Latest / Paging America / FDA Chief Scientist Exposes Trump’s Vaccine Executive Order

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FDA Chief Scientist Exposes Trump’s Vaccine Executive Order · Paging America

0:00
SPEAKER_03: This is the thing is they kind of correctly identify big problems,
0:04
SPEAKER_03: whether it's healthcare,
0:05
SPEAKER_03: food systems, using the US military for silly things in the Middle East.
0:09
SPEAKER_03: Like you kind of go down the line.
0:11
SPEAKER_03: They've almost made the democratic agenda for when the Democrats take power.
0:16
SPEAKER_02: Only they have to actually do something about this stuff.
0:19
SPEAKER_02: All right, Democrats, pay attention.
0:20
SPEAKER_02: Pay attention.
0:20
SPEAKER_02: Keep the list going.
0:25
SPEAKER_03: Rob, what did you have for breakfast?
0:27
SPEAKER_02: This morning,
0:28
SPEAKER_02: a nice bowl of steel-cut oatmeal with a little slivered almonds
0:32
SPEAKER_02: and some brown sugar, lots of coffee, couple big pots of pour-over coffee.
0:36
SPEAKER_02: How about you?
0:37
SPEAKER_02: That sounds like normal breakfast.
0:39
SPEAKER_03: My baby woke up at 4 o'clock,
0:41
SPEAKER_03: and so I've just been drinking coffee,
0:42
SPEAKER_03: and I barely made it on time today because it throws the morning off.
0:46
SPEAKER_03: But it sounds like Robert Kennedy has a different kind of breakfast.
0:50
SPEAKER_01: I eat breakfast, I eat a lot of protein.
0:52
SPEAKER_01: Okay.
0:53
SPEAKER_01: I had this morning a cheeseburger and three eggs.
0:57
SPEAKER_01: And I made them into an omelet.
0:59
SPEAKER_01: What the fuck?
1:02
SPEAKER_03: What?
1:03
SPEAKER_03: Yeah.
1:04
SPEAKER_03: Yeah.
1:05
SPEAKER_03: The cheeseburger and three eggs made into an omelet.
1:07
SPEAKER_03: Do you think what he did?
1:08
SPEAKER_02: He made into an omelet, so it's like it's fancy and healthy.
1:11
SPEAKER_03: Do you think he dices the cheeseburger or he like just smashes it?
1:14
SPEAKER_03: What do you think?
1:14
SPEAKER_02: He just eats it all in one.
1:16
SPEAKER_02: I don't even know if it's real.
1:18
SPEAKER_02: It's probably the discount beef that Trump's securing that we don't know where
1:21
SPEAKER_02: the hell it's from, right?
1:23
SPEAKER_02: Uh-huh.
1:24
SPEAKER_02: I don't know, how old is RFK Jr.?
1:26
SPEAKER_02: 70s, right?
1:27
SPEAKER_02: Yeah.
1:28
SPEAKER_03: If I had a cheeseburger for breakfast, I would have a terrible day.
1:32
SPEAKER_03: Anyway, everyone,
1:33
SPEAKER_03: welcome back to Paging America,
1:35
SPEAKER_03: where we explore the power and profit shaping American healthcare and your home base
1:38
SPEAKER_03: for news and interviews from people building the universal healthcare movement.
1:42
SPEAKER_03: I'm your host, campaign strategist, Miles Baker.
1:45
SPEAKER_02: And I'm Dr.
1:45
SPEAKER_02: Rob Davidson.
1:46
SPEAKER_03: And we have a great show for you today,
1:48
SPEAKER_03: but before we get started,
1:49
SPEAKER_03: please head over to our YouTube and hit the subscribe button.
1:52
SPEAKER_03: We are making a big push on our YouTube page to help us fight misinformation
1:55
SPEAKER_03: and disinformation on the platform with real healthcare news and viewpoints from
2:00
SPEAKER_03: over here at Paging America.
2:01
SPEAKER_03: So thank you for doing that in advance.
2:02
SPEAKER_02: Rob, we got a great show.
2:05
SPEAKER_03: We have news coming out of Florida, some weird stuff that Ron DeSantis is up to again.
2:10
SPEAKER_03: He's doing it again, stealing from people.
2:13
SPEAKER_03: He's paying for healthcare out of pocket is rising.
2:16
SPEAKER_03: We're going to cover that trend.
2:18
SPEAKER_03: Those Trump healthcare deals with industry groups seem to be coming apart at the seams.
2:23
SPEAKER_03: Maybe never, never real in the first place.
2:26
SPEAKER_03: And the CDC's new tobacco advisor is a pastor.
2:29
SPEAKER_03: And then in the back half of the show,
2:30
SPEAKER_03: we have a great interview with Dr.
2:31
SPEAKER_03: Jesse Goodman, So everyone, stick around for that.
2:35
SPEAKER_03: Why don't we start with Ron DeSantis today, Rob?
2:39
SPEAKER_02: Yeah, boy.
2:40
SPEAKER_03: The DeSantis administration down in Florida is at it again,
2:43
SPEAKER_03: diverting public funds into its personal political projects.
2:49
SPEAKER_03: CBS News reports that a leaked grand jury report shows that it found that
2:53
SPEAKER_03: the administration of Florida,
2:54
SPEAKER_03: Governor Ron DeSantis,
2:55
SPEAKER_03: redirected $10 million from a Medicaid settlement to go to Hope,
2:59
SPEAKER_03: Florida,
2:59
SPEAKER_03: A group run by DeSantis' wife as part of a,
3:02
SPEAKER_03: quote, sophisticated scheme to fund political activities, end quote.
3:06
SPEAKER_03: The $10 million was first sent to the Hope Florida Foundation and was quickly routed
3:10
SPEAKER_03: through two different nonprofits before making its way
3:13
SPEAKER_03: into Dark Money Political Action Committee controlled by James Ulthmeyer.
3:17
SPEAKER_03: From there, most of it was rerouted to the Republican Party of Florida's bank account.
3:21
SPEAKER_03: Those funds were then used in 2024 to defeat Amendment 3,
3:25
SPEAKER_03: the citizen initiative to legalize marijuana in Florida,
3:27
SPEAKER_03: which DeSantis and his wife hated and campaigned vigorously against.
3:32
SPEAKER_03: The settlement stemmed from claims of overbilling for pharmacy services by Centene.
3:36
SPEAKER_03: Florida's largest Medicaid contractor.
3:38
SPEAKER_03: Florida agreed that Centene would pay 57 million to the state,
3:41
SPEAKER_03: while 10 million would go to the Hope Florida Foundation.
3:43
SPEAKER_03: One last thing,
3:44
SPEAKER_03: the Tampa Bay Times wrote last year that Hope Florida took more than $867,000
3:49
SPEAKER_03: in donations in its first year,
3:51
SPEAKER_03: mostly from companies regulated by the state or doing business with it,
3:55
SPEAKER_03: according to the organization's first tax filing.
3:57
SPEAKER_03: In other words,
3:57
SPEAKER_03: it appears to be little more than a money laundering operation
4:00
SPEAKER_03: that peddles influence in the state government.
4:02
SPEAKER_03: So we're taking public funds, And we're moving them to the Republican Party in Florida.
4:08
SPEAKER_03: This is not particularly new for Ron DeSantis since he used public funds to defeat
4:13
SPEAKER_03: the abortion ballot initiative back when that ran.
4:17
SPEAKER_03: And so this seems to be like a reoccurring theme coming out of the administration
4:20
SPEAKER_03: where your public tax dollars are his personal political piggy bank.
4:26
SPEAKER_03: What do you think, Rob?
4:27
SPEAKER_02: Yeah, and I think on the abortion ballot work, it was like true, like from the state coffers.
4:32
SPEAKER_02: This was specific money that was supposed to go to getting health insurance for poor kids.
4:40
SPEAKER_02: Like that's what it was supposed to do.
4:42
SPEAKER_03: Yeah.
4:42
SPEAKER_02: But to me, it's like, if you're like a fiscal hawk, I don't want my tax dollars.
4:48
SPEAKER_02: Maybe it's not worse.
4:49
SPEAKER_02: But if you're just a human being who gives a shit about anyone other than yourself,
4:54
SPEAKER_02: this is to me worse, right?
4:56
SPEAKER_02: Sure.
4:56
SPEAKER_02: Sick, poor kids.
4:58
SPEAKER_02: Staying sick,
5:00
SPEAKER_02: not having insurance,
5:01
SPEAKER_02: this ties into something we're going to talk about later,
5:03
SPEAKER_02: about people paying for hospital care out of pocket, all that.
5:09
SPEAKER_02: It's that being used to funnel money to Ron DeSantis' wife's charity, just sick.
5:15
SPEAKER_02: And it's expected, right?
