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

>> Yeah, he's hard to keep up with. I mean, he moves incredibly fast and it makes him really fun to work for because he wants to get things done. >> Yeah. >> Every day he wants to get things done.

>> There's a sense of urgency. >> Yeah. And you know, 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.

>> And he does that meeting after meeting, hour after hour, day after day, week after week. And when you compound that desire to get things done and he acts on it right there, it has a huge impact. and 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 and this I think across the different parts of the administ ministration. 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 and tertiary impact 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 developing AI where there probably wasn't a rule book before anyway, but in healthcare, you know, there have been doctors since the dawn of of, you know, 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 the negotiated final result uh sometimes falls short. You have rulemaking, second big area, which is, you know, 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.

Uh it does take some time. Uh and it's prone to lawfare. 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 a rule that would reduce fraud, but the blue cities didn't like it because it was coming from someone they didn't like, the president.

So, they enjoined 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, right? So, you make laws, you pass rules.

The third way, which historically government has not used, I don't think as effectively as possible. And this president, because he's a great negotiator, is able to 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 harbor to industry to come together and discuss problems that historically they would shy away.

>> What's the great example of that? I'm I'm wondering if it's the drug companies who they have something to lose because Trump's been 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's paying. Is that the best example in your experience so far? >> 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 the drug companies uh create some opportunities for risk for them you know make some rules create some pro projects that if we were to act on them would really hurt them >> a little pressure >> little pressure you know build the crowbars and the baseball bats >> okay >> cut some trees down hone the wood but don't use them >> and he's very specifically said do not hurt the innovative nature of pharmaceuticals they are important to our nation they save lives uh 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 uh but proportionally more. It's got to be fair.

And 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 you know foreign governments. There's internal threats like cancer.

>> Yeah. >> So we want everyone to chip in. We pay in United States 8% of our GDP towards pharmaceutical products. >> 8% 1% of our GDP goes to drugs.

That's not the health care system which I think is 17%. >> Right. >> 1% of it a full 6% of our healthcare goes just directly to the drug companies. So we want >> What's with your math?

>> It's quite quite impressive. >> Yeah. Thank you. >> So point I only bring this up because the percentages make a difference here.

08% >> comes from us playing blackjack. >> Calculator to this. I know you comes from us playing blackjack and poker together. You I've lost a lot two hours over here.

>> I Well, I've been 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.

>> What's the upshot of this? Because you hear this term affordability a lot. So the average American's going to pay less for their drug prices. >> We're going to pay less.

The Europeans, we are telling the 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.3%. So less than half of what we paid percentwise is being spent by them. And and they get away with it because their people don't realize that if you get cancer, more advanced cancers in Europe, your survival rate's way below the US.

And if you don't 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 going to say the most important message I'm going to deliver today. The most important message is don't think about healthcare like an expense. Think of it as an investment because if I can get the average American to work one year longer because I got them a medication at a better price, they didn't turn away at the drugstore or because we able to do something else correct >> whatever the envir 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 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 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 healthcare. Now, you did point out that they get things later. So, we have a better system, but we pay through the nose for it. That that would be an accurate way of describing the current state of affairs.

>> Precisely stated. Yes. >> Okay. So, how do we get every American healthcare?

because I believe a lot of the tension we have comes from a fear from people maybe who are not as well off as 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 healthcare, 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 healthcare. 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 healthare and then I tell the doctors, give them healthare, but they don't deal with the financial costs of then you all of a sudden start to restrict the access to care. So you can get the health care like you do in socialized medicine countries.

You just have to wait 6 months or a year or longer or you don't get the care at all. And when you start having that discussion with Americans, they say, "Wait, wait, hold on a second. Yes, of course I want uh to get the healthcare for an affordable price." But the question the fundamental question is how long till I actually get the care there >> being denied is something they live with. So they complain about their universal healthcare.

We complain about not having universal healthcare. What are the two or >> the thing I would look at is the flow of patients who seek treatment internationally. So I hear lots of stories about Canadians coming to the US to get treatment because they don't want to wait two years for some proced not just the latest to get some procedure because they could be dead in 2 years. So they come here.

