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Trifectas on the Table: How State Races Could Reshape Health Care · Paging America

• 0:00
  SPEAKER_00: Particularly small communities,
• 0:01
  SPEAKER_00: hospital is like the center of that town, of that community for jobs.
• 0:05
  SPEAKER_00: You know, if those hospitals close, people just leave town.
• 0:08
  SPEAKER_00: They don't have anything else to do.
• 0:10
  SPEAKER_00: And so making that connection between Roger Marshall's supporters' corruption
• 0:14
  SPEAKER_00: and Roger Marshall's corruption,
• 0:16
  SPEAKER_00: directly increasing costs, directly taking away healthcare, that is the story.
• 0:21
  SPEAKER_00: People are pissed about corruption,
• 0:22
  SPEAKER_00: but I think they're pissed about it in the guise
• 0:24
  SPEAKER_00: of it actually making their lives more difficult.
• 0:30
  SPEAKER_00: Miles, it's good to see you upright today.
• 0:33
  SPEAKER_00: You were down.
• 0:33
  SPEAKER_00: You were down yesterday.
• 0:34
  SPEAKER_00: Yes, I was.
• 0:35
  SPEAKER_02: What's going on?
• 0:36
  SPEAKER_02: I don't know.
• 0:36
  SPEAKER_02: I've been burning the candle at both ends because we're mid-election season, so I was down.
• 0:40
  SPEAKER_02: But I'm feeling a lot better today.
• 0:42
  SPEAKER_02: You were at an event with a lot of physicians supporting Dr.
• 0:48
  SPEAKER_02: Abdul El-Sayed down at the Detroit debate.
• 0:50
  SPEAKER_02: Is that right?
• 0:51
  SPEAKER_00: Yeah, we're outside the studio,
• 0:53
  SPEAKER_00: doctors in white coats, you know, supporting our fellow Dr. Abdul El-Sayed.
• 0:58
  SPEAKER_00: Also kind of on the heels,
• 0:59
  SPEAKER_00: you know,
• 0:59
  SPEAKER_00: of a big letter coming out from doctors in Michigan and healthcare providers,
• 1:03
  SPEAKER_00: over a thousand healthcare professionals in Michigan,
• 1:06
  SPEAKER_00: you know, declaring their support for fellow Dr. Abdul El-Sayed.
• 1:09
  SPEAKER_00: And I'm going to tell you,
• 1:11
  SPEAKER_00: Some of the just meanest people I've ever seen in real life on
• 1:16
  SPEAKER_00: the other side just screaming at us with Mike Rogers signs.
• 1:19
  SPEAKER_00: Just like every racist rant against Abdul and just socialism.
• 1:28
  SPEAKER_00: Someone looked and said my white coat was from Party City.
• 1:31
  SPEAKER_00: That's pretty funny.
• 1:35
  SPEAKER_00: But it was a person in a Dalmatian suit with a megaphone.
• 1:39
  SPEAKER_00: And I think...
• 1:41
  SPEAKER_00: Like guns is a real divisive issue in this country.
• 1:44
  SPEAKER_00: I think megaphone control needs to be a thing we talk about.
• 1:48
  SPEAKER_00: This person didn't need a megaphone and really shouldn't have had one.
• 1:53
  SPEAKER_00: And also, somebody brought, I think, a 30-foot Jeffrey Epstein to this rally.
• 1:59
  SPEAKER_00: Like an inflatable?
• 2:01
  SPEAKER_02: I watched it on the internet.
• 2:02
  SPEAKER_02: I wasn't able to be there, but I was watching it.
• 2:04
  SPEAKER_02: Yeah, yeah,
• 2:05
  SPEAKER_02: I just know that the Mike Rogers protesters,
• 2:07
  SPEAKER_02: the ones who were there protesting Abdul or supporting Mike Rogers
• 2:11
  SPEAKER_02: and screaming their heads off like crazy people,
• 2:14
  SPEAKER_02: they spent a lot of time trying to cover up Um,
• 2:19
  SPEAKER_02: the giant inflatable Jeffrey Epstein, like with their signs.
• 2:22
  SPEAKER_02: It almost looked like Jeffrey Epstein was,
• 2:25
  SPEAKER_02: uh, like the big inflatable Jeffrey Epstein was supporting Mike Rogers.
• 2:29
  SPEAKER_02: But irony is dead if these guys spent their time trying to cover up the phrase on
• 2:35
  SPEAKER_02: the thing that said,
• 2:36
  SPEAKER_02: Epstein class,
• 2:36
  SPEAKER_02: that the Mike Rogers people were trying to cover up the Epstein class,
• 2:40
  SPEAKER_02: were engaging in a cover up.
• 2:41
  SPEAKER_02: They were totally unselfaware.
• 2:43
  SPEAKER_00: A little too on the nose, right?
• 2:47
  SPEAKER_02: Back in the day,
• 2:48
  SPEAKER_02: a long time ago,
• 2:50
  SPEAKER_02: wild-eyed protestors were the providence of the left,
• 2:53
  SPEAKER_02: and it seems like it's the right now.
• 2:57
  SPEAKER_02: You have physicians and nurses calmly showing their support,
• 3:01
  SPEAKER_02: and these people just going absolutely nuts.
• 3:04
  SPEAKER_00: Hey, man, it started with the Tea Party.
• 3:06
  SPEAKER_00: It ramped up on January 6th, right?
• 3:09
  SPEAKER_00: Like that was the ultimate, like actually attacking police officers.
• 3:13
  SPEAKER_00: And they, you know, the rhetoric just continues.
• 3:16
  SPEAKER_00: And yeah, it was ugly.
• 3:17
  SPEAKER_00: I was not,
• 3:18
  SPEAKER_00: I was kind of not prepared for like that level and the ability
• 3:22
  SPEAKER_00: to not completely engage.
• 3:24
  SPEAKER_00: I'm not going to say I didn't engage a little bit, but like, you know, to not really go off.
• 3:28
  SPEAKER_00: That took a lot of restraint, 55 years of living in restraint to not go there.
• 3:34
  SPEAKER_02: All right, everyone.
• 3:35
  SPEAKER_02: Welcome back to Paging America.
• 3:37
  SPEAKER_02: This is the show where we explore the power and profit shaping American healthcare
• 3:40
  SPEAKER_02: and your home base for news and interviews from people building
• 3:43
  SPEAKER_02: the universal healthcare movement.
• 3:44
  SPEAKER_02: I'm your host, campaign strategist Miles Baker.
• 3:46
  SPEAKER_00: And I'm Dr.
• 3:47
  SPEAKER_00: Rob Davidson.
• 3:48
  SPEAKER_02: And we have a great Great show for you today,
• 3:50
  SPEAKER_02: but before we get started,
• 3:50
  SPEAKER_02: please head over to our YouTube and hit the subscribe button.
• 3:53
  SPEAKER_02: Help us fight misinformation and disinformation on the platform
• 3:56
  SPEAKER_02: with real healthcare news and opinions.
• 3:58
  SPEAKER_02: Thank you.
• 3:58
  SPEAKER_02: So we got a big show today, Rob.
• 4:01
  SPEAKER_02: We're going to talk a little bit.
• 4:02
  SPEAKER_02: There's a lot in the news about what's happening federally,
• 4:05
  SPEAKER_02: and a lot of people are covering that in a great way,
• 4:07
  SPEAKER_02: but we're going to dive a little deeper into what might happen in states and
• 4:10
  SPEAKER_02: the implications for healthcare policy.
• 4:12
  SPEAKER_02: We're going to touch on the physician running for re-election down in Kansas,
• 4:17
  SPEAKER_02: Dr. Det, Roger Marshall, as he limps through the finish line.
• 4:22
  SPEAKER_02: RFK Jr.
• 4:22
  SPEAKER_02: will head up the new White House Women's Health Task Force in one of the craziest,
• 4:26
  SPEAKER_02: I mean, just stupid ideas ever.
• 4:29
  SPEAKER_02: And then a vaccine research program in Guinea-Bissau touted by RFK has major ethical issues.
• 4:35
  SPEAKER_02: And then, Rob, who did you, I know you did the interview yesterday.
• 4:39
  SPEAKER_02: Who did we talk to?
• 4:40
  SPEAKER_00: I talked with oncologist Dr. Mikhail Sekiris.
• 4:43
  SPEAKER_00: We talked a bit about Pope Leo and his lung cancer diagnosis and surgery
• 4:47
  SPEAKER_00: and potential prognosis.
• 4:48
  SPEAKER_00: Now, since then, I will say, news dropped yesterday that the Pope is done with treatment, right?
• 4:52
  SPEAKER_00: They cured his cancer.
• 4:53
  SPEAKER_00: We're all very happy.
• 4:55
  SPEAKER_00: For the Pope, right?
• 4:56
  SPEAKER_00: Great voice of reason and promoting peace in this world.
• 5:01
  SPEAKER_00: But we talk more about cancer, particularly cancer and nonsmokers.
• 5:06
  SPEAKER_00: It's just,
• 5:06
  SPEAKER_00: I think,
• 5:07
  SPEAKER_00: an interesting conversation,
• 5:08
  SPEAKER_00: a little different than what we sometimes do,
• 5:10
  SPEAKER_00: but I think interesting and definitely worth a listen.
• 5:12
  SPEAKER_02: Okay, yeah, so stick around for that if that's an interesting topic for you.
• 5:16
  SPEAKER_02: All right, let's get into some polling.
• 5:21
  SPEAKER_02: I'll say it again.
• 5:21
  SPEAKER_02: This year has been a deluge of polling.
• 5:25
  SPEAKER_02: Too many pollsters.
• 5:26
  SPEAKER_02: All right, guys, cool it, everybody.
• 5:28
  SPEAKER_02: We've got these fake pollsters.
• 5:30
  SPEAKER_02: Not everyone needs a research shop, you know?
• 5:33
  SPEAKER_02: But the Times-Siena poll came out, and that's really considered the gold standard.
• 5:39
  SPEAKER_02: The New York Times-Siena poll was showing that Dems are at
• 5:42
  SPEAKER_02: a plus 11 generic gubernatorial,
• 5:46
  SPEAKER_02: plus 5 for Senate races, and then plus 11 for Congress.
• 5:50
  SPEAKER_02: Trump has a 59% disapproval rating and 36% approval,
• 5:55
  SPEAKER_02: and a plurality of voters will vote for candidates who provide a check on Trump.
• 5:59
  SPEAKER_02: We were saying that this might be as bad as Bush in 06 or Clinton in 94,
• 6:06
  SPEAKER_02: but we are fully into Harry Truman territory.
• 6:10
  SPEAKER_02: There is not really a modern precedent for how unpopular the president is.
• 6:15
  SPEAKER_02: That does bode well for the Democrats in the midterms.
• 6:17
  SPEAKER_02: 43% of people are very dissatisfied with the Democratic Party,
• 6:20
  SPEAKER_02: but 52% are very dissatisfied with the GOP.
• 6:23
  SPEAKER_02: People trust Democrats over the GOP on a wide range of issues.
• 6:26
  SPEAKER_02: On health care, it's a 20-point gap.
• 6:29
  SPEAKER_02: So this year, a remarkable number of states.
• 6:32
  SPEAKER_02: So federally, that bodes really well.
• 6:34
  SPEAKER_02: And I know we're all really concerned about the House and the Senate.
• 6:37
  SPEAKER_02: And yeah, it makes sense to be concerned about those.
• 6:40
  SPEAKER_02: But a place where there's like some real interesting,
• 6:43
  SPEAKER_02: and the thing that could be really interesting this year,
• 6:45
  SPEAKER_02: is a remarkable number of states could end up with trifectas.
• 6:50
  SPEAKER_02: And it has sort of the corporatist group,
• 6:52
  SPEAKER_02: the State Policy Network, which is the Koch Brothers funded bill mill.
• 6:57
  SPEAKER_02: People have called it a bill mill.
• 6:59
  SPEAKER_02: It has them rattled according to their...
• 7:01
  SPEAKER_02: So this is from a right-wing think tank, not Democrats.
• 7:05
  SPEAKER_02: Their analysis says seven states have paths to new democratic trifectas.
• 7:09
  SPEAKER_02: That includes Nevada, Arizona, Minnesota, Wisconsin, Michigan, Pennsylvania, and New Hampshire.
