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MAHA investigating health, controlling prices, extracting interests, while keeping freedom · Cultural Wars | America Out Loud News

• 0:08
  Really, if we've learned anything from these past couple of years, my fellow Americans is that personal medical freedom and liberty are in crisis.
• 0:19
  American pulse brings together the top experts in health care related fields to keep you up beaten here.
• 0:29
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• 0:35
  Don't miss a moment.
• 0:36
  Join us every Friday at 5 p.m.
• 0:38
  Eastern.
• 0:38
  I'm Dr.
• 0:39
  Randall Bach here to Unpack Myths, explore innovations and give you actual insights into the world of medicine and health.
• 0:44
  So welcome everybody.
• 0:45
  I'm honored today to have with us Patrick Carriel.
• 0:48
  And he'll tell us his bona feet, his resume, his interest.
• 0:53
  But I know he's an incredibly intelligent man and um literate in a few different kind of systems.
• 0:59
  Um but I'll let him explain it because he's been an incredibly useful part in making our nation better and making our uh health better through MAHA.
• 1:08
  And he's been involved with two different silos there.
• 1:10
  But uh Patrick, tell us a little bit about your role and uh how you got there, first of all.
• 1:16
  Sure.
• 1:16
  Uh Randy, firstly, thank you very much for having me.
• 1:19
  It's such a pleasure uh to speak with you and your audience.
• 1:23
  Um so as mentioned, I I am a former uh RPH, that's the advanced projects research agency for health.
• 1:32
  Um I was one of the founding uh members over there in the very early days.
• 1:38
  Um but I come from a private sector experience.
• 1:40
  You know, I've I was uh 20 years in the private sector um non-pharma, uh, and then I get this opportunity to be a White House Presidential Innovation Fellow, be at RPIH, which is really meant as an agency to accelerate health innovation uh and to really improve the health of all Americans.
• 2:00
  That's the vision, that's the premise.
• 2:02
  So I was there for a number of years, uh, and then I got a chance to really engage with the presidential transition team for health um on just uh strategic initiatives, helped write uh one of the 100 day plans for Secretary Kennedy.
• 2:18
  Uh, and uh was also um a founding member at the Maha Institute, uh, and now I'm a strategic advisor for HHS.
• 2:27
  Well, that's amazing.
• 2:29
  Um so just kind of lay the groundwork a little bit for you know, less of the for the less political savvy um audience.
• 2:37
  Uh, what are these different areas?
• 2:39
  You know, there's Maha Institute, there's Maha Action.
• 2:42
  Um how do those interplay and how how do they kind of capture the ear of uh Robert F.
• 2:49
  Kennedy Jr.
• 2:50
  and or other people at HHS?
• 2:52
  And you know, what are the I so I guess you know, what's the chessboard?
• 2:55
  What are the what are the moving pieces?
• 2:57
  And uh how does that kind of translate in you know politically for the people who want to be involved in things of this sort?
• 3:04
  Sure.
• 3:05
  You know, so Maha itself is uh is a fairly loaded term.
• 3:10
  Um it means different things for different people, but largely that construct of Maha, there's Maha within government and there's Maha outside of government.
• 3:21
  And so let me sort of address both.
• 3:23
  Um the Maha within government, that's the executive order uh that was put in place the four, I think it was like 14212 mandate, uh, and and the strategy that we saw come about in like September, which is all about like making our children healthy again.
• 3:38
  And and really the you know, one of the challenges when people sort of think about Maha, there are over 120 different initiatives that were mentioned in that strategy document.
• 3:50
  Um, and so the way we sort of think about this is it's really an organizing principle around perhaps like five interlocking pillars.
• 3:59
  Um the first one's really around food and nutritional reform.
• 4:02
  You know, that's all the phasing out of like the petroleum dyes and closing of the grass loophole.
• 4:08
  Um, there's environmental toxins, there's vaccine safety, there's chronic disease prevention, which is a huge buck in itself, and then the final one is really around health care transparency, right?
• 4:18
  These are all when we think about Maha in government, this is really what Secretary Kennedy is driving from within HHS.
• 4:24
  This is why like NIH leadership, CDC, the FDA, they're driving.
• 4:29
  Now, in conjunction to that, there is Maha outside of government.
• 4:34
  Uh, and that's really there to help amplify what HHS is doing, but also to be a guidepost as to where HHS needs to move towards.
• 4:46
  So the the couple of entities that Randy, you mentioned there's Maha Action, there's Maha Institute, and there's also the Maha Holdings Company.
• 4:56
  So Maha is a trademark that the Secretary owns.
• 4:59
  Um I believe it was actually like put in place in 2024.
• 5:04
  Um, and that's what the Maha Holdings uh actually like holds, uh, is the the trademark.
• 5:11
  Now, Maha Action is a much larger entity, and they're the uh the big grassroots um entity that really just pushes and amplifies all of the strategic wins that HHS has actually like delivered over this last year.
• 5:30
  Um and they you know the the they have like these weekly calls, uh the where people and individuals and all Americans can really get uh a strong lens into what's really taking place within government.
• 5:43
  So that's a transparency component that I mentioned.
• 5:46
  And the Maha Institute is much smaller.
• 5:49
  Um they're uh a policy think tank uh and they take certain positions.
• 5:53
  They are able to leverage, they are convening power to really bring in experts and also governmental officials so that they're able to really drive an insight change within the administration.
• 6:06
  So those are the the when we think about Maha, there's the distinction within an outset government.
• 6:14
  Well, that's uh that's a lot to ponder there.
• 6:17
  Um so the think tank portion.
• 6:21
  I mean, what are the kind of conceptual aspects and how are they motivated?
• 6:25
  Um and I guess in a kind of a philosophic way or maybe a rubber meets the road kind of way.
• 6:32
  You know, people think of things.
• 6:34
  Um is it top down, bottom up?
• 6:37
  I mean, where do we decide on these initiatives for health per se?
• 6:42
  And I know people have feelings, um, you know, it's sometimes difficult to dissect feelings from facts, and people have you know sensibility about the foods and about the uh toxins and the environment, pollution, um, or you know, any other of the kind of things going around.
• 7:00
  Around.