5:16
SPEAKER_02: Ron DeSantis.
5:18
SPEAKER_02: My God, we haven't talked about Ron DeSantis much on this show.
5:21
SPEAKER_02: Right.
5:21
SPEAKER_02: But man, Ron DeSantis, a lot about Ron DeSantis back during COVID times.
5:26
SPEAKER_02: I remember talking about this guy a lot.
5:28
SPEAKER_02: He's just a particularly bad guy.
5:29
SPEAKER_03: Yeah, I agree.
5:31
SPEAKER_03: We'll argue.
5:31
SPEAKER_03: I actually think this is bad.
5:34
SPEAKER_03: The amount of money that they used to defeat
5:36
SPEAKER_03: the Florida Abortion Ballot Initiative was extraordinary.
5:39
SPEAKER_03: It was way more than $10 million.
5:42
SPEAKER_03: And it was public health money.
5:44
SPEAKER_03: So it wasn't like insurance for, I mean,
5:47
SPEAKER_03: insurance for little kids,
5:49
SPEAKER_03: I guess, maybe is like the ultimate evil, but they're right.
5:54
SPEAKER_03: You might be right.
5:55
SPEAKER_03: Maybe you're right, but it still was public health money.
5:58
SPEAKER_03: Stand your ground.
6:03
SPEAKER_03: Goddamn.
6:04
SPEAKER_03: They repurposed the public health money to basically run like nonsense PSAs against
6:12
SPEAKER_03: the ballot initiative to defeat it.
6:14
SPEAKER_03: And so it brings up a couple of things for me.
6:15
SPEAKER_03: One, Ron DeSantis could raise money.
6:17
SPEAKER_03: Ron DeSantis has a high profile.
6:19
SPEAKER_03: So this is like, Lazy, first off.
6:23
SPEAKER_03: He could go raise this money.
6:24
SPEAKER_03: He could go to fundraisers.
6:26
SPEAKER_03: He could jump on the telephone.
6:27
SPEAKER_03: He could ask conservative millionaires for millions of dollars.
6:30
SPEAKER_03: And he doesn't do that.
6:31
SPEAKER_03: He just steals tax dollars or settlements and diverts them into his political projects.
6:36
SPEAKER_03: So it's like, one, seems like a big crime, and two, seems really lazy.
6:41
SPEAKER_03: It seems like a crime born of laziness and total neglect for the public space and public funds.
6:47
SPEAKER_02: Yeah.
6:48
SPEAKER_02: And I think, I mean,
6:48
SPEAKER_02: I think the grand jury said, yeah,
6:50
SPEAKER_02: this was a crime,
6:51
SPEAKER_02: but they couldn't figure out who the hell they would charge with the crime
6:54
SPEAKER_02: because everybody involved.
6:55
SPEAKER_02: So I don't remember.
6:56
SPEAKER_02: I don't know who did that.
6:57
SPEAKER_02: I'm not sure,
6:57
SPEAKER_02: you know,
6:58
SPEAKER_02: everyone got amnesia about how this money was misappropriate or who directed it.
7:03
SPEAKER_02: So they're not recommending charges,
7:05
SPEAKER_02: but were there names to name or people were naming names like this is crime, right?
7:12
SPEAKER_02: It isn't just like, ooh, this is bad.
7:14
SPEAKER_02: This is gross.
7:14
SPEAKER_02: This is literal crime.
7:16
SPEAKER_02: And they're getting away with it or got away with it.
7:18
SPEAKER_02: And like, I don't know, first time it was public health dollars.
7:22
SPEAKER_02: Now it was settlement dollars.
7:23
SPEAKER_02: I don't know.
7:23
SPEAKER_02: What do they do next?
7:24
SPEAKER_02: Right?
7:25
SPEAKER_02: Or what do we not know about?
7:26
SPEAKER_02: What other,
7:27
SPEAKER_03: you know,
7:28
SPEAKER_03: if you're,
7:28
SPEAKER_03: if you're doing that,
7:29
SPEAKER_03: if you're doing something so brazen twice and getting away with it,
7:32
SPEAKER_03: what are the chances you're not doing it a third or fourth or fifth time?
7:35
SPEAKER_03: Like zero, right?
7:36
SPEAKER_03: So Ron DeSantis is going to run for president, likely going to run for president.
7:43
SPEAKER_03: So if you're interested in the immense amount of corruption that
7:48
SPEAKER_03: the Trump administration is doing,
7:50
SPEAKER_03: and you think maybe Ron DeSantis,
7:51
SPEAKER_03: you'll get all the conservative bona fides,
7:53
SPEAKER_03: but without the stealing of Nope, you'll get stealing again.
7:58
SPEAKER_03: You'll get more stealing.
7:59
SPEAKER_03: So that's just a quick note on that.
8:02
SPEAKER_03: But then two, I mean, his wife is obviously very involved in this.
8:06
SPEAKER_03: And it seems like the whole family is on,
8:08
SPEAKER_03: maybe they're not as on the take,
8:10
SPEAKER_03: but they're like putting these funds towards their ideological projects,
8:14
SPEAKER_03: which is almost scary.
8:15
SPEAKER_03: I mean, a lot of people have thought like,
8:16
SPEAKER_03: DeSantis is Trump just with a really hardcore conservative ideology.
8:19
SPEAKER_03: And so how much worse does that look if he has the reins of the federal government?
8:24
SPEAKER_03: So anyway, this guy can never be president.
8:26
SPEAKER_03: He should never hold public office again.
8:27
SPEAKER_03: He probably should be in jail.
8:29
SPEAKER_02: Just about Ron DeSantis running for president, right?
8:31
SPEAKER_02: Because right now we kind of have the front runners are like J.D.
8:34
SPEAKER_02: Vance, Marco Rubio, now Ron DeSantis.
8:37
SPEAKER_02: I don't think Ron DeSantis has a chance in hell of getting the nomination.
8:40
SPEAKER_02: Sure.
8:40
SPEAKER_03: Just because his personality is so weird and awful.
8:44
SPEAKER_02: I'm not entirely sad that he's just going to be out there being weird and awful
8:48
SPEAKER_02: that we're going to, I don't know.
8:50
SPEAKER_02: Sure.
8:51
SPEAKER_02: Run for president, Ron DeSantis.
8:53
SPEAKER_02: That's great.
8:54
SPEAKER_02: It'll give us lots of things to talk about, I guess.
8:57
SPEAKER_02: But it would be particularly horrible if this guy actually did get into power above
9:03
SPEAKER_02: the Florida governor where he is now.
9:05
SPEAKER_03: Yeah.
9:05
SPEAKER_03: We're going to stay on top of that because hopefully this is something
9:08
SPEAKER_03: that ends up having consequences for these folks
9:10
SPEAKER_03: on a long enough timeline.
9:11
SPEAKER_03: So there's not a new
9:14
SPEAKER_03: trend, but a trend we're going to highlight.
9:16
SPEAKER_03: Paying out of pocket for expensive healthcare is becoming more common.
9:19
SPEAKER_03: So it's a long time trend, but it's a trend that's increasing in its frequency.
9:25
SPEAKER_03: So a new report by Epic Research shows that more Americans are paying out of pocket
9:29
SPEAKER_03: for trips to the emergency department, while fewer rely on Medicaid.
9:33
SPEAKER_03: 7.6% of emergency department's visits were self-pay in early 2026,
9:37
SPEAKER_03: up from 5.5% in early 2022, an increase in 38%.
9:42
SPEAKER_03: At the same time,
9:43
SPEAKER_03: the percentage of patients with Medicaid insurance in the ED dropped from 18.2
9:46
SPEAKER_03: to 16.1.
9:48
SPEAKER_03: Via reporting from Healthcare Dive.
9:50
SPEAKER_03: Epic research analyzed more than 550 million US healthcare encounters
9:54
SPEAKER_03: to explore how coverage mix or medical providers,
9:56
SPEAKER_03: patients,
9:57
SPEAKER_03: or revenue from different types of health insurance shifted as a result
10:00
SPEAKER_03: of redeterminations.
10:01
SPEAKER_03: It found that the self-pay share of encounters often used as a proxy
10:05
SPEAKER_03: for uninsured patients rose sharply in the ER from 2022 to 2026.
10:09
SPEAKER_03: But self-pay patients increase across every setting studied from 1.9 to 2.6.
10:14
SPEAKER_03: For inpatient admissions,
10:15
SPEAKER_03: let's take a look at the trends for various types of out-of-pocket visits.
10:19
SPEAKER_03: And so you can just see in the yellow line that out-of-pocket emergency room visits,
10:24
SPEAKER_03: which I think you tell me about cost,
10:27
SPEAKER_03: whoever said it here, but that's rough that that's headed up and to the right.
10:32
SPEAKER_02: Rob, what do you think?