• 7:15
  SPEAKER_02: In addition,
• 7:15
  SPEAKER_02: eight existing trifectas could break,
• 7:17
  SPEAKER_02: including seven Republican trifectas and one Democratic trifecta.
• 7:21
  SPEAKER_02: Maine's Dem trifecta could break,
• 7:23
  SPEAKER_02: and the seven vulnerable GOP trifectas are Texas,
• 7:26
  SPEAKER_02: Iowa, Ohio, Georgia, South Carolina, Florida, and New Hampshire.
• 7:29
  SPEAKER_02: Obviously, like Dems taking the chamber in Florida, Maybe even Texas.
• 7:34
  SPEAKER_02: These all seem like a little challenging, but they're worried about them.
• 7:38
  SPEAKER_02: I'm not so sure that some of these Southern states are going to go,
• 7:41
  SPEAKER_02: but also,
• 7:42
  SPEAKER_02: a lot of them have super majorities,
• 7:44
  SPEAKER_02: and you're going to see wipeouts of super majorities,
• 7:46
  SPEAKER_02: and that has real implications if they end up in divided government.
• 7:51
  SPEAKER_02: Exciting stuff in the states.
• 7:53
  SPEAKER_02: And I will just say, like,
• 7:54
  SPEAKER_02: you have,
• 7:55
  SPEAKER_02: along with me and all of our friends at the Committee to Protect Healthcare,
• 7:59
  SPEAKER_02: we have done healthcare advocacy in states with divided government.
• 8:03
  SPEAKER_02: I'm wondering if you have any reflections on how difficult that is.
• 8:06
  SPEAKER_00: Yeah, yeah.
• 8:07
  SPEAKER_00: I mean, policy advocacy, right?
• 8:09
  SPEAKER_00: It's even tough with unified, you know, trifecta government.
• 8:13
  SPEAKER_00: And hopefully they've all and we've all learned a lesson now and don't read too much
• 8:18
  SPEAKER_00: into a big night on election night saying, Wow, everyone loves Democrats.
• 8:23
  SPEAKER_00: It's like, no, you have to do something, people.
• 8:25
  SPEAKER_00: You have to make people's lives better.
• 8:27
  SPEAKER_00: When it comes to healthcare,
• 8:28
  SPEAKER_00: it's lowering prescription drug costs,
• 8:29
  SPEAKER_00: like lowering insurance costs,
• 8:31
  SPEAKER_00: like breaking up these massive profit-driven monopolies
• 8:35
  SPEAKER_00: that hospitals have driving up prices.
• 8:37
  SPEAKER_00: You have to do those things.
• 8:39
  SPEAKER_00: But man, like trying to do anything when you don't have.
• 8:43
  SPEAKER_00: And again, we just got to be real here.
• 8:46
  SPEAKER_00: It is the Democrats who have done anything in states to lower prices when it comes
• 8:52
  SPEAKER_00: to health care, seemingly when it comes to anything.
• 8:54
  SPEAKER_00: And so getting full Democrat control in these places,
• 9:01
  SPEAKER_00: it just opens up the possibilities to a public option in Wisconsin,
• 9:05
  SPEAKER_00: to a prescription drug board or other ways of lowering drug prices in
• 9:08
  SPEAKER_00: a state like Michigan.
• 9:10
  SPEAKER_00: And so I'm ecstatic at the possibility of this because it just opens that aperture
• 9:16
  SPEAKER_00: on the places.
• 9:17
  SPEAKER_00: Because let's be real,
• 9:18
  SPEAKER_00: it's going to be tough to get anything significant done in Washington, D.C.
• 9:23
  SPEAKER_00: Or somebody who is a Republican will still be president until January 20th of 29.
• 9:29
  SPEAKER_02: The Hawaii Senator Brian Schatz thought that maybe they could restore Medicaid cuts.
• 9:33
  SPEAKER_02: And I'm glad he's saying that.
• 9:34
  SPEAKER_02: And I'm glad they're looking at it.
• 9:36
  SPEAKER_02: But I'm just very skeptical that Donald Trump is going
• 9:40
  SPEAKER_02: to let any health care restoration happen.
• 9:42
  SPEAKER_02: It doesn't benefit him personally.
• 9:44
  SPEAKER_02: They're not able to skim off the top.
• 9:45
  SPEAKER_02: It's not on his agenda.
• 9:46
  SPEAKER_02: He'll use the veto pen.
• 9:47
  SPEAKER_00: But I hope they call whatever they do Trump care.
• 9:50
  SPEAKER_00: Just give it to him.
• 9:51
  SPEAKER_00: I don't give Gild it, right?
• 9:55
  SPEAKER_00: He can get a peace prize out of it.
• 9:57
  SPEAKER_00: Who gives a shit?
• 9:57
  SPEAKER_00: We just gotta get relief for people.
• 9:59
  SPEAKER_02: Yeah, I'm fine for calling it that.
• 10:03
  SPEAKER_02: Just to run through some of the possibilities in the trifecta.
• 10:06
  SPEAKER_02: So ABC News reports that Dems plan to codify abortion rights if they win a trifecta
• 10:09
  SPEAKER_02: in Pennsylvania.
• 10:10
  SPEAKER_02: That's great.
• 10:11
  SPEAKER_02: Minnesota Dems say they plan to work on affordability and the cost of healthcare and housing.
• 10:16
  SPEAKER_02: That would be great.
• 10:17
  SPEAKER_02: A public option has been floated in the past in Minnesota.
• 10:20
  SPEAKER_02: I will say the Democrats weren't able to get that done because of
• 10:23
  SPEAKER_02: a left-wing Democrat, not because of a right-wing Republican.
• 10:27
  SPEAKER_02: The public option in Minnesota got tanked by a Medicare for All diehard,
• 10:31
  SPEAKER_02: which was very uncool of him because Medicare for All is not available at
• 10:35
  SPEAKER_02: the state level.
• 10:36
  SPEAKER_02: So it was just like a really, it was like a, you know, that was too bad.
• 10:40
  SPEAKER_02: So it's just like,
• 10:41
  SPEAKER_02: even if you have a trifecta,
• 10:42
  SPEAKER_02: it's not a foregone conclusion that you're going to be able
• 10:44
  SPEAKER_02: to pass significant healthcare reform.
• 10:46
  SPEAKER_02: Healthcare affordability is a top priority in Nevada for Aaron Ford,
• 10:49
  SPEAKER_02: who's running against Joe Lombardo, who held up the Nevada public option.
• 10:53
  SPEAKER_02: That's one of his claims to fame.
• 10:54
  SPEAKER_02: Joe Lombardo,
• 10:56
  SPEAKER_02: the current governor of Nevada,
• 10:58
  SPEAKER_02: basically has slow rolled a robust public option that was passed by the legislature,
• 11:03
  SPEAKER_02: and he's intervening on it at the executive level.
• 11:05
  SPEAKER_02: That's not going to happen if Aaron Ford wins.
• 11:07
  SPEAKER_02: In Arizona,
• 11:09
  SPEAKER_02: they're going to pass reproductive rights legislation,
• 11:11
  SPEAKER_02: and in Michigan,
• 11:12
  SPEAKER_02: Lowering prescription drug costs
• 11:14
  SPEAKER_02: and potentially putting hospital consolidation oversight inside of
• 11:18
  SPEAKER_02: the attorney general's office are on the table there.
• 11:20
  SPEAKER_02: So just really exciting.
• 11:21
  SPEAKER_02: Just like a list of like,
• 11:23
  SPEAKER_02: it's not as exciting as big universal health care proposals at the federal level,
• 11:26
  SPEAKER_02: but these are things that can make meaningful differences in people's lives in
• 11:30
  SPEAKER_02: the states.
• 11:30
  SPEAKER_02: And so the way that
• 11:32
  SPEAKER_02: the state legislators are shaping up could have Some really cool outcomes
• 11:36
  SPEAKER_02: for healthcare and healthcare politics.
• 11:38
  SPEAKER_00: What's the saying?
• 11:39
  SPEAKER_00: States are the laboratory of democracy or something like
• 11:42
  SPEAKER_02: that, right?
• 11:42
  SPEAKER_02: Laboratory of democracy.
• 11:44
  SPEAKER_02: Yeah.
• 11:45
  SPEAKER_02: One of the things that is true about public option healthcare,
• 11:49
  SPEAKER_02: we have not expanded healthcare in this country
• 11:53
  SPEAKER_02: that did not include significant giveaways to the private sector in
• 11:57
  SPEAKER_02: a very long time.
• 11:58
  SPEAKER_02: You start to experiment with that at the states and you can show that it can happen federally.
• 12:04
  SPEAKER_02: You know, it's just like it's been years since that's happened.
• 12:07
  SPEAKER_02: And so there's like,
• 12:08
  SPEAKER_02: you know, I think for some people that it's their imagination can't go there.
• 12:12
  SPEAKER_02: It's easy,
• 12:13
  SPEAKER_02: you know,
• 12:13
  SPEAKER_02: like for a policymaker,
• 12:14
  SPEAKER_02: for activists and for people who care about this stuff,
• 12:16
  SPEAKER_02: it's just like Medicare for all or federal public option.
• 12:19
  SPEAKER_02: And it's like so much easier said than actually done.
• 12:22
  SPEAKER_02: But if you go do the hard work,
• 12:23
  SPEAKER_02: the shovel work of getting some of this done in the states,
• 12:26
  SPEAKER_02: show the feds that it can happen.
• 12:28
  SPEAKER_02: It creates momentum, and the laboratories of democracy are at work.
• 12:32
  SPEAKER_02: So, yeah.
• 12:33
  SPEAKER_00: I think the other piece of this is, you touched on it, it's a proof point, right?
• 12:38
  SPEAKER_00: But it's also a proof point electorally.
• 12:40
  SPEAKER_00: And if you look at,
• 12:42
  SPEAKER_00: you know, like,
• 12:43
  SPEAKER_00: I hear all the time,
• 12:44
  SPEAKER_00: well, the Democratic Party is less popular than Trump or whoever, right?
• 12:49
  SPEAKER_00: But a lot of that unpopularity is from people who are Democrats, right?
• 12:53
  SPEAKER_00: People who are on the left or just pissed at their party for not doing enough.
• 12:57
  SPEAKER_00: It isn't like, no.
• 12:58
  SPEAKER_00: You lowered costs too much, right?
• 12:59
  SPEAKER_00: You gave too much healthcare.
• 13:01
  SPEAKER_00: It's like you're not doing enough.
• 13:02
  SPEAKER_00: And so if you can show in these states, okay,
• 13:05
  SPEAKER_00: you went to the mailbox,
• 13:06
  SPEAKER_00: you voted in a trifecta in Michigan,
• 13:08
  SPEAKER_00: in Arizona,
• 13:09
  SPEAKER_00: in Minnesota,
• 13:09
  SPEAKER_00: you know,
• 13:10
  SPEAKER_00: Wisconsin,
• 13:10
  SPEAKER_00: across the board,
• 13:11
  SPEAKER_00: and then look what you did It's saying, okay, now, 2028,
• 13:17
  SPEAKER_00: let's do this in a bigger way because we already showed you we could do it
• 13:20
  SPEAKER_00: in your state.
• 13:21
  SPEAKER_00: What the hell could we actually accomplish in DC if you give the reins of power
• 13:25
  SPEAKER_00: and we run on that and then we actually do it?
• 13:28
  SPEAKER_00: Like I think it's a one, two, three, however many step process to actually do it.
• 13:32
  SPEAKER_00: But I think it's essential if anyone's going to trust them heading into 28 and trust
• 13:38
  SPEAKER_00: the rhetoric that's going to be coming out in the Democratic primary
• 13:42
  SPEAKER_00: of helping people when it comes to lowering costs, particularly with health care.
• 13:46
  SPEAKER_02: Yeah, that's exactly right.
• 13:48
  SPEAKER_02: All right, enough on the states.
• 13:50
  SPEAKER_02: I know people don't want to,
• 13:51
  SPEAKER_02: I feel like when we talk about state politics,
• 13:53
  SPEAKER_02: it's kind of like serving up vegetables to people.
