Trump 2.0: A Game-Changing Vision for 2025 (Continued)
In our previous post, we discussed the size and complexity of the U.S. Department of Health and Human Services (HHS), and the recent nomination of Robert F. Kennedy Jr. to lead the department. Just hours after that release, news came that President Trump had nominated Dr. Mehmet Oz to head the Center for Medicare and Medicaid Services (CMS), the largest division within HHS.
CMS oversees not only Medicare and Medicaid but also the Affordable Care Act (ACA) (aka Obamacare) and the Graduate Medical Education (GME) program, which invests approximately $20 billion annually in doctor training, something I’m deeply passionate about, having played a role in founding two medical schools in Florida. The GME program needs to be expanded to address the growing doctor shortage, but that’s a topic for another day.
I wasn’t surprised to see the media focus on Dr. Oz’s “television personality” image, overlooking his remarkable medical career. However, President Trump made some important remarks in his announcement, stating, “America is facing a healthcare crisis, and there may be no physician more qualified and capable than Dr. Oz to Make America Healthy Again.” Trump also emphasized that Dr. Oz’s mandate would focus on reducing waste, fraud, and abuse while promoting disease prevention.
As we noted in earlier blogs, Trump’s focus on hospitals and insurance companies could gain even more momentum under Dr. Oz’s leadership. The Federation of American Hospitals released a one-sentence statement following his nomination: “We congratulate Dr. Mehmet Oz on his nomination to be CMS Administrator, and we look forward to working with the Administration to advance Americans’ healthcare outcomes and protect 24/7 patient care.”
Dr. Oz is a Harvard graduate with an M.D. and M.B.A. from the University of Pennsylvania. He completed his residency at Presbyterian Hospital/Columbia University in New York and is a former professor, a cardiothoracic surgeon, a published author, and an inventor with over 400 medical publications. While he is also a media personality, his medical credentials are far more substantial.
How Will Dr. Oz Impact CMS?
I believe Dr. Oz will significantly influence CMS, with a focus on patient care and supporting doctors—both of whom have been negatively impacted by the current system. Over the past 25 years, doctors’ compensation has effectively dropped by 25% when adjusted for inflation, and it’s likely they’ll see a further reduction in 2025, even if Congress increases funding by just 1%.
I’m always on the side of providers who are being asked to do more with less. AI is key to helping them work more efficiently, but it’s important to note that Trump’s nominees are also focusing on consumers—the voters, many of whom rely on programs like the ACA. I hope Trump 2.0 will focus on improving, rather than repealing, the ACA, as the majority of Americans have grown accustomed to it, and millions depend on it.
There’s also a compelling case for improving Medicare. I’m a fan of Medicare Advantage (formerly Part C) and believe the Trump administration should make it the standard Medicare program. CMS is gradually moving toward a fully managed Medicare system by 2030, but beneficiaries should still be able to opt for traditional Medicare if they prefer. The key is creating a more equitable system, and this would require stronger oversight of Managed Care Organizations (MCOs) through national regulations, as we see with national versus state banking.
AI’s Role in a New Era of Consumer Control
On November 14, 2023, the same day we referenced an article in Medical Economics, another headline caught my eye: “Primary care player Forward shutters after raising $400M, rolling out CarePods” (Fierce Healthcare). Forward Health, founded in 2016, had raised $657 million to offer AI-powered primary care through tech-enabled “CarePods.” Despite high expectations, the company struggled, and it’s a classic example of technology-driven innovation that overlooked the real challenges. The picture below is from the article referenced.
While I’m a huge fan of both healthcare and technology, the idea of walking into a “CarePod” at a mall to receive healthcare services seems far-fetched. In 2023, Forward was charging $99 per month for access to their Pods, which were meant to blend high-tech services with primary care. But as TechCrunch noted, “Forward Health launches CarePods, a self-contained, AI-powered doctor’s office,” the company faced a reality check when they realized that scaling technology alone wasn’t enough to solve healthcare’s deeper issues.
The founder, Adrian Aoun, is a computer scientist and AI expert—not a medical doctor. His vision relied on AI to create care plans based on the latest research, but this approach failed to address the real needs of the healthcare system. As we’ve said before, AI is going to change healthcare, but not in the way many people expect.
Why AI Won’t Replace Doctors Anytime Soon
AI will not replace doctors anytime soon. The reason is simple: no AI platform will be licensed to practice medicine in any U.S. state for decades, if ever. Medical boards, which are controlled by licensed doctors, won’t allow AI to take over the practice of medicine, particularly prescribing drugs.
Additionally, even if AI can assist with diagnoses, a licensed caregiver—such as a doctor or nurse—will always be required to approve any treatment or prescription. If something goes wrong, it will be the human professional’s license and reputation on the line. AI can’t indemnify doctors, and they’ll be hesitant to trust AI without the proper safeguards in place.
In the case of Forward Health, they employed over 100 primary care clinicians and had a medical advisory board of licensed doctors. But it’s expensive to maintain a high-tech infrastructure and employ licensed providers—especially when primary care doctors can cost upwards of $300,000 per year, plus benefits. No matter how much money Forward raised, the math didn’t work.
The Real Role of AI in Healthcare
AI is not ready to replace doctors, but it does have a valuable role in healthcare. It can help consumers by aggregating and analyzing their electronic health records (EHR) to provide insights into potential health issues. AI can also help consumers identify drug interactions, explore alternative treatments, and find clinical trials that may benefit them.
In clinical fields like radiology, pathology, and genetics, AI has already proven its value in supporting doctors with more accurate diagnoses. But for most Americans, AI can help make sense of their health data in ways that individual doctors may not be able to.
Conclusion: The Real Impact of AI on Healthcare
AI’s role in healthcare will be to enhance decision-making, improve efficiencies, and empower consumers. It will never replace human caregivers but will serve as a powerful tool to improve the healthcare experience. As we move toward a future with greater consumer control over healthcare, AI will help make that vision a reality by supporting both patients and providers in ways we can’t fully anticipate today.
-Noel J. Guillama, Chairman
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