us to have patients pushing us to pay attention to, for example, ambient collection of information in the doctor's office. So I get a medical report on what you told me. Why? Because 50% of what a doctor tells a patient is forgotten before the patient leaves the office. So when your kid asks you, Hey, what happened with the doctor? You don't remember. You're nervous, you're anxious. The doctor spoke quickly.

Use big words. Break all that down. All of a sudden, information gets flowing easily. Now you've got a lot more stakeholders. And who's the ultimate stakeholder? The patient. So the medical records who historically have been hijacked by medical record companies. And hidden.

How do you ever get them?

Yeah. And all those companies now are All right, we get the joke. And this is again, back to the President. He's not fooling around in this stuff. When he tells you he wants you to share data, you know he's going to come after your ass if you don't deal with this problem. And so they've all come and said, All right, we're not on the joke now. The pharma companies, when we're negotiating Most Favored Nation, you know what they said when we challenged them and said, You're charging several times more for the same products? They said, All right, well, we knew one day you'd come knocking. We knew. And we actually think the President will do something to us. So we're going to negotiate. And you don't want to throw away that power. Don't beg for forgiveness. Push for action. Make things happen. And if they don't work out fine, you'll get more bites at the apple.

Just on that point about the pledge, because I got to attend that event at the White House.

You organized it.

Don't be modest. It's going to be a little bit too much credit But it was honestly, it was you and Amy Gleason and Secretary Kennedy, and you guys just happened to invite me for some reason. But it was really interesting. This is my layman's understanding of it, which is the law gives us the right to our own medical records. But in practice, we don't get them.

Hipaa regulation?

Well, it's because the companies that store the health records do it in proprietary formats, and we don't really know how to get that data and what we do with it even if we did. The key is to get those health records shared to all the other medical companies in the space that we might want to use. Hence the power of the pledge, get these 600 companies agree. But I think that AI is the magic glue here because AI is so good at reading data from different formats and translating it. You don't need a perfect API anymore. You just get the unstructured data, dump it in, and now it just works.

Which is what we're starting to see. I'm taking my 8 Sleep data, my Whoop data, my blood panels, and I'm putting it into all four of the major ones asking it. I take pictures of every one of my supplements or drinks. What impact will this have? Which impact will this have on sleeping? I think that's this gigantic win.

You being able to realize the promise that the law gives you to actually own your own medical data, but to get it in a usable format that now you can use, again, a chat interface to understand it.

It's technological obscurification. Let's call it what it is. They're trying to use this proprietary formats always to get a technological advantage and to have a moat around their business.

Ai just decodes that and makes it usable, and now you can interact with it. Can I bring up one other example? You mentioned democratization. You and I have had a conversation about certain states are actually trying to ban the use of AI to be used in therapy. I think the point you made to me is, you know what? There's a lot of places all over the country, like rural areas, where there aren't psychiatrists or there isn't psychiatric care. So at least AI provides a baseline level of service. Version one may not have been perfect. There may have been some hallucination, but it is getting better and better every year. If you ban it, then a lot of people are just going to have nothing. I mean, Beautifully stated.

Let's just go over, let's unwrap that a little bit. But I'll be just at a high level, say AI is coming to a neighborhood near you. You're not stopping it. It's going to be there and patients are going to use it. You have to engage it. Running from it. We cannot stick our head in the sand on this one. There's other things you can delay, but I've encouraged every governor, go full bore with this, but do it in the right way. Allow professionals to function at the height of their licensure. Why don't we use pharmacists better? There's probably 70,000 pharmacists. And they're thinking by this way. Almost all Americans, 95%, live within 5 miles of a pharmacy. They don't live near a hospital, usually. So we don't have access to care in many ways. If we just took AI and allowed pharmacists and doctors, GPs, to function at a higher level, it itself would be worth the opportunity. I'm not even saying abdicate at all to an AI agent that doesn't really understand you, we can't control. Maybe some of the country gets involved in it. At its very practical level, we do not have enough practitioners.

There just aren't enough people to take care of rural America. 60 million Americans living in rural America don't have access to mental health services. Our vets commit suicide at a crazily high rate more than we lose in war because they don't have access to mental health services. Many of them do live in rural America. If we're going to fix those kinds of problems, which are time consuming, you're not going to get Park Avenue psychiatrists to go practice medicine. At $800 an hour. At $800 an hour in the north slope of Alaska in the winter. It's just not going to happen. This $50 billion The investment that we as a country just made, the money was part of the working families tax cut legislation that the President pushed through, and Congress got behind. $50 billion, the largest investment ever made in rural health care through our agency was given up by the end of the calendar year, all the governors have the money, and we charge them to make a difference in their communities. You know your communities, they almost all came back with some AI element. They all know to really be able to get health care in rural America, you've got to right size the system.

