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All right, everybody. Welcome back. It's
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all in at Davos. My bestie, David Saxs,
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is here. We're having a great time.
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We're here.
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>> Can you guys catch this in the
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background? Amazing.
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>> It's stunning.
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>> This is the Davos experience. It looks
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real. I know. Well, it kind of looks
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like a green screen from here cuz it's
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just so picturesque.
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>> It's literally like a
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>> green screen. It is. It's the real the
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real deal.
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>> And we'll we'll look over the ledge
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here. And what you'll see is all of the
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virtue signaling ESG DEI executives. And
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uh you'll you'll just it's emanating
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from this entire area. And they've put
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solar over every single building here.
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None of it's plugged in. It's just for
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aesthetics. But uh we're really excited,
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David and I, um to do a bunch of
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interviews here. Wow. Today we've got a
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great one for you. And we're going to
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talk about health and we're going to
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talk about the health care system with
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none other than Dr. Midas. Uh you're the
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administrator now for CMS. You've gone
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from being America's doctor, dare I say,
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to being a civil servant like my friend
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David Saxs. Why did you choose really
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height of your powers career to to go
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into public service like this?
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>> So, I'm in the change business. You guys
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are as well. And if you're in the change
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business and the project you're pursuing
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is not making a significant change, then
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you want to move on to something else
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that could make the impact you desire.
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And especially in healthcare, we don't
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have the luxury of fooling around for
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years of our lives pursuing uh interests
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that don't result in meaningfully
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changing the the quality of life, but
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also the opportunity that the American
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people have. And so although I loved
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being a TV host, did it for 13 years, I
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love practicing surgery, which I've done
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my whole life till recently. Uh this is
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the best job I've ever had. And it's the
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best job I've had because of the people
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that I get to work with, but also
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because you truly do get to make the
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change that I desire. And I think a lot
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of folks, the reason they watch the
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podcast is they they want to change
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stuff, too. And I encourage everybody
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to, you know, take some big swings and
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you'll break things once in a while. But
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if you want to be able to change
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meaningfully the the infrastructure,
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whatever's bothering you, uh, you got to
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go at full speed. And this
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administration offers us a unique
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opportunity to do that. It is
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interesting, David. Um, you were used to
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going at a pretty fast pace as well. And
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then I think our expectation was, hey,
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you get into public service, it's going
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to be about consensus building and it's
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going to take a lot of time. Say what
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you will about Trump. Some people might
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not agree with every policy, but he
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ships. He's like a founder who ships and
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ships product fast. That's also been
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your experience.
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>> Yeah, he's hard to keep up with. I mean,
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he moves incredibly fast and it makes
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him really fun to work for because he
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wants to get things done.
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>> Yeah.
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>> Every day he wants to get things done.
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>> There's a sense of urgency.
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>> Yeah. And you know, you'll be in a
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meeting with the president in the Oval
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Office and you'll tell him about a
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problem. His first instinct is to pick
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up the phone
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>> and call and fix it right then and
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there.
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>> And he does that meeting after meeting,
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hour after hour, day after day, week
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after week. And when you compound that
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desire to get things done and he acts on
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it right there, it has a huge impact.
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and he seems to get great pleasure in
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bringing together especially in this
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administration which I think is
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distinctly different than the first
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first administration he was new to
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politics and he brought in a lot of
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career politicians that I think maybe
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people told him were the right people
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this time he has explicitly gone and
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looked for people with expertise who are
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proven winners in the field yourself
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included
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>> he wants us to carry the water and this
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I think across the different parts of
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the administ ministration. He wants
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individuals that don't have to rely on
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the president to tell the story all the
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time because so much of the narrative
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that is reflected in the media is just
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completely off. I'm not even saying that
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they're doing it on purpose. They
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literally don't understand some of the
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secondary and tertiary impact of the
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decisions you're making. And it's our
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job to therefore tell not just the
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media, but the American people what
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we're trying to do. And that's
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especially important if you're
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unorthodox in how you govern. And this
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is a fundamentally important reality, at
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least at CMS. David, I don't know how it
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is in developing AI where there probably
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wasn't a rule book before anyway, but in
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healthcare, you know, there have been
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doctors since the dawn of of, you know,
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since humans left Africa 50,000 years
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ago, there were doctors in the
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encampment. And so there is a way of
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doing things. And in government, that
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exists as well, but it's not always the
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right way to do things. So, for example,
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we have the ability to make laws. Every
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part of the administration pretty much
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can. We get Congress to do stuff. It
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doesn't always turn out the way you want
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it to turn out, and it takes a lot of
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time. and the negotiated final result uh
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sometimes falls short. You have
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rulemaking, second big area, which is,
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you know, administrative entities like
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ours can write the rules that everyone
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has to follow. We're going to pay you
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this much. We're not going to let these
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people do that anymore. Uh it does take
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some time. Uh and it's prone to lawfare.
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By that, I mean the people you're
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regulating, if they don't like what
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you're saying, they can sue you and they
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can stop you. And in this
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administration, if the other party
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doesn't like what you're doing, even if
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it's the best thing, we had a a rule
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that would reduce fraud, but the blue
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cities didn't like it because it was
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coming from someone they didn't like,
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the president. So, they enjoined it, and
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that's now caught up in court. Now,
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we'll win, but it could take years. So,
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that's the second big way, right? So,
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you make laws, you pass rules. The third
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way, which historically government has
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not used, I don't think as effectively
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as possible. And this president, because
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he's a great negotiator, is able to to
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push us in ways that historically not
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been done, is to just use the power to
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convene. The US government can bring
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people together who would not normally
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talk. They can give safe harbor to
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industry to come together and discuss
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problems that historically they would
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shy away.
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>> What's the great example of that? I'm
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I'm wondering if it's the drug companies
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who they have something to lose because
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Trump's been President Trump has been
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very clear. Hey, I want these prices
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lowered. Why are we the sucker at the
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poker table? We're paying 10 times what
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Canada's paying. Is that the best
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example in your experience so far?
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>> It's a great example. Most favored
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nation drug pricing. It specifically
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addresses the problem you outlined,
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which is we just pay a bunch more for
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the exact same product made the same
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factory often in America than our
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counterparts do here in Europe. So the
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president says we need to change that.
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So he says go talk to the drug companies
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uh create some opportunities for risk
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for them you know make some rules create
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some pro projects that if we were to act
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on them would really hurt them
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>> a little pressure
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>> little pressure you know build the
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crowbars and the baseball bats
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>> okay
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>> cut some trees down hone the wood but
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don't use them
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>> and he's very specifically said do not
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hurt the innovative nature of
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pharmaceuticals they are important to
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our nation they save lives uh We want to
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have the most innovative industries in
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the world because that's where the
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opportunities are to differentiate
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ourselves. It's also part of our
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national destiny. Be the best. So don't
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hurt the industry, but take some of the
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fat out of it. Pull it back and give it
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to the American people. Plus, it's the
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fair way of doing things. And
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metaphorically, when you think about
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NATO and the president saying to NATO
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countries, we're all in it together to
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protect ourselves against external
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threats. You guys got to put up more
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money. We'll put up more uh but
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proportionally more. It's got to be
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fair. And they all did that pretty much
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with one or two exceptions. He did the
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same thing with pharmaceuticals. He said
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there's an external threat which is
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Russia or you know foreign governments.
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There's internal threats like cancer.
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>> Yeah.
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>> So we want everyone to chip in. We pay
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in United States 8% of our GDP towards
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pharmaceutical products.
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>> 8% 1% of our GDP goes to drugs. That's
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not the health care system which I think
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is 17%.
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>> Right.
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>> 1% of it a full 6% of our healthcare
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goes just directly to the drug
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companies. So we want
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>> What's with your math?
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>> It's quite quite impressive.
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>> Yeah. Thank you.
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>> So point I only bring this up because
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the percentages make a difference here.
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08%
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>> comes from us playing blackjack.
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>> Calculator to this. I know you comes
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from us playing blackjack and poker
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together. You I've lost a lot two hours
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over here.
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>> I Well, I've been I've lost a lot of
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money to this guy and I don't play him
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in chess anymore.
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>> Bend but don't break. You want them to
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bend a little bit. Be reasonable but you
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don't want to break the industry as a
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doctor.
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>> What's the upshot of this? Because you
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hear this term affordability a lot. So
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the average American's going to pay less
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for their drug prices.
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>> We're going to pay less. The Europeans,
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we are telling the all the countries,
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we're in the middle of these
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discussions. We've just gotten the
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British to say yes and other countries
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are talking to us about the fact that
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they pay.3%. So less than half of what
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we paid percentwise is being spent by
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them. And and they get away with it
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because their people don't realize that
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if you get cancer, more advanced cancers
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in Europe, your survival rate's way
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below the US. And if you don't if you
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don't get access to the drugs, which
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they don't for several years on average
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that we get in the US, yes, you can get
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it for cheaper, but your people are
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paying a price. And this is going to say
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the most important message I'm going to
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deliver today. The most important
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message is don't think about healthcare
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like an expense. Think of it as an
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investment because if I can get the
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average American to work one year longer
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because I got them a medication at a
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better price, they didn't turn away at
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the drugstore or because we able to do
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something else correct
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>> whatever the envir the movement. We'll
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talk about all this, but if you can get
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the average American to work one year
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longer, that is worth $3 trillion to the
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US economy. It's massive.
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>> So, we we need to get people feeling
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their best, feeling that they have
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agency over their future with confidence
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that they're going to make a difference
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in the world so they want to keep trying
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to do it at the workplace. And that
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extra one year, which gets them closer
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to Medicare, by the way, also helps deal
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with other financial crises that we're
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facing as a nation. So, this is the way
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to think about it the right way. Get the
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actual cost of care down. Don't just pay
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more money into the system. Get the
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actual cost of care down so the money
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we're spending gets us more value.
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>> We're spending twice as much as these
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other countries who have universal
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healthcare. Now, you did point out that
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they get things later. So, we have a
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better system, but we pay through the
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nose for it. That that would be an
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accurate way of describing the current
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state of affairs.
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>> Precisely stated. Yes.
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>> Okay. So, how do we get every American
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healthcare? because I believe a lot of
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the tension we have comes from a fear
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from people maybe who are not as well
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off as as the people on the pod right
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now and they live with that fear. We
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don't live with that fear. We know if we
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need to get healthcare, we're going to
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figure it out. We'll be able to pay for
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it out of pocket or insurance will pay
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for it. But there are people who go
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bankrupt because of this. You believe in
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universal healthcare. I would assume as
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a doctor.
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>> I want everyone to have access to health
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care. But how we pay for it is the
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defining issue here. How do you keep the
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system incentivized to take care of you?
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If I tell everybody in America that you
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have healthare and then I tell the
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doctors, give them healthare, but they
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don't deal with the financial costs of
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then you all of a sudden start to
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restrict the access to care. So you can
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get the health care like you do in
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socialized medicine countries. You just
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have to wait 6 months or a year or
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longer or you don't get the care at all.
