All In Interview - Dr. Mehmet Oz - Recap and Notes - January 23 2026

January 23 2026

(from NotebookLM)

• Head of CMS

Introduction

• Setting the Scene: The podcast is recording live from Davos with a picturesque background that looks like a "green screen" but is real. The hosts joke about the "virtue signaling ESG DEI executives" nearby and solar panels that aren't plugged in.
• Dr. Oz’s Role: Dr. Oz is introduced as the "Administrator for CMS" (Centers for Medicare & Medicaid Services), transitioning from being "America's Doctor" to a civil servant.

Transition to Public Service & Working with Trump

• Motivation: Oz views himself as being in the "change business." He believes healthcare offers no luxury for delay and felt he could make a more significant impact in this role than as a TV host. He calls it the "best job" he's ever had.
• Trump’s Management Style:

◦ Contrary to the expectation that government requires slow consensus building, Oz describes President Trump as a "founder who ships" and moves with extreme urgency.

◦ In meetings, if Trump hears a problem, he calls to fix it immediately rather than waiting.

◦ Personnel: Unlike his first term, Trump has sought experts and "proven winners" rather than career politicians to run agencies.

• Communication Strategy: The administration believes the media often misunderstands the secondary impacts of decisions, so it is the job of officials like Oz to explain the narrative directly to the American people.

Mechanisms for Government Change

• Oz outlines three ways to effect change in government:

1. Legislation: Getting Congress to pass laws (slow, results often fall short).

2. Rulemaking: Agencies writing rules. This is prone to "lawfare" (lawsuits) and delays. Oz notes that blue cities have enjoined rules meant to reduce fraud simply because they dislike the President.

3. Convening Power: Using the government's authority to bring disparate parties together to negotiate—a tool this administration uses heavily.

Drug Pricing & "Most Favored Nation"

• The Problem: The U.S. pays significantly more (often 10x) for the same drugs made in the same factories as other countries.
• Strategy: The President uses "Most Favored Nation" status to pressure drug companies. The approach is to "build the crowbars... but don't use them" to force price drops without destroying innovation.
• NATO Analogy: Oz compares this to NATO funding. Just as the U.S. demanded allies pay their fair share for defense, the U.S. is demanding Europe pay more for drugs so the U.S. can pay less.
• Current Stats: The U.S. spends 8% of its GDP on pharmaceuticals alone (almost half of total healthcare spending).
• The Trade-off: While Europe pays less, they often have lower cancer survival rates and delayed access to new drugs compared to the U.S..
• Healthcare as Investment: Oz argues healthcare should be viewed as an investment, not an expense. Keeping an American working just one year longer adds $3 trillion to the economy.

Universal Healthcare & Access

• The Tension: Wealthy Americans don't fear healthcare costs, but many others face bankruptcy. The challenge is providing access without removing the financial incentives that keep the system efficient.
• Wait Times: Oz notes that in socialized systems (universal care), costs are controlled by restricting access, leading to long wait times. Canadians often come to the U.S. for care to avoid waiting, whereas Americans rarely leave the U.S. for life-threatening procedures.

AI & Technology in Healthcare

• The "Big Swing": The administration is subsidizing a tech transformation because they believe AI is ready.
• AI vs. GPs: Studies show Large Language Models (LLMs) perform better on board exams and have better "bedside manner" (more patience) than average General Practitioners (GPs).
• Efficiency: The goal is to make doctors 5-10x more efficient because there is a shortage of GPs (medical students prefer high-paying specialties like ophthalmology).
• Role of AI: AI should handle paperwork and "busy work," allowing doctors to focus on human connection and reading the patient (50% of cognitive function is social/facial reading).
• Patient Empowerment: Oz envisions a future where patients dump their own data (blood panels, unstructured PDFs) into consumer AI tools to get diagnoses, making them smarter customers.
• Data Interoperability: 600 companies have signed a pledge to share data. The administration is forcing transparency so patients can own their records. AI solves the "proprietary format" issue by easily reading unstructured data.

