Latest / CareTalk: Healthcare. Unfiltered. / How Will We Make America Healthy Again?

Transcript

How Will We Make America Healthy Again? · CareTalk: Healthcare. Unfiltered.

• 0:00
  Republicans made Make America Healthy Again a key part of their closing argument, and voters seemed to like it.
• 0:06
  A major part of the focus is chronic disease.
• 0:09
  Does this agenda make sense, and what actions and concrete impacts can we expect?
• 0:19
  Welcome to Care Talk, America's home for incisive debate about healthcare business and policy.
• 0:24
  I'm David Williams, president of Health Business Group.
• 0:26
  And I'm John Driscoll, senior advisor at Walgreens.
• 0:29
  Well, John, before we get started, I want to take a moment to thank my extended family for making the effort to get together on Thanksgiving, traveling from places near and far.
• 0:38
  Because this month is all about gratitude, and along with my family, there's someone else that we don't thank enough.
• 0:44
  That's ourselves.
• 0:45
  It's sometimes hard to remind ourselves that we're trying our best to make sense of everything.
• 0:49
  And in this crazy world, that is not easy.
• 0:52
  So here's a reminder to send some thanks to the people in your life, including yourself.
• 0:57
  BetterHelp offers entirely online therapy that's designed to be convenient, flexible, and tailored to fit your schedule.
• 1:04
  Just fill out a brief questionnaire to get matched with a licensed therapist, and you can switch therapists at any time for no additional cost.
• 1:11
  It's helpful for learning positive coping skills and how to set boundaries.
• 1:16
  It empowers you to be the best version of yourself.
• 1:19
  So whether you're dealing with stress, anxiety, or seeking personal growth, BetterHelp connects you with licensed therapists who can support you on your mental health journey.
• 1:28
  Let the gratitude flow with BetterHelp.
• 1:31
  Visit betterhelp.com slash care talk to get 10 % off your first month.
• 1:37
  That's betterhelp, H-E-L-P dot com slash care talk.
• 1:42
  I'm grateful for you, Dave.
• 1:44
  I just want you to know that I really appreciate all of the good work you've done here.
• 1:49
  And you know, that gratitude practice that you're talking about couldn't be...
• 1:53
  more powerful, but I'm not so sure I'm grateful about the new Trump administration, at least from a healthcare perspective.
• 2:00
  Well, there's this concept, John, of make America healthy again, and maybe we'll start with a positive.
• 2:06
  mean, I think health is great.
• 2:09
  What does make America healthy again?
• 2:11
  Get right, must be something.
• 2:13
  If we step back a second, know, RFK Jr.
• 2:18
  has trafficked in a lot of conspiracy theories.
• 2:22
  around the organized medical establishment, particularly preying on people's fears about vaccines.
• 2:29
  But it's not like just because he's wrong on some of the big things, he's wrong in total.
• 2:34
  He's pointed out a number of things around the industrialization of food and how processed food is really a threat to people's health and the way we think about food and consume it.
• 2:50
  is obviously a problem.
• 2:51
  We've got an obesity epidemic, which he's pointed out.
• 2:54
  But where his conspiracy, I think, theories might be right is around how the United States has industrialized the food business so that we prioritize things like sugar-based snacks and salty snacks at a time when we've got a diabetes epidemic, even in children.
• 3:13
  And I think that's where, when you think about ways where we might agree that America's failing on a healthcare metric and could improve.
• 3:24
  think RFK Jr.
• 3:26
  has a point.
• 3:26
  So I would agree, John, there's a lot of chronic disease, not as much as what RFK Jr.
• 3:32
  says, and especially I think the fixation on children is probably not quite correct.
• 3:37
  Environmental risks are important contributors.
• 3:40
  there's too much- If you could pause there, David.
• 3:42
  I he talks about the statistics, 6 % of children had chronic disease under My uncle Jack always wants to pull in his family name and 60 % of kids, 60 % of kids today are not suffering from chronic disease.
• 4:01
  And in fact, in many ways from a healthcare perspective, whether it's heart disease or smoking cessation, we're actually making a lot of, have made generationally profound progress.
• 4:14
  And since Jack Kennedy, we actually have done a better job at extending life and managing chronic illness.
• 4:22
  We're failing on obesity.
• 4:24
  We're failing on addiction.
• 4:28
  But in many other areas, the areas that were the primary risks of death, coronary heart disease and cancer, we've really turned into manageable diseases.
• 4:42
  And he conveniently skips over those facts to then again, of blame it on the kids.
• 4:48
  Well, John, I'd like to, you know, the former CDC director, Tom Frieden, had a good framework that he just put out last week as well.
• 4:55
  He has a reminder for people interested in chronic disease.
• 4:58
  What do we, what should be the way we do it?
• 5:00
  Divided into three areas.
• 5:02
  There's some things that we know cause chronic disease.
• 5:05
  There's some things that might, and there's some things that are proven not to.
• 5:08
  So for the things that are known to cause chronic disease, which is tobacco, alcohol, junk food, you put in that, and air pollution, well, we should go after those with programs that work.
• 5:18
  They're not sexy.
• 5:19
  And by the way, the Biden administration has actually done a pretty good job on a number of these areas.
• 5:26
  For the things that might be causing chronic illness, and those are like these forever chemicals like PFAS, we should be investigating there.
• 5:36
  And there's some things that are proven not to cause chronic illness, namely vaccines.
• 5:42
  And so those should not be denigrated.
• 5:45
  and should not be, people should not be calling into question.
• 5:49
  So what's interesting to me partly is that, you some of this will go great with the, the new administration, but there's some other things like air pollution, John, which I'd like to just throw in the idea about, you know, so like air pollution and, junk food are, you know, things that are a concern and the problem.
