President-elect Donald Trump’s choice to run the sprawling government agency that administers Medicare, Medicaid, and the Affordable Care Act marketplace — celebrity doctor Mehmet Oz — recently held broad investments in healthcare, tech and food companies that would pose significant conflicts of interest.

Oz’s holdings, some shared with family, included a stake in UnitedHealth Group worth as much as $600,000, as well as shares of pharmaceutical firms and tech companies with business in the healthcare sector, such as Amazon. Collectively, Oz’s investments total tens of millions of dollars, according to financial disclosures he filed during his failed 2022 run for a Pennsylvania U.S. Senate seat.

Trump said Tuesday he would nominate Oz as administrator of the Centers for Medicare & Medicaid Services. The agency’s scope is huge: CMS oversees coverage for more than 160 million Americans, nearly half the population. Medicare alone accounts for approximately $1 trillion in annual spending, with more than 67 million enrollees.

UnitedHealth Group is one of the largest healthcare companies in the nation and arguably the most important business partner of the Centers for Medicare & Medicaid Services, through which it is the leading provider of commercial health plans available to Medicare beneficiaries.

UnitedHealth also offers managed-care plans under Medicaid, the joint state-federal program for low-income people, and sells plans on government-run marketplaces set up via the Affordable Care Act. Oz also had smaller stakes in CVS Health, which now includes the insurer Aetna, and in the insurer Cigna.

It’s not clear if Oz, a heart surgeon by training, still holds investments in healthcare companies, or if he would divest his shares or otherwise seek to mitigate conflicts of interest should he be confirmed by the Senate. Reached by phone on Wednesday, he said he was in a Zoom meeting and declined to comment.

An assistant did not reply to an email message with detailed questions.

“It’s obvious that over the years he’s cultivated an interest in the pharmaceutical industry and the insurance industry,” said Peter Lurie, president of the Center for Science in the Public Interest, a watchdog group. “That raises a question of whether he can be trusted to act on behalf of the American people.” (The publisher of KFF Health News, David Rousseau, is on the Center for Science in the Public Interest board.)

Oz used his TikTok page on multiple occasions in November to praise Trump and Robert F. Kennedy Jr., including their efforts to take on the “illness-industrial complex,” and he slammed “so-called experts like the big medical societies” for dishing out what he called bad nutritional advice. Oz’s positions on health policy have been chameleonic; in 2010, he cut an ad urging Californians to sign up for insurance under President Obama’s Affordable Care Act, telling viewers they had a “historic opportunity.”

Oz’s 2022 financial disclosures show that the television star invested a substantial part of his wealth in healthcare and food firms. Were he confirmed to run CMS, his job would involve interacting with giants of the industry that have contributed to his wealth.

Given the breadth of his investments, it would be difficult for Oz to recuse himself from matters affecting his assets, if he still holds them. “He could spend his time in a rocking chair” if that happened, Lurie said.

In the past, nominees for government positions with similar potential conflicts of interest have chosen to sell the assets or otherwise divest themselves. For instance, Treasury Secretary Janet Yellen and Atty. Gen. Merrick Garland agreed to divest their holdings in relevant, publicly traded companies when they joined the Biden administration.

Trump, however, declined in his first term to relinquish control of his own companies and other assets while in office, and he isn’t expected to do so in his second term. He has not publicly indicated concern about his subordinates’ financial holdings.

The Centers for Medicare & Medicaid Services’ main job is to administer Medicare. About half of new enrollees now choose Medicare Advantage, in which commercial insurers provide their health coverage, instead of the traditional, government-run program, according to an analysis from KFF, a health information nonprofit that includes KFF Health
News.

Proponents of Medicare Advantage say the private plans offer more compelling services than the government and better manage the costs of care. Critics note that Medicare Advantage plans have a long history of costing taxpayers more than the traditional program.

UnitedHealth, CVS and Cigna are all substantial players in the Medicare Advantage market. It’s not always a good relationship with the government. The Department of Justice filed a 2017 complaint against UnitedHealth alleging the company used false information to inflate charges to the government. The case is ongoing.

Oz is an enthusiastic proponent of Medicare Advantage. In 2020, he proposed offering Medicare Advantage to all; during his Senate run, he offered a more general pledge to expand those plans. After Trump announced Oz’s nomination for the Centers for Medicare & Medicaid Services, Jeffrey Singer, a senior fellow at the libertarian-leaning Cato Institute, said he was “uncertain about Dr. Oz’s familiarity with healthcare financing and economics.”

