Latest / Paging America / CDC’s Chaos, Florida’s Denial & Medicare’s AI Death Panels

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CDC’s Chaos, Florida’s Denial & Medicare’s AI Death Panels · Paging America

0:15
SPEAKER_02: All right,
0:15
SPEAKER_02: everyone,
0:15
SPEAKER_02: welcome back to Paging America,
0:17
SPEAKER_02: where we explore the power,
0:19
SPEAKER_02: profit,
0:19
SPEAKER_02: and politics shaping American health care and what you can do about it.
0:23
SPEAKER_02: I'm your host, Miles Baker, along with Dr. Rob Davidson.
0:26
SPEAKER_02: Dr. Rob, great to see you.
0:27
SPEAKER_02: How are you doing today?
0:28
SPEAKER_01: Oh, it's good to see you, too.
0:30
SPEAKER_01: You know, how am I doing?
0:31
SPEAKER_01: I don't know.
0:31
SPEAKER_01: I've done a lot of shows lately,
0:34
SPEAKER_01: podcasts and,
0:35
SPEAKER_01: you know,
0:35
SPEAKER_01: Sirius Radio and Substacks and all that.
0:39
SPEAKER_01: So it's good to be back talking to you about a lot of...
0:42
SPEAKER_01: The crazy shit going on.
0:44
SPEAKER_01: I appreciate your takes.
0:45
SPEAKER_01: And so how about you?
0:47
SPEAKER_01: Occupy Chicago yet?
0:48
SPEAKER_02: Yeah.
0:49
SPEAKER_02: It dominates the mind.
0:50
SPEAKER_02: If you live in Chicago, you're thinking about this.
0:53
SPEAKER_02: This is, you know, I mean, I know I know folks in D.C.
0:55
are thinking about it since it's sort of changed the landscape
0:58
of the city and
0:59
SPEAKER_02: brunch in particular,
1:00
since that seems to be the main thing they're doing is menacing
1:03
people at brunch.
1:03
SPEAKER_00: Yeah.
1:04
SPEAKER_02: And at the train station.
1:05
SPEAKER_02: But no,
1:06
the latest in Chicago is it sounds like there was a leaked memo
1:09
that the military
1:10
SPEAKER_02: has sent like an advanced team of some kind.
1:12
SPEAKER_02: And I'm not, I'm not a national security expert.
1:15
SPEAKER_02: I'm not exactly sure what they're up to, but we don't have troops.
1:17
SPEAKER_02: There's no Humvees at the train station yet.
1:21
SPEAKER_02: So, you know, another day.
1:23
SPEAKER_02: Another beautiful summer day in Chicago.
1:25
SPEAKER_02: Yeah.
1:26
SPEAKER_01: If there are tourist spots in D.C.
1:29
SPEAKER_01: and Brent's locations in D.C.
1:30
SPEAKER_01: are any indicator, I suspect something near Pizzeria Uno and Due, right?
1:34
SPEAKER_01: Because they're kind of kitty-cornered down the street.
1:36
SPEAKER_01: Probably something near the Water Tower place,
1:38
SPEAKER_01: like a real show of force for all those shoppers coming to Chicago.
1:43
SPEAKER_01: Yeah, right.
1:44
SPEAKER_01: Yeah, can't wait.
1:45
SPEAKER_02: So we're coming up on the end of summer.
1:47
SPEAKER_02: It looks like it's going to be the safest summer since 1965.
1:49
SPEAKER_02: Yeah.
1:51
SPEAKER_02: in the city of Chicago.
1:52
SPEAKER_02: I did bike the drive the other day where they shut down DuSable,
1:56
SPEAKER_02: which is the highway that run,
1:58
SPEAKER_02: if you're not familiar with the city,
1:59
SPEAKER_02: there is a beautiful highway that runs along the lake shore,
2:02
SPEAKER_02: the full length of the city.
2:04
SPEAKER_02: They shut that down and you get like many,
2:06
SPEAKER_02: many,
2:07
SPEAKER_02: many thousands of bicyclists that go up and down.
2:10
It was probably one of the most like bucolic and serene scenes
2:14
I've seen in the city.
2:15
And I thought,
2:16
well,
2:16
they're just going to fuck this up with soldiers,
2:18
aren't they?
2:19
SPEAKER_02: Yeah.
2:19
SPEAKER_02: How do you ride a bike through checkpoints?
2:21
SPEAKER_01: I mean, that seems like inconvenient.
2:22
SPEAKER_01: Yeah.
2:23
SPEAKER_02: It would be super annoyed.
2:24
SPEAKER_02: It would be like stopping the kids on Lime scooters on Milwaukee Avenue.
2:28
SPEAKER_02: Anyway, we got a lot to talk about.
2:30
SPEAKER_01: Yeah.
2:30
SPEAKER_02: Yeah.
2:31
SPEAKER_02: I have just a quick show note.
2:32
SPEAKER_02: We are recording this during the RFK Senate hearings.
2:36
SPEAKER_02: And so expect another show on that.
2:39
SPEAKER_02: We're going to produce after we see the results of that.
2:42
SPEAKER_02: We're going to have some reaction to that and some expert questions.
2:45
SPEAKER_02: some experts weighing in.
2:46
SPEAKER_02: But we're not going to do that on this show.
2:47
SPEAKER_02: We're going to get you up to speed.
2:49
SPEAKER_02: So if you're looking for RFK hearing reactions, stick around.
2:52
SPEAKER_02: There'll be more content coming shortly after we publish this.
2:56
SPEAKER_02: One more show note.
2:57
SPEAKER_02: On the back end of the show,
2:58
SPEAKER_02: we have an interview with the CEO of Tavern Research,
3:02
SPEAKER_02: Matt Lackey,
3:03
who's going to walk us through some really interesting survey
3:06
results they got on
3:07
SPEAKER_02: the Maha movement.
3:08
Sort of picking apart the complicated basket of opinions that
3:13
exist in the,
3:16
SPEAKER_02: I think,
3:16
SPEAKER_02: not homogenous Maha movement.
3:18
SPEAKER_02: And helping us understand sort of those things,
3:22
SPEAKER_02: the varied and different opinions that exist in that movement.
3:24
SPEAKER_02: So...
3:25
If you're interested in Maha or if you're interested in sort of
3:28
the technical side
3:29
SPEAKER_02: of survey research,
3:30
SPEAKER_02: I think either interest,
3:33
SPEAKER_02: it's a really great interview.
3:34
SPEAKER_02: So stick around for that.
3:35
SPEAKER_02: So,
3:35
SPEAKER_02: Rob,
3:36
the first thing I want to talk about today is this extremely
3:38
startling news out of
3:40
SPEAKER_02: Florida.
3:41
Florida,
3:41
just weeks and I'm going to pull something here from the Miami
3:45
Herald.
3:45
SPEAKER_02: Just weeks into the new school year,
3:47
Florida Surgeon General Joseph Lodipo announced that the state
3:50
is going to be
3:50
SPEAKER_02: working to eliminate all vaccine mandates.
3:53
SPEAKER_02: Lodipo,
3:53
SPEAKER_02: who made the announcement at a press conference Wednesday,
3:56
said forcing vaccine mandates is wrong and drips with disdain
4:00
and slavery.
4:01
SPEAKER_02: I don't know what to really, I don't know really what to say to that.
4:04
I think this means that folks are going to be able to go to
4:07
public school without
4:09
SPEAKER_02: vaccines,
4:10
SPEAKER_02: it sounds like.
4:11
What does that mean for people who have little kids in Florida
4:15
and for the rest of us?
4:16
SPEAKER_01: I mean, this is so dangerous, right?
4:19
SPEAKER_01: We say it all the time,
4:20
SPEAKER_01: Ben saying it,
4:21
SPEAKER_01: you know,
4:22
like public vaccination programs have been the single biggest
4:25
advancement in the
4:26
20th century and now into the 21st century for health care in
4:30
this country,
4:31
SPEAKER_01: for public health,
4:32
SPEAKER_01: for decreasing the number of kids,
4:34
SPEAKER_01: dead people.
4:34
I was just doing a subsec live from Lincoln Square and she said
4:38
something about,
4:38
SPEAKER_01: are we going to go back to like little kids' graves,
4:40
SPEAKER_01: you know,
4:41
SPEAKER_01: measles and polio?
4:42
SPEAKER_01: I mean, like infant or child mortality was such a big thing.
4:47
SPEAKER_01: 100 years ago or so, right, because of these preventable diseases.
4:51
And we've done such an amazing job at nearly eliminating or
4:54
eliminating many of
4:55
SPEAKER_01: these deadly diseases.
4:57
And what that means for the kids who don't get vaccinated is
5:01
being at extreme high risk.
5:02
And the problem with it being like kids is somebody else is
5:06
making that decision.
5:07
And parents have the right to make health care decisions for
5:09
their kids themselves.
5:10
SPEAKER_01: But boy,
5:11
SPEAKER_01: when something like this,
5:12
it's really terrifying to think some little six-year-old has no
5:15
idea that their
5:16
SPEAKER_01: parent is listening to someone like Joseph Latipo or R.K.
5:19
SPEAKER_01: Jr.
5:19
has drank the Kool-Aid on the complete nonsense that is
5:23
anti-vax rhetoric.
5:25
SPEAKER_01: And they are now at risk.
5:26
SPEAKER_01: But,
5:26
SPEAKER_01: you know,
5:27
SPEAKER_01: other kids are at risk,
5:27
SPEAKER_01: too,
5:28
SPEAKER_01: because not a single vaccine ever developed is 100 percent effective.
5:31
SPEAKER_01: Right.
5:32
SPEAKER_01: Some are approaching that, but none of them are 100 percent.
5:34
SPEAKER_00: Right.
5:35
And so the only way we achieve true immunity as a population is
5:39
having enough
5:40
SPEAKER_01: people vaccinated.
5:41
SPEAKER_01: So it just isn't out there.
5:42
SPEAKER_01: That virus or that bacterium just isn't around.
5:45
SPEAKER_01: And by doing this,
5:46
you're just increasing the odds of it circulating amongst kids
5:49
who are unvaccinated
5:50
and then creeping into kids who are vaccinated who aren't maybe
5:54
as well protected
5:55
SPEAKER_01: as others.
5:55
SPEAKER_01: It should be so alarming for Florida parents.
5:59
SPEAKER_01: And,
5:59
SPEAKER_01: you know,
5:59
SPEAKER_01: you hate to tell people because it does,
6:01
SPEAKER_01: again,
6:02
SPEAKER_01: comes from a position of privilege,
6:03
SPEAKER_01: you know,
6:04
SPEAKER_01: because as a physician,
6:05
SPEAKER_01: you can kind of get a job in pretty much anywhere,
6:07
SPEAKER_01: right?
6:07
SPEAKER_01: There's jobs.
6:08
SPEAKER_01: But man,
6:09
SPEAKER_01: if I was a parent in Florida,
6:11
I don't know that I'd want to be a parent of a school kid in
6:14
Florida for a whole
6:15
SPEAKER_01: lot longer.
6:15
SPEAKER_01: You know,
6:16
SPEAKER_01: I might be looking to go elsewhere because,
6:18
SPEAKER_01: again,
6:18
SPEAKER_01: you can get your kid vaccinated,
6:20
SPEAKER_01: but they're still at risk,
6:21
SPEAKER_01: man.
