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.