I don't hear any Americans talking about going to Canada to get treatment. >> We actually do have uh 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.

for electron procedures. You mentioned cosmetic surgery. That's definitely a trend. >> Uh and also there's some procedures that we don't do in America.

>> Stem cells, >> but your stem cells there that they're still going through the regulatory process. But the the the bigger issue is really is the one David's raising, which is most Americans complain that the health care system is broken. Almost none would leave the country to get top tier health care for a life-threatening problem. And so we have this sort of bizarre opportunity.

I do think it's an opportunity. How do we make the top tier health care available to to folks who need it but do it at a price that is sustainable? And 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's that's that could happen in healthcare is worth subsidizing. And by that I mean making it 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 valuation. >> The technology to lower the price. Obviously that's a huge win.

Let me ask you the 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 and 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 I'll put it in the show notes, but this is a pretty groundbreaking. What are your thoughts if 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 common 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 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 that Americans we very intolerant to. We actually understand if a human being who has an MD degree makes a mistake. We think AI is perfect >> and are completely intolerant of even a minor uh transgression. What you said earlier is true and these studies have been done several times now.

the the the large language models do better on board exams. So, ab general knowledge, they're better than a doctor. They're more patient than a doctor. If you talk to an AI uh 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 tur 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. So I think we have the opportunity and we looked at some of these models.

Uh in fact John Door 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 two to three times more just to keep up with Europe just per capita.

We're way below because my son just finished medical school. There aren't many kids in medical school at Colombia where he went who are going to become GPS. They all want to be opthalmologists and, you know, orthopedic surgeons because they pay a lot more >> and they got big loans for their uh >> Yeah. And they're in debt.

They're in debt. >> Yeah. And this is even Colombia is free. If you don't, if you don't have money, you don't have to pay tuition at Colombia.

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 and one way of doing it is to allow it to do most of the work and then especially with agentic 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 co high cognitive function 50% of it is to read your face. We're hardwired to be social animals. To understand the subtle little David's bored, you're not. I got to change the pacing.

I got to get back to him. He's doing card calculations in his head. >> He was, in fairness to David, he was out till 1:00 a.m. They dragged him to four meetings.

I was in bed at night. I have good sleep. 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. >> Well, 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 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 mean, 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. >> So, you know, what patients are going to use is a is a consumer product, JBT, Grock, you know, and so forth. What's interesting, I think, is when they can dump in their blood panels cuz cuz AI is so good at reading PDFs, you know, just unstructured data.

So, 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 consumer.

You're a better customer. >> So you go more educated and then the doctors they can use chat GBT or what have you, but actually they're using specialized much more specialized tools that the ones I've seen. They will give you a citation directly to a medical journal that you can bring. That's very important to doctors.

So, you know, it's not hallucinating. Just getting the answer from a, you know, from a was on Joe Rogan podcast, you need to know what the source is, >> which is fine. If you if you get information from Joe and backwards to respected medical journal, >> let me ask you about this trend. >> This is self-directed healthcare.

There's function health doing blood labs, superpower, whoop just started offering them. Aura, Apple Watch, HLEP, 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 life, your health span, your, you know, your actual age versus your health age.

I don't sure 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 healthcare doing two blood labs a year putting it into a database? Uh POVA with the 3D scans, Nico, Daniel X, new company doing a $300 full body scan. All of this is this going to be the paradigm shift?

>> 8020 rule. If 20% of Americans do what you're saying, and they will, yeah, >> it'll 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, Medicaid patients are twice as likely.

Medicaid is the folks who are vulnerable, who are, you know, have made less money, uh, they're getting government health insurance, right? >> Medicare, >> that is our universal healthare, >> right? That's 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. And so, it's hard to take care of them. Now, they they have two jobs. They'll get fired if they leave the job early.

They don't have the the 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 healthcare to them, that's a major crisis for us.

And so the real opportunity for AI is democratizing healthcare. Yes. 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, right? And so if I can put into to AI my labs and I don't know much about healthare 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? >> Less than 5%. >> No, it's not that bad. It's less than 50%.

>> Less than 50%. >> Okay. But most people don't do it. It's there.