• 7:00
  But I think a lot of, I mean, you know, for my own taste or concept of this, a lot of this came about, you know, from the COVID vaccine draconian authoritarian authoritarian authoritarian, you know, overreach uh for overarching, you know, over um giving of the vaccines, which were overpromised, and so forth.
• 7:00
  But I think a lot of, I mean, you know, for my own taste or our concept of this, a lot of this came about, you know, from the COVID vaccine draconian authoritarian, authoritarian authoritarian, you know, overreach uh for overarching, you know, over um giving of the vaccines, which were overpromised and so forth.
• 7:23
  Um kind of the bottom up you know, urgency in the populace.
• 7:23
  Um kind of the bottom up, you know, urgency in the populace that generated and motivated Maha.
• 7:32
  And then how do we pick out the things that are going to be effective for health and or affected politically, I guess?
• 7:38
  It's a tough question.
• 7:39
  I'm sorry.
• 7:40
  Yeah.
• 7:40
  No, no, I I think it's uh it's a smart question for sure.
• 7:44
  I think there is multiple uh variables that's taken into the calculus of it.
• 7:49
  So one, you know, what it what is the American public really care about.
• 7:54
  Um, and and this is you know, clearly like vetted through and like down selected back, you know, from like the uh a number of years leading up to Psychiatry Kennedy's like nomination as to be the Secretary of Health and Human Services.
• 8:08
  Um and so that's always around like vaccine reform is like a big part of it.
• 8:12
  Um the the restriction of of pesticide and glyphosate and the over medicalization of children, data transparency, right?
• 8:20
  So there's there's been like a couple of themes that's bubbled up over the the many years, um and and those uh get really emboldened as like key priorities like for uh think tanks.
• 8:32
  Um and then you've got like what HHS can do today, and typically the way this sort of operates is the interplay between the two.
• 8:41
  HHS will take action that it can do uh and it's it's taking incremental steps moving in the direction.
• 8:49
  Now, this administration is clearly taking like much more leaps and bounds, and we've we've had forward progress, but the way the sort of uh the interplays is HHS, because of like its its size and scope and scale will take incremental uh forward momentum, and the the political think tanks are meant to take much more of uh a drastic position so that it's sort of a signal or a signpost where HHS needs to go.
• 9:17
  So let me let me speak in terms of an example.
• 9:20
  The um we saw that at the start of the year that the um the the childhood vaccination schedule was ratified, right?
• 9:30
  Like the uh what was on the schedule was 18 diseases, and now that got ratified down to 11 diseases, so five effective seven diseases, whereas now no longer part of the vaccinations for those is no longer part of the uh the recommended schedule.
• 9:45
  Now, the position of uh a political think tank, like the Maha Institute is to eliminate the entire vaccination schedule and effectively pulling all these vaccines until they are proven to be safe.
• 9:59
  Like we know for a fact that none of the vaccines have been uh there's any safety tests that's been conducted.
• 10:06
  Uh on top of that, there's clearly no safety tests conducted on the entire schedule.
• 10:11
  So the position of the institute would be as any political think tank is like much more forward looking, where you want to remove the entire uh vaccination schedule, while HS's approach is incremental.
• 10:23
  Let's remove, let's carve out things that we know for a fact that it's just not needed, like the the taking off the hepatitis B vaccines for a newborn child, right?
• 10:32
  I think that things that, as you rightly said, there are things that's quite logical that HHS will start to do, but then there are things that are much more progressive uh and forward momentum oriented that the political think tanks will will start to take.
• 10:48
  Yeah, that's a lot of interesting stuff there.
• 10:51
  So I I'm it's hard to label oneself, you know, I think it's easier probably for other people to do it, but you know, I think of myself somewhat as a conservative, and you know, the overriding principle of being a conservative is you know, if you had to make it into a slogan is like leave me alone.
• 11:06
  Now I don't I don't really like to be left alone that much.
• 11:09
  I mean, I'm pretty social kind of person.
• 11:11
  I'm not you know living on the top of a mountain, you know, gated and all that kind of stuff.
• 11:16
  You know, I like the social flow of things.
• 11:17
  I like being part of you know, activities and sports and you know, conversations and uh I don't know, whatever.
• 11:22
  It's not it's not a party a day, but you know, I I'm kind of social and so forth, so I don't want to be left alone all the time, but I don't like being told what to do either.
• 11:32
  That probably started at a young age, you know.
• 11:35
  Um and you know, you like to find your own way through life.
• 11:38
  So uh this is leading to a question, believe it or not.
• 11:41
  Um and then you know, the the say more of the I'm not sure liberal is the right word, but more on the left, is you know, I don't like something, nobody can do it kind of thing.
• 11:52
  So the these are different concepts of how things are.
• 11:56
  So um, you know, you you may not you, but one may uh, I don't know, say smoke a cigarette, and you know, for the conservative is like, you know, that's really no, I don't care either way.
• 12:07
  Um, you know, that's your that's a you problem.
• 12:10
  But the way we've kind of had a lot of our interests merge, and especially with certain things that HHS does control, like Medicare, and they have grants for Medicaid and whatnot, you know, there is kind of this different concept of how things you know overlap, what who's stepping on whose toes.
• 12:25
  So I'll give you one quick side example.
• 12:27
  Like um, you know, we are I'm I'm literally uh driving in a car, so I'm not doing the video, I'm doing audio.
• 12:34
  But you know, I have I have my own car insurance.
• 12:36
  I have my own type of car.
• 12:37
  Uh frankly it's it's full self-driving, so I'm doing very little right now, but I do have to watch the road and so forth.
• 12:42
  And I'm paying insurance on it.
• 12:44
  Now, I get some discount because it's full self-driving.
• 12:46
  Uh somebody else has something else.
• 12:48
  You know, some people have old cars, they're getting inspected different ways.
• 12:51
  So they're all getting their health test, you know, this and that, and they have to all have to kind of pass their own insurance, and if they're bad drivers, they pay more, they're et cetera.
• 12:58
  So it's all actually assigned, mixed uh mixed in with certain state regulations, blah, blah, blah.
• 13:04
  So we we all pay different amounts of car insurance, although our personal health may very well impinge on how we well we do driving and how much insurance we have, etc.
• 13:13
  etc.
• 13:13
  But you know, I frankly don't care too too much, except when he crashes into me, you know, what the other guy's doing.
