It’s one of life’s sick ironies that many of the people who’ll suffer most under Donald Trump‘s policies are his most passionate supporters. But then, this shouldn’t be surprising, as rural Americans enthusiastically voting against their interests has been the bedrock of Republican success for decades.
Deep red Trump counties in deep red states have the highest poverty, lowest standards of living, and the most reliance on social security. If this were a logical world, you might expect these people to support candidates with social policies designed to benefit them.
Perhaps scared by rural voters’ dissatisfaction with seeing their local hospitals closed due to the Medicaid cuts, the Trump administration recently launched the Rural Health Transformation Program, which promises a commitment to “modernizing facilities and technology, and deploying innovative care models”.
Now we know what one of those changes is. As Dr Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, explained, rural communities are going to have to make do with an AI chatbot instead of a human doctor:
Dr Oz on rural healthcare: "There's no question about it, whether you want it or not — the best way to help some of these communities is gonna be AI-based avatars" pic.twitter.com/Zglys1vfrH
— Aaron Rupar (@atrupar) February 2, 2026
“I’m telling you right now, there’s no question about it, whether you want it or not — the best way to help some of these communities is gonna be AI-based avatars.”
“It’s actually sort of cool!”
Oh great, so it’s goodbye to kindly Doctor Smith and hello to the cold digital brain of Dr ChatGPT. Oz went on to wax lyrical about how great these chatbots are:
“Generative AI, capable of.. they do the intake. They catch the patient, customize to what their needs are, understand what they’re up to. Please go and play with these tools, they’re unbelievable. They’ll pick up subtle little nuances in how you’re saying things, if you do it on purpose, it’s actually sort of cool to find out that will alert the… the avatar.”
Oz is clearly aware that sick people don’t want a chatbot, they want a human being and goes on to emphasize that the AI will “report to” a human doctor. But he says they’re going to use AI “thoughtfully” and “do it right”, noting that AI might specifically be better for people suffering mental health issues.
Whatever the science or reasoning behind this, it’s worth underlining that there’s a huge unspoken factor that Oz isn’t mentioning. You don’t have to pay AI chatbots, so encouraging people to speak to them instead of doctors will save his department a lot of money. So, you’ll talk to a robot and you’d better like it, because a human being might be more than you can afford.