And part of the reason we think that's happening is you don't prioritize it. And here's the more important data point. People who 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 don't go to their doc or seek any kind of health advice think that they're doing great.

And actually, objectively, they're doing much worse. So, 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.

I'm with Amy Gleason who also ran Doge, you know, helping to to 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 and data transparency and to build these tools for the American people to be able to use them. Now, once I a 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 the 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. And 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 >> like how do you ever get them? >> Yeah. And all those companies now are saying, "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 all right, you know, 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 you're charging several times more for the same products." They said, "All right, well, we knew one day you'd come knocking." [laughter] We knew they do. So, and we actually think the president would do something to us, so we're going to negotiate. And you don't want to throw away that power. >> You know, don't beg for forgiveness.

Push for action. Yeah. >> You know, go make things happen. And if they don't work out, fine.

You you you'll get more 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. >> Well, don't be modest.

I mean, that'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, [laughter] but it was it was really interesting cuz so this is my kind of 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. >> HIPPA regulated. >> Well, it's it's because the the companies that store the health records Yeah. do it in proprietary formats and we don't really know how to get that data and what would we do with it even if we did.

So 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 agreeing. But I think that AI is kind of the magic glue here because AI is so good at reading data from different formats and translating it. So you don't need like 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 eight 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 like this gigantic win. >> Yeah.

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 these 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 you can interact with it. Can can I bring up one other example? So, Dr. You mentioned democratization.

And you and I have had a conversation about certain states are actually trying to ban the use of AI to be used in therapy. And 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. It 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, right? I mean, >> beautifully stated. Let's just go over let's unwrap that a little bit, but I'd be just at a high level say AI is coming to a neighborhood near you.

You're not stopping it. Yeah. >> So, it's going to be there and patients are going to use it. And so, you have to engage it running from it.

You know, uh, you know, we we we cannot stick our head in the sand on this one. There's other things you can sort of delay, but I I've encouraged every governor go full boore at this, but do it in the right way. Allow professionals to function at the height of their lensure. Why don't we use pharmacists better?

There's probably 70,000 pharmacists, right? And think about this way. Almost all Americans, 95% live within five miles of a pharmacy. There's they don't live near five, you know, 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. So, I'm not even saying advocate at all to a to a to an AI agent that doesn't really understand you. we can't control.

Maybe, you know, some other 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 crazy 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. And so, if we're going to fix those kinds of problems, which are timeconuming, you're not going to get Park Avenue psychiatrists to go practice medicine. $800 an hour >> at $800 bucks an hour in the North Slope of of Alaska in the winter.

It's just not going to happen. And so this $50 billion investment that we as a country just made just just I the money was part of the rural health the the working families tax uh cut legislation uh that the president pushed through and Congress got behind. $50 billion the largest investment ever made in rural healthcare 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 healthcare in rural America, you've got to rightsize the system. Right sizing the system means, you know, you have hospitals going to work out differently. Doctors will work differently with each other.

But AI is the core element of so much >> and these micro hospitals just like people are putting ADU units in the back of their homes to get an extra, you know, 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 uh who there's more available and then you tele medicine in just bringing the medicine to those areas without having to build a giant hospital is also a win yeah >> the micro clinics I think 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 parts of Alabama where there are no OBS, right? >> We have drones delivering uh prescription medications to the North Slope of uh of Alaska, where there are no roads, we have you have vending machines that can dispense smart dispensing of medications. By the way, this is happening in other countries.

So, we want this to take place in America. Why not take advantage of of an opportunity through with a huge massive inflow of money which the rural health transformation fund does $50 billion to start to do some innovative work in rural parts of the country which are the 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 now that you 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 it's it's 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. And it's not going to happen today, but we believe by the time the administration has completed this work, we will have dramatically changed the face of how Americans work with information in the health care system. Some of it's just blocking and tackling, as you said, make medical record companies, not data block. Some of it's forcing uh health information systems to share data more comfortably and elegantly at a at a fair price.

And part of it's us putting money into the system. seeding it the right way. Um but the most important thing is to make it safe to go outside. >> Yeah.

>> We want to make it comfortable to take financial risk 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 that I promised, they're all rushing in. >> The three places entrepreneurs have been reticent to uh take on uh to build new products and services.

