By MATTHEW HOLT
I have been trying hard to suppress this line of thought but when I woke up in the middle of the night with this piece basically fully formed in my head I couldn’t not write it. Yes I might lose some friends, but someone in health tech has to say this.
Last week a bunch of health tech companies, providers, plans and others went to the White House to an event remarkably called “Make American Health Technology Great Again”. The main organizer Amy Gleason is someone I consider an industry friend. No one can doubt her credentials in wanting to help patients, especially given her daughter Morgan’s medical condition and her awful experience in the health system. The initiatives spelled out–while they are voluntary and based on actions and regulations that are already on the books–will be net net good for American health care, and good for patients.
Now, almost everything proposed is happening anyway. Anyone in health tech knows that it’s much easier to get health data and to run AI on it than it was in 2020, and it was way easier to get health data in 2020 than it was in 2016. Yes, of course it should be better and easier than it currently is. Yes, it should have happened quicker. Yes, the big provider systems and their main EMR Epic have not exactly bent over backwards to make data access more convenient for patients and innovators. Yes, of course there are too many demands to “send us a fax”. I personally had great fun with a UCSF-affiliated hospital last week, speaking to 5 different people and ending up both emailing and faxing them a referral to get an appointment. I’m pretty sure I’ll be doing the same thing in 2028.
You can read tons more about the plans, the event and the voluntary agreement from luminaries like Lisa Bari and new dad Brendan Keeler.
But none of that is what is troubling me. What is deeply disturbing is the normalization of the people allegedly in charge of the nation’s health and health tech and the nonchalance and even knee-bending of those who went to the event last week.
Now I wasn’t there, even if several industry friends and clients were. I was at several similar events back in the Obama administration, but what we have seen from this Trump administration is a radical and toxic departure from America’s leadership in health and democracy, and it is not acceptable.
This is encapsulated by the people on the dias, and the actions they have taken.
Trump and his administration have committed so many egregious authoritarian acts that there’s no way to list them all. Just because people voted for him and the Congress and Judiciary is neutered does not obviate the fact that he was – deep breath – convicted of rape and separately found to be lying about mortgages in a civil court; convicted of 34 felonies for essentially tampering with the 2016 election; and impeached twice–once for politicizing America’s foreign policy and once for starting a violent coup. Don’t forget that at the time of the 2024 election he was being–another deep breath–prosecuted for stealing (and presumably selling) state secrets; being prosecuted for vote tampering in Georgia; and being prosecuted for planning the coup on Jan 6. It’s worth pointing out that two countries that have recent experience of dictatorships (Korea and Brazil) have both prosecuted and banned from office the leaders who attempted similar crimes there. (Incidentally I highly recommend you watch I’m Still Here, the Oscar-winning story of one family whose father was “disappeared” under Brazil’s military dictatorship in the 1970s).
Since his return to office, Trump has overseen the greatest direct political corruption ever in this country – you can bribe him directly via his memecoin. He has also overseen the transformation of ICE into an American-style Gestapo. Masked unidentified ICE agents are now snatching people, including both citizens and legal immigrants, off the streets and burying them in concentration camps here and abroad. Don’t forget that many immigrants or first generation immigrants are heading up those health tech companies at the meeting last week, not to mention how many poor, and perhaps undocumented, immigrants are working in our health care system.
I haven’t even mentioned the impending cuts to Medicaid, the program for the poorest Americans, which will be the result of Trump’s “One Big Beautiful Bill Act”. That is sure to have a terrible effect on patients and on much of the health system, including many health tech companies trying to support Medicaid patients.
I didn’t even mention Epstein! And this is the guy America’s health care community wants to go and politely applaud just because he reads a speech about interoperability?
And it doesn’t stop there.
Don’t forget RFK Jr was allegedly a Democrat running as an “independent” whose support was bought by Trump promising him the HHS job. Who knows? That may have been enough to swing Trump the election.
Kennedy’s denial of science is long standing and continues to this day. Just last week he was spouting falsehoods about a massive Danish study that proved vaccines were unrelated to autism. He’s dismantled a panel of experts advising the nation about vaccines, replacing them with his buddies who exist to misinform and grift, and have no expertise on the topic. I’ll forgive his heroin addiction, his brain worm, his bizarre wildlife disposal and planned eating habits. I won’t forgive him abandoning science and engaging in the wholesale destruction of America’s health management infrastructure in the cruelest way.
