WEBVTT - CDC’s Total Overhaul Takes Shape

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<v Speaker 1>Bloomberg Audio Studios, podcasts, radio news. You're listening to Bloomberg

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<v Speaker 2>and lost in the never ending flow of headlines, social

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<v Speaker 2>media posts, and DC press events. And so today we

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<v Speaker 2>wanted to take a look at the CDC. We're talking

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<v Speaker 2>about the Centers for Disease Control and Prevention, which was

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<v Speaker 2>the subject recently of a Bloomberg Business Week deep dive.

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<v Speaker 2>It was entitled America will Get Sick as CDC's total

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<v Speaker 2>overhaul takes shape, and Tim that reporting by Bloomberg's Jessica

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<v Speaker 2>Nicks and Madison Muller.

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<v Speaker 3>Jessica Nicks joins us now here in the studio. Also

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<v Speaker 3>joining us today doctor Richard E. Besser, President and CEO

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<v Speaker 3>of the Robert Wood Johnson Foundation, former acting director of

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<v Speaker 3>the CDC and the Agency for Toxic Substances and Disease

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<v Speaker 3>Registry in early two thousand and nine, I was during

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<v Speaker 3>the early months of the first Obama administration. He joins

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<v Speaker 3>us from New Jersey, doctor Bestar, I do want to

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<v Speaker 3>start with you and just big picture. I think many

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<v Speaker 3>Americans would agree, regardless of their political affiliation, regardless of

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<v Speaker 3>how they feel about what's happening at the CDC and

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<v Speaker 3>AHHS right now, that Americans are unhealthy in general, that

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<v Speaker 3>Americans are sick, that the American health system has not

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<v Speaker 3>been working for years. Why hasn't it? What hasn't been working?

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<v Speaker 1>Yeah, you know, I think that's the right diagnosis.

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<v Speaker 4>And the big question is what are the drivers of

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<v Speaker 4>that and their many you know, starting at the healthcare level.

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<v Speaker 4>You know, healthcare is a small component of people's overall health,

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<v Speaker 4>but we it is important. And we're the only wealthy

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<v Speaker 4>nation in which your ability to access health care is

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<v Speaker 4>so dependent on where you happen to have a job.

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<v Speaker 4>There are millions of people in our country who work

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<v Speaker 4>more than one job per day who don't have access

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<v Speaker 4>to high quality comprehensive affordable health care, and without that,

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<v Speaker 4>they will tend to show up in emergency rooms, They'll

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<v Speaker 4>show up.

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<v Speaker 1>Late for care and be sicker.

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<v Speaker 4>We also are seeing with the latest legislation out of

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<v Speaker 4>Washington that tens of millions of people in addition, are

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<v Speaker 4>going to lose their health care access, so that will

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<v Speaker 4>move us in their own direction. Some of the biggest

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<v Speaker 4>drivers of health I have to do with income and

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<v Speaker 4>whether someone has the income to be able to afford healthy,

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<v Speaker 4>nutritious food, whether they have the income and the leisure

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<v Speaker 4>time to be able to get physical activity. These are

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<v Speaker 4>critical components of health in America. But we are seeing

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<v Speaker 4>that in America the rates of chronic disease are extremely

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<v Speaker 4>high and we need to do more to address that.

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<v Speaker 4>So I think that there probably is a lot of

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<v Speaker 4>agreement around what the problem is. There is less agreement

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<v Speaker 4>in terms of what the drivers of that are or

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<v Speaker 4>what the solution should be.

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<v Speaker 2>All Right, so let's get to and I want to

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<v Speaker 2>bring in Bloomberg News health reporter Jessica Nicks, who wrote

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<v Speaker 2>the story with Madison Muller and Jessica, in your reporting,

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<v Speaker 2>you know that there is a small but vocal contingent

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<v Speaker 2>that's long been demanding changes at the CDC, and then

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<v Speaker 2>with an ally in RFK junior the AHHS Secretary, finally

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<v Speaker 2>getting these critics kind of getting what they want. But

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<v Speaker 2>scientists are really worried because they feel like they've been sidelined.

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<v Speaker 2>What is everyone so worried about.