Right size in the system means hospitals are going to work out differently. Doctors will work differently with each other. But AI is the core element of so much of this.

And these micro hospitals, just like people are putting ADU units in the back of their homes to get an extra apartment for grandma and grandpa or as an Airbnb. My understanding is there's a bunch of startups working on the equivalent building a micro hospital, a room with the central services, perhaps a nurse practitioner, there's more available, and then you telemedicine in. Just bringing the medicine to those areas without having to build a giant hospital is also a win.

The microclinics, I think, have a huge opportunity to provide top-tier care. But this goes beyond that. We have AI-supported robots that are going to be doing ultrasounds in At the hearts of Alabama where there are no OPs. We have drones delivering prescription medications to the North slope of Alaska, where there are no roads. We have bending machines that can dispense smart dispensing of medications. By the way, this is What's happening in other countries? We want this to take place in America, and why not take advantage of an opportunity with a huge, massive inflow of money, which is the Rural Health Transformation Fund does, the $50 billion, to start to do some innovative work in rural parts of the country, which is the foundational element of who we are as a nation. Those values ripple up to the rest of us. I also think that states now are talking to each other differently. Now that you've got money that's out there that can be used to change the world, they start talking about AI and technology, generally very differently. Now, it's not a sparse research. We live in a world of abundance, and AI makes it that much more abundant if we use it correctly.

It's not going to happen today, but we believe by the time the administration has completed its work, we will have dramatically changed the face of how Americans work with information in the healthcare system. Some of it's just blocking and tackling, as you said, make medical record companies not data block. Some of it's forcing health information systems to share data more comfortably and elegantly at a fair price. And part of it's us putting money into the system, seeding it the right way. But the most important thing is to make it safe to go outside. We want to make it comfortable to take financial risks to invest in these areas. That's why 600 companies have invested. Every major AI company, every major foundational technology company, but all a bunch of these surgeons that I have promised they're all rushing in.

The three places entrepreneurs have been reticent to take on, to build new products and services: education, housing, health care. These also happen to be the ones most regulated, most controlled by the government. To the extent you can give them access and make it go faster, it's going to work. The only investments we've ever made in those spaces are ones that go direct to consumer because we know going through the government, there's just not enough run a way for those companies to get to the other side.

Let me ask you about- We're open for business, and I got to make this plug while I'm here. We want to work with the industry. We believe the private sector will come up with better ideas, come work with us, and we're also looking for people. We had nine engineers, nine engineers when we came in. All of CMS, our cobalt-based infrastructure built in the '70s, where we don't even have engineers that- You're talking about in the department, you had nine engineers out of what's the denominator of employees? 6,500 employees and 40,000 contractors. You basically have an HR person in government working with a government affairs person at the company. There's no engineers there.

Sixteen basis points, David.

We took $3 billion of cost out. There was a company that we fired that had billed us $200 million, not a single use We have a terrible line of code. Here's the good part. When we fired them, you know what they said? Nothing. Yeah, we knew it.

We knew it. Yeah, we were underperforming. No accountability. Underperforming. God, we could go on about fraud forever. But I want to ask you about this wonder drug. Four years ago, I was listening to my friend Tim Farris and Kevin Rose, who are biohackers, and they're always on the edge of this stuff. He wanted to lose some visceral fat. Kevin was in great shape, and he heard about this diabetes drug, Ozempic, and that he was going to give it a shot. He dialed the pen all the way up, he He was puked, dialed it back down, lost his visceral fat. I heard that. I was like, 40. I was 213 pounds at the time. Went to my doctor. He said, I have no idea what you're talking about. You're not diabetic, but you are fat. And he said, You're a fat bastard. I think I said that. I had just gained like 2 or 3 pounds a year for 20 years. I used to be a marathon runner. I used to be 165, 170 pounds. I'm now 172.

You look like a gazelle right now, by the way.

Well, I had a little muscle, too. Thank you, Dr. Rice. You look great, too. But this is a miracle drug. This In my mind, we now have, theoretically, tens of millions of Americans have experienced it. It's going to be in pill format. The Four Horsemen of the Apocalypse, Heart disease.

Kidney failure, liver disease, dementia.

Dementia. These are all four of four are impacted by obesity, and these GLP-1s seem to be impacting them. I was like, You know what? If President Trump just gave a national, Anybody can get this drug if they I think he'd win the election. He won anyway. What do you think about a mandate to make it available, to make the fat drug available for all Americans? Would that be- I'm glad you came to work today.

About two months ago in the oval office, the President basically did that. He said that we're going to take the prices of these drugs, which are now prohibitively high for many Americans, $1,200 cash pay.

It's crazy.