6:22
SPEAKER_01: It's pretty scary.
6:23
SPEAKER_01: Yeah.
6:23
SPEAKER_02: Yeah.
6:24
SPEAKER_02: Yeah.
6:24
SPEAKER_02: You know me, we got a kid coming and I think we were sort of planning.
6:30
We planned out like when we were first going to like go maybe
6:34
on a vacation or
6:36
SPEAKER_02: travel with a kid and we were saying,
6:37
SPEAKER_02: look,
6:37
we got to get through the vaccine schedule and sort of on the
6:39
calendar for an
6:41
SPEAKER_02: unborn child.
6:42
SPEAKER_02: We were saying like the vaccine schedule happens here.
6:44
SPEAKER_02: Then we can get out of Dodge.
6:46
SPEAKER_01: And we didn't really think about it.
6:48
SPEAKER_01: At least get through six months, right?
6:49
SPEAKER_01: You're two, four, and six months.
6:50
SPEAKER_01: Like, you get kind of big whammies up front.
6:52
And then after that,
6:53
like,
6:53
they've got some immunity,
6:54
some big bad things.
6:55
And,
6:56
you know,
6:56
that's a good time to kind of get them accustomed to travel.
6:59
SPEAKER_01: I mean, we did that with our kids.
7:01
SPEAKER_01: And, you know, that made life easier as they got older.
7:04
SPEAKER_01: But, yeah, that has to be.
7:05
SPEAKER_01: Now you have to figure where you can actually go, you know.
7:08
SPEAKER_01: I don't know if you're Disney folks,
7:09
SPEAKER_01: but I don't know if I take my kid to Disney,
7:11
SPEAKER_01: you know,
7:12
SPEAKER_01: if they amongst all of this,
7:14
SPEAKER_01: you know,
7:14
SPEAKER_01: that's pretty scary.
7:15
SPEAKER_01: You know, maybe we go out to Anaheim and go to that Disney instead.
7:19
SPEAKER_02: Yeah.
7:20
SPEAKER_02: Joseph Latipo is a boon for the California Disneyland.
7:24
SPEAKER_01: Right, right, right.
7:26
SPEAKER_01: There's also Disney in Paris and Disney.
7:28
SPEAKER_01: Well, I don't know about Hong Kong anymore, but yeah.
7:31
this this joseph latipo guy seems just like a craven he was
7:34
trying to score points
7:35
on covid in a way that was so extreme back in the day yeah i
7:40
had sort of thankfully
7:41
SPEAKER_02: forgot that he existed until i saw this news about well he was out and i
7:45
SPEAKER_01: I think he was out in California.
7:47
SPEAKER_01: And Ron DeSantis, you know, imported him to Florida.
7:50
He thought he did such a fantastic job of spreading anti-COVID,
7:54
anti-vaccine rhetoric.
7:55
SPEAKER_01: He wanted to bring him in and kind of,
7:57
SPEAKER_01: you know,
7:57
somehow do more damage to the folks of Florida than DeSantis
8:00
already managed to do
8:01
SPEAKER_01: on his own.
8:02
SPEAKER_01: And looks like this is now a success.
8:05
SPEAKER_01: Yeah, that's too bad.
8:06
SPEAKER_02: Well,
8:06
we hope the parents in Florida will go out and find correct
8:09
information and not
8:11
SPEAKER_00: necessarily...
8:13
SPEAKER_02: It seems like...
8:14
SPEAKER_02: I mean,
8:14
SPEAKER_02: we'll get into the CDC in a second,
8:16
SPEAKER_02: but it does seem like they are using the public health infrastructure as,
8:23
SPEAKER_02: in so many ways,
8:25
SPEAKER_02: both state and federal,
8:27
when it comes to vaccines or when it came to COVID at the time
8:31
or sort of ongoing
8:31
SPEAKER_02: conversations around COVID...
8:33
SPEAKER_02: And then also on reproductive rights.
8:35
SPEAKER_02: I know in Florida,
8:36
they were using some of the public health infrastructure to
8:38
combat the Florida
8:39
ballot initiative that would have made abortion legal in the
8:44
state or would have
8:44
SPEAKER_02: expanded reproductive rights.
8:46
They were using the public health infrastructure to basically
8:48
campaign against that
8:49
SPEAKER_02: ballot initiative down there,
8:51
SPEAKER_02: you know,
8:51
SPEAKER_02: included to the tune of like lots of money on television,
8:54
SPEAKER_02: the public money on television.
8:55
It was just sort of an incredible repurposing of government as
8:59
political weaponry.
9:00
SPEAKER_02: Yeah.
9:00
SPEAKER_02: I hope we don't see more of it, Rob.
9:03
SPEAKER_02: I find it very troubling.
9:04
SPEAKER_02: I think when you think of like the Trump administration is,
9:07
SPEAKER_02: we call it like authoritarian creep and their authoritarian impulses.
9:11
DeSantis' authoritarian impulses and the use of the state for
9:14
political ends has
9:15
SPEAKER_02: been,
9:16
SPEAKER_02: you know,
9:16
SPEAKER_02: he's been doing it for years.
9:17
SPEAKER_02: This is not new territory if you've been down in Florida,
9:20
SPEAKER_02: what we're seeing at the federal government.
9:22
SPEAKER_01: Yeah, yeah.
9:23
SPEAKER_01: I mean, it's, again, just highly dangerous.
9:25
And they seem to know that they can get away with it,
9:29
right,
9:29
especially in the era of Trump.
9:30
SPEAKER_01: I mean,
9:30
SPEAKER_01: I think when you're criming all the time,
9:32
SPEAKER_01: it's kind of hard to single out any one crime to get people on.
9:35
SPEAKER_01: So they figure they can,
9:36
SPEAKER_01: you know,
9:37
I don't think the courts could keep up with all the criming
9:39
going on in MAGA world.
9:40
So they just do what they want,
9:42
you know,
9:42
and ask for forgiveness after the fact.
9:45
SPEAKER_00: Yeah.
9:46
SPEAKER_02: I just encourage,
9:47
SPEAKER_02: could they use a different part of the government,
9:49
SPEAKER_02: like a slightly less important part of the government?
9:52
SPEAKER_02: Instead of the public health infrastructure,
9:54
SPEAKER_02: if you guys got to use the government to do crimes or to do politics,
10:00
SPEAKER_02: could you skip the health department?
10:04
SPEAKER_02: Yeah, yeah.
10:04
SPEAKER_01: Drug commission.
10:05
SPEAKER_01: I don't know.
10:05
SPEAKER_01: Something.
10:06
SPEAKER_01: Well, I mean, I talked about this.
10:08
SPEAKER_01: I talked about this today earlier on an interview,
10:10
SPEAKER_01: how,
10:11
SPEAKER_01: you know,
10:12
SPEAKER_01: RFK was put in place to get Trump the voting bloc.
10:15
SPEAKER_01: Right.
10:15
SPEAKER_01: He needed a voting bloc to get elected.
10:17
SPEAKER_01: Right.
10:17
SPEAKER_01: And so,
10:18
SPEAKER_01: I mean,
10:19
if you want to do that with an undersecretary of who knows what
10:22
at transportation
10:23
or some ambassador to some country that isn't super strategic
10:27
on the world stage,
10:29
SPEAKER_01: I don't know,
10:29
SPEAKER_01: probably still not great,
10:31
SPEAKER_01: but OK.
10:32
SPEAKER_01: But when you do that for like one of the two biggest agencies,
10:35
SPEAKER_01: you know,
10:36
SPEAKER_01: in the in the government,
10:37
SPEAKER_01: HHS,
10:38
and something that is charged with like keeping people healthy
10:41
and not having
10:42
SPEAKER_01: people die.
10:43
particularly craven and just shows like the transactional
10:46
nature of everything
10:47
SPEAKER_01: about this president and about this whole movement.
10:50
SPEAKER_01: It's all about personal,
10:52
SPEAKER_01: you know,
10:52
benefit and gain and that of your cronies and very little to do
10:57
with actually
10:58
looking out for the folks out there and the red hats who are
11:01
singing your praise.
11:02
SPEAKER_02: OK, Rob, on to the on to the next news, just to revisit a little bit.
11:05
We talked about this last week,
11:06
but to revisit what's happening at the CDC,
11:08
just set this up.
11:09
Last week,
11:10
CDC director Susan Minares was ousted by the Trump
11:13
administration.
11:14
SPEAKER_02: She was escorted out of the building by security.
11:16
In response to the firing Minares,
11:18
four senior CDC officials announced their resignations.
11:20
They were escorted out of the building amid applause and cheers
11:23
of the CDC
11:23
SPEAKER_02: employees who staged a rally to honor their decisions.
11:26
SPEAKER_02: So just to recap, especially if you're watching the RFK news,
11:30
SPEAKER_02: hearings today,
11:31
we had the decapitation of the CDC and then we had four senior
11:36
leaders out at the
11:37
SPEAKER_02: CDC.
11:38
SPEAKER_02: This is on the heels of a pretty extreme shooting at the CDC.
11:42
And then you have like sort of lower level officials holding
11:45
like a rally of
11:46
SPEAKER_02: support for the senior officials that are walking out.
11:49
SPEAKER_02: The CDC seems like a place that should be boring as a rule.
11:52
SPEAKER_02: Like, it should be a pretty boring work.
11:56
SPEAKER_02: Like, it should not have this much excitement at the CDC.
11:58
SPEAKER_02: It's just really too bad.
11:59
SPEAKER_02: And just one thing on this is,
12:01
SPEAKER_02: like,
12:02
Susan Menares and these officials seem incredibly brave to have
12:06
stuck around there
12:07
and waited until they felt like they would be doing harm if
12:11
they executed what was
12:13
SPEAKER_02: being asked of them.
12:14
It just strikes me that we're going to need a lot of bravery in
12:17
the next couple of years.
12:18
SPEAKER_02: And these people are showing us the way in some ways.
12:21
SPEAKER_01: Yeah.
12:21
SPEAKER_01: You said it should be boring.
12:23
And I can't think of one person who went into public health as
12:25
a career to get famous,
12:27
right?
12:27
SPEAKER_01: To be known.
12:28
SPEAKER_01: You can see people going into healthcare to be deemed important, right?
12:32
I mean,
12:32
I know in the ER when we're running a code,
12:35
I'm top of the food chain on that.
12:36
SPEAKER_01: And everyone's kind of looking at me for what to do next.
12:38
SPEAKER_01: And I say, yes, I want to do that, right?
12:40
SPEAKER_01: That's what I've been trained to do.
12:42
SPEAKER_01: And surgeons in the OR are known to have pretty...
12:46
SPEAKER_01: pretty decent egos.
12:47
Like,
12:47
I guess I don't mind that if they're cutting me open and not
12:50
cutting bad things like that.
12:51
SPEAKER_01: Okay.
12:52
SPEAKER_01: Yes.
12:52
SPEAKER_01: Be confident.
12:52
SPEAKER_01: You want a confident surgeon.
12:54
SPEAKER_01: Yeah.
12:54
SPEAKER_01: Yeah.
12:55
SPEAKER_01: So,
12:55
SPEAKER_01: I mean,
12:56
SPEAKER_01: we can take criticism of,
12:57
SPEAKER_01: you know,
12:57
docs who go on TV and want to make hay about all this shit
13:01
that's going on.
