Scott Galloway on big tech, doctor's offices and why "free college is a dumb idea"

The CNN+ host appeared on "Salon Talks" to discuss his "unfiltered" new show and how COVID prompted innovation

By Mary Elizabeth Williams

Published April 12, 2022 7:00PM (EDT)

Scott Galloway speaks onstage at 'Featured Speaker: Scott Galloway' during the 2022 SXSW Conference and Festivals at Austin Convention Center on March 11, 2022 in Austin, Texas. (Jason Bollenbacher/Getty Images for SXSW)
Scott Galloway speaks onstage at 'Featured Speaker: Scott Galloway' during the 2022 SXSW Conference and Festivals at Austin Convention Center on March 11, 2022 in Austin, Texas. (Jason Bollenbacher/Getty Images for SXSW)

Scott Galloway thinks we've weaponized obesity and that free college is a "dumb" idea. The author, podcaster, entrepreneur and, as he is known on Twitter, Professor isn't afraid to speak his mind. As the host of a brand new CNN + series called "No Mercy, No Malice" and the author of "Post Corona: From Crisis to Opportunity," he's shared plenty of them.

On a recent episode of "Salon Talks," Galloway opened up about how COVID transformed scientific innovation, why going to see your doctor is such a terrible retail experience and why we need to stop talking college education like we do about Chanel bags. Watch my conversation with Galloway here, or read it below.

This conversation has been lightly edited for clarity.

Let's start with CNN +. New network, new show. Tell me about what the show is, and what you're going to be talking out every week.

We're still figuring it out, but we're trying to talk about the collision of technology and business and society. When I was initially asked to do the show, I asked them what they wanted, and they said, "We want your unfiltered takes on technology in the business world." "Unfiltered" is the way I would describe it.

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One of the phrases I have heard you using has been, "Corona as an accelerant." Tell me what that means. What that has meant in terms of an accelerant in health care, in business, as opposed to a change agent? 

I think that will be COVID's enduring feature from a business standpoint. It hasn't really spawned a ton of new trends. It's just taken the slope of the trajectory of trends who were already in place. There were more kids moving in with their parents, but now more young adults under the age of 30 are living with their parents than living on their own. Home delivery of grocery was growing, but it accelerated a decade. E-commerce, in the first eight weeks of the pandemic, accelerated a decade. For government spending, in 2020, we spent what we were supposed to spend in 2044. Remote work was a trend. It accelerated dramatically. Pre-pandemic, less than 1% of doctor's office visits were virtual. By the middle of 2021, 30% were virtual.

"Everything is here, it's just here faster."

We've seen telehealth, remote learning, work from home, home delivery of grocery, e-commerce, government spending this notion that we should just cut checks to our neediest, a trend towards UBI [universal basic income]. There's just been a massive acceleration in some of the biggest trends in our society. The consumption of media at home, we've going to see $140 billion invested in the original scripted programming this year. That's greater than the defense budget of Germany. I would argue everything is here, it's just here faster.

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Telemedicine is an opportunity to bring health care to people who don't have access, who can't travel. But there's the potential there to disrupt health care in a way that's not great. As you put it, there's a lot of ill will we have towards health care. What can we be doing to take advantage of this, especially those of us who don't have unlimited resources?

There's a lot of silver linings here. Arguably health care is the most disruptable business in the world. It's arguably the largest consumer business in the world. It's about a $3 trillion business in the US, and 17% of our economy. The ability to disperse health care away from doctors' offices and hospitals to our smart speakers and our smartphones could be a really dramatic unlock. Think about the tens, if not hundreds of millions of Americans, who end up in the emergency room because of a lack of preventive care. Get into the head space of that person. They don't have the time to get to the doctor to check out the rash on their arm. They're intimidated. They're underinsured. They don't have the money. They don't quite frankly have the knowledge. They don't have the cultural impetus to treat health care offensively instead of defensively.

Imagine that I'm an investor in a text-based preventive health care company. We use a certain amount of AI. We ask [patients] questions and then we pair them with a medical professional to try and answer their questions. They might turn on their camera to look at the rash. The dermatologists who they're referred to might prescribe them a steroid cream that's then delivered to them within two hours. If you think about all those steps and the amount of time it would take to do that and reduction in friction and cost, you might have this dispersion away from hospitals and doctors offices. 

You could distribute health care out to the home — and by some estimates about two-thirds of it could be digitized and dispersed to home. You can't have an appendectomy on your iPhone, but you can get the pre-consultation, you can get the physical therapy, you can get the drugs, you can get the check-in.