Education, housing, healthcare. These also happen to be the ones most regulated, most controlled by the government. So 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 runway 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 industry. We believe the private sector will come up with better ideas.

Come work with us. And we're also looking for people and we we had nine engineers. Nine engineers when we came in and all of CMS the our cobalt based infrastructure built in the 70s where we don't 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.

So there's you basically have an HR person in government working with a government government affairs person at the company. There's no engineers there. >> 16 basis points. David, >> we took out we took $3 billion of cost out there.

There was a company that we fired that had build us $200 million. Not a single usable line of code. And 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 for forever. But I want to ask you about this wonder drug.

Four years ago, I was listening to my friend uh Tim Ferris and Kevin Rose who are biohackers and they're always on the edge of this stuff and he wanted to lose some visceral fat. Kevin was in great shape and he heard about this diabetes drug OMIC and that he was going to give it a shot. He dialed the pen all the way up, 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 I think he said, "You're a fat bastard." I think I said that.

And I had just gained like two or three pounds a year for 20 years. And I used to be a marathon runner. I used to be 165, 170 lbs. So now 172 gazelle right now by the way.

>> Well I add a little muscle too. Thank you Dr. O. You look great too.

Um 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 the four uh horsemen of the apocalypse, heart disease, >> kidney failure, liver disease, dementia.

>> Dementia. These are all four of four are impacted by obesity. and these GOP ones seem to be impacting them. I was like, you know what?

If Trump just President Trump just gave a national anybody can get this drug if they want it, I think he'd win the election. He won anyway. Um, what do you think about a mandate to make it available to make the fat drug available for all Americans? Would that be >> So, I'm glad you came to work today.

So, uh, 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. >> And u with the pills, it's $150 and the pills will come out. Uh the first FDA approved pills will start this month. Um and so we believe at that price day >> because think carefully.

That's right. It's a 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 illnesses, the four horsemen of the apocalypse that you mentioned that we will save money that we spend over half the money we I believe within health care on these chronic illnesses driven by obesity.

And so either 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 Liy.

We will launch next week. I don't know when this podcast airs but launch next week Trump RX with those products so you can cash pay at a price that is completely affordable. And here's the good news. Every Medicare patient gets it for $50 co-pay.

Every Medicaid patient gets it for nothing. >> Amazing. >> So the people who need it the most, the folks that are most vulnerable, this is what it 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, you 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. >> Right. >> Cuz people can afford it or >> because they're vain.

>> They're vain. They want to lose two pounds for their daughter's wedding and they can afford it. $1,200 a rounding area. Yeah.

Right. But $1,200 for someone that's not making money. You're not you're just not going to take the drug and they're the ones that die early. The life expectancy in rural America, I'll go back to them in vulnerable populations 9 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 and then getting to market and then you know this off label use starting with people with diabetes. What is that?

What is that? 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, this, you know, the drug actually came, it's a poisonous uh chemical, a venom actually, that was uh deciphered and found to have an impact on some of these core cells in the in the the appetite system of the body, which is so fundamental to who we are that it'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 at GLP-1s. So the newer drugs are going to be even more effective at that. >> Red True Tide is the one you >> for example, Red Tide.

But the other thing I would say is the form factor matters in sending someone an injection that's that goes bad in the warm weather that a lot of wastage and you don't know the exact dose. the pills make it like most other drugs and now the drug the price point is much lower as well. So it's easier for us to deliver that at scale to the American people. So it does leapfrog us beyond today's problems and this is a big theme of our administration.

Don't bother fixing today's broken pipes if the world you're building doesn't have pipes >> and that's what we're doing with drugs like semagutide and interzepide which is the the lily product. We're also getting these companies to unshore 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 favored nation drug um event, we had an executive order on childhood cancer.

20 beautiful children, smiley bright eyes, all of whom all of whom should have been ghosts. They survived because technologies were afforded to them. Don't exist in other parts of the world to keep them alive. That's our goal.

But I need to I'd be poorly served. I hear the bell tolling if I didn't get into the other >> for whom we don't know. We probably asked for the belt holes for sure for you, Jac. But >> I think that's [laughter] all I think that's totally for the pharma companies who don't bend the knee.