• 13:19
  I mean, I want to have a functional car, so he's not gonna be skittering all around the road and make cause a hazard for everybody else, but within means if his car's inspected, it's all in one piece, et cetera.
• 13:28
  I don't really care.
• 13:29
  It's a little car, big car, blah, blah, blah.
• 13:31
  You know, um, health insurance has certain aspects of that.
• 13:34
  No, mind you, I also don't care if he has a Ferrari.
• 13:36
  I don't care if he spends you know a half a million dollars on this car or only drives it on Thursday.
• 13:41
  It doesn't really float my boat or unfloated either way.
• 13:44
  But with the world world, so this is kind of a concept of rights and whatnot, but with health and management, if in the private world, you know, for kind of middle-aged people who are on their prior private insurance and so forth, and in the in the old days, before it got a kind of really tied to jobs and whatnot, you could buy or not buy health insurance based on your own personal situation, and it was tailored to you.
• 14:00
  You could buy or not buy health insurance based on your own personal situation.
• 14:03
  And it was tailored to you.
• 14:05
  Now health insurance has taken away.
• 14:05
  Now, health insurance that is taken away from it's all kind of things.
• 14:09
  It's all kind of things.
• 14:10
  I think during FDR, it got tied to employment, uh, for better or worse.
• 14:10
  I think during FDR, it got tied to employment, not for better or for worse.
• 14:14
  And then and now it's kind of this mystery object that people don't really know about, they don't control.
• 14:14
  And then, and now it's kind of this mystery object that people don't really know about, they don't control, they know it goes up all the time, and whatnot.
• 14:18
  They know it goes up all the time and whatnot.
• 14:20
  And then there are state benefits of one type or another.
• 14:20
  And then there are state benefits of one type or another, not all benefits.
• 14:23
  Not all benefits.
• 14:23
  I mean, Medicare is kind of a policy you pay into over time, kind of like an annuity kind of thing.
• 14:23
  I mean, Medicare is kind of a policy you pay in for over time, kind of like an annuity kind of thing.
• 14:28
  But but those are
• 14:28
  But but those are governmental, and then we care about how much get they get used because those do matter.
• 14:34
  Like other people's level insurance, because we don't want to pay too much for this, and whether somebody gets his car, you know, detailed or not, I don't care.
• 14:41
  But if somebody gets you know some kind of elective policy, you know, elective insurance, uh, excuse me, elective procedure, and then Medicare pays for like, you know, uh, I don't know, dental work or something like that, or or you know, transitions, you know, sexual transition, it doesn't matter because it gets expensive for for other people.
• 14:59
  Right.
• 15:00
  And so here's the question, you know, what is the HHS uh overriding aspect about this and and how does it uh play out uh for kind of the the way people should care about the way health gets managed through HHS.
• 15:15
  And does Maha have an interest in any uh of those type of things where there's like overlapping interest.
• 15:20
  I I apologize for the density of that question.
• 15:23
  I can I can thin it out for if you like.
• 15:25
  No, I I think it's uh it's an important question, and and there is like multiple strands to it.
• 15:31
  Like I think the the idea around health care spend is actually an all-time high, while the chronic disease conditions is actually an all-time low, right?
• 15:44
  Like the the overall healthcare outlook is actually an all-time low.
• 15:47
  So and and that that level of um of interplay is actually like not seen anywhere else, right?
• 15:54
  Like, you know, you we're increasing healthcare cost, and so and and that cost is it is basically borne by the Americans, right?
• 16:02
  Like I think all of our health insurance premiums are going up.
• 16:05
  And so what's really interesting is um that there are a couple of different facets of this that are attacked by HHS, like they're really going uh headstrong into it.
• 16:17
  And one of those is really around price transparency, which you know, I think the the overall thinking on this is if we all had uh full transparency into all the out-of-pocket costs that we would have to pay for it, then that that life, if that asymmetry that sort of exists today where I don't really know like what I'm gonna pay for it, well, because my insurance is different from your insurance Randy, and therefore like my copies are different, and then like someone who walks in to the door without having to uh without having insurance, you know.
• 16:48
  I think the the hospital groups are the service providers will have to normalize all of it.
• 16:53
  And so I I think that level of information asymmetry will disappear.
• 16:57
  And the whole idea is that's going to reduce and bring down the the cost of service delivery, because there's going to be a need for competition.
• 17:06
  If I knew, like for a fact that I can drive 20 minutes uh to go to a nearby provider at that cost is like X, and and over here, it's like X plus some variable, right?
• 17:16
  Like it's much greater, then I I will choose to economize and go to like a lower cost um service provider.
• 17:23
  So that that's like one angle of trying to really bring down the the healthcare cost.
• 17:30
  Uh the other, which the uh again, the the administration's been trying to do, and um I think we've we've seen like one version of it roll out.
• 17:38
  That's the whole like most favored nation, drug pricing.
• 17:41
  Now that's it's affecting the drug pricing aspect of things, and it's again it's not the uh the overall um cost of like premiums and so on, but you know, I we've seen like a Zampeg drop from like a thousand dollars to as low as like in a 200 bucks or so.
• 17:56
  Um and part of the uh the the other part of this, like you know, with respect to the drug pricing and also like you know, hospital and service delivery price transparency efforts is like the whole great healthcare plan.
• 18:10
  Uh, and that's really asking Congress to, you know, how do you codify these savings?
• 18:14
  How do you redirect any um uh any insurance subsidies directly to patients through like any HSA uh style accounts, or you know, how do you force like the um the PVMs to be much more transparent?
• 18:29
  Uh I I think it's gonna take multiple strands of like getting at this problem to really lower the healthcare cost down.
• 18:37
  Right.
• 18:37
  Um I I don't necessarily think there's gonna there's really like one initiative um that that will really suppress it.
• 18:46
  Um and it this is being built and like you know, it it's clearly bloated over the many many years.
• 18:53
  Um something else, like you know, Dr.
• 18:55
  Oz has been doing is like uh he's attacking the problem from uh from a fraud and waste standpoint, right?
• 19:03
  Like we saw that he had closed down, I think like hundreds of uh of hospice cares.
• 19:09
  And so which is another vantage point, another strand to all of this around like when you think about these very large healthcare costs that we have to tackle.
