Latest / Paging America / Ebola Survivor Dr. Craig Spencer and is RFK Done at HHS?

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Ebola Survivor Dr. Craig Spencer and is RFK Done at HHS? · Paging America

0:00
SPEAKER_02: I think they know that the chemtrails crowd,
0:02
the people who believe the weirdest stuff that Kennedy brings
0:05
into the fold,
0:06
SPEAKER_02: that the kook alignment inside the Republican Party is complete.
0:10
SPEAKER_02: Maha has broad support in a low salience way,
0:16
but the people who are like that are really into the weird
0:19
stuff coming out of
0:19
SPEAKER_02: Kennedy's mouth and brain,
0:21
SPEAKER_02: they're already in.
0:23
SPEAKER_02: They're not going anywhere.
0:28
SPEAKER_02: Hi, everyone.
0:28
SPEAKER_02: Welcome back to Paging America,
0:30
where we explore the power of profit and politics shaping
0:32
American health care.
0:34
SPEAKER_02: I'm your host, Miles Baker, along with Dr.
0:36
SPEAKER_02: Rob Davidson.
0:37
SPEAKER_02: Today, we got a big show for you today.
0:41
SPEAKER_02: Our guest is Ebola survivor and public health leader Craig Spencer.
0:45
SPEAKER_02: So don't miss that.
0:46
SPEAKER_02: We got a bunch of great content on the back half of the show with Craig.
0:49
SPEAKER_02: Dr.
0:50
SPEAKER_02: Rob did an excellent interview with him, and you won't want to miss it.
0:52
SPEAKER_02: But before we get in to the contents of today's show,
0:55
SPEAKER_02: we have a big announcement at Paging America.
0:58
SPEAKER_02: And our dear friend Dr. Kristen Lyarly is here to make it.
1:01
SPEAKER_02: Kristen, what do you want to tell our folks?
1:04
Oh,
1:04
I'm so,
1:05
so,
1:05
so excited about what we've been drumming up in the background.
1:08
So we've got an incredible group of people who are doing work
1:12
in the reproductive
1:12
SPEAKER_03: rights abortion space.
1:14
SPEAKER_03: And you'll see our faces, you know, here and there.
1:18
SPEAKER_03: But now we're bringing a bunch of us together.
1:20
SPEAKER_03: So me, Dr. Chris Ford, Dr. Aaron Stevens, Dr. Chelsea Daniels,
1:27
We're going to sit down once a week and talk about what are the
1:30
latest things
1:30
happening in repro and abortion rights and we're calling it Are
1:35
you ready?
1:36
SPEAKER_03: Can I have a drumroll please?
1:37
SPEAKER_03: Thank you The Situation Womb The Situation Womb
1:47
SPEAKER_02: Wow, that's great.
1:48
And that's coming out this,
1:51
the first episode is coming this next Monday,
1:53
right?
1:53
SPEAKER_03: On Monday, we are shooting it in the morning.
1:56
We're going to get it up by drive time on Monday afternoon so
1:59
that y'all can hear
1:59
SPEAKER_03: what's going on.
2:00
SPEAKER_03: Latest stuff that hot off the presses about repro,
2:04
SPEAKER_03: about abortion,
2:05
SPEAKER_03: about politics and how it intersects with all of it.
2:08
SPEAKER_03: And this group
2:09
SPEAKER_03: I mean we're fun so you should join us I think you're gonna love these
2:12
conversations this is I mean so I know all of you individually
2:15
right doing doing
2:16
content and just sort of working with you all and advocacy and
2:19
just talking to you
2:19
you know socially and you're all great people but I got a
2:22
little peek a little
2:23
sneak peek at like the four of you together and it's fucking
2:26
magic like it is
2:27
pretty cool I don't know man Miles and I gotta step up our game
2:30
if we're gonna keep
2:31
SPEAKER_00: up with with the quartet uh every Monday
2:35
you guys are like laying down the gauntlet in the beginning of
2:37
the week for like
2:38
what the hell we got to be doing and then we're going to try to
2:41
come and like keep
2:42
up with you all you know three days later every Thursday so
2:45
yeah this is exciting
2:46
and I think really necessary and you all are such good
2:49
communicators and explainers
2:51
and I think for so many people in this audience and and a
2:54
bigger audience this is
2:55
SPEAKER_00: going to be huge
2:56
SPEAKER_03: It's great for the general public.
2:58
SPEAKER_03: This is not a doctor-focused podcast.
3:00
SPEAKER_03: It is about what does the general public need to know?
3:03
SPEAKER_03: I mean, Chris is an emergency medicine doc.
3:05
SPEAKER_03: Aaron and I are both OBGYNs.
3:07
SPEAKER_03: Chelsea is family medicine.
3:08
We see so many things from so many different perspectives,
3:12
and we're all over the country.
3:13
SPEAKER_03: So I think you're going to really appreciate all of the conversation,
3:20
SPEAKER_03: the approach that we take,
3:21
and then some of the crazy stories that don't get a lot of
3:24
press because a lot of
3:25
SPEAKER_03: these things are...
3:26
SPEAKER_03: kind of suppressed when it comes to the traditional media.
3:29
SPEAKER_03: But we're not going to let that happen.
3:30
We want you to know what's happening to people all across the
3:32
country as Medicaid
3:34
is being taken away and ACA subsidies are being slashed and
3:37
people can't get access
3:38
SPEAKER_03: to health care.
3:39
SPEAKER_03: So yeah, stay tuned.
3:40
SPEAKER_03: Monday is going to be a banger.
3:42
SPEAKER_02: Great.
3:42
SPEAKER_02: Yeah.
3:43
SPEAKER_02: Awesome.
3:44
SPEAKER_02: Awesome.
3:44
SPEAKER_02: All right.
3:44
Well,
3:44
Dr.
3:45
Lylee,
3:45
thank you for coming and joining us and making this big
3:48
announcement.
3:49
SPEAKER_02: And we'll tune in next Monday.
3:51
SPEAKER_03: Thanks, friends.
3:52
SPEAKER_03: Have fun talking about Ebola.
3:54
SPEAKER_02: Thanks.
3:59
Well,
3:59
thank you so much to Dr.
4:00
Lyle and we'll be tuning in this Monday for the Situation Womb.
4:04
SPEAKER_02: Couldn't be more excited about it.
4:05
SPEAKER_02: The rest of today's episode is we got a lot, a lot to cover.
4:10
SPEAKER_02: We have hospital closures in rural Virginia.
4:14
We have the Trump administration wants insurance companies to
4:16
offer loans to their customers.
4:18
We have a whole big rundown of RFK strangeness and then new
4:23
leadership coming into
4:23
SPEAKER_02: the American Medical Association.
4:25
SPEAKER_02: We want to talk about it.
4:27
So lots to get into Why don't we hop in So Virginia's rural
4:32
hospitals are in big
4:33
trouble Virginia Public Media reports that despite Republicans
4:36
claiming they're
4:37
making the biggest investment in rural hospitals in history as
4:39
many as 20% of rural
4:41
hospitals in the state are at risk of closure Seven of
4:44
Virginia's 36 rural
4:45
hospitals either face an immediate closure risk or high risk of
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experiencing
4:49
financial distress according to a presentation given last week
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at the state's Joint
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SPEAKER_02: Commission on Health Care
4:55
SPEAKER_02: After this hearing,
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SPEAKER_02: Delegate Rodney Willett,
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SPEAKER_02: he's a Democrat from Henrico,
5:00
SPEAKER_02: asked about the rural hospitals that didn't quite make the list.
5:03
About 18 additional hospitals are kind of right there in the
5:05
next tier of risk,
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SPEAKER_02: he said,
5:08
which brings the total to around 25 hospitals across the
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Commonwealth that are
5:12
SPEAKER_02: facing fairly critical risk.
5:14
This means that 90% to 70% of Virginia's rural hospitals are
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under the risk of
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SPEAKER_02: closure or financial distress.
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SPEAKER_02: Virginia is hardly alone.
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SPEAKER_02: Becker's Hospital Review found 720 rural hospitals nationally at risk.
5:25
SPEAKER_02: This is getting bad.
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SPEAKER_02: I mean,
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SPEAKER_02: as people take stock of what Trump's reconciliation bill is doing,
5:32
SPEAKER_02: it looks like rural healthcare in America is in real trouble.
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SPEAKER_00: Yeah, I mean, we sounded the alarm on this.
5:38
SPEAKER_00: So many advocates sounded the alarm.
5:40
SPEAKER_00: And I think people were described by Trump and by Republicans as,
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SPEAKER_00: you know,
5:45
SPEAKER_00: Chicken Little,
5:45
SPEAKER_00: the sky is falling.
5:47
SPEAKER_00: Oh, these people.
5:48
SPEAKER_00: And then that bogus slush fund, right?
5:50
SPEAKER_00: They took away a trillion from Medicaid.
5:52
They put 50 billion to some weird slush fund that who knows who
5:55
the hell gets it and why.
5:57
SPEAKER_00: We know why it's not based on absolute need.
6:00
SPEAKER_00: And yeah, it's terrible.
6:02
Yeah,
6:03
so the slush fund had this enormous risk in terms of corruption
6:08
with it,
6:08
right?
6:08
And it looks like it wasn't a maximalist corruption fund like
6:13
some of the other
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SPEAKER_02: funds that they're setting up,
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SPEAKER_02: like the January 6th Ryder funds.
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SPEAKER_02: But it also doesn't cover the problem.
6:21
Even if they use it and distribute it correctly,
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it's a band-aid on an amputation.
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SPEAKER_02: It just doesn't get the job done even close.
6:32
SPEAKER_02: Yeah,
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SPEAKER_02: hospital closures coming to a rural county near you,
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SPEAKER_02: it looks like,
6:39
SPEAKER_02: particularly for the folks in Virginia.
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SPEAKER_00: It isn't just closures, right?
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SPEAKER_00: It's reduction in services in these rural communities.
6:46
SPEAKER_00: So maybe the hospital,
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SPEAKER_00: this structure is there and the doors are still open,
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SPEAKER_00: but you might lose the mammogram suite,
6:52
SPEAKER_00: right?
6:52
So now women who need to get breast cancer screening need to
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drive an hour or more.
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You might lose the person who's doing colonoscopies for colon
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cancer screening,
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right?
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SPEAKER_00: Because they can't come up anymore.
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They can't afford that staff,
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you know,
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or the outpatient lab or x-ray suite or so many things.
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SPEAKER_00: I mean, I've worked my entire career in rural hospitals.
7:11
I still work in rural hospitals in a few different states now,
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including Michigan.
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and rural hospitals these places have like a pharmacy that
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during business hours is
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available to folks so they don't have to drive you know 30
7:22
minutes or what have you
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it's just like all of these little things drip drip drip and
7:27
again like we said
7:28
over and over it isn't just people on Medicaid who are getting
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screwed by this it's
7:33
the entire community it's retirees people on Medicare people on
7:37
workplace insurance
7:38
and it's the whole community because the hospital is in most of
7:42
these rural
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SPEAKER_00: communities the sort of
7:44
the nexus of employment uh of the entire community right as
7:48
often the biggest in a
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lot of these towns yeah so like the entire community gets
7:54
destroyed and young
7:54
people just get the hell out because there's no jobs they can't
7:57
you know and how do
7:58
you turn that back on like how do you turn that back on this is
8:01
decades that we're
8:02
talking yeah all right well we'll we'll we'll keep an eye out
8:05
on Virginia uh it's
8:06
glad that they're taking stock glad that they're publicly
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communicating about it
8:09
SPEAKER_02: but
8:10
SPEAKER_02: It does look like potentially rough sledding ahead for some of the rural
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SPEAKER_02: communities in Virginia.
8:14
All right,
8:14
on to HSA providers want to cash in on the next reconciliation
8:18
bill.
8:19
SPEAKER_02: So last March,
8:20
SPEAKER_02: STAT reported on the formation of the Great American Health Alliance,
8:23
which is trying to further cash in after reaping a windfall
8:27
with Trump's big
8:28
SPEAKER_02: billionaire tax giveaway law.
8:29
SPEAKER_02: The nonprofit membership includes Health Equity,
8:31
SPEAKER_02: which is one of the largest administrators of health savings accounts,
8:34
SPEAKER_02: and the American Bankers Association,
8:37
SPEAKER_02: which represents institutions holding about 90% of HSAs.
8:41
The group is now aggressively promoting including HSAs in the
8:44
so-called Reconciliation 3.0 bill.
8:47
That's the process they use to pass a bill that doesn't require
8:53
60 votes to get
8:53
SPEAKER_02: through the filibuster.
8:55
SPEAKER_02: And legislation being contemplated by Congress
9:00
SPEAKER_02: They're really running for it, too.
9:04
I think we have an ad that we want to show on how this quote
9:09
unquote coalition of
9:11
SPEAKER_02: healthcare providers and banks are using to lobby Congress.
9:15
SPEAKER_02: Let's take a look.
9:16
Let the money go directly to the people where they can buy
9:20
their own healthcare.
9:21
the legislation is written real price tags lower prescription
9:25
costs and health
9:26
savings accounts for everyone tax-free dollars for prevention
9:30
for wellness for
9:31
SPEAKER_00: better health congress support the president's great health care plan and
9:36
reconciliation put americans back in control of their health
9:40
you can own health
9:42
SPEAKER_00: care
9:45
Okay,
9:47
so yeah,
9:48
so it looks like you're gonna be able to do ban yoga looks like
9:54
we're
10:00
SPEAKER_02: We're replacing healthcare with Pilates and yoga.
10:06
SPEAKER_02: I think that sucks.
10:07
SPEAKER_02: As a reminder,
10:08
HSAs mainly benefit people with high incomes and are used
10:11
essentially as tax
10:12
SPEAKER_02: shelters.
10:13
SPEAKER_02: So you have a real sleight of hand,
10:16
SPEAKER_02: like not particularly clever sleight of hand in them promoting HSAs over,
10:23
SPEAKER_02: you know,
10:23
SPEAKER_02: after doing enormous,
10:25
SPEAKER_02: the largest healthcare cuts in American history.
10:27
yeah i mean hsas give you the triple tax benefit right tax-free
10:31
money going in
10:32
tax-free growth tax-free money coming out when you pay for
10:35
health care and if
10:36
people again really wealthy people just keep padding these hsas
10:39
and they don't use
10:40
all the money once they turn 65 they get on medicare they can
10:43
use that for tax-free
10:45
payment of medicare premiums medicare parts b and c and d um
10:50
like it's it's
10:52
SPEAKER_00: It's just so gross.
10:54
SPEAKER_00: Because they put an ad like that, right?
10:56
SPEAKER_00: And the way Trump has talked about it and other Republicans,
10:59
SPEAKER_00: they make it sound appealing to everyday folks.
11:02
SPEAKER_00: Like you get to keep your money, right?
11:04
SPEAKER_00: They do this all the time with bullshit tax cuts for billionaires.