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<v Speaker 5>Well, we've seen that in the past few months since

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<v Speaker 5>RFK came in to take over the Department of Health

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<v Speaker 5>and Human Services, a complete dismantle at the CDC for

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<v Speaker 5>what we've seen in the past. There was a lot

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<v Speaker 5>of criticisms of the CDC during the COVID pandemic in

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<v Speaker 5>terms of guidance around what schools should be doing, social

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<v Speaker 5>distancing masking. It really divided a lot of the public.

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<v Speaker 5>Since RFK has come in, we've seen mass layoffs in

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<v Speaker 5>terms of divisions that study chronic disease, gun violence, injury prevention.

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<v Speaker 5>We've also seen the dismantle of a vaccine panel called

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<v Speaker 5>the Advisory Committee on Immunization Practices, whos supposed to meet

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<v Speaker 5>next week and hand picked members from RFK have now

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<v Speaker 5>come into that panel and dismantled vaccine policy as we

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<v Speaker 5>know it. In August, we also saw a shooting at

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<v Speaker 5>the CDC. Where the CDC was the attack from a

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<v Speaker 5>gunman who fired nearly five hundred rounds at the buildings.

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<v Speaker 5>Weeks after that, the CDC director was fired weeks into

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<v Speaker 5>her tenure over vaccine policy. So there's so much confusion

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<v Speaker 5>and chaos at the CDC that the actual work is

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<v Speaker 5>not as able to get done because everyone's gone.

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<v Speaker 2>So doctor Bester, let's bring you in. I mean, the

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<v Speaker 2>worries justified.

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<v Speaker 1>Do we need you know?

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<v Speaker 2>I guess I want to take a step back because

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<v Speaker 2>I think it's fair to say that sometimes we of

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<v Speaker 2>institutions that have been in place for a long time

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<v Speaker 2>and there are aspects that get a little stale or

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<v Speaker 2>that maybe could be improved, and so it's good to

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<v Speaker 2>take a look at things. But I'm just wondering your view,

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<v Speaker 2>as a former acting director of the CDC, what needs

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<v Speaker 2>to maybe be fixed at the CDC, What is maybe

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<v Speaker 2>wrong about the current approach, and what is right maybe

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<v Speaker 2>about the current approach.

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<v Speaker 1>Yeah, I mean it is so important to look critically

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<v Speaker 1>at our institutions and ask the question, how can they

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<v Speaker 1>perform better?

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<v Speaker 4>Where have they not performed well? And how do you

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<v Speaker 4>address that? It's critical. I worked at the CDC for

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<v Speaker 4>thirteen years under Republican and democratic administrations. I ran emergency

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<v Speaker 4>preparedness for four years during the Bush administration, which is

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<v Speaker 4>why I was made acting director at the start of

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<v Speaker 4>the Obama administration to be able to respond to public

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<v Speaker 4>health crises. What we're seeing here is the destruction of

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<v Speaker 4>the world world's leading public health agency. The CDC doesn't

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<v Speaker 4>just provide public health expertise for the United States. It

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<v Speaker 4>had been looked at as a beacon for public health

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<v Speaker 4>around around the world.

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<v Speaker 1>That's no longer the case.

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<v Speaker 4>The administration came in and haphazardly fired of tens of

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<v Speaker 4>thousands of federal health workers, so many people at the

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<v Speaker 4>CDC For an administration that is concerned about chronic disease.

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<v Speaker 4>They eliminated the Office on Smoking in Health, and smoking

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<v Speaker 4>is the leading preventable cause of chronic disease. There hasn't

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<v Speaker 4>been any coherent approach to this. At the start of

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<v Speaker 4>the Obama administration, there were efforts to look across the agency,

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<v Speaker 4>where was it lacking, where could it do better. Before

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<v Speaker 4>the start of the COVID pandemic, the public's take on

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<v Speaker 4>the CDC was very high and had very high approval ratings.

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<v Speaker 4>But we saw with the COVID pandemic see makes some mistakes,

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<v Speaker 4>but we also saw the intentional politicization of public health

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<v Speaker 4>by an administration that saw the opportunity for a political gain,

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<v Speaker 4>and so across the nation we saw hundreds of talented

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<v Speaker 4>public health professionals be vilified, people leave their jobs, some

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<v Speaker 4>forced out, some not able to take the stress or

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<v Speaker 4>the blatant threats to their health and safety.

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<v Speaker 1>And now, with this.