• 13:55
  SPEAKER_02: But if you're this interested in healthcare policy,
• 13:57
  SPEAKER_02: that you're listening to Paging America, you're probably interested in this state.
• 14:00
  SPEAKER_02: So that's a little rundown.
• 14:03
  SPEAKER_02: We'll be watching it on election night.
• 14:04
  SPEAKER_02: And I will share,
• 14:06
  SPEAKER_02: we will be circulating in the show notes,
• 14:08
  SPEAKER_02: not next episode,
• 14:09
  SPEAKER_02: but before election day,
• 14:11
  SPEAKER_02: A comprehensive tracker of all the state elections
• 14:14
  SPEAKER_02: that have healthcare policy implications.
• 14:16
  SPEAKER_02: So that'll be a resource that we're going to be providing for folks,
• 14:18
  SPEAKER_02: and you can take a look at it.
• 14:20
  SPEAKER_02: That'll be sponsored by the Committee to Protect Healthcare.
• 14:22
  SPEAKER_02: We'll make sure that we make it available to listeners of this show as well.
• 14:25
  SPEAKER_00: Are we going to have a nerd alert with it?
• 14:27
  SPEAKER_02: Nerd alert?
• 14:27
  SPEAKER_02: Yeah.
• 14:28
  SPEAKER_02: Nerd alert.
• 14:28
  SPEAKER_02: Amen.
• 14:29
  SPEAKER_02: I'll be looking at it.
• 14:30
  SPEAKER_02: I'll be on it.
• 14:30
  SPEAKER_02: I'll be on it all day.
• 14:31
  SPEAKER_02: I'll have a real nerd alert.
• 14:33
  SPEAKER_00: Yeah, yeah, yeah.
• 14:33
  SPEAKER_00: Okay.
• 14:35
  SPEAKER_02: All right, so let's transition over to federal elections for healthcare.
• 14:40
  SPEAKER_02: And this is my favorite Senate race in America, Alaska to Miami.
• 14:44
  SPEAKER_02: This is the best one.
• 14:45
  SPEAKER_02: It's the most exciting.
• 14:46
  SPEAKER_02: Vulnerable Republican, Kansas Senator Roger Marshall.
• 14:50
  SPEAKER_02: He's limping into Election Day.
• 14:53
  SPEAKER_02: He's run an absolutely pathetic campaign.
• 14:56
  SPEAKER_02: His congressional finance report
• 14:59
  SPEAKER_02: with no staff makes it seem like he's probably doing a federal crime
• 15:04
  SPEAKER_02: by having his government employees run his campaign.
• 15:07
  SPEAKER_02: Allegedly, no one's proved that yet, but I bet when he loses, he's in trouble.
• 15:14
  SPEAKER_02: On the heels of absolutely brutal reporting by The Times
• 15:17
  SPEAKER_02: about Roger Marshall suing his indigent patients and having them arrested,
• 15:21
  SPEAKER_02: in the final days of the election cycle,
• 15:22
  SPEAKER_02: his campaign is looking very much in jeopardy.
• 15:24
  SPEAKER_02: First, he's on the record and on camera saying that Kansas don't care about
• 15:28
  SPEAKER_02: the astronomical cost of gas,
• 15:30
  SPEAKER_02: and they don't care about having no money because,
• 15:32
  SPEAKER_02: well, let's just watch his own awful words.
• 15:36
  SPEAKER_02: So what I'm trying to say,
• 15:37
  SPEAKER_02: answer your question,
• 15:38
  SPEAKER_02: certainly the cost of gas is an issue,
• 15:40
  SPEAKER_02: but now people are coming home saying, oh, What's more important than money?
• 15:44
  SPEAKER_02: There are things more important than money to Kansans.
• 15:47
  SPEAKER_00: Two weeks out?
• 15:49
  SPEAKER_00: This is what you say, two weeks from election.
• 15:51
  SPEAKER_00: I mean, it's a hell of a closing message.
• 15:53
  SPEAKER_00: People might be voting.
• 15:53
  SPEAKER_00: I don't know the early voting calendar in Kansas.
• 15:55
  SPEAKER_00: They might be.
• 15:56
  SPEAKER_00: I don't know.
• 15:56
  SPEAKER_00: But hell, two weeks?
• 15:57
  SPEAKER_02: Yeah, it's a hell of a closing message.
• 16:01
  SPEAKER_02: Also, last night on the debate stage,
• 16:03
  SPEAKER_02: one, Roger Marshall got absolutely thumped in his second debate.
• 16:08
  SPEAKER_02: It was just ugly.
• 16:10
  SPEAKER_02: I was trying to keep track.
• 16:11
  SPEAKER_02: There was the Crowley debate, the Abdul debate, and the Roger Marshall-Adam Hamilton debate.
• 16:17
  SPEAKER_02: I was trying to keep track of all three of them last night.
• 16:19
  SPEAKER_02: But it was almost like, oh, let him up.
• 16:23
  SPEAKER_02: He's hurt.
• 16:24
  SPEAKER_02: But he looked like he had a Miami tan.
• 16:27
  SPEAKER_00: Oh, yeah.
• 16:28
  SPEAKER_00: Oh, he's another Florida guy.
• 16:30
  SPEAKER_00: He lives in Florida.
• 16:31
  SPEAKER_02: And he looks like he just like, I wanted to check his feet for sand.
• 16:36
  SPEAKER_02: The guy looks like he just got in from Tampa or something.
• 16:40
  SPEAKER_00: And he bolted after, right?
• 16:41
  SPEAKER_00: Like the news organization who hosted it, they interviewed Adam Hamilton.
• 16:45
  SPEAKER_00: They said, well, we tried to interview Senator Marshall, but he left.
• 16:48
  SPEAKER_00: He left.
• 16:48
  SPEAKER_02: Yeah, he left the room.
• 16:50
  SPEAKER_02: He like ran out of the building.
• 16:52
  SPEAKER_00: He knew, man.
• 16:53
  SPEAKER_02: It's incredible to watch some of these red state Republicans who just kind of luck
• 16:56
  SPEAKER_02: into their seats because of endurance or just like,
• 16:59
  SPEAKER_02: they're just like around and easy to elect,
• 17:02
  SPEAKER_02: that the minute the spotlight hits them,
• 17:04
  SPEAKER_02: you're like, oh,
• 17:05
  SPEAKER_02: this person is like,
• 17:07
  SPEAKER_02: you know, I wouldn't trust this person to do anything in my life.
• 17:10
  SPEAKER_02: One of the more.
• 17:12
  SPEAKER_00: And Adam Hamilton said, well, did you call ICE on those people right after they delivered?
• 17:16
  SPEAKER_00: You know, like, because that is the reality.
• 17:27
  SPEAKER_00: What's going on now, right?
• 17:29
  SPEAKER_00: And I don't know.
• 17:30
  SPEAKER_00: I mean, and for a guy who sued people for bills as low as $100,
• 17:34
  SPEAKER_00: some of them ending up in jail,
• 17:36
  SPEAKER_00: when he was making three quarters of a million dollars and he set
• 17:40
  SPEAKER_00: the loan shark rate of 18% on the debt people owed him,
• 17:45
  SPEAKER_00: this guy is saying, well, Kansans care about more things than money.
• 17:48
  SPEAKER_00: Well, he sure as hell didn't.
• 17:49
  SPEAKER_00: Like, that's all he cared about.
• 17:51
  SPEAKER_00: Like, it's crazy.
• 17:52
  SPEAKER_00: You know, what's good for you, but not for me.
• 17:54
  SPEAKER_00: It's insane.
• 17:54
  SPEAKER_02: And that's not all.
• 17:55
  SPEAKER_02: We have more.
• 17:56
  SPEAKER_02: Sorry, we're gonna go in on Roger Marshall, because this guy's such a scumbag.
• 18:00
  SPEAKER_02: The American Prospect has a piece out this week titled,
• 18:02
  SPEAKER_02: A Major Roger Marshall Donor Is a Hospital Bandit.
• 18:07
  SPEAKER_02: In it, they reveal that one of Marshall's top donors One of those owners
• 18:10
  SPEAKER_02: a rapacious private equity investor who buys hospitals,
• 18:14
  SPEAKER_02: strips them of all their value, and then dumps them.
• 18:16
  SPEAKER_02: Four months ago,
• 18:17
  SPEAKER_02: a Kansas-based private equity mogul named Dan Tasset posted on LinkedIn
• 18:20
  SPEAKER_02: about his admiration for a trusted representative in Congress.
• 18:24
  SPEAKER_02: Raising Marshall in his capacity as a constituent,
• 18:27
  SPEAKER_02: he and Marshall have been business partners for nearly 30 years.
• 18:31
  SPEAKER_02: Going back to the co-ownership of a health facility in Great Bend,
• 18:34
  SPEAKER_02: Kansas in 1998,
• 18:35
  SPEAKER_02: Marshall and his family have also invested in several of TASIT's venture funds,
• 18:39
  SPEAKER_02: as TASIT's private equity firm, Nutera,
• 18:42
  SPEAKER_02: where the business model is familiar for private equity forays into healthcare.
• 18:46
  SPEAKER_02: Nutera and its affiliates,
• 18:47
  SPEAKER_02: which TASIT claims have developed, quote,
• 18:49
  SPEAKER_02: More than 150 surgical facilities across 38 states have a nasty habit of buying
• 18:54
  SPEAKER_02: and strip mining hospitals that spiral into bankruptcy.
• 18:57
  SPEAKER_02: Two hospitals in Missouri and one in Florida have suffered this fate in the last decade.
• 19:02
  SPEAKER_02: Tacit brags on its website that it has deployed more than $850 million
• 19:05
  SPEAKER_02: in capital,
• 19:06
  SPEAKER_02: helped create approximately $4.5 billion in enterprise value,
• 19:10
  SPEAKER_02: and distributed more than $3 billion to investors.
• 19:12
  SPEAKER_02: It gets worse.
• 19:13
  SPEAKER_02: In addition to direct funding,
• 19:15
  SPEAKER_02: Marshall's campaign,
• 19:16
  SPEAKER_02: a tacit-affiliated company gave $100,000 to a pro-Marshall super PAC
• 19:19
  SPEAKER_02: that helped him win the Senate seat back in 2020.
• 19:22
  SPEAKER_02: So the game is they use private equity.
• 19:26
  SPEAKER_02: They invest in clinics and hospitals.
• 19:28
  SPEAKER_02: They strip mine those.
• 19:30
  SPEAKER_02: They flip some of the profits into a super PAC to make this guy a senator.
• 19:34
  SPEAKER_02: And then once anyone looks at it, they're like, he's the worst senator.
• 19:38
  SPEAKER_02: That's where we're at in Kansas.
• 19:42
  SPEAKER_02: Yeah, Marshall has worked to return the favor,
• 19:44
  SPEAKER_02: repeatedly introducing legislation to benefit Nutera.
• 19:46
  SPEAKER_02: In at least one instance,
• 19:47
  SPEAKER_02: legislation Marshall introduced benefited specific tacit companies
• 19:51
  SPEAKER_02: that Marshall's family was personally invested in.
• 19:53
  SPEAKER_02: This is the corruption.
• 19:55
  SPEAKER_02: This is the corruption that is driving up costs.
• 19:59
  SPEAKER_02: It is case number one.
• 20:01
  SPEAKER_02: This guy,
• 20:01
  SPEAKER_02: if Roger Marshall makes it back to the Senate, I mean,
• 20:06
  SPEAKER_02: I know the Senate doesn't really investigate other senators,
• 20:09
  SPEAKER_02: but this guy's engaged in some of
• 20:11
  SPEAKER_02: the grossest healthcare business practices you could possibly be engaged in.
• 20:15
  SPEAKER_02: And this is the waste and fraud.
• 20:17
  SPEAKER_02: Anyway, Rob, what do you think?
• 20:18
  SPEAKER_00: Yeah.
• 20:18
  SPEAKER_00: Well, and I think your analysis is exactly where I think we've seen John Ossoff talk
• 20:23
  SPEAKER_00: about this a lot.
• 20:24
  SPEAKER_00: Like, it's not just corruption for corruption's sake.
• 20:26
  SPEAKER_00: Because most of us,
• 20:27
  SPEAKER_00: I think most people in this country can look at what Trump's doing in office
• 20:30
  SPEAKER_00: and think this is just gross, right?
