WEBVTT - Interview Only w/ Abdul El-Sayed - Why American Healthcare Is Broken & How To Fix It 0:00:03.440 --> 0:00:06.320 Well as many of my listeners. Note, if I were 0:00:06.360 --> 0:00:10.600 running a newsroom, a national newsroom, and said I needed 0:00:10.640 --> 0:00:15.360 to open a bureau on the midterms and have a 0:00:15.360 --> 0:00:20.960 bureau that was just focused on how the midterms were 0:00:20.960 --> 0:00:22.720 going to go, what were the most important races, I 0:00:22.720 --> 0:00:24.639 would be in one state and one state only, and 0:00:24.680 --> 0:00:27.600 it is the state of Michigan. Whether it's the governor's race, 0:00:27.640 --> 0:00:33.960 the senate race. I think a lot of our political confrontations, 0:00:34.000 --> 0:00:38.360 whether it's left and right, progressive, centrist, a fight on 0:00:38.479 --> 0:00:42.280 the right between the right, independence, you name it. Michigan's 0:00:42.360 --> 0:00:44.639 got it all. So you know I'm going to over 0:00:44.720 --> 0:00:47.320 index on all things Michigan. Joining me today is one 0:00:47.360 --> 0:00:50.519 of the candidates in the senate race. It is a candidate. 0:00:50.560 --> 0:00:53.599 Then in my conversation with Ron Fournier, who is a 0:00:53.640 --> 0:00:58.440 Michigan native, he was screaming from the rooftops, don't overlook 0:00:58.560 --> 0:01:01.800 this candidate. The candidate's name is Abdul Lsi ed he 0:01:01.920 --> 0:01:05.679 joins me. Now, Abdul, nice to meet you virtually here 0:01:06.160 --> 0:01:08.560 and welcome to the podcast, Chuck. 0:01:08.640 --> 0:01:10.560 It is a privilege, in an honor to be with you. 0:01:10.600 --> 0:01:12.480 Grateful to you, and also if you had that Bureau 0:01:12.520 --> 0:01:15.680 in Michigan, you would experience the greatest fall that America 0:01:15.680 --> 0:01:18.240 has to offer, not just because you get to watch 0:01:18.280 --> 0:01:20.759 my Wolverines, yeah play in the Big House from time 0:01:20.800 --> 0:01:23.480 to time. But you know, y'all in Miami don't have 0:01:23.480 --> 0:01:24.120 a bad team either. 0:01:24.200 --> 0:01:26.240 No, it's the it's the you know, it's U M 0:01:26.319 --> 0:01:30.280 versus you of M. As as I've learned over the years, 0:01:30.680 --> 0:01:33.360 you've run for office before. But and look, your people 0:01:33.400 --> 0:01:36.399 may not know your background a physician, You're an epidemiologist, 0:01:36.480 --> 0:01:39.679 You've worked in public health, you've worked in academia. And 0:01:39.720 --> 0:01:41.600 I guess I'm going to say this. Look, you're you know, 0:01:41.680 --> 0:01:46.000 you're you're in your early forties. Why a career in 0:01:46.040 --> 0:01:47.559 politics now? 0:01:47.840 --> 0:01:48.000 Now? 0:01:48.040 --> 0:01:51.120 And I say career? You know, let's let you've run twice, 0:01:51.160 --> 0:01:55.880 so the career is? Why politics? Now? Why give me 0:01:55.920 --> 0:01:58.800 your your origin story as to what got you in 0:01:58.840 --> 0:01:59.920 to this side of the arena. 0:02:01.080 --> 0:02:03.480 Yeah, you know, I don't think of it as a 0:02:03.520 --> 0:02:04.320 career per se. 0:02:04.400 --> 0:02:07.200 I grew up wanting to be a doctor, and that's 0:02:07.320 --> 0:02:09.840 in large part because of my own experiences growing up. 0:02:09.880 --> 0:02:12.000 My folks immigrated to this country from Egypt, and I 0:02:12.040 --> 0:02:14.520 was raised by my father who's an Egyptian immigrant, and 0:02:14.600 --> 0:02:17.000 my stepmom, Jackie, who's a daughter of the American Revolution 0:02:17.200 --> 0:02:20.799 from the middle of the state of Michigan. And I 0:02:20.840 --> 0:02:22.840 would get, you know, sent off to Egypt often in 0:02:22.880 --> 0:02:25.200 the summers, where I'd hang out with my grandmother. 