All-In Podcast: "Healthcare Needs Builders, Not Bureaucrats — Dr. Mehmet Oz Live from Davos"

Date: January 24, 2026
Guests: Chamath Palihapitiya, Jason Calacanis, David Sacks, David Friedberg
Special Guest: Dr. Mehmet Oz, CMS Administrator

Episode Overview

Broadcast live from Davos, the All-In crew sits down with Dr. Mehmet Oz, now Administrator of the Centers for Medicare & Medicaid Services (CMS), for a candid deep dive on the future of U.S. healthcare. The group discusses innovation, bureaucracy, artificial intelligence (AI), reforming access, institutional waste and fraud, obesity drugs, and the philosophy needed for lasting impact. Dr. Oz frames the moment as an inflection point: “Healthcare doesn’t need more bureaucrats, it needs builders.” The discussion offers rare insight into the internal strategies and attitudes underpinning the Trump Administration’s approach.

Key Discussion Points & Insights

1. Why Dr. Oz Chose Public Service ([01:05])

• Oz reflects on leaving television and private practice for government: “If you want to be able to change meaningfully, the infrastructure, whatever’s bothering you, you gotta go at it full speed. And this administration offers us a unique opportunity.” — Dr. Oz (01:05)
• The group notes the urgency and "shipping" mentality of President Trump: “He’s like a founder who ships product fast. You tell him about a problem, his first instinct is to pick up the phone and fix it right then.” — David Sacks (02:42)

2. How the Trump Administration Approaches Healthcare & Rulemaking ([03:26])

• Oz explains three levers of government change:
  • Making Laws: Slow, often diluted by negotiation.
  • Rulemaking: Faster via agencies, but prone to "lawfare" (regulatory lawsuits and injunctions).
  • Power to Convene: Bringing industry players together to solve big problems outside rigid lawmaking.
• “The US government can bring people together who would not normally talk...and give the industry safe harbor to discuss problems.” — Dr. Oz (04:41)

3. Drug Pricing: Most Favored Nation & Fairness ([05:49])

• U.S. overpays for prescription drugs vs. Europe; Trump admin applies pressure to lower prices without stifling innovation.
• “Don’t hurt the industry, but take some of the fat out of it. Pull it back, and give it to the American people.” — Dr. Oz (06:25)
• Healthcare should be seen as an investment: “If I can get the average American to work one year longer...that is worth $3 trillion to the US economy.” — Dr. Oz (08:39)

4. Universal Healthcare & Access — The Real Barriers ([09:46])

• Oz says the central challenge is not promising universal care, but how it gets paid for and actually delivered: “If I tell everyone you have healthcare, then force doctors to deliver it but don’t fix the financing, you end up restricting access. Like in socialized systems, you wait six months or a year—or never—for care.” (10:14)
• Panellists discuss "healthcare tourism," with Canadians coming to the U.S. for timely and advanced procedures—rarely the reverse.

5. The Tech Transformation: AI, Self-Directed Healthcare, and Smarter Patients ([12:43])

• AI’s readiness is making big swings possible: “We’re taking big swings because we think AI is ready...We think the tech transformation that could happen in healthcare is worth subsidizing.” — Dr. Oz (12:07)
• Large Language Models (LLMs) now outperform average general practitioners on board exams and empathy: “They’re better than a doctor, they’re more patient than a doctor...they’ll answer the same ten questions all day long.” — Dr. Oz (13:48)
• Hybrid vision: AI augments doctors — especially for routine care, information retrieval, patient education, and paperwork.
• “I think we have the opportunity...to make the average GP five or even ten times more efficient. There are not enough GPs in America — we probably need two to three times more.” — Dr. Oz (14:06)
• Patient empowerment: Integrating personal lab results, wearable data, and chat interfaces is making patients “better consumers” and forcing doctors to level up ([16:45]).

6. Healthcare Inequality and the True Promise of AI ([18:28])

• Deep concern for the disengaged end—the poor, overworked, Medicaid recipients missing appointments due to logistical hardship.
• <50% of Medicare patients use their free annual wellness exam.
• “People who see doctors think they’re sicker, but they’re actually healthier. People who don’t seek care think they’re just fine, but objectively, do much worse.” — Dr. Oz (19:52)
• Democratization via Tech: CMS pledges, 600+ companies supporting data interoperability, transparency, and better tools for the public ([21:27]).