• 20:32
  SPEAKER_00: The crypto schemes and all that.
• 20:34
  SPEAKER_00: But it's like the corruption directly linked to driving up costs,
• 20:38
  SPEAKER_00: or in the case of this guy,
• 20:40
  SPEAKER_00: right, taking away hospitals, taking away jobs for people at hospitals.
• 20:45
  SPEAKER_00: In most communities,
• 20:47
  SPEAKER_00: particularly small communities,
• 20:48
  SPEAKER_00: hospitals It's like the center of that town, of that community for jobs.
• 20:54
  SPEAKER_00: You know,
• 20:55
  SPEAKER_00: if those hospitals close,
• 20:56
  SPEAKER_00: it's what we're going to see, frankly, from the HR1 Medicaid cuts.
• 21:01
  SPEAKER_00: Like people just leave town.
• 21:02
  SPEAKER_00: They don't have anything.
• 21:04
  SPEAKER_00: And so, like,
• 21:06
  SPEAKER_00: making that connection between Roger Marshall's supporters' corruption
• 21:10
  SPEAKER_00: and Roger Marshall's corruption directly increasing costs,
• 21:13
  SPEAKER_00: directly taking away healthcare, like, that is the story.
• 21:17
  SPEAKER_00: People are pissed about corruption,
• 21:18
  SPEAKER_00: but I think they're pissed about it in the guise
• 21:20
  SPEAKER_00: of it actually making their lives more difficult.
• 21:23
  SPEAKER_02: Yeah.
• 21:24
  SPEAKER_02: This is, like, how countries, like, go under.
• 21:26
  SPEAKER_02: It's, like, the impunity for corruption.
• 21:28
  SPEAKER_02: It is, you know,
• 21:29
  SPEAKER_02: the United States had, like,
• 21:31
  SPEAKER_02: There's been a lot of discussion around legalized corruption in the United States
• 21:35
  SPEAKER_02: for a long time,
• 21:36
  SPEAKER_02: but it just seems like it's so accelerated during the Trump era
• 21:40
  SPEAKER_02: that it just makes nothing work right.
• 21:43
  SPEAKER_02: Yeah.
• 21:43
  SPEAKER_02: Yeah.
• 21:44
  SPEAKER_02: So anyway, Roger Marshall, you're a bad guy.
• 21:48
  SPEAKER_02: Best of luck to you, Adam Hamilton.
• 21:49
  SPEAKER_02: Oh my gosh.
• 21:50
  SPEAKER_00: I am maybe going to be, I'm with you.
• 21:51
  SPEAKER_00: I'm going to be watching that almost more than any other race.
• 21:55
  SPEAKER_00: It would be so beautiful to see Dr. Dett go down.
• 21:58
  SPEAKER_02: Tacit bragging that they've helped create approximately $4.5 billion in enterprise value.
• 22:05
  SPEAKER_02: That's the private equity phrase that makes me want to vomit on my own shoes.
• 22:09
  SPEAKER_02: That's the four-point strip mining hospitals creates enterprise value.
• 22:12
  SPEAKER_02: You're gross, Roger Marshall.
• 22:13
  SPEAKER_02: Get out of here.
• 22:15
  SPEAKER_02: Okay.
• 22:17
  SPEAKER_02: Trump created a new White House Women's Task Force and handed it to a leathery man.
• 22:24
  SPEAKER_02: Trump made the announcement at an event
• 22:26
  SPEAKER_02: for his latest executive order advancing women's health to improve outcomes
• 22:29
  SPEAKER_02: in all phases of life,
• 22:31
  SPEAKER_02: which featured a rare appearance by his wife,
• 22:33
  SPEAKER_02: Melania,
• 22:33
  SPEAKER_02: who Trump says is responsible for the creation of the new division of women's health
• 22:37
  SPEAKER_02: within the National Institutes of Health and a new Women's Health Task Force within
• 22:41
  SPEAKER_02: the White House.
• 22:42
  SPEAKER_02: I'm sure Melania Trump is qualified to conceive of that and design it.
• 22:47
  SPEAKER_02: I'm sure she was a real driving force behind it.
• 22:49
  SPEAKER_02: It seems hard to believe.
• 22:51
  SPEAKER_02: Frank Yemi at Alternet reports that Trump took the opportunity to humiliate his wife
• 22:56
  SPEAKER_02: and make her look insignificant.
• 22:58
  SPEAKER_02: After signing the document,
• 22:59
  SPEAKER_02: Trump bragged about his signature,
• 23:01
  SPEAKER_02: got laughs from officials,
• 23:02
  SPEAKER_02: and handed a pen to his wife and invited to add her name before adding
• 23:05
  SPEAKER_02: a dismissive remark.
• 23:06
  SPEAKER_02: I don't know if her signature means anything,
• 23:08
  SPEAKER_02: the president told the crowd, which responded with uncomfortable laughter.
• 23:12
  SPEAKER_02: The New York Times reports that there is actually already a women's health office in the NIH.
• 23:16
  SPEAKER_02: So this is kind of, you know, we don't really know what this is.
• 23:20
  SPEAKER_02: This is kind of for show.
• 23:21
  SPEAKER_02: The NIH already has an office of research on women's health created in 1990 during
• 23:25
  SPEAKER_02: the administration of President George H.W.
• 23:27
  SPEAKER_02: Bush.
• 23:28
  SPEAKER_02: It is unclear whether the Trump administration is putting any money behind the new division.
• 23:32
  SPEAKER_02: Women's organizations and patient groups have been clamoring for years for
• 23:35
  SPEAKER_02: the federal government to spend more on women's health.
• 23:37
  SPEAKER_02: Some said the executive order would accomplish little without new funding from Congress.
• 23:41
  SPEAKER_02: In April of last year,
• 23:42
  SPEAKER_02: a few months after Mr.
• 23:43
  SPEAKER_02: Trump took office,
• 23:44
  SPEAKER_02: the Department of Health and Human Services decided to slash funding for
• 23:47
  SPEAKER_02: the Women's Health Initiative,
• 23:48
  SPEAKER_02: a long-running taxpayer-funded study by a broad range of women's health issues
• 23:52
  SPEAKER_02: that began in the 1990s.
• 23:53
  SPEAKER_02: But officials restored the money after a public outcry.
• 23:56
  SPEAKER_02: In announcing the White House Task Force,
• 23:58
  SPEAKER_02: Trump revealed that the Women's Health Task Force would be chaired by a man,
• 24:02
  SPEAKER_02: but not just any man,
• 24:03
  SPEAKER_02: by leathery RFK Jr.,
• 24:05
  SPEAKER_02: Who he described as a little different and suggests the jury is still out
• 24:10
  SPEAKER_02: on his tenure at AJ's Chats.
• 24:11
  SPEAKER_02: I did say that.
• 24:12
  SPEAKER_02: That's so crazy.
• 24:13
  SPEAKER_02: All right.
• 24:13
  SPEAKER_02: Do we want to watch a clip on that?
• 24:15
  SPEAKER_02: Let's watch a clip on that.
• 24:16
  SPEAKER_00: Oh, yeah.
• 24:16
  SPEAKER_00: Also establishes the White House Women's Health Task Force,
• 24:20
  SPEAKER_00: which will mobilize the entire federal government to coordinate action focused
• 24:24
  SPEAKER_00: on improving women's health.
• 24:26
  SPEAKER_00: And this task force will be led by Secretary of Health and Human Services, Robert F. Kennedy.
• 24:32
  SPEAKER_00: That's a big one.
• 24:34
  SPEAKER_00: And he's been fantastic, I have to tell you.
• 24:37
  SPEAKER_00: He's a little different.
• 24:38
  SPEAKER_00: We understand that, don't we?
• 24:40
  SPEAKER_00: Cheryl, do we understand?
• 24:41
  SPEAKER_00: He is a little different.
• 24:43
  SPEAKER_00: But that's what makes him good, I think.
• 24:46
  SPEAKER_00: I'll let you know about it.
• 24:49
  SPEAKER_00: That's what makes him good.
• 24:51
  SPEAKER_00: I mean, he's a
• 24:53
  SPEAKER_02: funny guy.
• 24:54
  SPEAKER_02: He's falling off a cliff, man.
• 24:55
  SPEAKER_02: His brain's mush.
• 24:56
  SPEAKER_02: He's so toast.
• 24:58
  SPEAKER_02: I agree with the president.
• 24:59
  SPEAKER_02: Bobby Kennedy is a little different.
• 25:01
  SPEAKER_02: A little.
• 25:02
  SPEAKER_02: He's a little different.
• 25:03
  SPEAKER_02: Jesus.
• 25:04
  SPEAKER_02: Do we have a lot of hope for this new old I
• 25:08
  SPEAKER_00: mean,
• 25:10
  SPEAKER_00: these signing ceremonies, it's the pomp and circumstance that he loves.
• 25:15
  SPEAKER_00: It's getting an audience, people to clap, laugh nervously.
• 25:18
  SPEAKER_00: He gets a chance to make fun of his wife, make fun of Bob Bobby Kennedy.
• 25:23
  SPEAKER_00: Like, it's so bizarre.
• 25:25
  SPEAKER_00: It's just a PR stunt, right?
• 25:27
  SPEAKER_00: He's done this so many times, these executive orders.
• 25:30
  SPEAKER_00: Meanwhile, I mean, I was doing some research on this back in April of last year.
• 25:34
  SPEAKER_00: The Pregnancy Risk Assessment Monitoring System, the 17-member task force, they got rid of it.
• 25:39
  SPEAKER_00: Done.
• 25:39
  SPEAKER_00: They're gone.
• 25:41
  SPEAKER_00: They fired nearly the entire Division of Reproductive Health at the CDC around
• 25:45
  SPEAKER_00: the same time, you know, with the HHS reduction in force, partly from Doge.
• 25:50
  SPEAKER_00: Just kind of got rid of it, right?
• 25:51
  SPEAKER_00: So these actual programs that have been there trying to address women's health and
• 25:57
  SPEAKER_00: the disparities in women's health, they got rid of.
• 25:59
  SPEAKER_00: And now they're just going to form a, quote, task force, right, at the presidential level.
• 26:03
  SPEAKER_00: The other piece, the abortion bans that are a direct result of Trump 1.0, right?
• 26:08
  SPEAKER_00: His Supreme Court that he got on there and got rid of Roe v. Wade.
• 26:13
  SPEAKER_00: Maternal mortality in the U.S. after abortion bans is higher in banned states.
• 26:18
  SPEAKER_00: Like, dramatically higher, right?
• 26:20
  SPEAKER_00: They're creating deserts of OBGYN care because of these bans and policies
• 26:26
  SPEAKER_00: that allow women to bleed out in parking lots of hospitals because
• 26:30
  SPEAKER_00: of their legislation.
• 26:32
  SPEAKER_00: Like, geez, it's such a slap in the face to people who actually want to improve women's health.
• 26:37
  SPEAKER_00: And again,
• 26:37
  SPEAKER_00: it's just a PR stunt for this guy to feel good,
• 26:41
  SPEAKER_00: or maybe not, for them to say that they're doing something.
• 26:44
  SPEAKER_02: Man, yeah.
• 26:45
  SPEAKER_02: We hate that.
• 26:47
  SPEAKER_02: Yeah, I think that putting, I mean,
• 26:50
  SPEAKER_02: Bobby Kennedy shouldn't be in charge of a pair of shoes,
• 26:53
  SPEAKER_02: let alone a new task for us, let alone HHS.
• 26:57
  SPEAKER_02: He's bursting with madness every time we see him.
• 26:59
  SPEAKER_02: He seems to be getting weirder with each passing day and a little different, we might say.
• 27:04
  SPEAKER_02: This is a little different.
• 27:07
  SPEAKER_02: All right.
• 27:07
  SPEAKER_02: A little more on the, you know, that's dark, but it's like a PR dark.
• 27:11
  SPEAKER_02: This is actually really dark.
• 27:13
  SPEAKER_02: This other thing Bobby Kennedy's up to.
• 27:15
  SPEAKER_02: So a vaccine research program in Guinea-Bissau touted by RFK Jr.
• 27:19
  SPEAKER_02: and financially supported by the CDC has major ethical issues
• 27:23
  SPEAKER_02: and was abruptly halted this week.
