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Social Security has been considered among the most efficient, cleanest government programs in the country. For instance, a study by the Inspector General of the Social Security Administration, published in July, found that from 2015-2022, the government had made $25 billion in Social Security overpaymentstypically payments that went out after someone had already died. But a good chunk of those payments was recouped, so the total amount lost to improper Social Security payments over those eight years was around $2 billion a year, a minuscule sum relative to the Social Security Administration (SSA)s budget (which is now well over a trillion dollars). Yet, to hear Elon Musk and President Trump tell it, Social Security may well be the site of what Musk called the biggest fraud in history. While Musks so-called Department of Government Efficiency (DOGE) was rummaging around in the SSAs various databases, it found one in which more than 19 million people who are 100 years old or older had no official death date recorded. In other words, as far as the database was concerned, they were still alive. Musk posted a table of the living centenarians, broken up by age, and then suggested that these people might be getting Social Security payments, joking, Maybe Twilight is real, and there are a lot of vampires collecting Social Security. Over the next couple of days, the Trump administration amplified this idea. First, press secretary Karoline Leavitt said during a TV appearance that Musk and DOGE suspect there are tens of millions of deceased people who are receiving fraudulent Social Security payments. Then, last night, Trump himself said that we have millions and millions of people over 100 years old in Social Security, and that if we took them all off the payment rolls, all of a sudden we have a very powerful Social Security. If these claims were true, they would, of course, be an absolutely staggering revelation. And fixing them would, as Trump suggested, put Social Securitys finances back on a healthy trajectory. However, the claims are false and are, in fact, absurd. Social Security is not sending out checks to tens of millions, or hundreds of thousands, of dead people, and there was never any reason to suspect that this was the case. What happened here was pretty simple: Elon Musk didnt understand what the table he was looking at represented, and apparently, rather than ask someone who might know (or even just google the subject), he leapt to the conclusion that he and DOGE might have uncovered the biggest fraud in history. Ghosts in the machine What Musk was looking at was data from whats called the Numident database, or “Numerical Identification System,” which is a database of every Social Security number issued. And its true: There are millions of people in that database who are dead, and not receiving fraudulent checks, but for whom the SSA has no official death date. In most cases, thats because these people died before the SSA had systematized the collection of death dates (which is trickier than you might think since death certificates are recorded on the state level, not the federal). In other cases, its because the death date was entered in the payment-records database (which is separate), but not in Numident. The important point, though, is that the Numident database is not the database of people who are getting Social Security checksas Musk and now Trump erroneously seem to think. Thats a separate database, and all those millions and millions of people over 100 years old that Trump referred to are not on the active database of people receiving Social Security checks. We know this because we can check the correct database of how many people ages 99 and older received their regular Social Security checks in December (the last month for which data is available): 89,106 people ages 99+ collected Social Security benefits. Thats a long way from tens of millions, and its also fewer than the estimated number of centenarians in the U.S. In other words, there is no evidence of fraud at all. Even beyond the question of the very elderly, theres no reason to think Social Security fraud is a meaningful problem. Some 51.8 million people over the age of 61 collected retired-worker Social Security benefits (what we think of as traditional Social Security) in Decemberout of a population of well over 60 million people ages 62 and older. If the SSA were paying loads of dead people, the number of old people collecting benefits would not be smaller than the number of old people overall. One other part of the story thats worth noting: The issue of having a database with all these dead people without recorded official death dates is one that the SSA has, obviously, been aware of for a long time. In 2023, in fact, the Inspector General did a report on the subject, recommending that the SSA take steps to fix it as much as possible. The challenge is that would take millions of dollars and lots of work hours to track down death dates from all over the country, most of them from between 50 and 80 years ago. The question is whether it’s worth doing, given that the actual costs of not having the death-date info are trivial, since these people are not getting checks. The point, in any case: This is not a new issue that DOGE has uncovered, but one thats been discussed for many years. More important, the way Musks misunderstanding of a table of numbers quickly turned into the president of the United States making baseless insinuations of fraud about the Social Security Administration is no way to run a government, or any kind of business, for that matter. But now having that erroneous information and baseless claims of fraud out there, courtesy of the misinformed Musk and Trump, can understandably erode peoples confidence in this reliable and most valuable federal program, creating a climate of unnecessary, and inadvertent, anxiety and distrust. Musk and DOGE have been given a tremendous amount of power in this administration. They need to use that power responsibly.