11:08
SPEAKER_00: Well, you get to decide what you do with your money.
11:10
SPEAKER_00: Well,
11:10
SPEAKER_00: shit,
11:11
SPEAKER_00: if we do that too much,
11:12
is someone just going to get to decide to get the fire truck to
11:15
come to their house
11:15
SPEAKER_00: when it's on fire?
11:16
SPEAKER_00: There has to be a base of revenue to like
11:20
fund like the services people need and if we just keep letting
11:24
rich people shelter
11:25
all their money like shit there's gonna be nothing left for
11:29
folks for regular folks
11:31
hopefully in hopefully the American Bankers Association's foray
11:35
into healthcare is
11:37
tilting at windmills hopefully these folks are not going to be
11:39
successful for
11:40
reasons fully unrelated to the HSAs we have heard from at least
11:44
McConnell who is
11:46
SPEAKER_02: ill right now and then Senator Susan Collins up in Maine
11:50
SPEAKER_02: that a reconciliation 3.0 bill is unlikely.
11:53
So it may be true that they just don't have the votes in the
11:56
Senate to move forward
11:57
SPEAKER_02: with the third reconciliation bill,
11:59
SPEAKER_02: and that would make the health savings accounts sort of moot.
12:04
SPEAKER_02: But it's still something to watch because it's going to be close, right?
12:07
It'll come down to one or two senators whether there's a
12:10
reconciliation 3.0.
12:11
SPEAKER_00: Did Collins express concern
12:13
no she actually said no she said oh wow okay so this could be a
12:17
new line yeah I
12:18
think she's I think she's far enough down in the polls that I
12:21
think she's decided
12:22
SPEAKER_02: she has to take a position yeah
12:25
SPEAKER_02: Okay, moving on.
12:26
The Trump administration has an answer for you if you can't
12:29
afford your medical bills.
12:30
SPEAKER_02: Take out a loan.
12:31
SPEAKER_02: You can go get a loan for your health care.
12:34
SPEAKER_02: From your health insurance provider.
12:35
SPEAKER_02: Yeah, you can just take it right out from your provider.
12:39
SPEAKER_02: In addition to profiting from your elevated insurance programs,
12:41
the Trump administration wants health insurance corporations to
12:44
have another
12:45
SPEAKER_02: revenue source,
12:46
SPEAKER_02: interest from loans they give you for health care.
12:49
This will be particularly profitable if people purchase the
12:52
high deductible plans
12:54
SPEAKER_02: they're pushing.
12:55
This is from reporting from the New York Times buried in the
12:58
fine print of
12:58
SPEAKER_02: Obamacare regulations.
13:00
The Trump administration is floating a novel idea for those who
13:03
can't afford to
13:03
SPEAKER_02: shell out tens of thousands of dollars in out of pocket medical costs.
13:07
SPEAKER_02: Why not borrow the money from your health insurance company?
13:10
In the dense 1,121-page final rule issued last month about how
13:15
the Affordable Care
13:16
SPEAKER_02: Act market will operate next year,
13:19
the administration suggested that insurers consider offering
13:22
loans to cash-strapped
13:23
SPEAKER_02: customers.
13:24
SPEAKER_02: Under this approach,
13:25
people who develop a costly disease or need unexpected
13:27
emergency care would be able
13:28
to turn to their health insurer for loans to cover their share
13:31
of the bill.
13:31
SPEAKER_02: The debt, though, would have to be repaid, presumably with interest.
13:35
Trump administration officials say this idea is a way to help
13:38
people who chose a
13:39
SPEAKER_02: plan with a low monthly premium and high out of pocket costs,
13:42
SPEAKER_02: but unexpectedly encounter a devastating medical bill.
13:46
With more than a third of American households already have some
13:48
kind of medical
13:49
SPEAKER_02: debt,
13:49
SPEAKER_02: this would be a boon for health insurance companies.
13:53
SPEAKER_02: Rob, I struggle to think of a worse idea.
13:58
SPEAKER_02: If you want the health of Americans to be better.
14:01
SPEAKER_02: And insurance companies,
14:03
SPEAKER_02: which are already vile corporations,
14:07
SPEAKER_02: the only way to make them worse would be to make them a bank.
14:10
SPEAKER_00: Yeah, make them a loan shark, right?
14:12
SPEAKER_00: Pay their loans.
14:12
SPEAKER_00: Like, this sounds great.
14:13
SPEAKER_00: Like, I mean, I'm sure amazing terms on those loans, right?
14:16
SPEAKER_00: I mean, this is the illustration of the 50-year mortgage, right?
14:19
SPEAKER_00: So these guys want
14:21
Americans working class Americans just to be in debt to banks
14:25
insurance companies
14:27
for the rest of their lives and and someone else just keep
14:29
making money off them
14:30
it's it's yeah it's gross and it's tough right because it's
14:34
buried in 1100 pages of
14:36
a rule and who's paying attention thank god somebody's paying
14:39
attention right and
14:40
and hopefully more people can start reporting out on this uh
14:44
just another proof
14:44
point of how this this administration just doesn't give a shit
14:47
about the plight of
14:48
SPEAKER_00: actual people out there
14:50
It just seems like they would just like pop champagne bottles
14:53
at United Health Group.
14:54
SPEAKER_02: Well, it's just like, oh, we get to be a bank now too?
14:58
SPEAKER_02: Great.
14:59
SPEAKER_00: Well, they already have thousands of entities under the banner, right?
15:04
SPEAKER_00: Different corporations that avoid paying corporate tax.
15:07
SPEAKER_00: And why not just throw a little banking arm?
15:09
SPEAKER_00: I'm sure they already have something like, right?
15:11
SPEAKER_00: As they do the HSAs.
15:12
SPEAKER_00: I mean, probably not a real stretch to just giving out loans.
15:16
SPEAKER_02: Just spin up a big insurance bank.
15:18
SPEAKER_00: Yeah.
15:18
SPEAKER_00: Ooh.
15:20
I hate this idea and we should fight it tooth and nail and
15:22
we'll move on to the
15:23
SPEAKER_02: next topic,
15:24
but we're going to stay on top of the continued vertical and
15:28
horizontal integration
15:30
SPEAKER_02: of America's self-insurers.
15:34
SPEAKER_02: So RFK Jr. is promoting some very strange things again.
15:38
SPEAKER_02: The Guardian's reporting that Kennedy is promoting a bizarre,
15:41
SPEAKER_02: unproven treatment for autism stem cells from human umbilical cords.
15:47
Autistic children as young as 18 months are being injected with
15:50
human stem cells
15:50
SPEAKER_02: derived from umbilical cords in an unapproved,
15:54
SPEAKER_02: unproven,
15:54
SPEAKER_02: and potentially harmful treatment,
15:56
SPEAKER_02: treatment in quotes,
15:57
SPEAKER_02: that scientists warn are proliferating across the U.S.
16:01
SPEAKER_02: under the act of encouragement of U.S.
16:02
SPEAKER_02: Health Secretary Robert F.
16:04
SPEAKER_02: Kennedy Jr.
16:05
SPEAKER_02: The procedure,
16:06
SPEAKER_02: which can involve the child being sedated with ketamine before receiving
16:09
SPEAKER_02: intravenous doses of millions of stem cells,
16:12
SPEAKER_02: costs upwards of $20,000.
16:14
families are often advised to return for regular top ups of
16:18
their stem cells
16:19
profoundly stressed parents are being wooed to the clinics with
16:22
promises that high
16:23
dose infusion of umbilical cord stem cells can lead to dramatic
16:26
improvements in
16:27
their children's ability to speak socialize or avoid aggressive
16:30
aggressive behavior
16:31
or self harming behavior yet there's no scientific evidence
16:33
that the procedure
16:34
works at all Rob what do we know about the science of injecting
16:40
children with
16:41
SPEAKER_02: umbilical cord stem cells
16:44
SPEAKER_00: Stem cells have such promise for so many diseases and are being studied,
16:48
SPEAKER_00: should continue to be studied.
16:50
Now,
16:50
a faction of the right has concerns about using stem cells in
16:55
research.
16:56
SPEAKER_00: That's a piece.
16:58
SPEAKER_00: But like they should be proven, right?
17:01
SPEAKER_00: We should have studies before we start injecting them into kids.
17:04
And it's just another example of taking parents of kids on the
17:09
autism spectrum who
17:11
SPEAKER_00: are looking for something,
17:12
SPEAKER_00: right?
17:12
SPEAKER_00: Looking for answers,
17:13
SPEAKER_00: looking for solutions and promising them something and,
17:16
SPEAKER_00: you know,
17:19
SPEAKER_00: subjecting their kids to potential danger.
17:20
SPEAKER_00: You mentioned ketamine there.
17:21
SPEAKER_00: Like we use ketamine.
17:23
SPEAKER_00: We give ketamine to kids.
17:24
SPEAKER_00: If they break their arm and you got to reset their arm,
17:26
SPEAKER_00: it's a great drug and used in the right setting.
17:29
um but we shouldn't be having to sedate kids to get treatments
17:32
that have no have no
17:33
basis in science or proof yeah crazy crazy that is crazy I
17:37
think it's just as weird
17:38
as the thing could be that this guy's out here this mad hatter
17:42
of a mad scientist
17:43
of a not a scientist sorry man there is better this mad hatter
17:47
is at HHS out there
17:48
SPEAKER_02: promoting ejected kids with umbilical cord stem cells it's nuts I uh
17:54
I think there's like a there's like a very real you know I was
17:57
like the that
17:58
they're right and and these folks like correctly identify the
18:02
problem and then find
18:04
a solution that's absolutely cookie banana like cuckoo bananas
18:07
and so the challenge
18:09
SPEAKER_02: with like novel treatments is the FDA can be really slow
18:13
approvals can get bottlenecked there's not enough resources to
18:17
run enough clinical
18:18
trials and those are all things that are fixable problems if
18:21
the government were to
18:22
you know if Congress and the government were to lean in and say
18:24
we're going to open
18:25
this process back up we're going to make it a lot faster we're
18:27
going to make it
18:28
we're going to try to keep it safe and we're going to make sure
18:30
it has the
18:30
resources it needs to work really well and go out and find
18:34
novel treatments for
18:35
SPEAKER_02: things but like
18:36
SPEAKER_02: Sounds like right now,
18:37
Kennedy's promoting experimenting on these kids in kind of like
18:42
a mad scientist lab
18:45
SPEAKER_02: scenario.
18:45
SPEAKER_02: That is pretty wild.
18:47
SPEAKER_00: I mean,
18:47
SPEAKER_00: former FDA Commissioner Marty McAree,
18:49
SPEAKER_00: when he swooped in,
18:50
SPEAKER_00: that was part of his platform of expediting getting these drugs,
18:53
SPEAKER_00: like not relying on multiple studies,
18:55
SPEAKER_00: maybe just one study.
18:57
SPEAKER_00: And so even under that framework of the supposedly more streamlined FDA,
19:02
SPEAKER_00: if you're still having to use treatments that haven't been approved,
19:06
SPEAKER_00: haven't been shown scientifically to be helpful,
19:09
SPEAKER_00: like that's saying something,
19:10
SPEAKER_00: right?
19:10
SPEAKER_00: That is saying something.
19:12
SPEAKER_00: and they're putting kids at risk potentially.
19:14
SPEAKER_00: And again, preying on families and parents who are just desperate.
19:18
SPEAKER_00: It's just gross.
19:19
SPEAKER_02: It's always what they're,
19:20
SPEAKER_02: it's,
19:21
SPEAKER_02: they're always going to have,
19:22
SPEAKER_02: they're always like punching way down in order to make political points.
19:26
SPEAKER_00: And I don't blame the parents.
19:28
SPEAKER_00: I don't.
19:29
peterogburn peterogburn peterogburn peterogburn peterogburn
19:31
peterogburn peterogburn
19:32
peterogburn peterogburn peterogburn peterogburn peterogburn
19:34
peterogburn peterogburn
19:35
peterogburn peterogburn peterogburn peterogburn peterogburn
19:38
peterogburn peterogburn
19:58
SPEAKER_02: All right.
19:59
SPEAKER_02: Kennedy is out on a big tour.
20:02
SPEAKER_02: He is stumping for Republicans in toss-up districts.
20:05
He is basically on the campaign trail while there's
20:09
simultaneously reporting that
20:11
SPEAKER_02: he's neglecting huge swaths of HHS's HHS portfolio.
20:16
SPEAKER_02: He's hitting the campaign trail.
20:18
SPEAKER_02: And as we talked about in a previous podcast,
20:19
SPEAKER_02: RFK Jr.
20:20
SPEAKER_02: made an appearance with embattled GOP rep Derek Van Orden,
20:23
SPEAKER_02: whose Western Wisconsin district in America's dairy land
20:26
SPEAKER_02: is one of the Republicans' need to hold to keep the majority.
20:30
SPEAKER_02: It turns out that's just one of the many stops that he's making.
20:34
He just stopped in your home state of Michigan to boost
20:39
Representative Tom Barrett.
20:41
SPEAKER_02: None of the visits are being called campaign stops,
20:43
SPEAKER_02: however,
20:44
SPEAKER_02: even though they very much appear to be,
20:46
SPEAKER_02: given that the Democrats have a real chance to take these seats.
20:49
This is reporting from a Lansing outlet called MLive inside a
20:53
barn at Country Mill
20:54
SPEAKER_02: Farms in Charlotte.
20:56
Kennedy spoke on a panel with leaders from Michigan Farm Bureau
20:58
and America First
20:59
SPEAKER_02: Policy Institute,
21:01
SPEAKER_02: plus a local farmer and U.S.
21:03
SPEAKER_02: Rep Tom Barrett,
21:04
SPEAKER_02: who is running for reelection.
21:05
Kennedy has been making stops across the country on his Take
21:08
Back Your Health tour,
21:09
SPEAKER_02: and he's been doing that since January.
21:11
SPEAKER_02: During similar events,
21:12
he's touted his agenda as necessary to improve the quality of
21:15
American food.
21:17
Yeah,
21:18
there's pretty good research out of Michigan that his vaccine
21:22
agenda
21:23
SPEAKER_02: is really unpopular, even in Michigan, even in rural Michigan.
21:28
SPEAKER_02: I'm not sure that Kennedy's showing up in the district that,
21:33
SPEAKER_02: for people that don't know,
21:34
SPEAKER_02: this is the district that Michigan State is in and that Lansing is in,
21:39
so you have a lot of the government workers for the state of
21:41
Michigan live there.
21:43
SPEAKER_02: I can't imagine that.
21:44
SPEAKER_02: There is some farmland,
21:45
but I can't imagine that Kennedy's stance on a whole host of
21:48
things plays very
21:49
SPEAKER_02: well.
21:49
SPEAKER_02: I'm not sure that this is helpful to Tom Barrett.
