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The PC gave us computing power at home, the internet connected us, and mobile let us do it pretty much anywhere. Now generative AI lets us communicate with technology in our own language, using our own senses. But figuring it all out when you're living through it is a totally different story. Welcome to Leading the Shift.
a new podcast for Microsoft Azure. I'm your host, Susan Etlinger. In each episode, leaders will share what they're learning to help you navigate all this change with confidence. Please join us. Listen and subscribe wherever you get your podcasts. Hey, everybody. Welcome back to the Elon Musk Podcast. This is a show where we discuss the critical crossroads that shape SpaceX, Tesla, X, The Boring Company, and Neuralink. I'm your host, Will Walden.
How exactly is Elon Musk's Department of Government Efficiency getting access to sensitive federal systems? And what impact could this have on Medicare and Medicaid funding? And also, why are career government employees sounding the alarm right now? Let's break it down and see what happens inside U.S. health agencies as DOGE officials move in, gaining access to key financial systems.
Now, in recent days, representatives of Musk's Doge have visited multiple federal health agencies, including the Centers for Disease Control and Prevention, the CDC in Atlanta, and the Centers for Medicare and Medicaid Services, CMS. According to five people familiar with the matter, Doge officials have requested access to payment and contracting systems, which handle hundreds of billions of dollars in annual health care payments.
Now, the Wall Street Journal previously reported that some of these requests have been granted, allowing Doge personal access to CMS's grant management system. Elon Musk himself appeared to acknowledge Doge's focus on federal health care spending, writing on X that Medicare is, quote, where the big money fraud is happening.
Now, he did not provide specific evidence to support his claim. In response to the growing involvement of Doge officials, HHS spokesperson Andrew Nixon stated in an email that two senior CMS officials, one responsible for policy, another for operations, are overseeing Doge's collaboration. Now, Nixon said the department is assessing, quote, where there may be opportunities for more effective and efficient use of resources in line with meeting the goals of President Trump.
Now, the Department of Health and Human Services, the HHS, is responsible for merely $2 trillion in annual spending, much of it on Medicare and Medicaid. And these programs have long been scrutinized by both lawmakers and dependent watchdogs for potential fraud and waste. Now,
Now, Musk, along with his former Doge partner, Vivek Ramaswamy, has previously spoken about targeting health care spending as part of the broader plan to cut at least $1 trillion from federal expenditures. However, past attempts to reduce Medicare costs have often sparked backlash from health care providers and advocacy groups concerned about the impact of patient care.
Doge's efforts to gain access to financial systems extend beyond health agencies. Over the weekend, Treasury Secretary Scott Besant authorized a Doge representative to access a crucial federal payment system that disperses trillions of dollars annually. Besant later clarified that the access was limited to read-only status and that the Doge representative had been formally appointed as a Treasury official.
Now, Musk's allies have also taken on key roles within the Office of Personal Management and other government agencies. Some career government employees are increasingly concerned that Doge is bypassing standard procedures designed to protect sensitive data. One primary fear is that Doge officials who are not long-term civil servants may not be subject to the same oversight as corruptors.
career government workers. Now, while Musk and President Trump have defended these actions as necessary for rooting out waste, others question whether Doge is circumventing established safeguards. Now, concerns about improper payments in Medicare and Medicaid are not new, though. Avik Roy, who's the founder of the Foundation for Research on Equal Opportunity, pointed to longstanding bipartisan concerns about waste in these programs.
They said nonpartisan experts have long believed that more than 10% of Medicare and Medicaid spending is improper. It's essential to identify and root out these improper payments in order to direct more funding to patient care for seniors and vulnerable populations, Royce said. Now, a report from the Government Accountability Office, the GAO, in April 2024 found that Medicare and Medicaid accounted for over 40% of improper payments across the federal government.
Now, the GAO estimated that these programs were responsible for more than $100 billion in erroneous payments in 2023 alone. Now, while efforts to reduce fraud are widely supported, the extent of DOJA's authority and its methods for addressing the issue remain unclear. Now, DOJA officials have also sought access to specific federal financial systems, including the Unified Financial Management System and the Healthcare Integrated General Ledger Accounting System,
or High Glass. Now High Glass contains financial information for hospitals, physicians, and other healthcare providers that receive payments from Medicare, Medicaid, and the Affordable Care Act. This database is considered highly sensitive as it tracks nearly all federal healthcare payments.
Now, accessing these systems typically requires specialized training under the Health Insurance Portability and Accountability Act, or HIPAA, to ensure compliance with privacy protections. It is not yet known whether DOJ officials have undergone this training or if they have been granted full access to the systems. Some current and former government officials have raised concerns about potential violations of privacy laws if untrained personnel are handling sensitive data.
Now, beyond financial systems, though, DOGE has also made personnel-related inquiries. At the CDC, DOGE officials have requested lists of employees with less than a year of service, as well as those in their two-year probationary periods. The purpose of these requests has not been made clear, but some federal employees have interpreted it as an attempt to assess which staff members could be more easily removed or reassigned.
Doge's reach is not limited to health agencies, though. At the Department of Labor, senior leaders have informed staffers responsible for handling sensitive data that they will soon be working with Doge. And according to a Labor Department employee who spoke on the condition of anonymity, these new Doge-related assignments will take precedent over the staff's usual responsibilities.
The collaboration is set to begin with an initial meeting, which was originally scheduled to take place in person, but was later shifted to a virtual format. Now, the decision to move the meeting online came after labor unions, including the AFL-CIO, announced a protest against Doge outside the labor department. Union leaders have expressed concerns that Doge's involvement could lead to workforce reductions and
policy changes, or reduced oversight of work protections. The Labor Department oversees critical data related to unemployment claims, disability insurance, workplace safety investigations, wage theft, and child labor violations. It also enforces whistleblower protections across multiple industries, including food safety, aviation, and nuclear energy. It remains unclear exactly which Labor Department records DOGE intends to access. It
Some federal employees worried that DOJA's push for efficiency could come at the expense of regulatory enforcement, potentially weakening protections for workers. Others argue that scrutinizing agency operations is a necessary step towards eliminating efficiencies in government spending. And while the full impact of DOJA's efforts remain uncertain, the group's rapid expansion into key federal agencies has raised questions about transparency.
oversight, and the long-term consequences for government operations. But for now, agencies and officials and watchdog groups are monitoring the situation closely to see exactly how much access Doge ultimately gains and how it chooses to use it, and if they use it illegally.
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