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E-Commerce
The Fast Company Impact Council is a private membership community of influential leaders, experts, executives, and entrepreneurs who share their insights with our audience. Members pay annual membership dues for access to peer learning and thought leadership opportunities, events and more. Healthcare navigation was supposed to be the ultimate guidea GPS for the healthcare maze. Instead its more like an old paper map with half the roads missing. What was meant to simplify care has become just another layer of complexity, dressed up as concierge support but too often steering people based on cost, not quality.At a time when AI, telehealth, and integrated care models are merging and transforming how people experience healthcare, navigation as we know it is becoming obsolete. The riseand fallof Navigation 1.0 Navigation started with a clear, patient-first mission: Remove barriers to care. The concept was pioneered by doctors to improve cancer outcomes for underserved patients who struggled with delays in diagnosis and treatment. The original vision was simple: Get people to high-quality care, faster.But then the industry lost the plot.As digital health took off, the market became flooded with big vision front doorsslick apps that promised convenience but ultimately led nowhere. These platforms were entryways without hallwaysflashy introductions to healthcare that failed to connect people to integrated clinical expertise or personalized support. Instead of providing a pathway to better health, they left people stranded.Then insurers stepped in.They highjacked navigation, repackaging it as a cost-control tool rather than an independent, patient-first service. The incentivesand the experiencewere not the same. Instead of guiding people to the best possible care, insurer-led navigation steered them toward lower-cost providers with little regard for quality or fit. What should have been an unbiased clinical advocate became just another mechanism for network steering.The result? People arent just underserved; some are actively led away from quality care, facing more barriers, more frustration, and worse outcomes. Navigation was supposed to help people get to and through the system, but instead, it became a roadblock.Lets not forget, weve seen this before. Like with the first wave of telehealth, Navigation 1.0 has become an add-on to a fragmented system rather than a real solution. And just like Telehealth 1.0, too many navigation services are now commodity, or more specifically low-value check-the-box offeringsutilization management in disguise. What comes next: A more integrated, person-centric model If Navigation 1.0 is dying, what replaces it?A smarter, all-in-one healthcare modelone that doesnt just point people in a direction, but actually gets them the right care at the right timeproactively, ongoing, and when called upon. Navigation was always meant to simplify healthcare, but that only happens when clinical expertise, advocacy, and technology work together and are deeply integrated to eliminate friction, improve access, and drive better health outcomes. Heres what that looks like: Advocacy, not just guidance People dont need another appthey need someone in their corner. True advocacy means:Fighting billing errors and helping people understand and resolve insurance denials.Connecting people with high-quality doctors, not just network-preferred ones. Helping people navigate treatment decisions and medication costs. Its not about pointing people in the right direction; its about walking beside them. AI + EQ: Smarter, more empathetic care AI assistants and guides are hot topics, but technology alone isnt enough. What people want is AI + EQ = the efficiency of AI-driven experiences combined with real human expertise and empathy.In healthcare, AI should either free up humans to focus on tasks that only humans can accomplish, or provide guidance to humans to help them perform uniquely human roles more effectively. If a system isnt human-centered, its just another version of the problem. At this point in the game, integration cant be vision Navigation without deep clinical expertise, system-wide connectivity, and personalized visibility into an individuals benefits, history, and preferences is about as useful as a tour guide whos never been to the cityhelpful on the surface, but not when you drill down for trusted, known, and proven guidance.For navigation to be effective, it must provide direct access to clinical expertise as part of an integrated teamnot just for finding a doctor. It should go even further to holistically support people across mental and physical health, administrative, financial, and social needs. It must include addressing the unexpected too, such as medication support, in-home care, and a broad range of social determinants of health issues. Smarter, cost-conscious care (not just the latest trend) The GLP-1 drug boom (Ozempic, Wegovy) is a case study in why smarter healthcare decision making matters.These drugs are breakthrough treatments for diabetes and weight lossbut theyre also so expensive that if prescribed indiscriminately, they could bankrupt the system and individuals too.Thats why Navigation 2.0 must be evidence-based, guiding people toward treatments that work, are clinically appropriate, and are informed by a persons benefits and based on what a person can afford short term and ongoing.Better healthcare isnt just about access; its about making smart, data-driven decisions with and for people. The future: Personalized all-in-one healthcare Navigation 1.0 was about helping people wayfind. The next era is about creating a fully connected, advocacy-driven experience that actually improves health, lowers costs, and removes complexity.At Included Health, we call this personalized, all-in-one healthcare. Its not just a replacement for navigationits a new category altogether, one that finally delivers on the original promise of making healthcare simpler, better, and more human.Healthcare navigation, as it exists today, is dying. RIP.Owen Tripp is cofounder and CEO of Included Health.