21:52
no I don't think so a couple things here one you can tell you
21:54
from Michigan when
21:55
you pronounce it Charlotte and not Charlotte it is Charlotte
21:58
probably only here in
21:59
Michigan yeah I mean it's a farming community but like any of
22:04
the press they get is
22:05
mostly either statewide or Lansing Press you know so those are
22:08
the folks seeing it
22:09
and they don't talk about the two biggest issues these guys
22:12
need to hear about with
22:13
related to health care one Tom Barrett voted for the big awful
22:16
bill the whatever
22:16
you want to call it and trillion dollars in Medicaid cuts to
22:19
fund tax cuts for
22:20
SPEAKER_00: billionaires
22:21
Which specifically endangered clinics in his district,
22:25
which is not a totally rural district.
22:28
SPEAKER_02: It goes from urban to ex-urban with some rural areas,
22:32
but there are specific clinics in his district that are
22:34
imperiled because of his
22:36
SPEAKER_02: Medicaid cuts.
22:37
SPEAKER_02: Anyway, back to you.
22:38
SPEAKER_00: Yeah,
22:38
SPEAKER_00: and then RFK Jr.
22:39
rode into HHS on the back of his anti-vax rhetoric and stances
22:45
and his children's
22:47
SPEAKER_00: health defense.
22:48
SPEAKER_00: His entire resume to become HHS director was
22:51
SPEAKER_00: was based upon bringing Maha into MAGA based on his anti-vax views.
22:56
SPEAKER_00: And you heard nothing about any of that, right?
23:00
SPEAKER_00: It was all about the food pyramid and decreasing obesity rate.
23:04
SPEAKER_00: Like they're basically crediting their upside down food pyramid,
23:08
promoting red meat and saturated fats as decreasing the
23:12
childhood obesity numbers.
23:14
SPEAKER_00: Like what the fuck?
23:15
SPEAKER_00: What the fuck are they talking about?
23:18
SPEAKER_00: That's what they're doing on these non-campaign stops.
23:20
SPEAKER_02: Like insane.
23:23
I want 50% of people I know are on GLP-1 class drugs and
23:28
getting smaller every time I see them.
23:30
SPEAKER_00: The people or the number of people?
23:32
SPEAKER_00: Oh, the people are actually getting smaller.
23:33
SPEAKER_02: Including me when I look in the mirror.
23:39
SPEAKER_02: And to say like your promotion of fattier milk and red meat
23:45
is making America obesity trend reverse while simultaneously
23:51
you have this mass
23:52
SPEAKER_02: adoption of GLP-1 class drugs.
23:55
SPEAKER_02: And you're gonna say like, which one is causing the thing?
23:58
SPEAKER_02: So like,
23:58
SPEAKER_02: I just think it's like such a dumb lie that even everyone,
24:02
SPEAKER_02: everyone knows people on GLP-1 drugs.
24:05
SPEAKER_02: Like it's such a lie that I can't imagine anyone believes it.
24:10
SPEAKER_00: I've never heard you say you can pry it out of my cold dead hands,
24:13
SPEAKER_00: but I imagine that is clunking around in your brain somewhere.
24:16
SPEAKER_02: Oh, yeah.
24:17
SPEAKER_02: Good luck.
24:17
SPEAKER_02: Good luck.
24:18
SPEAKER_02: Take it.
24:19
SPEAKER_02: Good luck.
24:19
SPEAKER_02: Take it.
24:20
SPEAKER_02: What is it?
24:21
SPEAKER_02: Zetbound?
24:21
SPEAKER_02: Good luck getting my Zetbound.
24:23
SPEAKER_02: You can't have it.
24:24
SPEAKER_02: I'm keeping it.
24:25
SPEAKER_00: I wonder if we get a case of free Zetbound from that mention.
24:27
SPEAKER_02: I just can't even imagine.
24:29
SPEAKER_02: While you're on Zetbound,
24:30
SPEAKER_02: by the way,
24:31
SPEAKER_02: the idea of drinking a big cup of whole milk is disgusting,
24:36
SPEAKER_02: by the way.
24:38
SPEAKER_02: So let's ask the question, why?
24:41
SPEAKER_02: is Bobby out on the road.
24:43
Why is he traipsing around middle America,
24:46
stumping for embattled Republican congressmen?
24:50
SPEAKER_02: We think we know why.
24:51
SPEAKER_02: We think it's because Bobby's about to get fired.
24:53
SPEAKER_02: He's trying to keep his government job.
24:54
SPEAKER_02: He's trying to keep his government job.
24:56
SPEAKER_02: And it seems like we're going to talk about this a lot more coming up.
25:00
But just just to tease it,
25:02
we think Robert Kennedy is in a little bit of trouble.
25:04
Individuals and organizations have been calling for RFK to
25:07
resign or be fired
25:08
SPEAKER_02: almost since the first minute.
25:10
SPEAKER_02: He became secretary of the U.S. Department of Health and Human Services.
25:13
SPEAKER_02: Our organization,
25:13
SPEAKER_02: the Committee to Protect Health Care,
25:15
said he shouldn't have been confirmed in the first place and
25:18
fought the nomination
25:18
SPEAKER_02: tooth and nail.
25:20
SPEAKER_02: But more and more,
25:20
there are whispers that he's creating so much turmoil for the
25:23
administration that
25:24
SPEAKER_02: Trump himself is planning on firing him.
25:27
SPEAKER_02: Consider this from Puck News.
25:28
SPEAKER_02: For months,
25:29
SPEAKER_02: rumors have swirled that the president's had it with RFK,
25:31
SPEAKER_02: whose anti-vaccine advocacy has generated a series of negative headlines.
25:35
SPEAKER_02: Several sources have told
25:37
SPEAKER_02: Several sources told Puck that Kennedy's time is indeed limited,
25:40
SPEAKER_02: though each presented a different timeline for when the axe might fall.
25:43
SPEAKER_02: Some suggested Kennedy would leave in the coming months.
25:46
SPEAKER_02: Others said that it's after the midterms.
25:48
And when Puck put the question directly to Oz at the White
25:51
House Correspondents'
25:52
SPEAKER_02: Dinner in April,
25:53
he insisted that Kennedy's relationship with the president was
25:56
in good standing.
25:58
SPEAKER_02: That being said, Politico has like hit piece after hit piece.
26:02
SPEAKER_02: People are leaking.
26:03
SPEAKER_02: on Kennedy.
26:04
SPEAKER_02: People inside the administration are leaking on Kennedy.
26:07
SPEAKER_02: He's obviously out on this road tour.
26:10
And anyone who's looking at public research knows that his
26:13
position on vaccines is
26:15
SPEAKER_02: unpopular and getting worse by the day.
26:19
SPEAKER_02: It makes sense that this guy might be headed out.
26:24
SPEAKER_02: Donald Trump and Vance and sort of the inner circle of the White House,
26:28
SPEAKER_02: not necessarily the agencies,
26:30
SPEAKER_02: have never actually been in on the project.
26:33
of making America healthy again,
26:35
getting rid of chemicals,
26:36
getting rid of food dyes.
26:38
SPEAKER_02: They've always thought about it as a voting block to be managed,
26:41
SPEAKER_02: never as a goal to be accomplished.
26:44
SPEAKER_02: And I think a lot of people,
26:45
SPEAKER_02: when Kennedy gets the boot,
26:46
SPEAKER_02: I think a lot of people are gonna feel very duped.
26:49
SPEAKER_00: Yeah.
26:50
SPEAKER_00: Well, it's like, what is he bringing to them anymore, right?
26:52
SPEAKER_00: Is he keeping that voting block in their camp?
26:56
SPEAKER_00: Definitely not, right?
26:57
SPEAKER_00: Like their reversal on glyphosate
26:59
right the fact that I mean the only things this guy can speak
27:03
passionately about is
27:05
SPEAKER_00: the the harms of vaccines
27:07
the bullshit about about what can or can't cause autism and
27:11
like working out in
27:12
SPEAKER_00: jeans and grabbing snakes and other wildlife.
27:15
SPEAKER_00: I mean, this is like, these are his passion projects.
27:18
SPEAKER_00: Yeah, none of that.
27:19
None of that is wooing voters in Michigan 7th Congressional
27:23
District or in
27:24
SPEAKER_00: Wisconsin,
27:24
SPEAKER_00: Western Wisconsin.
27:26
So what the hell is what's what function is he serving to these
27:30
people anymore?
27:32
I mean it's it would be crazy to me if they hung on to him
27:36
longer than tomorrow I
27:37
don't know should we start a countdown clock waiting for like
27:40
when Bobby's gone I
27:41
don't know we might we might be covered soon I just think yeah
27:45
I think they know
27:46
that the chemtrails crowd the people who believe the weirdest
27:50
stuff that that
27:51
Kennedy brings into the fold that the kook alignment inside the
27:54
Republican Party is
27:55
SPEAKER_02: complete
27:56
they're not going back to the democrats there are parts of the
27:59
you know maha is has
28:01
broad support in in in like in like a low salience way like but
28:06
the people who are
28:07
like that they're really into the weird stuff coming out of
28:09
kennedy's mouth and
28:10
brain um they're already at they're they're they're not going
28:14
anywhere and i i
28:15
think they are hemorrhaging support among the the sort of maha
28:18
light supporters and
28:20
SPEAKER_02: and you're gonna we're gonna find out i mean i
28:23
SPEAKER_02: Van Orden and Tom Barrett are both going to lose their seats.
28:26
SPEAKER_02: I'm pretty sure of it.
28:28
SPEAKER_02: Those folks are gone.
28:30
Kennedy's tour might just underscore the impotency of his
28:36
political cachet now.
28:38
SPEAKER_02: That would be good for the country.
28:40
SPEAKER_00: Maha works as a political movement because it's so similar to MAGA.
28:44
SPEAKER_00: You can put them side by side on a hat or on a banner.
28:48
SPEAKER_00: People who truly want to make people healthy
28:52
SPEAKER_00: who aren't fully invested in anti-vax or chemtrails or any of that,
28:57
that truly want to limit pesticides and have concerns about if
29:02
food dies and want
29:04
SPEAKER_00: their people to eat healthy foods.
29:06
SPEAKER_00: These aren't naturally Republican voters, right?
29:09
They kind of got swept up in the Maha movement because they
29:12
didn't find a home.
29:14
SPEAKER_00: So news alert to Democrats, we have to start or you all have to start
29:21
actually showing concern for these concerns of this group of
29:24
people because your
29:27
base voters actually also give a shit about healthy food and
29:31
their kids being
29:31
SPEAKER_00: healthy.
29:32
SPEAKER_02: It won't take long to take it back.
29:34
SPEAKER_02: It won't take long to take it back.
29:36
SPEAKER_02: You start talking about
29:38
you can start talking about generalized health you can at the
29:41
same time because you
29:43
are talking about universal health care you will be credible
29:46
down the line the
29:47
reason this weird shit doesn't work for Kennedy is because
29:50
they're closing rural
29:51
SPEAKER_02: hospitals in Virginia
29:54
SPEAKER_02: Time.
29:54
SPEAKER_02: It's so it's such an obvious disconnect that the credibility melts away.
29:58
SPEAKER_02: Democrats take this space.
30:00
SPEAKER_02: You will be credible in it.
30:02
If you're if you're also promoting universal health care at the
30:04
same time,
30:05
SPEAKER_02: it all will make sense in people's brains.
30:08
SPEAKER_00: And if you came to this for the interview with Dr.
30:10
SPEAKER_00: Spencer about Ebola,
30:12
SPEAKER_00: we talk a lot about that.
30:14
The work he's doing now is not focused on Ebola so much as sort
30:18
of getting into the
30:19
SPEAKER_00: minds of the Maha voter.
30:20
He went to the Children's Health Defense meeting last year just
30:24
to talk to people.
30:25
like god love them like give them credit and so there's quite a
30:28
bit about that and
30:29
and i'm i'm very encouraged that folks like him are taking that
30:33
on because it's
30:34
it's it's not easy to go into those spaces i think if you're
30:38
not fully bought in
30:39
but i think it's understanding like what's on the horizon just
30:41
what you said well
30:43
rob why don't we why don't we um why don't we toss to that
30:46
interview right now
30:47
because it sounds like it's a it's a big one and um i think
30:50
people are really going
30:51
SPEAKER_02: to enjoy it so stick around
30:55
Welcome back to Paging America everyone have a really great
30:57
guest here today to
30:58
SPEAKER_00: talk to Dr.
31:00
Craig Spencer is associate professor of practice of health
31:03
services policy at Brown
31:05
University School of Public Health also fellow emergency
31:08
physician also from the
31:09
state of Michigan Detroit for nearly two decades he has worked
31:14
at the intersection
31:14
SPEAKER_00: of global health humanitarian response and community centered care
31:17
He led Doctors Without Borders national epidemiologic response
31:20
during the West
31:21
SPEAKER_00: African Ebola outbreak.
31:22
SPEAKER_00: Hey, Craig, welcome to Paging America.
31:24
SPEAKER_00: Great to talk to you.
31:24
SPEAKER_01: Thank you.
31:25
SPEAKER_01: Thanks for having me and thanks for your patience and getting me on.
31:28
SPEAKER_01: I think we've tried a couple different times.
31:30
SPEAKER_01: I'm glad to finally make it here.
31:32
SPEAKER_01: You know, I'm persistent.
31:33
SPEAKER_00: I'm a pain in the ass, so I'll keep it up.
31:36
SPEAKER_01: You're good here, Doc.
31:37
SPEAKER_01: Yeah, you need to chase folks out.
31:38
SPEAKER_01: I get it.
31:39
SPEAKER_00: Yeah, absolutely.
31:39
SPEAKER_00: Absolutely.
31:40
SPEAKER_00: Hey, so, and I want to talk to you a bit here at the top about sort of
31:46
Ebola,
31:46
your experience with Ebola,
31:47
our response to Ebola,
31:48
what's going on right now.
31:49
SPEAKER_00: But then I know you're working on a whole lot of other stuff.
31:51
SPEAKER_00: So I think more toward the back end,
31:53
we want to dive into a host of issues because you're just a
31:56
wealth of information.
31:57
SPEAKER_00: But I know you've been interviewed about this on a bunch of shows.
32:01
SPEAKER_00: But for our listeners who maybe haven't come across your story before,
32:04
SPEAKER_00: why are you a go-to person to tell us about Ebola?
32:09
SPEAKER_01: That's a good question.
32:09
SPEAKER_01: So 12 years ago, I was in...
32:13
Eastern Congo at that point as an Ebola outbreak was taking off
32:17
in Guinea,
32:18
SPEAKER_01: Liberia,
32:18
SPEAKER_01: and Sierra Leone.
32:19
Folks remember in 2014 an outbreak that was first declared in
32:23
March of 2014 didn't really
32:26
SPEAKER_01: Peter Ogburn pagingamerica
32:52
SPEAKER_01: Gekadu, actually, the epicenter of where the outbreak started.