>> No, actually, but the the the the issue right now that is consuming us is the fraud, the waste and abuse. And >> what have you found, Dr. Oz? Tell us what is the most concerning to you?

>> Well, let me as a preamble w without a better visibility into where the money is spent, which we need technology to be able to do >> or audits. Well, audits are interesting. You can audit the spreadsheet. You can't tell if the input to the spreadsheet was legitimate unless you actually go and do site visits, and states don't want to do that.

So, let me just give it >> Are they blocking it these states? >> Of course. First of all, let me just 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, uh, 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 kind of voter like you don't have a law that if you go to an NRA convention uh right for for you know gun advocates that you sign up voters right you can go to that event not get signed up to vote obviously they would 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 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 and personal care services. There are more Americans, I believe, providing some of these homebased services that maybe might exist in retail in America. We've shifted the entire employment economy towards some of these services.

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

>> Well, the government's paying for it, >> right? So 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? Yeah.

And this is what happened in Minnesota where you had a subculture. It was prim, you know, just the mathematically most of the indictments with are with Somalians. So the Somalian community realized, hey, my goodness, no one's watching. >> Now there's an adage, you know, that only the morons get caught in healthcare fraud because it's so easy to do.

And if if you get you steal $5 million uh in medic in Medicare Medicaid, you go to jail for 18 months. I mean, for many people, that's a pretty good deal. >> Yeah. >> You, you know, 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 wheelchairs and knee braces. Twi there's actually 20 times more in South Florida than McDonald's.

I mean, how many do you need? Turns out they're all Cuban pretty much. They all seem to fly back to Cuba and escape, you know, law enforcement. They They build millions of dollars.

They get away with it. There >> what's the solution? There's got to be really practical, easy solution. >> There are, but and I'm going to share that, but let me just give you two others because you would remember these.

We have seven times more hospice in California. Hospice is for people at the end of their life. Seven times more hospice than was there five, six, seven years ago. Seven times more.

We don't have that many people dying in California. And 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.

Completely paying for it. But no one's dying because you're not supposed to. >> When did the government start paying for that? >> Oh, 40 years ago.

Okay. It was designed. >> And then what happened in the last seven or 10 that the fraud just went 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 on 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 and it becomes I'll give you I'll just tell you a true story about uh a whistleblower. Again, I I can't prove this, but it's what he said. He said that he uh he was building a beautiful mansion. He owns all these hospices.

He's a doctor, but he's a fraudster. Uh and so he built this puer house. They the plumber comes in and says, "Hey, you know, I hear you in the hospice space." The guy says, "Yeah, I made my money in hospice." that the plumber says, "You know, I've got a side hustle. I own a hospice, too." >> Right?

Then the carpenter hears him and he says, "Me, too. I'm in the hospice business. We're all in the hospice business." Absolutely. >> So then the guy says, "Okay, well, he realized he's got to get ahead of these guys." So he goes to a a major hospital in LA and a doctor at the hospital, very prominent hospital that everyone's heard of, says, "Hey, listen.

You, 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, this you send patients over. So the guy says, "Okay, but what about the actual inpatients like the people hospitalized? Can I get them?" They got and the doctor says, "I can't do that because it turns out the members some 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 in organized crime, but if you tolerate it, it poisons the whole system.

>> And that's the bigger reason we've got a problem. So what are we doing? We have a fraud uh war room. Uh I'm going to put a moratorum on some of these services.

We're not going to let new people sign up. Uh we're going to actively and aggressively stop paying Medicaid uh 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. So, we're going to stop paying on behalf of the taxpayer if we don't think you're taking care of the money.

>> And people should know there are whistleblower laws where you get a percentage of whatever is reported and they should look into that. And 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, you know, 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 >> and and 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. 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 into poverty. We take care of them. Those at the twilight of life, those are the seniors, right?

We owe it to them. Every great society takes care of the most vulnerable. We're great people will do that. And he 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 child care, but the child care dollars are being stolen.

Therefore, they can't access them. And the same thing's 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 a leaky bucket.