• 6:07
  I agree.
• 6:08
  Now the Biden administration has actually tried to do certain things on this, but you can see how the politics come around on air pollution.
• 6:15
  There's a famous thing you'll see, know, gas stoves that was picked up upon.
• 6:18
  The Inflation Reduction Act has incentives for people to put in electric appliances as opposed to gas because gas stoves can actually contribute to asthma.
• 6:29
  And this has been taken obviously by some of the Trump folks as, you know, what is it, God, gas stoves and guns.
• 6:39
  That's going to be the winner.
• 6:40
  So I mean, the challenge that mean, if you really look, if you really want to make America healthy again, David, we've got to deal with this epidemic of gun violence.
• 6:53
  And maybe there's some middle ground around tying sensible gun safety legislation and regulations to a focus on mental health, because apparently the Republicans only agree with dealing with issues of gun violence if we're talking about issues of mental health, but that's a place to build.
• 7:12
  I think that the challenge that RFK jr is going to run into on the industrialization of food obesity and and sugary and salty stacks is that america loves Making those choices and frankly sugar and salt are addictive.
• 7:27
  You're take my pepsi away john along with well bloomberg tried Yeah, and the thing is that actually places the tax sugary drinks.
• 7:34
  They actually Actually do better and keep them out of this out of the school.
• 7:38
  So But yeah, you can imagine coming from the other side, right?
• 7:41
  They're gonna take my Coke and Pepsi and my Big Mac.
• 7:44
  Look, we are the land of the free.
• 7:46
  There's not a great track record of government either incenting, regulating, or prohibiting things that people really want, with the exception of taxing the bejesus out of tobacco, which has had an impact in regulating access to tobacco.
• 8:03
  The temperance movement failed around alcohol.
• 8:06
  One of the best public health...
• 8:09
  politicians ever, Bloomberg, was universally elected three times as mayor of New York, really failed around his taxing the big gulp and sugary snacks, but was successful with Tom Frieden in banning smoking in restaurants, which was a massive, public health win.
• 8:27
  So I guess the lesson from regulations and regulators past is to find the few big levers where you might be able to actually improve public health.
• 8:39
  But I don't think taking things away is something that we could expect to be easily to easily happen in a country that sort of celebrates the live free or die ethos and a party that's built its identity around that.
• 8:55
  Yeah.
• 8:55
  Well, John, and I think some of these things like RFK Jr.
• 9:00
  wants to steer the NIH away from research on infectious disease toward chronic disease, presumably, or maybe just cut the budget.
• 9:08
  pandemic, you getting rid of the office of pandemic preparedness, which, you know, is going to happen as well.
• 9:13
  There's a lot of contradictions built in.
• 9:15
  And I guess what we're going to see is whether the populace gives a darn about that or not, John, or whether it's OK if there's contradictions, as long as it's coming from a certain party.
• 9:25
  Well, I think I think what's what's tricky right now and why we have to be a little bit careful is we don't really know what we're going to get till we get it.
• 9:33
  And personnel in this in this particular Well, in every administration, but personnel will turn into policy.
• 9:42
  And I don't think that RFK Jr.
• 9:44
  is going to have an administrative role that requires anything close to Senate confirmation.
• 9:49
  As he said, there's so many skeletons in his closet, they don't fit anymore.
• 9:54
  So I don't think on the administrative role, it's more how might the Trump administration start to lean into some of the concerns that Bobby has about, you know, the food tying to obesity.
• 10:12
  And that's actually, think, a rich area that honestly, the Democrats have not been willing to lean in on.
• 10:19
  There's the the farm bill comes up next year.
• 10:23
  The farm bill is the biannual congressional bill that that drives subsidies or structures the subsidies for agriculture and farming in the US and to a large degree, incents larger farms over smaller ones, less traditionally organic and local and more national.
• 10:46
  And it really subsidizes corn and other sugary based insulin driving food production.
• 10:56
  And I think that if the Trump administration really wanted to go at the health of America, particularly the obesity epidemic, it would align with some of the more thoughtful players in Congress around reducing the subsidies for producing what we shouldn't eat and improving the subsidies for things that we should eat.
• 11:22
  And I think that's the way to make America healthy again.
• 11:24
  But it'll be really interesting.
• 11:25
  It's a very detailed in the weeds kind of thing.
• 11:29
  But that's where I'd look at, does he appoint in the Department of Agriculture and HHS and CDC and NIH, people who could support that kind of an initiative, because that actually could have an impact.
• 11:41
  Well, John, there's plenty of work to be done, and some of the things point in a direction that could be positive and different from what we've seen in the past.
• 11:50
  And I think we should, if not provide the benefit of the doubt, at least leave the option open and the opportunity to see good things done.
• 11:58
  And we should encourage those and cheerlead for them on our show.
• 12:01
  We should cheer lead for the things we agree with.
• 12:04
  We're going to criticize the ones we don't, David.
• 12:07
  That's fair, John.
• 12:08
  Well, that's it for yet another episode of Care Talk.
• 12:11
  We are giving some coaching to the new administration on what they can do about chronic disease.
• 12:16
  I'm David Williams, president of Health Business Group.
• 12:19
  And I'm John Driscoll, senior advisor at Walgreens.
• 12:21
  If you like what you heard and you did, we'd love you to subscribe on your favorite service.