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<v Speaker 4>Administration, at a time where we need to rebuild trust,

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<v Speaker 4>we have as our Secretary of Health one of the

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<v Speaker 4>nation's leading anti vaccine advocates and someone who has demonstrated

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<v Speaker 4>no respect for the Centers for Disease Control and Prevention.

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<v Speaker 5>Doctor Besser, you mentioned that the CDC is this beacon

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<v Speaker 5>of global public health. We saw what they did during

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<v Speaker 5>the COVID pandemic. But what does this mean for future

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<v Speaker 5>pandemics that might pop up if we have a dismantled CDC,

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<v Speaker 5>not just for the US, but also for the world.

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<v Speaker 2>Okay, my heart just stopped beating, because we are going

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<v Speaker 2>to get another global pandemic arm a doctor Pessor.

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<v Speaker 4>Yeah, the question is when not in but one of

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<v Speaker 4>the challenges it's not just the CDC being decimated the

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<v Speaker 4>elimination of USAID, the Agency for International Development. The CDC

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<v Speaker 4>works very closely with USAID personnel around the globe to

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<v Speaker 4>make sure that health departments are ready, public health professionals

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<v Speaker 4>are ready to be able to detect and respond to

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<v Speaker 4>signals very quickly to ensure that other countries can control disease,

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<v Speaker 4>but it also helps ensure that new diseases don't come

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<v Speaker 4>to our shores. Dropping out of the World Health Organization,

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<v Speaker 4>which is designed to be the body to help share

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<v Speaker 4>information around the globe help ensure that problems are contained

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<v Speaker 4>where they arise. That is leading leaving us as a

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<v Speaker 4>nation less secure, more defenseless. The cut of billions of

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<v Speaker 4>dollars to the CDC means a cut of billions of

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<v Speaker 4>dollars to state in local health departments.

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<v Speaker 1>Because most of the money to the CDC has passed on.

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<v Speaker 4>That means that in our communities they're not going to

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<v Speaker 4>be as well prepared, not just for the next pandemic

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<v Speaker 4>or major infectious disease crisis, but for making sure the

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<v Speaker 4>restaurant you go to for dinner is serving you food

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<v Speaker 4>that doesn't make you sick, and when your kids go

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<v Speaker 4>to the swimming pool, they can swim in that water

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<v Speaker 4>without getting harmed. These are some of the things that

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<v Speaker 4>the CDC has done that they're not able to do

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<v Speaker 4>with what's taken place under this administration.

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<v Speaker 3>So, doctor, when, in your view, do we start to

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<v Speaker 3>see the effects if we haven't already of these cuts

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<v Speaker 3>that you've been talking about, Well, we are.

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<v Speaker 1>Seeing them, and you're reporting that. Such a nice job

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<v Speaker 1>lifting that up.

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<v Speaker 4>Where a health department in Texas calls the cd for

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<v Speaker 4>the CDC for assistance and there's nowhere there, there's no

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<v Speaker 4>one there to help. We heard early on in Milwaukee

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<v Speaker 4>where they're dealing with lead and their water supply. They

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<v Speaker 4>called the CDC, but the group that worked on lead

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<v Speaker 4>poisoning had been like, oh, these are things that will

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<v Speaker 4>affect people at the community level. It will continue to grow,

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<v Speaker 4>but in general, public health is invisible.

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<v Speaker 1>When it's working properly. It's only when it's not working

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<v Speaker 1>properly and then get stressed. So whenever there's a crisis

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<v Speaker 1>in a community and.

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<v Speaker 4>Public health can't respond, then you will see it and

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<v Speaker 4>then hopefully people in their communities will say this doesn't

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<v Speaker 4>work for us. We need the CDC to be supported.

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<v Speaker 4>We need our state and local public health departments to

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<v Speaker 4>be supported.

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<v Speaker 2>Doctor Besser, Why are we so divided when it comes

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<v Speaker 2>to There are those of us who are like, yeah,

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<v Speaker 2>I trust the government, I trust the CDC and what

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<v Speaker 2>they say, and then there are those that don't. Is

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<v Speaker 2>it just politically motivated or is it people who don't

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<v Speaker 2>feel like they get good health care and so they're like,

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<v Speaker 2>the system is just not working.

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<v Speaker 1>Yeah, it's a great question, and I think that there

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<v Speaker 1>are a number of factors. Before COVID pandemic, the approval

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<v Speaker 1>rating by both parties was very, very strong.