13:01
SPEAKER_01: But people in public health to a person that I've ever met in my career,
13:06
SPEAKER_01: in my education,
13:07
SPEAKER_01: I got my MPH a few years ago during COVID.
13:10
SPEAKER_01: I
13:10
not a single one of them is someone like seeking the limelight
13:14
right when they do
13:15
the job well you don't know about it you don't know about the
13:19
disease outbreak that
13:20
was prevented or stopped dead in its tracks and that's a good
13:23
thing and so talking
13:25
about cdc this much and it being in the news this much for
13:29
everything that's really
13:30
i think probably very stressful for them and for everybody in
13:34
public health at the
13:34
SPEAKER_01: state level the county level
13:36
You know,
13:36
in cities,
13:37
really stressful because these folks don't want to be part of
13:40
politics.
13:41
Now,
13:41
we're finding public health practitioners deciding to get more
13:45
involved in politics,
13:46
right?
13:46
SPEAKER_01: Defend Public Health,
13:47
SPEAKER_01: a group of academics and researchers and epidemiologists,
13:51
SPEAKER_01: you know,
13:51
SPEAKER_01: has emerged and a lot of other groups has emerged,
13:53
SPEAKER_01: I know,
13:54
SPEAKER_01: within the Committee to Protect Health Care.
13:56
We have quite a few people involved in public health who are
13:58
wanting to speak out,
14:00
SPEAKER_01: but not because it's something they sought in their lives.
14:02
SPEAKER_01: It's because they're seeing this damage being done.
14:05
SPEAKER_01: And they said,
14:05
SPEAKER_01: OK,
14:06
I guess I'm going to have to do the uncomfortable thing and
14:09
actually put my name
14:10
SPEAKER_01: and my face and my voice out there defending the thing that I do.
14:14
SPEAKER_01: I guess I'm hopeful, you know, for that.
14:16
SPEAKER_01: piece of it, right?
14:17
The mobilization of these folks in opposition and in advocacy
14:21
for the craft that
14:22
SPEAKER_01: they have committed their lives to.
14:23
SPEAKER_01: But yeah, the damage is going to be generational, right?
14:27
SPEAKER_01: It's going to take a while to build it back up.
14:29
SPEAKER_02: It really is.
14:30
There's one of the gentlemen at the CDC,
14:32
I want to focus in on his case because I think at...
14:35
SPEAKER_02: It speaks to,
14:36
SPEAKER_02: like,
14:37
SPEAKER_02: one,
14:37
SPEAKER_02: the bigotry of some of the folks on the right here,
14:41
SPEAKER_02: but then two,
14:43
how complete the attack is on vaccines and how they're trying
14:49
to conflate vaccines
14:50
SPEAKER_02: in the culture war,
14:51
SPEAKER_02: with the culture war.
14:52
SPEAKER_02: Yeah.
14:53
SPEAKER_02: One of the four folks who left for the CDC,
14:55
SPEAKER_02: Dimitri Daskalakis,
14:57
SPEAKER_02: who led the National Center for Immunization and Respiratory Diseases,
15:01
SPEAKER_02: pulled back the curtain on the anti-vax direction of the agency,
15:04
SPEAKER_02: so one of his public statements after departing the CDC.
15:07
SPEAKER_02: Daskalakis said,
15:09
added that he was very concerned that there's going to be an
15:11
attempt to relitigate
15:12
vaccines that have already had clear recommendations with
15:15
science that has been
15:16
SPEAKER_02: vetted.
15:17
SPEAKER_02: He warned this could undermine public trust.
15:19
SPEAKER_02: If you can't attack access, then why not attack trust?
15:23
SPEAKER_02: And I think that that's the playbook.
15:24
SPEAKER_02: So he's just, he's calling it for what it is.
15:28
SPEAKER_02: So in addition, it's not just RFK.
15:31
SPEAKER_02: So we had Rand Paul gave an interview to The Hill this week
15:35
SPEAKER_02: bashing Daskalakis support for vaccinating infants against hepatitis B.
15:40
SPEAKER_02: I think that's a good idea.
15:42
SPEAKER_02: That seems like a good idea.
15:45
SPEAKER_02: So he says, so this is Rand Paul.
15:47
One of the guys that is the biggest proponent of doing all this
15:50
is the guy who
15:51
SPEAKER_02: describes the risky behavior that he and his lifestyle involve.
15:54
SPEAKER_02: So basically, Rand Paul is going after him for being an out gay man.
16:01
By basically like going by having like sort of a bigot attack
16:05
on his sexuality,
16:07
he is going after vaccines and he's conflating the culture war
16:12
with the vaccines
16:13
like that would have anything to do with whether the hepatitis
16:16
B vaccine was a safe
16:17
SPEAKER_02: and effective vaccine.
16:19
SPEAKER_02: That's crazy to me.
16:20
SPEAKER_02: And it's so scary.
16:22
It also conjures up the Lavender Scare was a purge that
16:27
happened way back in the
16:28
day with Congress where they would try to out people and accuse
16:32
people of being gay
16:33
SPEAKER_02: men or lesbians.
16:34
SPEAKER_02: And it was a it was a way to discredit political opponents.
16:37
SPEAKER_02: And that seems so far away.
16:39
SPEAKER_02: That is such that generations ago,
16:42
SPEAKER_02: that was something that occurred in the United States of America.
16:45
And it seems like Rand Paul is trying to bring it back and do
16:47
it as part of the
16:48
SPEAKER_02: strategy to attack public health.
16:50
SPEAKER_01: Yeah, I mean, so this is Dr. Rand Paul.
16:52
SPEAKER_01: Dr.
16:52
SPEAKER_01: Rand Paul,
16:53
SPEAKER_01: who didn't join the,
16:54
SPEAKER_01: I think he was an eye doctor,
16:55
SPEAKER_01: didn't join the,
16:56
SPEAKER_01: get board certified for doing that surgery,
16:59
created his own board on the outside of that board
17:01
certification process to be able
17:03
SPEAKER_01: to do that.
17:03
And then touts himself as a great libertarian that just wants
17:07
to let people live
17:07
SPEAKER_01: their lives and do their thing.
17:09
SPEAKER_01: And yet he's now dragging Dr. Deskalakis, you know, through the mud.
17:14
SPEAKER_01: Based on Rand Paul,
17:15
SPEAKER_01: Dr.
17:16
Rand Paul's perceived connection between being an out gay man
17:20
and the ability to be
17:22
SPEAKER_01: a leader at CDC and have medical opinions based on fact and science,
17:26
SPEAKER_01: it's bullshit.
17:28
SPEAKER_01: It should be a wake-up call for anyone on the left, on the right.
17:32
SPEAKER_01: You know, these guys will do anything else.
17:35
SPEAKER_01: anything to push their agenda.
17:37
SPEAKER_01: And Rand Paul is willing to try to conflate this, right?
17:40
Maha does a similar thing with putting together all the little
17:42
pieces of Maha,
17:44
SPEAKER_01: whereby if you accept that maybe pesticides and food aren't a good thing,
17:48
SPEAKER_01: I will acknowledge that,
17:50
SPEAKER_01: would rather have fewer pesticides.
17:51
SPEAKER_01: Maybe the dyes and foods should be non-toxic.
17:54
SPEAKER_01: Yep, let's make sure that's true.
17:55
SPEAKER_01: But you got to you got to take on the anti-vaccine bullshit.
17:59
SPEAKER_01: You got to listen to RFK when he says,
18:01
SPEAKER_01: I mean,
18:01
SPEAKER_01: RFK is a guy who back in the day,
18:04
SPEAKER_01: not that long ago,
18:05
SPEAKER_01: said,
18:05
SPEAKER_01: well,
18:06
SPEAKER_01: HIV isn't necessarily the cause of AIDS.
18:08
He was saying that people were saying it was poppers because
18:11
gay men used poppers.
18:13
SPEAKER_01: And that there was a direct link, right?
18:14
SPEAKER_01: Not understanding correlation does not equal causation.
18:17
SPEAKER_01: Like they're wanting people to now accept if you,
18:21
SPEAKER_01: I guess,
18:22
maybe trying to drag in kind of homophobic culture war piece of
18:25
this to say,
18:26
SPEAKER_01: well,
18:26
SPEAKER_01: if you're that,
18:27
SPEAKER_01: then surely this guy can't be trusted.
18:29
SPEAKER_01: So he must be lying and gaslighting you about vaccines.
18:32
SPEAKER_01: And it's just it's dangerous.
18:34
SPEAKER_01: It's gross.
18:35
SPEAKER_01: It's like this guy should be this guy.
18:37
SPEAKER_01: I don't know.
18:37
SPEAKER_01: He should have some consequence for doing this as a sitting senator.
18:41
SPEAKER_01: I hope somebody does this on his side or on our side.
18:44
SPEAKER_01: I haven't heard a lot of pushback against this yet.
18:46
What the what the fuck were the Democrats doing letting RFK
18:50
like speak at some of
18:52
SPEAKER_02: their events before?
18:53
SPEAKER_02: I remember he was like a Democrat in good standing.
18:55
If people remember back to the Obama years,
18:57
he was a Democrat in good standing.
18:59
But like gay moral panic to undermine public health is not like
19:02
a new tactic for them.
19:05
SPEAKER_02: And it seems like it's been part of his playbook for a while now.
19:08
SPEAKER_02: Why did they even let him in the door?
19:09
SPEAKER_02: Yeah.
19:11
SPEAKER_01: I mean, I think the Kennedy name, right?
19:13
SPEAKER_01: Yeah, it does, right?
19:14
The card-carrying Kennedy part of it gets you admittance or got
19:18
him admittance.
19:19
SPEAKER_01: Now,
19:19
his entire family has kind of denounced everything he stands
19:22
for and has come out
19:23
SPEAKER_01: against him.
19:24
SPEAKER_01: You know,
19:24
SPEAKER_01: if he'd channel his uncle and his dad a little bit more,
19:27
SPEAKER_01: you know,
19:27
SPEAKER_01: maybe we could be on some solid footing.
19:30
SPEAKER_01: Yeah, I mean, it's the unfortunate nature of two-party politics, right?
19:34
SPEAKER_01: If a Kennedy won in the day,
19:36
SPEAKER_01: even though a crazy,
19:37
SPEAKER_01: you know,
19:38
worm brain infested bear killing Kennedy wanted to come and
19:41
speak at your thing,
19:42
SPEAKER_01: probably got people in seats.
19:44
SPEAKER_01: And so it was thought to be an okay idea.
19:46
SPEAKER_02: Well,
19:46
SPEAKER_02: I just,
19:47
SPEAKER_02: I like,
19:47
SPEAKER_02: you know,
19:48
SPEAKER_02: I hate that they're bringing back this sort of,
19:50
SPEAKER_02: it's not,
19:50
SPEAKER_02: they've been doing it for a while.
19:53
SPEAKER_02: They did it during the election too.
19:54
But I mean,
19:55
it puts it in stark relief when it's applied to public health
19:58
conversations.
19:59
As opposed to like,
20:00
Republicans have always used gender panic or moral panic around
20:05
elections.
20:06
SPEAKER_02: It's like part of their,
20:08
it's been part of their playbook as long as I have been able to
20:10
like read the
20:11
SPEAKER_02: newspaper.
20:11
SPEAKER_02: So I guess like that, maybe I'm just desensitized.
20:13
SPEAKER_02: It's still gross, but I'm desensitized to it.