• 19:18
  It's you kind of have to like multiplex the the the most favorite drug prices to the the service provider price transparency to thinking about like you know the healthcare plans and like you know, can we get more subsidies to to patients?
• 19:35
  Can't how do we minimize fraud?
• 19:37
  So and that's why like I think this is just uh a massive undertaking, and and this transition is painful.
• 19:44
  Um we've seen premiums are going up significantly.
• 19:48
  My premiums went up this particular year, right?
• 19:50
  And coverage is declining.
• 19:51
  We've seen that as well.
• 19:53
  So uh and and families are really caught in that gap.
• 19:56
  Well, that's excellent, but we're gonna have to take a break.
• 19:58
  So stick with us for our second next segment with Patrick Carriel of Maha Action.
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• 22:12
  Welcome back.
• 22:13
  I'm Dr.
• 22:13
  Randall Bach here to unpack myths, explore innovations and give you actual insights into the world of medicine and health.
• 22:19
  And we are here for our second segment with Patrick Carriel of Maha Action.
• 22:24
  So Patrick, I've always had some skeptic skepticism about how much later life dietary change really moves the needle.
• 22:31
  Since so many habits are set early, and the whole food as medicine idea can get overstated.
• 22:36
  But at the same time, it seems to me that people might make better decisions if there were real tangible incentives.
• 22:41
  Right now, HHS often feels like a distant parent giving broad advice, like the food pyramid without much individual tailoring or reward.
• 22:49
  You know, the actual patients under their purview are Medicare and Medicaid.
• 22:55
  And Medicare, not really by choice.
• 22:57
  Medicaid is indigent and Medicare are people who had to pay the government some you know amount of money all throughout their career from payroll tax in order to get this health insurance, which maybe they would have rather had something else.
• 23:09
  But anyway, those are the things under HHS, Medicaid not directly, but through you know transfer payments to the states, which manage Medicaid, you know, health insurance for the indigent.
• 23:19
  But in any case, I'm wondering instead of that top-down model, could we think about something more like automobile or home insurance, where if you're safer and more prudent, you actually get a dividend or benefit.
• 23:31
  In other words, is there a way to build into individualized incentive-based health structures that reward people for their own best practices rather than relying on generalized guidance?
• 23:42
  I think Phil Graham had something along these lines with health savings accounts and incentive payments.
• 23:48
  You know, if you're not gonna use it, you wind up keeping some fraction of that.
• 23:53
  A lot of um faith-based uh kind of credit union type uh cooperative uh health groups, not really insurance per se, uh, do that to a certain extent, so that you know, everyone kind of uses it if it's completely completely necessary, but everyone benefits as a whole if they stay healthier.
• 24:12
  I I I don't know if I think of systems as well as you do, but I tend to think of systems, even though you know my history as a primary care doctor, I treat people one by one, and I look at their own internal systems, but you know, I I don't know, can't tell you exactly why, but you know, I I think in analogies, and I you know I I know that people do well with incentives, you know.
• 24:33
  Um there's the old concept of you know, giving people uh stock shares when they're in a startup company or whatever company, you know, you're working for Apple.
• 24:42
  Um, and I've got a young relative working for Apple, and I'm imagining he's getting some you know things that will vest over time.
• 24:49
  They want to keep him loyal, they want to keep him happy, they want to keep him productive, and they want him to have some benefit, you know, skin in the game, and and some game for his skin that that you know, if he does good effort that they'll show up.
• 25:01
  I may not show up directly for his individual piece of work, but he's gonna want the company to do well.
• 25:06
  And and you know, there are obviously incentives, you know, getting back to the driving example to be a good driver if you go X, you know, if you have conversely, if you have tickets or fines, whatever you're going to speed, you know, it'll go away.
• 25:26
  You're cautious.
• 25:27
  Um, you know, still uh Graham back in the day, uh, wanted to you know bring about medical savings accounts to a greater extent and kind of have a health benefit or bonus, like uh you know the Bill Clinton's you know, quote unquote peace dividend back in the day, you know, the cold war was supposedly over and it was over, I guess.
• 25:45
  But you know, if we figure out other kind of ways to, you know, keep our military busy and whatnot, but you know, for better for worse.
• 25:51
  But um, you know, the the the kind of the piece of dividend of making yourself do well, you know.
• 25:58
  I'm just wondering, you know, I think it so again, this is again apologize for Den's question, but you know, a lot of the things that seems like Maha pays attention to, and it's a slight criticism, I apologize.
• 26:08
  But you know, are things that are on the fringes of diet and whatnot.
• 26:12
  It's all I mean, I I try to do a lot of those things they actually recommend, the whole foods and all this kind of stuff.
• 26:17
  But it's not necessarily all scientifically based.
• 26:19
  You know, I watch the NBA a lot, a lot of those you know, guys, and you know, some of them were teenagers or whatnot.
• 26:24
  You know, I'm sure they were eating their fair share of junk food, yet they can jump over me like you know, without my stooping very much, you know, and they can do incredible things.
• 26:33
  And they probably did a lot of those things, you know, growing up with diet.
• 26:36
  I had you know, with you know households these days and whatnot.
• 26:43
  And so, you know, I think there's I I just always have a little bit of skepticism about the you know major effects of dietary change and you know, see food as medicine, whatnot.
• 26:52
  But I do think that people would be able to figure things out on a on a on their own and pay much more attention to kind of maha and the best you know uses and best practices if they kind of had a health dividend, you know, or if we could facilitate this more, that you know, again, akin to car insurance or home insurance, that if you were safe and cautious, you would get some benefit from it.
• 27:12
  And I'm wondering whether that could you know be part, I mean the government part is really more Medicare for a part of HHS.
• 27:17
  I don't think HHS necessarily, you know, corresponds to all aspects of all people's health across the board if they're not part of a governmental piece of insurance, and otherwise it just kind of acts like you know, a you know, locum parentis or a distant parent, you know, telling people what to do.
• 27:31
  So there's that kind of advice for food pyramids and whatnot.
• 27:34
  But as far as like actionable items, I'm wondering whether we can, you know, create or think about some kind of incentives for people on individual basis within their plans, which otherwise seem to be, you know, not quite Soviet, but very uh stubborn to really listen to individual benefits or people's benefiting from their own, you know, best practices.