• 27:25
  SPEAKER_02: From reporting from The Guardian,
• 27:26
  SPEAKER_02: the U.S.-backed hepatitis B vaccine trial in African newborns
• 27:29
  SPEAKER_02: that drew global backlash was halted.
• 27:31
  SPEAKER_02: The lead researcher said on Wednesday,
• 27:34
  SPEAKER_02: it was now clear that the study will be moved forward in Guinea-Bissau.
• 27:38
  SPEAKER_02: Frederick Schatz Buchholzer,
• 27:40
  SPEAKER_02: a Danish researcher,
• 27:41
  SPEAKER_02: wrote on LinkedIn, adding, we're not given the necessary government approval.
• 27:46
  SPEAKER_02: The study was to be funded with $1.6 million from the U.S.
• 27:50
  SPEAKER_02: Centers for Disease Control and Prevention,
• 27:51
  SPEAKER_02: along with another $1.6 million from private partners.
• 27:54
  SPEAKER_02: In separate reporting,
• 27:55
  SPEAKER_02: The Guardian said that Kennedy praised the Danish researchers at
• 27:58
  SPEAKER_02: a recent anti-vaccine conference, calling them the deities of vaccine research.
• 28:02
  SPEAKER_02: The weird language continues.
• 28:05
  SPEAKER_02: Sid Wapp explains why the study was controversial.
• 28:07
  SPEAKER_02: The University of Southern Denmark confirmed that it has given the green light to
• 28:10
  SPEAKER_02: a controversial study in Guinea-Bissau funded with $1.6 million from the U.S.
• 28:14
  SPEAKER_02: Centers for Disease Control and Prevention that plans
• 28:17
  SPEAKER_02: to offer life-saving hepatitis B vaccines to only half of the enrolled babies.
• 28:22
  SPEAKER_02: So news of the study,
• 28:23
  SPEAKER_02: first reported in December by CIDRAP News,
• 28:25
  SPEAKER_02: prompted an international outcry from health groups and political leaders
• 28:27
  SPEAKER_02: who condemned its design as unethical.
• 28:29
  SPEAKER_02: Nearly one in five people in Guinea-Bissau are infected with hepatitis B,
• 28:32
  SPEAKER_02: which kills 15% to 25% of people with chronic infections by causing cancer
• 28:37
  SPEAKER_02: or liver failure.
• 28:38
  SPEAKER_02: Vaccinating babies at birth is safe and can prevent lifelong infections.
• 28:41
  SPEAKER_02: So they are doing randomized controls for a vaccine that we know already works,
• 28:48
  SPEAKER_02: basically making sure that these folks in Guinea-Bissau are in the control group
• 28:53
  SPEAKER_02: and do not have access to the vaccine.
• 28:56
  SPEAKER_00: In a place where hepatitis B is running rampant, right?
• 29:00
  SPEAKER_00: And the downstream outcomes of not getting vaccinated are dire, like liver failure, cancer.
• 29:05
  SPEAKER_00: I mean, it's horrific.
• 29:06
  SPEAKER_00: Like this is a place where Dr.
• 29:09
  SPEAKER_00: Senator Bill Cassidy, soon to be former senator, has been very animated, right?
• 29:14
  SPEAKER_00: Because he was a gastroenterologist, right?
• 29:16
  SPEAKER_00: He still put through these idiots and maybe he'll come clean now with Heidi Overton
• 29:21
  SPEAKER_00: and not put her through.
• 29:22
  SPEAKER_00: But like, this is a huge deal.
• 29:24
  SPEAKER_00: It's why we have institutional review boards at hospitals and universities
• 29:28
  SPEAKER_00: that approve studies and say, is this actually ethical?
• 29:31
  SPEAKER_00: This would be like taking half of the population of wherever and saying,
• 29:35
  SPEAKER_00: you guys don't wear seatbelts for You guys do,
• 29:38
  SPEAKER_00: and let's see who dies more in car accidents.
• 29:40
  SPEAKER_00: So, you know, you kids don't wear helmets, and you do.
• 29:42
  SPEAKER_00: It's like, no, you have a thing you know works.
• 29:44
  SPEAKER_00: Just do it.
• 29:45
  SPEAKER_00: And if you want to fund it, yes, hell yes, fund it, right?
• 29:48
  SPEAKER_00: Save these kids.
• 29:48
  SPEAKER_00: Save these folks.
• 29:50
  SPEAKER_00: It's terrible.
• 29:50
  SPEAKER_00: I just want to say the other thing.
• 29:52
  SPEAKER_00: Your ability to pronounce the name of the Dutch researcher
• 29:54
  SPEAKER_00: and Guinea-Bissau astounds me because it's perfect, and yet Haemophilus kills you.
• 29:59
  SPEAKER_02: It's just the science terms, Rob.
• 30:01
  SPEAKER_02: Sorry.
• 30:02
  SPEAKER_02: Rob, I read good.
• 30:04
  SPEAKER_02: It's just the science terms, you know?
• 30:06
  SPEAKER_02: Okay.
• 30:06
  SPEAKER_02: It's just tossing crazy fake Latin that you guys come up with in the lab at me all the time.
• 30:12
  SPEAKER_02: Anyway.
• 30:13
  SPEAKER_02: Yeah, yeah, yeah.
• 30:15
  SPEAKER_02: Just kidding.
• 30:15
  SPEAKER_02: So, yeah, I mean,
• 30:17
  SPEAKER_02: I think, like,
• 30:18
  SPEAKER_02: the callousness,
• 30:19
  SPEAKER_02: which they treat, like, African life, essentially, with USAID and this.
• 30:26
  SPEAKER_02: But it even goes beyond that because if they could get away with it,
• 30:30
  SPEAKER_02: they'd come up with some of this weird shit right here in the United States.
• 30:33
  SPEAKER_02: Oh, yeah.
• 30:34
  SPEAKER_02: Kennedy's like long,
• 30:36
  SPEAKER_02: his insane campaign in American Samoa that led to the deaths of all those children.
• 30:44
  SPEAKER_02: We just got to have him not have any levers of government.
• 30:48
  SPEAKER_02: He needs to have his hands off anything that has range or budget because he goes
• 30:52
  SPEAKER_02: and does insane things with it every time.
• 30:56
  SPEAKER_02: God willing,
• 30:57
  SPEAKER_02: the Dems get the Senate and we can do something about
• 31:00
  SPEAKER_02: The mad scientist science projects that Bobby Kennedy's up to over at HHS.
• 31:07
  SPEAKER_02: Yeah.
• 31:08
  SPEAKER_02: All right, Rob, why don't you intro the interview.
• 31:13
  SPEAKER_00: Let's... Yeah, I spoke with a great guest, Dr. Mikhail Sekharis, oncologist down in Miami.
• 31:20
  SPEAKER_00: And we talked a lot about Pope Leo and his lung cancer diagnosis.
• 31:23
  SPEAKER_00: I learned a lot.
• 31:23
  SPEAKER_00: Like, I'm a doc, right?
• 31:25
  SPEAKER_00: I know more than you maybe about cancer,
• 31:27
  SPEAKER_00: but certainly I have a lot to learn from an oncologist,
• 31:30
  SPEAKER_00: and I think people will learn, and he's just an interesting dude.
• 31:33
  SPEAKER_00: So, yeah.
• 31:34
  SPEAKER_00: All right.
• 31:34
  SPEAKER_00: Let's talk to that now.
• 31:47
  SPEAKER_03: Welcome back to Paging America, everyone.
• 31:49
  SPEAKER_03: Really excited to be joined by Dr.
• 31:51
  SPEAKER_03: Mikhail Sekeris today,
• 31:53
  SPEAKER_03: who is a professor of medicine and chief of the Division of Hematology
• 31:56
  SPEAKER_03: at Sylvester Comprehensive Cancer Center at the University of Miami.
• 31:59
  SPEAKER_03: His research focuses on the epidemiology,
• 32:02
  SPEAKER_03: genetics,
• 32:02
  SPEAKER_03: and treatment of cancers of the blood and bone marrow,
• 32:04
  SPEAKER_03: and he is the author or co-author of over 500 peer-reviewed scientific manuscripts
• 32:09
  SPEAKER_03: and 650 conference abstracts.
• 32:11
  SPEAKER_03: He has written over 100 essays for The Washington Post,
• 32:14
  SPEAKER_03: The New York Times,
• 32:15
  SPEAKER_03: The Wall Street Journal, Huffington Post, and more, and has authored eight books.
• 32:19
  SPEAKER_03: Dr. Secharis, welcome to Paging America.
• 32:20
  SPEAKER_01: What a pleasure it is to be here.
• 32:22
  SPEAKER_01: Thank you for inviting me.
• 32:23
  SPEAKER_03: Yeah, great to have you, and wanted to talk to you a bit today.
• 32:26
  SPEAKER_03: It's a little different for this show,
• 32:27
  SPEAKER_03: for listeners,
• 32:28
  SPEAKER_03: but I think something that we're all interested in,
• 32:30
  SPEAKER_03: and we saw you wrote a bit about it in the Washington Post,
• 32:33
  SPEAKER_03: and I wanted to talk to you about Pope Leo.
• 32:36
  SPEAKER_03: This has been in the news.
• 32:37
  SPEAKER_03: I mean, Pope Leo is certainly a massive figure,
• 32:39
  SPEAKER_03: obviously, worldwide, whether you're Catholic or not.
• 32:42
  SPEAKER_03: And with all the conflicts going on,
• 32:44
  SPEAKER_03: certainly has a lot,
• 32:45
  SPEAKER_03: kind of his involvement and his words on that are really important.
• 32:48
  SPEAKER_03: And a lot of our listeners, I think, would share that.
• 32:50
  SPEAKER_03: But he had the lower lobe of his right lung removed and was diagnosed with adenocarcinoma.
• 32:55
  SPEAKER_03: And I'm just, I guess, from what's been made public, what is this cancer?
• 33:00
  SPEAKER_03: And from kind of what we know, what kind of prognosis might Pope Leo be looking?
• 33:05
  SPEAKER_01: Yeah, so good for Pope Leo.
• 33:08
  SPEAKER_01: And I really think he's a special guy.
• 33:11
  SPEAKER_01: I'm not Catholic, but everything I've seen from him, he seems to really be like real people.
• 33:15
  SPEAKER_01: And, you know, it's easy for us in the U.S. to say that because he is.
• 33:19
  SPEAKER_01: He lived in the U.S. For a long time, even a Chicago White Sox fan.
• 33:24
  SPEAKER_01: And he was very upfront about his diagnosis.
• 33:28
  SPEAKER_01: And not everyone is for their own reasons.
• 33:32
  SPEAKER_01: But in being upfront about the diagnosis,
• 33:34
  SPEAKER_01: he's probably This has spurred a lot of people to go out and get screened and
• 33:37
  SPEAKER_01: to follow up on symptoms that they have in their own lungs.
• 33:41
  SPEAKER_01: We don't know a lot, so some of this is speculative.
• 33:44
  SPEAKER_01: He has pulmonary adenocarcinoma, and he is not known to be a smoker.
• 33:48
  SPEAKER_01: And those two facts actually go together pretty well.
• 33:51
  SPEAKER_01: Lung cancer,
• 33:52
  SPEAKER_01: as I think most of your listeners know,
• 33:54
  SPEAKER_01: is one of the most common cancers in the U.S.
• 33:56
  SPEAKER_01: It affects about 230,000 people each year.
• 34:00
  SPEAKER_01: And that represents about 11% of all cancer diagnoses.
• 34:03
  SPEAKER_01: The prognosis has improved over the past couple of decades,
• 34:07
  SPEAKER_01: but still only 30% of people diagnosed with lung cancer live for five years
• 34:12
  SPEAKER_01: after their diagnosis.
• 34:13
  SPEAKER_01: So that's lung cancer all comers.
• 34:15
  SPEAKER_01: What we don't know is his stage, and that's really going to affect his prognosis.
• 34:22
  SPEAKER_01: You know,
• 34:23
  SPEAKER_01: I took a special interest in this story because my mom was diagnosed
• 34:27
  SPEAKER_01: with lung cancer about eight years ago.