20:15
SPEAKER_02: But when it's like reapplied to undermining public health,
20:17
SPEAKER_02: it takes on like a new,
20:19
SPEAKER_02: it feels like it's like extra sinister in that context,
20:21
SPEAKER_02: but...
20:22
SPEAKER_01: Well,
20:22
SPEAKER_01: Pete Buttigieg,
20:23
SPEAKER_01: Mayor slash Secretary Pete,
20:24
SPEAKER_01: faced this,
20:25
SPEAKER_01: you know,
20:25
SPEAKER_01: all the time as Secretary of Transportation,
20:27
SPEAKER_01: right?
20:28
Undermining his excellent leadership at that agency because
20:33
he's a gay man who's
20:34
SPEAKER_01: married to a man who has kids and sort of denigrating his,
20:37
SPEAKER_01: accepting him as a parent like other parents.
20:40
SPEAKER_01: I mean, it's, so it's not, again, not new in the very recent past.
20:44
SPEAKER_01: It's just particularly troubling when a sitting U.S.
20:46
SPEAKER_01: senator and a cabinet secretary are the people doing it, right?
20:49
Like if Alex Jones and the fringes of the Internet,
20:52
they say all sorts of crazy shit.
20:54
SPEAKER_01: And I guess we can't expect anything more out of them.
20:57
SPEAKER_01: I think we should be able to expect a little bit more out of a U.S.
21:01
SPEAKER_01: senator, right?
21:01
SPEAKER_01: One in the club of 100 and a sitting cabinet secretary.
21:05
SPEAKER_01: But it doesn't seem like that's the case.
21:06
SPEAKER_02: Yep, that's right.
21:07
SPEAKER_02: All right.
21:08
SPEAKER_02: I'm going to do a quick Committee to Protect Health Care plug.
21:10
If you're a doctor and you're listening to the show and you
21:12
want to join the
21:13
SPEAKER_02: Committee to Protect Health Care and fight back against this bullshit,
21:15
SPEAKER_02: please do.
21:16
SPEAKER_02: Dr. Rand Paul, you are not invited to become a member.
21:19
SPEAKER_02: You can stay where you are.
21:21
SPEAKER_01: All right.
21:23
SPEAKER_01: But Dr. Deskalakis, you are absolutely invited.
21:25
SPEAKER_01: And if anybody knows Dr.
21:27
SPEAKER_01: Dimitri Deskalakis and wants to give him my email,
21:30
SPEAKER_01: rob at committee to protect dot org,
21:32
SPEAKER_01: please,
21:33
SPEAKER_01: please share.
21:34
SPEAKER_02: Yeah, we'd love to talk to them.
21:35
SPEAKER_02: So,
21:36
SPEAKER_02: Rob,
21:36
the New York Times is reporting that Medicare is conducting a
21:40
pilot program called
21:42
SPEAKER_02: the Wasteful and Inappropriate Service Reduction Model.
21:46
SPEAKER_01: That very benign name.
21:48
SPEAKER_01: Well, that sounds boring and benign.
21:49
SPEAKER_01: Yeah, that sounds boring.
21:50
SPEAKER_02: That must not be anything.
21:52
SPEAKER_02: The Wasteful and Inappropriate Service Reduction Model.
21:57
SPEAKER_02: It will be rolled out in six states to require,
22:00
SPEAKER_02: drumroll,
22:00
SPEAKER_02: prior authorization for certain procedures.
22:03
The Centers for Medicare and Medicaid Services plans to begin a
22:07
pilot program that
22:07
SPEAKER_02: would involve a similar review process for traditional Medicare,
22:11
SPEAKER_02: the federal service program for people 65 and older,
22:13
SPEAKER_02: as well as for many younger people with disabilities.
22:16
SPEAKER_02: The pilot would start in six states this year.
22:19
SPEAKER_02: Rob,
22:20
SPEAKER_02: for listeners who aren't physicians,
22:21
can you explain prior authorization briefly and why people get
22:25
so pissed off about
22:26
SPEAKER_02: it?
22:26
SPEAKER_01: Yeah.
22:27
So prioritization is insurance companies ways of denying care
22:30
to be to be straightforward.
22:32
It's requiring doctors to justify getting certain procedures
22:36
for patients or
22:37
SPEAKER_01: certain treatments for patients.
22:39
SPEAKER_01: It sounds OK on its surface.
22:40
SPEAKER_01: Like, of course, why wouldn't you want that?
22:42
SPEAKER_01: Right.
22:42
SPEAKER_01: But in practice,
22:43
SPEAKER_01: what it is,
22:44
it's doctors sitting on phone trees for internable amounts of
22:47
time to then talk to
22:49
SPEAKER_01: maybe a doctor,
22:50
SPEAKER_01: maybe not,
22:51
SPEAKER_01: maybe some kind of like more bureaucratic minded individual.
22:55
SPEAKER_01: trying to justify.
22:56
SPEAKER_01: And I mean,
22:57
SPEAKER_01: it's very much anecdotal,
22:58
but also very much rooted in actual data on the kinds of things
23:02
that they deny.
23:03
And the reality of prior auth is the default for so many of
23:07
these profit-driven
23:08
SPEAKER_01: insurance companies is to deny,
23:09
SPEAKER_01: deny,
23:10
SPEAKER_01: deny,
23:10
and maybe then eventually approve something if the doctor or
23:15
the patient keeps
23:15
SPEAKER_01: pushing hard enough.
23:16
But the reality is they know people most of the time will just
23:19
give up because they
23:20
don't have the time to sit on those phone trees forever and
23:23
ever and ever.
23:24
SPEAKER_01: My wife is a family doc.
23:25
SPEAKER_01: I've mentioned this.
23:25
SPEAKER_01: I remember coming home saying,
23:27
I've got like a 62-year-old with a family history of heart
23:31
disease and high blood
23:31
SPEAKER_01: pressure and cholesterol having chest pain,
23:33
SPEAKER_01: and I wanted a stress test,
23:34
SPEAKER_01: and they denied it.
23:35
SPEAKER_01: And she had to sit on the phone for like 20 minutes through...
23:37
SPEAKER_01: You know,
23:38
SPEAKER_01: like five different phone trees to eventually get some doc to say,
23:40
SPEAKER_01: oh,
23:41
SPEAKER_01: yeah,
23:41
SPEAKER_01: that makes sense.
23:42
SPEAKER_01: OK, that's OK.
23:42
SPEAKER_01: Like something that obviously is indicated and is appropriate.
23:46
SPEAKER_01: Now,
23:47
the other piece of this project isn't just adding
23:50
prioritization to Medicare,
23:52
SPEAKER_01: which hasn't been done before.
23:54
SPEAKER_01: It's the way they're doing it.
23:55
SPEAKER_01: Right.
23:55
SPEAKER_01: They're now going to use A.I.,
23:57
And they're going to reward the technology companies for
24:01
denying claims,
24:02
right?
24:02
SPEAKER_01: They're going to have a monetary benefit to the more claims they deny.
24:06
SPEAKER_01: So incentivizing,
24:07
setting up the model to do just what the human versions do at
24:11
big insurance like
24:12
SPEAKER_01: UnitedHealthcare to deny,
24:14
SPEAKER_01: deny,
24:14
SPEAKER_01: deny,
24:15
SPEAKER_01: and then reap the financial rewards of that as the AI tech company.
24:20
And I think this has been dubbed by many,
24:22
and I think it's appropriate as the AI death penalty.
24:25
SPEAKER_02: AI death panels.
24:26
SPEAKER_02: And so Dr. Oz is in charge of CMS.
24:31
SPEAKER_02: And so Dr.
24:32
SPEAKER_02: Fraudster Grifter,
24:34
SPEAKER_02: Dr.
24:35
Oz is in charge of setting up a robot to intervene when a
24:41
physician says a patient
24:43
SPEAKER_02: who is 65 years or older or disabled needs a treatment,
24:49
that there will now be a robot in between that decision and the
24:53
government paying
24:54
SPEAKER_02: for it.
24:55
SPEAKER_02: At least in six states in their pilot program.
24:58
SPEAKER_02: Am I correctly formulating that?
25:00
SPEAKER_01: Well, and I think let's say it here first.
25:02
Can someone please look into the investments of said Dr.
25:05
Oz and two AI tech companies?
25:08
SPEAKER_00: I don't know.
25:08
SPEAKER_01: I don't have any information on that.
25:10
SPEAKER_01: But if that...
25:11
SPEAKER_01: If that were to be true,
25:13
SPEAKER_01: that would be the least shocking thing that you could tell me today,
25:17
SPEAKER_01: that this guy was somehow going to profit off of this.
25:20
SPEAKER_00: Yeah, that's wild.
25:21
SPEAKER_00: Yeah.
25:21
SPEAKER_01: So, I mean, I think, I guess the future is now.
25:26
SPEAKER_01: And,
25:26
SPEAKER_01: you know,
25:27
SPEAKER_01: they're coming up with ways,
25:28
SPEAKER_01: again,
25:29
SPEAKER_01: for tech billionaires to extract profit out of the health care system.
25:34
This time it's denying grandma and grandpa the test that they
25:36
need or the treatment they need.
25:38
And I saw the list of some of the initial ones,
25:39
you know,
25:40
incontinence treatment.
25:41
That seems like something that's pretty important to an elderly
25:44
person out there in
25:44
SPEAKER_01: the world,
25:45
SPEAKER_00: right?
25:45
SPEAKER_01: They'd rather, that seems like a good thing, right?
25:48
SPEAKER_01: Yeah.
25:49
SPEAKER_01: I mean, that's just one of the ones I remember them listing.
25:51
SPEAKER_01: And it's just, you know, treatment for pain, right?
25:53
SPEAKER_01: Injections for chronic pain.
25:55
SPEAKER_01: You know,
25:55
SPEAKER_01: pain is one of the most,
25:56
is the most common complaint people come to the ER with is pain
25:59
of any kind,
26:00
SPEAKER_01: back pain,
26:00
SPEAKER_01: chronic headaches.
26:01
And then to set this up to sort of routinely deny these
26:05
treatments and let people suffer.
26:07
SPEAKER_01: Right.
26:07
SPEAKER_01: Yeah.
26:07
So I think it's if you're in one of those six states,
26:09
I guess stay tuned right now.
26:10
SPEAKER_01: But if you're anywhere in this country,
26:12
like it seems like if this in this profit driven society and
26:17
where everyone's
26:17
SPEAKER_01: extracting a little bit out of health care,
26:19
just another little trick seems like something they're probably
26:21
going to spread to
26:22
SPEAKER_01: everyone.
26:22
SPEAKER_02: Yeah.
26:23
SPEAKER_02: So the AI,
26:23
SPEAKER_02: just to just so people know that some of the some of the procedures,
26:27
SPEAKER_02: not an exhaustive list,
26:28
SPEAKER_02: include incontinence control,
26:30
SPEAKER_02: cervical fusion,
26:31
SPEAKER_02: certain steroid injections for pain management.
26:33
SPEAKER_02: like nerve stimulators and the diagnosis and treatment of impotence.
26:38
You know,
26:39
robot,
26:39
we're going to have federal robots weighing in on people's
26:43
impotence.
26:44
SPEAKER_02: Cool.
26:44
SPEAKER_01: Seems like a problem.
26:45
SPEAKER_01: I think we can all get behind.
26:47
SPEAKER_01: Seems like a problem.
