174. Dr. Mehmet Oz: The BIG Problem with America's Healthcare System Nobody Talks About

its very core, we're sicker people.

And what's the best way to reduce how much we spend on pharmaceuticals?

Make people healthier.

If they're healthy, they don't need the pills.

And yet our life expectancy keeps slipping.

If you wanted to cut a person's life expectancy in half, put them in isolation.

If you don't have another person in your life, that you can crutch on that can support you.

But because we're supposed to be in community and supporting each other, many of these chronic illnesses begin to grow.

I think we think of chronic disease, we look at these very myopically as later in life-borne illnesses.

And what's really really scary about this report is the age at which this seed is being planted and the necessity for us to take dramatic action.

We have definitely made it hard to be healthy in America.

80% of obese teens remain obese into adulthood.

And this is a big problem to solve.

Where do we start?

A major driver of all of this, and the number one driver of costs overall for what I do.

Hey guys, welcome back to the Ultimate Human Podcast.

I'm your host, human biologist Gary Brecker, where we go down the road of everything: anti-aging, biohacking, longevity, and everything in between.

And today's guest, Dr.

Mehmet Oz, is the 17th administrator of the CMS, the Centers for Medicaid and Medicare Services.

Before we even get started, I just want to interject a personal anecdote here.

You came to my home a little over a year ago, I think with Steve Wynn and the wives.

And I just want to say for the people watching this podcast, very sincerely from my heart,

you struck me as a very passionate, purpose-driven human being.

I don't think anyone sits in this seat, takes on the role that you're taking

because they want to be rich and famous.

It's because they want to make a difference.

Thank you very much.

I had a strong sense of that when you were in my home and we got to know each other a little bit.

And I just wanted to start with that because I think a lot of times, you know,

people

take a very slanted view of people in public policy positions of power.

And it's important to know that some of the people that I've gotten to know in this administration are some of the most passionate, purpose-driven, intentional human beings that I've ever met.

And you're one of them.

So

it's a great honor to be sitting here next to you.

You know, when we walked in, I've got a whole list of questions for you, but you handed me a life expectancy and health expenditure per capita by country.

I don't think it's any secret that we are the biggest spender on healthcare worldwide.

What are we getting for it?

Well, that's the big challenge that we have at the Centers for Medicare and Medicaid.

We got to figure out why is it we're paying twice as much as every other developed country or more.

And yet our life expectancy keeps slipping.

when i was going through medical school we were roughly equal with europe now we're about four or five years behind

four or five years four or five years that's a massive decline and you start to search for why that is and it has to do with this maha report more than you would think at its very core we're sicker people and when you have chronic illness and that drives probably 70 of all the expenditures then you're sort of stuck in a bind.

And what's the best way to reduce how much we spend on pharmaceuticals?

Make people healthier.

Yeah.

If they're healthy, you don't need the pills.

So who cares?

There wasn't even a chronic medication concept until the birth control pill.

So what really sort of got this whole thing going was this concept, was this belief that instead of doing the right thing with your lifestyle, it wasn't your fault.

And sometimes it's not, by the way, but sometimes it is.

So if you sprinkle a statin drug on a kiobasa, it doesn't make the sandwich any better.

So that's the fundamental disconnect.

And the Maha report.

that we're so proud about is fundamentally about curiosity.

What do you actually want to know about why we're sick?

And if you're courageous enough to ask the question and act on what you've learned, you ruffle some feathers.

Get back to the point you brought up.

People don't like you as much because you're saying things that are inconvenient.

Right.

Inconvenient, but the inconvenient truth.

But the good news is that we can do something about it.

And I think getting away from the victim mentality, taking responsibility for some of your own healthcare choices, realizing that maybe it's not the governmental elite

and entities that are going to take care of you.

Some self-responsibility is required on this journey.

I want to talk about it.

I haven't seen the full report, but I have a couple of notes here, some extractions from it.

And some of these statistics are very scary.

Over one in five children over six years old are obese, which is a 270% increase since the 1970s.

The U.S.

obesity rate is more than double that of the G7 countries.

80% of obese teens remain obese into adulthood.

And so this is a, you want to talk about a pandemic.

And this is a pandemic.

And this is a big problem to solve.

And where from a government public policy standpoint, where do we start?

Let's put some numbers on the risk factors you identified.