Singer said Oz’s Medicare Advantage proposal could require large new taxes — perhaps a 20% payroll tax — to implement.

Oz has gotten a mixed reception from elsewhere in Washington. Pennsylvania Sen. John Fetterman, the Democrat who defeated Oz in 2022, signaled he’d potentially support his appointment to the Centers for Medicare & Medicaid Services. “If Dr. Oz is about protecting and preserving Medicare and Medicaid, I’m voting for the dude,” he said on the social platform X.

Oz’s investments in companies doing business with the federal government don’t end with big insurers.

He and his family also hold hospital stocks, according to his 2022 disclosure, as well as a stake in Amazon worth as much as nearly $2.4 million. (Candidates for federal office are required to disclose a broad range of values for their holdings, not a specific figure.)

Amazon operates an internet pharmacy, and the company announced in June that its subscription service is available to Medicare enrollees. It also owns a primary care service, One Medical, that accepts Medicare and “select” Medicare Advantage plans.

Oz was also directly invested in several large pharmaceutical companies and, through investments in venture capital funds, indirectly invested in other biotech and vaccine firms. Big Pharma has been a frequent target of criticism and sometimes conspiracy theories from Trump and his allies. Kennedy, whom Trump has said he’ll nominate to be Health and Human Services secretary, is a longtime anti-vaccine activist.

During the Biden administration, Congress gave Medicare authority to negotiate with drug companies over their prices. CMS initially selected 10 drugs. Those drugs collectively accounted for $50.5 billion in spending between June 1, 2022, and May 31, 2023, under Medicare’s Part D prescription drug benefit.

At least four of those 10 medications are manufactured by companies in which Oz held stock, worth as much as about $50,000.

Oz may gain or lose financially from other Trump administration proposals.

For example, as of 2022, Oz held investments worth as much as $6 million in fertility treatment providers. To counter fears that politicians who oppose abortion would ban in vitro fertilization, Trump floated during his campaign making in vitro fertilization treatment free. It’s unclear whether the government would pay for the services.

In his TikTok videos from earlier in November, Oz echoed attacks on the food industry by Kennedy and other figures in his “Make America Healthy Again” movement. They blame processed foods and underregulation of the industry for the poor health of many Americans, concerns shared by many Democrats and more mainstream experts.

But in 2022, Oz owned stakes worth as much as $80,000 in Domino’s Pizza, Pepsi and US Foods, as well as more substantial investments in other parts of the food chain, including cattle; Oz reported investments worth as much as $5.5 million in a farm and livestock, as well as a stake in a dairy-free milk startup. He was also indirectly invested in the restaurant chain Epic Burger.

One of his largest investments was in the Pennsylvania-based convenience store chain Wawa, which sells fast food and all manner of ultra-processed snacks. Oz and his wife reported a stake in the company, beloved by many Pennsylvanians, worth as much as $30 million.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Bustling crowds and early-morning lines were back as this year’s Black Friday weekend kicked off — a hopeful sign for retailers as they head into the critical holiday shopping season with consumers still grappling with inflation and economic uncertainty.

Shoppers plan to spend an average of $650 during the four-day consumer sprint from Black Friday through Cyber Monday, according to a Deloitte survey, up 15% from last year. Eight out of 10 people said they planned to do some sort of shopping during that stretch, when retailers try to jumpstart holiday sales with deals, the survey found.

The National Retail Federation also made encouraging projections, saying it expects as much as $989 billion in sales during the holiday shopping season, which would mark a 3.5% jump over last year’s total.

Although that would be a slower pace of growth compared with holiday shopping in previous years, NRF Chief Economist Jack Kleinhenz said, “We remain optimistic about the pace of economic activity and growth projected in the second half of the year.”

“Household finances are in good shape and an impetus for strong spending heading into the holiday season, though households will spend more cautiously,” he said.

Consumers in all income groups plan to spend more than last year, but those in the highest and lowest brackets are expected to increase their spending the most, the Deloitte survey found. Shoppers who make $50,000 or less per year plan to spend $422 over the weekend, up 22% from last year, while those who earn $200,000 or more are expected to spend $1,257, up 20% from last year, according to the survey.

Spending is expected to be highest among millennials, who are also more likely than other age groups to buy gifts for themselves. They will spend around $750, according to the survey, while baby boomers will spend about $485.

Commerce’s Citadel Outlets was bustling Friday morning, with many families saying they’d been scouring the massive shopping center for hours scouting for deals.