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And when you start having that
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discussion with Americans, they say,
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"Wait, wait, hold on a second. Yes, of
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course I want uh to get the healthcare
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for an affordable price." But the
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question the fundamental question is how
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long till I actually get the care there
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>> being denied is something they live
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with. So they complain about their
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universal healthcare. We complain about
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not having universal healthcare. What
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are the two or
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>> the thing I would look at is the flow of
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patients who seek treatment
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internationally. So I hear lots of
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stories about Canadians coming to the US
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to get treatment because they don't want
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to wait two years for some proced not
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just the latest to get some procedure
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because they could be dead in 2 years.
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So they come here. I don't hear any
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Americans talking about going to Canada
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to get treatment.
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>> We actually do have uh a number of
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examples of that in surgeries and
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treatments that you have to pay for out
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of pocket. Cosmetic, dental, people are
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going and this has become tourism and
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there are people who do change
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locations. Yes. for electron procedures.
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You mentioned cosmetic surgery. That's
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definitely a trend.
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>> Uh and also there's some procedures that
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we don't do in America.
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>> Stem cells,
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>> but your stem cells there that they're
00:11:45
still going through the regulatory
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process. But the the the bigger issue is
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really is the one David's raising, which
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is most Americans complain that the
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health care system is broken. Almost
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none would leave the country to get top
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tier health care for a life-threatening
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problem. And so we have this sort of
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bizarre opportunity. I do think it's an
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opportunity. How do we make the top tier
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health care available to to folks who
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need it but do it at a price that is
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sustainable? And that's where I think
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your specialty area comes into play.
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Before this administration, I think
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because we didn't have the right
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technologies to promise convincingly
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that we could do this, there was a
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hesitancy to make big shifts. We're
00:12:21
taking big swings because we think AI is
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ready. We think the tech transformation
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that's that's that could happen in
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healthcare is worth subsidizing. And by
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that I mean making it possible for top
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tier entrepreneurs who are building apps
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that can help you deal with the medical
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crisis that you're dealing with their
00:12:36
diabetes. We can put money into the
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system to make that worth you doing. So
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you can get investors to support you.
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You can get a fair valuation.
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>> The technology to lower the price.
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Obviously that's a huge win. Let me ask
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you the the difficult question as a
00:12:49
doctor. There have been studies that
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came out recently that not only do LLMs
00:12:52
currently give better advice than the
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average general practitioner, they have
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better bedside manner and the customers
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or the patients enjoy the LLM more than
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they enjoyed a GP.
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>> Where did you see that? I haven't seen
00:13:06
that.
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>> This is a study that came out of either
00:13:08
Harvard or MIT. I I'll put it in the
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show notes, but this is a pretty
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groundbreaking. What are your thoughts
00:13:14
if you were going to a new society? Is
00:13:18
this idea that you have to go to the GP,
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they ask you a bunch of questions, then
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they go on their medical text, figure
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out what their advice is, is that the
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best modality or would it be better for
00:13:29
the common cold for an ankle sprain to
00:13:32
do what most Americans without insurance
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are doing or people who are
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self-directed? They go on a large
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language model. It says here's how you
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deal with these issues and they do it
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themselves and they can take care of a
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couple things. Wouldn't it be better to
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just have them do this stuff and then
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decide if they should go see their GP?
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>> I think there's a hybrid of that that
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derisks it a little bit early on. There
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are definitely problems with
00:13:53
hallucination and the like that that
00:13:55
Americans we very intolerant to. We
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actually understand if a human being who
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has an MD degree makes a mistake. We
00:14:01
think AI is perfect
00:14:03
>> and are completely intolerant of even a
00:14:05
minor uh transgression. What you said
00:14:07
earlier is true and these studies have
00:14:08
been done several times now. the the the
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large language models do better on board
00:14:13
exams. So, ab general knowledge, they're
00:14:15
better than a doctor. They're more
00:14:17
patient than a doctor. If you talk to an
00:14:19
AI uh informed avatar, they'll answer
00:14:22
the same 10 questions on diabetes all
00:14:24
day long and not get bored. Talk to a
00:14:26
general practitioner after they've
00:14:27
talked to 10 patients with diabetes
00:14:28
who've asked the same 10 questions, you
00:14:31
get a little tur in your responses.
00:14:32
That's just human nature. I don't want
00:14:33
to answer the same question every time,
00:14:35
but that's what patients need you to do.
00:14:37
So I think we have the opportunity and
00:14:39
we looked at some of these models. Uh in
00:14:41
fact John Door brought a bunch of very
00:14:42
thoughtful entrepreneurs into the
00:14:44
building to talk about the possibility
00:14:46
of us taking the average general
00:14:48
practitioner and making them five times
00:14:50
maybe even 10 times more efficient. Now
00:14:53
here's the big deal. There are not
00:14:54
enough GPS in America. We probably need
00:14:56
two to three times more just to keep up
00:14:58
with Europe just per capita. We're way
00:15:00
below because my son just finished
00:15:02
medical school. There aren't many kids
00:15:03
in medical school at Colombia where he
00:15:05
went who are going to become GPS. They
00:15:07
all want to be opthalmologists and, you
00:15:08
know, orthopedic surgeons because they
00:15:09
pay a lot more
00:15:11
>> and they got big loans for their uh
00:15:12
>> Yeah. And they're in debt. They're in
00:15:14
debt.
00:15:14
>> Yeah. And this is even Colombia is free.
00:15:15
If you don't, if you don't have money,
00:15:17
you don't have to pay tuition at
00:15:18
Colombia. They did that so that kids
00:15:20
would go into general practice and
00:15:21
hasn't had the desired impact yet. But
00:15:23
the broader question is how do we allow
00:15:26
AI to play a role as this transition
00:15:28
period happens so people feel confident
00:15:31
and one way of doing it is to allow it
00:15:32
to do most of the work and then
00:15:34
especially with agentic AI take the
00:15:36
paperwork out of it the busy work out of
00:15:38
it and feed the doctor the key
00:15:40
information. What's the most important
00:15:41
thing I do as a doctor? I look at you in
00:15:43
the eyes and I read you and I try to
00:15:45
connect with you. 50% of our cortex of
00:15:48
our co high cognitive function 50% of it
00:15:50
is to read your face. We're hardwired to
00:15:54
be social animals. To understand the
00:15:56
subtle little David's bored, you're not.
00:15:58
I got to change the pacing. I got to get
00:16:00
back to him. He's doing card
00:16:01
calculations in his head.
00:16:02
>> He was, in fairness to David, he was out
00:16:04
till 1:00 a.m. They dragged him to four
00:16:06
meetings. I was in bed at night. I have
00:16:08
good sleep. I got my Whoop. I got my
00:16:10
sleep score. I am a pillow princess like
00:16:12
you, Dr. Oz. I hear that you're extreme
00:16:16
about your sleep.
00:16:16
>> Well, I'm a good sleep. My wife is a
00:16:18
world-class sleeper. She brings her own
00:16:19
pillows.
00:16:20
>> Your wife is delightful, by the way. I I
00:16:22
did an hour interview with Lisa before
00:16:24
you even got on stage here. I was like,
00:16:26
"Wow, she's impressive."
00:16:27
>> To build on this point, I mean, I think
00:16:29
it's interesting. I think we're going to
00:16:30
get smarter doctors and smarter
00:16:32
patients, and they're each going to use
00:16:33
their own version of AI.
00:16:36
>> So, you know, what patients are going to
00:16:38
use is a is a consumer product, JBT,
00:16:41
Grock, you know, and so forth. What's
00:16:42
interesting, I think, is when they can
00:16:44
dump in their blood panels cuz cuz AI is
00:16:46
so good at reading PDFs, you know, just
00:16:48
unstructured data. So, you dump all your
00:16:50
stuff in it. You ask for a diagnosis,
00:16:52
you get smarter. You can research your
00:16:54
own condition. You're not wasting
00:16:56
frankly the doctor's time by asking
00:16:58
basic consumer. You're a better
00:17:01
customer.
00:17:02
>> So you go more educated and then the
00:17:04
doctors they can use chat GBT or what
00:17:07
have you, but actually they're using
00:17:08
specialized much more specialized tools
00:17:11
that the ones I've seen. They will give
00:17:14
you a citation directly to a medical
00:17:16
journal that you can bring. That's very
00:17:17
important to doctors. So, you know, it's
00:17:19
not hallucinating. Just getting the
00:17:21
answer from a, you know, from a was on
00:17:24
Joe Rogan podcast, you need to know what
00:17:25
the source is,
00:17:26
>> which is fine. If you if you get
00:17:28
information from Joe and backwards to
00:17:31
respected medical journal,
00:17:32
>> let me ask you about this trend.
00:17:34
>> This is self-directed healthcare.
00:17:36
There's function health doing blood
00:17:37
labs, superpower, whoop just started
00:17:40
offering them. Aura, Apple Watch, HLEP,
00:17:43
I'm an investor in that one. Full
00:17:44
disclosure, it's doing great. These
00:17:46
things are now putting all that data
00:17:47
together and starting to tell you your
00:17:50
life, your health span, your, you know,
00:17:52
your actual age versus your health age.
00:17:55
I don't sure what that metric is, but
00:17:57
people are now measuring things and
00:17:59
getting some knowledge of this and then
00:18:00
going to a GP. The problem I'm having
00:18:02
is, and I'm not price sensitive. I could
00:18:05
get any concierge doctor I want. There's
00:18:08
very few doctors who want to work like
00:18:09
this at the moment. That's something's
00:18:12
got to change. But what do you think of
00:18:13
this new group of people who are doing
00:18:15
self-directed healthcare doing two blood
00:18:17
labs a year putting it into a database?
00:18:20
Uh POVA with the 3D scans, Nico, Daniel
00:18:23
X, new company doing a $300 full body
00:18:26
scan. All of this is this going to be
00:18:27
the paradigm shift?
00:18:28
>> 8020 rule. If 20% of Americans do what
00:18:31
you're saying, and they will, yeah,
00:18:32
>> it'll make all of medicine function
00:18:34
better. I'm actually concerned about the
00:18:36
other end of the spectrum. Tell me
00:18:38
>> the people who don't go to their
00:18:39
doctors, Medicaid patients, Medicaid
00:18:41
patients are twice as likely. Medicaid
00:18:43
is the folks who are vulnerable, who
00:18:45
are, you know, have made less money, uh,
00:18:47
they're getting government health
00:18:48
insurance, right?
00:18:49
>> Medicare,
00:18:50
>> that is our universal healthare,
00:18:51
>> right? That's that's where we need help.
00:18:53
The chance of a Medicaid patient who
00:18:55
doesn't pay for their health care
00:18:56
because they don't have the means to do
00:18:57
it. The chance of them canceling their
00:18:59
doctor's appointment is twice that of a
00:19:00
Medicare patient. And so, it's hard to
00:19:02
take care of them. Now, they they have
00:19:04
two jobs. They'll get fired if they
00:19:05
leave the job early. They don't have the
00:19:06
the the flexibility of moving their
00:19:08
calendar around. They don't have
00:19:10
transportation. There's lots of reasons
00:19:11
they don't show. But if I can't get
00:19:13
healthcare to them, that's a major
00:19:14
crisis for us. And so the real
00:19:16
opportunity for AI is democratizing
00:19:18
healthcare. Yes. See, you guys are
00:19:20
already smart. You just listed off top
00:19:21
of your head a dozen companies all doing
00:19:22
great work. Most people have no idea
00:19:24
these companies exist or what they do
00:19:26
exist, right? And so if I can put into
00:19:28
to AI my labs and I don't know much
00:19:31
about healthare I can get information
00:19:33
sent to me in a way that I can process
00:19:34
it and at the time I'm ready to hear it.