It's going to be a starting price of around $200. Easy. With the pills, it's FD. The pills will come out. The first FD approved pills will start this month. We believe at that price-Fine dollars a day. Because Zincarapay is right. Basically, you get coffee a day. At that price, we will, within two years, return money to the American taxpayer. It's going to save us so much money from reducing hypertension, diabetes, and the downstream illness is the Four Horsemen of the Apocalypse that you mentioned, that we will save money. We spend over half the money, I believe, within health care on these chronic illnesses driven by obesity. And so, if you're directly or indirectly because you hurt your knees because you're overweight, or you get autoimmune problems, or even cancer is linked to obesity because you have a metabolically active state, all of these are going to drop precipitously. We have pretty good data on this from an internal modeling. So we agreed to those prices with the two major companies, Novo Nordisk and Eli Lilly. We will launch next week. I don't know when this podcast airs, but launch next week, TrumpRx, with those products.

So you can cash pay at a price that is completely affordable. Here's the good news. Every Medicare patient gets it for $50 copay. Every Medicaid patient gets it for nothing. Amazing. The people who need it the most, the folks that are most vulnerable. When people say the President doesn't want to protect Medicaid, he doesn't love and cherish Medicare, it drives me bonkers because he's doing more for underserved Americans than any other President ever has. Giving Americans where the obesity epidemic lives, underserved Americans, vulnerable Americans who are on Medicaid, access to these drugs for no out-of-pocket costs truly democratizes the weight loss issues. Because right now, what's the number one zip code for weight loss? Drugs. Number one zip code, upper east side of Manhattan.

I was about to say it's got to be Manhattan or LA.

La is number two.

Okay.

Does the field can afford it?

Because they're vain. They're vain. They want to lose 2 pounds for their daughter's wedding, and they can afford it, $1,200 a rounding there. But $1,200 for someone that's not making money, you're just not going to take the drug. They're the ones that die early. The life expectancy in rural America, I'll go back to them, in vulnerable populations nine years shorter than yours in the same country.

It's something that came out of left field. What does that tell us about what's going to happen in medicine going forward? Because GLPs, how long of a journey has that been? Then getting to market and then this off-label use, starting with people with diabetes, how does that inform you of how we can make even more impact in the future? How do we make another GLP-like discovery and implement it the way President Trump has?

Well, the drug actually came. It's a poisonous chemical, a venom, actually, that was deciphered and found to have an impact on some of these core cells in the appetite system of the body, which is so fundamental to who we are. That's very hard to hack the appetite. But GLP-1s are just the tip of the iceberg. There are more and more sophisticated ways for us to be able to address not just appetite, but addiction, addictive behavior drops of GLP-1s. So The newer drugs are going to be even more effective at that.

Redditrutide is the one you call it.

For example, Redditrutide. But the other thing, what they say is the form factor matters. In sending someone an injection that goes bad in the warm weather, a lot of wastage, you don't know the exact dose, The pills make it like most of the drugs. The price point is much lower as well. It's easier for us to deliver that at scale to the American people. It does leapfrog us beyond today's problems, which is a big theme of our administration. Don't bother fixing today's broken pipes. If the world you're billing doesn't have pipes. That's what we're doing with drugs like Semaglutide and Therzepotide, which is the lily product. We're also getting these companies to onshore their production facility, hire American workers, stay innovative. This is why, again, the President doesn't want us hurting innovation. With the same day we did the first Most Favorite Nation drug event, we had an executive order on childhood cancer. Twenty beautiful children, smiley, bright eyes, all of whom, all of whom should have been ghosts. They survived because Those technologies were afforded to them. They don't exist in other parts of the world to keep them alive. That's our goal. But I be poorly served.

I hear the belt holding. If I didn't get into the other thing-For whom we don't know. For the belt holds, for sure.

I think that's totally for the pharma companies who don't bend the knee.

No, actually, the issue right now that is consuming us is the fraud, the waste, and abuse. What have you found, Dr. Oz?

Tell us, what is the most concerning to Well, as a preamble, without a better visibility in where the money spent, which we need technology to be able to do-Or audits.

Well, audits are interesting. You could audit the spreadsheet. You can't tell if the input to the spreadsheet was legitimate unless you actually go and do site visits. States don't want to do that. Let me just give it to people. Why are you blocking it, these states? Of course. First of all, I'll tell you, that's a good question. Why would you let fraud happen? It is by federal law, By federal law mandated that if you give a patient a welfare program, Snap, Medicaid, you must also give them the ability to sign up to vote. So you're basically recruiting voters at the same time you're giving them free government services, which then you might actually end up recruiting a different voter. You don't have a law that if you go to an NRA convention for gun advocates, that you sign up voters. You can go to that event, not get signed up to vote. Obviously, they will be probably skewing to the right. So there is an issue there. We also have an active role of unions, especially in California, where we have a major problem because the unions have seemed, this is all what I'm hearing from talking to people on the ground, seem to have gotten involved in, for example, signing up home health care workers and personal care services.

