Here's a sentence I need you to read slowly: the man running America's Medicare and Medicaid programs wants to replace rural healthcare workers with AI avatars — while simultaneously overseeing $1 trillion in cuts to the programs that keep rural hospitals open.
Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, made the pitch at an Action for Progress event focused on addiction and mental health earlier this month.
"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."
He said AI could multiply the reach of doctors fivefold. He proposed robotic ultrasounds for pregnant women. He described a future where a patient doesn't see the image — just gets "digitized insights" about whether the child is OK.
"You take a wand, you don't even see the image — you just get digitized insights that tell you whether the child's OK," Oz said. "And frankly, I don't have to see the image. I just have to know if the image is good enough to tell me the child doesn't have a problem."
The Context Nobody's Connecting
Oz's AI pitch is part of the Trump administration's $50 billion plan to modernize rural healthcare, which includes digital avatars for medical interviews, robotic diagnostics, and medication delivery drones.
But here's what makes this story land differently than a standard tech-optimism headline: it's happening against the backdrop of the One Big Beautiful Bill Act, signed by President Trump last year, which cuts federal Medicaid spending by approximately $1 trillion over 10 years.
Rural hospitals have been devastated. According to the nonpartisan research organization KFF, more than 190 rural hospitals closed between 2005 and early 2024 — about 10% of all rural hospitals in the country. Those closures have accelerated since the Medicaid cuts took effect.
The CDC reports that people in rural counties are more likely to die early from heart disease, cancer, stroke, and other leading causes than urban residents. Many of those deaths are preventable — with timely, quality care.
So the sequence is: cut the funding that keeps rural hospitals alive, watch them close, then propose AI avatars as the solution to the gap you created.
What the Critics Are Saying
Carrie Henning-Smith, associate professor at the University of Minnesota and co-director of its Rural Health Research Center, told NPR that the proposal strips away something essential.
"Health care has always been about humanity and relationship. If your first and only provider is an avatar, we're removing trust, comfort, and continuity."
She also raised a point that deserves more attention: deploying unproven AI technology on already underserved populations is, functionally, using the most vulnerable communities as test subjects.
Rural Americans didn't ask for AI avatars. They asked for the hospital that closed down the road to reopen. They asked for the OB-GYN who left because reimbursement rates made the practice unsustainable to come back. They asked for the pharmacy that shut down to be replaced with an actual pharmacy — not a drone.
CMS, in a statement to NPR, clarified that Oz was emphasizing the need to "responsibly explore tools" that extend the reach of clinicians, not replace them. But Oz's own words — "whether you want it or not" — suggest a vision that's less about exploration and more about inevitability.
Why This Matters
This story matters because it reveals a pattern we're going to see more of: AI being positioned as a solution to problems created by policy choices.
Cut healthcare funding → hospitals close → propose AI as the fix. It's cheaper, scalable, and doesn't require reversing the political decisions that caused the crisis.
There are legitimate uses for AI in rural healthcare. Telehealth has already shown that remote consultations can help bridge gaps. AI-assisted diagnostics can flag conditions earlier. These tools work best when they supplement human care, not when they're deployed because human care was defunded.
The question isn't whether AI can help rural healthcare. It's whether we're using AI to avoid doing the harder, more expensive thing: actually funding it.
When the head of CMS tells rural communities they're getting an avatar instead of a doctor, "whether you want it or not" — that's not innovation. That's abandonment with a tech veneer.
Watch this space. The $50 billion modernization plan is still being rolled out, and the details of how AI tools will be deployed, regulated, and overseen haven't been finalized. The communities that will be most affected have the least say in how this goes.