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Donald Trump appears to experience the world through the glow of a television screen. He has long placed a premium on those who look the part in front of the camera. Paging Dr. Mehmet Oz.

Trump has picked Oz to lead the Centers for Medicare and Medicaid Services. CMS, as the agency is known, falls under the Department of Health and Human Services (HHS). Last week, Trump nominated Robert F. Kennedy Jr. to serve as HHS secretary. As you may have guessed, Kennedy and Oz are not only friends but kindred spirits. Oz is a global adviser at iHerb, a for-profit company that offers “Earth’s best-curated selection of health and wellness products at the best possible value.” He and Kennedy, two relative outsiders, are now positioned to enjoy a symbiotic relationship within Trump’s chaotic ecosystem.

Oz was last seen running for a Pennsylvania Senate seat in 2022. He lost to John Fetterman, who, despite dealing with the aftereffects of a stroke, carried the state by five points. Throughout that race, Oz struggled to combat the perception that he was a charlatan and carpetbagger who primarily lived in New Jersey. (Fetterman’s team repeatedly tagged Oz as an out-of-touch elitist, trolling him, for example, when he went grocery shopping for crudités and lamented high prices.) After that electoral defeat, Oz’s political dreams seemed all but dashed. But he wisely remained loyal to Trump—a person who has the ability to change trajectories on a whim.

In the pre-Trump era, it might have been a stretch to describe CMS administrator as an overtly political position. But Oz’s objective under Trump couldn’t be clearer. In a statement, Trump, using his reliably perplexing capitalization, telegraphed that Oz will bring a certain ethos to the job—a little MAGA, a little MAHA. Oz, Trump promised, will “cut waste and fraud within our Country’s most expensive Government Agency, which is a third of our Nation’s Healthcare spend, and a quarter of our entire National Budget.” And, because he’s Trump, he mentioned Oz’s nine daytime Emmy Awards.

Some 150 million Americans currently rely on the agency’s insurance programs, including Medicaid, Medicare, and Obamacare. Oz has been a proponent of Medicare Advantage for All. Though that sounds like the Medicare for All initiative championed by progressives such as Senator Bernie Sanders, the two programs are quite different. At its core, Medicare for All would set the U.S. on a path toward nationalizing health care. Trump would never go for that. But Medicare Advantage already exists within America’s patchwork private/public system, and Oz might push to strengthen it. He could also face budgetary pressure to weaken it. Oz’s own health-care views haven’t remained consistent. Though he once praised the mandatory universal models of Germany and Switzerland, as a Republican politician he threw his support behind privatized Medicare.

When asked about Oz’s nomination, Fetterman, his former opponent, told CNN: “As long as he’s willing to protect and preserve Medicaid and Medicare, I’m voting for the dude.” Some people were pissed. Victoria Perrone, who served as the director of operations on Fetterman’s Senate campaign, called out her old boss on social media: “Dr. Oz broke his pledge to ‘do no harm’ when he said red onions prevent ovarian cancer. My sis died of OC in 6/2022. This is a huge personal betrayal to me. We know he won’t protect the Medicaid that paid for her treatments,” Perrone posted on X. “I feel like I’ve been duped and 2 years of working on your campaign was a waste,” she added.

The above argument is illustrative of another reality Trump acknowledged in announcing his pick: “Make America Healthy Again” keeps growing. Oz, Trump declared, “will work closely with Robert F. Kennedy Jr. to take on the illness industrial complex, and all the horrible chronic diseases left in its wake.” He went a step further, promising that Oz will bring “a strong voice to the key pillars of the MAHA Movement.” Oz holds degrees from Harvard and Penn, and he worked as a professor of surgery at Columbia. In spite of that pedigree, Oz has spent years facing credible accusations of medical quackery for his endorsement of dietary supplements. In 2014, he received a dramatic dressing-down on Capitol Hill. Senator Claire McCaskill read three statements that Oz had made on his eponymous show:

“You may think magic is make-believe, but this little bean has scientists saying they’ve found the magic weight-loss cure for every body type: It’s green coffee extract.”

“I’ve got the No. 1 miracle in a bottle to burn your fat: It’s raspberry ketone.”

“Garcinia cambogia: It may be the simple solution you’ve been looking for to bust your body fat for good.”

Oz’s defense that day was that his job was to be a “cheerleader” for the Dr. Oz audience. “I actually do personally believe in the items I talk about in the show. I passionately study them. I recognize oftentimes they don’t have the scientific muster to present as fact, but nevertheless, I would give my audience the advice I give my family,” he testified.