32:54
I was working in the Bullitt Treatment Center there in like
32:57
September and October of 2014.
33:01
SPEAKER_01: It was horrible.
33:02
SPEAKER_01: It felt like the worst thing ever.
33:04
SPEAKER_01: It felt,
33:04
SPEAKER_01: you know,
33:05
really tough as a provider that's normally used to trying to
33:07
save lives to see and
33:09
SPEAKER_01: feel so helpless.
33:10
SPEAKER_01: And then I came back to the U.S.,
33:13
I don't know four or six days I forget the numbers now it's
33:16
over a decade ago days
33:18
after I got back I was symptomatic myself ended up going to
33:22
Bellevue Hospital in
33:23
New York City where I was treated for 19 days I was New York
33:28
City's first and last
33:30
Ebola survivor up until just a few days ago New York had had
33:36
more Ebola survivors
33:37
SPEAKER_01: than Nick's titles in like the last five decades so yeah
33:43
and after that I spent a couple months kind of recuperating
33:47
went back into some
33:48
clinical work and then went back to Guinea in 2015 early 2015
33:53
to work on the
33:54
epidemiologic side because I suspected for the rest of my life
33:58
people were going to
33:58
ask me questions about Ebola and up until then like I had just
34:02
worked in a
34:02
treatment center I'd seen how horrible it is and what it can do
34:05
and how it can kill
34:06
someone in the span of a couple hours I didn't understand kind
34:09
of the larger
34:10
SPEAKER_01: socio-cultural
34:12
really dynamics of the disease from the outside and I'm glad
34:16
that I did because you
34:17
know since then obviously there's been a handful of outbreaks
34:20
and there's this
34:20
massive outbreak now which I've spent a lot of time thinking
34:23
about working on and
34:24
then trying to talk about so that people are aware yeah I
34:27
appreciate that hey and
34:28
this next one kind of gets into a little bit of inside baseball
34:31
for us as docs but
34:32
also kind of more general question so as docs we spend our
34:35
careers on the other
34:36
side of the bed right we treat patients make the calls most of
34:39
us operate with an
34:40
SPEAKER_00: unspoken assumption we're not going to be a patient
34:43
and often not many of us ignore symptoms when we should be a
34:46
patient so when you
34:47
started developing symptoms in New York what was it like that
34:50
kind of that moment
34:50
you had to say okay I know I'm a doctor I know that I treat
34:53
people but now I have
34:55
to present I have to hand over the control I have to have trust
34:58
and I guess just
34:59
more basically like what was it like like having Ebola going
35:02
through yeah I was
35:04
fine it was great I'd recommend it 19 days alone I was getting
35:06
yeah right now you
35:08
SPEAKER_01: know the
35:11
It was kind of hard to transition because,
35:12
you know,
35:13
imagine like the worst day of your career.
35:15
SPEAKER_01: I mean, how many patients do you lose on like your worst day?
35:17
SPEAKER_01: I think people don't recognize that even in,
35:19
SPEAKER_01: you know,
35:20
SPEAKER_01: emergency medicine,
35:21
SPEAKER_01: like it's pretty rare that we lose people,
35:22
SPEAKER_01: that people die,
35:23
SPEAKER_01: right?
35:24
SPEAKER_01: Because we're pretty damn good at keeping people alive.
35:27
SPEAKER_01: Yeah.
35:29
SPEAKER_01: But imagine,
35:30
SPEAKER_01: you know,
35:31
SPEAKER_01: COVID,
35:31
SPEAKER_01: there were days where it was like,
35:32
SPEAKER_01: you know,
35:32
SPEAKER_01: five or six people a day would die,
35:34
SPEAKER_01: which was catastrophic for a lot of us.
35:36
SPEAKER_01: Like, that was pretty normal in an Ebola treatment center.
35:40
SPEAKER_01: And it was people young and old,
35:42
SPEAKER_01: all ages,
35:43
SPEAKER_01: you talk to them in the morning,
35:44
SPEAKER_01: and they'd come back in the afternoon,
35:45
SPEAKER_01: they'd be dead.
35:45
SPEAKER_01: I mean, that happened all the time.
35:47
so that's in the back of your mind not only when you're
35:51
thinking about oh my gosh
35:52
was I exposed but it's in the back of your mind when you start
35:55
having symptoms and
35:55
I'm like did I have a peptic ulcer or I'm just incredibly
35:59
nervous and anxious that
36:00
SPEAKER_01: maybe I had an exposure today um
36:02
Am I incredibly tired because I just spent the last I don't
36:05
know how much time
36:06
working 7am to like 8pm taking care of Ebola patients and you
36:10
know the heat of
36:11
Guinea and now I'm coming home and finally getting an
36:13
opportunity like the things
36:15
that go through your mind are relentless and you're like am I
36:18
sick or am I just
36:20
like mentally unwell as anyone would be having worked in that
36:24
situation and so when
36:26
SPEAKER_01: it translated more into symptoms of
36:29
oh hey a temperature of 100.3 and you're like I took all my
36:33
malaria medicine every
36:34
single day and like none of the other symptoms okay you start
36:38
knocking things off
36:39
your differential and thankfully we had a pretty clear plan for
36:43
what to do and and
36:45
SPEAKER_01: Honestly,
36:46
I describe it as the best case scenario of a worst case
36:48
scenario because you do not
36:49
SPEAKER_01: want to get Ebola.
36:50
SPEAKER_01: I don't recommend it, despite what I said at the top here.
36:53
But if you're going to,
36:54
you want to be at a place that can take good care of you.
36:57
SPEAKER_01: And Bellevue Hospital had that morning,
36:59
SPEAKER_01: about an hour before I arrived,
37:02
finished their kind of wrapping up their protocols and their
37:06
training for having a
37:08
SPEAKER_01: patient exactly like me.
37:10
and when I came in I found out later that they told me that
37:14
they thought that I was
37:16
like a plant I was a secret shopper from the city to like make
37:20
sure that you know
37:22
they're like yeah we just done a dusted had lunch and then oh
37:24
yeah now we're
37:25
SPEAKER_01: getting an alert okay yeah but when I showed up
37:28
SPEAKER_01: Even in that scenario, and I think this is important for physicians.
37:32
SPEAKER_01: We work in tough places.
37:33
SPEAKER_01: Rob, you probably put in a million IVs.
37:35
SPEAKER_01: You've probably done everything.
37:37
For me,
37:37
I struggled the first few days when I was in Guinea putting in
37:42
IVs,
37:42
and I sat out.
37:43
SPEAKER_01: It's the PPE.
37:44
SPEAKER_01: It's the double gloves.
37:45
SPEAKER_01: It's the hot.
37:46
SPEAKER_01: It's all this stuff,
37:47
SPEAKER_01: but it was truly just because I was afraid,
37:50
and I knew that a needle stick injury from an Ebola patient was
37:52
a certain death
37:53
SPEAKER_01: sentence.
37:54
SPEAKER_01: It takes time to get over that,
37:58
And I remember going into the hospital at Bellevue and the
38:01
nurse that put a line on
38:03
SPEAKER_01: me,
38:03
SPEAKER_01: I was at that point 33 and healthy,
38:05
SPEAKER_01: like finding a line that's not tough.
38:09
SPEAKER_01: And the ICU nurse had done this for decades, missed twice.
38:13
SPEAKER_00: You probably had big ropes on your arms right?
38:15
I had big ropes yeah yeah exactly right yeah exactly and she
38:20
missed twice and I
38:21
think even if they thought that I was a plant right and so just
38:24
to get you in that
38:24
mental headspace of like what it's like being a provider and
38:28
then as a patient I
38:30
think they realized that I was the real deal when my labs came
38:33
back you can't fake
38:34
a you know a platelet count of thrombocytopenia and so at that
38:38
point we're like all
38:40
SPEAKER_01: right
38:41
let's uh let's get a line in let's get a central line in so I
38:44
chatted with my
38:45
provider who was amazing she's awesome um a good friend to this
38:49
day and we were
38:51
both like all right let's do it central line um and then I was
38:54
like give me a
38:54
little dose of Versed I love a little Versed let me tell you
38:57
it's the only time I
38:57
SPEAKER_01: ever had Versed it was great um and had a line put in
39:03
SPEAKER_00: For people who are listening who don't know,
39:05
SPEAKER_00: Verset is a type of anxiolytic,
39:07
SPEAKER_00: kind of a sedation drug a little bit.
39:09
SPEAKER_00: It makes you just chill a bit.
39:10
SPEAKER_00: It also makes you forget things, right?
39:12
SPEAKER_00: That is exactly... That's nice sometimes.
39:15
SPEAKER_01: So I don't remember the line going in.
39:16
SPEAKER_01: I don't remember any part of it.
39:18
SPEAKER_01: Like it was...
39:19
SPEAKER_01: It was really, really great.
39:20
SPEAKER_01: I do it for NT tubes.
39:22
SPEAKER_01: I do it for spinal taps.
39:25
SPEAKER_01: It was great to be a provider.
39:27
SPEAKER_01: I was like, I want this.
39:28
SPEAKER_01: We're going to do this.
39:30
Line went in and it was good to feel like at least I could be
39:35
helpful because these
39:36
folks were all scared to death as they should be to treat their
39:39
first Ebola
39:40
SPEAKER_01: patient.
39:40
SPEAKER_01: I had at that point treated hundreds and hundreds.
39:43
SPEAKER_01: I felt certainly more comfortable.
39:45
SPEAKER_01: That being said, the difference between
39:47
The care I was able to provide intense in Guinea versus what
39:52
was offered me in,
39:53
SPEAKER_01: you know,
39:54
the seventh or whatever floor of Bellevue Hospital was like
39:57
dramatically different.
39:58
SPEAKER_01: And I'm here, thankfully, because of that.
40:00
SPEAKER_01: But it's something that I've thought about,
40:03
SPEAKER_01: you know,
40:03
SPEAKER_01: nonstop of the past 12 years,
40:05
what I was able to offer in the fact that I was probably taking
40:08
care of 30 to 40
40:09
SPEAKER_01: patients at any time.
40:11
And there were probably 30 to 40 people on call at any point
40:14
for me in New York
40:15
SPEAKER_01: City if I needed a chest x-ray,
40:16
SPEAKER_01: if I needed whatever it was.
40:18
SPEAKER_01: So I'm grateful.
40:20
SPEAKER_01: But it certainly was a kind of radicalizing moment for me.
40:23
SPEAKER_00: For sure.
40:24
SPEAKER_00: And I guess building on that,
40:25
SPEAKER_00: so I think you probably heard and listeners maybe have that the U.S.
40:28
and Kenya have struck a deal to build an Ebola quarantine
40:31
facility at Likipia Air
40:33
SPEAKER_00: Base rather than bring exposed Americans home.
40:35
SPEAKER_00: That's right.
40:36
SPEAKER_00: This is for people to quarantine if they have been exposed.
40:38
SPEAKER_00: Thirteen and a half million has been committed,
40:40
SPEAKER_00: construction underway,
40:41
SPEAKER_00: but there's been a court order now blocking it,
40:43
SPEAKER_00: protests in Kenya that killed two people.
40:46
SPEAKER_00: You know,
40:47
SPEAKER_00: and then they have said,
40:47
SPEAKER_00: well,
40:48
SPEAKER_00: if someone then ends up being positive for Ebola,
40:51
SPEAKER_00: they'll kind of
40:52
SPEAKER_00: make the decision in the moment, like where they go, right?
40:55
SPEAKER_00: Do they stay in country?
40:56
SPEAKER_00: Do they come home?
40:58
SPEAKER_00: As someone who credits Bellevue,
40:59
SPEAKER_00: which you just did with your survival,
41:02
what can that facility actually do for an American who gets
41:04
sick or another
41:05
SPEAKER_00: facility,
41:06
SPEAKER_00: say,
41:06
on the ground in country versus coming to a place like Bellevue
41:11
if this happens
41:12
SPEAKER_00: operational?
41:13
SPEAKER_01: There's like a million things to say here.
41:15
SPEAKER_01: Let me focus on three.
41:17
SPEAKER_01: One is a lot of people probably don't know
41:21
that really the only good thing to come out of my treatment
41:24
here and the treatment
41:25
SPEAKER_01: of other Ebola patients in the U.S.,
41:27
SPEAKER_01: of which we had,
41:28
SPEAKER_01: I think,
41:29
SPEAKER_01: 11.
41:30
SPEAKER_01: The only good thing to come out of that was the recognition that,
41:32
SPEAKER_01: holy shit,
41:33
we probably should have a system of hospitals and providers and
41:37
protocols and money
41:38
SPEAKER_01: and resources available at any point
41:41
SPEAKER_01: in the event that this happens again.
41:43
And so in,
41:44
you know,
41:45
just over a decade ago,
41:46
we started this thing called NEETEC.
41:48
SPEAKER_01: We have this NSPS, National Special Pathogen System.
41:52
SPEAKER_01: We have over a dozen hospitals all throughout the United States,
41:55
SPEAKER_01: you know,
41:56
SPEAKER_01: in Nebraska,
41:57
SPEAKER_01: in New York,
41:57
SPEAKER_01: in Emory,
41:58
SPEAKER_01: in Michigan,
41:59
SPEAKER_01: and,
41:59
SPEAKER_01: you know,
42:00
SPEAKER_01: in places throughout the country.
42:01
that are centers of excellence that can take care of Ebola
42:04
patients that can take
42:05
SPEAKER_01: care of any high consequence pathogen.
42:08
SPEAKER_01: And they train all the time.
42:10
Like this is an everyday on thing,
42:12
even when there's no hantavirus or Ebola in the news.
42:15
SPEAKER_01: And this is important because this takes a lot of resources.
42:19
SPEAKER_01: It takes money to sustain.
42:20
SPEAKER_01: It takes people's time.
42:22
SPEAKER_01: Like there are people that dedicate their whole life to this.
42:24
SPEAKER_01: And
42:25
SPEAKER_01: The reason I say that is,
42:26
SPEAKER_01: one,
42:26
we've put a lot of money into this to make sure that we have a
42:29
Bellevue and an
42:30
SPEAKER_01: Emory,
42:30
SPEAKER_01: etc.
42:31
always on the ready because we're going to need them and we
42:33
want them to be ready
42:34
SPEAKER_01: for American citizens.
42:38
The thing about the Kenya Treatment Center and the second point
42:40
is that it seems to
42:42
SPEAKER_01: forget about all of that stuff.
42:45
SPEAKER_01: It says,
42:46
SPEAKER_01: okay,
42:46
SPEAKER_01: well,
42:47
SPEAKER_01: you know,
42:47
we can just set up this temporary thing on a tarmac on an
42:51
airbase in Kenya.
42:53
SPEAKER_01: And I don't necessarily
42:55
Fully disagree with the idea of having some type of facility
42:58
closer by in the event
42:59
that we need to get people out as a way to coordinate getting
43:01
people to more
43:02
SPEAKER_01: definitive care.
