Dr. Mehmet Oz on Fixing American Healthcare + Fraud | Live from Davos

Recorded at Davos, this conversation features Dr. Mehmet Oz, introduced as the current administrator of CMS, alongside David Sacks, who is described as a fellow civil servant. The hosts open by asking why someone at the height of a media and medical career would move into public service. The answer is about impact. The speaker describes being "in the change business": if a project is not producing significant change, it is time to move to one that can. Health care, the argument goes, offers no "luxury of fooling around for years" on work that does not meaningfully improve quality of life. The speaker mentions 13 years as a TV host and a lifelong surgical practice, and calls the current role the best job they have had, both because of colleagues and because it allows real change.

The conversation then turns to the pace of the administration. The participants describe President Trump as moving unusually fast, comparing him to a founder who "ships and ships product fast." One anecdote describes him hearing about a problem in an Oval Office meeting and picking up the phone to fix it on the spot, repeated "meeting after meeting, hour after hour, day after day." The discussion contrasts this term with the first, in which he is said to have brought in many career politicians. This time, the speakers say, he has recruited people with proven expertise and expects them to explain policy themselves, because much of the media narrative is "just completely off." The speaker frames this as a lack of understanding rather than bad faith: reporters "literally don't understand some of the secondary and tertiary impacts" of decisions.

The discussion sets out three ways an agency like CMS can make change. The first is legislation: getting Congress to act, which takes time and often yields negotiated results that "fall short." The second is rulemaking, where administrative bodies write rules everyone must follow, such as payment levels or bans on certain practices. This is described as slow and "prone to law fair" (lawfare), because regulated parties or political opponents can sue to stop a rule. As an example, the speaker cites a rule intended to reduce fraud that "blue cities" opposed and had enjoined; it is now in court, and while the speaker predicts a win, it "could take years."

The third lever, described as historically underused, is the government's power to convene: bringing together parties who would not normally talk and giving industry "safe harbor" to discuss problems it would otherwise avoid. The speakers credit the president's negotiating style with making this lever work.

Drug pricing is offered as the main example of the convening lever. The question frames the U.S. as "the sucker at the poker table," claiming the country pays "10 times what Canada's paying"; no source is given for that figure. The answer describes most favored nation pricing as targeting a narrower point: Americans pay much more for "the exact same product, made the same factory, often in America," than people in Europe do. The described approach was to create credible risks for drug companies without acting on them, using the metaphor of building "the crowbars and the baseball bats" but not using them.

There is an explicit limit on that pressure. The president is said to have instructed officials not to harm the innovative nature of pharmaceuticals, which are described as life-saving and part of "our national destiny." The aim is to "take some of the fat out of it" and pass savings to the American people. The speaker compares this to asking NATO members to contribute proportionally more to shared defense, with "internal threats like cancer" standing in for external threats.

Bend, but don't break. You want them to bend a little bit, be reasonable, but you don't want to break the industry.

Figures cited in the drug-pricing discussion: - The U.S. spends 0.8% of GDP on pharmaceutical products. - Total health care spending is given as "I think" 17% of GDP, so roughly 6% of health care spending goes directly to drug companies. - Other countries are said to pay 0.3% of GDP, "less than half" the U.S. share. - Negotiations are described as ongoing; the British are said to have agreed, and other countries are in talks.

The defense of the higher U.S. spending is that Europeans pay a price in access and outcomes. The speaker says survival rates for more advanced cancers in Europe are "way below the U.S.," and that new drugs reach European patients several years later on average. No specific survival figures or delay estimates are given in this part of the conversation.

The message the speaker calls the most important of the day is to treat health spending differently.

don't think about health care like an expense. Think of it as an investment

The supporting claim is that if the average American worked one year longer, for example because they could afford medication instead of turning away at the drugstore, that would be worth $3 trillion to the U.S. economy. The extra year would also bring people closer to Medicare eligibility, which the speaker says helps with other national financial pressures. The stated goal is to lower the actual cost of care so that spending buys more value, rather than putting more money into the system.

One participant summarizes the trade-off: the U.S. spends about twice as much as countries with universal health care and gets earlier access, so "we have a better system, but we pay through the notes for it," a characterization the other side accepts. That participant then raises the fear of medical bankruptcy among people who are less well off and asks whether universal coverage is the answer. The reply separates access from financing. Everyone should have access, the speaker says, but if coverage is promised without dealing with cost, systems end up restricting access through waiting, six months, a year, or longer, as in "socialized medicine countries."

The participants test this with patient flows. One cites stories of Canadians coming to the U.S. to avoid waiting two years for procedures, and says they do not hear of Americans going to Canada for treatment. The other partly disagrees: Americans do travel abroad for out-of-pocket care such as cosmetic and dental work, and for some procedures, including some cell therapies, that are still going through U.S. regulatory review. The agreed point is narrower: most Americans say the system is broken, yet almost none would leave the country for top-tier care for a life-threatening problem. The challenge is framed as making that top-tier care available at a sustainable price.