He emerged from that hearing largely unscathed. Two years later, Oz would go on to read what he claimed were Trump’s medical records on that same show. He famously praised Trump’s testosterone levels and supposed all-around health. Four years after that, once Trump was president, Oz sent emails to White House officials, including Trump’s son-in-law Jared Kushner, pushing them to rush patient trials for hydroxychloroquine, an unproven treatment for COVID.

In the next Trump administration, those are the sorts of exchanges Oz could be having with Kennedy—or with Trump himself. How did we get here? Oz landed this gig because he’s good on TV, yes, but also because, when he entered the political arena, he fully aligned himself with Trump. The 47th president rewards loyalty. If there’s one thing that’s become clear from his administration nominations so far, it’s that.

Some of Trump’s appointments will be less consequential than others. Anything involving the health and well-being of tens of millions of Americans is inarguably serious. Oz’s confirmation is not guaranteed, but his selection has already confirmed that nothing about Trump 2.0 is mere bluster.

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Evening Read

Video by Joanne Imperio / The Atlantic. Sources: Archive Films / Getty; Internet Archive; Prelinger Associates / Getty.

Put Down the Vacuum

By Annie Lowrey

The other night, a friend came over. A dear friend. A friend who has helped me out when I’ve been sick, and who brought over takeout when I had just given birth. Still, before he arrived, I vacuumed.

I thought about this while reading the Gender Equity Policy Institute’s recent report on gender and domestic labor. The study finds that mothers spend twice as much time as fathers “on the essential and unpaid work” of taking care of kids and the home, and that women spend more time on this than men, regardless of parental and relationship status. “Simply being a woman” is the instrumental variable, the study concludes.

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Stephanie Bai contributed to this newsletter.

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This is an edition of The Atlantic Daily, a newsletter that guides you through the biggest stories of the day, helps you discover new ideas, and recommends the best in culture. Sign up for it here.

A note from Tom:

As we were about to publish this newsletter, Donald Trump announced that he has asked the Fox News personality Pete Hegseth, a military veteran who has no experience in leading large organizations and no serious background as a senior leader in national-security affairs, to be his secretary of defense. This is exactly the kind of unqualified nomination that I was warning could be looming after this first group of nominees were announced—and it explains why Trump is determined to bypass the U.S. Senate to get some of his nominees confirmed. I will have more to say about Hegseth soon.

So far, the new Trump administration has a chief of staff, a “border czar,” and a national security adviser; all three are White House positions controlled by the president. Donald Trump has also reportedly named six people to senior positions that require Senate confirmation: secretary of state, United Nations ambassador, secretary of homeland security, secretary of defense, CIA director, and administrator of the Environmental Protection Agency. (He has also chosen an ambassador to Israel.) His first picks are neither very surprising nor very impressive, but this is only the beginning.

His co–campaign manager Susie Wiles will make White House history by becoming the first female chief of staff. People around Trump seem relieved at this appointment, but she’ll likely be saddled with Stephen Miller as a deputy, which could get interesting because Miller apparently has a tendency to get out of his lane. (According to a book by the New York Times reporter Michael Bender, Miller attended a tense meeting that included Trump, Attorney General Bill Barr, and General Mark Milley, the chairman of the Joint Chiefs of Staff, during the Black Lives Matter protests in 2020. As the nation’s leaders debated what to do, Miller interjected and said that America’s major cities had been turned into war zones. General Milley, Bender writes, turned to Miller, pointed at him, and said: “Shut the fuck up, Stephen.”)

The rest of the appointments are unsurprising, given the limited pool of Republicans willing to serve in another Trump administration. (Some Trump loyalists such as Senator Tom Cotton have reportedly declined a role in the administration, likely protecting their future for the 2028 GOP race to succeed Trump.) Marco Rubio, who sits on the Foreign Relations and Intelligence Committees in the Senate, was a reasonable choice among the Trump coterie to become America’s top diplomat as secretary of state.

Likewise, Representative Mike Waltz of Florida is a reasonable choice for national security adviser—but again, that’s in the context of the now-smaller universe of national-security conservatives in politics or academia willing to work for Trump at this point. He is a veteran, and like Rubio, he has served on relevant committees in Congress, including Armed Services, Foreign Affairs, and the House Permanent Select Committee on Intelligence. Waltz may be a credible voice on national security, but he was also a 2020 election denier. He pledged to oppose certifying Joe Biden’s 2020 win and signed on to an amicus brief supporting a Texas lawsuit to overturn the election. He changed his mind—but only after the events of January 6.

Representative Elise Stefanik of New York, meanwhile, was bound to be rewarded for her loyalty. Although Vice President–elect J. D. Vance took the gold in the race to replace the disowned Mike Pence, Stefanik was a comer even by the standards of the sycophantic circle around Trump, and so she’ll head to the United Nations, a low-priority post for Trump and a GOP that has little use for the institution. A former member of Congress from New York, Lee Zeldin (who was defeated in the 2022 New York governor’s race) will head up the EPA, another institution hated by MAGA Republicans, thus making Zeldin’s weak—or strong, depending on your view—legislative record on environmental issues a good fit for this administration.