Well, you're talking about California >> and New York. >> Yeah. And I couldn't help but notice that Gavin Newsome arrived here at Davos 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 >> to basically uh advocate for foreign leaders to defy the American. >> What next? like partner with communist countries for your f I mean >> but I think honestly it's all a distraction because the 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 and >> the tip is Minnesota but California is the fourth largest economy in the world so we know there's massive fraud I think Newsome knows there's massive fraud too that's that's why he's vetoed >> audits >> I mean can we just pause for a second audit >> veto audits Right.

>> Who would veto an audit? >> Someone doesn't want to get caught. >> A criminal. [laughter] A criminal would veto it.

I'm not saying he's a criminal, but >> No, this is to government spending what the ban on voter ID is to elections. >> Why wouldn't >> you only do that? You you you're banning the thing that helps you catch the fraud. >> Yeah.

>> So why would you ever do that unless you want the fraud to happen? >> Exactly. It's it's Yeah. It's still >> now and now even >> distraati as we say here.

But California the budget's $350 billion by far the biggest. >> It has doubled in the last decade >> and it's like three times per capita >> two and a half times the inflation rate. Okay. And they're still running a huge deficit.

And that's why they're now driving all the job creators out 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 and home health care, we believe it's about three and a half billion dollars.

Just in those two programs in one city, there's probably 10% of all home healthcare expense in America is in LA. So there's so much to do to improve the system that would restore confidence. And when you have governors who are unwilling to do their job, and it does make people think that listen, when smart people don't do things, it's not an accident. right?

>> 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 had to ask those questions. This president is not going to tolerated, but the American people shouldn't either. >> We had an interesting moment.

Uh 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. And one of the things was they had just signed up for tons of software and you know basically subscriptions and uh CFO comes in, auditor comes in, we're all trying to figure it out and Elon said that Twitter and Elon says um >> how are they paying all these? They're like oh yeah they're on credit cards. He said okay um cancel all the cards.

>> Yeah. >> And [laughter] so we said they're like yeah cancel the cards. Immediately I get three back channels from software companies who are like hey um I know you're helping Elon. I saw a story in the New York Times.

Um, our bill stopped getting paid. Can we come in? And 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, not a private company. >> Yeah. >> But your point is, look, when when no one is minding the store, bad things are going to happen.

And when no one has minded 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 metastasizes. 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. Yeah. >> At the Minnesota daycare centers that were receiving millions of Learing center.

Yeah, the the Learing Center. They're all empty. Yeah. >> Dozens of them.

Each one's receiving millions of dollars. >> And that's one program in one state. And these aren't low lives doing this. The lives are involved obviously, but these are politically connected groups.

>> Sophisticated. >> Yeah. And that's why I'm emphasizing these are government, foreign governmentbacked efforts at times, but certainly the people doing them are often foreign nationals. And we are being taken advantage of because we're like a big hippopotamus.

You know, all you need to penetrate Medicare and Medicaid is a beneficiary number. they can buy those and you're off to the races. So, the solutions are 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 passport to it and um 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. >> Right.

So, you're saying cancel the credit cards. >> Yeah. >> And then >> and just let them then reopen the account or tell you. >> Yeah.

Come in. Yeah. We just want to reverify what's going on. Literally >> zero baseline budgeting.

Not saying the program is over. And that's the thing that that I think Elon found when he was doing Doge is these payments were just on recurring autopay every year. >> Autopay equals >> with no with no code explaining what the money was going to. >> Autopay equals from that.

That's all you have to know. And if you look at like some of the great I mean if you want to talk about like 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 was 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 they you're on the phone for an hour just want to cancel it. And I asked the woman, I said, "Uh, hey, can I ask you just a simple question, um, why can't I just cancel online?" They're like, "Oh, well, because of fraud." I'm like, [laughter] "But you took my money through the website, so that's where the fraud would actually occur." She's like, "Yeah, that kind of makes sense, but I'm just an operator, Mr.

Calican." They said, "Okay, fine." But that this is the same concept, which is if you want the money, hey, why don't you come into the office and we'd love to hear how the program's going. We got your check right here. Come pick it up in person. Want to hear about it.

And uh 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. >> Yeah. >> How is this hard?