There are more Americans, I believe, providing some of these home-based services that maybe might exist in retail in America. We've shifted the entire employment economy towards some of these services. Here's the risk, if you really want to understand why we have fraud in America. When I give you things that your family used to give you, we are going to have fraud. So your family used to drive you to the doctor's office. Your family would take you home after you got home back from the hospital to make sure you got well nourished and taken care of. Your family would carry the groceries up the stairs. Your family would negotiate your contract with the landlord. Guess what? Healthy Human Services does all that for you now. All you got to do is ask. And in some states, it's so easy to do that you end up with significant fraud.

So they have intercepted the transaction. Therefore, that's where grift can occur and fraud.

Also, the government's paying for it. When the consumer is paying for it out of their own pocket, they have their own incentive to get value for the transaction. But when the government's paying for it, who really has the incentive to make sure that value has been provided in exchange for that money.

And this is what happened in Minnesota, where you had a subculture. It was just the mathematically, most of the indictments are with Somalians. So the Somalian community realized, Hey, my goodness, no one's watching. Now, there's an adage that only the morons get caught in health care fraud because it's so easy to do. And if you steal $5 million in Medicaid, you go to jail for 18 months. I mean, for many people, that's a pretty good deal. You sit in the pen for 18 months. But unfortunately, I'll just give you a lay of the land. There are twice as many durable medical equipment providers. They sell the wheelchairs and knee braces. There's actually 20 times more in South Florida than McDonald's. I mean, how many do you need? It turns out they're all Cuban, pretty much. They all seem to fly back to Cuba and escape law enforcement. They bill millions of dollars. They get away with it.

What's the solution? There's got to be a really practical, easy solution.

There are, and I'm going to share that. But let me just give you two others because you're going to remember these. We have seven times more hospices in California. Hospice is for people at the end of their life. Seven times more hospices than was there 5, 6, 7 years ago. Seven times more. We don't have that many people dying in California. More importantly, the survival rates on hospice, again, designed for cancer patients dying within six months. The survival rate for most of these hospice centers is 100%.

Wait a second. They shouldn't have gone to hospice.

Exactly. Is the government paying for it?

Yes, they're paying for it. But no one's dying because you're not supposed to be in hospice.

When did the government start paying for that?

Oh, 40 years It was a long time ago.

Then what happened in the last seven or 10 that the fraud just went to be financial?

Two things. Foreign governments got involved. In LA, the hospice is driven by the Russian-Armenian gangs. They're foreign nationals. They fly back to Russia. We had a big $15 billion bust One of these guys earlier in the year, again, they all escape. The other thing is no one's watching because there's a opportunity if you get into these businesses to make a lot of money. I'll just tell you a true story about a whistleblower. Again, I can't prove this, but it's what he said. He said that he was building a beautiful mansion. He owns all these hospices. He's a doctor, but he's a fraudster. He built this huge house. The plumber comes in and says, Hey, I hear you're in the hospice space. The guy says, Yeah, I made my money in the hospice. Then the plumber says, I've got a side house, so I own a hospice, too. Then the Carpenter hears him and he says, Me, too. I'm in the hospice business. We're all in the hospice business. Absolutely. Then the guy says, Okay, well, he realized he's got to get ahead of these guys. So he goes to a major hospital in LA, and a doctor at the hospital, very prominent hospital that everyone's heard of, says, Hey, listen, if you give me $1,000 a month, I'll send hospice patients to you, which is how it's done in LA, by the way.

You get paid, you send patients over. So the guy says, Okay, what about the actual inpatients? The people hospitalized, can I get them? The doctor says, I can't do that because it turns out there are some members of the board that own hospice, and they like the patients to go to their centers. You see that the corruption starts in organized crime, but if you tolerate it, it poisons the whole system. That's the bigger reason we've got a problem. What are we doing? We have a fraud war room. I'm going to put a moratorium on some of these services. We're not letting people sign up. We're going to actively and aggressively stop paying Medicaid If we can prove that states are not obliging their fiduciary responsibility to the American people. Because states administer Medicaid, I pay the bills at CMS. We're going to stop paying on behalf of the taxpayer if we don't think you're taking care of the money.

People should know there are whistleblower laws where you get a percentage of whatever is reported and they should look into that. The fact that we have so many people in the administration now communicating that, Hey, we want to have you report fraud to us has changed everything. The number of people reporting fraud must have gone up since.

Dramatically, people in the government, this is probably the part that's most rewarding to me. Many government workers are Democrats, probably most. What they tell me again and again is they just came to government to do their job. They wanted to do the right thing. They were told not to do their job. They were told not to focus on the fraud, to focus on getting more people signed up. But if you don't take care of the fraud, this is an important message, you will kill the system, even Eventually, you will destroy Medicaid. And I'm not going to let that happen on our watch. Medicaid, as Hubert Humphrey said, is there to protect those at the dawn of life, which are our children. 53% of kids are born in the poverty. We take care of them. Those at the twalight of life, those are the seniors. We owe it to them. Every great society takes care of their most vulnerable. We're great people. We'll do that. And Hubert Humphrey said, You got to take care of those living in the shadows. We are not going to let them get hurt. When you let organized criminal elements steal at scale from the federal government, you are killing those programs.