• 34:29
  SPEAKER_01: Now, she was a smoker, but her path to diagnosis and staging, I think, might be illustrative.
• 34:37
  SPEAKER_01: You'll allow me the hubris of a minute to talk about it.
• 34:42
  SPEAKER_01: She was diagnosed where she was living in Rhode Island at the time I was practicing
• 34:47
  SPEAKER_01: in Cleveland,
• 34:48
  SPEAKER_01: and she underwent a biopsy,
• 34:51
  SPEAKER_01: CAT scans, She was a PET scan, and she was told that she had stage 3 lung cancer.
• 34:56
  SPEAKER_01: Now, stage 3 lung cancer is pretty advanced, but potentially surgically resectable.
• 35:01
  SPEAKER_01: To get to that surgical resection,
• 35:03
  SPEAKER_01: though, people have to receive chemotherapy and radiation therapy.
• 35:07
  SPEAKER_01: It has to shrink enough so that it can then be resected and then people undergo
• 35:10
  SPEAKER_01: a pretty massive surgery to get there.
• 35:12
  SPEAKER_01: I was having trouble as a doctor coordinating her care across multiple states.
• 35:17
  SPEAKER_01: And I'm sure many of your listeners have been in the same situation where we're in
• 35:21
  SPEAKER_01: the sandwich generation.
• 35:22
  SPEAKER_01: I had young kids at home.
• 35:24
  SPEAKER_01: I was trying to get my mom adequate cancer diagnosis and care.
• 35:29
  SPEAKER_01: Even when I had the phone number to the back rooms and doctor's offices,
• 35:34
  SPEAKER_01: I wasn't getting anywhere.
• 35:35
  SPEAKER_01: So I finally said to her,
• 35:36
  SPEAKER_01: why don't you come to Cleveland where I have a little more control over it
• 35:38
  SPEAKER_01: and let's go through this.
• 35:41
  SPEAKER_01: And she did.
• 35:41
  SPEAKER_01: She came to Cleveland.
• 35:42
  SPEAKER_01: I showed her the scans that she had undergone to one of my besties who was head
• 35:48
  SPEAKER_01: of our lung cancer program but also coached my kid in Little League,
• 35:51
  SPEAKER_01: so he was a friend.
• 35:53
  SPEAKER_01: And he looked at the scans and said, you know, I don't believe this is stage three.
• 35:58
  SPEAKER_01: I'm going to send you for a bronchoscopy to try to see if these lymph nodes
• 36:02
  SPEAKER_01: that are lighting up on the scan are real.
• 36:05
  SPEAKER_01: And she underwent that bronchoscopy and the results came back and she was downstage
• 36:08
  SPEAKER_01: to a stage one.
• 36:10
  SPEAKER_01: You know,
• 36:10
  SPEAKER_01: the teaching point,
• 36:11
  SPEAKER_01: I think,
• 36:12
  SPEAKER_01: from this experience to me was it's worthwhile to go to a major medical center with
• 36:17
  SPEAKER_01: a diagnosis of cancer,
• 36:19
  SPEAKER_01: make sure the staging is accurate, make sure the diagnosis is accurate.
• 36:23
  SPEAKER_01: And make sure that you get the right treatment for the right cancer.
• 36:26
  SPEAKER_01: So instead of having to undergo chemotherapy,
• 36:29
  SPEAKER_01: radiation therapy,
• 36:30
  SPEAKER_01: and then a massive surgery,
• 36:32
  SPEAKER_01: she underwent the same surgery that Pope Leo XIV underwent.
• 36:37
  SPEAKER_01: And that's resection of a portion of her lung.
• 36:39
  SPEAKER_03: And that tells us something about his staging probably or possibly, correct?
• 36:43
  SPEAKER_01: Probably.
• 36:44
  SPEAKER_01: So it's a great question, right?
• 36:47
  SPEAKER_01: Stage, if it's truly a stage one lung cancer,
• 36:50
  SPEAKER_01: he has a decent chance of being alive five years from now.
• 36:54
  SPEAKER_01: If it's not,
• 36:55
  SPEAKER_01: let's say they do the surgery,
• 36:56
  SPEAKER_01: they remove the lung cancer,
• 36:57
  SPEAKER_01: and then they sample some lymph nodes around there,
• 36:59
  SPEAKER_01: and whoops,
• 37:00
  SPEAKER_01: by accident,
• 37:00
  SPEAKER_01: all the pre-test scans were wrong,
• 37:02
  SPEAKER_01: and those lymph nodes have lung cancer in it,
• 37:05
  SPEAKER_01: then we're talking about a stage 2 or stage 3 lung cancer,
• 37:08
  SPEAKER_01: and his chances of being alive five years from now are much lower.
• 37:12
  SPEAKER_03: Okay, okay.
• 37:13
  SPEAKER_03: But merely by the fact that they went in primarily with surgery,
• 37:16
  SPEAKER_03: he did not have chemo or radiation or,
• 37:18
  SPEAKER_03: you know,
• 37:18
  SPEAKER_03: any other treatment before surgery would argue at least they were thinking,
• 37:22
  SPEAKER_03: hey, this is something we can we can cure with surgery.
• 37:25
  SPEAKER_01: You got it.
• 37:26
  SPEAKER_01: I mean, I heard this whole story and thought,
• 37:28
  SPEAKER_01: my word, I'm reliving my mom's diagnosis eight years ago.
• 37:31
  SPEAKER_01: This sounds like stage one lung cancer.
• 37:34
  SPEAKER_03: Yeah.
• 37:34
  SPEAKER_03: Well, that's good for him.
• 37:35
  SPEAKER_03: I think good for all of us.
• 37:37
  SPEAKER_03: Now, you did write in the Washington Post about lung cancer in nonsmokers.
• 37:40
  SPEAKER_03: And as far as we know, he is not known to be a smoker.
• 37:44
  SPEAKER_03: I think that's the way you put it.
• 37:44
  SPEAKER_03: That's probably the right way to put it.
• 37:46
  SPEAKER_03: We don't know.
• 37:46
  SPEAKER_03: But that is not thought to be the case, at least.
• 37:49
  SPEAKER_03: What is your main message?
• 37:50
  SPEAKER_03: And what was your main message from the article?
• 37:52
  SPEAKER_01: So if you look at lung cancer diagnoses,
• 37:55
  SPEAKER_01: it's kind of similar to some other cancer diagnoses in the U.S.,
• 38:00
  SPEAKER_01: and that is that they've changed over time.
• 38:03
  SPEAKER_01: So, for example,
• 38:05
  SPEAKER_01: because of smoking cessation programs,
• 38:09
  SPEAKER_01: it's estimated that from 1975 to 2020,
• 38:10
  SPEAKER_01: 3.4 million lung cancer deaths have been averted in the U.S. 3.4 million, Rob.
• 38:19
  SPEAKER_03: From public health.
• 38:20
  SPEAKER_03: From public health.
• 38:21
  SPEAKER_01: That's from putting messages on packages of cigarettes that say this can lead
• 38:26
  SPEAKER_01: to lung cancer,
• 38:27
  SPEAKER_01: this can lead to birth defects in women who are pregnant,
• 38:32
  SPEAKER_01: that smoking is bad and can directly lead to lung cancer.
• 38:35
  SPEAKER_01: It's not messing around with the message, right?
• 38:39
  SPEAKER_01: That's a tremendous victory for cancer avoidance in the U.S.
• 38:46
  SPEAKER_01: The rates of new cases continue to fall on average by 2% per year since 2014
• 38:52
  SPEAKER_01: and death rates have dropped an average of 4% per year.
• 38:55
  SPEAKER_01: And that's a combination of effects.
• 38:57
  SPEAKER_01: It's because people who are in higher risk groups,
• 39:00
  SPEAKER_01: like smokers, are undergoing CT scan surveillance.
• 39:05
  SPEAKER_01: And that has been shown to be able to detect lung cancer when it's at an earlier
• 39:09
  SPEAKER_01: and potentially curable stage.
• 39:11
  SPEAKER_01: It's also a testimony to some of the new treatments we have for lung cancer.
• 39:16
  SPEAKER_01: But if you really dive into those statistics,
• 39:19
  SPEAKER_01: the rate of decline in lung cancer diagnoses for women during that time It's only
• 39:24
  SPEAKER_01: about one-third of the decline from men.
• 39:27
  SPEAKER_01: You know,
• 39:27
  SPEAKER_01: we think about women in cancer and immediately what jumps to mind is breast cancer,
• 39:31
  SPEAKER_01: right?
• 39:31
  SPEAKER_01: Just like when we think about men with cancer as an isolated group,
• 39:35
  SPEAKER_01: we think about prostate cancer.
• 39:37
  SPEAKER_01: But lung cancer remains the number one cause of cancer-related deaths in women in the U.S.
• 39:43
  SPEAKER_01: But up to 20% of lung cancer diagnoses occur in non-smokers.
• 39:49
  SPEAKER_01: How does that happen?
• 39:51
  SPEAKER_01: And this is particularly more common in women.
• 39:54
  SPEAKER_01: So all these public health campaigns about stopping smoking,
• 39:56
  SPEAKER_01: that definitely cuts at the majority of causes of lung cancer.
• 40:00
  SPEAKER_01: Yet lung cancer and nonsmokers persist.
• 40:03
  SPEAKER_01: So what are some of the causes of that?
• 40:05
  SPEAKER_01: Well, it could be secondhand smoke.
• 40:08
  SPEAKER_01: Maybe, for example,
• 40:09
  SPEAKER_01: Pope Leo didn't smoke,
• 40:11
  SPEAKER_01: but all the people in his household when he was growing up were smoking and all
• 40:14
  SPEAKER_01: the people he's around now are smoking.
• 40:16
  SPEAKER_01: I find that Probably a bit of a stretch.
• 40:19
  SPEAKER_01: It could be exposure to other environmental factors.
• 40:24
  SPEAKER_01: I don't know the last time you bought a new house in the Northeast,
• 40:29
  SPEAKER_01: but in the Northeast,
• 40:30
  SPEAKER_01: we have these things called basements,
• 40:31
  SPEAKER_01: which we don't have in Miami,
• 40:33
  SPEAKER_01: for obvious reasons,
• 40:34
  SPEAKER_01: because it would quickly transform from a basement to my underground pool.
• 40:39
  SPEAKER_01: But in basements,
• 40:40
  SPEAKER_01: whenever I bought a new house in Shaker Heights,
• 40:43
  SPEAKER_01: Ohio, where I lived, we would have a radon test.
• 40:47
  SPEAKER_01: And what that was doing, and they always put this canister in the basement.
• 40:50
  SPEAKER_01: Why the basement?
• 40:51
  SPEAKER_01: Because radon comes from the earth.
• 40:55
  SPEAKER_01: So the closer you get down into the soil, the higher the radon rates.
• 41:00
  SPEAKER_01: It turns out radon is a There's a very specific risk factor
• 41:03
  SPEAKER_01: for developing not just cancer, but lung cancer.
• 41:07
  SPEAKER_01: And there are mitigation things that we can do to minimize radon effects.
• 41:11
  SPEAKER_01: So exposure to radon could be a cause as well.
• 41:14
  SPEAKER_01: That's number two.
• 41:14
  SPEAKER_01: So secondhand smoke, number one.
• 41:16
  SPEAKER_01: Radon number two.
• 41:18
  SPEAKER_01: The third are environmental pollutants.
• 41:21
  SPEAKER_01: So there are some epidemiology studies that have shown that if you're in areas of
• 41:25
  SPEAKER_01: the world where there are high rates of pollutants,
• 41:28
  SPEAKER_01: it turns out that non-smoking associated lung cancer rates are also high.
• 41:34
  SPEAKER_01: So maybe that's one of the reasons that is contributing to the increased recognition
• 41:41
  SPEAKER_01: of lung cancer in non-smokers.
• 41:43
  SPEAKER_03: Okay, okay.
• 41:44
  SPEAKER_03: It's fascinating because whether it's smoking and the campaign that resulted in
• 41:51
  SPEAKER_03: so many fewer smokers or testing for radon and then doing mitigation from there
• 41:57
  SPEAKER_03: or limiting other environments.
• 41:59
  SPEAKER_03: I always tell people...
• 42:15
  SPEAKER_03: Sometimes people poo-poo the contribution of public health doctors to overall patient care.