43:03
SPEAKER_01: Like that's okay.
43:05
What I think we're seeing here is this creation of a fortress
43:10
America and this
43:12
SPEAKER_01: insistence on keeping Ebola out of the country at all costs,
43:15
SPEAKER_01: regardless of the cost to other American citizens.
43:18
SPEAKER_01: For anyone who feels surprised that the U.S.
43:22
SPEAKER_01: would potentially leave a man behind,
43:25
SPEAKER_01: given especially what we saw in April,
43:27
SPEAKER_01: you know,
43:27
SPEAKER_01: just two,
43:28
SPEAKER_01: three months ago,
43:29
SPEAKER_01: where the U.S.
43:29
put in unbelievable resources to get a service member out of
43:34
Iran after their plane
43:37
SPEAKER_01: went down,
43:38
SPEAKER_01: and thankfully did,
43:39
SPEAKER_01: and was able and successfully did so.
43:41
SPEAKER_01: Like, the U.S. famously does not leave people behind.
43:44
SPEAKER_01: But what we're
43:47
doing here is creating a facility on an airbase that is
43:50
undoubtedly going to
43:51
SPEAKER_01: provide lower quality care.
43:53
SPEAKER_01: I can talk more about that in a second.
43:55
But the reason that it's being done is at the insistence of the
43:59
White House.
44:01
SPEAKER_01: You have heard in the beginning of this outbreak from day one,
44:04
SPEAKER_01: Secretary of State Marco Rubio said,
44:06
SPEAKER_01: our number one priority is to keep a bull out of the US.
44:09
SPEAKER_01: Number two priority is like, you know,
44:12
SPEAKER_01: putting out the outbreak on the ground.
44:14
SPEAKER_01: So this brings me to my third point,
44:16
which is you cannot keep Ebola out of the US if you do not
44:20
control the outbreak at
44:21
SPEAKER_01: the ground.
44:21
Number one priority needs to be managing the outbreak because I
44:27
can tell you for
44:28
SPEAKER_01: all viruses,
44:30
SPEAKER_01: putting up a wall
44:32
SPEAKER_01: It can't be thick enough, it can't be tall enough to keep viruses out.
44:35
SPEAKER_01: We've seen this over like 700 years of viral transmission.
44:41
SPEAKER_01: We know very,
44:43
very well that the greatest risk is that if we allow this
44:46
outbreak in Eastern Congo
44:48
SPEAKER_01: to continue to spiral out of control as it currently is,
44:51
there will be more regional spread there'll be more
44:53
international spread it will
44:54
SPEAKER_01: cost more for the national international community including the U.S.
44:58
to put this out and the risk there will remain dramatically
45:01
higher for a long time
45:02
and you know I think the the messaging of we need to keep a
45:06
bull out at all costs
45:08
like maybe that works with a certain voter or people who are
45:12
like yeah you're right
45:12
SPEAKER_01: I don't want to pull in the country but I think it does a few things it
45:17
SPEAKER_01: It shows that we've abdicated our leadership in global health,
45:20
which over the past year we've thrown a lot of the programs
45:23
that would have helped
45:24
us respond to this diagnosis earlier rapidly get on the ground
45:28
and help end it.
45:29
Like we've thrown those into the dustbin and you have people
45:32
like Elon Musk who
45:32
SPEAKER_01: gleefully,
45:33
SPEAKER_01: you know,
45:34
SPEAKER_01: threw USAID into the wood chipper.
45:36
SPEAKER_01: And because of that, we're more flat footed here.
45:39
SPEAKER_01: But in addition to that abdication of our global health responsibility,
45:42
SPEAKER_01: we're abdicating our responsibility to American citizens.
45:46
And we have shown in the past that we are very capable of
45:49
taking care of Ebola
45:50
SPEAKER_01: patients here in the U.S.
45:52
SPEAKER_01: safely,
45:52
SPEAKER_01: efficiently,
45:53
SPEAKER_01: and in a way that saves lives.
45:56
And I worry that this insistence on treating people in a tarmac
46:00
where they're not
46:01
SPEAKER_01: going to have access to
46:03
things that you and I are used to that we know save lives think
46:06
even something as
46:07
kind of basic as hemodialysis right like there is at least one
46:10
Ebola survivor
46:11
SPEAKER_01: American Ebola survivor today who is still with us because they received
46:15
hemodialysis and so what does it mean that we're going to say
46:18
we're going to bring
46:19
people to this facility to quarantine and if they get sick
46:23
we'll send them back
46:24
I think both of those things don't make sense because one if I
46:28
have a needle stick
46:29
injury or if I have an exposure today you could put me on a
46:32
commercial flight and
46:34
SPEAKER_01: send me back to the U.S.
46:35
I'm at zero risk to anybody right like the incubation phase for
46:39
Ebola so that's
46:40
like that's not a concern for me and so that doesn't hold water
46:43
I think that them
46:46
saying they're going to do a reassessment and then transport
46:49
people if they need
46:50
higher level of care I think it's actually just bullshit I
46:53
don't think they're
46:53
SPEAKER_01: going to do that
46:54
I think that's them saying the right thing to make it sound
46:56
like they are but what
46:57
they're going to say is all right this person's doing pretty
47:00
well to the point in
47:01
which they're not and then they're going to say it's too
47:02
dangerous to transfer them
47:04
and then they're going to say well Ebola is really deadly you
47:06
know that so like
47:07
nothing could have been done right and not yet it is deadly
47:10
right it's a bad
47:11
SPEAKER_01: disease yeah wow yeah so I think this is a mix of a lot of
47:16
I think poor decision making I think it's a lot I can tell you
47:20
people that were
47:21
even responsible for putting this plan together because they
47:25
were told to by people
47:26
above them don't like the plan and I do want to just reiterate
47:30
that like we have
47:31
really wonderful capable people on the inside we don't have
47:34
enough of them but we
47:35
have really capable people that have experience doing this not
47:39
just here in the US
47:39
but you know have experience responding abroad that are like
47:42
really really really
47:43
SPEAKER_01: good
47:44
um it's just that the people above them have clearly no idea
47:48
what they're doing and
47:49
are not talking to each other in a way that's efficient or
47:51
helping do anything
47:52
right to end this outbreak yeah I mean so a couple of questions
47:56
out of that I guess
47:57
one maybe just an observation I don't know if you want to even
47:59
comment on it it
48:00
SPEAKER_00: feels like Ebola is a proxy for foreigner as a proxy for
48:04
for you know dark skin foreigner which is something this
48:07
administration seems to
48:08
have animus toward and with with any kind of issue right so
48:13
keep it out at all
48:14
costs certainly fits with that I guess given my assumption that
48:17
that is true and
48:18
SPEAKER_00: you're nodding to that um
48:21
is do the people who are above the people who don't like what
48:24
they're being told to
48:24
do do they actually know do we think do we think they know
48:28
what's the right thing
48:29
to do they just don't want to do it because it doesn't look
48:31
good it doesn't fit
48:32
with that mentality or do we think they just don't know what
48:34
the hell they're doing
48:35
yeah um i think the latter you know to your point of you know
48:39
we have a long time
48:40
of externalizing disease threats seeing them as african or you
48:44
know as other
48:46
SPEAKER_01: um i will say we've gone beyond the pale here and that's true i think for
48:51
bipartisan unfortunately like this idea that we can like keep
48:55
diseases out in a way
48:56
that's just like disease is humble you Ebola is the most
48:59
humbling virus i've ever
49:00
worked with right um what is more surprising to me is that this
49:05
administration has
49:06
SPEAKER_01: clearly taken that as a given but it's built on top of that
49:10
If you look at the only American that has had Ebola in the past
49:14
month,
49:16
there was one.
49:17
SPEAKER_01: It was a Christian missionary from Eastern Congo,
49:21
SPEAKER_01: an American that had been living in Eastern Congo with his family.
49:26
Even when the plan was to evacuate him,
49:29
the U.S.
49:30
said,
49:30
nah,
49:32
and sent him to Germany.
49:33
SPEAKER_01: And so even for a white Christian missionary, the plan was the same.
49:39
SPEAKER_01: We're going to keep it out at all costs, no matter what.
49:41
SPEAKER_01: And this should not be surprising.
49:44
SPEAKER_01: There is always a tweet.
49:45
If you go to 2014 and you see what Donald Trump tweeted at that
49:49
time about people
49:50
SPEAKER_01: like myself and others,
49:52
SPEAKER_01: he essentially said,
49:54
and if any leader that brings Ebola back into this country is a
49:59
incompetent leader
50:01
and said they're fine if they should these people are heroes
50:04
they should be able to
50:05
go but if they go then and get sick then they should pay the
50:09
price like so for over
50:11
a decade it has been very clear how Donald Trump would respond
50:16
to Ebola cases and
50:18
SPEAKER_01: the need to bring come back to the US Wow yeah
50:22
SPEAKER_00: All right.
50:22
SPEAKER_00: I mean, there you have it.
50:23
That seems like there you have pretty much baked in pretty much
50:25
baked into the mentality.
50:27
SPEAKER_00: So,
50:27
SPEAKER_00: I mean,
50:28
SPEAKER_00: getting to some of that,
50:28
SPEAKER_00: when you were on the ground with Doctors Without Borders,
50:30
SPEAKER_00: you were there as an American,
50:31
SPEAKER_00: but also part of a broader international infrastructure that the U.S.
50:34
SPEAKER_00: helped build and fund and lead.
50:37
SPEAKER_00: Other countries trusted us to show up.
50:39
SPEAKER_00: You know,
50:39
I'm wondering how that felt from the field and then now
50:41
watching from sort of
50:42
SPEAKER_00: academia and the role you have now.
50:46
SPEAKER_00: What has it been like to see that standing erode,
50:48
SPEAKER_00: not just the funding,
50:49
SPEAKER_00: but the relationships,
50:50
SPEAKER_00: the trust,
50:50
SPEAKER_00: the credibility?
50:52
SPEAKER_00: Is that something we can rebuild or is it just like it's gone?
50:56
SPEAKER_01: It's a good question.
50:59
SPEAKER_01: I think some of the technical stuff we can and will rebuild.
51:03
SPEAKER_01: A lot of what we got rid of are kind of boring things.
51:06
SPEAKER_01: People don't know this.
51:07
SPEAKER_01: There was a Marburg outbreak.
51:09
SPEAKER_01: Marburg is very similar to Ebola.
51:11
There was a Marburg outbreak in Tanzania in 2023 that was
51:15
identified by a local
51:17
SPEAKER_01: Tanzanian community health worker who had been trained by the CDC.
51:21
And so like we have our tentacles or had kind of all over in
51:27
terms of training and
51:28
resources and technical capabilities that allowed us to
51:31
identify things really
51:32
early on not just because it was good for the local communities
51:35
and economies but
51:37
because it meant that we could address them when they were much
51:39
smaller they were
51:40
easier they were simpler they were certainly a lot less
51:43
expensive and a lot less
51:45
SPEAKER_01: risky to the rest of the world.
51:47
SPEAKER_01: That stuff is gone, right?
51:48
SPEAKER_01: And so some of those tools kind of exist.
51:50
SPEAKER_01: The U.S.
51:51
has transitioned into some different things and is now rolling
51:54
out kind of its
51:54
different idea of what humanitarian support and bilateral
51:58
global health deals look
51:59
SPEAKER_01: like to countries all over the world.
52:01
But those are quite different in that they're pretty explicitly
52:05
extractive.
52:06
SPEAKER_01: So they'll say,
52:07
SPEAKER_01: hey,
52:07
SPEAKER_01: we'll give you,
52:07
SPEAKER_01: you know,
52:08
SPEAKER_01: a couple hundred million dollars to do this,
52:09
SPEAKER_01: this and this.
52:10
SPEAKER_01: But in return, we need access to your sensitive health data.
52:14
SPEAKER_01: to which many countries are saying, okay, weird, but sure.
52:17
But a lot of countries are walking away and saying,
52:19
we're not going to do that.
52:21
SPEAKER_01: So I think there's technical capacity that we can rebuild.
52:23
I think the bigger thing that it's going to take us a lot
52:26
longer to address is
52:28
anti-American sentiment that has bubbled up in the aftermath of
52:32
these cuts.
52:32
So imagine yourself as someone in Eastern Congo,
52:37
where the outbreak is at now.
52:39
SPEAKER_01: You used to go to a clinic that had the USAID flag on it.
52:42
SPEAKER_01: Maybe you lied on a bed that had,
52:44
SPEAKER_01: you know,
52:44
SPEAKER_01: the American flag,
52:46
and you'd go there for your care or for your kids when they got
52:49
really sick,
52:50
SPEAKER_01: or maybe that's where you got your HIV medications.
52:52
SPEAKER_01: And you saw this tagline that said, you know, from the American people.
52:56
SPEAKER_01: And then one day, overnight, essentially that closed.
53:00
SPEAKER_01: You weren't able to get your medicine, your kids died.
53:03
and this is not a hypothetical a good friend of mine who has
53:06
worked in Congo for
53:06
the last 30 years is publishing a study soon in BMJ after a
53:10
year of working uh
53:12
after the in the last year he had been in the kivus in eastern
53:15
Congo and been
53:17
documenting the increase in mortality from the USAID cuts and
53:21
the violence plus
53:21
USAID cuts have doubled mortality in the past year doubled in a
53:26
place where
53:26
SPEAKER_01: mortality was already incredibly high so
53:29
SPEAKER_01: There's that.
53:29
There's also the fact that the US has been seen by many in
53:33
Eastern Congo as this
53:36
SPEAKER_01: biased interlocutor in this recent agreement between Rwanda,
53:40
SPEAKER_01: which is next door,
53:41
SPEAKER_01: has for decades been sending kind of militias into Eastern Congo.
53:47
SPEAKER_01: The U.S.
53:47
SPEAKER_01: has been seen as this bias interlocutor between Rwanda and Congo,
53:51
SPEAKER_01: and many people in Congo feel like the U.S.
53:53
SPEAKER_01: is supporting Rwanda.
53:54
These things together have led to a lot of anti-American
53:57
sentiment in Eastern
53:58
SPEAKER_01: Congo,
53:59
SPEAKER_01: which makes it hard to manage Ebola outbreaks,
54:01
SPEAKER_01: but also hard to manage foreign policy for other things.
54:07
Tell you now That once Kenya has its first case of Ebola Which
54:12
if this outbreak
54:12
SPEAKER_01: continues As it looks like it's going to Seems like a given at some point
54:18
SPEAKER_01: That case is going to be 100% pinned on the back of the U.S.,
54:22
SPEAKER_01: regardless of whether it's associated with that airbase or not.
54:25
SPEAKER_01: And it's going to be 100 miles away,
54:26
SPEAKER_01: but someone's going to be like,
54:27
SPEAKER_01: this is the U.S.