• 27:56
  No, yeah.
• 27:57
  And definitely, I think a number of good points there as well.
• 28:00
  well where you like I think Wendy you brought up the the notion around you know like there are athletes who eat um yeah um perhaps a suboptimal diet or so and we're seeing uh and and they're doing fine um I think when you when you look at in terms of averages right there's always going to be individuals that's many standard deviations outside of the norm but in the general sense of this like we're not while we see athletes who have made it who have really you know thank goodness they've they've got to to a level where they're at but we're not seeing kids with the same talent who are sidelined by metabolic disease or ADHD medication or um obesity or chronic inflammation right like I think that's that's the that's what we don't see and that's the the lion share of uh of of of our constituents today you know are we we've got the the highest chronic disease rates in any developed nations right the one in five kids are obese and and and I think where the the way uh HHS has sort of really thought about this and again from our the their strategy talk and so on is is really around what can they how can they incentivize um doctors how can they incentivize uh the service providers uh the healthcare service providers to uh to be awarded based on outcomes and not based on uh just whether or not like uh a well wizard was conducted right like it's not based on action uh but rather based on like what the outcome is and so when you start to measure outcomes um that changes like the dynamic there now you've got like service providers uh doctors physicians like nurses like taking a vested interest in you know what is the outcome that I can deliver that can really help change like the trajectory of that kid's life so hopefully we'll have like more athletes or hopefully we'll have like just more people who um would uh be in that standard deviation versus like being in that mean um but also to your point right I think part of it is really uh the there is a level of of impact that that each of us can have on our own lives um and some of it's really through just helping understand like you know ultra processed foods are are perhaps like not the best and but that the challenge for the common consumer is really what do they trust you know can they trust this because the signs on this have we we've kind of gone back and forth on it right like we know saturated fats were bad for you like that's been a message that we've been hearing right like red meat is not good for you um and and now we're starting to see uh the the the true science on this where uh that there's been like challenges with the data presented uh we do know now now know that uh red meat and uh and fat is important um less less uh carbohydrates like those are the norms that that we need to uh to really pick up on um and so there is uh an almost a dual action here uh the first action is really help inform the public uh and that's why we see like the these sort of slogans around eat real food like it's simple it's much more effective um psychiatry kennedy mentioned like when he took office uh what was passed on to him as part of the nutritional guidelines was like a 400 page document and he uh was in charge of um boiling that down to six pages like much simpler that people can understand right that's what the whole eat real food is um so there's that action of like helping uh people know uh but then also there's an enforcement action component too like the the snap waivers right now like we've um because of the work that the USDA has done and along with HHS um things like sugary drinks and uh and so in ultra processed foods are no longer going to be uh snap eligible so there's an enforcement component there as well apart from just education facilitation and then on the other side like you know the dual uh action that I mentioned is really um putting place um you know Medicare and Medicaid uh reimbursements based on outcomes and not just based on like whether or not like uh a well visit was conducted like I think those are the kinds of um influence that HHS can really exercise and can really use a power of the government to really drive change.
• 28:01
  I think when you brought up the notion around, you know, like there are athletes who eat um yeah, uh perhaps a suboptimal diet or so, and we're seeing uh and they're doing fine.
• 28:14
  Um, I think when you when you look at in terms of averages, right, there's always going to be individuals that's many standard deviations outside of the norm.
• 28:25
  But in the general sense of this, like we're not while we see athletes.
• 32:37
  But this is it's it's going to be it it'll take some time for sure like behavioral change is like one of the hardest and especially because we know like food is addictive it's it's uh uh addictive um and and that's just part of the the preservatives used that's like what's really in in our food and so uh I think to be able to change behavior it's not just like changing the mental models but it's also uh introducing um you know what what what the dietary guidelines ought to be or what the the dietary interventions ought to be and we need to give it some time because else like without that latency period we're not gonna see that type of behavioral change we need.
• 33:19
  Yeah no that's really really interesting stuff and thank you for that comprehensive answer.
• 33:23
  But I'm gonna kind of go back uh philosophically again kind of this left right dialectic and the right is kind of let's let's pause it that it's our stipulated more like the leave me alone world and then the right is uh I don't like something I don't want anyone else to do it.
• 33:40
  And so one is say more libertarian the other is more uh um I guess uh authoritative or authoritarian and you know insofar as HHS um is there um to uh do something you know again this got seems to have two different hats that for which it is running their insurance in some way or another which is Medicare and by by proxy the state Medicaid by giving grants you know in kind and whatnot.
• 34:13
  So there's two separate issues there.
• 34:15
  And then the other one is you know whether you are um you know giving kind of this moral authority you know the bully pulpit of of you know sussing things out and kind of giving people warning about certain things more like you know not not quite the cigarette you know label and whatnot and surgeon general you know saying cigarettes are bad and all that kind of stuff but you know kind of weighing in on things that may not be that well defined you know again you know stipulating that I you know do like to do a lot of the same things that are being recommended.
• 34:45
  I'm not saying I don't but you know the question is you know is that the government's role you know it seems like Maha kind of is a mix of you know left and right um maybe you know I'm not sure you know if you go back three elections and like you know say most of the people there might have both voted for Obama over you know McCain for instance or something like that.
• 35:00
  say most of the people there might have both voted for Obama over you know McCain for instance or something like that.
• 35:05
  I don't know for a fact.
• 35:05
  I don't know for a fact but there seems to be like conflicting tendencies in a sense of what HHS role should be.
• 35:06
  But there seem to be like conflicting tendencies in a sense of what HHS role should be.
• 35:12
  You know, I I I again I don't know the whole encompassing you know bureaucracy of HHS.
• 35:12
  You know I I again I don't know the whole encompassing you know bureaucracy of HHS um I know a little bit about it.
• 35:17
  Um I know a little bit about it.
• 35:19
  I understand what the initials stand for.
• 35:19
  I understand what the initials stand for.
• 35:21
  Um and it's like you know I I I like so much of it, you know, for the transparency and science and figuring out you know kind of getting first principles, which is like my favorite term of art, you know, letting you know vaccines stand on their own.