So if an obese child costs about $2,000 more per year than a child who's not obese, that's roughly 50% more than it would normally cost.

And remember, half the kids in America are on Medicaid or CHIP, children's health insurance.

Half the kids in America.

Half the children in this country.

So we're paying for half the kids as a government.

So if the kids are sick, we're footing the bill.

We pay now, we pay later.

You improve their school lunches, you improve SNAP, this food stamp system, you help kids understand that where they have agency over their future.

You know, you mentioned that

over the age of six, you've got this, you know, significant upswing in obesity rates.

But the downstream problems from that are, for example, diabetes and pre-diabetes.

A quarter of children, a quarter are pre-diabetic now.

That is tens of thousands of dollars over their lifetime.

A quarter of kids have allergies.

We've had increases in things like celiac by tenfold in a generation.

These are crazy numbers.

You can't even begin to put your arms around them.

A quarter of teenage boys are believed to be ADHD, and a quarter of women, children,

young girls under the age of 18 have significant depression.

Suicide rates are way up because of that.

Anxiety rates are way up.

I mean, everything in between.

And this comes back, back, I think, Gary, to some fundamental issues, and I'll bring one of them up right off the bath.

This is not a government solution.

A major driver of all of this and the number one driver of costs overall for what I do is loneliness.

Really?

If you don't have another person in your life that you can crutch on, that can support you, we are social beings.

Absolutely.

So most of my brain right now is functioning on your face and is designed to very precisely intuit every single micro change in how your facial expressions are altering based on whether you're bored or on, or on board.

Are you upset with me?

Are you endorsing me, embracing me?

It's all read pretty subconsciously, but we're not using our brains if we're lonely.

Plus, the things you're doing that make you lonely might be a problem as well.

But because we're supposed to be in community and supporting each other, and young people aren't doing that, many of these chronic illnesses begin to grow.

That stated, we have definitely made it hard to be healthy in America.

No question.

For young kids who are the canaries in the coal mine, it's that much more evident.

And it's manifesting itself in a whole slew of chronic illnesses that we...

That are getting younger and younger, too.

I think we think of chronic disease and the pandemic of chronic disease and morbid obesity, type 2 diabetes, multiple chronic disease in a single biome.

I think we look at these very myopically as adult-borne or later in life-borne illnesses.

And what's really scary about this report in particular is the age at which this seed is being planted and the necessity for us to take dramatic action.

You know, it's interesting that you talk about community, sense of of purpose and connection, because when you look at the blue zones, there really was no continuity in diet, right?

It wasn't a dogmatic diet.

It wasn't carnivore, keto, paleo, pescatarian.

It was a whole food diet

that had people living the longest.

But the two non-negotiables were sense of community and purpose and mobility into later in life.

And I have a background as a population mortality expert for 20 years.

I was in the research space in population mortality.

We knew that if you wanted to cut a a person's life expectancy in half at any age, put them in isolation.

Wow.

So I find it really fascinating that you bring that up because this is one of those nebulous

concepts of community, sense of purpose, connection.

I feel like because of social media, because of a lot of reasons, you know, lack of recess, just lack of activity,

we've lost the human connection.

We've lost our connection to nature.

We've lost our connection to one another.

And people are becoming more and more isolated in plain sight.

It's hard to build connectivity through your iPhone.

So I wonder if you might talk about that for a moment.

And before we wrap, I definitely would like to address some of the narrative.

I find it to be highly false, but a narrative that your intention is to cut spending, cut services,

reduce access to healthcare.

I don't think anything could be further from the truth.

But I want to give you a chance with my audience to address that specifically.

So I'm a heart surgeon.

And I made a rule early in my career that I would not operate on patients who came to the office alone.

Wow.

Because heart surgery is life and death, measurably life and death.

So not everyone's going to make it through the procedure.

And if you don't have anyone that you think you can bring with you to the office to talk about this, that's a concern for me.

It's a concern because you might actually think it's true, and I'm sure it's not.

There's someone who cares about you.

But there's also the possibility you've done things to force those folks away.

So I would push, they would always deliver, they'd find a dormant or a cousin or estranged kid, and they'd bring them back into their life.

And I'd say to them, I need to celebrate the success of your operation with somebody.

When you're under anesthesia and I finish, who am I going to high five with?

And that message generally got them out of their shell and to do some of these things we're talking about.

There are massive opportunities for us to improve the way we think about healthcare delivery.

