vision for healthcare in America Healthcare broken: Americans pay double what other nations for inferior outcomes. Drugs cost 10× more in US.
Trump’s demanded most-favored-nation pricing (negotiate lower prices like other countries pay). Pressure pharma without killing innovation (make offers that they cannot refuse).
Goal is affordability + access. Think healthcare as investment (extra work year from better health = trillions in GDP).
Methods are laws, rulemaking, convening power (safe harbors for industry talks). Avoid lawfare delays.
Universal access desired, but must preserve incentives (no waitlists like socialized systems). US superior outcomes but high cost.
AI & self-directed healthcare
AI outperforms average GPs on exams/bedside manner. Patients prefer it (less boredom, more patience).
Future:is hybrid—AI handles routine (cold/ankle sprain advice, paperwork, ambient notes) and doctors focus on human connection/eyes/face reading.
Democratization will empower patients (upload labs/PDFs to LLMs/Grok/Claude for insights).
Self-directed care via wearables (Whoop, Oura, Apple Watch) + blood panels.
Shortage solution by AI making doctors 5–10× efficient. Rural access via robots/drones/micro-clinics/telemedicine.
Interoperability pledge (600+ companies) + AI decoding proprietary formats = true data ownership/use.
Bottom-up where educated patients push doctors and top-down: CMS subsidies seed AI health apps.
Risks are hallucination (early stage). Regulatory bans in some states (therapy). Engage AI, don’t ban—rural/mental health crises need it.
The future of GLP-1s and affordability
GLP-1s (Ozempic, Mounjaro) miracle drugs. combat obesity → reduce heart/kidney/liver/dementia/cancer.
Negotiated prices drop dramatically ($1,200 → $200/month injection, $150 pill). Trump Rx launches soon.
Medicare has $50 copay and Medicaid will be free for GLP-1.
This will save trillions (longer work years, fewer chronic illnesses). Pills easier delivery, less waste.
Pharma will onshore production, hire Americans. The US will protect innovation while cutting fat.
The Medical Fraud Crisis
Massive fraud/waste/abuse: 20–30%+ of Medicare/Medicaid (hundreds of billions).
FRAUD Examples
– are 20× more DME providers than McDonald’s in South Florida (Cuban gangs)
– 7× hospice in CA (Russian/Armenian gangs)
– Minnesota daycares (Somali subculture).
Root probem is government pays → no consumer incentive and states don’t audit (vetoed) and foreign nationals exploit.
Solutionsare fraud war room, moratoriums on new providers, stop payments to non-compliant states, require attestation/photos/ID verification, whistleblower incentives.
Outcome is real audits → accountability.
Fraud kills programs where autism kids lose access but fraudster get the money.
California fraud and accountability
CA is the 4th largest economy, doubled budget last decade, massive deficit → proposed asset seizure tax.
Fraud iceberg is tip Minnesota but bulk California (LA hospice/home health ~$3.5B fraud).
Newsom vetoes audits. Prioritizes enrollment over integrity (Medicaid for illegals, union involvement).
Federal response is cut payments for ineligible illegals and CA now pays own way → forced accountability.
Hypocrisy is high taxes + fraud tolerance and poor states subsidize CA fraud.
Immigration and addiction
Illegal immigration incentives.
Free healthcare/housing/food → $30k+ value/person; no deportation path (200-year legal backlog).
Solution is remove pull factors (end benefits) → reduce crossings.
Legal immigration ok, but close border.
Addiction/fentanyl/meth crisis fueled by lax enforcement + incentives (SF: $5–10 hits, free housing).
Harm reduction fails (enables). Tough love needed (arrest → rehab, repeat efforts).
Homelessness = addiction problem, not housing. SF/Kensington enable suffering.
GLP-1s/addiction meds. Reduce cravings and future drugs more effective.
Overall: incentives drive outcomes. Trump’s urgency + fraud crackdown + AI enable real change.
Brian Wang is a Futurist Thought Leader and a popular Science blogger with 1 million readers per month. His blog Nextbigfuture.com is ranked #1 Science News Blog. It covers many disruptive technology and trends including Space, Robotics, Artificial Intelligence, Medicine, Anti-aging Biotechnology, and Nanotechnology.
Known for identifying cutting edge technologies, he is currently a Co-Founder of a startup and fundraiser for high potential early-stage companies. He is the Head of Research for Allocations for deep technology investments and an Angel Investor at Space Angels.
A frequent speaker at corporations, he has been a TEDx speaker, a Singularity University speaker and guest at numerous interviews for radio and podcasts. He is open to public speaking and advising engagements.