10:33
SPEAKER_03: Have you seen this in the year?
10:35
SPEAKER_03: Has out-of-pocket payments in the emergency room increased?
10:39
SPEAKER_02: Well, listen,
10:40
SPEAKER_02: uninsured patients have and at the bedside,
10:42
SPEAKER_02: like we have no,
10:43
SPEAKER_02: we really don't have any idea like about payments or that,
10:46
SPEAKER_02: but the people without insurance, right?
10:47
SPEAKER_02: So those are folks who are going to be sent a bill.
10:51
SPEAKER_02: So a couple of things,
10:52
SPEAKER_02: emergency department care is more expensive than like going
10:55
SPEAKER_02: to your primary care doctor for either the same thing or earlier on
10:58
SPEAKER_02: in whatever process you then eventually come in with
11:01
SPEAKER_02: because you just can't wait any longer, right?
11:02
SPEAKER_02: The diabetes out of control, the infected
11:04
SPEAKER_03: foot of a diabetic, right?
11:06
SPEAKER_03: That could have been dealt with.
11:07
SPEAKER_02: The other piece is, and this is such a terrible component of our entire system.
11:13
SPEAKER_02: So hospitals and doctor groups are, you know, more and more, it's just hospitals, right?
11:18
SPEAKER_02: Hospital systems.
11:19
SPEAKER_02: They negotiate with insurance companies and with banks.
11:24
SPEAKER_02: They have rates that are set by these.
11:25
SPEAKER_02: They are different rates than an uninsured patient will be charged.
11:30
SPEAKER_02: They're significantly lower, significantly lower.
11:34
SPEAKER_02: And so not only is it expensive care,
11:37
SPEAKER_02: but it's like a double whammy if you lose your insurance
11:39
SPEAKER_02: because it's now expensive care that's maybe twice what UnitedHealth Group would pay
11:45
SPEAKER_02: for that same thing, right?
11:46
SPEAKER_02: Or whatever Medicaid provider you're using, if it's a privatized Medicaid or the state Medicaid.
11:53
SPEAKER_02: And so they're getting these huge bills.
11:54
SPEAKER_02: The other thing I know for a fact from being an emergency doctor for 25 years
11:59
SPEAKER_02: and having previously been part of an independent group is
12:04
SPEAKER_02: On those self-pay patients,
12:06
SPEAKER_02: only about 5% for our group in the place that I practice of that,
12:10
SPEAKER_02: those dollars actually come in, right?
12:12
SPEAKER_02: For hospitals, it's a little higher.
12:13
SPEAKER_02: It's like 12, 13, maybe up to 20%.
12:17
SPEAKER_02: But this is the uncompensated care, right?
12:19
SPEAKER_02: This is part of MTALA.
12:21
SPEAKER_02: We've talked about MTALA before,
12:22
SPEAKER_02: Emergency Medical and Treatment of Active Labor Act,
12:25
SPEAKER_02: like hugely important, should be there.
12:27
SPEAKER_02: It says, we can't turn you away.
12:28
SPEAKER_02: And it used to happen before 1986, people dying on the steps of private hospitals.
12:34
SPEAKER_02: But then the problem is it's an unfunded mandate and hospitals are gobbling up the cost.
12:39
SPEAKER_02: We talked about this maybe a month ago,
12:41
SPEAKER_02: a few weeks ago with 3 million people without insurance because of
12:44
SPEAKER_03: ACA subsidies.
12:45
SPEAKER_03: Hospitals have reported increasing numbers of people coming in without insurance.
12:49
SPEAKER_02: And so, yeah, like it is self-pay, but in most cases it ends up being no pay.
12:54
SPEAKER_02: But people carry that debt, right?
12:56
SPEAKER_02: Previous administration tried to keep that debt off of the balance sheet of people
12:59
SPEAKER_02: for purposes of credit.
13:01
SPEAKER_02: This administration came in and said, no, screw that.
13:03
SPEAKER_02: We're going to make you suffer and not be able to get a house or a car loan because of it.
13:07
SPEAKER_02: It's all around just a miserable situation.
13:10
SPEAKER_03: Well, it doesn't seem like it's going anywhere with the full force of
13:15
SPEAKER_03: the Medicaid cuts not having been felt yet until after the midterms.
13:19
SPEAKER_03: It seems like this trend isn't going to continue.
13:21
SPEAKER_03: It's going to increase in frequency and speed,
13:23
SPEAKER_03: and it's going to mean problems that will probably touch a lot of different parts
13:28
SPEAKER_03: the healthcare system.
13:29
SPEAKER_02: Yeah, and what's the fix?
13:30
SPEAKER_02: I mean, you know, what is the fix, right?
13:32
SPEAKER_02: People having insurance,
13:34
SPEAKER_02: whether it be Medicaid or some other insurance,
13:36
SPEAKER_02: and the actions of this Republican administration and the Congress were to go in
13:40
SPEAKER_02: the opposite direction.
13:41
SPEAKER_03: Yeah.
13:42
SPEAKER_03: You know, we're moving on to our next topic, what is not the fix?
13:46
SPEAKER_03: So the Trump administration has been announcing these deals,
13:49
SPEAKER_03: he's making deals with private healthcare industries across the board,
13:55
SPEAKER_03: and they don't seem to be panning out.
13:57
SPEAKER_03: They seem to be bad deals.
13:59
SPEAKER_02: They're always bad deals.
14:00
SPEAKER_02: Boy, surprise.
14:01
SPEAKER_02: They're always bad deals.
14:02
SPEAKER_03: Anyway,
14:03
SPEAKER_03: so modern healthcare has a new piece out outlining how the health deals that Trump
14:07
SPEAKER_03: and RFK Jr.
14:08
SPEAKER_03: have been touting are actually toothless and are not paying
14:10
SPEAKER_03: the dividends they promised.
14:12
SPEAKER_03: Like the focus on artificial dyes,
14:14
SPEAKER_03: many of the administration's highest profile health initiatives rely
14:17
SPEAKER_03: on voluntary agreements.
14:19
SPEAKER_03: The goals such as lower drug prices and nutrition classes
14:21
SPEAKER_03: for doctors have widespread appeal,
14:23
SPEAKER_03: cutting across party lines and economic divisions,
14:26
SPEAKER_03: but the administration Industry deals lack the enforcement teeth
14:29
SPEAKER_03: of more traditional federal regulation.
14:31
SPEAKER_03: Their details are vague and with minimal oversight makes it hard to monitor progress.
14:35
SPEAKER_03: In some cases, the administration has claimed victories that have not yet materialized.
14:40
SPEAKER_03: The same could be said for many of Trump's executive orders.
14:42
SPEAKER_03: His order on childhood vaccines, for example, is not required to be followed.
14:45
SPEAKER_03: The administration said 80% of insurers pledged changes
14:47
SPEAKER_03: to pre-authorization requirements for 80% of diseases and injuries by January 2026.
14:52
SPEAKER_03: The administration also promised public dashboards to track progress.
14:56
SPEAKER_03: It will happen very quickly, Dr. Oz said at an event.
14:59
SPEAKER_03: Necessary care will be delivered when it's needed in the right way.
15:02
SPEAKER_03: As of July,
15:04
SPEAKER_03: months past that January target date,
15:07
SPEAKER_03: no public dashboards have been debuted to track the deal.
15:10
SPEAKER_03: And some insurers that signed the pledge last summer told KFF Health News
15:13
SPEAKER_03: that this year they will not implement,
15:15
SPEAKER_03: as promised, the reforms, as outlined by AHIP.
15:20
SPEAKER_03: Ending of prior authorization in lots of different instances.
15:26
SPEAKER_03: And that is simply not happening.
15:29
SPEAKER_03: Conversely, some states have been doing prior authorization reform and those have been working.
15:35
SPEAKER_03: So when you legislate it and you outline the rules,
15:40
SPEAKER_03: you can get prior authorization under control.
15:42
SPEAKER_03: For those who don't know what prior authorization is,
15:44
SPEAKER_02: Rob, which is the big one.
15:46
SPEAKER_02: This is the thing that makes everyone mad.
15:48
SPEAKER_03: Can you tell us a little bit about prior authorization and why it's
15:50
SPEAKER_03: a living nightmare for a lot of physicians trying to treat their patients?
15:53
SPEAKER_02: Yeah, physicians and patients.
15:55
SPEAKER_02: I mean, basically it's saying,
15:57
SPEAKER_02: as a physician,
15:58
SPEAKER_02: and this doesn't come up in the ER, denial of payments happen, right?
16:02
SPEAKER_02: Because they, after the fact, say, we don't think that was necessary.
16:05
SPEAKER_02: But for like primary care docs and other specialists saying,
16:08
SPEAKER_02: we think this I don't know,
16:11
SPEAKER_02: amputation to save their leg and take out part of their foot or whatever,
16:15
SPEAKER_02: a stress test.
