Squawk Pod Podcast Summary

Episode: America’s Health Care: Affordability, AI, & Politics
Date: November 21, 2025
Hosts: Becky Quick, Andrew Ross Sorkin
Featured Guests: Rep. Hakeem Jeffries (House Minority Leader), Dr. Toby Cosgrove (former Cleveland Clinic CEO)

Overview

This episode dives into the urgent state of health care affordability in America, exploring the political gridlock over the Affordable Care Act (ACA) subsidies, the challenges hospitals and patients face as costs rise, and the promise of artificial intelligence (AI) in transforming care delivery and administration. Key voices include House Minority Leader Hakeem Jeffries, who explains the stakes and politics of the ACA "subsidy cliff," and Dr. Toby Cosgrove, who breaks down why costs keep rising—and how technology could help.

Key Topics & Discussions

1. Market Recap & Economic Context (02:18–08:01)

• The hosts discuss recent market volatility, with the Dow, S&P 500, and NASDAQ posting their worst week since April.
  • Becky Quick: "Markets are on track for their worst week since April 4th ... this time it's a little harder to pin down. Nvidia had really strong numbers ... but those concerns about the valuations certainly dogging the markets." (02:18–03:05)
• Bitcoin has fallen for 11 consecutive sessions—a new record.
  • Andrew Ross Sorkin: “There are people who are shorting, they're not just shorting bitcoin, they're shorting MicroStrategy as the strategy.” (04:03)
• Updates on international events: President Trump’s decision to roll back tariffs on Brazilian food imports and stalled bailout plans for Argentina provide additional context for economic pressures that tie back to affordability—especially of consumer goods.

2. Biotech Industry Frustrations with the FDA (08:01–10:54)

• A coalition of biotech leaders and patient advocates have sent a letter to President Trump and federal officials expressing concern over the unpredictable FDA approval process for rare disease therapeutics.
• Drop in orphan drug approvals is cited, with worries that "China will seize our biotech leadership and America will lose jobs, investment, and the historic momentum you built." (Letter paraphrased by Becky Quick, 09:27)
• Becky Quick: “It is unusual to see an industry speak up like this about the, basically the regulator.” (10:27)

3. Political Standoff Over ACA Subsidies (13:24–24:16)

Context:

• The ACA’s enhanced premium tax credits are set to expire December 31st, which would cause sharp increases in premiums, co-pays, and deductibles.
• Senate promises a vote by mid-December; in the House, Democrats have launched a discharge petition for a 3-year extension, needing four Republicans to sign on.

Hakeem Jeffries Interview Highlights:

• What’s at Stake:
  • Hakeem Jeffries: "If [the ACA tax credits] expire, tens of millions ... are going to experience dramatically increased premiums ... In some cases, premiums ... will increase by $1,000 or $2,000 per month." (13:59)
• On the Partisan Divide:
  • Becky Quick: “It's important context to make me realize that I don't think you want to get a deal done. I think this is ... You'd like to see the rates go higher and allow the Republicans to hang themselves with that. Is that the answer?” (16:55)
  • Hakeem Jeffries: “That's absolutely a ridiculous assertion. ... Shame on you for saying that.” (17:05)
• State Impact & Republican Involvement:
  • ACA expiration affects “West Virginia, Wyoming, Alaska, Mississippi, Tennessee ... We can go through the list.” (17:29)
• On Attempts at Bipartisanship:
  • “This is not a partisan fight for us. It's a patriotic fight ... We want to sit down and have a reasonable discussion, find common ground.” (17:40)
• Why Not a One-Year Deal?
  • Becky Quick: “Why not start with a one-year extension or potentially even a two-year extension?” (16:06)
  • Jeffries: Republicans have already refused one-year extensions and “are not interested in finding a resolution to a health care crisis that they've created.” (18:56)
• Summary Soundbite:
  • Jeffries: “The cost of living crisis is out of control. But the Republican approach since day one of this presidency has been my way or the highway.” (20:42)
• Call for Cooperation:
  • "We've repeatedly said we will sit down anytime, anyplace, with any of our Republican colleagues. ... We want to find a bipartisan path forward, but we need Republicans to operate in good faith." (20:42)
• On Government Shutdown:
  • Jeffries: “We didn't shut the government down. Donald Trump and Republicans control the House, the Senate and the presidency ... the American people ... know who was responsible.” (21:56)

Notable Exchange:

• Becky Quick: “So what I'm hearing ... is that there is no middle ground. There is no bipartisanship. This is at this point, us versus them, and we are not going to agree on anything, am I?” (20:32)
• Jeffries: “No, that's absolutely not the case. We've repeatedly said we will sit down anytime, anyplace...” (20:42)