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<v Speaker 4>With the COVID pandemic, there were mistakes that CDC made,

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<v Speaker 4>but I led the CDC at the start of the

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<v Speaker 4>H one N one swine flu pandemic, and during that

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<v Speaker 4>period we saw extremely high approval ratings. And the reason

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<v Speaker 4>for that was there was intentionally efforts to not politicize

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<v Speaker 4>the response. People from both parties came together and said,

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<v Speaker 4>we're going to do what it takes to keep people

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<v Speaker 4>in our communities safe. What we recommend now may change

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<v Speaker 4>as we learn more information. That's a good thing. With

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<v Speaker 4>the COVID pandemic. Whenever there was a change in guidance.

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<v Speaker 4>It was jumped on as a sign that the agency

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<v Speaker 4>didn't know what they were doing. And CDC wasn't allowed

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<v Speaker 4>to talk directly to the public after the first two

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<v Speaker 4>months in the pandemic, and that is a setup for

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<v Speaker 4>disaster because you need active communication to build trust and

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<v Speaker 4>maintain trust, and once you've lost trust, it's extremely hard to.

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<v Speaker 5>Get it back, doctor Besser. We've also seen this dismantle

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<v Speaker 5>of the Vaccine Committee at the CDC, which decides which

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<v Speaker 5>insurance people are going to be able to have to

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<v Speaker 5>be able to get their vaccines. So what does that

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<v Speaker 5>mean to watch this dismantle of the vaccine policy as well.

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<v Speaker 4>Yeah, So, I'm a general pediatrician and I practiced pediatrics

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<v Speaker 4>for more than thirty years, and I know that nothing

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<v Speaker 4>I did as a pediatrician had more proven value than

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<v Speaker 4>helping my patients make sure that they were vaccinated completely

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<v Speaker 4>and on time. And that took spending a lot of

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<v Speaker 4>time with parents answering their really good questions so that

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<v Speaker 4>they were comfortable making the right decision for their children.

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<v Speaker 4>And I always said, if you have a question, if

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<v Speaker 4>you want some honest information, go to the CDC website.

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<v Speaker 4>They'll give you all the information. We can't do that anymore,

0:12:45.440 --> 0:12:49.160
<v Speaker 4>and that is a major problem. We're seeing other organizations

0:12:49.160 --> 0:12:53.040
<v Speaker 4>step up. The Academy of Pediatrics represents pediatricians. I'm a

0:12:53.080 --> 0:12:56.200
<v Speaker 4>member of that group. They have guidance. We're seeing states

0:12:56.240 --> 0:12:59.040
<v Speaker 4>come up with guidance. But the idea that we can't

0:12:59.080 --> 0:13:02.640
<v Speaker 4>look to the CDC because this advisory group has become

0:13:02.720 --> 0:13:07.720
<v Speaker 4>so politicized, so staffed with people who who have strong

0:13:07.760 --> 0:13:11.000
<v Speaker 4>anti vaccine agendas, will put us at great risk. And

0:13:11.480 --> 0:13:13.959
<v Speaker 4>what I'm hearing about the committee meeting for next week

0:13:14.440 --> 0:13:17.240
<v Speaker 4>is that they will raise great concerns about safety in

0:13:17.280 --> 0:13:22.520
<v Speaker 4>the COVID vaccine, safety concerns that have not been verified scientifically.

0:13:22.600 --> 0:13:26.080
<v Speaker 4>And this again will lead people to be confused and

0:13:26.160 --> 0:13:28.120
<v Speaker 4>will lead some people to make a decision that I

0:13:28.160 --> 0:13:30.439
<v Speaker 4>think is not good for the health of their families.

0:13:30.520 --> 0:13:32.720
<v Speaker 2>All right, And as we know, confusion uncertainty never good,

0:13:32.880 --> 0:13:35.800
<v Speaker 2>doesn't matter what area of the world or our lives

0:13:35.800 --> 0:13:38.040
<v Speaker 2>that we're talking about. Doctor Besser, thank you so much,

0:13:38.120 --> 0:13:41.760
<v Speaker 2>Doctor Richard Besser, President CEO of the Robert Wood Johnson Foundation,

0:13:41.920 --> 0:13:44.880
<v Speaker 2>former Acting Director of the CDC, joining us from New

0:13:44.920 --> 0:13:48.520
<v Speaker 2>Jersey on this Friday. Hey, Jessica before you go. Incredible story.