• 35:22
  And it's like you know I I I I like so much of it you know for the transparency in science and figuring out you know kind of getting first
• 35:35
  I think all those are wonderful things.
• 35:37
  So that's more like being a faithful arbiter and a a fair referee.
• 35:42
  You know, you watch a I watch my share of NBA games and whatnot, you know, I don't want the referee in anybody's pocket.
• 35:47
  I want them to judge the calls fairly across the board.
• 35:49
  I don't want vaccines to have you know some edge because of you know the they paid the referees and whatnot and vice versa.
• 35:55
  I don't think they should be gone either because somebody doesn't like them you know if because of the overreach in in COVID.
• 36:01
  You know so the the question I have I guess is bifold whether you know how much of this is gets to be you know I want to hate to use this word but kind of school marmy you know um accusative um of of you know what people should and shouldn't do when really the only people in the sense they should have that kind of sway over is people who are getting governmental benefits.
• 36:19
  And some of them don't even want it like you know as you get older may not even wanted Medicare.
• 36:23
  That's kind of foist upon you.
• 36:24
  The the the Medicaid is a different question because you're there you know because you're indigent in some level and then their disability payments SSDI and whatnot.
• 36:32
  So that's a kind of a general question.
• 36:35
  You can either take it or leave it.
• 36:36
  Uh tell me I could come up with something else if you don't like that one.
• 36:39
  No, no I think it's it's totally fine.
• 36:41
  Um you are correct though I think it's a it's a delicate balance between the government taking more of a an outsized role to tell people what they should and shouldn't be doing or should they be more um you know hands off so to speak and just provide like you know light directionality in terms of what people should be doing.
• 37:06
  And and I think the answer is somewhere in the middle where the what the federal government ought to do is really take these like bold positions.
• 37:15
  But then it's ultimately up to the the state levels to really endorse it and then really codify that into law because like what we've seen and rightfully as you called out right like I think the uh every single time like we would have an election and like they the party switches hands um you'd find like the the federalist agenda just sort of shift like we saw that like during Trump one we saw that uh as it passed on to like the Biden administration and then back to in Trump too.
• 37:48
  So I I think like the the stance as to what the government shouldn't shouldn't do like and the classic example of this is like you know the vaccine agenda where our colleagues on the left would would clearly say that everyone should be vaccinated because you know I believe in vaccines, right?
• 38:05
  Like that's the stance the the the Maha approach on this is uh informed consent, right?
• 38:12
  Like they're not they're not advocating for new vaccines, although uh I think uh political think tanks and so on will take that position but I think largely the position is get informed consent where if you want to take vaccines you can have it.
• 38:24
  If you don't you don't need to right so I think that that sort of middle ground is sort of important um but then to my earlier point around this where you know how do you ensure that um that that the federal government is not really encroaching on people's rights and and uh and their freedom and their liberties especially as it pertains to healthcare I think it's going to have to be you need those state level uh reform uh and the way I sort of think about this is like anything that states can do is effectively a force multiplier.
• 38:59
  Um like you I think this was a case like with with Utah right they're the first state to ban like fluoride in drinking water or we saw in uh in um what was it uh West Virginia um they were they banned like uh multiple like synthetic dyes from like school lunches um and so when when the states take action then it gets truly codified and then uh it becomes the norm.
• 39:23
  No longer is that I just up for a debate uh such like right now we're debating on what is the definition of ultra processed foods.
• 39:31
  Uh well in Arizona like as part of the R a Healthy Schools Act like they've banned ultra processed foods and and foods with any harmful additives in schools.
• 39:40
  So my my only point there is I think the federal government uh it in line with the administration's agenda which is not for it to you know have this like outsized role but to to really signal to guide um and to end so enforce when it needs to be so that the states can then adopt those and then codify them and then it becomes like the norm in that particular state that's really good that's really good.
• 40:13
  The uh um you know the codified part is interesting for me and uh let's see if I come up with a reasonable question in this regard.
• 40:28
  Um you know I I was thinking that you know we have this federal system which actually cuts both ways the federal which is this you know national um and then there's the federation of states you know what federalism is kind of a mixed word because it's funny you know it actually means more states' rights these days although it sounds like it's the federal government doing it.
• 40:48
  But um you know having the crucible of this kind of experimentation between states is also uh interesting you know they you can you can kind of come up with more um different experiments the one quick one for me is like South Dakota North Dakota during COVID uh they had you know one was more locked down the other um I think it was north was more locked down than south it could have been vice versa but you know they both look like rectangles they've basically the same um kind of Nordic uh German uh population um they're very similar in income and you know everything else and you could kind of do this experiment because they did it voluntarily you know one way or another that about how they would react to COVID.
• 41:27
  So you could look at that and whatnot.
• 41:28
  So you know codifying something or pushing is interesting but it's also interesting that people might follow their own pathway one or not one way or another.
• 41:37
  I'm just uh throwing that out there.
• 41:39
  I don't know if that's considered at all whether you know how much down push there should be from above or whether there should be observation and you know kind of experimentation within reason.
• 41:49
  No I I think you're definitely touching on something that's genuinely important it's substantive um and I think the the Dakota comparison is it's it's real and I think that's uh it's almost like a it was a a natural experiment right like as you rightfully called out and said it's comparable populations and um and when we saw like South Dakota um I think it was actually under a Christie gnome at that time and they uh famously refused even like a mask mandate and they kept businesses open and but like North Dakota um they they did issue a mask mandate and they had like much tighter um
• 42:00
  Is it's it's real, and I think that's uh it's almost like a it was a natural experiment, right?
• 42:06
  Like uh as you rightfully called out and said it's comparable populations and um and when we saw like South Dakota, um I think it was actually under Christy Gnome at that time, and they uh famously refused even like a mask mandate and they kept businesses open.
• 42:23
  And but like North Dakota, um they they did issue a mask mandate and they had like much tighter uh restrictions.
• 42:30
  So the outcomes were definitely like genuinely mixed in, like there was uh lots of um uh it was really contested uh as it pertained to like the percafeter like death rates.
• 42:42
  I remember uh during especially like fall of 2020, like the surge and the economic outcomes were uh divergent, and so but you know, I I think federalism, at least this is my point of view.
• 42:55
  Right, like I think um it's it it isn't just um um a structural fact.