7. Breaking the Data Moat in Healthcare ([22:13])

• Longstanding issue: Proprietary EMR systems block patient data portability.
• AI expected to bypass format barriers, making medical records genuinely accessible and useful.
• “AI is the magic glue...You don’t need a perfect API anymore...you just get the unstructured data, dump it in, and now it just works.” — David Sacks (23:13)

8. AI in Mental Health & Rural Care ([24:29])

• Some states try to ban AI-driven therapy. Oz argues bans are misguided, especially where there are no providers.
• “Allow professionals to function at the height of their licensure...Almost all Americans live within five miles of a pharmacy...If we just took AI and allowed pharmacists and doctors, GPs, to function at a higher level...” — Dr. Oz (24:59)
• $50B "World Health Transformation Fund" going into rural health, with “micro-clinics,” AI-supported diagnostics, drone/digital delivery, and new inter-state collaboration ([26:36]).

9. Opening the System to Builders — and the ENGINEER SHORTAGE ([29:18])

• Government is notoriously risk-averse and under-resourced in tech: “We had nine engineers for 6500 employees...$3 billion of cost out just by firing one company billing $200 million—no usable code.” — Dr. Oz (29:35)
• Emphasis on partnership: “We are open for business...We want to work with industry...Private sector will come up with better ideas.” — Dr. Oz (29:18)

10. Obesity Drugs (GLP-1s): The “Miracle Drug” Mandate ([30:52])

• Panellists hail semaglutide (Ozempic, Wegovy, etc.) as “miracle drugs” for obesity and associated epidemics.
• Announcement: Trump will launch “Trump Rx” — $150-200/month GLP-1 pills for Americans (and $0 out-of-pocket for Medicaid, $50 co-pay on Medicare): “We will, within two years, return money to the American taxpayer. It’s going to save us money from reducing hypertension, diabetes, and the downstream illnesses.” — Dr. Oz (31:54)
• “Right now, the number one zip code for weight loss drugs? Upper East Side of Manhattan. Number two, LA. But $1,200 for someone not making money—you’re just not going to get the drug.” (33:38)
• Key: Price parity, access, avoid suppressing medical innovation ([35:05]).

11. Massive Fraud & Institutional Corruption ([36:09])

• Stark description of Medicaid/Medicare fraud: manipulations by union groups, organized crime, foreign nationals, and weak oversight.
• “There are more durable medical equipment providers than McDonald’s in South Florida—most Cuban-owned, many used to escape legal recourse.” — Dr. Oz (38:48)
• “Hospice survival rates at 100%? Seven times more hospice centers in California than seven years ago. These are not end-of-life patients.” (39:41)
• Motivation for lax oversight: Tied to laws requiring welfare users to be offered voter registration, political patronage, and "legalized money laundering" via overbilling by contractors and foreign nationals.

Memorable Fraud Story ([41:07]):

• “The plumber says, ‘I hear you’re in hospice.’ Guy says, ‘Yes, I made my money there.’ Plumber: ‘I got a side hustle. I own a hospice too.’ Carpenter: ‘Me too.’ We’re all in the hospice business.” — Dr. Oz (41:07)

Solutions:

• “Fraud war room; active moratorium on suspicious providers; refuse to pay states not upholding fiduciary duty; whistleblowers incentivized with rewards.” (42:13)
• Alignment of presidential/congressional interests and bold executive action to stop the “legalized looting.”

12. California, Newsom & The Audit Wars ([44:13])

• Panelists criticize California’s governor for vetoing audits, escalating taxes while tolerating fraud.
• “When smart people don’t do things, it’s not an accident...there are ulterior motives…” — Dr. Oz (46:14)
• Example: $1.5B charged to federal government for undocumented immigrants; when challenged, CA dropped spending as soon as liability shifted to the state.
• “I’m not going to let tax payers in Alabama, Mississippi, New Mexico—our poorest states—subsidize California.” (56:29)

13. Immigration, Incentives, & Healthcare’s Magnetic Pull ([56:45])

• “You cannot send 10 million people back...You have to remove the incentives to stay: free housing, free food, free healthcare...of course you’re going to stay.” — Dr. Oz (58:52)
• Value of U.S. healthcare for an illegal immigrant’s family? About $30,000/year.