We now have so many kids signed up falsely for autism that the kids with autism aren't getting access to care.

Yeah, this is the incredibly frustrating thing, having talked to some young parents who are millennials, Gen Z. They're going to work. They got two jobs. They would love to have childcare, but the childcare dollars are being stolen, therefore, they can't access them. The same thing is happening across the system. I think this could be just such a defining moment for America because on the other side, we have Socialists, lunatic communists running some of these cities who want to seize people's assets, want to raise taxes before fixing fraud. This is like pouring water into a leaky bucket.

You're talking about California.

And New York.

Yeah. I couldn't help but notice that Gavin Newsom arrived here at Davis yesterday.

He's here.

Yeah. He was encouraging European leaders to defy President Trump, which is a weird thing for a governor to come here to basically advocate foreign leaders to defy the American President.

What next? Partner with communist countries?

But I think, honestly, it's all a distraction because the real thing happening in California right now is everybody knows there's massive fraud there. You see that image on the internet where it's an iceberg.

The tip is Minnesota.

There's Minnesota, but California is over the water.

I mean, it's the largest economy in the world.

We know there's massive fraud. I think Newsom knows there's massive fraud, too. That's why he's vetoed audits. I mean, can we just pause for a second? How do you veto an audit?

Veto audits. Who would veto an audit? Someone doesn't want to get caught.

A criminal.

A criminal would get caught. I'm not saying he's a criminal.

No, this is to government spending what the ban on voter ID is to elections. Why wouldn't- You only do that. You're banning the thing that helps you catch the fraud. Why would you ever do that unless you want the fraud to happen?

Exactly. It's... Yeah, it's. Now, even though- Distrazione. Grosse odd, as we say here.

But California, the budget is $350 billion, by far the biggest. It has doubled in the last decade.

It's like three times per capita.

Two and a half times the inflation rate. They're still running a huge deficit. And that's why they're now driving all the job creators of the state with this proposed asset seizure. Wild. If they just clamp down on the fraud, they wouldn't have this hole in their budget.

Just LA County alone, just in hospice at Home Health care, we believe it's about three and a half billion Just those two programs in one city, there's probably 10% of all home health care expense in America is in LA. So there's so much to do to improve this system that would restore confidence. And when you have governors who are unwilling to do their job, it does make people think that, listen, when smart people don't do things, it's not an accident. They're not doing these things because they have ulterior motives that either aren't transparent to you or they think you're not smart enough to figure out. We need to ask those questions. This president is not going to tolerate it, but the American people shouldn't either.

We had an interesting moment. Our friend Elon Musk had asked us after he purchased Twitter, now X, to come in, and we were looking at the bills, trying to figure out how this company was hemorrhaging cash at a level that just didn't even seem possible. One of the things was they had just signed up for tons of software and basically subscriptions. Cfo comes in, auditor comes in, we're all trying to figure it out. Is that Twitter? Is that Twitter? Yeah. Elon says, How are they paying all these? They're like, Oh, yeah, they're on credit cards. He said, Okay, cancel all the cards. We said, They're like, Yeah, cancel the cards. Immediately, I get three back channels from software companies who are like, Hey, I know you're helping Elon. I saw a story in the New York Times. Our bill stopped getting paid. Can we come in? I'm like, Yeah, we're not using your software anymore. Nobody's ever used. It's never been installed. The software had been... You want to talk about fraud at a scale that was deranged.

This is a private company now.

This is a private company.

But your point is, look, when no one is mining the store, bad things are going to happen. When no one has mined the store for decades and the government's paying for it, you don't even have that private sector profit motive to basically be efficient, then think about how the fraud just metastases.

It's got to be 20, 30%. Hundreds of billions. It's got to be a double-digit, I'm going to guess, 20, 30% of all these fraud.

All it took was a YouTuber with a video camera to actually show up at the Minnesota Daycare Center that were receiving millions of dollars.

The Leering Center.

Yeah, the Leering Center. They're all empty, dozens of them. Each one is receiving millions of dollars. And that's one program in one state.

These aren't lowlifes doing this. They're lowlifes involved, obviously, but these are politically connected groups. Sophisticated. That's why I'm emphasizing, these are foreign government-backed efforts at times, but certainly the people doing them are often foreign nationals. We are being taken advantage of because we're like a big hippopotamus. All you need to penetrate Medicare and Medicaid is a beneficiary number. They can buy those, and you're off to the races. The solutions, I'm not claiming they're simple, but they're eminently doable, but you have to expect it of your leaders.