• 42:23
  SPEAKER_03: And it's like,
• 42:23
  SPEAKER_03: I've worked 28 years as an ER doc,
• 42:25
  SPEAKER_03: and if someone works in public health,
• 42:27
  SPEAKER_03: they've saved far more lives I have in my career, right?
• 42:31
  SPEAKER_03: They don't know the names of the people whose lives they've saved.
• 42:34
  SPEAKER_03: And I don't know if that sounds like it may be also true for oncologists.
• 42:37
  SPEAKER_03: Like one of my best friends is an oncologist.
• 42:39
  SPEAKER_03: You guys do amazing work.
• 42:41
  SPEAKER_03: Our families had to deal with oncologists before.
• 42:43
  SPEAKER_03: But man, stopping people from smoking, right?
• 42:46
  SPEAKER_03: Teaching people to test for radon and then mitigate,
• 42:49
  SPEAKER_03: if necessary, other environmental pollutants.
• 42:52
  SPEAKER_03: This is such a huge driver of decreasing the rates of cancer, particularly lung cancer.
• 42:58
  SPEAKER_01: It really is, and of a number of different cancers.
• 43:00
  SPEAKER_01: Cancer avoidance is our best tool for better survival rates
• 43:05
  SPEAKER_01: because people hopefully don't get cancer,
• 43:08
  SPEAKER_01: or if they do, they get it at a lower stage.
• 43:10
  SPEAKER_01: The challenge with it,
• 43:11
  SPEAKER_01: as you know, Rob,
• 43:12
  SPEAKER_01: from a public health perspective,
• 43:14
  SPEAKER_01: is that it's hard for an insurance company to pony up a lot of cash
• 43:18
  SPEAKER_01: for these cancer avoidant behaviors.
• 43:21
  SPEAKER_01: Because someone might not stick with the same insurance company long enough for
• 43:25
  SPEAKER_01: the insurance company to then reap the benefits of it by
• 43:27
  SPEAKER_01: the person not having cancer.
• 43:30
  SPEAKER_03: I mean, I think as much as public health is so critical,
• 43:34
  SPEAKER_03: I think we've seen it's been massively underfunded.
• 43:37
  SPEAKER_03: The funding of the public health apparatus in this country certainly has taken a bit of a hit.
• 43:41
  SPEAKER_03: And I think we need to get back to the point of prioritizing that.
• 43:45
  SPEAKER_03: I remember as a kid, see Everett Coop.
• 43:47
  SPEAKER_03: I mean, you couldn't forget his beard, but he was the first one, right?
• 43:50
  SPEAKER_03: The Surgeon General warning on the cigarette packages.
• 43:55
  SPEAKER_01: And I was actually in med school at Penn when he was at Children's Hospital of Philadelphia.
• 44:01
  SPEAKER_01: So he was kind of a local celebrity when he was doing this.
• 44:04
  SPEAKER_01: And I'm sure you remember the history as I do.
• 44:08
  SPEAKER_01: He was hired because he wasn't supposed to be this public health zealot.
• 44:15
  SPEAKER_01: He was supposed to practice pretty conservative policies.
• 44:17
  SPEAKER_01: It was in the Reagan administration.
• 44:19
  SPEAKER_01: But then he realized that the public good trumped any kind of political affiliations he had.
• 44:24
  SPEAKER_03: Man, yearn for the days, right?
• 44:29
  SPEAKER_03: Wow.
• 44:29
  SPEAKER_03: Wow.
• 44:29
  SPEAKER_03: That's saying something.
• 44:31
  SPEAKER_03: We had a little something here that Yul Brynner, his last message was just don't smoke.
• 44:36
  SPEAKER_03: Like so after he had died, I think it was a posthumous message.
• 44:38
  SPEAKER_03: But a story came out recently.
• 44:41
  SPEAKER_03: This is an interview by Palantir Chief Technology Officer Shyam Sankar on Face
• 44:47
  SPEAKER_03: the Nation a little over a week ago.
• 44:49
  SPEAKER_03: And he had stated,
• 44:51
  SPEAKER_03: so many AI researchers have started smoking to signal how much they believe in AI
• 44:56
  SPEAKER_03: and they're betting it will cure cancer.
• 44:58
  SPEAKER_03: One, I'd love your thoughts on that kind of statement or that kind of behavior.
• 45:01
  SPEAKER_03: And then second,
• 45:03
  SPEAKER_03: as AI is having so many concerning impacts on society and the risk of,
• 45:09
  SPEAKER_03: I guess,
• 45:09
  SPEAKER_03: the downfall of humanity,
• 45:11
  SPEAKER_03: potentially, what are your thoughts on AI in the fight to, quote, cure cancer?
• 45:17
  SPEAKER_01: Yeah.
• 45:17
  SPEAKER_01: Well, so first of all,
• 45:19
  SPEAKER_01: with the Yul Brynner message,
• 45:20
  SPEAKER_01: I remember that was a television commercial that he filmed.
• 45:23
  SPEAKER_01: And he basically started off the commercial by saying,
• 45:26
  SPEAKER_01: if you're seeing this, I've now died as a consequence of smoking.
• 45:30
  SPEAKER_01: Right?
• 45:31
  SPEAKER_01: It was this very powerful message from someone who was a really famous movie actor.
• 45:36
  SPEAKER_00: Yeah.
• 45:37
  SPEAKER_01: You know,
• 45:38
  SPEAKER_01: the notion that people are deliberately going to engage in risky behaviors
• 45:42
  SPEAKER_01: because they're so confident that AI is going to help them down the line seems,
• 45:46
  SPEAKER_01: to me, myopic and rather foolhardy.
• 45:49
  SPEAKER_01: Why would you tempt fate?
• 45:51
  SPEAKER_01: Cancer's bad.
• 45:53
  SPEAKER_03: Yeah, right.
• 45:55
  SPEAKER_03: You're right.
• 45:55
  SPEAKER_03: Just because something could potentially cure it,
• 45:57
  SPEAKER_03: just like you said, avoiding it is really the key.
• 45:59
  SPEAKER_01: I always say I'm involved in clinical research and some translational research
• 46:06
  SPEAKER_01: in cancer because eventually I want to put myself out of a job.
• 46:10
  SPEAKER_01: I don't want to tempt fate and I don't want to tempt genetic changes in our cells.
• 46:15
  SPEAKER_01: There's, in general, a lot of concern about AI.
• 46:18
  SPEAKER_01: There's also a lot of good that's already coming out of it in medicine.
• 46:22
  SPEAKER_01: So, for example,
• 46:23
  SPEAKER_01: there's this terrific study where tens of thousands of women were randomized
• 46:30
  SPEAKER_01: to undergoing regular mammogram screening for breast cancer or Mammogram screening
• 46:35
  SPEAKER_01: with the assistance of AI.
• 46:37
  SPEAKER_01: So AI assisting the radiologists who were reading those mammograms.
• 46:41
  SPEAKER_01: The addition of AI It's kind of a funny conclusion, so let me walk you through it.
• 46:47
  SPEAKER_01: The addition of AI reduced the rate of intercurrent breast cancer by about 12%.
• 46:54
  SPEAKER_01: What that means is that the use of AI detected abnormalities in the breast
• 47:00
  SPEAKER_01: that were breast cancer so that they could be removed right then and there.
• 47:04
  SPEAKER_01: So the next time a woman underwent screening,
• 47:07
  SPEAKER_01: No breast cancer was detected because it was already detected by AI.
• 47:11
  SPEAKER_01: The teaching from that is that AI,
• 47:15
  SPEAKER_01: in combination with humans,
• 47:16
  SPEAKER_01: with radiologists,
• 47:18
  SPEAKER_01: looks like it's doing better for reading screening mammograms
• 47:21
  SPEAKER_01: to detect breast cancer It also allowed radiologists to reach
• 47:28
  SPEAKER_01: a diagnosis almost 50% faster than without AI.
• 47:33
  SPEAKER_01: So there was a higher volume that radiologists could look at for detecting the breast cancer.
• 47:38
  SPEAKER_01: We're going to have some research at the American Society
• 47:40
  SPEAKER_01: of Hematology annual meeting, which occurs in December, using AI techniques.
• 47:45
  SPEAKER_01: To diagnose a type of leukemia called myelodysplastic syndromes.
• 47:49
  SPEAKER_01: So I was fortunate to be the chair of the National Heart, Lung,
• 47:55
  SPEAKER_01: and Blood Institute,
• 47:56
  SPEAKER_01: the NHLBI,
• 47:57
  SPEAKER_01: which is a college within the NIH,
• 47:59
  SPEAKER_01: MDS Natural History Study,
• 48:01
  SPEAKER_01: where we collected information on over 2,000 people in the U.S.
• 48:04
  SPEAKER_01: who were suspected to have a bone marrow cancer.
• 48:08
  SPEAKER_01: They all underwent bone marrow biopsies.
• 48:09
  SPEAKER_01: About half were diagnosed with myelodysplastic syndromes or its precursor,
• 48:14
  SPEAKER_01: and about half weren't.
• 48:16
  SPEAKER_01: The other half had things like vitamin deficiencies or maybe endocrine abnormalities.
• 48:20
  SPEAKER_01: When those bone marrow biopsies were performed, we digitized all of them.
• 48:24
  SPEAKER_01: And in this study,
• 48:26
  SPEAKER_01: we allowed AI to read the digital bone marrow biopsies and its accuracy is now well
• 48:33
  SPEAKER_01: over 80%.
• 48:35
  SPEAKER_01: So we're starting to use it even to read cancer diagnoses to distinguish cancer
• 48:40
  SPEAKER_01: from non-cancer diagnoses.
• 48:42
  SPEAKER_03: Yeah.
• 48:43
  SPEAKER_03: I mean, I think it's important to always remember, right?
• 48:46
  SPEAKER_03: I mean, I think there certainly are concerns with AI and it needs guardrails and,
• 48:50
  SPEAKER_03: you know, I would argue some level of regulation.
• 48:52
  SPEAKER_03: But, you know,
• 48:53
  SPEAKER_03: as a tool,
• 48:54
  SPEAKER_03: right, to augment our ability to care for patients and And to diagnose disease.
• 48:59
  SPEAKER_03: I'm wondering, I think it has huge promise.
• 49:02
  SPEAKER_03: I mean, the site that I most recently worked at,
• 49:06
  SPEAKER_03: a hospital,
• 49:08
  SPEAKER_03: every radiology read of a plain film would come through with an AI fracture,
• 49:12
  SPEAKER_03: no fracture.
• 49:12
  SPEAKER_03: It was like, it was a very much a dichotomous decision, yes or no.
• 49:16
  SPEAKER_03: And it wasn't always right,
• 49:19
  SPEAKER_03: but there were times where it was actually quite helpful before
• 49:21
  SPEAKER_03: the official read came in,
• 49:23
  SPEAKER_03: where you saw some that looked pretty good,
• 49:24
  SPEAKER_03: you know,
• 49:25
  SPEAKER_03: especially in the hand,
• 49:26
  SPEAKER_03: multiple bones or in the foot,
• 49:28
  SPEAKER_03: and then you start zooming in a little bit and you,
• 49:30
  SPEAKER_03: oh, okay, I think I see what it's looking at.
• 49:32
  SPEAKER_03: That's kind of anecdotal right there.
• 49:34
  SPEAKER_03: I guess I'm wondering from a cancer perspective,
• 49:38
  SPEAKER_03: kind of helping devise new treatments,
• 49:40
  SPEAKER_03: are there currently models that are out there being utilized by researchers?
• 49:46
  SPEAKER_03: Researchers,
• 49:47
  SPEAKER_03: you know,
• 49:47
  SPEAKER_03: looking at ways to,
• 49:48
  SPEAKER_03: you know,
• 49:48
  SPEAKER_03: potentially anticipate how people respond to certain kind of treatments,
• 49:53
  SPEAKER_03: that kind of thing.
• 49:54
  SPEAKER_03: Is there sort of a horizon where that looks like it could be promising in
• 49:58
  SPEAKER_03: the treatment of cancer?
• 49:59
  SPEAKER_01: Oh, absolutely.
• 50:00
  SPEAKER_01: You nailed it.