54:29
SPEAKER_01: And there's already,
54:30
SPEAKER_01: as you pointed out,
54:31
SPEAKER_01: there's already been a couple deaths from people riding and,
54:34
SPEAKER_01: you know,
54:35
SPEAKER_01: protesting against this facility.
54:36
SPEAKER_01: People are furious about the U.S.
54:39
SPEAKER_01: opening up this,
54:40
SPEAKER_01: you know,
54:40
SPEAKER_01: Ebola treatment,
54:41
SPEAKER_01: bringing Ebola into the country.
54:43
Like these things combined will lead to so much anti-American
54:47
sentiment in a region
54:48
SPEAKER_01: that is beset by violence,
54:50
SPEAKER_01: by outbreaks and a whole host of other things.
54:52
I think those are the things that are going to take a lot
54:54
longer for us to have any
54:56
SPEAKER_01: modicum of success in bringing back
54:59
SPEAKER_00: Yeah.
54:59
So and I've talked to other folks involved in kind of or had
55:05
been involved,
55:05
SPEAKER_00: say,
55:06
SPEAKER_00: in PEPFAR,
55:06
SPEAKER_00: right,
55:07
SPEAKER_00: and affected by the USAID cuts.
55:09
SPEAKER_00: And they talked about China moving in.
55:11
SPEAKER_00: Right.
55:12
SPEAKER_00: And like as we're on the global stage, right, is some a.
55:15
SPEAKER_00: Peter Ogburn pagingamerica
55:33
As I mean China's moving in a bit but they're certainly not
55:36
going to take the place
55:38
of the US they're not going to like fill that that hole by any
55:40
means and also like
55:41
the way that China works in the kind of international
55:43
humanitarian space is very
55:44
SPEAKER_01: different they have
55:46
to their credit been explicitly extractive for as long as
55:50
they've been doing kind
55:50
of global engagement work we'll build this and in return you
55:54
know we're gonna get
55:56
minerals like so in a way the US is kind of moving more towards
56:00
the China approach
56:00
but just China is doing at an economic level much greater than
56:03
the US ever has been
56:05
SPEAKER_01: and
56:06
I will say that the China approach has backfired in a lot of
56:11
places and people are
56:12
SPEAKER_01: really upset about what they see as kind of a neocolonial intervention.
56:17
SPEAKER_01: The U.S., you know,
56:20
I think we talked about this a lot last year USAID was pennies
56:24
you know when I
56:25
talked to people even in my own family that big Trump
56:28
supporters maybe hated you
56:31
know a lot of the things that we were spending money on thought
56:34
that we needed to
56:34
get rid of waste fraud and abuse when I said you know would you
56:37
support a program
56:38
SPEAKER_01: that for you know $30 a year and
56:43
SPEAKER_01: out of your pocket,
56:44
SPEAKER_01: like prevents Ebola from coming to the US,
56:47
SPEAKER_01: make sure people,
56:48
SPEAKER_01: tens of millions of people around the world,
56:49
SPEAKER_01: including hundreds of thousands of kids get HIV medicine,
56:53
SPEAKER_01: dot,
56:53
SPEAKER_01: dot,
56:53
SPEAKER_01: dot.
56:53
SPEAKER_01: They'll say, but absolutely, of course, like that's small change.
56:57
SPEAKER_01: But when you talk about it as a
56:58
40 billion dollar kind of US thing it feels a lot bigger but
57:03
again like I don't
57:04
know are we sending 300 billion dollars back to to Iran you
57:08
know is that like seven
57:09
years of USAID funding that we could have we could have
57:12
supported so it's it's
57:15
truly it has been small small small investments with massive
57:19
outsized impacts not
57:21
only on making sure Ebola doesn't come to the US but creating
57:25
stability in places
57:26
SPEAKER_01: and creating
57:28
support for the US in far flung spots all around the world that
57:33
has been incredibly
57:33
SPEAKER_01: helpful at points and we really needed it.
57:36
Yeah yeah so I mean USAID like this has all happened right
57:40
they've cut it CDC is
57:42
pretty much gutted or at least like the leadership is is
57:45
completely gone I'm
57:46
wondering like given all of that what what can what should we
57:49
be asking what do we
57:50
think is achievable and then as a follow-up to that and
57:53
something you talked about
57:54
you know doge claimed Ebola prevention was accidentally cut
57:57
then restored but
57:58
there's been no seems like there's been no political price for
58:01
that in particular
58:02
how do we hold our government accountable is it going to take
58:04
cases arriving in the
58:06
US outside of their desire to keep it out and for people like
58:09
you and others to say
58:10
hey look see this is the result of you abandoning these people
58:13
I a lot there but I
58:15
don't know your thoughts on that yeah I wrote a piece a year
58:18
ago in the Atlantic
58:19
said the diseases are coming and I think the main takeaway is
58:22
that we are going to
58:22
regret this like this is very clear we're going to regret it
58:25
and I think we're
58:26
SPEAKER_01: seeing it I see we're seeing that regret already
58:30
SPEAKER_01: how it'll translate to the average American.
58:33
SPEAKER_01: Maybe they've heard about the simple outbreak and I've had people ask me,
58:37
SPEAKER_01: is this something that I need to be concerned about?
58:38
SPEAKER_01: Is it coming to the U.S.?
58:40
SPEAKER_01: And to your point, there's a reason they chose USAID to attack first.
58:46
SPEAKER_01: It was something that was distant, that was helping other people.
58:49
SPEAKER_01: It was an easy cudgel.
58:52
I think that people will are and will increasingly wake up to
58:57
how much it did.
59:00
SPEAKER_01: And it may be that USAID's greatest strength was that it was,
59:05
SPEAKER_01: quote,
59:05
from the American people But its greatest weakness was that it
59:08
did not prove to
59:10
SPEAKER_01: people like,
59:11
SPEAKER_01: I don't know,
59:11
my parents and some of my friends That it was also for the
59:14
American people And I
59:15
think when it comes to how we do some version of this better in
59:20
the future We need
59:21
to make that more obvious and explicit We need to say that it's
59:25
not just for
59:27
SPEAKER_01: national security,
59:28
SPEAKER_01: which it is
59:29
SPEAKER_01: We need to lean into this argument, which I think still holds, right?
59:34
Alexis de Tocqueville apocryphally said,
59:37
America is great because America is good.
59:38
SPEAKER_01: And if it stops being good, it'll stop being great.
59:40
Like,
59:41
that's why America is great,
59:42
because it has done really good things.
59:45
SPEAKER_01: all around the world.
59:46
SPEAKER_01: It has responded in 2014 by building treatment centers in Liberia.
59:51
It has set up global health programs that have slashed
59:55
mortality from HIV by tens
59:58
SPEAKER_01: of millions of lives in the past few decades.
1:00:00
One of the most impactful global health programs ever that was
1:00:04
pushed by empathy
1:00:07
SPEAKER_01: and by the evangelical community.
1:00:10
SPEAKER_01: There are bedfellows that can be made here.
1:00:12
SPEAKER_01: The American people I think want to do this work.
1:00:14
SPEAKER_01: I think they were sold an incorrect version of what this work was doing.
1:00:20
SPEAKER_01: Elon Musk would say things like this money was going to support
1:00:25
like trans parties at the Irish embassy or some other garbage
1:00:28
which wasn't true at
1:00:29
all um he said that they accidentally cut very briefly Ebola
1:00:34
funding but turned it
1:00:35
back on also not true the day literally the day after he said
1:00:39
that um the US
1:00:41
canceled a bunch of uh Ebola contracts like hours after he said
1:00:45
that so um
1:00:47
SPEAKER_01: There will be a comfortability here.
1:00:48
SPEAKER_01: I don't think that it will be as obvious as other programs that we lost.
1:00:52
But I think people will wake up to the fact that getting rid of
1:00:55
these programs was
1:00:56
SPEAKER_01: a massive mistake.
1:00:57
SPEAKER_01: And we need to put some version,
1:00:59
a better version of them back in place that addresses
1:01:03
legitimate criticisms,
1:01:04
SPEAKER_01: but is able to do that incredible work that had been done prior.
1:01:07
SPEAKER_00: Yeah, I think that's the first de Tocqueville quote on Paging America.
1:01:10
SPEAKER_00: Congrats.
1:01:11
SPEAKER_00: Is that right?
1:01:12
SPEAKER_00: Okay, great.
1:01:12
SPEAKER_00: You just rolled it right in.
1:01:13
SPEAKER_00: You didn't even have to search the depths.
1:01:15
SPEAKER_00: That's great.
1:01:16
SPEAKER_00: Hey,
1:01:17
SPEAKER_00: just kind of to end this little part about Ebola,
1:01:20
SPEAKER_00: and you've talked about a lot of this,
1:01:21
SPEAKER_00: but I wonder for a soundbite or for a clip,
1:01:24
SPEAKER_00: I'm a person sitting at home here in West Michigan,
1:01:27
SPEAKER_00: right?
1:01:27
SPEAKER_00: I don't know anything about Ebola.
1:01:29
SPEAKER_00: I've never been to Africa.
1:01:30
SPEAKER_00: Why should I care about this right now?
1:01:34
SPEAKER_01: There are a couple reasons one should care about this.
1:01:36
SPEAKER_01: One,
1:01:36
SPEAKER_01: because Ebola is a horrible disease,
1:01:38
SPEAKER_01: I know this firsthand,
1:01:39
and we should do everything we can to try to prevent anyone
1:01:43
anywhere from getting
1:01:44
SPEAKER_01: it.
1:01:45
SPEAKER_01: Two,
1:01:46
SPEAKER_01: is that if this spreads and continues spreading and goes unchecked,
1:01:51
SPEAKER_01: the number of cases will increase and there will be cases,
1:01:54
SPEAKER_01: places far afield,
1:01:55
SPEAKER_01: including possibly the U.S.,
1:01:57
And ultimately the biggest reason that I think we should be
1:02:00
concerned is that this
1:02:02
has really highlighted exactly what we've lost by getting rid
1:02:05
of the surveillance
1:02:07
SPEAKER_01: programs,
1:02:07
SPEAKER_01: response programs that we had for a long time.
1:02:10
SPEAKER_01: And maybe it's not hantavirus,
1:02:11
SPEAKER_01: maybe it's not Ebola,
1:02:13
but there will be some infectious threat that we don't pick up
1:02:17
on early enough
1:02:18
SPEAKER_01: because of what we've cut.
1:02:20
And there is a plausible link between something like that
1:02:23
happening and your
1:02:25
SPEAKER_01: community in Western Michigan or your hospital in Western Michigan
1:02:29
SPEAKER_01: being impacted by your providers getting sick,
1:02:33
SPEAKER_01: by resources not being made available,
1:02:35
SPEAKER_01: by what happens in the chaos of outbreaks,
1:02:38
SPEAKER_01: which we all saw during COVID,
1:02:39
SPEAKER_01: the quality of care for other things can be impacted.
1:02:42
SPEAKER_01: So I think for those three reasons,
1:02:44
SPEAKER_01: these are exactly why we should be concerned about not just Ebola,
1:02:48
but the U.S.'s ability to engage and help with outbreaks
1:02:53
exactly like this.
1:02:55
SPEAKER_00: That's great.
1:02:55
I feel like you've answered that question before because that
1:02:57
was too good.
1:02:58
SPEAKER_00: Hey, I appreciate your expertise.
1:03:01
SPEAKER_00: I appreciate your ability to explain this,
1:03:04
SPEAKER_00: even to dummies like me,
1:03:05
SPEAKER_00: because I'm an ER doc,
1:03:06
SPEAKER_00: but I've never treated Ebola.
1:03:09
SPEAKER_00: I hope you never do.
1:03:10
SPEAKER_00: It's horrible.
1:03:11
SPEAKER_00: Amen.
1:03:12
SPEAKER_00: What else are you working on?
1:03:14
SPEAKER_00: I know you talk a lot about Ebola because you got Ebola, right?
1:03:17
SPEAKER_00: That was a pretty big deal 12 years ago.
1:03:19
SPEAKER_00: What else have you been working on?
1:03:23
SPEAKER_01: So for the last year and a half,
1:03:26
I've spoken less about Ebola and thought more about kind of
1:03:29
what the parallels are
1:03:30
with the global health work that I've done and what is
1:03:34
challenging the domestic
1:03:35
SPEAKER_01: situation here in the U.S.
1:03:38
SPEAKER_01: I don't know if you've heard,
1:03:40
SPEAKER_01: but things are a little topsy-turvy when it comes to health in the U.S.
1:03:45
I spent a long time working in the global health space and I
1:03:50
thought about how
1:03:52
People responded to a bullet in 2014 and talked about how
1:03:55
ignorant Africans just
1:03:56
SPEAKER_01: weren't stopping doing burials.
1:03:58
SPEAKER_01: And if only they did that, this outbreak would be over.
1:04:00
SPEAKER_01: And what is wrong with them?
1:04:01
SPEAKER_01: And then,
1:04:02
SPEAKER_01: you know,
1:04:03
SPEAKER_01: I worked during COVID and I saw how folks would repeatedly say,
1:04:08
SPEAKER_01: these people,
1:04:09
SPEAKER_01: what is wrong with them?
1:04:10
SPEAKER_01: This COVID is not a real virus.
1:04:11
It was made from a lab or it was made from this and the vaccine
1:04:14
will kill you.
1:04:16
SPEAKER_01: And I saw,
1:04:17
SPEAKER_01: one,
1:04:17
that I should have my own humility in terms of thinking about
1:04:20
things different
1:04:22
SPEAKER_01: abroad versus at home.
1:04:23
SPEAKER_01: But two,
1:04:24
what this learning represented as an opportunity for me to be
1:04:28
more engaged here
1:04:29
SPEAKER_01: domestically in what those lessons were.
1:04:32
SPEAKER_01: And, you know, the last year and a half,
1:04:34
SPEAKER_01: has been pretty catastrophic in terms of our public health preparedness.
1:04:38
We not just lost the CDC folks abroad,
1:04:40
but we lost them here,
1:04:41
including many of my friends.
1:04:44
SPEAKER_01: I've spoken to a bunch of folks in public health departments,
1:04:46
SPEAKER_01: and I know what those cuts look like,
1:04:48
SPEAKER_01: and I continue to work in the emergency room.
1:04:49
So I see the impact of what's coming from the top and how it
1:04:53
trickles down.
1:04:55
SPEAKER_01: And instead of running away,
1:04:57
SPEAKER_01: I've done the opposite,
1:04:58
SPEAKER_01: I guess,
1:04:59
SPEAKER_01: similar to what I did with Ebola a decade ago.
1:05:00
SPEAKER_01: I engaged.
1:05:01
SPEAKER_01: I
1:05:02
went to the Children's Health Defense Conference last November
1:05:05
and spent three days
1:05:07
talking to people about what they believe why they believe that
1:05:10
why it's important
1:05:11
SPEAKER_01: I have
1:05:14
worked with and then ultimately befriended a lot of people in
1:05:17
the Maha community.