There's going to be some low-hanging fruit here. I can tell you, you cutting off payments and saying, very simply, Hey, we've cut off payments. All you have to do is sign this attestation that you delivered the service, and I would like you to attach your driver's license and a passport to it. And by the way, you've been randomly selected to come into the office. We want to hear all about what you're doing and jump on a Zoom call.

You're saying cancel the credit cards and just let them then reopen the account or tell you-Yeah, come in.

We just want to We verify what's going on.

Zero baseline budgeting. We're saying the program is over. And that's the thing that I think Elon found when he was doing Doge is these payments were just on the- AutoPay. Repairing. Autopay every year.

Auto-pay equals-with no code explaining what the money was going to. Autopay equals for all. That's all you have to know. If you look at some of the great... I mean, if you want to talk about some of the good stuff Lena Khan did, and I was opposed to about 80% of it. One of the things she did that was really well is she said, If you sign up for a service, you have to be able to cancel it the same way you signed up. So newspapers, these bastions of virtue, you'd sign up for Wall Street Journal. You probably have had this experience. You try to cancel it, they're like, Give us a call. And then you're on the phone for an hour, just want to cancel I asked the woman, I said, Hey, can I ask you just a simple question? Why can't I just cancel online? They're like, Oh, well, because of fraud. I'm like, But you took my money through the website, so that's where the fraud would actually occur. She's like, Yeah, that makes sense, but I'm just an operator, Mr. Callican. They said, Okay, fine. But this is the same concept, which is if you want the money, Hey, why don't you come into the office?

We'd love to hear how the program is going. We got your check right here. Come pick it up in person. Want to hear about it. Can you just take a picture of the service you provided? Just taking a picture of the service you provided and then send it in.

How is this hard? Like you said, how do you argue for... California already has some of the highest tax rates in the nation, and now you're arguing for more taxes, novel taxes It says taxes that no one's ever seen before. Unconstitutional tax. Unconstitutional, probably, and will require a massive new enforcement mechanism. Before you do that, you haven't even rung the obvious fraud of the system.

Listen, our biggest allies are state auditors. I met with I stayed with an auditor in Minnesota. She confided that she's been trying to get this on the radar. Just people didn't want to listen. I talked to folks within the agency, Health and Human Services. You were shuttled around. One woman was actually escorted out of the building for raising the reality that there was fraud. And this happened over several years. And eventually, either you leave if you're ethical or you're quiet because you don't want to get fired. And you make it such a harsh environment for anybody to just tell the truth. This reminds me a friend of mine who is a billionaire now, Tomas Petraffy. You probably know him, interactive brokers. A really great guy. And he said he was growing up in Hungary. And he said when he was young, he knew that everyone was lying to him. But that wasn't the big problem. The big problem is He knew that they knew that he knew that they were lying to him. So pretty soon, we are all in on the fact that this is a big lie. The whole thing is corrupt. And so working in these agencies, the good people are weeded out.

The people who are left either don't care or aren't good people. Or are complicit. Some of them are complicit. But I think fundamentally, there was a misalignment of values. This actually was probably the most important thing we had to do in that legislation last year, the working families tax legislation. We had to align the President with the governors. There were so many ways of getting the federal government to give you money that wasn't really yours, legalize money laundering schemes, all kinds of things that clever consultants had figured out over the years that we estimated we would have lost $5. 4 trillion just for Medicaid, which is again, why I often joke, we were becoming one massive health care system with a small country attached. It doesn't work long term. If we don't take bold action, which I get a major message on a lot of things the President is doing. If you don't take bold action on some of these issues, you're leaving the next generation with a train wreck. They can't fix it anymore because the train has gone way off the rails.

Yeah, and just think of the absolute hypocrisy. You have someone like Mondami who says he wants to increase services, provide more for the citizens, and they're not doing the audits. They're not fighting fraud. Gavin Newsom is talking about wanting to to provide more for the bottom half of society, but not doing the audits.

Frankly, this whole budget hole that is causing this now asset seizure tax, it all started in 2022 when Newsom promised Medi-Cal for all including illegal aliens. What happened is, in Big Beautiful Bill, President said, Listen, we're not going to reimburse for illegal aliens.

Think about incentives there.

Right. Then the SEIU, UHW, the Health Worker Union, they're upset because they don't want that funding cut because it indirectly impacts them. That's how this whole thing happened. I think about the layers of fraud there that the government of California is paying for illegal aliens. Probably shouldn't be doing that.

If you ask the American people, which is who you both work for, how many Americans believe that illegal aliens should get universal health care? I think you're going to get 98% are going to say, Absolutely not. And the 2% with Purple Hair and Berkeley who want it, I don't know what their That's what the motivation is.