00:19:36
Now I'll give you one more data point
00:19:38
that might be useful. All Medicare
00:19:40
patients, all seniors over 65, all of
00:19:42
them are given a free wellness exam
00:19:43
every year. What percentage of people
00:19:46
take their free medical exam with?
00:19:47
>> Less than 5%.
00:19:48
>> No, it's not that bad. It's less than
00:19:51
50%.
00:19:51
>> Less than 50%.
00:19:52
>> Okay. But most people don't do it. It's
00:19:53
there. And part of the reason we think
00:19:55
that's happening is you don't prioritize
00:19:57
it. And here's the more important data
00:19:58
point. People who actually see their
00:20:00
doctor think they're sicker, but they're
00:20:02
actually much healthier than people who
00:20:04
don't see their doctor because ignorance
00:20:05
is bliss. People don't go to their doc
00:20:07
or seek any kind of health advice think
00:20:09
that they're doing great. And actually,
00:20:11
objectively, they're doing much worse.
00:20:12
So, we have an opportunity to
00:20:14
democratize this by saying, "Okay, I'm
00:20:16
going to meet you where you are. You
00:20:17
don't care about going to see a doctor
00:20:18
even though it's free. It's yours in
00:20:20
this new health tech ecosystem we're
00:20:21
building out. I'm with Amy Gleason who
00:20:23
also ran Doge, you know, helping to to
00:20:25
to roll this all out. We're making it
00:20:27
easier for every tech company to
00:20:29
participate. 600 companies have signed a
00:20:32
pledge agreeing to interoperability and
00:20:34
data transparency and to build these
00:20:36
tools for the American people to be able
00:20:38
to use them. Now, once I a deputize you
00:20:41
to be better equipped to take care of
00:20:43
yourself, you change the system. Because
00:20:45
when you ask a doctor a question, the
00:20:46
first time you're the only patient, they
00:20:48
don't pay attention. The second patient
00:20:49
who asks the same question, we change.
00:20:52
As a physician, I'm telling you, it
00:20:53
helps us to have patients pushing us to
00:20:56
pay attention to, for example, ambient
00:20:58
collection of information in the
00:20:59
doctor's office. So, I get a medical
00:21:01
report on what you told me. Why? Because
00:21:03
50% of what a doctor tells the patient
00:21:05
is forgotten before the patient leaves
00:21:07
the office. So, when your kid asks you,
00:21:09
hey, what happened with the doctor? You
00:21:11
don't remember. You're nervous. You're
00:21:12
anxious. The doctor spoke quickly. Use
00:21:14
big words. Break all that down. And all
00:21:16
of a sudden, information gets flowing
00:21:18
easily. Now you've got a lot more
00:21:19
stakeholders. And who's the ultimate
00:21:21
stakeholder? The patient. So the medical
00:21:23
records who historically have been
00:21:24
hijacked by medical record companies
00:21:26
>> and hidden
00:21:27
>> and hidden
00:21:27
>> like how do you ever get them?
00:21:28
>> Yeah. And all those companies now are
00:21:29
saying, "All right, we get the joke."
00:21:30
And this is again back to the president.
00:21:32
He's not fooling around in this stuff.
00:21:34
When he tells you he wants you to share
00:21:35
data, you know he's going to come after
00:21:37
your ass if you don't deal with this
00:21:39
problem. And so they've all come and all
00:21:40
right, you know, we're not on the joke
00:21:42
now. The pharma companies when we're
00:21:43
negotiating most favored nation. You
00:21:44
know what they said when we challenged
00:21:46
them and said, "You're you're charging
00:21:47
several times more for the same
00:21:49
products." They said, "All right, well,
00:21:50
we knew one day you'd come knocking." We
00:21:52
knew they do. So, and we actually think
00:21:54
the president would do something to us,
00:21:56
so we're going to negotiate. And you
00:21:58
don't want to throw away that power.
00:22:00
>> You know, don't beg for forgiveness.
00:22:02
Push for action. Yeah.
00:22:03
>> You know, go make things happen. And if
00:22:04
they don't work out, fine. You you
00:22:06
you'll get more more bites at the apple.
00:22:07
>> Just on that point about the pledge
00:22:09
because I got to attend that event at
00:22:10
the White House.
00:22:11
>> You organized it.
00:22:12
>> Well, don't be modest. I mean, that's
00:22:13
going to be a little bit too much
00:22:14
credit, but it was honestly it was you
00:22:16
and Amy Gleason and Secretary Kennedy
00:22:19
and you guys just happened to invite me
00:22:21
for some reason, but it was it was
00:22:23
really interesting cuz so this is my
00:22:25
kind of layman's understanding of it,
00:22:27
which is the law gives us the right to
00:22:29
our own medical records, but in
00:22:32
practice, we don't get them.
00:22:34
>> HIPPA regulated.
00:22:36
>> Well, it's it's because the the
00:22:38
companies that store the health records
00:22:41
Yeah. do it in proprietary formats and
00:22:43
we don't really know how to get that
00:22:45
data and what would we do with it even
00:22:47
if we did. So the key is to get those
00:22:50
health records shared to all the other
00:22:52
medical companies in the space that we
00:22:53
might want to use. Hence the power of
00:22:55
the pledge get these 600 companies
00:22:57
agreeing. But I think that AI is kind of
00:22:59
the magic glue here because AI is so
00:23:02
good at reading data from different
00:23:04
formats and translating it. So you don't
00:23:07
need like a perfect API anymore. You
00:23:10
just get the unstructured data, dump it
00:23:11
in, and now it just works.
00:23:13
>> Which is what we're starting to see. I'm
00:23:15
taking my eight sleep data, my Whoop
00:23:18
data, my blood panels, and I'm putting
00:23:20
it into all four of the major ones,
00:23:22
asking it. I take pictures of every one
00:23:24
of my supplements or drinks. What impact
00:23:26
will this have? Which impact will this
00:23:27
have on sleeping?
00:23:29
>> I think that's like this gigantic win.
00:23:31
>> Yeah. you being able to realize the
00:23:34
promise that the law gives you to
00:23:35
actually own your own medical data, but
00:23:37
to get it in a usable format that now
00:23:39
you can use again a chat interface to
00:23:42
understand it.
00:23:42
>> It's technological obscurification.
00:23:44
Let's call it what it is. They're trying
00:23:45
to use these proprietary formats always
00:23:48
to get a technological advantage and to
00:23:50
have a moat around their business.
00:23:51
>> AI just decodes that and makes it usable
00:23:53
and now you can you can interact with
00:23:54
it. Can can I bring up one other
00:23:56
example? So, Dr. You mentioned
00:23:57
democratization. And you and I have had
00:23:59
a conversation about certain states are
00:24:01
actually trying to ban the use of AI to
00:24:04
be used in therapy. And I think the
00:24:07
point you made to me is you know what
00:24:08
there's a lot of places all over the
00:24:10
country like rural areas where there
00:24:12
aren't psychiatrists or there isn't
00:24:15
psychiatric care. So at least AI
00:24:18
provides a baseline level of service. It
00:24:21
version one may not have been perfect.
00:24:23
There may have been some hallucination
00:24:24
but it is getting better and better
00:24:25
every year. If you ban it, then a lot of
00:24:27
people are just going to have nothing,
00:24:29
right? I mean,
00:24:30
>> beautifully stated. Let's just go over
00:24:31
let's unwrap that a little bit, but I'd
00:24:32
be just at a high level say AI is coming
00:24:34
to a neighborhood near you. You're not
00:24:35
stopping it. Yeah.
00:24:36
>> So, it's going to be there and patients
00:24:37
are going to use it. And so, you have to
00:24:39
engage it running from it. You know, uh,
00:24:42
you know, we we we cannot stick our head
00:24:44
in the sand on this one. There's other
00:24:46
things you can sort of delay, but I I've
00:24:47
encouraged every governor go full boore
00:24:49
at this, but do it in the right way.
00:24:52
Allow professionals to function at the
00:24:54
height of their lensure. Why don't we
00:24:55
use pharmacists better? There's probably
00:24:57
70,000 pharmacists, right? And think
00:25:00
about this way. Almost all Americans,
00:25:02
95% live within five miles of a
00:25:04
pharmacy. There's they don't live near
00:25:06
five, you know, near a hospital usually.
00:25:08
So, we don't have access to care in many
00:25:10
ways. If we just took AI and allowed
00:25:12
pharmacists and doctors, GPS to function
00:25:14
at a higher level, it itself would be
00:25:16
worth the opportunity. So, I'm not even
00:25:18
saying advocate at all to a to a to an
00:25:20
AI agent that doesn't really understand
00:25:22
you. we can't control. Maybe, you know,
00:25:24
some other country gets involved in it.
00:25:26
At its very practical level, we do not
00:25:28
have enough practitioners. There just
00:25:30
aren't enough people to take care of
00:25:32
rural America. 60 million Americans
00:25:34
living in rural America don't have
00:25:35
access to mental health services. Our
00:25:37
vets commit suicide at a crazy high
00:25:39
rate, more than we lose in war because
00:25:41
they don't have access to mental health
00:25:43
services. Many of them do live in rural
00:25:44
America. And so, if we're going to fix
00:25:46
those kinds of problems, which are
00:25:47
timeconuming, you're not going to get
00:25:49
Park Avenue psychiatrists to go practice
00:25:51
medicine. $800 an hour
00:25:52
>> at $800 bucks an hour in the North Slope
00:25:54
of of Alaska in the winter. It's just
00:25:57
not going to happen. And so this $50
00:25:59
billion investment that we as a country
00:26:01
just made just just I the money was part
00:26:04
of the rural health the the working
00:26:06
families tax uh cut legislation uh that
00:26:09
the president pushed through and
00:26:10
Congress got behind. $50 billion the
00:26:12
largest investment ever made in rural
00:26:14
healthcare through our agency was given
00:26:16
up by the end of the calendar year. All
00:26:18
the governors have the money and we
00:26:19
charge them to make a difference in
00:26:21
their communities. You know, your
00:26:22
communities, they almost all came back
00:26:23
with some AI element. They all know to
00:26:26
really be able to get healthcare in
00:26:27
rural America, you've got to rightsize
00:26:28
the system. Right sizing the system
00:26:30
means, you know, you have hospitals
00:26:32
going to work out differently. Doctors
00:26:33
will work differently with each other.
00:26:34
But AI is the core element of so much
00:26:36
>> and these micro hospitals just like
00:26:38
people are putting ADU units in the back
00:26:40
of their homes to get an extra, you
00:26:41
know, apartment for grandma and grandpa
00:26:43
or as an Airbnb. My understanding is
00:26:46
there's a bunch of startups working on
00:26:48
the equivalent building a micro hospital
00:26:51
a room with the central services perhaps
00:26:53
a nurse practitioner uh who there's more
00:26:55
available and then you tele medicine in
00:26:58
just bringing the medicine to those
00:27:00
areas without having to build a giant
00:27:02
hospital is also a win yeah
00:27:03
>> the micro clinics I think a huge
00:27:05
opportunity to provide top tier care but
00:27:08
this goes beyond that we have AI
00:27:11
supported robots
00:27:13
>> that are going to be doing ultrasounds
00:27:14
in parts of Alabama where there are no
00:27:16
OBS, right?
