Now we have Dr. Oz and of course RFK "on deck" for CMS and HHS, respectively.

There are many changes that must be made but let me highlight one that must be made on an administrative basis on the first day and then coded into Statute through Congress so it can never be changed in any government-funded medical or health program again by any future adminsitration.

No payment can ever be made on an "incentive" basis except for documented, measurable and quantified success, irrespective of circumstances.

Specifically, what was done during Covid where hospitals were paid for procedures rather than results must be absolutely barred as this perversion almost-certainly led to hundreds of thousands of deaths, specifically by paying hospitals for ICU use, ventilator use, Remdesivir use and finally, a bonus for those who died which is ethically identical to paying someone who commits homicide.

In addition those "incentive payments" were a monstrous budgetary boondoggle while at the same time wildly enriching many hospitals, including the one in my county which cashed in to the tune of millions beyond their ordinary and customary charges for treating persons in those programs.

There is no way to "protect Medicare and Medicaid", as Senator Fetterman says is his condition for supporting Dr. Oz as the head of CMS, other than by collapsing the cost of medical care generally.  It simply cannot be done any other way because roughly four dollars in five spent in that program are not backed by a tax receipt and there no reasonable way to expect that expanding taxation for those programs by a factor of five could be sustained either politically or economically.

I have for more than a decade, and indeed all the way back to when I was running MCSNet in the 1990s, identified that the expansion of CMS as a percentage of GDP, in that the programs were established with the premise of about a 4% overall health care spend in the economy that has now reached 20%, simply cannot continue.

But additional cost-shifting into the private sector, which is rampant in Medicaid and is exploited among Medicare providers, cannot be sustained either.  This is choking the economy and driving uneconomic acts across the board including deficit spending, bubbles in the economy all over the place and inflation that cannot be hidden any longer or sustained.

Fixing that is not (directly) within the purview of either HHS or CMS except as relates to both agency's mandate, under statute generally, to not permit criminal acts of those it contracts with to be ignored.  Specifically, in the context of both Medicare and Medicaid payments made from firms for "compliance" with vaccine and other schedules are, legally, a kickback, explicitly barred under law and such conduct carries felony criminal penalties.  All such acts, including any other act constituting a kickback either form or substance must be prosecuted.

CMS can materially impact cost by, for example, paying bonuses for those people who successfully bring their blood sugar and body mass under control through the use of non-pharmaceutical approaches such as, for example, getting both seed oils and fast carbohydrates out of one's diet.  Objective proof in the form of lack of prescription drug use and documented metabolic results in the form of body mass reduction, glucose control, fasting insulin, hsCRP and blood pressure are all trivially and, with the exception of minor blood draws or finger-sticks for testing able to be shown on a non-intrusive and near-zero-cost basis.

Surprisingly Fox has come out with an article by a physician who echoes much of this.  Where he's wrong is on the statins; the lipid hypothesis has, at this point, been disproved and his adherence to that "religion" is likely why he has insulin resistance problems.  Simply put the problem is systemic inflammation, not cholesterol.  Getting seed oils out of what you eat makes a huge difference -- if you think not pay $200 for a Garmin Instinct that can do overnight HRV and check the impact on HRV yourself when you eat or do not eat them.  Note that it is basically impossible to avoid them in a restaurant so to do this test you must cook at home or be extremely careful if eating out; you can, for example, eat a steak but you cannot have a salad with dressing, virtually any bread or breaded thing or any sort of "butter", fried or grilled anything other than a fatty meat because all restaurants will use these oils rather than tallow, lard or butter for baking and cooking purposes because they're cheaper.  For the huge percentage of people, perhaps everyone, the amount you can consume of these substances without serious negative impact is zero and, incidentally, yes that includes infants and if you really want to freak out look at any bottle of packaged infant formula.  Enfamil and Similac, two common brands by means of example both have listed as their third ingredient seed oils; the amount that an infant, absent their use, would consume and that any mammal has consumed through history other than by our intervention is in fact ZERO.

Further, if drug use is permitted as a means of mitigation then all expense as a consequence of adverse events that have a legitimate risk in the use of said drugs and all costs occasioned by them including the drug itself and all expense due to adverse events or monitoring for same must be directly counted against any such results.  If this was done then statins, for example, would almost-certainly be off the recommendation list because they are a known cause of Type II diabetes and the cost of that, if and when it occurs, is more than the rather-dubious (known at this point) "benefit" from their use.  While punishing a provider for prescribing them is likely unwise if the provider is incented to do whatever works, where "works" is defined objectively both in terms of outcomes AND COST, said providers now have a reason to find and promote that which is cheaper and works rather than simply be paid to "do things."

Many of these changes can -- and must -- be made administratively but they then must also be codified into Statute so that physicians, hospitals and pharmaceutical companies cannot lobby this or a future administration to reverse these rules and screw people for money as occurred in size, and which put into stark relief exactly how prevalent and death-causing it was during Covid.