An example would be the mother of a child with childhood diabetes. Let's be honest; it's always the mom handling this. She spends five months of her year managing that child's health care between the insurance forms, the specialists, the traipsing off to the primary doctor to get a referral to a specialist, to get to CVS. If you could give her two or three of those months back for self-care, care for others, the opportunity to make the more money, there just could be a huge unlock. There could also be a huge decrease in preventable ailments.

When we start thinking about dying, when we start thinking about, "Okay, this is a UTI now, but it could get much worse if we don't treat it right away," it's pretty obvious. Treat these things. I think health care could be a huge unlock.

Could we use remote learning as a means to dramatically increase the supply across universities and hopefully bring down some of the costs? Dispersing media — I think most of us have decided we just would prefer to consume content in our homes versus a movie theater. The dispersion of financial services — people don't want the language of their financial life to be an ATM or a teller or a branch. They want it to be their phone and they want to be able to transmit funds seamlessly at low transaction costs, so that's being dispersed to our phones.

" I'd like to think we'll re-embrace science again."

There's enormous unlocks on a more spiritual level. This taught us that we should be cooperating across nations. There were some nations that handled this really well, others that didn't. Why aren't we learning from one another? Why isn't the World Health Organization connective tissue? I'd like to think we'll re-embrace science again. I like to think that America's brand on one level has grown in power because we invented the vaccines. At the same time, we stand here as the wealthiest nation in the world that has the highest per capita death rate. A lot's going to come out of this, a lot of potential unlocks. That is the winners.

Whenever you have technology come into a sector, it ends up in a great winner-take-most. One thing coming out of this pandemic that I don't think is a good thing is it used to be one in three people met online. Now, it's one in two. Online dating creates sort of this mating inequality, where the most attractive get 80% of the opportunities and everybody else gets shut out. I think you're going to have lower marriage rates, lower household formation, much lower sex rates, which is a bad thing in terms of household formation. It's usually a key component of establishing a relationship. I think there's big winners and big losers coming out of this.

A lot of us have been looking at what happened over the past two years and asking, "Where is our Operation Warp Speed? If we can do it for this, why aren't we doing it for diabetes? Why aren't we doing it for Parkinson's?" Or we are, but we're not doing it to the same level that apparently is possible. Do you think that Operation Warp Speed was a one off? 

These are all great questions. I just want to be clear, I don't have the domain expertise to answer them thoughtfully. I have read enough to feel somewhat confident that the one of the great unlocks might be the development of different omnibus vaccines. There's been more money, financial and human capital that have gone into vaccine research in the last 24 months than the last 24 years. Vaccines were seen as an unprofitable side of the pharmaceutical industry, so they didn't get a lot of attention. That changed dramatically.

You can imagine an omnibus vaccine, after we distributed diagnostics to our home. There's a company called QHealth that got its start by doing in-home COVID tests, but you can see it starting to track your blood sugar levels, your PSA levels, all kinds of things for early diagnosis.

And then here's the opportunity to develop these omnibus vaccines, where we say, "Once every couple of years, we might give you something that not only screens or protects you against COVID-19, but protects you against a variety of different ailments." There's been 11,000 academic papers published on vaccines in the last 24 months. You'd like to think that we're going to get all sorts of what I'll call the pandemic dividend around health care and around vaccines. I think health care is going to be a very exciting place to work, and that will be the beneficiaries of a lot of hopefully wonderful discovery.

"Our vaccines are just better. They're better than the Chinese vaccine. They're better than the Russian vaccine."

When you think about it, people in business will say that the most important product of the last quarter-century has been the iPhone. I think, vaccines. I think American vaccines have been probably the most important product of the last half century. They estimate that somewhere between two and three million additional Americans would have perished without the vaccine. We produce them. By the way, our vaccines are just better. They're better than the Chinese vaccine. They're better than the Russian vaccine. And we developed them in record time. The supply chain is here. That's just an enormous feather in our cap, that America still has kind of the right stuff, that we produce the best and the most important product of the last 50 years.

The downside is that we're so politicized and polarized, we decided not to take them, that we're at sitting at vaccination rates at 68% versus a lot of wealthy nations at 90-plus%. It's just staggeringly disappointing. We invented them. We have the supply chain and an unlimited supply. And yet, on the right, we've weaponized vaccines or politicized vaccines. Also on the left, we've weaponized obesity. Now, what do I mean by that? Highest per cap death rate of any wealthy nation and the two data sets or the two strongest signals around the explainer for that death rate is one, see above, lower vaccination rates and two, we're an obese nation. We don't want to talk about that because the left wants to describe it as body positivity or finding your true self.