16:16
SPEAKER_02: My wife,
16:16
SPEAKER_02: she told me the other day,
16:17
SPEAKER_02: someone who's like in their late 50s,
16:19
SPEAKER_02: having chest pain with a family history of heart disease, they need a stress test.
16:22
SPEAKER_02: And she had to go through a phone tree of about eight different buttons to get to
16:25
SPEAKER_02: a person on the other end who wasn't a physician to eventually say,
16:30
SPEAKER_02: oh yeah, we think they need that.
16:31
SPEAKER_02: Like that was a positive result, right?
16:34
SPEAKER_03: Why the fuck are they having to like, Go to the
16:36
SPEAKER_02: phone tree.
16:36
SPEAKER_02: The problem is the sort of default response from insurance companies is to deny,
16:42
SPEAKER_02: is to say, no, that's not okay.
16:44
SPEAKER_02: That's not appropriate.
16:44
SPEAKER_02: That surgery is not appropriate.
16:46
SPEAKER_02: What have you?
16:46
SPEAKER_02: Or that hospital stay after surgery and a lot of cases of that.
16:50
SPEAKER_02: And they hope people just give up.
16:52
SPEAKER_02: They hope they give up.
16:53
SPEAKER_02: They use AI to do this, right?
16:55
SPEAKER_03: I'm going to use that example.
16:58
SPEAKER_03: I went at GLP once and I got more fit and trim and I loved it.
17:03
SPEAKER_03: And then I didn't...
17:04
SPEAKER_03: So I had to go back and renew it and we had to do it again,
17:07
SPEAKER_03: but I had already like lost weight, right?
17:10
SPEAKER_03: So like they denied it.
17:12
SPEAKER_03: And I was like, oh no, I'm not gonna be able to do this if they're denying it.
17:17
SPEAKER_03: And the doctor's office said, we have a person on staff To navigate prior authorization.
17:24
SPEAKER_02: That was their job.
17:25
SPEAKER_02: What an unsatisfying job, one, first.
17:28
SPEAKER_03: Anyone working on that, that sucks.
17:30
SPEAKER_03: But it just means that it's a cost shift away from the insurance companies
17:35
SPEAKER_03: to hospitals, doctor's offices, private practices.
17:39
SPEAKER_03: It's a way to offload costs because all these groups have
17:44
SPEAKER_03: to adopt administrative burden to navigate the prior authorization system.
17:49
SPEAKER_03: Of course,
17:50
SPEAKER_03: if they're so invested in this,
17:52
SPEAKER_03: the insurance companies aren't going to reform from some side deal with Trump
17:57
SPEAKER_03: where they say they'll do it, but there's no penalty for not doing it.
18:02
SPEAKER_02: And it's absolutely a part of their business model.
18:05
SPEAKER_02: They depend upon not providing care.
18:08
SPEAKER_02: The only way insurance companies make money is by bringing in premiums
18:12
SPEAKER_02: and not paying for health care.
18:14
SPEAKER_02: And so premiums keep getting jacked up higher and higher every year.
18:18
SPEAKER_02: Double-digit percent increases.
18:20
SPEAKER_02: People see this.
18:22
SPEAKER_02: And yet the denials continue and get worse and worse and worse.
18:25
SPEAKER_02: And now, again, with AI, they're happening at such a pace.
18:28
SPEAKER_02: Before, it actually took humans.
18:30
SPEAKER_02: Now it's just an AI thing, and they can plug in some framework.
18:36
SPEAKER_03: Well, okay,
18:37
SPEAKER_03: if anyone's listening and you have a story where a robot denied someone's care,
18:41
SPEAKER_03: we want to hear from you.
18:42
SPEAKER_03: Please email us.
18:44
SPEAKER_03: We'll put it in the show notes.
18:45
SPEAKER_02: Well, the other piece that says so crazy,
18:46
SPEAKER_02: the original story about Trump is these are all just press conferences, right?
18:50
SPEAKER_02: All of these EOs he signed, all of these, it's just all to like win the day.
18:54
SPEAKER_02: I mean, this is, he does this with the war in Iran, right?
18:57
SPEAKER_02: Just to win the day.
18:59
SPEAKER_02: Oh, deals imminent.
19:00
SPEAKER_02: Oh, we're talking.
19:01
SPEAKER_02: Oh, it's going to be great.
19:02
SPEAKER_02: We're going for world peace.
19:03
SPEAKER_02: Otherwise we're going to bomb the shit out of them.
19:05
SPEAKER_02: Like, like this is all it is to him is, is, is a day to have the press.
19:10
SPEAKER_03: This is the thing is they kind of,
19:12
SPEAKER_03: Correctly identify big problems,
19:14
SPEAKER_03: whether it's healthcare,
19:16
SPEAKER_03: food systems, using the US military for silly things in the Middle East.
19:21
SPEAKER_03: Like you kind of go down the line and they've almost made the democratic agenda For
19:27
SPEAKER_03: when the Democrats take power.
19:29
SPEAKER_03: Only they have to actually do something about this stuff as opposed
19:33
SPEAKER_03: to have endless press conferences and tweets about it.
19:36
SPEAKER_02: Absolutely.
19:36
SPEAKER_02: All right, Democrats, pay attention.
19:38
SPEAKER_02: Pay attention.
19:38
SPEAKER_02: Make a little list.
19:39
SPEAKER_02: We'll help you make a list.
19:40
SPEAKER_03: We'll help you make a list.
19:41
SPEAKER_03: Okay.
19:42
SPEAKER_03: So the more problems at the CDC route, this is our next story.
19:45
SPEAKER_03: We have Dr.
19:47
SPEAKER_03: Erica Schwartz,
19:48
SPEAKER_03: who immediately,
19:51
SPEAKER_03: upon taking office,
19:53
SPEAKER_03: bent the knee and has politicized these very tragic measles deaths in the state
19:58
SPEAKER_03: of Pennsylvania.
20:00
SPEAKER_03: So it doesn't seem like we're going to get a lot out of the new CDC director
20:03
SPEAKER_03: in terms of science, integrity, you name it.
20:07
SPEAKER_03: The expectations are on the floor at this point after the first act.
20:12
SPEAKER_03: But the CDC's new tobacco advisor is a pastor with no experience in public health.
20:17
SPEAKER_03: This week,
20:18
SPEAKER_03: Trump announced that Pastor Darrell Scott will be serving the administration as
20:22
SPEAKER_03: an advisor for tobacco health issues on the advisory committee for the director in
20:26
SPEAKER_03: the CDC.
20:27
SPEAKER_03: Who is Pastor Darrell Scott?
20:29
SPEAKER_03: He was one of the first African-American pastors to support Trump
20:31
SPEAKER_03: and encouraged other African-American pastors to attend meetings at Trump Tower.
20:35
SPEAKER_03: His Wikipedia career entry is small at best.
20:38
SPEAKER_03: Scott is the founder and pastor of the New Spirit Revival Center
20:41
SPEAKER_03: in Cleveland Heights, Ohio,
20:43
SPEAKER_03: which owns radio station WCCD AM 1000 in Parma,
20:47
SPEAKER_03: Ohio, where Scott has a daily program.
20:50
SPEAKER_03: No words so far on why a man with zero public health credentials was chosen.
20:54
SPEAKER_03: Just seems like he picked his favorite pastor in Ohio.
20:57
SPEAKER_03: To advise on tobacco.
21:00
SPEAKER_03: I don't think that's going to work out, Rob.
21:02
SPEAKER_03: I don't think we're going to be seeing a big crackdown on big tobacco or regulations
21:07
SPEAKER_03: on vapes or all the normal things that the CDC does when it comes to tobacco use
21:12
SPEAKER_03: in America,
21:12
SPEAKER_03: the former leave the largest public health crisis in the country for a long,
21:17
SPEAKER_03: long time.
21:17
SPEAKER_02: I mean, maybe he smokes.
21:19
SPEAKER_02: I don't know.
21:19
SPEAKER_02: Maybe he used to smoke.
21:21
SPEAKER_02: Yeah, it's bizarre.
21:22
SPEAKER_02: I mean, like on the long list of like horrible people they've appointed
21:27
SPEAKER_02: at public health agencies, right?
21:29
SPEAKER_02: I don't know.
21:29
SPEAKER_02: Is Pastor Scott going to be dangerous?
21:32
SPEAKER_02: Just like, no, maybe, I don't know, but maybe not.
21:35
SPEAKER_03: Well, the relaxing of tobacco policy is like, has the highest body count you can do, right?
21:42
SPEAKER_03: There's not really anything you can do in public health besides like, smoke whippy, got him.
21:48
SPEAKER_03: Yeah.
21:51
SPEAKER_02: Executive probably would be a worse person for this.
