DOGE did real damage in one place: USAID. Harvard doctor Atul Gawande estimates 600,000 to 800,000 people have died as a result of the foreign aid cuts. The USAID budget wasn't large to begin with, which makes that death toll even more chilling.
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At 30:20 · chapter starts 28:30
Scaramucci pivots to DOGE, noting that its July 4th end date passed almost without comment — even Kay had forgotten it was happening. The DOGE website claims roughly $215 billion in savings through job cuts and contract cancellations, but Kay immediately flags that even this number is widely disputed and represents a drop in the ocean against a $7 trillion federal budget. [1] — Katty Kay "DOGE did real damage in one place: USAID. Harvard doctor Atul Gawande estimates 600,000 to 800,000 people have died as a result of the fore…" 30:20 The real damage, both hosts agree, was done to USAID: Scaramucci estimates 800,000 people have died as a result of gutted foreign aid programmes; Kay cites Harvard's Atul Gawande putting the range at 600,000 to 800,000. The USAID budget was not large to begin with, which makes the death toll even more confronting. Scaramucci then gives a structural explanation for why the $2 trillion goal was always fantasy: the government's budget is no longer subject to a formal annual process — continuing resolutions have replaced real budgets since around 2011, baking in automatic 3–7% departmental increases with no accountability and no way to challenge them without political martyrdom.
DOGE promised $2 trillion in government savings but ultimately fell dramatically short of that figure by its July 4th 2026 end date.
The DOGE website claimed approximately $215 billion saved through job cuts and contract cancellations, far short of the $2 trillion target.
Harvard doctor Atul Gawande cited estimates of 600,000 to 800,000 deaths attributable to DOGE's cuts to USAID programs.
The structural reason DOGE failed: mandatory entitlements and defence spending are untouchable politically, and without pay-as-you-go guardrails there is no accountability mechanism. Scaramucci explains that fixing a runaway government requires decades of bipartisan consensus, not a chainsawing billionaire on a stage.
The US no longer passes an actual budget. Congress and the president rely on continuing resolutions that automatically increase departmental spending by 3–7% every year with no accountability. Scaramucci traces this to the collapse of the formal budget process under Obama and Paul Ryan in 2011.
Self-help fails because people are sold one universal cure by the hyper-responders who had a transformative result from it. The real problem is context: every method works for the right person at the right time, which is almost never you just because the author says so.
Spencer Greenberg was once so socially anxious his heart pounded just approaching a stranger. His therapist gave him homework: go to a bar alone, talk to 5 strangers. Starting with asking for the time, he worked up to asking men for hugs — and his anxiety fell dramatically in 6 months.
A person who flies regularly but obsessively checks weather forecasts before every flight is not doing exposure therapy — they're teaching their brain that flying is only safe with the ritual. Safety behaviors prevent the brain from ever learning that the feared thing is actually fine.
The worry-time technique assigns all worries to one scheduled slot (e.g. 5 PM). Every time a worry surfaces, you write it down and ban yourself from engaging with it until that time. When 5 PM arrives, most worries feel trivial and the act of batch-worrying exposes how little it actually accomplishes.
In a randomized study of 20 habit techniques, 'habit reflection' stood out: recall a past habit you successfully built, write down what helped you succeed, then apply those same strategies to your new habit. It works because it's self-adapting — it uses whatever worked for YOU.
The tiny habits technique — always having a minimal version of your habit you can do when life gets in the way — keeps the mental machinery of habit formation from breaking. Paradoxically, people given a tiny-habit fallback option were MORE successful at the full habit, not less.
Fears and worries act like playground bullies — they want to ambush you. But when you deliberately seek them out and choose the time of engagement, they lose their power. The volitional act of starting the fight on your own terms is one of CBT's most underappreciated insights.
Most downtime defaults are things you regret immediately after — phone scrolling, binge TV. 'Glad you did it' activities meet the same need for rest but leave you feeling like you spent your time well. The switch from a bad screen to a documentary, a book, or a walk costs almost no extra effort but compounds into identity over time.
You rarely control your first reactive thought. But you can train your second thought — the response to the trigger — by asking whether your initial reaction is the most helpful one and replacing it with something equally true but more constructive. Over time, that second thought becomes automatic.
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