Dr. Oz's AI Health Care Push Sparks Rural Debate

Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services, has proposed using artificial intelligence avatars as a solution to America's rural health care crisis. Speaking at an Action for Progress event focused on addiction and mental health, Oz suggested AI could multiply doctors' reach fivefold without burnout, as part of a broader $50 billion Trump administration plan to modernize rural health care.

Oz's vision includes digital avatars conducting basic medical interviews, robotic systems for remote diagnostics, and drones delivering medication to areas without pharmacies. He even suggested replacing in-person obstetric care with AI-guided ultrasound devices, arguing that digitized insights could determine fetal health without clinicians viewing actual images.

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The proposal comes at a critical time for rural health care. According to KFF research, over 190 rural hospitals have closed between 2005 and early 2024—about 10% of all rural hospitals nationwide. These closures have left many communities without local medical facilities, forcing residents to drive long distances for basic and emergency care. The CDC reports that rural residents face higher mortality rates from five leading causes compared to urban populations, with many deaths preventable through timely care.

However, the timing of Oz's AI proposal has raised eyebrows. Rural hospitals have already faced steep cuts under the One Big Beautiful Bill Act, which reduces federal Medicaid spending by approximately $1 trillion over ten years. This financial pressure compounds existing challenges including limited provider access, longer travel times, fewer emergency services, higher poverty rates, and lower insurance coverage in rural areas.

Critics argue that AI avatars cannot replace the human connection essential to health care. Carrie Henning-Smith, associate professor at the University of Minnesota and co-director of its Rural Health Research Center, emphasizes that "health care has always been about humanity and relationship." She warns that making avatars the first and only provider removes trust, comfort, and continuity of care.

Henning-Smith raises several concerns about testing unproven technology on already underserved populations. She questions whether rural communities should serve as "guinea pigs" for AI health care, pointing to logistical challenges including unreliable broadband, low health literacy, and fragile transportation systems. Without stable digital infrastructure, AI systems could deepen existing health care gaps rather than bridge them.

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The economic implications concern rural advocates as well. Henning-Smith notes that when local health care workers like nurses and doctors are employed in rural towns, their salaries circulate within the community. Replacing these jobs with AI tools developed in Silicon Valley would divert money away from rural economies, potentially causing broader economic harm beyond health care access.

Supporters of AI in health care argue the technology could help rather than replace rural providers. Matt Faustman, co-founder and CEO of Honey Health, develops AI tools designed to automate administrative tasks for providers. He notes that 30-40% of physician time gets absorbed by paperwork, including managing fax inboxes, processing prior authorizations, and retrieving patient records. Automating these tasks could free clinicians to focus on patient care, particularly in rural settings where clinics may lack large administrative teams.

Faustman also sees potential for AI to serve as initial triage or early access points when the right provider isn't immediately available. This could help rural patients get directed to appropriate care more quickly, addressing one of the key challenges in rural health care delivery.

However, critics maintain that AI cannot replicate the nuanced aspects of clinical care. Henning-Smith argues that AI cannot read facial expressions, tone of voice, or body language—elements where patient-provider relationships are built. Even when AI tools are accurate, they cannot offer the reassurance or cultural sensitivity that comes from trusted clinicians, particularly in communities where medical system trust is already fragile.

Public reaction to Oz's proposal has been largely skeptical. Social media users questioned whether rural communities want AI doctors when many still lack reliable internet access. Others mocked the idea of replacing nurses with "cartoons," while a few defended the concept as better than no care at all.

CMS has stated that Oz was emphasizing the need to "responsibly explore tools" that can extend the reach of licensed clinicians, not replace them altogether. The agency supports using AI-enabled tools when they are evidence-based, patient-centered, and used appropriately under clinical oversight.

Oz has not provided a full implementation plan, and it remains unclear whether AI avatars will become a formal part of CMS's rural health strategy. Henning-Smith hopes the conversation doesn't end with cost savings, asking whether Oz would want an avatar treating his own family. She warns this approach could create a two-tiered system—one for those with resources and another for those without.

The debate highlights fundamental questions about the role of technology in addressing health care disparities. While AI may offer solutions for administrative burdens and initial triage, critics argue that replacing human clinicians with avatars risks undermining the trust, relationships, and economic stability that rural communities desperately need.