1:05:19
And I am now working on a program to try and set up community
1:05:25
trust fellows,
1:05:27
SPEAKER_01: people all across the U.S.
1:05:28
SPEAKER_01: that can work as interlocutors between community members,
1:05:31
SPEAKER_01: community leaders,
1:05:33
and local health leaders as a way towards co-creating actual
1:05:37
health ideas and
1:05:38
SPEAKER_01: health policies.
1:05:39
SPEAKER_01: Because what I've learned is that
1:05:42
SPEAKER_01: We have a few,
1:05:44
SPEAKER_01: you know,
1:05:44
SPEAKER_01: there's the Maha of RFK Jr.
1:05:46
SPEAKER_01: in Cali Means,
1:05:48
SPEAKER_01: and I think,
1:05:48
SPEAKER_01: you know,
1:05:49
SPEAKER_01: an absolute,
1:05:50
SPEAKER_01: so much of that is so misguided,
1:05:52
SPEAKER_01: is not based on any,
1:05:53
SPEAKER_01: like,
1:05:54
SPEAKER_01: rational understanding of reality.
1:05:57
SPEAKER_01: But then you have this much bigger cohort of Americans who,
1:06:02
SPEAKER_01: for all the reasons you understand,
1:06:03
SPEAKER_01: Rob,
1:06:04
SPEAKER_01: are pissed about health in the U.S.
1:06:06
SPEAKER_01: And Maha has given them a label that
1:06:09
is essentially a big tent of people who have been pissed about
1:06:12
healthcare costs,
1:06:13
SPEAKER_01: about healthcare quality,
1:06:14
SPEAKER_01: about access,
1:06:15
SPEAKER_01: but also about a whole host of other issues,
1:06:17
SPEAKER_01: about food quality,
1:06:20
SPEAKER_01: anything else that seems to fit under this tent.
1:06:23
SPEAKER_01: And I worry that,
1:06:25
SPEAKER_01: you know,
1:06:25
we've often conflated anyone that says I support Maha or I
1:06:29
support some of these
1:06:30
SPEAKER_01: things as like immediately being an anti-vaxxer.
1:06:33
And what I've learned by engaging over the past year and a half
1:06:37
is that many of my
1:06:38
SPEAKER_01: really good friends in Maha don't give a shit about vaccines.
1:06:41
SPEAKER_01: They don't think about them at all.
1:06:42
But what radicalized them was seeing their mom addicted to
1:06:46
opioids and how there
1:06:48
didn't seem to be any accountability for pharma or to see
1:06:51
people radicalized by
1:06:53
SPEAKER_01: health issues with family members because of food,
1:06:55
SPEAKER_01: etc.,
1:06:56
And so I'm trying to find a space where I can work with folks
1:06:59
that understandably
1:07:01
SPEAKER_01: are frustrated with healthcare and health in the U.S.
1:07:04
SPEAKER_01: for all the good reasons.
1:07:05
SPEAKER_01: I wrote a piece in the middle of 2024 before the election about
1:07:13
SPEAKER_01: food quality in the U.S.,
1:07:14
SPEAKER_01: about public health as an economic issue,
1:07:16
SPEAKER_01: about lack of access to healthcare,
1:07:18
how we spend more than any other country on healthcare and get
1:07:21
some of the worst
1:07:21
SPEAKER_01: outcomes.
1:07:23
SPEAKER_01: None of these things are controversial,
1:07:25
SPEAKER_01: but once we put them under this crazy mantle of pseudoscience and false
1:07:33
SPEAKER_01: accusations,
1:07:34
SPEAKER_01: a lot of this fell apart.
1:07:35
SPEAKER_01: I worry that
1:07:37
In the field of public health,
1:07:40
we are going to look at the last year and a half.
1:07:44
SPEAKER_01: Once RFK Jr.
1:07:45
SPEAKER_01: ultimately is pushed out of his position or leaves,
1:07:48
SPEAKER_01: we're going to look at what happened and say,
1:07:52
SPEAKER_01: hi,
1:07:53
SPEAKER_01: we told you so.
1:07:54
And insist on re-implementing a lot of the policies that made a
1:08:00
Maha and an RFK Jr.
1:08:01
SPEAKER_01: possible,
1:08:02
SPEAKER_01: as opposed to really
1:08:06
thinking about how we do something better how we take what made
1:08:10
maha so powerful
1:08:12
this idea that you just like stand up for people stop being so
1:08:16
sheepish public
1:08:16
health has become way more comfortable with a p-value than a
1:08:19
podium public health
1:08:21
is a field that was born of politics you know more than anyone
1:08:26
that health is
1:08:27
political let's not let's stop pretending otherwise yeah we can
1:08:30
do it so that it
1:08:31
SPEAKER_01: doesn't have to feel partisan
1:08:33
SPEAKER_01: But what Maha has shown is that people want someone in their corner.
1:08:37
SPEAKER_01: They want to know that someone is fighting for them,
1:08:39
not just going to roll over and demand more data as an alibi
1:08:43
for an action.
1:08:44
And so I've spent a lot of the last year trying to figure out
1:08:47
how do you actually
1:08:48
SPEAKER_01: make that work?
1:08:49
How do you work with people that you don't agree with on all
1:08:52
things,
1:08:52
some things,
1:08:53
many things?
1:08:55
SPEAKER_01: And two months ago,
1:08:58
put together an event through an organization called States
1:09:01
Forum focused on states
1:09:02
SPEAKER_01: policy in Columbus,
1:09:04
SPEAKER_01: Ohio.
1:09:05
where it was me my friend brindad akari from the why should i
1:09:08
trust you podcast um
1:09:10
we got 30 people into a room and locked in there for like a day
1:09:13
and a half some
1:09:14
cocktails some food but people from public health um people
1:09:18
from you know amy actin
1:09:19
democratic uh nominee for governor um tim ryan tenter and
1:09:23
congressman um bunch of
1:09:25
SPEAKER_01: public health people grassroots supporters from east palestine ohio
1:09:29
and people from Maha and we all got into a room and we said
1:09:33
what are the things
1:09:33
that we care about particularly when it comes to environmental
1:09:36
health we had
1:09:37
farmers regenerative farmers traditional farmers and we all got
1:09:41
into a room we said
1:09:42
let's work on policy and we came out of that room with a bunch
1:09:45
of policy ideas that
1:09:46
we're continuing to push forward we have relationships that
1:09:49
we're working on and
1:09:51
SPEAKER_01: We're going to recognize that we don't agree on all things,
1:09:54
SPEAKER_01: but there's a couple levers that we can all pull together.
1:09:57
SPEAKER_01: And I think that is the way we need to move forward.
1:10:02
SPEAKER_01: Otherwise,
1:10:03
SPEAKER_01: you know,
1:10:04
SPEAKER_01: setting ourselves up into these different camps,
1:10:06
working on similar things by calling them different things or
1:10:09
working against each
1:10:10
SPEAKER_01: other is going to get us nowhere.
1:10:12
And it's just going to recreate a lot of the same frustrations
1:10:15
that you and I see
1:10:16
SPEAKER_01: on a daily basis in the emergency department.
1:10:19
SPEAKER_00: Yeah,
1:10:19
and on this program and within the the broader context of the
1:10:23
advocacy work with
1:10:24
SPEAKER_00: the Committee to Protect Healthcare,
1:10:25
SPEAKER_00: the organization of,
1:10:26
SPEAKER_00: you know,
1:10:27
SPEAKER_00: 40,000 docs,
1:10:27
SPEAKER_00: 50,000 healthcare professionals that are out there pushing for,
1:10:31
SPEAKER_00: you know,
1:10:31
SPEAKER_00: building power for patients for more affordable,
1:10:34
SPEAKER_00: more accessible healthcare.
1:10:36
SPEAKER_00: We talk about that,
1:10:36
SPEAKER_00: like,
1:10:36
SPEAKER_00: we can't just say we need to,
1:10:39
SPEAKER_00: you know,
1:10:39
SPEAKER_00: get rid of the Medicaid cuts that they passed a year ago.
1:10:42
SPEAKER_00: We can't just say we need to, you know, get the ACA tax credits back.
1:10:45
Like the system that existed before Donald Trump came into
1:10:48
office was failing far
1:10:50
SPEAKER_00: too many people,
1:10:51
SPEAKER_00: right?
1:10:51
SPEAKER_00: Way too many people who couldn't afford drugs, couldn't afford care.
1:10:56
SPEAKER_00: We need to be forward looking like what happens, right?
1:10:59
SPEAKER_00: Trump will be gone on January 21st of 2029 or 1201 on January 20th, 2029.
1:11:06
what what does it look like after that it can't just be all
1:11:09
right we're here we're
1:11:11
going right back to where we were congratulations right good
1:11:13
job pat yourself in
1:11:14
the back that is like that is you're just doomed to failure a
1:11:17
couple of things from
1:11:18
what you said and you you may see this um i i see uh kids who
1:11:23
are unvaccinated in
1:11:23
the er all the time right especially you know west michigan
1:11:26
where i work i work in
1:11:26
SPEAKER_00: other rural communities in other states
1:11:29
and their parents and what I've said a million times on this
1:11:31
show and otherwise,
1:11:32
SPEAKER_00: they are folks who love their kids,
1:11:35
SPEAKER_00: right?
1:11:35
SPEAKER_00: They love their kids dearly as much as I love my kids.
1:11:38
SPEAKER_00: I believe that.
1:11:39
They didn't choose to not vaccinate their kids because they
1:11:42
wished harm upon their
1:11:44
they chose to do that in part because they're getting just bad
1:11:48
information right
1:11:49
not every what someone we might call quote an anti-vaxxer is
1:11:53
doing it from the
1:11:53
SPEAKER_00: position of RFK Jr.
1:11:55
or Callie Means you know any of these folks who are profiting
1:11:58
off of it all right
1:11:58
or building their public persona or you know kind of getting
1:12:02
their path to power
1:12:03
through doing that they're just out there like living their
1:12:06
lives working their
1:12:07
SPEAKER_00: jobs they don't think much about it beyond what
1:12:10
They somehow has gotten into their feeds about what vaccines do
1:12:14
and don't do.
1:12:15
SPEAKER_00: So yeah, I think it is incumbent upon all of us to figure out ways.
1:12:19
SPEAKER_00: I love that you're doing that.
1:12:21
SPEAKER_00: The other piece is about how public health is political.
1:12:24
I got my MPH during COVID at the University of Michigan to
1:12:27
juxtapose from your media.
1:12:28
SPEAKER_00: I remember that, yes.
1:12:30
And I remember telling one of my professors in particular on
1:12:34
the communication and
1:12:35
SPEAKER_00: public health,
1:12:35
SPEAKER_00: like,
1:12:36
SPEAKER_00: hey man,
1:12:37
SPEAKER_00: You all need to be more political.
1:12:39
SPEAKER_00: You don't have to be partisan political necessarily.
1:12:41
SPEAKER_00: You don't have to agree with me.
1:12:43
SPEAKER_00: I'm voting for Democrats.
1:12:44
SPEAKER_00: That's clear from the content we have here and the work we do.
1:12:48
SPEAKER_00: But you have to be political.
1:12:50
SPEAKER_00: And knock on wood,
1:12:53
SPEAKER_00: at some point in the future,
1:12:54
we'll be able to bring something to these programs that teaches
1:12:59
people how to be
1:13:00
SPEAKER_00: more political.
1:13:01
SPEAKER_00: The intersection of politics and healthcare
1:13:04
SPEAKER_00: is clear.
1:13:04
SPEAKER_00: This podcast is entirely about that.
1:13:06
SPEAKER_00: But the intersection of politics and public health has always been there.
1:13:10
It's just always brought into such stark relief these last few
1:13:14
years during COVID.
1:13:15
SPEAKER_00: But then again,
1:13:16
these last few years of all these cuts and now the outbreak and
1:13:19
the lack of
1:13:19
SPEAKER_00: response,
1:13:20
SPEAKER_00: it's inevitable that politics is happening.
1:13:23
The problem is the way politics happened in the last few years
1:13:25
has devastated
1:13:26
SPEAKER_00: public health and that public health seemed to be flat footed,
1:13:29
SPEAKER_00: not able to respond.
1:13:30
SPEAKER_00: Peter Ogburn peterogburn
1:13:53
the importance of the advocacy and being engaged and the
1:13:56
importance of recognizing
1:13:57
that like this is political work and we need we need to show up
1:14:01
like this has
1:14:01
always been political public health it's always been political
1:14:04
and what I remind
1:14:05
folks is that just over 100 years ago medicine was in full
1:14:09
disarray right like
1:14:10
medical schools were being shut down they were essentially
1:14:13
paper mills and over the
1:14:14
SPEAKER_01: past century
1:14:16
medicine itself has somehow created this transition from being
1:14:20
a mess to having the
1:14:22
SPEAKER_01: largest lobbying event.
1:14:24
SPEAKER_01: Like the AMA lobbies more,
1:14:26
SPEAKER_01: spends more in lobbying than anyone,
1:14:27
but at the same time has somehow made us all feel that it's not
1:14:31
political,
1:14:32
SPEAKER_01: right?
1:14:32
SPEAKER_01: Like that your doctor is there for you.
1:14:35
And the exact opposite has happened with public health where it
1:14:38
went from being political.
1:14:39
It went from fighting for sewers and clean air and what we now
1:14:43
call social
1:14:44
SPEAKER_01: determinants of health
1:14:45
to stepping back and supporting medicine in the footnotes as
1:14:49
opposed to out front.
1:14:51
SPEAKER_01: And we need to find a way to switch that.
1:14:55
SPEAKER_01: We need to make people understand
1:14:58
SPEAKER_01: how political medicine has become in particularly problematic ways,
1:15:03
SPEAKER_01: but also how to get public health out front.
1:15:05
SPEAKER_01: All the things that you don't think about,
1:15:07
SPEAKER_01: whether it's cryptosporidia on your cabbage at the grocery store,
1:15:12
SPEAKER_01: whatever it is that public health is doing,
1:15:14
people need to be reminded of the incredible value to prevent
1:15:18
us from cutting it in
1:15:20
SPEAKER_01: the future.
1:15:21
And so thanks for the work that you all are doing and
1:15:23
highlighting that and happy
1:15:24
SPEAKER_01: to work together on exactly that.
1:15:26
SPEAKER_01: Thanks for this conversation.
1:15:27
SPEAKER_01: This is great.
1:15:28
SPEAKER_00: Yeah, yeah, you too.
1:15:29
SPEAKER_00: Well, boy, with that, I think we can pray call to a close.
1:15:32
SPEAKER_00: Again,
1:15:34
SPEAKER_00: Craig Spencer,
1:15:35
SPEAKER_00: Ebola survivor,
1:15:37
certainly a guy who once over a decade ago saw a problem and
1:15:41
charged right into it
1:15:43
SPEAKER_00: and now is seeing our current problem,
1:15:47
sort of the epidemic of our current age in public health and is
1:15:50
charging into it
1:15:50
SPEAKER_00: headfirst and appreciate you doing that,
1:15:52
SPEAKER_00: appreciate your work.