• 50:01
  SPEAKER_01: And first of all,
• 50:01
  SPEAKER_01: I want to say,
• 50:02
  SPEAKER_01: God bless you for reading those x-rays in the ER and trying to figure out
• 50:06
  SPEAKER_01: if somebody has a broken bone or not.
• 50:08
  SPEAKER_01: That is not easy work.
• 50:10
  SPEAKER_01: Yeah, there are a couple different ways it's being used.
• 50:11
  SPEAKER_01: So one way is looking at huge data sets of patients who have cancer
• 50:17
  SPEAKER_01: and identifying those who are responders versus aren't responders and trying to get
• 50:21
  SPEAKER_01: at the meat of Of why they may be responders or not responders.
• 50:25
  SPEAKER_01: So looking for patterns,
• 50:27
  SPEAKER_01: whether those are clinical patterns,
• 50:28
  SPEAKER_01: pathologic patterns, or genetic mutational patterns that might lead to response.
• 50:35
  SPEAKER_01: Mining different genetics databases to find some of those rare mutations
• 50:40
  SPEAKER_01: that we don't put into our standard 60 gene panels
• 50:43
  SPEAKER_01: for diagnosing something like acute leukemia.
• 50:47
  SPEAKER_01: They're also looking at it in a drug discovery perspective.
• 50:50
  SPEAKER_01: And I think we've both seen in the news within the past month,
• 50:55
  SPEAKER_01: some of these drugs are now moving into clinical trials for the first time,
• 50:59
  SPEAKER_01: something that was generated by AI.
• 51:01
  SPEAKER_01: It's a really special time.
• 51:04
  SPEAKER_01: I think that the guardrail on this is that all of this still needs
• 51:08
  SPEAKER_01: a tremendous amount of surveillance by us.
• 51:11
  SPEAKER_01: So I can imagine,
• 51:13
  SPEAKER_01: so interesting,
• 51:13
  SPEAKER_01: we have like a green light, red light for fracture versus no fracture, right?
• 51:18
  SPEAKER_01: But it still takes you looking at the x-ray and saying, I agree or I don't agree, right?
• 51:24
  SPEAKER_01: And maybe when it says, yep,
• 51:26
  SPEAKER_01: you got a fracture there,
• 51:27
  SPEAKER_01: it would make somebody like me take a closer look to see what is it seeing
• 51:31
  SPEAKER_01: that I'm not, right?
• 51:32
  SPEAKER_01: To try to figure out what confirmed the diagnosis or tricked AI.
• 51:37
  SPEAKER_01: But it still needs that human guidance, doesn't it?
• 51:39
  SPEAKER_01: Yeah.
• 51:40
  SPEAKER_03: I think the pattern recognition,
• 51:42
  SPEAKER_03: the first piece where you said where you put all these cases into a database
• 51:46
  SPEAKER_03: and it tries to kind of mine it for something you could,
• 51:49
  SPEAKER_03: you know, maybe elucidate that is common to the folks maybe who weren't responders.
• 51:54
  SPEAKER_03: That really gets at when I see, I mean, I've seen Elon Musk talk about it.
• 51:58
  SPEAKER_03: I've seen people at HHS talk about, well, AI is going to replace doctors, right?
• 52:01
  SPEAKER_03: You won't need this person.
• 52:02
  SPEAKER_03: You won't need that.
• 52:03
  SPEAKER_03: I'll be AI.
• 52:04
  SPEAKER_03: And I think about this myself in my career in 20-some-odd,
• 52:08
  SPEAKER_03: almost 30 years of practicing medicine, so much is, it is evidence-based, right?
• 52:14
  SPEAKER_03: We should know the science,
• 52:15
  SPEAKER_03: know the data, know the latest research, but so much is pattern recognition.
• 52:19
  SPEAKER_03: I've seen this so many times.
• 52:20
  SPEAKER_03: I've seen this kind of case.
• 52:22
  SPEAKER_03: I can remember this one.
• 52:23
  SPEAKER_03: And I think that it discounts that.
• 52:25
  SPEAKER_03: I mean, it's good to know that you can plug these into AI.
• 52:28
  SPEAKER_03: It can look for patterns maybe that it would take dozens or hundreds or thousands
• 52:33
  SPEAKER_03: of doctors to come up with on kind of rare diseases or non-responders
• 52:37
  SPEAKER_03: that we don't know why they didn't respond.
• 52:40
  SPEAKER_03: But it also feels like the accumulated knowledge of individual people Still has a place.
• 52:46
  SPEAKER_03: And I think having AI as a tool, all for it.
• 52:49
  SPEAKER_03: I think as a replacement,
• 52:50
  SPEAKER_03: man, seems like a stretch, at least right now, to be able to predict that.
• 52:55
  SPEAKER_01: At least right now.
• 52:56
  SPEAKER_01: But the way that AI is performing and...
• 53:00
  SPEAKER_01: My word, and taking over.
• 53:03
  SPEAKER_01: Listen, we're in the middle of,
• 53:05
  SPEAKER_01: my youngest is applying to college right now,
• 53:07
  SPEAKER_01: so he's in the middle of college essay writing season, right?
• 53:11
  SPEAKER_01: And he's doing it the old-fashioned way.
• 53:13
  SPEAKER_01: You sit in front of a computer and write an essay.
• 53:15
  SPEAKER_01: But increasingly,
• 53:16
  SPEAKER_01: colleges are moving away from essays even because of the fear that AI is generating
• 53:21
  SPEAKER_01: so much of them.
• 53:22
  SPEAKER_01: Right, man.
• 53:23
  SPEAKER_03: So you have a new book coming out, I think it is now, yeah, Chasing Truth and Cancer.
• 53:27
  SPEAKER_03: I wonder if you could tell us a little bit about what it's about and when's it coming out?
• 53:30
  SPEAKER_01: Yeah, thanks for the opportunity.
• 53:32
  SPEAKER_01: So in early 2027, it's gonna be published by University of Toronto Press.
• 53:38
  SPEAKER_01: And the book is very similar to the articles I write monthly in the Washington Post.
• 53:43
  SPEAKER_01: So the first half of it talks about cancer,
• 53:47
  SPEAKER_01: the risks for developing cancer, and what we can do to minimize that risk.
• 53:52
  SPEAKER_01: And these are not instructions to eat eight servings of vegetables a day
• 53:57
  SPEAKER_01: while standing on your head drinking a gallon of water, right?
• 53:59
  SPEAKER_01: They're not these things that are...
• 54:02
  SPEAKER_01: That are hard to do.
• 54:03
  SPEAKER_01: They're behaviors that we can all adapt to and incorporate into our lives to lower that risk.
• 54:10
  SPEAKER_01: The second half of the book is geared towards people who have a cancer diagnosis.
• 54:15
  SPEAKER_01: So it explains the rudiments and theory behind the therapies people receive.
• 54:20
  SPEAKER_01: I find that a lot of my patients have no idea why we give,
• 54:22
  SPEAKER_01: for example, multiple courses or cycles of chemotherapy to treat cancer.
• 54:27
  SPEAKER_01: And also talks about behaviors people with a diagnosis of cancer can engage in
• 54:32
  SPEAKER_01: to actually enhance their chance of being cured.
• 54:35
  SPEAKER_01: It was a really fun book to write,
• 54:37
  SPEAKER_01: and I incorporate in it a lot of patient stories,
• 54:40
  SPEAKER_01: which is very similar to how I write for The Post or some of the articles I wrote
• 54:45
  SPEAKER_01: for The New York Times.
• 54:46
  SPEAKER_01: And also some personal stories,
• 54:48
  SPEAKER_01: like about my mom and her lung cancer diagnosis and how we manage that as a family.
• 54:52
  SPEAKER_03: Yeah.
• 54:53
  SPEAKER_03: Any teasers for the people tuning in and for myself from the first half of the book?
• 55:00
  SPEAKER_01: So there's some obvious things like don't take up smoking.
• 55:05
  SPEAKER_01: Duh.
• 55:06
  SPEAKER_01: I do believe the surgeon The lowest category for alcohol intake is one
• 55:10
  SPEAKER_01: to two drinks per day, which to me seems like a lot, but maybe a lot.
• 55:12
  SPEAKER_01: Yeah.
• 55:29
  SPEAKER_01: So ways to minimize alcohol intake,
• 55:33
  SPEAKER_01: some directions on exactly the type of exercise to engage in
• 55:38
  SPEAKER_01: to lower your cancer risk as well.
• 55:40
  SPEAKER_01: And some, you know, I do dive into the epidemiology, Rob.
• 55:43
  SPEAKER_01: I have a background in epidemiology and I find that statistics are really hard
• 55:47
  SPEAKER_01: to manipulate and really hard to understand.
• 55:49
  SPEAKER_01: So there's kind of a basic clear explanation on how to understand statistics and how
• 55:55
  SPEAKER_01: to critically appraise medical literature as it comes out.
• 55:58
  SPEAKER_03: Great, great.
• 55:59
  SPEAKER_03: And you mentioned the Washington Post and your book coming out in early 27.
• 56:03
  SPEAKER_03: Where else can folks find you?
• 56:05
  SPEAKER_01: More information about the stuff I've written.
• 56:07
  SPEAKER_01: It's almost embarrassing to say this, but I have my own web page.
• 56:11
  SPEAKER_01: That's okay.
• 56:12
  SPEAKER_01: That's okay.
• 56:12
  SPEAKER_01: We're happy to let you promote it, for sure.
• 56:14
  SPEAKER_01: So find MikhailSekaris.com,
• 56:16
  SPEAKER_01: and that has a list of a lot of the essays I've written and information
• 56:21
  SPEAKER_01: on other books.
• 56:22
  SPEAKER_03: Great, great, great.
• 56:22
  SPEAKER_03: Well, Dr. Mikhail Sekaris, it's really been a pleasure talking to you.
• 56:25
  SPEAKER_03: Thanks so much for joining me.
• 56:26
  SPEAKER_01: It's been absolutely delightful.
• 56:27
  SPEAKER_01: Thank you, Rob, for focusing on this.
• 56:31
  SPEAKER_02: Great interview.
• 56:31
  SPEAKER_02: Why don't I go ahead and read us out?
• 56:33
  SPEAKER_02: Today's episode was written by Chris Savage, Dr.
• 56:35
  SPEAKER_02: Rob Davidson, and me, Miles Baker, Paging America, The Situation Womb.
• 56:39
  SPEAKER_02: And all of our on-call segments this week were produced by Peter Ogburn and Chris Savage.
• 56:43
  SPEAKER_02: All shows were edited by Peter Ogburn and April Stewie.
• 56:45
  SPEAKER_02: Our music is by Annette Somerset at Duneflower Productions.
• 56:48
  SPEAKER_02: And if you enjoyed today's show,
• 56:49
  SPEAKER_02: please subscribe and leave us a rating on YouTube,
• 56:50
  SPEAKER_02: Spotify, Apple Podcasts, or wherever you listen.
• 56:53
  SPEAKER_02: And physicians, your voice matters.
• 56:55
  SPEAKER_02: Join the fight for better American healthcare by becoming a member of the Committee
• 56:58
  SPEAKER_02: to Protect Healthcare.
• 56:59
  SPEAKER_02: Visit www.committeetoprotect.org to learn more.
• 57:02
  SPEAKER_02: And if you're not a physician,
• 57:03
  SPEAKER_02: if you're a nurse practitioner or an RN, Or a physician's assistant.
• 57:09
  SPEAKER_02: There are also going to be some options post-election at thecommitteetoprotect.org
• 57:12
  SPEAKER_02: for you as well.
• 57:13
  SPEAKER_02: So stay tuned on that and visit us sort of mid-November and you can check it out.
• 57:19
  SPEAKER_02: And so, Rob, it was great chatting with you today.
• 57:22
  SPEAKER_02: Thanks for getting after it this Thursday morning.
• 57:24
  SPEAKER_00: You too.
• 57:25
  SPEAKER_00: Have fun on the Polo Coaster.
• 57:26
  SPEAKER_00: See you in a week.
• 57:27
  SPEAKER_02: Yeah, I'm going to maybe close my laptop today.
• 57:29
  SPEAKER_02: Anyway, thanks for listening, everybody.
• 57:31
  SPEAKER_02: See ya.