• 43:01
  It's the way I sort of think about this is like it's uh it from a maha perspective, it's perhaps like the single most political uh an effective political and policy tool.
• 43:13
  Um because like every state that has a Maha win, it's it's permanent.
• 43:19
  And uh and it's something that you know can't be cannot be ratified by uh potentially future hostile administration, right?
• 43:28
  So I think and these states are uh you know running parallel experiments in in real time.
• 43:34
  Like I think that's what's actually like uh really good in the example that you rightfully called out.
• 43:39
  Um so with something I mentioned earlier, right?
• 43:42
  With Utah banning fluoride and drinking water, in in about five years, we will have like some actual outcome data.
• 43:50
  We will know, based on like dental health and IQ studies and and thyroid function, uh, you know, what's the impact of that?
• 43:58
  The same thing with like snap soda restrictions that we've seen, like in in many of the uh the southern states.
• 44:03
  Um that's running an experiment.
• 44:05
  So by effectively having these states be the uh the purveyor of um of many of these like policies, uh, and you'll have states like California and New York, they will be the control group.
• 44:19
  And we get to see really what the childhood obesity rates are going to look like and and truly how the science is that's really how the science is supposed to work.
• 44:28
  So um I think that's one um silver lining in all this.
• 44:34
  That's awesome.
• 44:36
  So um what what's your kind of like roadmap on a personal professional level for your you know way of figuring things out for um Maha going forward?
• 44:48
  I mean, what what what are the great five um so I have two daughters, um, and both of them are um I I should say like one of my my older one is partially vaccinated.
• 45:04
  I think she's gotten like three vaccines or so, uh, and my younger one is fully unvaccinated.
• 45:10
  Uh and I've just even seen like just between the two of those, like it's uh again, it's a it's an um sample size of one, but I've seen like the trajectory of your immune system and uh and just even how much like three doses of uh of vaccines can make an effect.
• 45:25
  So that I think selfishly, what I would really like to see uh is informed consent be the norm where we're not forced to take vaccines or um having to miss out on school.
• 45:41
  So we are Maine residents, we live in Maine.
• 45:45
  Um, although I'm um we spent we split our time between Maine and Washington, DC.
• 45:50
  Um I can't send my kids to school in Maine.
• 45:53
  Uh and that's because like Maine has is one of the I think the like five states in in America where there is no exemptions, there's no religious exemptions, there's no like philosophical exemptions.
• 46:04
  The only exemptions that exist is like medical exemption, and you and the child has to be acutely like uh a life-threatening acute um um aversion towards vaccines or allergies towards vaccines, and that's the only condition that they would give an exemption.
• 46:20
  So you've got kids across the coast of Maine and just uh all through this state that is unable to go to school.
• 46:26
  And and so my kids, like we had to homeschool them, and um that's a city.
• 46:31
  So I would really like to see like informed consent be like the norm.
• 46:36
  That's something that Supreme Court probably have to like so we're gonna have to stop right here, take a slight pause for our sponsors.
• 46:43
  Uh stick with us for our third and final segment with Patrick Carriel of Maha Action.
• 46:50
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• 48:49
  Welcome back.
• 48:49
  I'm Dr.
• 48:49
  Randall Bach here at Unpack Myths, Explore Innovations and give you actual insights into the world of medicine and health.
• 48:55
  And for that purpose, and I'm very much honored to have uh Patrick Carriel, uh, who's an HHS advisor, as well as um one of the principles of Maha action.
• 49:00
  Ariel, uh, who's an HHS advisor, as well as um one of the principles of Maha action, make America healthy again.
• 49:07
  Make America healthy again.
• 49:08
  And to wit, I you know, I want to discuss Patrick that I'm a medical doctor, and I I've given out thousands of vaccines over the years, and I've taken dozens of them myself.
• 49:08
  And to wit, I you know, want to discuss Patrick that I'm a medical doctor, and I I've given out thousands of vaccines over the years, and I've taken dozens of them myself.
• 49:17
  I took the flu shot every year, and I did have my own personal calculus.
• 49:17
  I took the flu shot every year, and I did I had my own personal calculus.
• 49:21
  I ran my own solo medical practice, and I noticed the years that I gapped, you know, the my gap years for vaxx for flu vaccine that I got sicker.
• 49:21
  I ran my own solo medical practice, and I noticed the years that I gapped, you know, the my gap years uh for vaccine for flu vaccine that I got sicker.
• 49:30
  You know, I was seeing people with the flu.
• 49:32
  I mean, mind you, I I've interviewed people who don't even believe that that viruses are real, and I've got people who believe the virus is real, but they don't do anything to humans.
• 49:39
  And I you know, I I I listened to all kinds of stuff out there.
• 49:42
  So this is my own little personal thing.
• 49:44
  I listen read the medical literature, and I I noticed that when I was a kid, you know, that we all we went to measles parties, we went to rubella parties, German measles party.
• 49:53
  We didn't have we didn't have to speak German, fortunately, because none of us could, but um, but and we there were chicken pox parties, you know, and none of us none of us died from that.
• 50:01
  And it may have been a better thing overall, maybe we should bring them back.
• 50:04
  That's a separate question.
• 50:06
  Um, but you know, it's it would it wouldn't be the I I have the thing called uh I'm gonna make a funny joke, but I the zombie apocalypse apocalypse rule.
• 50:16
  You know, if if there's a a random zombie apocalypse virus coming around, a mix of anthrax and I don't know, zombie virus, and and it's it's airborne, and it's you know, you get it within two seconds of getting it, like HIV, you know, airborne HIV.
• 50:30
  That would be like, oh my god, I want a vaccine from that if I could.
• 50:33
  No, there's no HIV vaccine, another story.
• 50:35
  But you know, I would want something for that right away, and I'd pretty much want everyone else to get it.
• 50:40
  So the zombie apocalypse rule is actually goes back to the George Washington days, you know, pre uh pre-United States.
• 50:48
  We were fighting against the British, and he had his ragtag army, and uh there was smallpox around.
• 50:54
  And to have an army defimated by smallpox would not be a good idea if you want them to keep fighting.
• 50:59
  So they they enforced uh vaccination, which was not even a term of art at the time.
• 51:03
  In fact, the vaccination word comes from vaccinia, which is uh um uh the cowpox, which they use to immunize against smallpox.