Well said about Esformes. Wait until crypto pump and dump and ponsi schemes hit. Brought to you by recently pardoned con men.
I will try to point out how stupid this article is, analyzing it quote by quote
1) “Universal access desired, but must preserve incentives (no waitlists like socialized systems). US superior outcomes but high cost.”
—In every EU nation, you do not need to figure out in-network/out-of-network hospitals/doctors/clinics. If you get sick, you have a doctor, or you can go immediately to the hospital. This makes the process already faster. In a hospital, you wait based on a TRIAGE system, so severe cases are treated first. You wait if you went to the hospital, and your situation can wait. Medical exams and checkups are scheduled on a regular basis (6 months, 12 months, and so on). It does not mean that you have to wait to get a medical examination it means that your next scheduled medical examination is in 12 months. You usually have a MD that is your MD, or you have a healthcare center of reference, if you go there because you are sick, medical examinations are prescribed WITH A WAITING TIME based on the urgency. Otherwise, you go to the hospital.
I might also note that the view on the “waiting list” is a bit distorted: if an insurance does not cover a medical procedure or medical examination, that procedure will not be done, so your “waiting list” is de facto infinite.
—The US does not have superior outcomes. Life expectancy is lower, with more chronic diseases (so not only is it lower, but it is worse), even for insured people.
2) “AI & self-directed healthcare”
—Technology is not the issue. EU healthcare is not cheaper and better because it has better tech. The tech is the same. It is the business model of US healthcare that drives up costs and reduces performance. AI can replace doctors, sure, but if the cost goes down, and you have a fiduciary duty to increase profits, you can simply maintain the price the same.
3) “Negotiated prices drop dramatically ($1,200 → $200/month injection, $150 pill). Trump Rx launches soon.”
—That sounds like the concept of a plan…
— You know what would work even better? And the world already figured it out? Centralized national healthcare.
4) “The Medical Fraud Crisis”… “California fraud and accountability.”
—sure sure, these bad democrats and the immigrant gangs… You know what would help to solve the issue of the frauds? Maybe Trump should stop pardoning and commuting sentences for people that has been CONVICTED for billions in Medicare and Medicaid fraud like nursing home magnate Philip Esformes.
—and by the way, the rate of fraud confirmed is less than 3% not 20-30%
5) “Immigration and addiction”
—immigrants (especially illegal ones!) are on average way younger than the population at large and cost less than average healthcare-wise.
—I know that Trump and RFKjr do not get it, but there is also a very important public health reason to maintain health, even the illegal immigrants population: pandemics. This is way, again, in the EU we tend to take care of everybody. If an illegal immigrant is cleaning the floor in the offices of a Fortune 500 through a subcontract from a subcontract cleaning agency, the nation has a REAL INTEREST in him/her going to the hospital if the coughing blood: what is the cost of a board of directors to getting infected with tuberculosis?
All the statements in your article, to me, demonstrate one thing: the general lack of understanding that healthcare is a POPULATION PROBLEM.
— Trump removed health monitoring institutions that were monitoring the Sars viruses in its first time at the White House. And he got the Covid. Now RFKjr is revising the polio vaccine guidelines. This is a complete lack of understanding of the issue…
Well considered and I agree with most of your points.
Unfortunately the US health system seems to be mostly about profit and less about patient care. As an example the new HHS food pyramid recommendations are based on a good start, of discouraging processed food, but then it is explicitly stated to be aimed at supporting producers rather than focusing on end consumer health, so business and profit.
Government and private– premium based– health insurance systems are inherently inflationary allowing hospitals and clinics to easily game the system.
Replacing them with simple Singapore-like government financed (your taxes) and private financed (your job) medical savings account systems would provide universal health care for all Americans while cutting annual expeditures by at least two or three trillion dollars annually!
I remember when the Right complained about Mrs. Obama acting like food police-now they are.
All meds should be over the counter—Doctors keep you coming back to pay them the privilege of having the same meds you always took.
Voltare had them dead to rights.
Pain management they don’t care about.
In our province, pharmacists are allowed to prescribe some medications without needing a doctors prescription. The government has been monitoring this and slowly increasing the range of medications the pharmacist can prescribe.
Enforcement of 15 USC Chapter 1 against the entire medical system (hospitals, insurance companies, drug companies) is what will cut the cost of health care by 80% within months. 15 USC Chapter 1 is 100 year old law that mandates 10 year prison sentences for price fixing of any kind. Thousands of hospital administrators, insurance executives, and pharmaceutical executives need to go to prison. Trump can do this administratively without the need of congress. His failure to pursue this will probably cost him his legacy.
Yes, powerful