On New York’s Mayor-Elect Visit to the White House:

• Discussions will focus on the “cost of living” and “public safety.” (23:24–24:16)

4. Health Care System Stressors & Solutions (Dr. Toby Cosgrove) (24:42–34:51)

The Cost Problem:

• Dr. Cosgrove: “Three things that are really driving the cost up. One is inflation, two is more older people, and three, there's more things we can do for people. ... Health care is getting more and more sophisticated ... premiums are going up enormously, 26% across for people ... some 16 million are going to lose coverage.” (24:42–27:50)

Prevention & Lifestyle:

• Dr. Cosgrove: “There’s prevention ... 40% of the United States is obese and that causes diabetes.” (28:06–28:44)
• GLP-1 (Ozempic-type) drugs are “part of the solution ... a fabulous drug ... but they're expensive.” (28:47–28:58)

Pharmaceutical Pricing:

• Drug costs remain high due to "evergreen" patents; generics are delayed, “so things don't get to be generic drugs, which drives up the cost.” (29:11)
• Cosgrove: “It's not going to be a single solution to this. ... we're going to have to address it uniformly.” (29:56)

Hospitals’ Financial Squeeze:

• Supplies and labor costs rising; margins razor thin.
• Cosgrove: “10% of the cost of drugs are going up, 10% of supplies are going up and 6% increase in the cost of labor.” (30:17)

Artificial Intelligence: Promise & Application

• “I think we're actually hitting on an exciting new time in health care. And that's around AI.” (01:44, expanded 30:57–33:07)
• Cosgrove: “AI brings the efficiency ... productivity of hospitals has gone continuously down. ... There’s 2 million unfilled jobs in healthcare. ... AI can bring the efficiency to healthcare.” (30:57–31:44)
• Example: Automated note-taking, billing, predicting no-shows, and managing supplies could "bring down 10–15% of the cost of health care." (31:44–31:56)
• ROI on AI investment is positive despite initial costs. (33:00)

Persistent Price Disparities:

• Andrew Ross Sorkin: “If you go in, depending on where you go to get an MRI ... some places that will charge you 1,000 bucks ... others ... 6,000 bucks or 8,000 bucks ... is that just a margin situation?”
• Cosgrove: “It's the same [machine] ... all the factors that go into managing a major hospital are expensive. ... an outpatient facility ... is more convenient and lower cost ... That's where things need to move.” (33:45–34:28)

Notable Quotes & Memorable Moments

• Hakeem Jeffries (13:59): “The Affordable Care act tax credits are going to expire on December 31st. And if that happens, tens of millions ... are going to experience dramatically increased premiums.”
• Becky Quick (16:55): “I don't think you want to get a deal done ... you'd like to see the rates go higher and allow the Republicans to hang themselves with that. Is that the answer?”
• Hakeem Jeffries (17:05): “That's absolutely a ridiculous assertion. ... Shame on you for saying that.”
• Dr. Toby Cosgrove (27:02): “There's more things we can do for people. That's a great problem they have.”
• Dr. Toby Cosgrove (31:44): “McKinsey would say that 10 to 15% of the cost of health care in the United States can be brought down using AI. ... particularly using it in administrative work.”
• Dr. Toby Cosgrove (34:28): “An outpatient facility ... no question, is more convenient and lower cost to do it. And that's where things need to move.”

Timestamps for Key Segments

• 02:18 – 04:03: Market volatility and Bitcoin slide
• 08:01 – 10:54: Biotech letter to FDA/administration
• 13:24 – 24:16: Hakeem Jeffries interview (ACA, politics, bipartisanship)
• 24:42 – 34:51: Dr. Toby Cosgrove interview (health system costs, prevention, AI in healthcare)

Tone & Takeaways

• The episode is direct, urgent, and at times contentious—especially in the political debate between Becky Quick and Hakeem Jeffries.
• Jeffries is firm, portraying Republican inaction as harmful to Americans’ health and Democrats as seeking bipartisan solutions, while Quick presses on the realities of negotiation and potential political gamesmanship.
• Dr. Cosgrove is pragmatic and optimistic about healthcare’s future, especially around technology, but clear-eyed about how structural cost drivers—from aging populations to expensive innovations—complicate reform.

Bottom Line:
This Squawk Pod episode offers a comprehensive, real-world look at the issues making American health care so unaffordable—from D.C. politics to hospital hallways—while highlighting both the frustration in stalled reforms and the hope in technological progress.