0:13:48.600 --> 0:13:51.520
<v Speaker 2>Highly recommend everybody check it out on the Bloomberg I'm

0:13:51.559 --> 0:13:55.480
<v Speaker 2>reading and you do quote doctor Besser. He said it

0:13:55.480 --> 0:13:57.280
<v Speaker 2>here and he said, in a very short time, we've

0:13:57.280 --> 0:13:59.959
<v Speaker 2>seen an incredible destruction of the agency that leaves people

0:14:00.040 --> 0:14:01.959
<v Speaker 2>here and around the world at increasing risk. And of

0:14:02.040 --> 0:14:04.440
<v Speaker 2>course he was talking about the CDC. Your kind of

0:14:04.440 --> 0:14:07.600
<v Speaker 2>thoughts After having a further discussion with doctor Besser and

0:14:07.640 --> 0:14:10.840
<v Speaker 2>where we are in terms of healthcare in America.

0:14:10.920 --> 0:14:13.840
<v Speaker 5>It's going to be really interesting to watch what happens

0:14:13.880 --> 0:14:16.880
<v Speaker 5>to public health across the US right now. We're seeing

0:14:16.880 --> 0:14:20.960
<v Speaker 5>a bit of a piecemeal policy around vaccine policy in

0:14:21.000 --> 0:14:23.320
<v Speaker 5>the US too. States are kind of adopting their own

0:14:23.360 --> 0:14:26.160
<v Speaker 5>guidelines or working together about how can we start making

0:14:26.240 --> 0:14:29.560
<v Speaker 5>sure that COVID vaccines are still offered at pharmacies now

0:14:29.600 --> 0:14:33.320
<v Speaker 5>as well. So we're seeing a state by state approach

0:14:33.400 --> 0:14:36.120
<v Speaker 5>to public health now, which is difficult without the CDC,

0:14:36.160 --> 0:14:39.600
<v Speaker 5>because the CDC does provide that nationwide view of what's

0:14:39.640 --> 0:14:42.360
<v Speaker 5>happening to the nation's healthcare right.

0:14:42.240 --> 0:14:44.520
<v Speaker 2>And it sounds like different states have different moneies and

0:14:44.600 --> 0:14:46.200
<v Speaker 2>that will kind of determine some of the healthcare.

0:14:46.240 --> 0:14:47.920
<v Speaker 3>Well, not just that, I think insurance companies have an

0:14:47.920 --> 0:14:51.800
<v Speaker 3>interesting position here because if the CDC doesn't necessarily recommend something,

0:14:51.880 --> 0:14:54.640
<v Speaker 3>but states do, then what is an insurance company going

0:14:54.680 --> 0:14:57.520
<v Speaker 3>to cover And to what extent does that actually push

0:14:57.560 --> 0:14:59.960
<v Speaker 3>somebody to get or not get a certain medicine.

0:15:00.840 --> 0:15:02.720
<v Speaker 5>That's a great question, and I think we're going to

0:15:02.800 --> 0:15:05.560
<v Speaker 5>be seeing that play out, especially starting next year when

0:15:05.600 --> 0:15:08.920
<v Speaker 5>the next plans start. As of this year, insurance companies

0:15:08.920 --> 0:15:11.400
<v Speaker 5>are still going to cover vaccines, but health experts have

0:15:11.440 --> 0:15:14.240
<v Speaker 5>been telling us in our reporting that the cost of

0:15:14.280 --> 0:15:16.880
<v Speaker 5>a vaccine is probably less than the cost of the

0:15:16.920 --> 0:15:18.720
<v Speaker 5>illness that you're going to get later on and then

0:15:18.720 --> 0:15:20.440
<v Speaker 5>your hospital bill and everything else.

0:15:20.680 --> 0:15:23.440
<v Speaker 2>So they are a whole idea of preventive medicine right,

0:15:23.640 --> 0:15:26.440
<v Speaker 2>exactly right, and folks have been preaching that for such

0:15:26.440 --> 0:15:29.040
<v Speaker 2>a long time. Thank you so much you're reporting and

0:15:29.080 --> 0:15:31.720
<v Speaker 2>also joining us here. Bloomberg News Health reporter Jessica Nick