00:27:17
>> We have drones delivering uh
00:27:19
prescription medications to the North
00:27:21
Slope of uh of Alaska, where there are
00:27:23
no roads, we have you have vending
00:27:25
machines that can dispense smart
00:27:27
dispensing of medications. By the way,
00:27:29
this is happening in other countries.
00:27:31
So, we want this to take place in
00:27:32
America. Why not take advantage of of an
00:27:35
opportunity through with a huge massive
00:27:37
inflow of money which the rural health
00:27:39
transformation fund does $50 billion to
00:27:42
start to do some innovative work in
00:27:43
rural parts of the country which are the
00:27:45
the foundational element of who we are
00:27:47
as a nation. Those values ripple up to
00:27:49
the rest of us. I also think that states
00:27:51
now are talking to each other
00:27:52
differently. Now now that you got money
00:27:54
that's out there that can be used to
00:27:56
change the world. They start talking
00:27:58
about AI and technology generally very
00:28:00
differently. Now, it's not a it's it's
00:28:02
it's not a sparse research. We live in a
00:28:04
world of abundance. And AI makes it that
00:28:05
much more abundant if we use it
00:28:07
correctly. And it's not going to happen
00:28:08
today, but we believe by the time the
00:28:10
administration has completed this work,
00:28:12
we will have dramatically changed the
00:28:14
face of how Americans work with
00:28:16
information in the health care system.
00:28:17
Some of it's just blocking and tackling,
00:28:19
as you said, make medical record
00:28:20
companies, not data block. Some of it's
00:28:22
forcing uh health information systems to
00:28:25
share data more comfortably and
00:28:26
elegantly at a at a fair price. And part
00:28:28
of it's us putting money into the
00:28:29
system. seeding it the right way. Um but
00:28:32
the most important thing is to make it
00:28:34
safe to go outside.
00:28:35
>> Yeah.
00:28:35
>> We want to make it comfortable to take
00:28:37
financial risk to invest in these areas.
00:28:39
That's why 600 companies have invested.
00:28:41
Every major AI company, every major
00:28:44
foundational technology company, but all
00:28:45
a bunch of these surgeons that I that I
00:28:47
promised, they're all rushing in.
00:28:48
>> The three places entrepreneurs have been
00:28:50
reticent to uh take on uh to build new
00:28:54
products and services. Education,
00:28:57
housing, healthcare. These also happen
00:28:59
to be the ones most regulated, most
00:29:01
controlled by the government. So to the
00:29:03
extent you can give them access and make
00:29:06
it go faster, it's going to work. The
00:29:08
only investments we've ever made in
00:29:10
those spaces are ones that go direct to
00:29:11
consumer because we know going through
00:29:13
the government, there's just not enough
00:29:14
runway for those companies to get to the
00:29:16
other side. Let me ask you about
00:29:18
>> We're open for business. And I got to
00:29:19
make this plug while I'm here. We want
00:29:21
to work with industry. We believe the
00:29:22
private sector will come up with better
00:29:24
ideas. Come work with us. And we're also
00:29:25
looking for people and we we had nine
00:29:28
engineers. Nine engineers when we came
00:29:29
in and all of CMS the our cobalt based
00:29:32
infrastructure built in the 70s where we
00:29:34
don't have engineers that
00:29:36
>> you're talking about in the department
00:29:37
you had nine engineers out of what's the
00:29:39
denominator of employees?
00:29:40
>> 6,500 employees and 40,000 contractors.
00:29:43
So there's you basically have an HR
00:29:45
person in government working with a
00:29:47
government government affairs person at
00:29:48
the company. There's no engineers there.
00:29:50
>> 16 basis points. David,
00:29:52
>> we took out we took $3 billion of cost
00:29:54
out there. There was a company that we
00:29:56
fired that had build us $200 million.
00:29:59
Not a single usable line of code. And
00:30:00
here's the good part. When we fired
00:30:02
them, you know what they said? Nothing.
00:30:04
>> Yeah, we knew it. We knew it.
00:30:05
>> Yeah, we were underperforming. No
00:30:07
accountability.
00:30:08
>> Underperforming.
00:30:08
>> God, we could go on about fraud for
00:30:10
forever. But I want to ask you about
00:30:12
this wonder drug. Four years ago, I was
00:30:13
listening to my friend uh Tim Ferris and
00:30:15
Kevin Rose who are biohackers and
00:30:18
they're always on the edge of this stuff
00:30:19
and he wanted to lose some visceral fat.
00:30:21
Kevin was in great shape and he heard
00:30:23
about this diabetes drug OMIC and that
00:30:26
he was going to give it a shot. He
00:30:28
dialed the pen all the way up, puked,
00:30:30
dialed it back down, lost his visceral
00:30:32
fat. I heard that I was like 40. I was
00:30:34
213 pounds at the time. Went to my
00:30:36
doctor. He said, "I have no idea what
00:30:38
you're talking about. You're not
00:30:39
diabetic, but you are fat." And I think
00:30:41
he said, "You're a fat bastard." I think
00:30:43
I said that. And I had just gained like
00:30:44
two or three pounds a year for 20 years.
00:30:47
And I used to be a marathon runner. I
00:30:48
used to be 165, 170 lbs. So now 172
00:30:52
gazelle right now by the way.
00:30:54
>> Well I add a little muscle too. Thank
00:30:55
you Dr. O. You look great too. Um but
00:30:57
this is a miracle drug. This in my mind
00:31:01
we now have theoretically tens of
00:31:04
millions of Americans have experienced
00:31:05
it. It's going to be in pill format. The
00:31:08
the four uh horsemen of the apocalypse,
00:31:11
heart disease,
00:31:12
>> kidney failure, liver disease, dementia.
00:31:14
>> Dementia. These are all four of four are
00:31:18
impacted by obesity. and these GOP ones
00:31:21
seem to be impacting them. I was like,
00:31:23
you know what? If Trump just President
00:31:26
Trump just gave a national anybody can
00:31:29
get this drug if they want it, I think
00:31:30
he'd win the election. He won anyway.
00:31:32
Um, what do you think about a mandate to
00:31:35
make it available to make the fat drug
00:31:37
available for all Americans? Would that
00:31:39
be
00:31:40
>> So, I'm glad you came to work today. So,
00:31:42
uh, about two months ago in the Oval
00:31:44
Office, the president basically did
00:31:45
that. He said that we're going to take
00:31:47
the prices of these drugs, which are now
00:31:49
prohibitively high for many Americans,
00:31:51
$1,200 cash pay. It's
00:31:53
>> crazy.
00:31:54
>> It's going to be a starting price of
00:31:55
around $200.
00:31:57
>> Easy.
00:31:58
>> And u with the pills, it's $150 and the
00:32:00
pills will come out. Uh the first FDA
00:32:02
approved pills will start this month. Um
00:32:04
and so we believe at that price
00:32:07
day
00:32:08
>> because think carefully. That's right.
00:32:09
It's a basically you get coffee a day.
00:32:11
At that price, we will within two years
00:32:14
return money to the American taxpayer.
00:32:16
It's going to save us so much money from
00:32:18
reducing hypertension, diabetes, and the
00:32:20
downstream illnesses, the four horsemen
00:32:22
of the apocalypse that you mentioned
00:32:23
that we will save money that we spend
00:32:26
over half the money we I believe within
00:32:29
health care on these chronic illnesses
00:32:31
driven by obesity. And so either
00:32:34
directly or indirectly because you hurt
00:32:36
your knees because you're overweight or
00:32:37
you get autoimmune problems or even
00:32:38
cancer is linked to obesity because you
00:32:40
have a metabolically active state. All
00:32:42
of these are going to drop
00:32:43
precipitously. We have pretty good data
00:32:44
on this from an internal modeling. So we
00:32:46
agreed to those prices with the two
00:32:48
major companies Novo Nordisk and Eli
00:32:50
Liy. We will launch next week. I don't
00:32:52
know when this podcast airs but launch
00:32:54
next week Trump RX with those products
00:32:57
so you can cash pay at a price that is
00:32:59
completely affordable. And here's the
00:33:00
good news. Every Medicare patient gets
00:33:03
it for $50 co-pay. Every Medicaid
00:33:05
patient gets it for nothing.
00:33:07
>> Amazing.
00:33:07
>> So the people who need it the most, the
00:33:09
folks that are most vulnerable, this is
00:33:10
what it when people say the president
00:33:12
doesn't want to protect Medicaid, he
00:33:13
doesn't love and cherish Medicare. It
00:33:15
drives me bonkers because he's doing
00:33:17
more for underserved Americans than any
00:33:19
other president ever has. Giving
00:33:21
Americans where the obesity epidemic
00:33:23
lives, underserved Americans, you
00:33:25
vulnerable Americans who are on Medicaid
00:33:27
access to these drugs for no out-of-
00:33:29
pocket costs. truly democratizes the
00:33:32
weight loss issues because right now
00:33:33
what's the number one zip code for
00:33:34
weight loss drugs. Number one zip code
00:33:37
upper east side of Manhattan.
00:33:38
>> I was about to say it's got to be
00:33:39
Manhattan or LA.
00:33:40
>> LA is number two.
00:33:41
>> Okay.
00:33:41
>> Right.
00:33:42
>> Cuz people can afford it or
00:33:43
>> because they're vain.
00:33:44
>> They're vain. They want to lose two
00:33:45
pounds for their daughter's wedding and
00:33:47
they can afford it. $1,200 a rounding
00:33:49
area. Yeah. Right. But $1,200 for
00:33:51
someone that's not making money. You're
00:33:53
not you're just not going to take the
00:33:54
drug and they're the ones that die
00:33:56
early. The life expectancy in rural
00:33:58
America, I'll go back to them in
00:34:00
vulnerable populations 9 years shorter
00:34:02
than yours in the same country.
00:34:04
>> It's something that came out of left
00:34:06
field. What does that tell us about
00:34:08
what's going to happen in medicine going
00:34:10
forward? Because GLPS,
00:34:12
how long of a journey has that been and
00:34:14
then getting to market and then you know
00:34:17
this off label use starting with people
00:34:20
with diabetes. What is that? What is
00:34:22
that? How does that inform you of how we
00:34:25
can make even more impact in the future?
00:34:26
How do we make another GLP like
00:34:29
discovery and implement it the way
00:34:31
President Trump has?
00:34:32
>> Well, this, you know, the drug actually
00:34:33
came, it's a poisonous uh chemical, a
00:34:36
venom actually, that was uh deciphered
00:34:39
and found to have an impact on some of
00:34:41
these core cells in the in the the
00:34:44
appetite system of the body, which is so
00:34:46
fundamental to who we are that it's very
00:34:48
hard to hack the appetite. But GLP-1s
00:34:50
are just the tip of the iceberg. There
00:34:52
are more and more sophisticated ways for
00:34:54
us to be able to address not just
00:34:55
appetite but addiction, addictive
00:34:57
behavior drops at GLP-1s. So the newer
00:35:00
drugs are going to be even more
00:35:02
effective at that.