1:15:54
and really looking forward to staying in touch and maybe
1:15:56
getting some updates as as
1:15:58
SPEAKER_00: your your projects are coming to fruition.
1:16:00
SPEAKER_00: I think that's all great.
1:16:02
SPEAKER_01: Love it.
1:16:02
SPEAKER_01: Let's do it again.
1:16:04
SPEAKER_01: All right.
1:16:04
SPEAKER_01: Thanks, Greg.
1:16:07
SPEAKER_02: That was a great interview, Rob.
1:16:09
We got just a couple more things before we wrap up that we have
1:16:13
some updates on
1:16:14
some stories that we've been covering on the show for people
1:16:17
who listen every week.
1:16:18
SPEAKER_02: We just want to revisit a few things.
1:16:20
SPEAKER_02: So first off, we've already talked about how Trump is
1:16:22
SPEAKER_02: probably the most pro-nicotine president in memory.
1:16:26
SPEAKER_02: His administration recently approved fruit flavored vapes, for example.
1:16:30
He's also proven himself to be the most self-dealing grifter to
1:16:32
occupy the Oval
1:16:33
SPEAKER_02: Office maybe ever.
1:16:34
You may recall the news that he accepted campaign donations
1:16:37
from the companies that
1:16:38
SPEAKER_02: make the flavored vapes.
1:16:39
SPEAKER_02: This past week,
1:16:40
KFF Health News reported that the president bought stock in
1:16:43
multiple tobacco
1:16:44
SPEAKER_02: companies.
1:16:45
SPEAKER_02: Big tobacco is back.
1:16:48
SPEAKER_02: And so the second shoe has dropped on all of the coverage around their
1:16:52
fast-tracking fruity vapes is that they have actually bought
1:16:56
stock in these
1:16:58
SPEAKER_02: companies.
1:16:58
SPEAKER_02: So since late 2023,
1:17:00
SPEAKER_02: Mega Inc.
1:17:01
SPEAKER_02: has received over $20 million in funding from the tobacco industry.
1:17:04
Federal campaign records show Trump's inauguration garnered
1:17:06
nearly $4 million more
1:17:08
his ballroom project has disclosed donations of an unknown
1:17:11
amount from Altria and
1:17:13
Reynolds American Altria being a tobacco company and Reynolds
1:17:16
American being one of
1:17:19
the old ones recent Trump administration action show he's
1:17:23
followed through with his
1:17:23
pro tobacco campaign rhetoric in May the FDA released
1:17:26
consequential guidance that
1:17:28
allows manufacturers to market their vapes and nicotine pouches
1:17:31
while awaiting
1:17:32
agency approval so you can just go for it before you get
1:17:34
approval and it also
1:17:36
SPEAKER_02: approves several vaping products
1:17:38
SPEAKER_02: The month before,
1:17:38
SPEAKER_02: the Vapor Technology Association,
1:17:40
SPEAKER_02: which donated $1.25 million to Trump's inauguration,
1:17:44
told its vape manufacturer members it had met with the White
1:17:46
House to discuss its
1:17:47
SPEAKER_02: concerns.
1:17:48
SPEAKER_02: By that point, Trump had gone on a stock purchasing spree.
1:17:51
In March,
1:17:52
he made eight separate purchases of Philip Morris and Altria
1:17:55
stock.
1:17:58
SPEAKER_00: I mean, least surprising thing you're going to read about today.
1:18:01
SPEAKER_00: Probably.
1:18:01
SPEAKER_00: Truly, right?
1:18:03
SPEAKER_00: But like,
1:18:03
SPEAKER_00: again,
1:18:03
going back to the Maha and like that void and the fact that
1:18:06
they don't give a shit
1:18:07
SPEAKER_00: about making anyone healthy.
1:18:08
SPEAKER_00: It's just about padding their own coffers, right?
1:18:11
SPEAKER_00: It's about the grift and it's about the self-dealing.
1:18:14
And that has to be part of the conversation and Democrats have
1:18:16
to come in and clamp
1:18:18
SPEAKER_00: down on that shit.
1:18:19
SPEAKER_02: Totally.
1:18:20
SPEAKER_02: It's I mean, it's that's corruption is that that is legal corruption.
1:18:23
SPEAKER_02: And and we should call it legal corruption.
1:18:26
We should try to make it illegal corruption if they if the
1:18:29
Democrats ever get power back.
1:18:31
SPEAKER_02: So, OK, second update on something we've been covering on the show.
1:18:34
This is the ongoing conversation we've been having about
1:18:36
Trump's physical health,
1:18:38
SPEAKER_02: his repeated trips to the doctor,
1:18:39
SPEAKER_02: bruising,
1:18:39
SPEAKER_02: falling asleep in meetings.
1:18:41
SPEAKER_02: for some reason taking the cognitive test over and over and over again.
1:18:44
SPEAKER_02: He liked the results, Miles.
1:18:47
SPEAKER_00: He liked the results so much he wanted to do it again.
1:18:50
SPEAKER_00: Next time you get your colonoscopy report, think about that one.
1:18:54
SPEAKER_02: Correctly identified the giraffe every single time.
1:18:57
SPEAKER_02: Every damn time.
1:18:59
SPEAKER_02: This week,
1:19:00
SPEAKER_02: The Washington Post reported that Trump is seeing a whopping 22 medical
1:19:05
SPEAKER_02: specialists,
1:19:06
SPEAKER_02: which appears to set a new bar for presidents.
1:19:08
SPEAKER_02: For George H.W.
1:19:09
SPEAKER_02: Bush, his first medical checkup as president was in 1989.
1:19:14
SPEAKER_02: He was seen by five specialists.
1:19:16
SPEAKER_02: The White House said at the time his son,
1:19:17
SPEAKER_02: George W.
1:19:18
SPEAKER_02: Bush,
1:19:18
SPEAKER_02: was seen by 12 in his first presidential checkup.
1:19:21
SPEAKER_02: White House officials said a dozen a year later.
1:19:25
President Donald Trump appears to have set a new bar with 22
1:19:28
medical specialists
1:19:29
assessed him as part of his latest checkup according to a
1:19:32
medical report recently
1:19:33
released by the White House so that's a lot of specialists Rob
1:19:37
I'm trying to think
1:19:38
SPEAKER_00: of 22 specialists in my head right now and if I think of
1:19:41
All the subset pediatric specialists,
1:19:43
like pediatric cardiologists,
1:19:45
I can get there.
1:19:46
SPEAKER_00: I can definitely get there.
1:19:46
But I'm not sure I've talked to that many specialists in
1:19:50
consultation in my career.
1:19:52
SPEAKER_00: That's crazy.
1:19:54
SPEAKER_02: I go to a place of, because I don't trust the White House Medical Report.
1:19:57
SPEAKER_02: It has lies in it every time it gets released.
1:20:03
SPEAKER_02: So are they lying about the number of specialists to make it a brag?
1:20:08
or are they accurately reporting something that is like
1:20:11
troubling because he is
1:20:12
extremely ill or is it is he obviously ill and so they just
1:20:17
want to reassure the
1:20:19
public by like saying we have this many specialists on this
1:20:22
really difficult
1:20:22
project of keeping this old man alive like what I don't what
1:20:26
what are they saying
1:20:29
SPEAKER_00: it's
1:20:30
SPEAKER_00: Yeah, I have no idea.
1:20:33
SPEAKER_00: Just thinking of like adult specialists.
1:20:35
SPEAKER_00: He's not seeing a pediatric oncologist, right?
1:20:37
SPEAKER_00: We would expect.
1:20:38
SPEAKER_00: He's not seeing a pediatric whatever.
1:20:40
So thinking of like adult specialists,
1:20:42
I'm just trying to come up with a number that even...
1:20:45
SPEAKER_00: in any way makes sense.
1:20:46
SPEAKER_00: In any way makes sense.
1:20:48
If you go to one of the bigger kind of hospital institutions
1:20:52
like the Mayo Clinic
1:20:53
SPEAKER_00: or Cleveland Clinic,
1:20:54
SPEAKER_00: I was thinking of the Midwest,
1:20:55
SPEAKER_00: and you go for like a comprehensive evaluation,
1:20:58
you might see multiple specialists in a day about your
1:21:00
particular problem,
1:21:01
SPEAKER_00: you know,
1:21:01
SPEAKER_00: maybe three,
1:21:02
SPEAKER_00: maybe four that are all working conjunction,
1:21:04
SPEAKER_00: hopefully to deal with your medical problem.
1:21:06
SPEAKER_00: But 22?
1:21:06
SPEAKER_00: 22?
1:21:07
SPEAKER_00: I don't know.
1:21:09
I think they made it I think it's like a wrong brag it's like
1:21:13
an attempt at a brag
1:21:14
that comes across as weird and it's not true but of course he's
1:21:18
healthy he's seeing
1:21:19
all these specialists how could he not be healthy it's like uh
1:21:22
well other side of
1:21:23
that coin tells us something's really fucking wrong with this
1:21:25
guy the president is
1:21:27
ill and we he's very ill and we just and the American people
1:21:30
deserve to understand
1:21:31
SPEAKER_02: how ill is the president the man who holds the nuclear codes
1:21:37
President JD Vance yeah all right we got we got one more story
1:21:43
to follow up on
1:21:44
everyone any longtime listener this show knows that we are
1:21:47
critical of the American
1:21:48
Medical Association uh we know not everyone who listens to the
1:21:51
show is a doctor but
1:21:52
we know we have some doctors who listen we are critical of the
1:21:54
American Medical
1:21:55
SPEAKER_02: Association um uh if people remember uh Bobby McConnell was uh
1:22:02
scene with robert kennedy jr who more or less kind of used him
1:22:05
as a prop he's the
1:22:06
he was the president of the american medical association and it
1:22:09
was not great it
1:22:10
did not look great it did not come out great in the press it
1:22:13
was sort of an ugly
1:22:14
scene but the ama just elected a president who is ready to take
1:22:17
the kid gloves off
1:22:18
according to politico so someone who ran sort of in is as
1:22:22
someone who will stand up
1:22:24
to robert kennedy american doctors want their leading lobby to
1:22:27
drop its nice guy
1:22:27
SPEAKER_02: routine uh with robert f kennedy jr
1:22:30
SPEAKER_02: At the AMA's annual meeting this week,
1:22:32
members of the group's House of Delegates are sending a clear
1:22:34
message to their
1:22:35
SPEAKER_02: leaders,
1:22:35
SPEAKER_02: call out Kennedy,
1:22:36
SPEAKER_02: even if it costs our pocketbook.
1:22:40
SPEAKER_02: That message was stated most clearly in the election of Sandra Fryhoffer,
1:22:44
SPEAKER_02: an internist from Atlanta,
1:22:46
SPEAKER_02: and an uncompromising Kennedy critic as AMA president-elect.
1:22:49
SPEAKER_02: She beat Michael Suk,
1:22:52
SPEAKER_02: who as AMA board chair in 2024 and 2025,
1:22:54
prioritized doctors' Medicare reimbursement fees and promised
1:22:57
continued pragmatism
1:22:59
SPEAKER_02: in dealing with Kennedy.
1:23:01
SPEAKER_02: That seems like at least a change in orientation,
1:23:06
SPEAKER_02: at least a change in attitude out of the delegates of the AMA.
1:23:10
SPEAKER_02: What do you think, Rob?
1:23:11
SPEAKER_00: Yeah, I mean, I think that's great, right?
1:23:14
SPEAKER_00: Let's see,
1:23:15
because the criticism of the AMA and a lot of the professional
1:23:19
societies of
1:23:19
SPEAKER_00: specialties is that
1:23:21
SPEAKER_00: Their primary purpose is maintaining the sort of the income,
1:23:25
the reimbursement to physicians and dealing with sort of scope
1:23:29
of practice issues.
1:23:30
And then a secondary objective may be to make,
1:23:35
you know,
1:23:35
healthcare better for patients,
1:23:37
right?
1:23:37
SPEAKER_00: Right.
1:23:38
SPEAKER_00: But that isn't the primary purpose.
1:23:41
I'm not sure it's a stated purpose,
1:23:42
but they sort of haven't acted that way,
1:23:44
right?
1:23:44
And particularly in the era of Bobby Kennedy,
1:23:48
the Bobby on Bobby time with the AM
1:23:50
SPEAKER_00: and HHS.
1:23:52
So having now someone coming in as their president who's saying
1:23:56
we're not going to
1:23:57
SPEAKER_00: take this shit,
1:23:57
SPEAKER_00: we're not going to,
1:23:58
SPEAKER_00: you know,
1:23:59
SPEAKER_00: and I like a credit to the delegates who said,
1:24:02
SPEAKER_00: even if it hurts our reimbursement,
1:24:04
SPEAKER_00: like,
1:24:04
SPEAKER_00: thank God.
1:24:06
The doctors I talk to all the time who are interested in
1:24:09
building power for
1:24:09
patients and better American healthcare for patients say our
1:24:13
problem with our jobs,
1:24:15
even with the job dissatisfaction that does exist in medicine
1:24:19
has nothing to do
1:24:20
SPEAKER_00: with how much we make or reimbursement.
1:24:21
It has everything to do with our ability just to take care of
1:24:24
patients and the
1:24:24
SPEAKER_00: patient's ability to exist within the existing system.
1:24:28
SPEAKER_00: So I fucking love it.
1:24:29
SPEAKER_00: And I'd love to have her come on and talk to both of us, one of us.
1:24:33
SPEAKER_00: I don't know what you think.
1:24:34
SPEAKER_02: Dr. Sandra Fryhofer, you were invited on Paging America.
1:24:36
You can come here and talk about what you're planning on doing
1:24:38
at the AMA anytime you'd like.
1:24:40
SPEAKER_02: We'd love to hear about it.
1:24:41
SPEAKER_02: We do have some questions.
1:24:43
SPEAKER_02: We have some thoughts.
1:24:45
SPEAKER_02: We have maybe even some suggestions.
1:24:47
SPEAKER_02: Dr. Fryhofer, please join us if you'd like.
1:24:50
SPEAKER_02: And so with that, Rob, I think that's our show.
1:24:54
SPEAKER_02: sounds good today's episode was written by Chris Savage Dr.
1:24:57
Rob Davidson and me Miles Baker it was produced by Joel Bryson
1:25:01
Peter Ogburn and
1:25:02
Chris Savage it was edited by Peter Ogburn and April Stewie our
1:25:05
music is by Annette
1:25:06
SPEAKER_02: Somerset at Duneflower Productions and if you enjoyed today's show
1:25:09
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1:25:12
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don't miss it that'll
1:25:31
SPEAKER_02: be out Monday and you can subscribe thanks everyone for listening Dr.
1:25:35
SPEAKER_02: Rob always great chatting you too see you next week