>> And like you said, how do you argue for you? California already has some of the highest tax rates in the nation. And now you're arguing for more taxes, novel taxes, taxes that no one's ever seen. >> Unconstitutional.

>> Unconstitutional probably. And will require a massive new enforcement mechanism. Before you do that, you haven't even rung the obvious fraud out of the system. >> Yeah.

Listen, our biggest allies, our state auditors. I met with the state auditor in Minnesota. Uh confided that, you know, she's been trying to get this on the radar. Uh just people didn't want to listen.

And I talked to folks within the agency, Healthy Human Services. U you were shuttled around. Uh 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 be you're quiet because you don't want to get fired. And you make it such a a harsh environment for anybody to just tell the truth. This reminds me of a friend of mine who was uh he's a billionaire now. Tomas Pedy, you probably know him, Interactive Brokers.

Uh really really great guy. And he said he was growing 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, >> right?

>> So pretty soon we are all in on the fact that there's 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, aren't good people, >> or complicit.

>> And some of them are complicit. But I think fundamentally there was a misalignment of values. And this actually was probably the most important thing we had to do in that legislation last year, the working families tax cut legislation. We had to align the president with the governors.

There were so many ways of getting this the federal government to give you money that wasn't really yours. legalized moneyaundering schemes, all kinds of things that clever consultants had figured out over the years that we estimated we would have lost 5.4 trillion dollars just for Medicaid, which is again why I often joke we were becoming one massive health care system with a small country attached. >> Well, and if it doesn't work long term, if we don't take bold action, which again 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 our the next generation with a train wreck. They can't fix it anymore because the train's gone way off the rails.

Yeah. And just think of the absolute hypocrisy. You have someone like Mandami 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 Newsome is talking about wanting to provide more for the bottom half of society, but not doing the audits. >> And frankly, this whole budget hole that is causing this now acid seizure tax, it all started in 2022 >> when Newsome promised medical for all including illegal aliens. And so what happened is in big beautiful bill president said listen we're not going to reimburse for illegal aliens like >> think about incentives there >> right so then the SEIU uh the health worker union >> they're upset because they don't want that funding cut because it indirectly impacts them. So that's how this whole thing happened.

Think about the layers of fraud there that you've got you know the the government the government of California is paying for illegal aliens probably shouldn't be doing that. I mean, if you ask the American people, which is who you both work for, how many Americans believe that illegal aliens should get universal healthcare, I think you're going to get like 98% are going to say absolutely not. And the 2% with purple hair in Berkeley who want it. I >> I don't know what what their motivation is.

>> Support them. Just to finish the point, if you are going to have the politics of a Gavin Newsome and you're going to tell Benal 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 Yeah. >> 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 but it doesn't hurt California. This is the the part of the story that's so infuriating. You don't audit the books in California because the federal government's 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. So Gavin Newsome was given 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. So anyway, so you've got taxpayers in New Mexico, right, 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 Medcal. Now, he didn't take them off. He took them up on the federal side.

In theory, only emergency services are going to get paid for for illegal immigrants in California, which is a national law >> and is and is reasonable. >> Reasonable. Now, I'm I'm all we want babies delivered, car accident victims hurt, get of course get healthcare, but not elective hernia surgery, cataracts, you know, you have to be an American citizen who paid into the system to get these. So, anyway, so we 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 $1.5 billion dollar of money spent wrongly. We've audited it.

They're not even arguing. $1.5 billion dollars from uh that California charged the federal government for illegal immigrants that they're not allowed to pay charge us 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 and Mississippi, New Mexico, you know, our poorest states pay for the fourth largest economy in the world." And they get less. >> And they get less. And you know, the immigr 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. I mean, they also picked a terrible candidate on the other side and didn't have a primary. Put that aside.

If you >> We had an amazing candidate, too. >> Incredibly tremendous. Okay. >> The best ever.

>> They're the greatest ever. >> I'm minimizing. >> I'm just saying. I mean, you kind of went up against a we Anyway, put it aside.

You know, the the thing that I think is super important is incentives matter. You 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, you know, some number are going to stay back.

And 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.

And that's a very simple solution here. You 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 healthcare in America?