26:47
SPEAKER_01: Probably wanting to help people with that if we can, right?
26:51
SPEAKER_02: Yeah.
26:51
SPEAKER_02: All right.
26:52
SPEAKER_02: You heard it here first, Rob.
26:53
This show is officially against federal robots weighing in on
26:56
people's impotence.
26:57
SPEAKER_01: Amen.
26:58
SPEAKER_01: We are libertarian in that respect.
27:01
Yep.
27:03
SPEAKER_02: No, no.
27:04
SPEAKER_02: Okay.
27:04
SPEAKER_02: So we're going to, we're going to stay on top of this.
27:06
We're going to,
27:07
we're going to be talking about the AI death panels as we learn
27:10
more about them.
27:10
SPEAKER_02: But that's a, what a bummer.
27:12
SPEAKER_02: Actually, can I, I can't think of, I can't, I just cannot.
27:16
SPEAKER_02: I can't get over it.
27:17
SPEAKER_02: I can't.
27:18
SPEAKER_02: It seems like I play with chat GPT.
27:21
SPEAKER_02: Like we're going to,
27:22
we're going to actually talk about some AI applications in the
27:25
interview here that
27:25
SPEAKER_02: are,
27:26
SPEAKER_02: that are really interesting and really cool.
27:27
SPEAKER_02: But like,
27:28
SPEAKER_02: It's not 100 percent all the time, you know, and no one thinks it is.
27:31
SPEAKER_02: I don't know.
27:32
I think when applied to the health care setting and
27:35
particularly around prior
27:36
SPEAKER_02: authorization and how sometimes those things,
27:39
SPEAKER_02: sometimes time really matters.
27:41
SPEAKER_02: Right.
27:41
SPEAKER_02: When you're when you're ordering up,
27:42
ordering up tests or ordering up treatments for something that
27:46
if if if if you're
27:47
SPEAKER_02: putting a robot in between and it's blocking things,
27:49
SPEAKER_02: it's really going to cause a lot of suffering,
27:52
SPEAKER_02: it seems like so.
27:53
SPEAKER_01: Yeah.
27:53
SPEAKER_01: And in the ER, we don't usually deal with prior auth, right?
27:56
SPEAKER_01: Right.
28:14
SPEAKER_01: And a while back, we sort of dispensed with this.
28:16
SPEAKER_01: We have now something called the prudent layperson standard,
28:19
SPEAKER_01: meaning if someone,
28:20
SPEAKER_01: prudent layperson,
28:21
SPEAKER_01: thinks that what they're coming in with is an emergency,
28:24
SPEAKER_01: it's an emergency.
28:24
SPEAKER_01: Because I see people with chest pain,
28:26
but not every person I see with chest pain has a heart attack
28:29
or a blood clot or a
28:30
SPEAKER_01: collapsed lung or an aneurysm,
28:32
SPEAKER_01: right?
28:32
SPEAKER_01: Some of the really deadly causes of chest pain.
28:35
SPEAKER_00: Right.
28:35
SPEAKER_01: But they come in,
28:36
SPEAKER_01: particularly folks with risk factors,
28:38
SPEAKER_01: worrying that they may or may not have that.
28:40
SPEAKER_01: And you may do an EKG.
28:41
SPEAKER_01: You may do some blood tests.
28:42
SPEAKER_01: You may do x-rays, CAT scans, that kind of thing.
28:44
And there had been times now that it's been largely pushed back
28:48
against where if
28:50
everything came up negative and they were sent home with a
28:52
diagnosis that wasn't a
28:53
SPEAKER_01: life-threatening condition,
28:54
SPEAKER_01: the insurance company would say,
28:55
SPEAKER_01: well,
28:55
SPEAKER_01: see,
28:55
SPEAKER_01: that wasn't an emergency,
28:56
SPEAKER_01: so we're not going to pay for that.
28:58
It's like,
28:58
well,
28:58
how the hell do you know it was an emergency until you did the
29:01
tests?
29:01
SPEAKER_01: And if every person we see and take care of is having a heart attack,
29:05
a lot of people are sitting at home having heart attacks and
29:08
aren't being treated
29:08
SPEAKER_01: and are dying as a result.
29:10
SPEAKER_01: So like that in my world,
29:12
SPEAKER_01: that has got to be what they're thinking of next,
29:14
SPEAKER_01: letting the AI go through all of our discharges,
29:17
SPEAKER_01: all of our patients we see and determine,
29:19
SPEAKER_01: well,
29:19
SPEAKER_01: this person,
29:20
we won't pay for that because they shouldn't have been there in
29:22
the first place.
29:23
SPEAKER_01: Yeah, I think it's a scary place.
29:25
SPEAKER_01: I think AI has a place in healthcare.
29:27
SPEAKER_01: I think if I were a non-interventional radiologist,
29:30
I would be very worried about AI because we already have AI
29:33
looking at x-rays and
29:34
SPEAKER_01: then the radiologist oversees them.
29:35
Pretty good at pattern recognition and finding calcifications
29:40
on a mammogram or a
29:41
SPEAKER_01: fracture on an x-ray.
29:42
I think not quite so good at determining if somebody needs
29:46
treatment for their
29:47
impotence or their chronic pain or their incontinence and who
29:50
knows where they're
29:51
SPEAKER_01: going to roll it out next.
29:52
SPEAKER_02: Yeah.
29:53
SPEAKER_02: Yeah,
29:53
SPEAKER_02: it seems like in the practice,
29:54
SPEAKER_02: when uses a tool or an aid to a clinician or someone doing any analysis,
30:00
SPEAKER_02: it could end up being a really game-changing tool.
30:03
SPEAKER_02: It's also like a powerful tool like that in the hands of
30:09
A federal government where there was like a lot of trust and
30:12
you knew they were
30:12
working in good faith is a different situation than a federal
30:17
government that's
30:17
full of grifters and people with long history of ripping other
30:21
people off and a
30:22
SPEAKER_02: long history of stealing.
30:24
That's a pretty powerful tool for a group of people that it's
30:27
hard to trust because
30:28
SPEAKER_02: of their behavior in the past.
30:30
SPEAKER_02: For sure.
30:31
SPEAKER_01: For sure.
30:31
SPEAKER_02: Anyway, maybe we'll come back to AI death battles soon.
30:36
SPEAKER_02: How about this, Rob?
30:38
SPEAKER_02: Now let's go over to the interview.
30:41
CEO of Tavern Research,
30:42
Matt Lackey,
30:42
is up next and had a great conversation.
30:45
SPEAKER_02: So we'll go to that now.
30:49
SPEAKER_02: Hi, everybody.
30:49
SPEAKER_02: Welcome back to Paging America.
30:52
SPEAKER_02: Today's guest,
30:53
SPEAKER_02: we are joined by Matt Lackey,
30:55
SPEAKER_02: who is the CEO of Tavern Research,
30:57
SPEAKER_02: who just completed a large research project on the Maha movement.
31:01
And he's here to tell us a little bit about that and what he's
31:04
learned as a
31:05
researcher and someone who deals with a lot of public research
31:09
to help us unpack
31:10
some things about public sentiment and the Make American
31:13
Healthy Again movement.
31:15
SPEAKER_02: Matt, thanks so much for joining us.
31:17
SPEAKER_02: Where are you coming to us from today?
31:19
I am coming to the podcast from the South Loop in Chicago,
31:24
Illinois,
31:25
in America.
31:25
SPEAKER_03: Great.
31:26
SPEAKER_02: Well, yeah, also just across towns.
31:28
SPEAKER_02: Great to be with you.
31:30
SPEAKER_02: Maybe we could have done it in person.
31:31
SPEAKER_02: Maybe we'll do that next time.
31:32
SPEAKER_02: Next time, yeah.
31:34
SPEAKER_02: Great.
31:34
Well,
31:35
your research on Maha,
31:38
this really large survey that you guys did with 7,913
31:42
responses.
31:43
I'm wondering if you could tell us a little bit,
31:45
maybe first about tavern research.
31:48
And then get into this and then we'll jump into the research
31:51
specifically on Maha.
31:53
SPEAKER_02: What is Tavern Research and what do you guys do there?
31:55
SPEAKER_02: And yeah, just tell us a little bit about it.
31:57
SPEAKER_03: Yeah, yeah.
31:58
So we're an AI company and we happen to do opinion research
32:02
along the way.
32:03
SPEAKER_03: Broadly speaking,
32:04
Our point of view is that intelligence that's thrown off of
32:07
feedback loops is the
32:08
SPEAKER_03: currency of the future.
32:09
And specifically what that means is being in the business of
32:13
generating and
32:14
SPEAKER_03: measuring allows you to be much better at generating.
32:17
SPEAKER_03: So we do,
32:17
SPEAKER_03: we write everything from messages that might show up as like,
32:21
SPEAKER_03: you know,
32:22
SPEAKER_03: campaign slogans or ads.
32:23
SPEAKER_03: We make videos that go into,
32:26
SPEAKER_03: that can,
32:27
SPEAKER_03: you know,
32:27
SPEAKER_03: sort of be evaluated or show up on TV or digital.
32:34
SPEAKER_03: We can simulate what organic social looks like, for example.
32:38
And we want to own both the content generation and the
32:42
measurement side of it
32:43
SPEAKER_03: because the interplay between those two is really where the value is.
32:46
SPEAKER_03: So oftentimes our customers are like, well, are you...
32:50
SPEAKER_03: Are you an ad company or are you a pollster?
32:52
SPEAKER_03: And it's like, no, we're a secret third thing.
32:55
SPEAKER_03: And it makes the fit sometimes weird,
32:58
but it also allows us to do what is oftentimes uniquely
33:00
situated and interesting
33:02
research that I think oftentimes meets the moment in a way that
33:04
like you can't when
33:05
SPEAKER_03: you desegregate the two functions.
33:07
SPEAKER_02: Yeah, that's great.
33:08
One of the things that I've found for a long time that's been
33:11
really difficult is
33:12
that when you're trying to do research or you're trying to
33:15
understand something,
33:16
SPEAKER_02: like,
33:16
SPEAKER_02: for example,
33:17
SPEAKER_02: something as complicated as Maha,
33:20
SPEAKER_02: in a normal poll or a normal research instrument,
33:23
SPEAKER_02: you have so few bites at the apple.
33:25
And if you are sort of incorrect in your guesses on what
33:31
questions you should be
33:31
SPEAKER_02: asking,
33:32
it throws the whole thing out the window and you end up sort of
33:35
walking down a
33:35
SPEAKER_02: wrong road.
33:36
SPEAKER_02: and never really knowing it.
33:38
SPEAKER_02: It's a real challenge for political practitioners.
33:40
SPEAKER_02: I'm wondering if any component of that you guys are trying to solve for.
33:44
SPEAKER_03: Yeah, yeah.
33:44
SPEAKER_03: So there are a few things that I want to hear.
33:47
One is I think that your listeners and you and I both sort of
33:52
like fundamentally
33:52
SPEAKER_03: believe in science.
33:53
SPEAKER_03: You know, science is about hypothesis testing.
33:55
SPEAKER_03: And so that means that you have to come in with a hypothesis.
33:59
There are basically two approaches to sorting what we ought to
34:03
do that are widely
34:05
SPEAKER_03: adopted in politics.
34:06
SPEAKER_03: One is I throw a lot of things at the wall.
34:09
SPEAKER_03: And the other one is I throw a few things at the wall.