21:55
SPEAKER_02: I don't know, wouldn't it?
21:56
SPEAKER_02: I don't know.
21:59
SPEAKER_03: Yeah, at least they'd be making jobs.
22:01
SPEAKER_03: Like this guy just seems like he's going to be like, I'm at it, fellas.
22:05
SPEAKER_02: Yeah,
22:06
SPEAKER_03: just weird.
22:06
SPEAKER_03: Yeah, that's a big step back.
22:09
SPEAKER_03: You know, I was reading, Rob, I don't know if you know this.
22:11
SPEAKER_03: Europe has a really big problem with people continuing to smoke.
22:14
SPEAKER_03: Like this is one of the rare things that we're like better than Europe at is
22:19
SPEAKER_03: that we've been like, hey, it's not cool to smoke cigarettes, kids.
22:23
SPEAKER_02: And like it largely in America,
22:24
SPEAKER_02: that's like an agreed upon
22:26
SPEAKER_03: public policy intervention that everyone sort of is like,
22:29
SPEAKER_03: yeah, we probably shouldn't let the kids smoke.
22:31
SPEAKER_03: But in Europe, they have a really hard time.
22:33
SPEAKER_03: Like tobacco rates are just much higher than America.
22:36
SPEAKER_03: So that's sad.
22:37
SPEAKER_03: I mean,
22:37
SPEAKER_03: you get like with the rest of the developing world and when it comes to health care,
22:41
SPEAKER_03: the United States is really far behind.
22:42
SPEAKER_03: But on intervention on tobacco use, the United States has done a pretty good job.
22:47
SPEAKER_03: But this seems like it's going to be a big step back,
22:49
SPEAKER_02: which is too bad.
22:49
SPEAKER_02: But if you're in Europe and you get heart disease or lung cancer, you will not go broke.
22:55
SPEAKER_02: You will not have to file for bankruptcy.
22:57
SPEAKER_03: You can smoke.
22:58
SPEAKER_03: You can smoke them if you
23:00
SPEAKER_02: got them.
23:00
SPEAKER_02: And if something bad happens, we'll take care of you.
23:02
SPEAKER_02: We'll take care of you.
23:03
SPEAKER_02: I don't know.
23:03
SPEAKER_02: Maybe that's the mindset.
23:05
SPEAKER_02: No, I'm not promoting smoking.
23:06
SPEAKER_03: It's maximum freedom.
23:08
SPEAKER_03: The freedom to smoke a bunch of cigarettes and then the freedom
23:13
SPEAKER_02: to not get care
23:13
SPEAKER_02: for whatever illness results.
23:14
SPEAKER_02: Okay.
23:16
SPEAKER_03: We've covered quite a bit.
23:17
SPEAKER_03: I think we're going to head over to our guest, Dr. Jesse Goodman.
23:21
SPEAKER_03: What did we talk to Jesse Goodman about?
23:23
SPEAKER_02: So Dr. Goodman,
23:24
SPEAKER_02: former chief scientist at the FDA for, oh, five,
23:28
SPEAKER_02: six years there during the Obama administration,
23:30
SPEAKER_02: and has really an insider's view of public health agencies at the federal level
23:36
SPEAKER_02: and vaccines in particular,
23:37
SPEAKER_02: and we talked Talk a lot about Trump's executive order,
23:40
SPEAKER_02: how ridiculous it was,
23:41
SPEAKER_02: how dangerous it potentially is,
23:42
SPEAKER_02: but then really what happens at the regulatory agencies as far as the approval
23:47
SPEAKER_02: of drugs and vaccines in particular.
23:50
SPEAKER_02: Kind of a wide ranging conversation and just, I learned a lot.
23:53
SPEAKER_02: I learned a lot.
23:54
SPEAKER_02: Great.
23:54
SPEAKER_03: Well, let's go to Dr. Jesse Goodman now.
23:58
SPEAKER_02: All right.
23:58
SPEAKER_02: Welcome back, everyone.
24:00
SPEAKER_02: Really excited today.
24:01
SPEAKER_02: My guest is Dr. Jesse Goodman.
24:03
SPEAKER_02: Dr.
24:03
SPEAKER_02: Goodman is a professor of medicine and attending physician in infectious diseases
24:07
SPEAKER_02: at Georgetown University.
24:09
SPEAKER_02: He chairs the multi-institutional independent expert vaccine analysis team,
24:13
SPEAKER_02: EVAT, which provides information and analysis to communicators.
24:17
SPEAKER_02: He was previously chief scientist of the FDA and prior to that directed its Center
24:22
SPEAKER_02: for Biologics Evaluation and Research, or CBER.
24:24
SPEAKER_02: Dr. Goodman, welcome to Paging America.
24:27
SPEAKER_00: Thank you for having me.
24:29
SPEAKER_02: Yeah, so I guess we can start right off.
24:30
SPEAKER_02: Now, you ran CBER, then served as FDA's chief scientist.
24:34
SPEAKER_02: So you know that system,
24:36
SPEAKER_02: kind of the system at FDA and certainly kind of
24:38
SPEAKER_02: within our federal public health apparatus.
24:42
SPEAKER_02: And I know you've talked about I guess a couple things.
24:44
SPEAKER_02: What makes this different from previous political pressure on vaccine policy?
24:47
SPEAKER_02: And what are the risks if this kind of thing goes forward?
25:10
SPEAKER_00: Well, I think in years and years, we've never seen anything like this.
25:15
SPEAKER_00: So this kind of attempting to sort of get rid of scientists you don't like or agree
25:23
SPEAKER_00: with in the federal agencies,
25:26
SPEAKER_00: Replace them largely with people with an agenda you could call political,
25:31
SPEAKER_00: but how is being against lifesaving vaccines really political?
25:36
SPEAKER_00: And then upending all the processes around vaccine recommendations and around
25:42
SPEAKER_00: a system that's really worked to make it so that most people forget what it was like
25:48
SPEAKER_00: to have children die of measles or to have children with polio.
25:52
SPEAKER_00: So in a way, we're a victim of our success.
25:55
SPEAKER_00: And this is totally unprecedented.
25:58
SPEAKER_00: I don't know of anything like it.
25:59
SPEAKER_00: Now, this started over a year ago when,
26:03
SPEAKER_00: because they didn't like the advice
26:05
SPEAKER_00: that this very transparently functioning Advisory Committee
26:09
SPEAKER_00: on Immunization Practices was providing,
26:12
SPEAKER_00: they basically fired everyone and replaced the committee Mostly
26:17
SPEAKER_00: with unqualified people.
26:19
SPEAKER_00: And even that wasn't enough.
26:21
SPEAKER_00: Then just the secretary went ahead
26:23
SPEAKER_00: and made his own declarations around what vaccine should be used and how.
26:28
SPEAKER_00: And this latest presidential executive order is the same kind of thing.
26:35
SPEAKER_00: And it probably doesn't have immediate effects, but where it's going is dangerous.
26:42
SPEAKER_00: And it serves to increase people's confusion and mistrust.
26:47
SPEAKER_02: Yeah.
26:47
SPEAKER_02: And I guess before we get deeper into the controversies,
26:50
SPEAKER_02: I'd love,
26:51
SPEAKER_02: because of your previous work at FDA,
26:54
SPEAKER_02: if you could kind of give people a real answer.
26:56
SPEAKER_02: How does a vaccine actually get proven safe?
26:59
SPEAKER_02: And why should we trust that the process hasn't been compromised?
27:03
SPEAKER_00: It's a very good question.
27:05
SPEAKER_00: And I think it's important for people to realize,
27:08
SPEAKER_00: and I've seen Products evaluated across the spectrum at FDA,
27:12
SPEAKER_00: from drugs to devices to vaccines,
27:16
SPEAKER_00: that vaccines are probably the most exhaustively evaluated prior to their approval
27:24
SPEAKER_00: of any medical products.
27:27
SPEAKER_00: Typically, there are clinical trials involving tens of thousands of individuals.
27:33
SPEAKER_00: There's a lot of care in how they are developed.
27:38
SPEAKER_00: And then their safety is carefully tracked through a number of systems after they're approved.
27:45
SPEAKER_00: So essentially, there's a tremendous amount of data on their quality and safety before approval.
27:52
SPEAKER_00: FDA reviews hundreds of thousands or millions of pages of documents.
28:00
SPEAKER_00: Typically then brings any decision about a new vaccine to a public discussion with
28:05
SPEAKER_00: an expert advisory committee before even approving them.
28:10
SPEAKER_00: And then,
28:11
SPEAKER_00: as I said,
28:11
SPEAKER_00: if something is approved because its benefits clearly outweigh its risks,
28:17
SPEAKER_00: that safety is monitored,
28:19
SPEAKER_00: both by required reporting by manufacturers,
28:23
SPEAKER_00: But also typically using large databases,
28:27
SPEAKER_00: electronic health records in healthcare systems.