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E-Commerce
U.S. President Donald Trump and billionaire Elon Musk, one of his closest advisers, have mounted a sweeping campaign to slash the size of the 2.3 million-strong federal workforce, firing more than 10,000 employees in an unprecedented effort that shows no sign of slowing. The layoffs were primarily aimed at workers who have been in their current jobs for less than a year, who have fewer job protections than longer-tenured staffers. In addition, about 75,000 workers have accepted buyouts from the Trump administration. The Trump administration has yet to give a total number of how many people it has fired. Here are details on some of the layoffs at federal departments and agencies gleaned by Reuters reporters so far. Department of the Interior Around 2,300 workers were laid off from the Interior Department, sources said, including about 800 people from the Bureau of Land Management, which manages millions of federally owned acres for uses ranging from oil and gas development to timber harvesting, recreation and cultural preservation. Overall, the department employs more than 70,000 people and oversees 500 million acres (202.3 million hectares) of public lands, including dozens of national parks. Department of Energy About 700 workers have been laid off at the Department of Energy, the agency said on Wednesday. Sources have told Reuters that as many as 2,000 workers have been informed they were being laid off and that managers were told to provide evidence for why some of those should be re-hired. On Friday, sources said 325 workers had been sent notice that they had been laid off from the National Nuclear Security Administration, an Energy Department office that manages the U.S. nuclear weapons arsenal and secure dangerous nuclear materials around the world. But after a public uproar and a scramble by the administration to hire back some of these employees, fewer than 50 workers from the agency were ultimately purged, the Energy Department said on Sunday. Overall, the Energy Department has about 14,000 employees and 95,000 contractors. Department of Agriculture The U.S. Department of Agriculture said on Tuesday that it accidentally fired several employees working on the federal government’s response to the H5N1 avian flu outbreak and that it was attempting to rescind those layoffs. The U.S. Forest Service, a division of the Agriculture Department, which manages millions of acres of national forests and grasslands, is firing 3,400 probationary employees, equal to 10% of its workforce, people familiar with the plans said. Workers at the National Institute of Food and Agriculture, which supports agricultural science and technology research, and the Economic Research Service, which produces reports and data on the farm economy, have also been fired, sources said. The extent of layoffs across the Agriculture Department, which employs nearly 100,000 people, remained unclear. Department of Health and Human Services About 45% of recently hired employees still considered probationary at the Centers for Disease Control and Prevention were laid off, a source told Reuters. The Associated Press reported that nearly 1,300 CDC staff members had been fired, comprising one-tenth of the agency’s workforce. At the National Institutes of Health, 1,165 people, mostly probationary employees, were laid off, according to an internal email seen by Reuters. Workers at the Food and Drug Administration were also let go, STAT News reported. The exact number of FDA staff members who lost their jobs was unclear. The Department of Health and Human Services, which oversees the CDC, NIH, FDA as well as Medicare and Medicaid, has more than 80,000 employees. Around 5,200 of them have lost their jobs, STAT News reported. Consumer Financial Protection Bureau The independent Consumer Financial Protection Bureau (CFPB), which is responsible for consumer protection against banks, debt collectors and other companies in the financial sector, has been largely shuttered after the Trump administration ordered it to halt all activity. Roughly 140 to 200 of the agency’s probationary and so-called term employees have been fired, people familiar with the matter said. Department of Veterans Affairs More than 1,000 workers were let go from the Department of Veterans Affairs, which provides health and other benefits to millions of military veterans. The department employs more than 450,000 people and oversees more than 1,500 healthcare facilities. Office of Personnel Management All probationary employees at the Office of Personnel Management, which handles human resources for the U.S. government, were fired on Thursday in a group call that included around 100 people, sources said. Small Business Administration At least 45 probationary employees at the Small Business Administration were fired in a letter seen by Reuters. The agency, which employs several thousand people, provides support for small businesses and entrepreneurs. Department of Education At least 160 recent hires at the Department of Education have been notified of their termination, according to a letter seen by Reuters. Trump has called for the dissolution of the entire department and its 4,400 employees, though Congress would need to approve. While local and state governments hold sway over most educational issues in the United States, the federal department provides billions of dollars in student loans and grants for higher education as well as funding for students with disabilities and economically disadvantaged students. The department also enforces civil rights laws. General Services Administration About 100 employees at the General Services Administration received termination letters, according to sources. The independent agency, which manages the government’s real estate portfolio and oversees most government contracts, has more than 12,000 workers. Internal Revenue Service Senior executives at the Internal Revenue Service have identified roughly 7,500 out of 17,000 total probationary employees who could be dismissed as part of the administration’s efforts, according to a person familiar with the matter. No layoffs have occurred so far. The 7,500 target excludes workers deemed essential for tax filing season, as well as some employees involved in criminal investigations and security roles, the person familiar with the matter said. Overall, the tax-collecting agency has about 100,000 employees. Federal Aviation Administration The FAA fired more than 300 employees out of its workforce of 45,000, Transportation Secretary Sean Duffy said on X, as questions rise around air traffic safety amid a spate of recent plane accidents. Environmental Protection Agency The Environmental Protection Agency has fired 388 probationary employees. The agency, which enforces laws like the Clean Air Act and works to protect the environment, said the job cuts were made after “a thorough review of agency functions in accordance with President Trump’s executive orders.” Joseph Ax, Reuters
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E-Commerce
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