34:11
SPEAKER_03: And those few things are like sort of
34:14
cleverly curated,
34:15
we think that you think that that's just like the wrong way to
34:18
do research.
34:19
SPEAKER_03: So if you,
34:20
SPEAKER_03: for example,
34:21
SPEAKER_03: want to know if you should,
34:23
SPEAKER_03: and I'm going to use something pretty general here,
34:25
like if you should be communicating at like a fifth grade
34:26
reading level or an 11th
34:28
SPEAKER_03: grade reading level,
34:28
SPEAKER_03: right?
34:29
A thing you could do is you could have a message that's written
34:32
fifth grade level
34:33
and a message that's written at 11th grade level and test them
34:35
against each other.
34:36
SPEAKER_03: But there's a bunch of stuff that's going on in those messages that,
34:39
SPEAKER_03: you know,
34:40
SPEAKER_03: create these like confounders and you can't say it's like,
34:41
SPEAKER_03: oh,
34:42
SPEAKER_03: it's absolutely because of this.
34:43
And so what you need to do is have lots of different
34:46
expressions of a treatment and
34:47
SPEAKER_03: measure the aggregate across all of those where,
34:50
SPEAKER_03: you know,
34:50
you sort of balance across all of the things that could
34:53
confound like why that
34:54
SPEAKER_03: variable explain something.
34:56
SPEAKER_03: And you then get a clean read on like, oh, this works.
34:58
SPEAKER_03: We know what its marginal impact is.
35:00
SPEAKER_03: We know,
35:00
SPEAKER_03: you know,
35:00
you slot it in and you slot in fifth grade reading level when
35:04
you're talking about
35:04
SPEAKER_03: Medicare or when you're talking about climate.
35:06
SPEAKER_03: And it's, you know, it's giving, you know, what is either like
35:10
a boost of you know like a few percentage points or it's a
35:12
multiplier or something
35:13
like that but we think that doing sort of like really really
35:16
prolific content
35:17
generation and designing our experiments to sort of fit within
35:23
that framework
35:24
allows us to build a growing knowledge base which is just like
35:28
so different than
35:28
the a theoretical approaches i mean the other thing that's
35:30
really nice with that is
35:32
that when you're doing high frequency and large scale your risk
35:35
tolerance goes up
35:36
SPEAKER_03: pretty dramatically so one of the things that shows up a lot in both
35:39
paid media testing and in traditional polling is that you get
35:42
so few bites at the
35:43
apple because one there's finite time on a serving instrument
35:47
and so that means
35:48
that you get to like squeeze three or four things in with a lot
35:51
of the traditional
35:51
pollsters you're paying literally two hundred dollars an
35:53
interview i mean i could
35:55
i'll say it it's rent seeking um and the and the other uh the
35:59
other side of it is
35:59
you know if you're if you're if you're dealing in ads you're
36:02
paying ten twenty
36:03
thousand dollars for an ad and in both cases like we're just
36:06
we're just collecting
36:07
SPEAKER_03: a lot more interviews because we've automated
36:09
SPEAKER_03: that whole process.
36:10
SPEAKER_03: And we're producing, I mean, it takes us about a minute to make 200 ads.
36:14
SPEAKER_03: We have, you know, we have completely different margins.
36:17
And that means that like we can support a different sort of a
36:22
different paradigm
36:23
SPEAKER_03: for generating evidence.
36:24
SPEAKER_03: And we've been really thrilled with it so far.
36:27
SPEAKER_02: That's great.
36:27
SPEAKER_02: Yeah.
36:28
SPEAKER_02: I mean, it really is a challenge and you can see sort of
36:31
SPEAKER_02: Healthcare advocates like me missed what was happening with Maha,
36:35
SPEAKER_02: how big it was,
36:36
SPEAKER_02: where some of the trends were with public opinion.
36:39
SPEAKER_02: There was,
36:39
SPEAKER_02: I think,
36:40
fundamentally a misunderstanding of how big the movement was
36:45
and how sort of varied
36:47
SPEAKER_02: it was,
36:48
SPEAKER_02: sort of where opinions around vaccines were going,
36:50
SPEAKER_02: where opinions around different ways that people thought about health.
36:53
SPEAKER_02: And, you know, had we had a little bit more research on the front end...
36:56
maybe could have understood it earlier,
36:57
maybe could have combated it earlier.
36:59
So why don't we get into this memo that you all published at
37:02
Tavern titled,
37:03
Surprising New Research Finds Americans Oppose Technology That
37:06
Kills Us and
37:06
SPEAKER_02: Supports Technology That Saves Lives.
37:08
SPEAKER_02: Cheeky, funny.
37:09
Can you tell us a little bit about what was the approach here
37:12
to put this survey
37:13
SPEAKER_02: together and what were some of the findings?
37:15
SPEAKER_03: Yeah, yeah, sure.
37:16
So let me just let me start with the cheeky title is actually
37:19
like a thing that is
37:20
SPEAKER_03: part of our values.
37:21
SPEAKER_03: And I just sort of like for science communicators generally,
37:24
SPEAKER_03: we are competing against the most interesting parts of the Internet.
37:28
SPEAKER_03: It's not, is it science versus anti-science?
37:30
SPEAKER_03: It's science versus, you know, somebody speed running Super Mario.
37:34
and so like we really try to live our values and play with
37:39
attention as a part of
37:41
the communication of our of our work product because like this
37:44
is is the frontier
37:45
of science communications now and we just you know sort of have
37:47
to do it but in
37:48
terms of how we get to what we learned we had a customer come
37:53
in about two weeks
37:54
ago maybe maybe two and a half i don't know and asked for some
37:57
maha research they
37:59
had they were opinionated on some of the dimensions that they
38:01
wanted to look at um
38:03
SPEAKER_03: You know,
38:03
SPEAKER_03: our tech is pretty straightforward in that,
38:05
SPEAKER_03: like,
38:06
you can just sort of write questions in like a freeform Google
38:09
Doc and we turn it
38:10
SPEAKER_03: into a JavaScript that you can launch on the web,
38:13
SPEAKER_03: invite people to take surveys,
38:14
SPEAKER_03: write it back to our database,
38:15
SPEAKER_03: things like that.
38:16
SPEAKER_03: But there were a few different components here.
38:18
One is understanding baseline public opinion on various
38:21
components of Maha,
38:23
SPEAKER_03: which is interesting.
38:24
I think really important because oftentimes what we see
38:27
political researchers doing
38:29
SPEAKER_03: is bundling these things together.
38:31
SPEAKER_03: And,
38:31
SPEAKER_03: you know,
38:32
what you indicated a little bit in the lead up here is that
38:36
this is actually a
38:37
SPEAKER_03: pretty diverse basket of views.
38:40
SPEAKER_03: But, you know,
38:57
SPEAKER_03: That gives us not only a read on,
39:00
SPEAKER_03: you know,
39:00
SPEAKER_03: how opinion moves as the discourse unfolds,
39:02
SPEAKER_03: but also it gives us like an absolute read on the salience here,
39:05
SPEAKER_03: right?
39:06
Because like we do this type of work when we're talking about
39:09
Medicare and Medicaid
39:09
SPEAKER_03: cuts with one big,
39:11
SPEAKER_03: beautiful bill.
39:12
We see it with,
39:13
you know,
39:13
some of the stuff around climate with some of the stuff around.
39:16
um you know sort of other like high salience or newsworthy
39:19
things and so we can we
39:21
can say you know sort of like how does this uh situate itself
39:26
not just in the four
39:26
corners of this poll but more broadly um and i can talk about
39:29
some of the findings
39:30
now but i also know i've been sort of monologuing for a minute
39:33
so if you saw pause
39:34
SPEAKER_03: uh before yeah
39:36
SPEAKER_02: Well, yeah, let's take a look at some of the findings.
39:39
SPEAKER_02: So I'm going to just tee up some of this.
39:42
SPEAKER_02: At the first glance,
39:42
SPEAKER_02: you could read as another partisan divide,
39:44
SPEAKER_02: but the data tells a richer story.
39:46
SPEAKER_02: This is from your memo.
39:47
The public strongly backs Kennedy food safety initiatives like
39:50
banning artificial
39:51
SPEAKER_02: dyes,
39:52
SPEAKER_02: 63% support.
39:53
SPEAKER_02: Stricter FDA review of food additives, 66% support.
39:57
SPEAKER_02: And restricting ultra-processed foods in federal programs, 51% support.
40:01
But the public also rejects more controversial opinions on
40:04
vaccines and public
40:05
SPEAKER_02: health infrastructure cuts.
40:07
SPEAKER_02: Could you unpack that a little bit?
40:08
So it sounds like it sounds like the Maha movement generally is
40:13
people are divided on it.
40:14
SPEAKER_02: But when you get into the details,
40:16
you see sort of pretty big swings in favor of some components
40:19
and and either
40:21
SPEAKER_02: antipathy or opposition,
40:22
SPEAKER_02: significant opposition to some components of it.
40:24
SPEAKER_02: What stood out to you in some of those findings?
40:27
SPEAKER_03: Well, so there are a few things here.
40:28
SPEAKER_03: Like one,
40:29
you can see the traces of the distinct peripheral components of
40:34
like fringe health
40:35
that are present in the Maha movement that sort of turn it into
40:40
this one coalition
40:41
SPEAKER_03: that is in fact a bunch of
40:42
distinct groups and the thing i want to sort of point to here
40:45
um and this is a
40:47
little out of my lane because i'm not really a theory guy as
40:49
much as i am a like
40:51
spreadsheet guy there uh say what you will about uh a political
40:54
philosopher
40:55
alexander dugan he's like not a great guy uh or i don't know
41:00
him personally he's
41:01
SPEAKER_03: he's he's putin's uh favorite uh political scientist though
41:04
SPEAKER_03: But his book,
41:05
SPEAKER_03: The Fourth Political Theory,
41:07
like literally outlines how the Maha movement is built insofar
41:10
as it talks about,
41:11
SPEAKER_03: I mean,
41:12
there's sort of like weird Russia stuff that like I'm not going
41:15
to get into.
41:15
But the big thing here is that it is very easy to attack sort
41:21
of norms in the
41:22
SPEAKER_03: center from a bunch of different directions simultaneously.
41:24
SPEAKER_00: Yeah.
41:27
Building a coalition of the periphery against the center means
41:29
that you are
41:30
exposing every weak spot in what we would consider sort of like
41:33
institutions and
41:35
SPEAKER_03: norms and common sense around a lot of this stuff.
41:38
One of the most powerful aspects of that approach is that you
41:41
get to lead with
41:42
SPEAKER_03: things that have widespread public support.
41:44
SPEAKER_03: So literally nobody is going to say,
41:46
SPEAKER_03: you know what everybody needs to do is eat more Twinkies,
41:49
SPEAKER_03: right?
41:49
SPEAKER_03: That's sponsored by Hostess.
41:52
SPEAKER_02: We, no, we're mobbed up with the food dye companies.
41:58
SPEAKER_03: Yeah, yeah.
42:00
SPEAKER_03: I mean, the Yellow Five folks are, they are a powerful, powerful cohort.
42:05
You know,
42:07
the thing that we sort of see here is there is really
42:11
unobjectionable stuff in Maha.
42:12
SPEAKER_03: Right.
42:13
SPEAKER_02: Right.