“Honestly, you’ve got to come in with the mentality: It’s Black Friday,” said Gus Aguirre, a Simi Valley barber, who said his family never misses the biggest shopping day of the year. “It’s going to be busy, there are going to be lines, and people are going to be frustrated.”

He said the family tradition is more of a way to work off last night’s meal than get the best deals, which he says don’t feel all that special compared with what’s offered online.

“I feel like everybody started earlier in terms of releasing deals,” Aguirre said. “Last year was a little bit more hectic.”

By 9 a.m., he’s walked almost two miles — 5,830 steps, according to his partner’s tracker — and had the shopping bags full of Christmas gifts to show for it. He said business at his barbershop this year has been better than last, and he’s feeling less pressure to save.

Griselda Maldonado, meanwhile, came to the outlet with a hard spending cap. She and her 14-year-old daughter, Valentina, were going to stay until they spent $300.

They hit it quickly, she said, with the deals proving more lackluster than the family had hoped. Maldonado got some cosmetics and her daughter a jean skirt from Hollister. The 14-year-old said she’d been hoping for Samba shoes from Adidas, but they’d sold out by 6 a.m., when they arrived.

“We’re done,” Maldonado said. “There’s no extra money. This is it.”

Monique Carver and Gilbert McDonald said they were also feeling overwhelmed by the prices, but determined to get through some of their Christmas list — especially tiny Ugg boots for their baby granddaughter. They suspected they could get the same sort of deals during other times of the year, but shopping in person on Black Friday felt “festive.”

“I like hands-on shopping,” McDonald said. “The sales are all right.”

Big-box retailers prepare for months for the day after Thanksgiving, which for many marks the start of the holiday shopping season and serves as an indicator of consumer confidence.

High hopes about the economy, an increase in e-commerce activity and significant Black Friday participation among Gen Z and millennials will contribute to record spending this year, said Summer Taylor, a retail managing director at Deloitte. Shoppers will also have a strong focus on value, she said, and many will prioritize saving money over brand loyalty.

Rachel Stankus, right, and her mom Jane Codd shop in the Disney Outlet store on Black Friday at the Citadel Outlets in Commerce.

(William Liang / For The Times)

To prepare, major retailers have lined up discounts and offered early sales in the days leading up to Thanksgiving. Walmart unveiled online deals starting Nov. 25, including $250 off a Dyson vacuum and $600 off a Sony television. Target announced discounts beginning Nov. 21, offering 50% off a variety of items including holiday decor, toys and appliances.

Consumers nationwide will spend 56% of their holiday budget between Black Friday and Cyber Monday, Deloitte found. Many start spending sooner.

“For the last 10 years or more, Black Friday sales have started creeping in earlier and earlier,” said Lars Perner, a professor of clinical marketing at the USC Marshall School of Business. “It becomes an arms race to offer the big sales sooner,” he said.

Early spending may drive future spending, Perner said, which could bolster retailers trying to unload holiday-themed goods before the end of the season.

“The economy is, to a very large extent, driven by psychology,” Perner said. “When consumers do spend, that tends to spur on the economy.”

Target reported underwhelming third-quarter results this month and lowered its fourth-quarter outlook, while Walmart posted strong sales and a 27% increase in e-commerce.

“Saving money remains a top priority for our customers,” Walmart said in a statement provided to The Times. “We think we’re in a strong position to serve our customers throughout the holiday season.”

Retailers have to walk a fine line between attracting customers with discounts and maintaining healthy margins, said George Noceti, a wealth advisor at Morgan Stanley. Consumers are wary of high prices amid inflation and will shop around to seek out discounts, he said. The Deloitte survey found that 45% of shoppers reported experiencing higher prices for holiday gifts this season.

“The retailers know that they have to promote and discount,” Noceti said. “Those that do will benefit the most by having greater sales, but if they promote and discount too much, they’re going to have lower profitability.”

Crowds of people shop for Black Friday deals at the Citadel Outlets in Commerce.

(William Liang / For The Times)

Advertisement

Noceti said he expects Black Friday sales to be on par with or slightly above last year’s numbers. Despite data from Deloitte that show Angelenos are more optimistic about the economy than last year, the average American consumer is still operating cautiously, he said. Shoppers may be hesitant to spend because of high prices of everyday goods such as groceries and may feel unsure about the economy amid global conflict and the recent election.

“California is different from the rest of the nation,” Noceti said. “Consumer confidence isn’t sky high, and people won’t spend their whole wallet on Black Friday.”