00:35:02
>> Red True Tide is the one you
00:35:04
>> for example, Red Tide. But the other
00:35:06
thing I would say is the form factor
00:35:07
matters in sending someone an injection
00:35:10
that's that goes bad in the warm weather
00:35:12
that a lot of wastage and you don't know
00:35:14
the exact dose. the pills make it like
00:35:16
most other drugs and now the drug the
00:35:18
price point is much lower as well. So
00:35:20
it's easier for us to deliver that at
00:35:22
scale to the American people. So it does
00:35:25
leapfrog us beyond today's problems and
00:35:27
this is a big theme of our
00:35:28
administration. Don't bother fixing
00:35:30
today's broken pipes if the world you're
00:35:32
building doesn't have pipes
00:35:33
>> and that's what we're doing with drugs
00:35:34
like semagutide and interzepide which is
00:35:37
the the lily product. We're also getting
00:35:39
these companies to unshore their
00:35:40
production facility hire American
00:35:42
workers stay innovative. This is why
00:35:44
again the president doesn't want us
00:35:45
hurting innovation. With the same day we
00:35:47
did the first most favored nation drug
00:35:49
um event, we had an executive order on
00:35:52
childhood cancer. 20 beautiful children,
00:35:55
smiley bright eyes, all of whom all of
00:35:57
whom should have been ghosts. They
00:35:59
survived because technologies were
00:36:01
afforded to them. Don't exist in other
00:36:02
parts of the world to keep them alive.
00:36:04
That's our goal. But I need to I'd be
00:36:06
poorly served. I hear the bell tolling
00:36:08
if I didn't get into the other
00:36:09
>> for whom we don't know. We probably
00:36:11
asked for the belt holes for sure for
00:36:13
you, Jac. But
00:36:14
>> I think that's all I think that's
00:36:16
totally for the pharma companies who
00:36:18
don't bend the knee.
00:36:19
>> No, actually, but the the the the issue
00:36:22
right now that is consuming us is the
00:36:24
fraud, the waste and abuse. And
00:36:26
>> what have you found, Dr. Oz? Tell us
00:36:28
what is the most concerning to you?
00:36:30
>> Well, let me as a preamble w without a
00:36:33
better visibility into where the money
00:36:36
is spent, which we need technology to be
00:36:37
able to do
00:36:38
>> or audits. Well, audits are interesting.
00:36:41
You can audit the spreadsheet. You can't
00:36:43
tell if the input to the spreadsheet was
00:36:45
legitimate unless you actually go and do
00:36:47
site visits, and states don't want to do
00:36:49
that. So, let me just give it
00:36:50
>> Are they blocking it these states?
00:36:52
>> Of course. First of all, let me just
00:36:54
I'll tell you that's a good question.
00:36:56
Why would you let fraud happen? It is by
00:36:58
federal law, by federal law mandated
00:37:01
that if you give a patient a welfare
00:37:03
program, SNAP, uh, Medicaid, you must
00:37:06
also give them the ability to sign up to
00:37:08
vote. So you're basically recruiting
00:37:11
voters at the same time you're giving
00:37:13
them free government services which then
00:37:15
you might actually end up recruiting a
00:37:17
different kind of voter like you don't
00:37:19
have a law that if you go to an NRA
00:37:20
convention uh right for for you know gun
00:37:23
advocates that you sign up voters right
00:37:25
you can go to that event not get signed
00:37:27
up to vote obviously they would be
00:37:28
probably skewing to the right so there
00:37:30
is an issue there we also have an active
00:37:32
role of unions especially in California
00:37:35
where we have a a major problem because
00:37:37
the unions have seemed This is all what
00:37:39
I'm hearing from talking to people on
00:37:41
the ground seem to have gotten involved
00:37:43
in, for example, signing up home health
00:37:45
care workers and and personal care
00:37:46
services. There are more Americans, I
00:37:49
believe, providing some of these
00:37:50
homebased services that maybe might
00:37:52
exist in retail in America. We've
00:37:54
shifted the entire employment economy
00:37:57
towards some of these services. And
00:37:58
here's the risk. If you really want to
00:38:00
understand why we have fraud in America,
00:38:02
when I give you things that your family
00:38:05
used to give you, we are going to have
00:38:07
fraud. So, your family used to drive you
00:38:09
to the doctor's office. Your family
00:38:10
would take you home after you got home
00:38:12
back from the hospital to make sure you
00:38:13
got well nourished and taken care of.
00:38:15
Your family would carry the groceries up
00:38:16
the stairs. Your family would negotiate
00:38:18
your contract with the landlord. Guess
00:38:20
what? Healthy human services does all
00:38:21
that for you now. All you got to do is
00:38:23
ask. And in some states, it's so easy to
00:38:25
do that you end up with significant
00:38:27
fraud. We
00:38:28
>> So, they have intercepted the
00:38:30
transaction. Therefore, that's where
00:38:33
grift can occur and fraud.
00:38:34
>> Well, the government's paying for it,
00:38:35
>> right? So when the consumer is paying
00:38:36
for it out of their own pocket, they
00:38:38
have their own incentive to get value
00:38:40
for the transaction.
00:38:42
>> But when the government's paying for it,
00:38:43
who really has the incentive to make
00:38:45
sure that value has been provided in
00:38:47
exchange for that money? Yeah. And this
00:38:48
is what happened in Minnesota where you
00:38:49
had a subculture. It was prim, you know,
00:38:52
just the mathematically most of the
00:38:54
indictments with are with Somalians. So
00:38:56
the Somalian community realized, hey, my
00:38:58
goodness, no one's watching.
00:38:59
>> Now there's an adage, you know, that
00:39:00
only the morons get caught in healthcare
00:39:02
fraud because it's so easy to do. And if
00:39:05
if you get you steal $5 million uh in
00:39:07
medic in Medicare Medicaid, you go to
00:39:09
jail for 18 months. I mean, for many
00:39:11
people, that's a pretty good deal.
00:39:13
>> Yeah.
00:39:13
>> You, you know, sit in the pen for 18
00:39:14
months. But unfortunately, I'll just
00:39:16
give you a lay of the land. There are
00:39:18
twice as many durable medical equipment
00:39:20
providers. They sell wheelchairs and
00:39:22
knee braces. Twi there's actually 20
00:39:25
times more in South Florida than
00:39:27
McDonald's. I mean, how many do you
00:39:29
need? Turns out they're all Cuban pretty
00:39:31
much. They all seem to fly back to Cuba
00:39:33
and escape, you know, law enforcement.
00:39:35
They They build millions of dollars.
00:39:36
They get away with it. There
00:39:38
>> what's the solution? There's got to be
00:39:39
really practical, easy solution.
00:39:41
>> There are, but and I'm going to share
00:39:42
that, but let me just give you two
00:39:43
others because you would remember these.
00:39:44
We have seven times more hospice in
00:39:46
California. Hospice is for people at the
00:39:48
end of their life. Seven times more
00:39:49
hospice than was there five, six, seven
00:39:51
years ago. Seven times more. We don't
00:39:53
have that many people dying in
00:39:54
California. And more importantly, the
00:39:56
survival rates on hospice, again,
00:39:58
designed for cancer patients dying
00:40:00
within six months. The survival rate for
00:40:02
most of these hospice centers is 100%.
00:40:04
>> Wait a second.
00:40:05
>> They shouldn't have gone to hospice.
00:40:07
>> Exactly.
00:40:08
>> Is the government paying for it?
00:40:09
>> Yes. Completely paying for it. But no
00:40:11
one's dying because you're not supposed
00:40:12
to.
00:40:12
>> When did the government start paying for
00:40:13
that?
00:40:14
>> Oh, 40 years ago. Okay. It was designed.
00:40:16
>> And then what happened in the last seven
00:40:18
or 10 that the fraud just went foreign
00:40:21
governments got involved in LA? The
00:40:23
hospice is driven by the Russian
00:40:24
Armenian gangs. They're foreign
00:40:26
nationals. They fly back to Russia. We
00:40:28
had a big $15 billion bust on these guys
00:40:30
earlier in the year. Again, they all
00:40:31
escape. The other thing is no one's
00:40:33
watching because there's a opportunity
00:40:36
if you get into these businesses to make
00:40:37
a lot of money and it becomes I'll give
00:40:39
you I'll just tell you a true story
00:40:40
about uh a whistleblower. Again, I I
00:40:43
can't prove this, but it's what he said.
00:40:45
He said that he uh he was building a
00:40:47
beautiful mansion. He owns all these
00:40:48
hospices. He's a doctor, but he's a
00:40:50
fraudster. Uh and so he built this puer
00:40:52
house. They the plumber comes in and
00:40:54
says, "Hey, you know, I hear you in the
00:40:55
hospice space." The guy says, "Yeah, I
00:40:56
made my money in hospice." that the
00:40:58
plumber says, "You know, I've got a side
00:40:59
hustle. I own a hospice, too."
00:41:02
>> Right? Then the carpenter hears him and
00:41:04
he says, "Me, too. I'm in the hospice
00:41:06
business. We're all in the hospice
00:41:07
business." Absolutely.
00:41:08
>> So then the guy says, "Okay, well, he
00:41:10
realized he's got to get ahead of these
00:41:11
guys." So he goes to a a major hospital
00:41:13
in LA and a doctor at the hospital, very
00:41:16
prominent hospital that everyone's heard
00:41:17
of, says, "Hey, listen. You, if you give
00:41:19
me $1,000 a month, I'll send hospice
00:41:21
patients to you." Which is how it's done
00:41:22
in LA, by the way. You get paid, this
00:41:24
you send patients over. So the guy says,
00:41:26
"Okay, but what about the actual
00:41:27
inpatients like the people hospitalized?
00:41:28
Can I get them?" They got and the doctor
00:41:30
says, "I can't do that because it turns
00:41:33
out the members some there are some
00:41:34
members of the board that own hospice
00:41:36
and they like the patients to go to
00:41:37
their centers."
00:41:38
>> You see that the corruption starts in in
00:41:40
organized crime, but if you tolerate it,
00:41:43
it poisons the whole system.
00:41:45
>> And that's the bigger reason we've got a
00:41:47
problem. So what are we doing? We have a
00:41:49
fraud uh war room. Uh I'm going to put a
00:41:52
moratorum on some of these services.
00:41:54
We're not going to let new people sign
00:41:55
up. Uh we're going to actively and
00:41:57
aggressively stop paying Medicaid uh if
00:42:00
we can prove that states are not
00:42:02
obliging their fiduciary responsibility
00:42:04
to the American people because states
00:42:06
administer Medicaid. I pay the bills at
00:42:08
CMS. So, we're going to stop paying on
00:42:11
behalf of the taxpayer if we don't think
00:42:12
you're taking care of the money.