42:13
SPEAKER_03: The things that everybody's parents and grandparents and,
42:17
SPEAKER_03: you know,
42:17
SPEAKER_03: anybody who has kids would say,
42:18
SPEAKER_03: like,
42:18
SPEAKER_03: don't put that in your body,
42:19
SPEAKER_03: right?
42:20
SPEAKER_03: Like, of course, of course.
42:22
SPEAKER_03: And then there's other stuff where it's like,
42:23
SPEAKER_03: well,
42:24
SPEAKER_03: you know,
42:24
SPEAKER_03: we just,
42:25
SPEAKER_03: you know,
42:25
SPEAKER_03: we eradicated smallpox.
42:26
SPEAKER_03: That's pretty good.
42:27
SPEAKER_03: Let's keep that up.
42:28
SPEAKER_01: Yeah.
42:29
SPEAKER_03: And, and people aren't, aren't nearly as into that.
42:31
SPEAKER_03: And so like,
42:32
SPEAKER_03: if you do like a top line,
42:33
SPEAKER_03: you know,
42:34
SPEAKER_03: question on like,
42:34
SPEAKER_03: where's the public out on Maha,
42:36
SPEAKER_03: like you're going to get a mixed story.
42:38
SPEAKER_03: And like,
42:38
SPEAKER_03: it's,
42:38
it codes more as like a partisan question than it does about
42:41
like actual opinion on
42:42
SPEAKER_03: any of the component parts of the agenda.
42:44
SPEAKER_03: You know, it's, it's, it's pretty diverse.
42:47
Yeah,
42:47
this is actually an interesting point you're making,
42:49
Matt,
42:49
about how you compare.
42:50
So Americans favor the government covering gym memberships and
42:55
healthy food at 60
42:57
SPEAKER_02: percent,
42:57
SPEAKER_02: according to your memo.
42:58
SPEAKER_02: I think that the challenge that some of us have with this is it's so not
43:02
SPEAKER_02: proportional that that to us or to me,
43:05
SPEAKER_02: at least I'll just speak for me.
43:07
that sort of the coverage or non-coverage of a gym membership
43:10
is such a small
43:11
SPEAKER_02: component part versus the CDC,
43:13
SPEAKER_02: the main functions of the CDC,
43:15
SPEAKER_02: or big cuts at like sort of public health agencies,
43:18
SPEAKER_02: that those seem sort of not proportional.
43:20
But do you get any insight into like intensity or if people
43:26
make some distinctions
43:27
SPEAKER_02: here within this oppose and support?
43:29
SPEAKER_02: Does anything register that sort of shows intensity or shows like
43:33
SPEAKER_02: You know,
43:33
it may be that the top line numbers on banning artificial food
43:36
dyes are pretty
43:37
SPEAKER_02: good,
43:38
but it's not nearly as intense as the way people feel about the
43:41
handling of the CDC
43:42
SPEAKER_02: and the public health infrastructure.
43:43
SPEAKER_02: Or do you see something more complicated?
43:45
SPEAKER_03: Yeah, that's a great question.
43:46
SPEAKER_03: So I there is like intensity is really the story here.
43:51
But it's this is all all of this is much lower salience than
43:55
the stuff in the one
43:56
big beautiful bill with respect to cutting like our public
43:59
health infrastructure.
44:00
SPEAKER_03: Like.
44:00
SPEAKER_03: Got it.
44:01
Medicare,
44:01
Medicaid,
44:02
you know,
44:02
kicking,
44:03
kicking needy folks off of food assistance.
44:05
SPEAKER_03: Like those are those are things that people are like not OK with.
44:09
SPEAKER_03: Like those are those are wildly, wildly unpopular.
44:12
And all of this is like all of the intensity that we observe
44:15
here is like basically
44:16
SPEAKER_03: an artifact of like.
44:18
people kind of know they're being measured and there's like a
44:19
social desirability,
44:20
SPEAKER_03: desirability bias to be like,
44:22
SPEAKER_03: yeah,
44:22
SPEAKER_03: it'd be a good idea to go to the gym or yeah,
44:24
SPEAKER_03: it'd be a good idea or whatever.
44:26
SPEAKER_03: Like,
44:26
SPEAKER_03: but this is like,
44:27
SPEAKER_03: this is in a different category from like the Medicaid cuts,
44:30
SPEAKER_03: uh,
44:30
SPEAKER_03: you know,
44:31
SPEAKER_03: and,
44:31
SPEAKER_03: and all the threats to like,
44:33
SPEAKER_03: um,
44:33
sort of the social safety net and all of the entitlements that
44:36
folks have earned.
44:37
SPEAKER_02: Well, that's good to hear.
44:37
That's like good to hear as like maybe like a silver lining
44:41
that there's that some
44:42
of the stuff that at least the Democrats will probably will be
44:45
talking about or
44:45
SPEAKER_02: ought to be talking about do have higher intensity.
44:47
What is what is also true is that we are not going to be able
44:51
to just talk about Medicaid.
44:52
in all channels at all times in every forum and some of the
44:56
other some of the high
44:57
SPEAKER_02: salience issues that Democrats are going to run on.
45:00
There are going to be places where we are talking about Maha
45:02
and we're talking
45:03
SPEAKER_02: about the topics that Maha is bringing up.
45:05
I wondered if you could share your thoughts on analyzing sort
45:08
of what the Democrats
45:09
ought to be saying or what health care advocates ought to be
45:11
saying who are out
45:12
SPEAKER_02: there advocating,
45:13
whether it's for Democrats or whether it's for improving or
45:17
sort of on a public
45:17
SPEAKER_02: policy front.
45:18
Are there recommendations you have for folks who might be
45:21
messaging on these things
45:22
SPEAKER_02: and talking about Maha?
45:23
SPEAKER_03: Yeah,
45:24
I have a bunch and I'm going to go through the evergreen stuff
45:28
first because like
45:29
SPEAKER_03: nobody ever says it and that's the most important stuff.
45:31
SPEAKER_03: Sure.
45:31
SPEAKER_03: So the number one thing is be comprehensible.
45:34
SPEAKER_03: We have observed over, you know, at this point, I think like
45:38
SPEAKER_03: 16 or 17,000 tests that voters and survey respondents,
45:41
SPEAKER_03: people like that,
45:42
understanding what the heck you're saying mediates the majority
45:45
of the persuasion
45:46
SPEAKER_03: effect.
45:46
SPEAKER_03: And so like I harp on,
45:48
SPEAKER_03: you know,
45:49
writing like a normal human and not like somebody who went to
45:51
too much grad school.
45:52
SPEAKER_03: And this is like, this is the A number one most important thing.
45:55
SPEAKER_03: And so I would start there.
45:57
SPEAKER_03: The next most important thing is...
46:02
make sure that you are actually like make sure that what you're
46:04
saying is actually
46:05
interesting um and i think that like you know in the in the
46:07
business that you're in
46:08
with with this podcast like attention is like you know the tree
46:12
falls in the woods
46:13
and no one's around here right like that right like that's
46:16
that's such a huge deal
46:17
and so a lot of the guidance that says always talk about
46:19
medicare always talk about
46:20
the entitlements or whatever that is that is a byproduct of
46:24
like that's a medium
46:25
SPEAKER_03: issue so like
46:26
In most of these surveys that you are forcing people to view
46:29
content and then
46:30
SPEAKER_03: you're saying like conditional on this view,
46:32
SPEAKER_03: what happens to your opinion?
46:34
SPEAKER_03: That's not how the world works.
46:35
SPEAKER_03: People get to skip content all the time.
46:37
SPEAKER_03: And so you have to be interesting.
46:39
SPEAKER_03: You have to be relevant.
46:40
And if you can put a spin on the day's news,
46:41
that's like,
46:42
that's one way to do it.
46:43
SPEAKER_03: You could also obviously be funny.
46:46
be like very,
46:47
you know,
46:47
very,
46:47
very,
46:47
very good looking,
46:48
like lots of,
46:49
lots of options here.
46:50
SPEAKER_03: I do, I do want to say that we don't get to live in the lab.
46:52
SPEAKER_03: We have to live in the real world, but we have to fight for attention.
46:55
Now,
46:55
having said all that,
46:56
there are a few things that I think are probably most valuable
47:01
here.
47:01
Number one is there is no reason to fight the stuff that
47:05
everybody agrees with.
47:06
SPEAKER_03: So there's broad support.
47:07
SPEAKER_03: And in fact,
47:08
SPEAKER_03: like before Maha,
47:09
SPEAKER_03: like a lot of this stuff was liberally coded,
47:11
SPEAKER_03: like Democrats were like,
47:12
SPEAKER_03: yeah,
47:12
SPEAKER_03: let's,
47:12
SPEAKER_03: let's not eat poison.
47:14
SPEAKER_03: Right.
47:14
And so I think that not allowing Republicans to own that to own
47:18
that lane is like a
47:19
SPEAKER_03: very good idea.
47:20
SPEAKER_03: I have a I have a good friend who is like a public health expert.
47:23
And she brought up a thing that she was actually on the show
47:27
last last week or two weeks ago.
47:28
And there's a real risk with vaccines that they become
47:31
polarized in a way the climate did.
47:33
SPEAKER_03: And right now they enjoy pretty broad public support.
47:36
And the risks to public health of polarizing this issue could
47:40
be devastating.
47:41
SPEAKER_03: And one of the things that we can look to here is just like,
47:43
SPEAKER_03: you know,
47:44
SPEAKER_03: we can ask people what they believe in a survey,
47:46
SPEAKER_03: but like you observe the vaccination rates,
47:48
SPEAKER_03: right?
47:48
SPEAKER_03: Like people are still like people still got the COVID shot.
47:50
SPEAKER_03: People still are vaccinating their kids before they go to school.
47:54
SPEAKER_03: And this is really not my domain.
47:55
SPEAKER_03: But like,
47:56
SPEAKER_03: I think that,
47:57
SPEAKER_03: you know,
47:57
SPEAKER_03: we enjoy herd immunity benefits as long as we're like in high 80s.
48:00
And like you polarize this issue,
48:03
it gets to the 50s overnight and then we're fucked.
48:06
SPEAKER_02: That's bleak.
48:07
SPEAKER_02: Yeah, yes.
48:08
We were just talking about at the top of the show what Lattipo
48:10
is doing down in
48:11
SPEAKER_02: Florida,
48:11
where they're rolling back mandates for school and they're
48:14
actively trying to
48:15
SPEAKER_02: politicize vaccines as one of their cudgels.
48:18
SPEAKER_02: It's very troubling.
48:20
SPEAKER_02: It's very troubling.
48:22
SPEAKER_03: Yeah, yeah.
48:23
SPEAKER_03: I mean,
48:23
I think that the thing that we have going for us right now is
48:27
that norms do a lot
48:28
SPEAKER_03: of work.
48:29
and this runs a little bit deeper than like what we see in like
48:32
the four corners of
48:32
the survey but like we know that group opinion like perceived
48:37
group opinion does a
48:38
lot of work in shaping public opinion so like if i think that
48:41
people like me
48:42
believe a thing that goes a long way right and when you pierce
48:45
that belief we see
48:47
like a rapid decrease in support i mean it goes both ways like
48:50
this is why the
48:51
SPEAKER_03: first 25 union cards and an organizing drive are the hardest to get
48:55
SPEAKER_03: You get over 30, they get pretty easy.
48:57
SPEAKER_03: You get to 50, and then the next day you're at 75, right?