I don't support them. But just to finish the point, if you are going to have the politics of a Gavin Newsom, and you're going to tell Medi-Cal for all in the state, even illegal aliens, doesn't that create a responsibility on you to audit the system and make sure it's not being abused. When you then turn a blind eye to the fraud and you refuse to even acknowledge it, you just pretend like it doesn't exist, and you veto the audits, that's doubly wrong.

But it doesn't hurt California. This is the part of the story that's so infuriating. You I don't audit the books in California because the federal government is paying anyway. So why would I audit the books to find out that my people aren't getting free money from the federal government? Let's talk about illegal immigrants. Gavin Newsom was giving us a hard time for threatening the health insurance of illegal immigrants, just to be very transparent. If you're on Medicare, you don't get free dental, you don't get free vision. You do if you're an illegal immigrant in California. This is the inferior. Anyway, so you got taxpayers in New Mexico, which is a blue state, but a poor state, paying extra tax dollars to the federal government that are recycled back into LA to deal with the fraud that I'm talking about. So illegal immigrants, he's mad, he's mad, he's mad, he's mad. We're horrible people. We're Republicans. You have no conscience. You have no heart. As soon as we made it clear we were no longer going to pay for illegal immigrants in California. What did he do? He took them off Med-Cal. Now, he didn't take them off.

He took them off on the federal side. So in theory, only emergency services are going to get paid for for illegal immigrants in California, which is a national law. And it's reasonable. Reasonable. Now, we want babies delivered, car accidents, victims. Yeah, of course, get health care, but not elective hernia surgery, cataracts. You have to be an American citizen who paid into the system to get these. Anyway, so we deal with this. Gavin says, We're only going to pay for illegal immigrants through our own state-based system. We've audited him now. This data is coming out this week. We have now found over one and a half billion dollars of money spent wrongly. We've audited it. They're not even arguing. One and a half billion dollars that California charged the federal government for illegal immigrants that they're not allowed to pay charges for. They have to pay for it themselves. He's not happy, but they're paying us because they know we're right. So you're going to see something happen very interesting in California. As soon as the money is being paid by California government officials, they're going to start getting more serious about this. And that's why it's so important for us to say, We're not into this anymore.

I'm not going to let taxpayers in Alabama, Mississippi, New Mexico, our poorest states, pay for the fourth largest economy in the world, and they get less.

And they get less. We're a country of immigrants. You could absolutely believe in legal immigration and want the border closed. That's what we saw in the last election. That was the deciding issue, I think, at the end of the day. They also picked a terrible candidate on the other side, and you never primary. Put that aside.

He had an amazing candidate, too.

Incredible. Tremendous. Okay.

The best ever. The greatest ever. I'm minimizing.

I'm just saying, you went up against it. Anyway, we'll put it aside. The thing that I think is super important is The incentives matter. You've said this many times without explicitly saying it in our conversation. The incentive for people to come to America illegally is to make a better life for themselves and to have a job, employment, and these social services. If the social services aren't available, some number are going to stay back. If the jobs aren't available, then why would you risk it? Why would you pay one of these coyotes $5, $25,000 across the board? You wouldn't. You would get in the line to do it properly. That's a very simple solution here. You just change the incentive. Make it impossible for an illegal alien to come here for those two things.

Do you know what financial value there is of having free health care in America?

So many.

I'm not going to make you guess.

I was going to say for the employers, I can say it's very acute to insert yourself into the relationship with your employees because employees will not leave one company. They'll pick the company they work for based on the health care, and they will not leave a company to pursue a better opportunity in order to keep their health care, which is dysfunctional because you want talent to move. That's a uniquely Silicon Valley entrepreneurial way to look at it.

From the employer market, we think the money should follow the patient. But broadly speaking, because I don't regulate commercial insurance, for illegal immigrants, for your family, it's worth about $30,000. There is no good reason for you to go back home again if we give you world-class health care coverage. This is a major issue for us dealing with the immigration problem because you cannot send 10 million people back legally who are here illegally. The President has said this, I think he said it publicly, but I think he would. It would take us 200 years of legal machinations to send back people who came here illegally. There is no legal path to Expelling people who came here illegally. You have to remove the incentives to stay here. Free housing, free food, free health care, of course you're going to stay.

Show me an incentive, I'll show you the outcome. If you look at the war on drugs, how unsuccessful it's been, People go to San Francisco for a reason for their fentanyl because they can buy it and there's no policing. It is exactly a function of more policing means the price of those drugs go up, which means consumption goes down. Not only is there that dynamic missing in San Francisco because there's no enforcement and you can get fentanyl for $5 or $10 a hit, they also give you housing at $800 or something to that effect per month. The homeless industrial complex has now created an incentive Everybody in that really tragic junkie community knows that, and they leave Texas. They leave other states to go there, and then they bear the brunt of it, and they are actually increasing the suffering. What's your take on these new super drugs versus the rescheduling of drugs? Obama wanted to do it in his second term. He didn't have the political willpower or will to do it. Trump now is saying, Hey, maybe for cannabis, we should rethink that and do what Canada has done in other modern nations.