00:42:13
>> And people should know there are
00:42:14
whistleblower laws where you get a
00:42:16
percentage of whatever is reported and
00:42:19
they should look into that. And the fact
00:42:21
that we have so many people in the
00:42:24
administration now communicating that,
00:42:26
hey, we want to have you report fraud to
00:42:30
us has changed everything. The number of
00:42:32
people reporting fraud must have gone up
00:42:34
since
00:42:35
>> dramatically. People in the government,
00:42:37
this is probably, you know, the part
00:42:38
that's most rewarding to me. Many
00:42:40
government workers are Democrats.
00:42:43
Probably most
00:42:44
>> what they tell me again and again is
00:42:45
they just came to government to do their
00:42:47
job. They wanted to do the right thing
00:42:48
>> and and they were told not to do their
00:42:50
job. They were told not to focus on the
00:42:52
fraud, to focus on getting more people
00:42:54
signed up. But if you don't take care of
00:42:56
the fraud, this is an important message.
00:42:58
You will kill the system. Eventually,
00:43:00
you will destroy Medicaid. And I'm not
00:43:02
going to let that happen on our watch.
00:43:04
Medicaid, as Hubert Humphrey said, is
00:43:06
there to protect those at the dawn of
00:43:07
life, which are our children. 53% of
00:43:09
kids are born into poverty. We take care
00:43:11
of them. Those at the twilight of life,
00:43:13
those are the seniors, right? We owe it
00:43:15
to them. Every great society takes care
00:43:16
of the most vulnerable. We're great
00:43:17
people will do that. And he Hubert
00:43:19
Humphrey said you got to take care of
00:43:21
those living in the shadows. We are not
00:43:23
going to let them get hurt. When you let
00:43:25
organized criminal elements steal at
00:43:27
scale from the federal government, you
00:43:29
are killing those programs. We now have
00:43:31
so many kids signed up falsely for
00:43:32
autism that the kids with autism aren't
00:43:35
getting access to care.
00:43:36
>> Yeah. This is the incredibly frustrating
00:43:37
thing. Having talked to some young
00:43:40
parents who are millennials, Gen Z,
00:43:44
they're going to work. They got two
00:43:45
jobs. They would love to have child
00:43:47
care, but the child care dollars are
00:43:50
being stolen. Therefore, they can't
00:43:52
access them. And the same thing's
00:43:54
happening across the system. I think
00:43:56
this could be just such a defining
00:43:58
moment for America because on the other
00:44:00
side, we have socialists, lunatic
00:44:02
communists running some of these cities
00:44:05
who want to seize people's assets, want
00:44:08
to raise taxes before fixing fraud. This
00:44:10
is like pouring water into a a leaky
00:44:12
bucket. Well, you're talking about
00:44:14
California
00:44:14
>> and New York.
00:44:15
>> Yeah. And I couldn't help but notice
00:44:17
that Gavin Newsome arrived here at Davos
00:44:19
yesterday.
00:44:19
>> He's here.
00:44:20
>> Yeah. He was encouraging European
00:44:22
leaders to defy President Trump, which
00:44:24
is a weird thing for a governor to come
00:44:26
here to
00:44:27
>> to basically uh advocate for foreign
00:44:30
leaders to defy the American.
00:44:33
>> What next? like partner with communist
00:44:35
countries for your f I mean
00:44:36
>> but I think honestly it's all a
00:44:38
distraction because the the real thing
00:44:41
happening in California right now is
00:44:42
everybody knows there's massive fraud
00:44:44
there you see that image on the internet
00:44:46
where it's an iceberg and
00:44:48
>> the tip is Minnesota but California is
00:44:50
the fourth largest economy in the world
00:44:52
so we know there's massive fraud I think
00:44:54
Newsome knows there's massive fraud too
00:44:55
that's that's why he's vetoed
00:44:57
>> audits
00:44:58
>> I mean can we just pause for a second
00:45:00
audit
00:45:01
>> veto audits Right.
00:45:03
>> Who would veto an audit?
00:45:05
>> Someone doesn't want to get caught.
00:45:06
>> A criminal. A criminal would veto it.
00:45:08
I'm not saying he's a criminal, but
00:45:10
>> No, this is to government spending what
00:45:12
the ban on voter ID is to elections.
00:45:15
>> Why wouldn't
00:45:16
>> you only do that? You you you're banning
00:45:19
the thing that helps you catch the
00:45:20
fraud.
00:45:21
>> Yeah.
00:45:21
>> So why would you ever do that unless you
00:45:23
want the fraud to happen?
00:45:24
>> Exactly. It's it's Yeah. It's still
00:45:28
>> now and now even
00:45:29
>> distraati as we say here. But California
00:45:32
the budget's $350 billion by far the
00:45:34
biggest.
00:45:35
>> It has doubled in the last decade
00:45:38
>> and it's like three times per capita
00:45:40
>> two and a half times the inflation rate.
00:45:41
Okay. And they're still running a huge
00:45:44
deficit. And that's why they're now
00:45:46
driving all the job creators out of the
00:45:48
state with this proposed asset seizure.
00:45:50
Wild.
00:45:50
>> If they just clamp down on the fraud,
00:45:52
they wouldn't have this hole in their
00:45:54
budget. Just LA County alone, just in
00:45:56
hospice and home health care, we believe
00:45:58
it's about three and a half billion
00:46:00
dollars. Just in those two programs in
00:46:01
one city, there's probably 10% of all
00:46:04
home healthcare expense in America is in
00:46:06
LA. So there's so much to do to improve
00:46:09
the system that would restore
00:46:10
confidence. And when you have governors
00:46:13
who are unwilling to do their job, and
00:46:15
it does make people think that listen,
00:46:17
when smart people don't do things, it's
00:46:19
not an accident. right?
00:46:20
>> They're not doing these things because
00:46:22
they have ulterior motives that either
00:46:23
aren't transparent to you or they think
00:46:26
you're not smart enough to figure out.
00:46:27
We had to ask those questions. This
00:46:29
president is not going to tolerated, but
00:46:31
the American people shouldn't either.
00:46:32
>> We had an interesting moment. Uh our
00:46:34
friend Elon Musk had asked us after he
00:46:36
purchased Twitter now X to come in and
00:46:39
we were looking at the bills trying to
00:46:41
figure out how this company was
00:46:43
hemorrhaging cash at a level that just
00:46:45
didn't even seem possible. And one of
00:46:47
the things was they had just signed up
00:46:49
for tons of software and you know
00:46:51
basically subscriptions and uh CFO comes
00:46:54
in, auditor comes in, we're all trying
00:46:55
to figure it out and Elon said that
00:46:57
Twitter and Elon says um
00:46:59
>> how are they paying all these? They're
00:47:00
like oh yeah they're on credit cards. He
00:47:02
said okay um cancel all the cards.
00:47:04
>> Yeah.
00:47:05
>> And so we said they're like yeah cancel
00:47:07
the cards.
00:47:09
Immediately I get three back channels
00:47:11
from software companies who are like hey
00:47:14
um I know you're helping Elon. I saw a
00:47:15
story in the New York Times. Um, our
00:47:17
bill stopped getting paid. Can we come
00:47:18
in? And I'm like, yeah, we're not using
00:47:20
your software anymore. Nobody's ever
00:47:22
used it's never been installed. The
00:47:24
software had been You want to talk about
00:47:26
fraud at a scale that was deranged?
00:47:29
>> This is a private company, not a private
00:47:31
company.
00:47:31
>> Yeah.
00:47:32
>> But your point is, look, when when no
00:47:35
one is minding the store, bad things are
00:47:37
going to happen. And when no one has
00:47:38
minded the store for decades and the
00:47:40
government's paying for it, you don't
00:47:42
even have that private sector profit
00:47:44
motive to basically be efficient. Then
00:47:47
think about how the fraud just
00:47:49
metastasizes. It's got to be
00:47:52
>> 20 30%
00:47:53
>> hundreds of billions.
00:47:54
>> It's got to be a double digit. I'm going
00:47:57
to guess 20 30% of all these fraud.
00:48:00
>> All it took was a YouTuber with a video
00:48:02
camera to actually show up. Yeah.
00:48:04
>> At the Minnesota daycare centers that
00:48:06
were receiving millions of Learing
00:48:07
center. Yeah, the the Learing Center.
00:48:09
They're all empty. Yeah.
00:48:11
>> Dozens of them. Each one's receiving
00:48:12
millions of dollars.
00:48:13
>> And that's one program in one state. And
00:48:15
these aren't low lives doing this. The
00:48:17
lives are involved obviously, but these
00:48:19
are politically connected groups.
00:48:21
>> Sophisticated.
00:48:22
>> Yeah. And that's why I'm emphasizing
00:48:23
these are government, foreign
00:48:25
governmentbacked efforts at times, but
00:48:27
certainly the people doing them are
00:48:28
often foreign nationals. And we are
00:48:30
being taken advantage of because we're
00:48:31
like a big hippopotamus. You know, all
00:48:33
you need to penetrate Medicare and
00:48:34
Medicaid is a beneficiary number. they
00:48:37
can buy those and you're off to the
00:48:38
races. So, the solutions are I'm not
00:48:41
claiming they're simple, but they're
00:48:42
eminently doable, but you have to expect
00:48:45
it of your leaders.
00:48:45
>> There's going to be some low hanging
00:48:46
fruit here. I can tell you you cutting
00:48:49
off payments and saying very simply,
00:48:51
hey, we've cut off payments. All you
00:48:53
have to do is sign this attestation that
00:48:56
you delivered the service and I would
00:48:58
like you to attach your driver's license
00:48:59
and passport to it and um by the way,
00:49:01
you've been randomly selected to come
00:49:04
into the office. We want to hear all
00:49:05
about what you're doing and jump on a
00:49:06
Zoom call.
00:49:07
>> Right. So, you're saying cancel the
00:49:08
credit cards.
00:49:09
>> Yeah.
00:49:09
>> And then
00:49:10
>> and just let them then reopen the
00:49:12
account or tell you.
00:49:13
>> Yeah. Come in. Yeah. We just want to
00:49:15
reverify what's going on. Literally
00:49:17
>> zero baseline budgeting. Not saying the
00:49:19
program is over. And that's the thing
00:49:20
that that I think Elon found when he was
00:49:22
doing Doge is these payments were just
00:49:24
on recurring autopay every year.
00:49:27
>> Autopay equals
00:49:28
>> with no with no code explaining what the
00:49:30
money was going to.
00:49:31
>> Autopay equals from that. That's all you
00:49:34
have to know. And if you look at like
00:49:36
some of the great I mean if you want to
00:49:38
talk about like some of the good stuff
00:49:39
Lena Khan did and I was opposed to about
00:49:41
80% of it. One of the things she did
00:49:43
that was really well was she said if you
00:49:44
sign up for a service you have to be
00:49:46
able to cancel it the same way you
00:49:47
signed up. So newspapers
00:49:50
these bastions of virtue you'd sign up
00:49:54
for Wall Street Journal. You probably
00:49:54
have had this experience. You try to
00:49:56
cancel it. They're like give us a call
00:49:57
and then they you're on the phone for an
00:49:58
hour just want to cancel it. And I asked
00:50:01
the woman, I said, "Uh, hey, can I ask
00:50:02
you just a simple question, um, why
00:50:05
can't I just cancel online?" They're
00:50:06
like, "Oh, well, because of fraud." I'm
00:50:08
like, "But you took my money through the
00:50:11
website, so that's where the fraud would
00:50:12
actually occur." She's like, "Yeah, that
00:50:14
kind of makes sense, but I'm just an
00:50:16
operator, Mr. Calican." They said,
00:50:17
"Okay, fine." But that this is the same
00:50:19
concept, which is if you want the money,
00:50:21
hey, why don't you come into the office
00:50:23
and we'd love to hear how the program's
00:50:25
going. We got your check right here.