There's some hard conversations around re-embracing truth in the science, on the right. And on the left, recognizing that biology is not politically correct. We need to provide more low income households with opportunity to have good food, we need to do away with food deserts. At a young age, kids need to be taught about nutrition. I grew up with the Presidential Physical Fitness Awards, and it instilled this sense that even if you weren't an athlete, there was reward and motivation to be fit. I think we need to return back to that. So I'd like to think there'll be a huge pandemic dividend around vaccine progress and innovation.

When you look at where you have innovation, you also have the opportunity for malice. Not everyone is necessarily vetting their sources as well. That is also a huge problem in terms of what happens to our privacy and what happens with the information that we get. What do you think we can do to arm ourselves as better informed consumers when we have unlimited information coming at us and we have very limited time to make those kinds of assessments?

I would argue that new sources of information are tremendous forms of research, but they're not tremendous forms of prescription or diagnosis. You want Google to be a source of information, but you should never go to Dr. Google when you're sick. You shouldn't go to Google to try and figure out what's going on with you. I mean, all of us hit Google when we have any question, including, "What is this rash?" Or, "I can't sleep." But at the end of the day, the actions you take need to be a function. I think about the expertise that is developed by this incredibly well-trained, thoughtful group of people with various high standards called medical professionals but I do think there's huge opportunity to push some of that expertise.

Just a few years ago, my doctor wasn't allowed to text me. I had a question, you can't text them. It's HIPAA. A lot of these regulations that I would argue are put in place to protect insurance companies and serve the medical industrial complex, came down, and that was a good thing. I don't see any reason why you shouldn't be able to text your doctor. I don't see any reason why I shouldn't be able to send a photo of my kid's rash on his arm to a pediatric dermatologist, and for him to say, "I recognize this immediately. I know what this is. I'm in a position to prescribe medication and I'm on a system that immediately sends it to the closest pharmacy and gets dispatched to your home within an hour. I already have your insurance information. We're all set. Or if you don't have insurance, I can charge you less because it's pretty efficient."

"I think doctors' offices are the second-worst in retail in America."

I think doctors' offices are the second-worst in retail in America. The worst is a gas station. I bought an electric car just because I never want to go into a gas station again, but doctors' offices are a close second. Imagine going into a Williams-Sonoma or a Best Buy and the person doesn't even stand up. They pull back a cellophane window and you say, "I'm interested in cookware. I'm interested in Calphalon or I'm interested in a big screen TV." And they say, "I know you filled it out thousands of times before, but before I can talk to you about a big screen TV or a Le Creuset, I need you to fill out a ton of paperwork." Then you wait, and then someone will talk to you about a TV 30 minutes later, and they're there for three minutes.

The medical profession from a retail standpoint is terribly broken. It makes the experience so intimidating and so expensive that it's just not getting into the corners of where it needs to be most. I think health care is probably what I would call the most optimistic place.

"It's the big tech companies that don't give a s**t about your privacy."

I don't share your views around privacy. I believe that people's HIV status is held somewhere on a server. I think there's a central repository for it, I don't know if it's the CDC. But your doctor has an obligation, if you test positive for HIV, to report it. That has tremendous potential for abuse but our government's actually done a very good job of protecting our privacy. They realize that you're not going to get people to come in and get tested if you abuse that privacy.

It's the big tech companies that don't give a s**t about your privacy. They're in the business of molesting it and then leaking it out to anyone that will pay for it. I do think, as much as we like to go on a screed against incompetent government, our government probably knows the most personal things about us. It knows how much money we make. It knows what we spend it on it. It knows our health status. It knows if we have STDs. They've managed to keep it secure. Despite all the brilliance of the engineers at Meta, the government has actually done a much better job with our privacy.

"With a small layer of AI, Uber can tell when you're terminating a pregnancy or if you're having an affair."

I would argue that there's some consumer dissonance, that we're worried about privacy, but the majority of young people are telling Snap or Instagram 40 times a day where they are and what exactly they're doing. Uber knows your location. With a small layer of AI, Uber can tell when you're terminating a pregnancy or if you're having an affair, just with a very basic layer of intelligence based on where you are traveling and at what times. We've decided that we are willing to risk real potential violations of our privacy in exchange for utility. 

Everyone's had one of those scary moments, you're at a Beyoncé concert and you get served an ad for Beyoncé album. You're like, "They're listening to me?" The answer is, "Yeah, they are." The answer is you still keep your phone on. You complain about it, but consumer behavior is different than the rhetoric around privacy.

You and I are both passionate about higher ed and have personal stakes in that game. Two of the things that you talk about are that we need to have more kids taking gap years and free college is not the solution. Those are pretty radical ideas, Scott. Why?