49:00
And it's because perceived norms and group norms just do a ton
49:05
of heavy lifting.
49:06
SPEAKER_03: And we have that with vaccines right now.
49:08
Most of the people who are participating in society have been
49:12
vaccinated and have
49:14
SPEAKER_03: their kids vaccinated.
49:15
SPEAKER_03: So it is an out-group activity.
49:18
SPEAKER_03: And if we let that out-group get real big, that's super dangerous.
49:21
SPEAKER_03: Yeah.
49:22
SPEAKER_03: Yeah.
49:23
SPEAKER_03: But yes,
49:23
SPEAKER_03: I mean,
49:24
SPEAKER_03: I guess generally speaking,
49:25
I would not trust the limits of this poll for answering that
49:28
question because,
49:29
SPEAKER_03: you know,
49:30
what what helps Democrats win is not the thing that we want to
49:32
optimize on here.
49:33
The thing we want to optimize on here is like making sure that
49:36
we don't just,
49:37
SPEAKER_03: you know,
49:37
SPEAKER_03: get killed by smallpox in a generation.
49:39
SPEAKER_02: Yeah, that makes a ton of sense.
49:42
One more thing on the least effective messages,
49:44
and I'm going to just offer a caveat.
49:47
Criticizing big wellness or like tying NARFK to like a broader
49:51
war on science is
49:53
something that you guys concluded is not a particularly
49:56
effective message.
49:57
SPEAKER_02: For someone who like does worry about climate change,
50:00
SPEAKER_02: although it's not the main thing I work on,
50:02
is we saw messaging around like science and climate go nowhere
50:06
fast for a really
50:08
SPEAKER_02: long time.
50:08
SPEAKER_02: And it kind of took the climate advocates a long time to pivot.
50:12
SPEAKER_02: They were sort of advocating for science.
50:15
SPEAKER_02: You saw a little bit during the pandemic where there became this refrain,
50:19
SPEAKER_02: like follow the science.
50:20
SPEAKER_02: And I think people were saying that at the beginning with well intention,
50:24
but it kind of started getting like overused and kind of became
50:27
something that was
50:28
SPEAKER_02: maybe not the most effective.
50:29
SPEAKER_02: at the beginning.
50:30
SPEAKER_02: I wonder if you could talk a little bit about wellness.
50:32
SPEAKER_02: And I'll give the caveat before you answer.
50:34
SPEAKER_02: On this podcast, we are going to bash the wellness industry anyway.
50:38
It just doesn't necessarily mean that we should probably be
50:41
doing it out in public
50:42
SPEAKER_02: to a broader audience.
50:43
You know,
50:43
when it's physicians talking to one another,
50:45
we could maybe not let this industry...
50:46
Why is that not an effective message or how sort of how
50:49
ineffective is it?
50:50
SPEAKER_02: And what's the risk if we're out there doing that?
50:52
SPEAKER_03: Well,
50:52
SPEAKER_03: I mean,
50:52
SPEAKER_03: like,
50:53
SPEAKER_03: let's let's just like I mean,
50:54
we like whatever we have these experimental results that like
50:58
say a thing.
50:58
But like evidence is quaint here when compared to like the
51:01
weight of the weight of
51:02
SPEAKER_03: the evidence that we get from like living in the world.
51:04
SPEAKER_00: Right.
51:04
SPEAKER_00: OK.
51:05
SPEAKER_03: Um,
51:06
SPEAKER_03: and,
51:06
SPEAKER_03: uh,
51:07
SPEAKER_03: I think there are a few things that are,
51:08
SPEAKER_03: that are like,
51:09
SPEAKER_03: that are sort of important to anchor on here.
51:11
SPEAKER_03: Like one, we're living through the replication crisis, right?
51:15
SPEAKER_03: Like, it's not like our science has its house in order, right?
51:18
SPEAKER_03: Like we've,
51:19
we've turned all of science into like a stupid game where you
51:22
win stupid prizes and
51:24
SPEAKER_03: like yourself,
51:25
like your worth is tied to like fake credentialing that like
51:28
only other elites are
51:29
SPEAKER_03: recognized.
51:29
SPEAKER_03: And like, that is not science.
51:35
that hill that's that's like number one number two is that like
51:38
a lot of like a lot
51:39
of what we see in wellness just it propagates because it made
51:41
people feel good and
51:43
like we are we are running into an issue that we saw in covid
51:48
that we see climate
51:49
which is that people don't believe bad things can happen but if
51:52
they can observe
51:53
good things happening you're bringing it you're bringing a
51:55
squirt gun to a gunfight
51:56
to some extent there's this like issue of like what gets
51:58
considered evidence and
52:00
i'm one of the like in my domain like i do not want to live and
52:04
die by the by the
52:05
randomized control trial is the only as the only source of
52:08
evidence but i also
52:09
SPEAKER_03: think that like uh i mean like
52:11
SPEAKER_03: You know,
52:12
SPEAKER_03: we observe it like in these experimental results,
52:14
but it's also just millions of people pay attention to these
52:17
folks and they're
52:19
SPEAKER_03: consensually opting in to learn more about these things.
52:23
SPEAKER_03: And if we're just like, well, actually, that doesn't work.
52:26
SPEAKER_03: And in fact, like people feel better.
52:28
I don't want to,
52:29
you know,
52:29
come off as like too much of a meathead here,
52:31
but like,
52:31
you know,
52:32
Like you would do better as a lifter listening to the big guys
52:36
at the gym than you
52:37
SPEAKER_03: would to exercise scientists 50 years ago.
52:39
SPEAKER_03: Right.
52:39
This is a thing where like we like institutionalists when I say
52:43
we like sometimes
52:44
SPEAKER_03: I'm an institutionalist who knows,
52:46
SPEAKER_03: but like we're not communicating uncertainty.
52:48
We're not communicating where there's a lack of depth and like
52:52
that's exploitable
52:53
SPEAKER_03: because like if a thing is uncertain.
52:55
And like the folks who are on PubMed going through the going
52:59
through the tables in
52:59
SPEAKER_03: the appendix to understand like what the otherwise actually look like.
53:03
SPEAKER_03: If they're then just saying this worked and it got peer reviewed.
53:06
So like we're doing it like eventually they get caught with
53:09
like that doesn't work
53:10
SPEAKER_03: in replication.
53:11
SPEAKER_03: And now guess what?
53:12
SPEAKER_03: The institution was wrong.
53:13
SPEAKER_03: Like I'm not trying to defend.
53:15
SPEAKER_03: Like people who sell bullshit vitamins and dick pills,
53:18
SPEAKER_03: like that's like,
53:19
SPEAKER_03: that's obviously exploitative.
53:21
But I also think that like institutional science is in a really
53:24
bad place right now.
53:25
SPEAKER_03: And like,
53:26
SPEAKER_03: it's the sort of thing where like,
53:27
SPEAKER_03: I don't know,
53:27
SPEAKER_03: like we kind of have to get our house in order.
53:29
SPEAKER_02: Interesting.
53:30
SPEAKER_02: That might be a good place to leave it, Matt.
53:34
Yeah.
53:35
SPEAKER_02: That would be a good place to leave it.
53:36
SPEAKER_02: Matt, thank you so much for joining us.
53:38
SPEAKER_02: We hope you'll consider coming back as you blaze a new path in research.
53:42
SPEAKER_02: It was a pleasure learning a little bit from you today.
53:44
SPEAKER_03: Yeah, it was a really good time.
53:46
SPEAKER_03: Thank you for having me.
53:46
SPEAKER_03: I really, really appreciate it, Miles.
53:51
SPEAKER_02: Okay, Rob.
53:51
SPEAKER_02: Yeah.
53:53
SPEAKER_02: Had a great conversation with Matt.
53:54
SPEAKER_02: Learned a lot,
53:55
SPEAKER_02: I think,
53:55
SPEAKER_02: for those of us who are thinking about how to grapple with Maha,
54:01
SPEAKER_02: how to understand it,
54:02
SPEAKER_02: how to fight back,
54:04
SPEAKER_02: and where are the places where we need to fight back,
54:07
SPEAKER_02: and where are some of the places where...
54:09
SPEAKER_02: You know, maybe things that are popular are popular.
54:11
SPEAKER_02: And you can either support them or just sort of leave them alone.
54:14
SPEAKER_02: I think we'd learn a little bit more about that.
54:16
And I think we have to keep learning about what this movement
54:19
means for health care
54:21
SPEAKER_02: and American politics.
54:23
SPEAKER_01: Right.
54:23
SPEAKER_01: I think you're exactly right.
54:25
Portions of it that are popular and really are popular across
54:28
the board shouldn't
54:29
SPEAKER_01: be dismissed out of turn because they come with a label of Maha,
54:32
SPEAKER_01: right?
54:33
SPEAKER_01: The problem is,
54:33
SPEAKER_01: just like we said with RFK Jr.,
54:35
SPEAKER_01: with him,
54:36
SPEAKER_01: you kind of had to swallow the whole big red pill to take all of it,
54:39
SPEAKER_01: including the anti-vax bullshit that's going to kill people.
54:41
And we got to be as good as possible at talking about that and
54:46
at kind of getting
54:47
those people to understand the dangers of that and of the
54:51
entire menu of options
54:52
SPEAKER_01: that
54:53
SPEAKER_01: When you take it all at once.
54:54
SPEAKER_01: But yeah, good job on that.
54:55
SPEAKER_01: I appreciate you doing that interview.
54:57
SPEAKER_01: Yeah, that's great.
54:58
SPEAKER_02: All right,
54:58
SPEAKER_02: well,
54:59
SPEAKER_02: I think,
54:59
SPEAKER_02: Rob,
54:59
SPEAKER_02: I think maybe our time together today has come to an end,
55:03
SPEAKER_02: so I'm going to read us out.
55:05
Today's episode was written by Dr.
55:06
Rob Davidson and me,
55:07
Miles Baker,
55:08
and Chris Savage.
55:10
It was produced by Amelia Dillenschneider and Joel Bryson,
55:13
editing by Darian Batigan.
55:15
SPEAKER_02: Our music is by Annette Somerset at Duneflower Productions.
55:18
SPEAKER_02: If you enjoyed today's show,
55:19
SPEAKER_02: please subscribe and leave us a rating on YouTube,
55:21
SPEAKER_02: Spotify,
55:21
SPEAKER_02: Apple Podcasts,
55:22
SPEAKER_02: or wherever you listen.
55:23
SPEAKER_02: Your support helps others discover the podcast.
55:26
SPEAKER_02: You can also follow Paging America on Substack.
55:28
SPEAKER_02: And Physicians,
55:29
SPEAKER_02: Your Voice Matters,
55:30
join the fight for better American health care by becoming a
55:32
member of the
55:33
SPEAKER_02: Committee to Protect Health Care at www.committeetoprotect.org.
55:38
SPEAKER_02: Great chatting with you today, Rob.
55:39
SPEAKER_01: Have a good one.
55:39
SPEAKER_01: You too.
55:40
SPEAKER_01: See you soon to break down the RFK hearings.
55:42
SPEAKER_02: Yep.
55:43
SPEAKER_02: Stick around.
55:43
SPEAKER_02: For those who made it to the end of the episode, stick around for that.
55:46
SPEAKER_02: We'll have more shortly.
55:47
SPEAKER_02: Yep.
55:48
SPEAKER_02: Talk to you soon.