14. Homelessness, Drugs, & the “Industrial Complex” ([60:13])

• Compassion vs. enablement: “You can’t give people free showers, great accommodations, lots of food, and expect them to stop using drugs.”
• On policy: “If you really love people, sometimes you do something that goes beyond ‘like’—that makes you ultimately respect them.” (62:02)
• Critique of "faculty lounge" policies and euphemistic framing (i.e., calling junkies ‘homeless’ ignores the substance abuse crisis):
  “Calling it homelessness means you’re trying to solve the wrong thing. Putting a junkie in a home...has nothing to do with it.” — Jason Calacanis (63:59)

Notable Quotes (with Timestamps)

• On Change at Scale:
  “If you want to be able to change meaningfully...you gotta go at it full speed." — Dr. Oz (01:05)

• On AI’s Promise:
  “We’re taking big swings because we think AI is ready.” — Dr. Oz (12:07)

• On Building vs. Breaking:
  “Bend but don’t break. You want them to bend a little bit...but you don’t want to break the industry.” — David Sacks (07:45)

• On Universal Healthcare:
  “How we pay for it is the defining issue here...Fundamental question is: how long till I actually get the care?” — Dr. Oz (10:14)

• On Data Liberation:
  “AI is the magic glue...you just get the unstructured data, dump it in, and now it just works.” — David Sacks (23:13)

• On Fraud:
  “Only the morons get caught in healthcare fraud because it’s so easy to do.” — Dr. Oz (38:48)

• On Institutional Failure:
  "When smart people don’t do things, it’s not an accident...they have ulterior motives..." — Dr. Oz (46:14)

• On Incentives & Outcomes:
  “Show me an incentive, I’ll show you the outcome.” — Jason Calacanis (58:52)

Important Segments & Timestamps

• [01:05] — Dr. Oz on why he chose to enter government and what change means at the federal level
• [03:26] — The three ways government gets things done (laws, rules, convening)
• [05:49] — Deep dive into drug pricing and the Most Favored Nation policy
• [10:14] — Realities of universal healthcare and access challenges
• [12:43] — AI, large language models, and the hybrid future of medicine
• [16:45] — Emergence of self-directed healthcare, data tracking, and smart patients
• [18:28] — Addressing inequality through tech, the role of Medicaid, and annual checkup statistics
• [22:13] — Patient rights, AI, and the end of data silos
• [24:29] — AI’s potential in rural and underserved mental health care
• [29:18] — Calls for private sector builders; government’s tech deficit exposed
• [30:52] — GLP-1 “miracle drugs” for obesity and bringing affordability to the masses
• [36:09] — Exposing fraud: mechanisms, scale, and proposed fixes
• [44:13] — California’s audit war, tax hikes, and Medicaid fraud
• [56:45] — Illegal immigration, incentives, and the magnet of free health care
• [60:13] — Homelessness, the limits of compassion, and substance abuse

Memorable Moments

• Dr. Oz’s story about entire tradesmen “side-hustling” as hospice scammers in LA (41:07).
• The “cancel the credit cards” story from the X/Twitter acquisition as a metaphor for fighting government waste (46:58).
• Announcement of nationwide affordable GLP-1 drugs through “Trump Rx” (31:54).
• The blunt critique of “faculty-lounge” policy making and the importance of seeing addiction for what it is—not just “homelessness” ([62:54]).

Conclusion

This episode pulls back the curtain on America’s health system at a rare moment of convergence: a risk-taking administration, a technologic inflection point, and urgent social/budgetary stresses. Dr. Oz’s repeated theme — "builders over bureaucrats" — runs throughout as the prescription for both innovation and institutional integrity. The conversation, rich with pointed anecdotes and practical policy discussion, is a must-listen for anyone interested in the intersection of health, tech, and politics in 2026.