• 51:11
  So it's uh it's got a long history.
• 51:13
  The word vaccination, you know, it's a cow and cowpox is vaca in Spanish for cow.
• 51:18
  So it's all there.
• 51:19
  You know, the history's like laid out in front of you.
• 51:21
  So they they saw that as a zombie apocalypse moment.
• 51:24
  That is if they wanted the country to be free, they needed to you know have everybody in the military vaccinated.
• 51:31
  Mind you, that's a small cohort of people in the general population.
• 51:34
  They didn't say every granny and every infant had to do this, but the guys were fighting.
• 51:39
  So in the purview of working, there was no federal government then.
• 51:42
  Um so they're working as a you know, kind of a uh whatever a volunteer force, uh militia, if you will, um so forth.
• 51:51
  So that that's the zombie apocalypse clause.
• 51:54
  And if there were one, you know, like that, and we you know, people watch zombie movies all the time.
• 51:58
  I don't, but you know, if there were something like that, airborne zombie ism, yeah, I think everybody should get it.
• 52:04
  But you know, to conflate, you know, uh chickenpox um with smallpox, they're very different, or to conflate you know, German or regular measles, whatever, with something that is the end of the of society is a mistake.
• 52:18
  And I I don't want people to get rubella um when they're you know young and pregnant and whatnot.
• 52:25
  So I think it's we useful for women girls to get you know rebella, but they can happen during rubella parties, whatever.
• 52:30
  So I think it's a reasonable thing to think about, but a lot of these things are not that.
• 52:34
  There's they're very, very, very far from zombie apocalypse level.
• 52:38
  Now I'm sorry to make you know that term sound comical or whatever, but it's serious if there was something serious enough for it.
• 52:43
  I mean, I think what happened is that COVID, uh coronavirus, uh, was put in that zombie apocalypse level that we're all gonna die.
• 52:50
  You know, you get people scared enough, they do everything that you know.
• 52:52
  I I have people at my gym, my indoor tennis club for the winter, you know, with the swimming gal, uh, she sits at the desk there, and she's only about 25, 30 years old.
• 53:01
  She's still wearing a mask, you know.
• 53:03
  I and and the what and the girl, the woman who teaches Chinese dancing, uh, she's not Chinese herself, but she's got a bunch of young gals there.
• 53:10
  They're all healthy, they're young, they're like nine, ten, twelve years old.
• 53:13
  She's still wearing a mask when the doors open and everything like that.
• 53:15
  It doesn't make any physical sense.
• 53:17
  But people got scared out of their wits over this kind of stuff.
• 53:20
  So, you know, I I think they're, you know, the the the this could be divied up in a way, we used to say, um, based on the severity.
• 53:29
  And it's like there might be reasonable statutes for it, but it has to pass some zombie apocalypse level.
• 53:34
  Like I would, you know, is this 40% zombie or you know, 2% zombie?
• 53:38
  If it's less than you know, 20% zombie scale, whatever, like could you just like chill out a little bit?
• 53:43
  I mean, I I that's that's that's my zombie rule.
• 53:46
  Sorry.
• 53:46
  No, I personally uh maybe it's just like such a pleasure.
• 53:49
  I think you have got like such eloquent delivery, but no, you're absolutely correct, right?
• 53:54
  Like I think uh I think even now outside of those mandates of uh you know, I think yes, if there's something that disproportionately um uh just uh harmful, then sure.
• 54:08
  I think mandates could potentially like come about.
• 54:11
  But what we're actually asking for is like, you know, um let there be informed consent so that the parents can decide if a child needs to get vaccinated, and the states would have to advertise that.
• 54:22
  Um and in in five states today, that's not the case.
• 54:26
  Uh and then you've got like uh examples such as like the um uh oh I think uh I think I've lost you, but but I'll just keep going.
• 54:38
  But you've got examples like uh in in Idaho, which is fantastic.
• 54:42
  Wait, I think that's uh uh as as a maha dad, um I would really there you're back.
• 54:49
  Um I would very much love to like just sort of see that level of uh proliferation across the various states where there's true medical um freedom act where no longer can any mandates be enforced.
• 55:03
  Um so that I I think I would love to sort of see that happen um again, selfishly, so I can send my kids to school in Maine.
• 55:10
  And and I don't think parents out there would actually like oppose that, right?
• 55:14
  Like I think that's uh it's just good decision making.
• 55:17
  Like we've we've taken all the facts into consideration.
• 55:20
  Um I personally know the what the safety levels are and safety studies done on vaccines are, and so we've chosen not to vaccinate.
• 55:28
  Uh and then just on on the same uh theme of vaccinations, and and and again, like not to uh to take up the air time on just vaccinations, but I think when we started this whole journey with Secretary Kennedy and like him running for office, and then now as as the um as a secretary for health and human services, the goal really is you know, how do we start to like repeal or reform the 1986 National Childhood Vaccine Injury Act, where we can start to like restore manufacturer liability, and that's it.
• 56:00
  Like that's all we're uh that my dad as a uh as an advisor to HHS as um as an American citizen.
• 56:00
  Like that's all we're uh that my dad, as a uh as an advisor to HHS, as a as an American citizen, what we really want is you have manufacturer liability in just about any product out there.
• 56:08
  What we really want is you have manufacturer liability in just about any product out there.
• 56:15
  Uh Randy, you were driving a uh self-driving car, right?
• 56:15
  Uh Randy, you were driving a uh a self-driving car, right?
• 56:18
  Like there is there's manufacturer liability in just about anything except for vaccines, and I think that's the biggest structural change that we can drive in healthcare accountability, period.
• 56:19
  Like there's there's manufacturer liability in just about anything except for vaccines.
• 56:22
  And I think that's the biggest structural change that we can drive in healthcare accountability, period.
• 56:29
  And I'd love to see like that take place.
• 56:33
  Um, you know, I I think like during this this administration's time.
• 56:38
  That's all for today.
• 56:39
  Remember, every myth has a solution, and every truth has the power to transform your health.
• 56:43
  Find us on America Out Loud Pulse Radio every Friday at 5 p.m.
• 56:46
  Eastern or on demand, wherever you get your podcasts.
• 56:49
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• 56:51
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