00:50:26
Come pick it up in person. Want to hear
00:50:28
about it. And uh can you just take a
00:50:30
picture of the service you provided?
00:50:31
Just taking a picture of the service you
00:50:33
provided and then send it in.
00:50:35
>> Yeah.
00:50:35
>> How is this hard?
00:50:36
>> And like you said, how do you argue for
00:50:38
you? California already has some of the
00:50:40
highest tax rates in the nation. And now
00:50:42
you're arguing for more taxes, novel
00:50:44
taxes, taxes that no one's ever seen.
00:50:46
>> Unconstitutional.
00:50:47
>> Unconstitutional probably. And will
00:50:49
require a massive new enforcement
00:50:51
mechanism. Before you do that, you
00:50:53
haven't even rung the obvious fraud out
00:50:55
of the system.
00:50:56
>> Yeah. Listen, our biggest allies, our
00:50:58
state auditors. I met with the state
00:51:00
auditor in Minnesota. Uh confided that,
00:51:03
you know, she's been trying to get this
00:51:04
on the radar. Uh just people didn't want
00:51:06
to listen. And I talked to folks within
00:51:08
the agency, Healthy Human Services. U
00:51:11
you were shuttled around. Uh one woman
00:51:13
was actually escorted out of the
00:51:14
building for raising the reality that
00:51:16
there was fraud. And this happened over
00:51:18
several years. And eventually either you
00:51:20
leave if you're ethical or you be you're
00:51:23
quiet because you don't want to get
00:51:24
fired. And you make it such a a harsh
00:51:27
environment for anybody to just tell the
00:51:29
truth. This reminds me of a friend of
00:51:30
mine who was uh he's a billionaire now.
00:51:32
Tomas Pedy, you probably know him,
00:51:34
Interactive Brokers. Uh really really
00:51:36
great guy. And he said he was growing
00:51:37
growing up in Hungary and he said when
00:51:39
he was young he knew that everyone was
00:51:41
lying to him.
00:51:42
>> But that wasn't the big problem. The big
00:51:44
problem is he knew that they knew that
00:51:46
he knew that they were lying to him,
00:51:47
>> right?
00:51:47
>> So pretty soon we are all in on the fact
00:51:49
that there's a big lie.
00:51:50
>> The whole thing is corrupt. And so
00:51:52
working in these agencies, the good
00:51:54
people are weeded out. The people who
00:51:55
are left either don't care, aren't good
00:51:57
people,
00:51:57
>> or complicit.
00:51:58
>> And some of them are complicit. But I
00:52:00
think fundamentally there was a
00:52:02
misalignment of values. And this
00:52:04
actually was probably the most important
00:52:05
thing we had to do in that legislation
00:52:07
last year, the working families tax cut
00:52:08
legislation. We had to align the
00:52:10
president with the governors. There were
00:52:12
so many ways of getting this the federal
00:52:15
government to give you money that wasn't
00:52:16
really yours. legalized moneyaundering
00:52:19
schemes, all kinds of things that clever
00:52:20
consultants had figured out over the
00:52:22
years that we estimated we would have
00:52:24
lost 5.4 trillion dollars just for
00:52:26
Medicaid, which is again why I often
00:52:28
joke we were becoming one massive health
00:52:30
care system with a small country
00:52:31
attached.
00:52:31
>> Well, and if it doesn't work long term,
00:52:33
if we don't take bold action, which
00:52:36
again a major message on a lot of things
00:52:37
the president is doing, if you don't
00:52:38
take bold action on some of these
00:52:40
issues, you're leaving our the next
00:52:43
generation with a train wreck. They
00:52:44
can't fix it anymore because the train's
00:52:46
gone way off the rails. Yeah. And just
00:52:47
think of the absolute hypocrisy. You
00:52:49
have someone like Mandami who says he
00:52:51
wants to increase services, provide more
00:52:53
for the citizens and they're not doing
00:52:56
the audits. They're not fighting fraud.
00:52:58
Gavin Newsome is talking about wanting
00:52:59
to provide more for the bottom half of
00:53:01
society, but not doing the audits.
00:53:03
>> And frankly, this whole budget hole that
00:53:05
is causing this now acid seizure tax, it
00:53:08
all started in 2022
00:53:10
>> when Newsome promised medical for all
00:53:12
including illegal aliens. And so what
00:53:14
happened is in big beautiful bill
00:53:17
president said listen we're not going to
00:53:18
reimburse for illegal aliens like
00:53:21
>> think about incentives there
00:53:22
>> right so then the SEIU uh the health
00:53:27
worker union
00:53:29
>> they're upset because they don't want
00:53:30
that funding cut because it indirectly
00:53:32
impacts them. So that's how this whole
00:53:34
thing happened. Think about the layers
00:53:35
of fraud there that you've got you know
00:53:37
the the government the government of
00:53:39
California is paying for illegal aliens
00:53:41
probably shouldn't be doing that. I
00:53:42
mean, if you ask the American people,
00:53:44
which is who you both work for, how many
00:53:47
Americans believe that illegal aliens
00:53:49
should get universal healthcare, I think
00:53:51
you're going to get like 98%
00:53:53
are going to say absolutely not. And the
00:53:55
2% with purple hair in Berkeley who want
00:53:57
it. I
00:53:58
>> I don't know what what their motivation
00:54:00
is.
00:54:00
>> Support them. Just to finish the point,
00:54:02
if you are going to have the politics of
00:54:05
a Gavin Newsome and you're going to tell
00:54:06
Benal for all in the state, even illegal
00:54:10
aliens, doesn't that create a
00:54:12
responsibility on you to audit the
00:54:14
system and make sure it's not being
00:54:15
abused? When you then turn a blind eye
00:54:18
Yeah.
00:54:18
>> to the fraud and you refuse to even
00:54:20
acknowledge it, you just pretend like it
00:54:21
doesn't exist and you veto the audits.
00:54:24
That's doubly wrong.
00:54:25
>> But but it doesn't hurt California. This
00:54:27
is the the part of the story that's so
00:54:28
infuriating. You don't audit the books
00:54:30
in California because the federal
00:54:32
government's paying anyway. So why would
00:54:34
I audit the books to find out that my
00:54:35
people aren't getting free money from
00:54:37
the federal government? Let's talk about
00:54:38
illegal immigrants. So Gavin Newsome was
00:54:41
given us a hard time for threatening the
00:54:43
health insurance of illegal immigrants.
00:54:44
Just to be very transparent, if you're
00:54:46
on Medicare, you don't get free dental.
00:54:47
You don't get free vision. You do if
00:54:49
you're an illegal immigrant in
00:54:50
California.
00:54:51
>> This is the inferior. So anyway, so
00:54:52
you've got taxpayers in New Mexico,
00:54:55
right, which is a blue state but a poor
00:54:57
state, paying extra tax dollars to the
00:54:59
federal government that are recycled
00:55:00
back into LA to deal with the fraud that
00:55:02
I'm talking about. So illegal
00:55:03
immigrants, he's mad. He's mad. He's
00:55:04
mad. He's mad. We're horrible people.
00:55:06
We're Republicans. You have no
00:55:07
conscience. You have no heart. As soon
00:55:09
as we made it clear we were no longer
00:55:12
going to pay for illegal immigrants in
00:55:13
California, what did he do? He took them
00:55:15
off Medcal. Now, he didn't take them
00:55:17
off. He took them up on the federal
00:55:18
side. In theory, only emergency services
00:55:21
are going to get paid for for illegal
00:55:23
immigrants in California, which is a
00:55:24
national law
00:55:25
>> and is and is reasonable.
00:55:26
>> Reasonable. Now, I'm I'm all we want
00:55:28
babies delivered, car accident victims
00:55:29
hurt, get of course get healthcare, but
00:55:31
not elective hernia surgery, cataracts,
00:55:33
you know, you have to be an American
00:55:35
citizen who paid into the system to get
00:55:36
these. So, anyway, so we we deal with
00:55:38
this. Gavin says, "We're only going to
00:55:40
pay for illegal immigrants through our
00:55:41
own state-based system." We've audited
00:55:44
him. Now, this data is coming out this
00:55:46
week. We have now found over $1.5
00:55:48
billion dollar of money spent wrongly.
00:55:52
We've audited it. They're not even
00:55:53
arguing. $1.5 billion dollars from uh
00:55:56
that California charged the federal
00:55:58
government for illegal immigrants that
00:56:00
they're not allowed to pay charge us
00:56:01
for. They have to pay for it themselves.
00:56:03
He's not happy. But they're paying us
00:56:05
because they know we're right. So,
00:56:06
you're going to see something happen
00:56:08
very interesting in California. As soon
00:56:10
as the money is being paid by California
00:56:12
government officials, they're going to
00:56:14
start getting more serious about this.
00:56:16
And that's why it's so important for us
00:56:17
to say, "We're not into this anymore.
00:56:19
I'm not going to let taxpayers in
00:56:21
Alabama and Mississippi, New Mexico, you
00:56:24
know, our poorest states pay for the
00:56:27
fourth largest economy in the world."
00:56:29
And they get less.
00:56:30
>> And they get less. And you know, the
00:56:31
immigr we're a country of immigrants.
00:56:33
You could absolutely believe in legal
00:56:35
immigration and want the border closed.
00:56:38
That's what we saw in the last election.
00:56:39
That was the deciding issue, I think, at
00:56:41
the end of the day. I mean, they also
00:56:43
picked a terrible candidate on the other
00:56:44
side and didn't have a primary. Put that
00:56:45
aside. If you
00:56:46
>> We had an amazing candidate, too.
00:56:48
>> Incredibly tremendous. Okay.
00:56:49
>> The best ever.
00:56:50
>> They're the greatest ever.
00:56:51
>> I'm minimizing.
00:56:52
>> I'm just saying. I mean, you kind of
00:56:54
went up against a we Anyway, put it
00:56:56
aside. You know, the the thing that I
00:56:58
think is super important is incentives
00:57:00
matter. You you've said this many times
00:57:02
without explicitly saying it in our
00:57:04
conversation. The incentive for people
00:57:06
to come to America illegally is to make
00:57:09
a better life for themselves and to have
00:57:12
a job, employment, and these social
00:57:15
services. If the social services aren't
00:57:17
available, you know, some number are
00:57:19
going to stay back. And if the jobs
00:57:20
aren't available, then why would you
00:57:22
risk it? Why would you pay one of these
00:57:24
coyotes 5 $25,000 across the board? You
00:57:27
wouldn't. You would get in the line to
00:57:29
do it properly. And that's a very simple
00:57:32
solution here. You you just change the
00:57:34
incentive. make it impossible for an
00:57:36
illegal alien to come here for those two
00:57:39
things.