28:30
SPEAKER_00: So we know a ton about these products.
28:34
SPEAKER_00: We also expect very high level of safety because they are typically given
28:41
SPEAKER_00: to millions of healthy individuals.
28:43
SPEAKER_02: I hear Kennedy all the time and maybe others kind of parrot this,
28:46
SPEAKER_02: you know, say, well,
28:48
SPEAKER_02: we need,
28:48
SPEAKER_02: you know,
28:49
SPEAKER_02: placebo controlled,
28:50
SPEAKER_02: you know,
28:51
SPEAKER_02: blinded placebo controlled studies of these vaccines of anything,
28:54
SPEAKER_02: you know, that's on the market.
28:56
SPEAKER_02: And then,
28:57
SPEAKER_02: you know,
28:58
SPEAKER_02: dear Lord,
28:58
SPEAKER_02: if they decide if there's a way we could actually split up MMR
29:01
SPEAKER_02: into three different shots,
29:02
SPEAKER_02: you know, Conceivably, they're going to ask for these kinds of trials.
29:07
SPEAKER_02: I saw an interview you did talking a little bit about this.
29:09
SPEAKER_02: I wonder if you could get into this.
29:10
SPEAKER_02: Is that exactly how we always are going to assess, in particular, vaccines?
29:17
SPEAKER_02: Are there other considerations that come to bear?
29:21
SPEAKER_00: Well, in the modern era,
29:23
SPEAKER_00: first of all,
29:23
SPEAKER_00: most new, truly novel vaccines have been studied in placebo-controlled trials.
29:32
SPEAKER_00: The COVID vaccines,
29:34
SPEAKER_00: which have made many people concerned and have been a big focus of all these kind
29:39
SPEAKER_00: of allegations,
29:40
SPEAKER_00: were studied in very large, randomized, double-blind, placebo-controlled trials.
29:47
SPEAKER_00: And that showed their effectiveness and characterized their safety well.
29:51
SPEAKER_00: So it's a falsehood that generally vaccines aren't studied in placebo-controlled studies.
29:58
SPEAKER_00: Some of the very older vaccines may have had other designs,
30:01
SPEAKER_00: for example,
30:03
SPEAKER_00: looking at effects on disease in a community before and after introduction of
30:08
SPEAKER_00: a vaccine.
30:09
SPEAKER_00: But in general, there are placebo-controlled studies.
30:12
SPEAKER_00: There are a number of cases where they would be unethical.
30:16
SPEAKER_00: For example, we have approved safe and effective vaccines against pneumonia.
30:22
SPEAKER_00: The pneumonia,
30:23
SPEAKER_00: you know,
30:24
SPEAKER_00: strep pneumo,
30:25
SPEAKER_00: which causes pneumococcal Pneumonia,
30:28
SPEAKER_00: but also meningitis and bacteremia, all of which are life-threatening diseases.
30:34
SPEAKER_00: They seem to imply that every time new strains are added or a vaccine is improved,
30:40
SPEAKER_00: you should have to go back and do a placebo-controlled trial.
30:43
SPEAKER_00: That would just be totally unethical when you have to let kids get meningitis
30:50
SPEAKER_00: or sepsis When you have a vaccine to prevent that, that's already approved.
30:56
SPEAKER_00: So in those cases,
30:57
SPEAKER_00: you typically study the new vaccine either against
31:01
SPEAKER_00: the already approved standard one,
31:03
SPEAKER_00: or in some cases you have known what we call correlates of protection or markers
31:09
SPEAKER_00: about the immune response that we know will correlate with protection and
31:16
SPEAKER_00: a vaccine may be approved on those correlates would then Confirmation
31:21
SPEAKER_00: of its effectiveness after approval.
31:24
SPEAKER_02: Yeah, I mean,
31:25
SPEAKER_02: I think,
31:25
SPEAKER_02: and boy,
31:26
SPEAKER_02: you see, I mean,
31:27
SPEAKER_02: I think RFK Jr.
31:28
SPEAKER_02: certainly and others come to this with a certain viewpoint of vaccines.
31:33
SPEAKER_02: And so when they say that, well,
31:34
SPEAKER_02: these things haven't all been put through this rigorous standard,
31:39
SPEAKER_02: when you put it,
31:39
SPEAKER_02: That way,
31:40
SPEAKER_02: and really inform people,
31:42
SPEAKER_02: if we literally gave kids a placebo instead of something with new strains,
31:47
SPEAKER_02: kids will get sick.
31:49
SPEAKER_02: Kids will die.
31:50
SPEAKER_02: We know that to be true.
31:53
SPEAKER_02: It would be unethical,
31:53
SPEAKER_02: but it would be horribly cruel to these families to do this to their kids.
31:58
SPEAKER_02: And for him to suggest that should be the gold standard
32:03
SPEAKER_02: or else we can't make progress
32:05
SPEAKER_02: on these already established vaccines seems absolutely ludicrous.
32:09
SPEAKER_00: It is completely ludicrous.
32:11
SPEAKER_00: What's also quite rich in all this is that in casting doubt on the safety
32:17
SPEAKER_00: of some vaccines or raising this issue of,
32:20
SPEAKER_00: do vaccines cause autism or immune disease?
32:25
SPEAKER_00: They cite studies that are almost 100% either case reports or not placebo-controlled trials.
32:32
SPEAKER_00: So it's sort of like one standard of evidence applies to development of vaccines
32:37
SPEAKER_00: and testing of them, but another applies to making comments about safety data.
32:44
SPEAKER_00: So I think people...
32:47
SPEAKER_00: Just have to listen to what really is being said and what really are the facts around it.
32:52
SPEAKER_00: And the scientific community needs to re-earn trust and be able to explain things
32:57
SPEAKER_00: to people in a way that they can appreciate and understand.
33:00
SPEAKER_00: Yeah.
33:01
SPEAKER_02: Absolutely.
33:02
SPEAKER_02: So one thing that's really strange to me is you hear so often that,
33:05
SPEAKER_02: you know, I forget that I see the numbers.
33:08
SPEAKER_02: I've seen Joe Rogan talking about,
33:09
SPEAKER_02: you know, 72 shots, so many shots, however many shots they say.
33:13
SPEAKER_02: It seems to be a bigger number every year.
33:16
SPEAKER_02: The number of shots kids get and they want to reduce the number of shots.
33:19
SPEAKER_02: But, you know,
33:20
SPEAKER_02: if the executive order Trump put forth what about three weeks ago were to come
33:25
SPEAKER_02: to pass, you'd be breaking up MNR into three shots.
33:28
SPEAKER_02: That means more injections, right?
33:29
SPEAKER_02: More chances for kids to fall through the cracks because they missed an appointment, perhaps.
33:34
SPEAKER_02: Do you think anyone in the administration is actually tracking the contradiction
33:38
SPEAKER_02: or is this like is that just doesn't really matter?
33:42
SPEAKER_00: It seems fundamentally a bit insane because one of the main complaints has been,
33:49
SPEAKER_00: oh, they're getting so many shots.
33:51
SPEAKER_00: And of course,
33:52
SPEAKER_00: nobody likes holding their child and maybe having them scream for 30 seconds,
33:58
SPEAKER_00: if that.
34:00
SPEAKER_02: Yeah, yeah, yeah.
34:01
SPEAKER_00: But with their proposals, you'd get more injections.
34:06
SPEAKER_00: So for example, with MMR, instead of Two shots, every child would get six.
34:14
SPEAKER_00: So that's four extra shots.
34:16
SPEAKER_00: And there are other combination vaccines.
34:18
SPEAKER_00: There's one that has, I gamed this out, there's one that has five components.
34:25
SPEAKER_00: And instead of getting four shots, they get 20 or 16 more.
34:33
SPEAKER_00: So these proposals are,
34:35
SPEAKER_00: I think, cruel for kids by giving them lots of shots when there's no need.
34:40
SPEAKER_00: And the other thing that nobody has focused on is the expense.
34:46
SPEAKER_00: I mean,
34:46
SPEAKER_00: every time you have a healthcare interaction to get another shot and have to have
34:50
SPEAKER_00: an appointment with a healthcare provider or a system, That's time off from work.
34:58
SPEAKER_00: That's money.
34:59
SPEAKER_00: It would amount to billions of dollars in expenses that,
35:03
SPEAKER_00: you know,
35:03
SPEAKER_00: would be better off spent,
35:05
SPEAKER_00: you know,
35:06
SPEAKER_00: fighting cancer or giving people who are now being taken off healthcare,
35:11
SPEAKER_00: you know, protecting their healthcare.
35:13
SPEAKER_00: This makes no sense.
35:16
SPEAKER_00: I do understand that some parents feel like their kids get a lot of shots.