This afternoon, Trump announced that John Ratcliffe will serve as CIA director. Ratcliffe previously served as director of national intelligence and will now be in a post that is functionally subordinate to his old job. Ratcliffe is a reliable partisan but an unreliable intelligence chief. The most baffling move Trump has made so far is the appointment of South Dakota Governor Kristi Noem to lead the Department of Homeland Security. Noem served four terms in Congress and is in her second as governor. She has very little relevant experience, especially as a government executive. (South Dakota might be a big place, but it’s a small state; DHS has more than 260,000 employees, making it a bit more than a quarter the size of the entire population of Noem’s home state.) DHS is a giant glob of a department—one I have long argued should never have existed in the first place and should be abolished—that has seeped across the jurisdictional lines of multiple institutions and, unlike some other Cabinet posts, requires someone with serious leadership chops.

DHS will also be central to some of Trump’s most abominable plans regarding undocumented immigrants—and, potentially, against others the president-elect views as “enemies from within.” (The “border czar” Trump has named, Tom Homan, once falsely implied that some California wildfires were worsened by an undocumented immigrant.) In that light, Noem is perfect: She is inexperienced but loyal, a political lightweight with no independent base of support or particularly long experience in Washington, and she can be counted on to do what she’s told. She will be no John Kelly or Kirstjen Nielsen, her confirmed predecessors at DHS, both of whom were on occasion willing to speak up, even if ineffectively.

This first passel of nominees should gain Senate confirmation easily, especially Rubio. (Sitting members of the chamber usually have an easier time, as do people who have close associations with the Senate.) And given Trump’s history and proclivity for mercurial and humiliating firings, few of them are likely to be very long in their post, and are probably better than the people who will later replace them.

But that in itself raises a troubling question. If Trump intends to nominate these kinds of fellow Republicans, why is he insistent that the new Senate allow him to make recess appointments?

For those of you who do not follow the arcana of American government, Article II of the Constitution includes a provision by which the president can make appointments on his own if the Senate is in recess and therefore unable to meet. The Founders didn’t think this was a controversial provision; sometimes, presidents need to keep the government running (by choosing, say, an ambassador) even when the Senate might not be around—a real problem in the days when convening the Senate could take weeks of travel. Such appointments last until the end of the next legislative session.

For obvious reasons, the Senate itself was never a big fan of a device—one that presidents routinely used—that circumvents constitutional authority to confirm executive appointments, especially once the practice got out of hand. (Bill Clinton made 139 recess appointments, George W. Bush made 171, and Barack Obama made 32.) The Senate’s response was basically to be wilier about not declaring itself in recess even when there’s no one around, and when President Obama tried to push through some of these appointments in 2012, the Supreme Court sided with the Senate.

Now Trump wants to bring back the practice. The obvious inference to draw here is that after some fairly uncontroversial nominations, he intends to nominate people who couldn’t be confirmed even in a supine and obedient Republican Senate. Perhaps this is too clever, but I am concerned that this first pass is a head fake, in which Trump nominates people he knows are controversial (such as Zeldin) but who are still confirmable, and then sends far worse candidates forward for even more important posts. Kash Patel—a man who is dangerous precisely because his only interest is serving Trump, as my colleague Elaina Plott Calabro has reported—keeps bubbling up for various intelligence posts.

“Ambassador Elise Stefanik” and “EPA Administrator Lee Zeldin” might not be great ideas, but they are not immediate threats to U.S. national security or American democracy. “CIA Director John Ratcliffe,” by contrast, is cause for serious concern. If Trump is serious about his authoritarian plans—the ones he announced at every campaign stop—then he’ll need the rest of the intelligence community, the Justice Department, and the Defense Department all under firm control.

Those are the next nominations to watch.

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Evening Read

Illustration by Mark Pernice

AI Can Save Humanity—Or End It

By Henry A. Kissinger, Eric Schmidt and Craig Mundie

The world’s strongest nation might no longer be the one with the most Albert Einsteins and J. Robert Oppenheimers. Instead, the world’s strongest nations will be those that can bring AI to its fullest potential.

But with that potential comes tremendous danger. No existing innovation can come close to what AI might soon achieve: intelligence that is greater than that of any human on the planet. Might the last polymathic invention—namely computing, which amplified the power of the human mind in a way fundamentally different from any previous machine—be remembered for replacing its own inventors?

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Stephanie Bai contributed to this newsletter.

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