00:57:39
>> Do you know what financial value there
00:57:41
is of having free healthcare in America?
00:57:42
>> So many will the
00:57:44
>> I'm not going to make you guess.
00:57:45
>> Well, I was going to say for the
00:57:46
employers I can say it's very acute to
00:57:48
insert yourself into the relationship
00:57:50
with your employees because employees
00:57:52
will not leave one company. They'll pick
00:57:54
the company they work for based on the
00:57:56
healthare and they will not leave a
00:57:57
company to pursue a better opportunity
00:57:59
in order to keep their healthare which
00:58:01
is dysfunctional because you want talent
00:58:03
to move. That's a uniquely Silicon
00:58:05
Valley entrepreneurial way to look at
00:58:06
it.
00:58:07
>> From the employer market, uh we we think
00:58:08
the money should follow the patient, but
00:58:11
broadly speaking, because I don't I
00:58:12
don't regulate commercial insurance. For
00:58:14
illegal immigrants, for your family,
00:58:15
it's worth about $30,000. So, there is
00:58:18
no good reason for you to go back home
00:58:20
again if we give you worldass healthcare
00:58:23
coverage.
00:58:24
>> Yeah.
00:58:24
>> So, this is a major issue for us dealing
00:58:26
with the immigration problem because you
00:58:28
cannot send 10 million people back
00:58:30
legally who are here illegally. The
00:58:32
president has said this, you know, I
00:58:34
think he said it publicly, but I think
00:58:35
he would. It would take us 200 years of
00:58:38
legal machinations to send back people
00:58:41
who came here illegally. So, there is no
00:58:43
legal path to expelling people who came
00:58:46
here illegally. You have to remove the
00:58:48
incentives to stay here. Free housing,
00:58:50
free food, free healthcare. Of course,
00:58:52
you're going to stay.
00:58:53
>> Show me an incentive. I'll show you the
00:58:54
outcome. If you look at the war on
00:58:56
drugs, um how unsuccessful it's been, uh
00:59:01
people go to San Francisco for a reason
00:59:03
for their fentinel because they can buy
00:59:04
it and there's no policing. And it is
00:59:06
exactly a function of more policing
00:59:09
means the price of those drugs go up,
00:59:11
which means consumption goes down. Not
00:59:14
only is there that dynamic missing in
00:59:16
San Francisco because there's no
00:59:17
enforcement and you can get fentinel
00:59:19
for5 or $10 a hit, they also give you
00:59:23
housing at $800 or something to that
00:59:26
effect per month. So the homeless
00:59:27
industrial complex has now created an
00:59:29
incentive and everybody in that you know
00:59:33
really tragic junky community knows that
00:59:35
and they leave Texas they leave other
00:59:37
states to go there and then they bear
00:59:39
the brunt of it and they are actually
00:59:41
increasing the suffering. What's your
00:59:44
take on these new super drugs versus the
00:59:47
the rescheduling of drugs? Uh Obama
00:59:50
wanted to do it in his second term. He
00:59:52
didn't have the political willpower or
00:59:54
will to do it. And Trump now is saying,
00:59:57
"Hey, maybe for cannabis we should
00:59:59
rethink that and do what Canada's done
01:00:01
in other modern nations." How do you
01:00:02
look at those specific drugs? Fentinyl,
01:00:07
9 or 12 overdoses a day in San Francisco
01:00:09
at the peak. Um, and then
01:00:11
methamphetamine, which is just another
01:00:13
>> We have good substance use disorder
01:00:15
medications. We can't get people into
01:00:17
the programs. Uh this is why
01:00:19
homelessness is an industrial complex
01:00:21
and the states that have done it well. I
01:00:23
mean I know Mayor Suarez in Miami
01:00:25
dropped the number by 90%. And he did it
01:00:27
just by making sure that you got
01:00:29
arrested every time you peed publicly.
01:00:31
And they don't put you in in jail. They
01:00:33
put you in in rehab. But it takes four,
01:00:35
five, six efforts. You can't give people
01:00:37
free showers, great accommodations, lots
01:00:40
of food, and then expect them to stop
01:00:41
using drugs because you're enabling that
01:00:43
behavior and not expecting bad outcomes,
01:00:45
which is what happened. But I was in the
01:00:47
in Kensington, Philadelphia, which is
01:00:48
the drug capital of the East. And
01:00:50
>> oh, this is where they have that other
01:00:52
super drug. I forgot the name of it.
01:00:53
It's very pernicious. Tran.
01:00:55
>> Yeah. Tran is a terrible drug. It it
01:00:57
creates massive ulcers on your body. And
01:00:59
so I I was there and you know I I I I
01:01:01
just walked the streets just talk to
01:01:02
people like, "Why are you here? Where'd
01:01:04
you come from? Why don't you go home,
01:01:05
etc." And I I ran into a guy uh who had
01:01:08
just saved someone's life giving them
01:01:10
the lock zone as an inhaler. And he's an
01:01:12
ambulance driver. And I said, 'Well, you
01:01:14
know what happened? He says, 'Well, they
01:01:16
odied. I gave it to them. And I said,
01:01:18
'Well, what did they tell you? How do
01:01:19
they thank you when they awaken from
01:01:21
near death, from that dark abyss of
01:01:23
darkness? And he said, they're almost
01:01:25
always livid at me.
01:01:27
>> Yeah, you ruined their high.
01:01:28
>> Well, not and you ruined their their
01:01:30
escape.
01:01:30
>> Oh, they're they're actually hoping to
01:01:33
end this suffering.
01:01:34
>> The pain was so bad. That's why it seems
01:01:36
nice. And that's a that's why I was
01:01:39
telling my friends in Minnesota,
01:01:40
Minnesota nice is great when you really
01:01:42
really mean it. But nice does not mean
01:01:45
allowing your public health system to be
01:01:47
raped. It's not allowing people to abuse
01:01:49
themselves expecting a different outcome
01:01:51
than what historically has happened. You
01:01:53
need to if you really love people, you
01:01:55
might not like them, but if you really
01:01:57
love them, you'll do something that
01:01:59
actually goes beyond like that makes you
01:02:01
ultimately gain respect for them for you
01:02:03
and you. There's a very simple tough and
01:02:05
if you were to take a Christian view of
01:02:07
it um and you were to talk to any of the
01:02:10
parents, these poor parents who are
01:02:12
suffering with a child addicted to drugs
01:02:14
and their adult child is on the street
01:02:16
and you said to them, "We can arrest
01:02:18
them and put them in jail. Uh we can
01:02:20
treat them incredibly severely and try
01:02:23
to, you know, just lock them up until
01:02:25
they they say, "Thank you. Please do
01:02:27
that." But there are a bunch of lunatics
01:02:28
who think you're harassing a homeless
01:02:30
person who had a bad beat and you're
01:02:33
infringing on their freedom. But the
01:02:35
parents and the family would say,
01:02:36
"Please lock them up. That's our last
01:02:38
stitch effort." So it's not compassion.
01:02:40
It is not Christian at all.
01:02:42
>> I That's a faculty lounge discussion
01:02:44
with your tweed jacket on. Yeah.
01:02:46
>> And your elbow protectors when you're
01:02:47
pontificating about people that you read
01:02:49
about, right?
01:02:50
>> Uh and I point that out because I'm on
01:02:52
the facult, you know, I' I've been
01:02:54
>> You got one of those tweet you you
01:02:55
talked to those tweet.
01:02:56
>> Yeah. I got rid of my tweet jackets.
01:02:57
>> The elbow patches, they look terrible
01:02:59
anyway.
01:02:59
>> But you know, you sit there and you act
01:03:01
and this is the the crazy thing about
01:03:03
intelligence is people. The more
01:03:05
intelligent you are, the better you are
01:03:07
to lying to yourself and to others
01:03:09
around you because you can construe
01:03:10
almost any data into something that has,
01:03:13
you know, a meaning that's not really
01:03:14
there. And we have tolerated that for
01:03:16
too long. I I actually think that's an
01:03:18
important part of President Trump's
01:03:20
appeal. He cuts through all that BS.
01:03:21
Don't tell me stuff that just defies
01:03:23
common sense because common sense is not
01:03:25
so common. I think
01:03:26
>> you you don't have to accept it. I think
01:03:29
that's the other thing that I think
01:03:30
Trump has has I think taught some folks.
01:03:33
We do not have to accept that state of
01:03:34
affairs. You don't have to accept and
01:03:37
the framing of it. Let's just call it
01:03:38
what it is. You know, I've used the term
01:03:39
here on our podcast and say junkies
01:03:41
because I grew up in New York in the 70s
01:03:42
and ' 80s and that's what we call people
01:03:44
who are addicted to smack, junkies. It's
01:03:46
not derogatory. It's an indication of
01:03:48
just how bad that disease is. Calling it
01:03:51
homelessness
01:03:52
means you're trying to solve the wrong
01:03:54
thing. Putting a junkie in a home. They
01:03:56
have plenty of homes to go to. It's
01:03:57
nothing to do with that.
01:03:59
>> All right. Well, look,
01:04:00
>> we got to let Doc This How long have we
01:04:01
talking? Two hours.
01:04:02
>> I don't know. But I got Dr. Surgeon with
01:04:05
tips.
01:04:05
>> All right. Let me Dr. House.
01:04:06
>> Yeah. Let me me can I
01:04:08
>> please?
01:04:08
>> All right. So, I just want Yeah, let me
01:04:10
just wrap this up. So, uh Dr. Oz first
01:04:12
reached out to me during the transition
01:04:14
because he's so intensely interested in
01:04:15
AI and he
01:04:17
>> This is when you were transitioning.
01:04:18
>> Yes. During my
01:04:19
>> transition, you supported him.
01:04:21
>> I loved I love David. Yes, we all did.
01:04:23
>> And uh he was looking for for uh names
01:04:26
of AI experts in Silicon Valley to build
01:04:28
his advisory panel and just impressed me
01:04:30
right away with the the energy that you
01:04:33
bring, the knowledge, the passion. You
01:04:35
really do care about improving health
01:04:38
outcomes for all Americans and I think
01:04:39
we are very lucky to have you in this
01:04:42
administration. uh from the president on
01:04:44
down and I think the country is very
01:04:46
lucky to have you could be doing many
01:04:47
many different things but you really
01:04:49
care about this job and I think it's
01:04:51
really incredible what you're doing.
01:04:52
Thank you for your service.
01:04:53
>> I wanted to have you speak to us on the
01:04:55
pods. Kind of long overdue.
01:04:57
>> Well, you're very kind to have me on.
01:04:58
I've enjoyed it. Big fan obviously of
01:04:59
your work in part because you brought a
01:05:02
sense of clarity to many of the issues
01:05:04
you discussed and I want to thank you
01:05:05
David for being a you first of all using
01:05:07
your ability to get people together. the
01:05:09
power to convene is remarkably
01:05:11
effective, but you've also demystified a
01:05:13
lot of this and allowed the
01:05:14
administration to embrace AI and
01:05:16
technology in general. So, God bless
01:05:17
you.
01:05:17
>> Great. Thank you. Thanks for being here.
01:05:19
>> We'll see you next time on Allin at
01:05:21
Davos. I'm going all in.
01:05:37
I'm going all in.