Consumers will split their spending evenly between in-person and online purchases, according to the Deloitte survey, but online shopping is growing at a faster rate. Whereas Black Friday foot traffic is expected to remain flat year over year, online spending could rise up to 15%.

The National Retail Federation also expects online sales to climb, saying in its holiday sales report that online and other non-store sales are expected to increase between 8% and 9%.

Online-only merchants are expected to be a popular destination this Black Friday weekend, with 69% of Deloitte survey respondents planning to stay home to shop at online-only retailers. Shoppers will spend an average of $195 on online purchases through Cyber Monday.

Retailers are relying more and more on so-called omnichannel shopping, which allows customers to browse products across in-person and online platforms.

“We aim to engage our customer where they are with an omnichannel strategy that puts product storytelling at the forefront across digital, social and in store,” Gap Chief Marketing Officer Faby Torres said.

Gap’s online platform offers customers Black Friday deals of 50% off sitewide, with some exclusions.

“Black Friday and Cyber Monday are all about value,” said Stephen Rogers, a managing director at Deloitte. “This year, all income levels and age groups are looking for deals. Consumers are relying on this week to stretch their dollars.”

State agriculture officials on Thursday banned Fresno-based Raw Farm from distributing its raw dairy products to retailers amid ongoing concerns about possible bird flu infections among its cattle.

However, with the exception of two limited recalls announced in the last few days, products from the farm that are already on store shelves can remain available for sale.

The ban comes after several days of contradictory test results conducted by different state and local health agencies, in which county public health departments found presumptive positive samples in bottled raw milk on store shelves, while state agriculture officials did not detect the virus in bulk milk tests.

On Thursday, California’s agriculture department reached out to the owner of Raw Farm LLC, Mark McAfee, and instructed him to suspend all sales to retailers.

“When raw milk disappears from the stores, that will be it,” he said.

According to McAfee, neither the agriculture or health department have recalled any products other than those involved in two limited recalls made in the past week involving quarter-gallon “cream top” whole milk products.

McAfee confirmed to The Times that his cows have H5N1 bird flu virus. He said he was not aware the cows had the disease until this week because they “are so healthy that they do not show the classic signs or symptoms. They are mostly all asymptomatic.”

He said two or three of his 1,800 cows had spiked a virus on Oct. 10, but he said they were not positive for the virus. He said he removed those cows from the herd.

It is unclear how long the cows were separated, or if a veterinarian or other professional tested the animals for H5N1.

He said regular bulk milk testing by the state’s agriculture department has consistently been negative.

“Obviously, we have some asymptomatic shedders at very low levels,” said McAfee.

He said he had a previous fever spike among his cows in August. Again, he said, the virus was not confirmed in the herd at that time.

He said he monitors each cow at his farms with a device that sits in a cow’s udder and sends real-time information about the animal’s body temperature, milk acidity, etc.

Last week, public health investigators from Santa Clara County tested a retail sample of raw milk they acquired at a store. That sample tested positive for presumptive H5N1 bird flu. The state’s public health department soon confirmed that finding and Raw Farm recalled a specific batch that was already off the shelves.

Meanwhile, the state’s agriculture department, which had been routinely testing Raw Farm milk products kept getting negative results — leaving infectious disease experts confused.

Then on Wednesday, Santa Clara County Public Health officials announced a second batch of presumptive H5N1-positive milk from Raw Farm. They made the announcement only hours after state agriculture investigators swept Raw Farm’s two herds, creamery, trucks and milk tank for samples.

According to McAfee, some of the samples collected by state officials also tested positive.

Questions to the state’s agriculture and public health departments, which were closed for the Thanksgiving holiday, went unanswered Friday.

On Wednesday, health officials from the L.A. County’s public health department expanded its list of retail stores that may have carried recalled raw milk products.

Untroubled by the positive tests and the possibility of selling raw milk products tainted with the bird flu virus, McAfee told The Times that he is urging consumers to “get to the store. Immediately!”

The magnitude of the risk to raw milk consumers is unclear. So far, 55 Americans have contracted H5N1 bird flu this year; these were predominantly dairy and poultry workers who were likely infected through their close proximity to animals and not by consuming contaminated products.

In two of those cases the source has not been identified, including a child in Alameda County who tested positive earlier this month.

In addition, a teenager in British Columbia was infected more than two weeks ago and has been in critical care since.

McAfee said herd immunity among his cows is his goal, and that when he’s clear to restock store shelves, “all of our raw milk will have antibodies to influenza HPAI H5N1. That’s awesome!”