Rural Healthcare & Mental Health

• The Crisis: 60 million Americans in rural areas lack access to care. Veterans in these areas have high suicide rates due to a lack of mental health services.
• AI Restrictions: Oz criticizes states trying to ban AI therapy, arguing that in rural areas with no psychiatrists, AI provides a necessary baseline of care.
• Pharmacists: Plans to allow pharmacists to function at a higher level of licensure since 95% of Americans live near a pharmacy.
• Rural Health Transformation Fund: A $50 billion investment is being used by governors for innovations like micro-hospitals, AI-supported ultrasounds, and drone delivery of meds to remote areas like the North Slope of Alaska.

The Private Sector & CMS

• Open for Business: Oz explicitly states CMS is "open for business" to work with the private sector.
• Tech Overhaul: Upon arriving at CMS, Oz found only 9 engineers for 6,500 employees. He fired a contractor who had billed $200 million without producing a single line of usable code.

GLP-1 Agonists (Weight Loss Drugs) & "Trump RX"

• Impact of Obesity: Obesity drives the "Four Horsemen" of health issues: heart disease, kidney failure, liver disease, and dementia.
• The Plan: The administration negotiated with Novo Nordisk and Eli Lilly to launch "Trump RX."

◦ Pricing: Cash pay price will drop to ~200 (injectables) and 150 (pills).

◦ Access: Medicare copay will be 50; Medicaid patients will get it for 0.

• Economic Logic: Providing these drugs is an investment that will save taxpayers money within two years by reducing chronic diseases.
• Democratization: Currently, weight loss drugs are a luxury for the wealthy (e.g., Upper East Side). This plan targets vulnerable populations in rural areas who have lower life expectancies.
• Future Tech: New drugs (like Retatrutide) will address addiction as well as appetite.

Fraud, Waste, and Abuse

• Scale of Fraud: Estimates suggest 20-30% of spending in some areas is fraud.
• Home Health/Personal Care: A major vector for fraud. Government is paying for services families used to do (driving to doctors, cooking). Since the consumer isn't paying, no one checks the value.
• Specific Examples of Fraud Rings:

◦ Minnesota: Somalian gangs exploiting daycare/learning center funding (millions stolen for empty centers).

◦ South Florida: Cuban rings running durable medical equipment scams (20x more equipment providers than McDonald's).

◦ California (LA): Russian/Armenian gangs running hospice fraud. A 7x increase in hospices where 100% of patients survive (because they aren't actually dying).

• The "Plumber" Story: Oz shares an anecdote about a whistleblower building a house where the plumber and carpenter both admitted to owning hospices as "side hustles" because it was easy money.
• Political Obstruction: Oz claims blue states (specifically California and Governor Newsom) veto audits and ignore fraud to protect political bases or funding streams.
• The Solution:

◦ "Cancel the Credit Cards": Stop autopayments. Require providers to "come into the office," verify their identity, and show photos of the services provided to restart payments.

◦ War Room: A fraud war room has been established to place moratoriums on new sign-ups in high-fraud sectors.

Illegal Immigration & Healthcare

• California's Deficit: Oz argues California’s budget crisis is partly due to Newsom promising "Medi-Cal for all" (including illegal aliens) without federal backing.
• The Audit: CMS audited California and found $1.5 billion wrongly charged to the federal government for illegal immigrant care. The feds are clawing this back.
• Incentives: Oz argues that free healthcare (worth ~$30k/family) acts as a massive magnet for illegal immigration. While mass deportation is legally difficult, removing financial incentives (free housing, food, healthcare) effectively encourages self-deportation.

Addiction & Homelessness

• Reframing the Issue: Oz and the hosts refer to the crisis not as homelessness, but as drug addiction ("junkies").
• Industrial Complex: A "homeless industrial complex" enables addiction by providing free services without requiring sobriety.
• San Francisco vs. Miami:

◦ SF: High fentanyl availability + no enforcement + free services = increasing death and homelessness.

◦ Miami: Enforced laws (arrests for public indecency) + mandatory rehab = 90% drop in homelessness.

• Compassion: Oz argues true compassion (and a Christian view) involves tough love—forcing treatment or jail to save lives—rather than letting people die on the streets under the guise of "freedom".

Conclusion

• Oz credits the "All-In" hosts for helping demystify AI for the administration and helping assemble his advisory panel. The group signs off from Davos.