How do you look at those specific drugs, Fentanyl, 9 or 12 overdoses a day in San Francisco at the peak, and then methamfetamine, which is just another sketch.

We have good substance use disorder medications. We can't get people into the programs. This is why homelessness is an industrial complex, and the States that have done it well. I know Mayor Suarez in Miami dropped the number by 90%, and he did it just by making sure that you got arrested every time you peed publicly. They don't put you in jail. They put you in rehab. But it takes four, five, six efforts. You can't give people free showers, great accommodations, lots of food, and then expect them to stop using drugs because you're enabling that behavior and not expecting bad outcomes, which is what happened. But I was in Kensington, Philadelphia, which is the drug capital of the East.

Oh, this is where they have that other super drug. I forgot the name of it. It's very pernicious.

Trank? Yeah. Trank is a terrible drug. It creates massive ulcers on your body. I was there, and I just walked the streets, just talked to people. Why are you here? Where'd you come from? Why don't you go home? Et cetera. Then I ran into a guy who had just saved someone's life giving them the loxone as an inhaler, an ambulance driver. I said, Well, What happened? He said, Well, they OD'd. I gave it to them. I said, Well, what did they tell you? How did they thank you when they awakened from near death, from that dark abyss of darkness? He said, They're almost always livid at me.

Yeah, you ruined their high.

And you ruined their escape.

Oh, they're actually hoping to end this suffering.

The pain was so bad. That's why it seems nice. That's why I was telling my friends in Minnesota, Minnesota nice is great when you really, really mean it. But nice does not mean It's not compassionate. It's not allowing your public health system to be raped. It's not allowing people to abuse themselves, expecting a different outcome than what historically has happened. If you really love people, you might not like them, but if you really love them, you'll do something that actually goes beyond like that makes you ultimately gain respect for them, for you and you can talk?

There's a very simple way. Well, and if you were to take a Christian view of it and you were to talk to any of the parents, these poor parents who are suffering with a child addicted to drugs, and their adult child is on the street, and you said to them, We can arrest them and put them in jail. We can treat them incredibly severely and try to just lock them up until they say, Thank you. Please do that. But there are a bunch of lunatics who think you're harassing Missing a homeless person who had a bad beat and you're infringing on their freedom. But the parents and the family would say, Please lock them up. That's our last-ditch effort. It's not compassion. It is not Christian at all.

That's a faculty lounge discussion with your tweed jacket on and your elbow protectors when you're pontificating about people that you read about. I point that out because I'm on the... You got one of those tweed.

You talked to those tweed.

Yeah, I got rid of my tweed jackets.

The elbow patches, they look terrible anyway.

But you You sit there and you act. Again, the crazy thing about intelligence is people, the more intelligent you are, the better you are to lying to yourself and to others around you because you can construe almost any data into something that has a meeting that's not really there. We have tolerated that for too long. I actually think that's an important part of President Trump's appeal. He cuts through all that BS. Don't tell me stuff that defies common sense because common sense is not so common.

You don't have to accept it. I think that's the other thing that I think Trump has, I think, taught some folks. We do not have to accept that state of affairs. You don't have to accept. The framing of it, let's just call it what it is. I've used the term here on our podcast, say junkies, because I grew up in New York in the '70s and '80s, and that's what we call people who are addicted to smack junkies. It's not derogatory. It's an indication of just how bad that disease is. 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. All right. Well, look. You got to let Dr. How long are we talking?

Two hours? I don't know, but I can talk to Dr. Oz for hours. I can talk to Dr. Oz for hours. I can serve you with no R-A-Tips. All right.

Dr. Oz. Can I- Please. All right. I just wanted to- Let me just wrap this up. Dr. Oz first reached out to me during the transition because he I was so intensely interested in AI. This is when you were transitioning? Yes, during my…

Transition, you supported him?

Yeah, very much. I love David. Yes, we all do.

He was looking for names of AI experts in Silicon Valley to build his advisory panel. This impressed me right away with the energy that you bring, the knowledge, the passion. You really do care about improving health outcomes for all Americans. I think we are very lucky to have you in this administration from the President on down. I think the country is very lucky. You could be doing many, many different things, but you really care about this job, and I think it's really incredible what you're doing. Thank you for your service. I wanted to have you speak to us on the pod. It's long overdue.

You're very kind to have me on. I'm a big fan, obviously, of your work, in part because you brought a sense of clarity to many of the issues you discussed. I want to thank you, David, for being a... First of all, using your ability to get people together, the power to convene is remarkably effective, but you've also demystified a lot of this and allowed 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. 'M going all in.