I'll give you one concrete example.

There are programs around the country where they take older folks who are living alone at home and they support them in these community health centers.

They're called PACE centers.

And so these PACE centers are designed to get you doing yoga and dancing and singing and just eating lunch together.

And then you go back to your own home and you're lonely at night oftentimes.

But back the next morning, they transport you and off you go.

It dramatically slows

the amount of time that people are in long-term care facilities, reduces it because you're living in this community setting instead of being in some nursing home.

It also seems to improve their health outcomes.

They've got doctors there.

And I like those kinds of approaches.

And I'll give you one concrete example.

I was visiting one in San Francisco last week.

And as we're dancing with these octogenarians, the little old lady next to me steps on a dumbbell, which she was using earlier, falls back, and bang, smacks her bottom.

Now, normally what happens then is as you smack your bottom, you smack your back, you smack your head, you get a subarachnoid hemorrhage or subdural hematoma.

Now you have to be in the hospital for weeks.

They try to drain it.

You get infections.

You have to be in a respirator, ventilator, all this stuff.

Instead, this woman tensed her core, held her neck up because she'd been dancing and exercising for months in this center, and she rolled and got back up again and started dancing.

And that's the difference between frailty and non-frailty.

Very as concrete as you can say it.

And you know, frailty is the single biggest predictor as you get older.

If you can't walk a mile, it means a lot.

You can't like a quarter mile, it means a lot.

This woman fell and did something a child does because she's,

though she's in her 80s, figured ways to go past that.

You asked me about what we're going to do in Medicaid in particular.

It is imperative that we protect Medicaid and not let anything hurt the people that every great society protects.

And we're great people, so we're going to do that, which is protect the vulnerable.

When you walk into the building that Bobby Kennedy and I work in, which is the Health and Human Services Building, it's called the Hubert Humphrey Building.

And Humphrey has a quote on the left side as you walk in.

He was there when they signed the original bill 60 years ago that created Medicare and Medicaid.

And it says that it's the moral obligation of government to protect those in the dawn of life, those who are young, those in the zenith, the twilight of life, the older folks, seniors, and then those who are living in the shadows.

That's our job.

But what has happened to Medicaid now is legalized money laundering, tons of waste, fraud, abuse,

structural challenges to allowing it to truly serve those people by expanding it to able-bodied populations who also deserve to have it if they're trying to either work or volunteer or get educated or just take care of of the rest of the family.

There's many reasons that you might not be able to go to a job, but you've got to show that you're trying, that you have agency over your future, that you care.

And that's the big disconnect.

It's amazing to me that there's so much vitriol about this because if you ask the average American, 80%

80% will say, yeah, if there's someone sitting in my basement that I don't know and they're getting something free like health insurance, which is important, and they're not even willing to pick up the phone, make a phone call to try to get a job or volunteer somewhere or

go get educated or take care of the kids, do something vacuum right right if they're not willing to do any of those things then do they really deserve it for free and we do this for food stamps already snap programs say yeah we'll give you food we don't want people to be hungry in america but you got to prove that you're trying to help a little bit right that's the break point in america right now and i think this is an argument the moral high ground this argument is to protect those original folks make sure nothing ever gets in the way and if you bankrupt the system you're hurting those people I couldn't agree with you more.

And it's interesting that there's actually a financial component to this that could really save our country from the burdening debt of health care.

I mean it's got to be one of the fastest, most ballooning areas of expenditure in our in our family.

Healthcare is growing at 2 to 3 percent faster than the rest of the economy.

It is the number one budget item for most governors that's increasing and they can't keep up with it.

Our states are crowding out education, child services, all the things that a state government is supposed to do.

They don't have the money because they're paying for Medicaid.

So we're trying to lead by taking bold action.

This is a generational opportunity to make a difference.

The people who come into this administration, led by President Trump, Secretary Kennedy, they are brave folks.

They are curious people, and they're courageous enough to act on what they learn.

And we're trying to do it with compassion for the people who really, really get hurt if you don't do it.

And there are plenty of special interests that don't like that because they might get hurt too.

Well, we're blessed to have passionate, purpose-driven people like yourself at the top of our agencies, really looking out for the future of healthcare.

I'm excited about this report.

I think it may rattle a few cages

based on what I'm seeing here.

But I'm happy to see there's people like you trying to fix it.

Thank you for coming on the ultimate human.