35:21
SPEAKER_00: But in fact, those combination vaccines reduce the number.
35:25
SPEAKER_00: They do that without making for a higher volume of fluid.
35:28
SPEAKER_00: So these aren't like, you know, giant syringes or giant vats of vaccine.
35:34
SPEAKER_00: Yeah.
35:34
SPEAKER_03: Yeah.
35:36
SPEAKER_00: Really reduces that exposure.
35:40
SPEAKER_00: And that number of 76 also was calculated saying that every kid got both COVID
35:47
SPEAKER_00: and flu vaccine every year until they were 18.
35:50
SPEAKER_00: And that doesn't happen.
35:53
SPEAKER_00: So it's far less.
35:56
SPEAKER_00: And I think a lot of countries and a lot of healthcare systems would be very happy
36:01
SPEAKER_00: if they could provide the vaccines that our country is able to afford to provide.
36:06
SPEAKER_02: Amen.
36:07
SPEAKER_02: Amen.
36:07
SPEAKER_02: And I mean, Trump,
36:08
SPEAKER_02: I know in that,
36:09
SPEAKER_02: I hate to keep going back to this,
36:10
SPEAKER_02: but he called them quite lethal and likened MMR to a nuclear weapon.
36:14
SPEAKER_02: Obviously, no data behind that.
36:15
SPEAKER_02: But his plan, right, this EO says they want to plan to phase it out in three months.
36:20
SPEAKER_02: I think I've seen some reporting that,
36:22
SPEAKER_02: you know, the pharmaceutical companies telling us maybe decades.
36:24
SPEAKER_02: I mean, you were deeply,
36:26
SPEAKER_02: kind of deeply involved in kind of the goings on at the FDA and the processes by
36:31
SPEAKER_02: which these all Get approved and kind of working with manufacturers, I'm sure.
36:35
SPEAKER_02: Is something like that even possible?
36:37
SPEAKER_00: Well, it's possible,
36:38
SPEAKER_00: you know,
36:38
SPEAKER_00: before we had, you know, we're talking about Measles, mumps, rubella, MMR vaccine.
36:44
SPEAKER_00: Before we had that,
36:46
SPEAKER_00: there were three vaccines,
36:49
SPEAKER_00: but they're individual vaccines that were given individually.
36:52
SPEAKER_00: There are currently no such approved products.
36:56
SPEAKER_00: So a company would have to redevelop its process to make each vaccine singly.
37:02
SPEAKER_00: You would have to have three times as many syringes or vials
37:06
SPEAKER_00: because you'd be having three times as many doses,
37:10
SPEAKER_00: going back to more shots, more needles, more syringes.
37:13
SPEAKER_00: So they would have to change their manufacturing facilities to do that.
37:17
SPEAKER_00: And then depending on how much data they have about
37:21
SPEAKER_00: the current individual components as opposed to the combined vaccine,
37:24
SPEAKER_00: they might require some clinical studies to show that the immune effects
37:29
SPEAKER_00: at least are similar.
37:31
SPEAKER_00: I can't imagine anything taking less than a year,
37:35
SPEAKER_00: costing hundreds of millions of dollars and perhaps taking longer and costing more.
37:42
SPEAKER_00: And I keep coming back to there is not one single fact that suggests that
37:49
SPEAKER_00: the MMR vaccine, the benefits don't massively exceed the risk.
37:55
SPEAKER_02: And it's frustrating.
37:56
SPEAKER_02: I know we've talked about it too much, and I'm sure you've been asked about it so many times.
38:01
SPEAKER_02: But we have to take it at least seriously to some extent because it is coming from
38:07
SPEAKER_02: the president, right?
38:08
SPEAKER_02: From the secretary of HHS.
38:11
SPEAKER_02: If it was just some crackpot just on a podcast somewhere just talking
38:15
SPEAKER_02: about doing this,
38:16
SPEAKER_02: you could just sort of brush it aside,
38:18
SPEAKER_02: even if it had a big reach like someone like Joe Rogan.
38:21
SPEAKER_02: We don't have to spend a lot of time on that.
38:22
SPEAKER_02: This is actually coming from the head of the government, like the head of HHS.
38:27
SPEAKER_02: And so even if it's not feasible, you're right.
38:31
SPEAKER_02: The fear that it instills in people, I think it's going to get kids hurt.
38:35
SPEAKER_00: I think while we can look at these pronouncements coming from High level officials
38:42
SPEAKER_00: and be very concerned because they do have this giant pulpit,
38:45
SPEAKER_00: even if people don't look to them for health advice.
38:48
SPEAKER_00: I mean, RFK say you shouldn't follow my health advice,
38:52
SPEAKER_00: but even if people don't,
38:53
SPEAKER_00: this adds so much noise and uncertainty to the system that a busy parent trying
38:59
SPEAKER_00: to decide what to do or trying to decide whether to get their flu shot,
39:03
SPEAKER_00: it may kind of compound the doubt enough to make people Make decisions
39:08
SPEAKER_00: that ultimately are life-threatening for them.
39:13
SPEAKER_00: I think even more than that,
39:14
SPEAKER_00: we have to be concerned and acknowledge in the medical profession that there are
39:19
SPEAKER_00: a sizable number of people influenced by sources like what they saw on YouTube
39:24
SPEAKER_00: or what a secretary who is not a healthcare provider or scientist says.
39:30
SPEAKER_00: There are a lot of people now who don't trust the system.
39:33
SPEAKER_00: They still generally trust They're doctors and nurses, and we need to build on that.
39:38
SPEAKER_00: But we really need to do a lot more communicating and not just say, oh,
39:43
SPEAKER_00: this stuff isn't true, it's stupid, but to sort of say, what are people's questions?
39:48
SPEAKER_00: And let's answer them respectfully,
39:51
SPEAKER_00: because we're going against a setting where people are getting their information
39:56
SPEAKER_00: on YouTube, essentially.
39:57
SPEAKER_02: For sure.
39:59
SPEAKER_02: And before I let you go, it kind of goes right into what I wanted to ask you about here.
40:02
SPEAKER_02: The state of the public health infrastructure in the U.S.
40:05
SPEAKER_02: We've spoken to a number of people who've been at the CDC who've left there
40:08
SPEAKER_02: and they describe career staff at HHS as dedicated and passionate.
40:13
SPEAKER_02: I'm just wondering how you're feeling about the state of the agencies now and
40:16
SPEAKER_02: then your thoughts on their ability to survive this era and can they be brought back
40:22
SPEAKER_02: to their previous levels of excellence or is there something different we need
40:26
SPEAKER_02: to do,
40:27
SPEAKER_02: not just to get them to where they were,
40:29
SPEAKER_02: but like you said, to instill trust in individuals in the system in general?
40:33
SPEAKER_00: Yeah, it's a great question.
40:35
SPEAKER_00: I mean, I think...
40:37
SPEAKER_00: The resources we have and the mind power and education and
40:43
SPEAKER_00: the people who've come out of our schools of medicine and nursing and public health.
40:48
SPEAKER_00: And especially those people who made a choice to go into public service
40:52
SPEAKER_00: that may not provide the same income,
40:55
SPEAKER_00: but provides that satisfaction of protecting the public's health.
40:59
SPEAKER_00: That's here.
41:01
SPEAKER_00: We have what has been the envy of the world.
41:03
SPEAKER_00: You know, everybody wanted to come here to work with that system.
41:08
SPEAKER_00: Our international partners wanted to partner with our public health agencies.
41:13
SPEAKER_00: For me, that was a great privilege of working in government.
41:16
SPEAKER_00: So I think there's a lot still there.
41:19
SPEAKER_00: But the fact is that between the doge cuts,
41:23
SPEAKER_00: which decimated morale,
41:27
SPEAKER_00: and then the kind of devaluing of so many of these people,
41:33
SPEAKER_00: many people have been driven away.
41:35
SPEAKER_00: We've seen that With tremendous turnover of the most experienced leadership at CDC
41:40
SPEAKER_00: and FDA and also NIH, where they basically replaced all the institute directors.
41:45
SPEAKER_00: I think I'm very concerned about this,
41:48
SPEAKER_00: both because of the loss of amazing people,
41:50
SPEAKER_00: but also because those people are needed to mentor the next generation.
41:58
SPEAKER_00: And for that next generation to choose public service,
42:01
SPEAKER_00: They have to feel that they're going to be kind of valued and be able
42:06
SPEAKER_00: to carry out their jobs.
42:08
SPEAKER_00: So I would describe the system as robust,
42:11
SPEAKER_00: still a lot of amazing people doing a great job,
42:14
SPEAKER_00: but threatened to a degree that is not paralleled.
42:18
SPEAKER_00: And I could go on and on, but the immigration stuff is part of it.