The people getting selfies with him at last week’s event should be considering that too.
Dr Oz was at one time a reputable surgeon. Somewhere along the way he forgot whatever scientific training he had and became a con artist. He was basically kicked out by Columbia for his anti-science stance and raked over the coals by a Congressional committee for his grifting and promotion of useless supplements. My favorite moment came in his (thankfully) unsuccessful 2022 PA Senate run when he said that abortion should be a decision between a woman, her doctor and local politicians.
Trump gave Oz the CMS job because Oz is a suck up and because Trump had seen him on TV. Oz has been associated with plenty of digital health companies, notably Sharecare which is more or less still in business and which was at the meeting last week. But given his total lack of credibility, why would the rest of the American health tech community want to associate with him?
The last two people on the dais were Amy Gleason and David Sacks. Remarkably both Sacks, promoted to “Crypto Czar” from his time on the Sili Valley Bros “All in” Podcast, and Gleason were both introduced as being the acting head of DOGE. (Saks by RFK Jr and Gleason by Oz). Who knows? Maybe they are both heads of DOGE?
Gleason certainly had a very close relationship with Brad Smith, the baby-faced assassin who was largely responsible for both the unthinking blood-bath at HHS and the naked vandalism of the cuts to in-progress NIH grants. She worked directly with Smith at the Bill Frist-funded Russell Street Ventures, which created and sold Carebridge to Elevance for $2.7bn. What exactly her role was in the early days of DOGE is unclear, but she was there for sure as head of the US Digital Service and named as acting head of DOGE in court in early March. Meanwhile, in addition to the wanton vandalism at NIH (that continues on), there was massive destruction caused by DOGE in the time when Musk, Smith and others were careening around DC. (You can see Smith discussing it at 13.26 in This Fox “interview” with Musk & his core DOGE team in March 2025).
DOGE was of course also responsible for destroying USAID in the early part of this Administration. This is already causing deaths among the poorest, most defenceless people in the world. A study in the Lancet predicts the demise of USAID will cause 14 million deaths including over 4 million children by 2030. And of course there’s little evidence DOGE actually saved any money, plenty that it squandered over $20Bn, and in the grand scheme of things, anything it did was a rounding error compared to the addition to the future increase to the deficit caused by the “One Big Beautiful Bill Act.”
Again, it’s not clear exactly what if anything Sacks and Gleason had to do with this, but they were clearly not not involved! Are the proponents of those actions the people you’d want to tell your kids you took a selfie with?
It is clearly not easy to deal with this Administration. Big media companies like Paramount are bending the knee. Law firms are kowtowing, with bad consequences for the independence of the bar and judiciary. Leading universities are paying them off in the hope to get Federal funds flowing again. Big tech is all in. Even as big, solid and rich an organization as Kaiser Permanente decided it was easier to end its science-based gender affirming care for teens, than to get in a spat with HHS. (Children’s Hospital Los Angeles and Stanford Medicine did the same).
Of course there are many very unpleasant people enjoying what’s happening in America right now. Private prison companies like GEO Group and CoreCivic are celebrating building concentration camps all the way to the bank. And a Miami-based couple, who bribed contributed $1.9m to Florida Gov Desantis and his wife, run CDR Maguire and its affiliated company, CDR Health which built “Alligator Alcatraz” and “treat” the health concerns of thousands of detainees. Plenty of corporations and industrialists got rich off Franco, Mussolini et al.
But for the leaders of the health tech companies and health systems involved last week, there was an easy choice. No one is saying they have to stand on the barricades and shout down every action of the Trump Administration that contravenes the constitution and veers America towards authoritarian rule. But they can quietly sign on to the interoperability pledges, advocate for the right things, and act in the right way without giving air cover to an Administration that is behaving as badly and wrecking the freedoms of the country as badly as this one. When their kids ask them what they did during the Trump Administration, will they be proud of themselves?
Matthew Holt is the Founder/Author/Publisher of THCB
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