"There are a lot of 18-year-olds that are just not emotionally ready for college."

Gap year is an easy one. I showed up to UCLA at the age of 17 and I just wasn't emotionally or academically prepared for college. That led to me getting too drunk and ending up in the emergency room and being on an academic probation by the end of my freshman year. I'm a big believer in mandatory conscription or public service, which is easy to say once you've aged out of that. But I think that there are a lot of 18-year-olds that are just not emotionally ready for college. We've seen skyrocketing teen suicide rates because as parents, we use so many sanitary wipes on our kids' lives. They get to NYU or University of Texas, they get their heart broken, they get their first C, and they don't have the emotional capability to deal with.

Some sort of public service not only gives them a chance to maybe season a little bit, emotionally and psychologically, but also gives them the opportunity to meet other great Americans from different backgrounds. In the '60s, when we had great legislation, people saw themselves as Americans before they saw themselves as Republicans or Democrats, I think parents, kids and America would benefit from some sort of public service, whether it's Teach For America or military conscription. I think we'd be better off as a society if for 12 to 24 months, kids coming right out of high school had a choice of several different things, where they were going to serve in their nation in the agency of others. I'm a big fan of whatever you want to call it, gap year, mandatory public service.

If you were to make college free, you're doing nothing but continuing what we do really well in America and that's transfer wealth from the poor to the rich. About 80% of kids in top quintile learning households go to college. It's about 18% at the lowest quintile. So if you're going to take government money and make college free, you're basically saying we're going to make country clubs and Lexus free. And that is we're going to take a product that is mostly consumed by middle class, upper-middle and wealthy people and we're going to make it free. I think you leave the prices exactly where they are, except for anyone who needs money, which is most people, most people cannot afford that, and then you provide them with Pell grants and loans if they need it.

It's not about making it free. Free college is a dumb idea. The majority of people at Yale can afford it. And what you want to do is you want to make sure the ones that can't don't end up with a quarter of a million dollars in debt, which hangs over their household like a cloud, ready to erupt in lightning and creates despair and anxiety. They don't want to start new businesses. They don't want to get married. They don't want to buy houses and they have this huge economic strain. So I think college should not be free for all, it should be available. And also even more than the economic barriers to college, the real barrier is that we haven't grown supply. Thirty years ago, one in three jobs demanded a college degree. Now, it's two in three. Yet, we've barely kept pace with population growth because we live in a scarcity economy where once we own a house, we become NIMBYists and we don't want new developments to increase the value of our house.

If we're a big company, we spend a ton of time and tens of millions of dollars trying to keep other small businesses out of business with regulatory capture or with anti-competitive acquisitions. The moment we have a degree from a good school, we encourage the dean to tighten admission standards. We love it. At my university, when the dean stands up and says, "We rejected 90% of applicants," the faculty goes crazy and applauds and the alumni feel good and want to put their name on the side of this luxury brand. The reality is that's tantamount to the head of a homeless shelter boasting that he or she turned away nine to ten people last night. We're not Chanel bags, we're public servants.

The reason I'm here with you today is because when I applied to UCLA, the admissions rate was 76% and I had to apply twice. The admissions rate now is 12%. We can scale Google and Salesforce 24% a year, but we haven't figured out a way to scale are great public universities 1-1/2%? I know you have a kid out in California looking at schools. She should have amazing opportunities from numerous schools because I'm going to go out on a limb and assume that she's one of the 99% of kids that's probably not in the top 1%. That by the time she was 16, she didn't have patents or wasn't building wells in Africa or wasn't captain of the lacrosse team.

It's like you know me.

Well, that's who I was. And without more freshman seats and without the culture of higher education for me and my colleagues busting out of this self-aggrandisement, arrogant, luxury brand positioning, the children of single immigrant mothers who lived and died as secretaries, i.e. yours truly, are not going to get the opportunity to go on and do remarkable things and be sitting here with you. America is higher education. It's where we develop our leaders. It's where we develop our primary thoughts and methodologies around how we're going to approach society.

Do we want America to be "The Hunger Games," where it's never easier to be a billionaire, but it's never been harder to be a millionaire, where the two cohorts who really succeed in America are the children of wealthy people working in the top one-income-earning household? America needs to be a place again that offers remarkable opportunities for unremarkable kids. I'd like to move higher education back from being a luxury brand, to the greatest upward lubricant of unremarkable kids in history.

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Mary Elizabeth Williams

Mary Elizabeth Williams is a senior writer for Salon and author of "A Series of Catastrophes & Miracles."

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