>> So many will the >> I'm not going to make you guess. >> Well, 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 healthare and they will not leave a company to pursue a better opportunity in order to keep their healthare 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, uh we we think the money should follow the patient, but broadly speaking, because I don't I don't regulate commercial insurance. For illegal immigrants, for your family, it's worth about $30,000. So, there is no good reason for you to go back home again if we give you worldass healthcare coverage. >> Yeah.

>> So, 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, you know, 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. So, 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 healthcare. 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, um how unsuccessful it's been, uh people go to San Francisco for a reason for their fentinel because they can buy it and there's no policing. And 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 fentinel for5 or $10 a hit, they also give you housing at $800 or something to that effect per month.

So the homeless industrial complex has now created an incentive and everybody in that you know really tragic junky 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 the rescheduling of drugs? Uh Obama wanted to do it in his second term. He didn't have the political willpower or will to do it.

And Trump now is saying, "Hey, maybe for cannabis we should rethink that and do what Canada's done in other modern nations." How do you look at those specific drugs? Fentinyl, 9 or 12 overdoses a day in San Francisco at the peak. Um, and then methamphetamine, which is just another >> We have good substance use disorder medications. We can't get people into the programs.

Uh this is why homelessness is an industrial complex and the states that have done it well. I mean 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. And they don't put you in in jail.

They put you in 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 the in Kensington, Philadelphia, which is the drug capital of the East.

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

>> Yeah. Tran is a terrible drug. It it creates massive ulcers on your body. And so I I was there and you know I I I I just walked the streets just talk to people like, "Why are you here?

Where'd you come from? Why don't you go home, etc." And I I ran into a guy uh who had just saved someone's life giving them the lock zone as an inhaler. And he's an ambulance driver. And I said, 'Well, you know what happened?

He says, 'Well, they odied. I gave it to them. And I said, 'Well, what did they tell you? How do they thank you when they awaken from near death, from that dark abyss of darkness?

And he said, they're almost always livid at me. >> Yeah, you ruined their high. >> Well, not and you ruined their their escape. >> Oh, they're they're actually hoping to end this suffering.

>> The pain was so bad. That's why it seems nice. And that's a 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 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. You need to 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. There's a very simple tough and if you were to take a Christian view of it um 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. Uh we can treat them incredibly severely and try to, you know, just lock them up until they they say, "Thank you.

Please do that." But there are a bunch of lunatics who think you're harassing 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 stitch effort." So it's not compassion. It is not Christian at all.

>> I That's a faculty lounge discussion with your tweed jacket on. Yeah. >> And your elbow protectors when you're pontificating about people that you read about, right? >> Uh and I point that out because I'm on the facult, you know, I' I've been >> You got one of those tweet you you talked to those tweet.

>> Yeah. I got rid of my tweet jackets. >> The elbow patches, they look terrible anyway. >> But you know, you sit there and you act and this is the 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, you know, a meaning that's not really there. And we have tolerated that for too long. I 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 just defies common sense because common sense is not so common. I think >> you you don't have to accept it. I think that's the other thing that I think Trump has has I think taught some folks. We do not have to accept that state of affairs.

You don't have to accept and the framing of it. Let's just call it what it is. You know, I've used the term here on our podcast and 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, >> we got to let Doc This How long have we talking? Two hours.

>> I don't know. But I got Dr. Surgeon with tips. >> All right.

Let me Dr. House. >> Yeah. Let me me can I >> please?

>> All right. So, I just want Yeah, let me just wrap this up. So, uh Dr. Oz first reached out to me during the transition because he's so intensely interested in AI and he >> This is when you were transitioning.

>> Yes. During my >> transition, you supported him. >> I loved I love David. Yes, we all did.

>> And uh he was looking for for uh names of AI experts in Silicon Valley to build his advisory panel and just impressed me right away with the the energy that you bring, the knowledge, the passion. You really do care about improving health outcomes for all Americans and I think we are very lucky to have you in this administration. uh from the president on down and I think the country is very lucky to have 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 pods. Kind of long overdue. >> Well, 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 and I want to thank you David for being a you 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. So, God bless you. >> Great.

Thank you. Thanks for being here. >> We'll see you next time on Allin at Davos. I'm going all in.

[music] I'm going all in.