42:23
SPEAKER_00: It's telling people.
42:25
SPEAKER_00: Foreign scientists who used to want to train here and then went back
42:29
SPEAKER_00: to their countries and worked with us.
42:31
SPEAKER_00: It's making it so that this may not be anymore the place that everybody wants to go.
42:37
SPEAKER_00: So all of these things make me really concerned.
42:40
SPEAKER_00: I think we can survive it, but I think it's going to be a 10, 20 year project to rebuild.
42:46
SPEAKER_00: I'm incredibly grateful for people who are staying in and doing the best that they can.
42:52
SPEAKER_00: You know,
42:52
SPEAKER_00: and all of that is good,
42:53
SPEAKER_00: but I think There's a lot to do and this is still playing out.
42:59
SPEAKER_00: And one of the things I've tried to do very hard from the outside is support
43:04
SPEAKER_00: the integrity of processes going on and support the people
43:07
SPEAKER_00: who really are trying hard to do a very good job.
43:11
SPEAKER_02: Yeah.
43:11
SPEAKER_02: I wonder if you could tell us a little bit about EVAT and kind of what you do,
43:15
SPEAKER_02: why you started that.
43:16
SPEAKER_02: Does it kind of have anything to do with this idea of,
43:20
SPEAKER_02: you know,
43:20
SPEAKER_02: obviously it's communicating, but,
43:22
SPEAKER_02: you know,
43:22
SPEAKER_02: kind of the institutions as they are and as they were,
43:25
SPEAKER_02: and hopefully as, you know, we can rebuild them to be.
43:28
SPEAKER_00: The way this originated,
43:30
SPEAKER_00: and we're basically a group of about a dozen people from multiple institutions,
43:34
SPEAKER_00: some of whom ex-government leaders,
43:37
SPEAKER_00: all of whom vaccine experts, some Inventors, vaccine inventors from academia.
43:43
SPEAKER_00: And all of us are concerned about communication of the facts around vaccines.
43:47
SPEAKER_00: It's not political.
43:49
SPEAKER_00: We're just saying when there's questions,
43:53
SPEAKER_00: you know, can we help people make more informed decisions?
43:56
SPEAKER_00: And this came about when at the beginning of COVID and all of this Concern
44:04
SPEAKER_00: about rapid vaccine development,
44:06
SPEAKER_00: this advocacy for unproven products like giving ivermectin,
44:12
SPEAKER_00: you know,
44:12
SPEAKER_00: the horse warming medicine or hydroxychloroquine,
44:16
SPEAKER_00: you know,
44:17
SPEAKER_00: lupus medicine,
44:18
SPEAKER_00: that there was tremendous pressure on FDA, CDC, and NIH around these issues.
44:23
SPEAKER_00: And also there was a Tremendous pressure to fast-track vaccines,
44:28
SPEAKER_00: and we all wanted to be sure that was done,
44:30
SPEAKER_00: but they also had the right safety studies.
44:33
SPEAKER_00: So we were getting tons of questions as individuals about what was going on,
44:39
SPEAKER_00: and we asked a few journalists, well,
44:41
SPEAKER_00: would you like a group to meet regularly with you and answer your questions
44:46
SPEAKER_00: and have briefings when events occur?
44:49
SPEAKER_00: And that's what happened,
44:50
SPEAKER_00: and we had something like 50 or 60 briefings during the COVID outbreak.
44:56
SPEAKER_00: And then when we realized that misinformation
44:59
SPEAKER_00: and misunderstanding was not going away,
45:02
SPEAKER_00: in fact,
45:02
SPEAKER_00: it was getting worse even post-COVID,
45:05
SPEAKER_00: we asked journalists, partners, and others, is this still useful?
45:08
SPEAKER_00: And we re-stood it up as EVAT to deal with vaccine issues more broadly.
45:13
SPEAKER_00: And we basically make ourselves available to journalists,
45:16
SPEAKER_00: hold series of briefings, put on webinars with journalism partners.
45:22
SPEAKER_00: And the idea is to help these communicators Better inform the public to make better decisions.
45:28
SPEAKER_00: So it's been really gratifying.
45:30
SPEAKER_00: And I have to say,
45:32
SPEAKER_00: there's lots of people from lots of organizations stepping in to try
45:36
SPEAKER_00: to provide accurate information.
45:38
SPEAKER_00: Like we've seen this with the pediatricians,
45:41
SPEAKER_00: et cetera,
45:41
SPEAKER_00: because when they can't look to government,
45:43
SPEAKER_00: they are looking for people they can trust for information.
45:48
SPEAKER_00: I always say you can never communicate too much.
45:51
SPEAKER_00: We all experience this from the patient level to the population level.
45:55
SPEAKER_02: Amen.
45:56
SPEAKER_02: Yeah, we always say it's about volume and volume, right?
45:58
SPEAKER_02: You got to be loud and you got to be everywhere and saying it all the time.
46:03
SPEAKER_02: Because currently the bully pulpit is being occupied by RFK Jr. at HHS.
46:08
SPEAKER_02: And I think it's going to take a lot to kind of flood the zone and get real information.
46:13
SPEAKER_02: So appreciate you doing that.
46:15
SPEAKER_00: Absolutely.
46:16
SPEAKER_00: It's really welcome.
46:17
SPEAKER_00: And I think a big part of it has that we have,
46:21
SPEAKER_00: you know,
46:21
SPEAKER_00: you and other healthcare providers all know,
46:24
SPEAKER_00: We don't have a lot of time in our patient practice,
46:28
SPEAKER_00: et cetera,
46:29
SPEAKER_00: but we need to figure out how our health systems and ourselves can make sure we have
46:34
SPEAKER_00: the time we need,
46:35
SPEAKER_00: not just to tell patients things,
46:37
SPEAKER_00: but to listen to them so they, again, come to us with their questions.
46:42
SPEAKER_00: And I told somebody else today that about half the time,
46:46
SPEAKER_00: so let's say I have a patient who comes and tells the nurse,
46:49
SPEAKER_00: I don't want to have flu vaccine this year.
46:51
SPEAKER_00: I don't Then when the patient comes in and say,
46:54
SPEAKER_00: you need to get flu vaccine this year, I say, you know, I see you chose not to.
46:59
SPEAKER_00: That's your decision.
47:00
SPEAKER_00: But what questions do you have?
47:02
SPEAKER_00: And I think we need to work to make ourselves available to,
47:07
SPEAKER_00: again, be this very trusted source of accurate information.
47:12
SPEAKER_03: Amen.
47:12
SPEAKER_03: Absolutely.
47:13
SPEAKER_02: Well, Dr. Jesse Goodman, I appreciate you so much.
47:16
SPEAKER_02: Appreciate the work you're doing.
47:17
SPEAKER_02: And thanks for taking some time today and joining me here at Paging America.
47:21
SPEAKER_00: Well, thank you so much for having me,
47:23
SPEAKER_00: and thank all your audience, too,
47:26
SPEAKER_00: for anything they can do to help make people understand,
47:29
SPEAKER_00: again, these are serious diseases, and we can generally prevent them.
47:35
SPEAKER_00: I mean, what's going on with measles now?
47:37
SPEAKER_00: We shouldn't be arguing about one deaf, two deaf, five deafs.
47:41
SPEAKER_00: We should be arguing about this is totally preventable.
47:44
SPEAKER_00: No child should die of measles, and we have to get back to there.
47:49
SPEAKER_03: All right, we're back.
47:50
SPEAKER_03: Should we call it a day, Rob?
47:51
SPEAKER_03: It was great chatting.
47:53
SPEAKER_03: All right, everyone.
47:53
SPEAKER_03: Today's episode is written by Chris Savage, Dr.
47:55
SPEAKER_03: Rob Davidson, and me, Miles Baker.
47:57
SPEAKER_03: Paging America,
47:58
SPEAKER_03: The Situation Womb,
47:59
SPEAKER_03: and all of our on-call segments this week were produced by Peter Ogburn
48:01
SPEAKER_03: and Chris Savage.
48:03
SPEAKER_03: All shows were edited by Peter Ogburn and April Stewie.
48:05
SPEAKER_03: Our music is by Annette Somerset and Duneflower Productions.
48:07
SPEAKER_03: If you enjoyed today's show,
48:09
SPEAKER_03: please subscribe and leave us a rating on YouTube,
48:10
SPEAKER_03: Spotify, Apple Podcasts, or wherever you listen.
48:13
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48:15
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48:17
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48:20
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48:23
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48:26
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48:28
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48:30
SPEAKER_03: to Protect Healthcare.
48:32
SPEAKER_03: You can head over to the nonprofit that Rob and I lead at www.committeetoprotect.org
48:38
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48:38
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48:41
SPEAKER_03: Rob, as always, it was great chatting with you, and I'm sure I'll talk to you soon.