0:02:25.400 --> 0:02:27.639 Why is this most intelligent person I ever met, who 0:02:27.680 --> 0:02:28.640 never got to go to school. 0:02:29.000 --> 0:02:31.320 She raised six kids of eight to whom she gave 0:02:31.360 --> 0:02:34.360 birth to, having died before the age of one. I 0:02:34.360 --> 0:02:37.480 would go fifteen hours and in that time I am 0:02:37.480 --> 0:02:40.080 the language for it then, but I would travel about 0:02:40.080 --> 0:02:42.800 ten years difference in life expectancy. I grew up just 0:02:42.840 --> 0:02:45.200 outside of the city Detroit. I didn't have to go 0:02:45.280 --> 0:02:48.400 fifteen hours. I could go fifteen minutes into the city 0:02:48.440 --> 0:02:51.360 and travel the same ten year life expectancy gap. And 0:02:51.440 --> 0:02:53.320 I wanted to do something about that. Growing up, my 0:02:54.280 --> 0:02:55.919 all my mentors always told me, someday you're going to 0:02:56.000 --> 0:02:58.079 run for office. I was like, that's nuts. I don't 0:02:58.080 --> 0:02:59.959 know if you all have seen my name, Abdulah is 0:03:00.120 --> 0:03:02.480 just like a truncated version of my whole first name, 0:03:02.760 --> 0:03:04.359 which has got sounds in it that come out. 0:03:04.200 --> 0:03:05.040 Of parts of people's throats. 0:03:05.080 --> 0:03:07.280 They don't know they have so like that's off limits 0:03:07.280 --> 0:03:09.080 for me, like so much so that when I graduated 0:03:09.080 --> 0:03:11.920 from Michigan in two thousand and seven, I was the 0:03:12.000 --> 0:03:15.240 senior speaker alongside President Bill Clinton, and he comes up 0:03:15.280 --> 0:03:16.560 to me after the speech. He's like, look, you got 0:03:16.600 --> 0:03:18.760 a gift for communicating. Maybe he'll run for office a 0:03:18.840 --> 0:03:20.280 limits or president. I don't if you saw my name, 0:03:20.280 --> 0:03:22.000 but like there are eleven letters in my name, and 0:03:22.040 --> 0:03:23.119 that's just the first. 0:03:23.160 --> 0:03:27.120 Have you met Barack Ussain Obama? Yes, A lot of people, 0:03:27.160 --> 0:03:30.440 including this guy here, who thought, ooh, Hussein, is that 0:03:30.520 --> 0:03:32.919 going to be an electable I was wondering if he 0:03:32.919 --> 0:03:35.160 could get elected to the Senate. So I think he 0:03:35.440 --> 0:03:38.800 disproved this. No, So that's exactly it. This was seven 0:03:38.880 --> 0:03:39.320 in o way. 0:03:39.400 --> 0:03:42.040 I got to watch him run for and win the presidency, 0:03:42.080 --> 0:03:44.720 and so you know, I went on had my career 0:03:44.960 --> 0:03:47.600 in medicine, only to realize that the things that were 0:03:47.600 --> 0:03:50.120 making people sick had a lot to do with access 0:03:50.160 --> 0:03:52.720 to some very basic things. Do you get to drink 0:03:52.840 --> 0:03:56.560 clean water, breathe clean air, A forge your groceries, which 0:03:56.600 --> 0:03:58.240 led me to career in public health. I got to 0:03:58.240 --> 0:04:01.320 rebuild Detroit's health department, got to lead Wayne County's Department 0:04:01.320 --> 0:04:03.200 of Health Human Veterans Services. Across my work, we did 0:04:03.240 --> 0:04:05.920 everything from put glasses on tens of thousands of kids' faces, 0:04:06.040 --> 0:04:07.960 take on some of the biggest corporate ruters in our state, 0:04:08.080 --> 0:04:10.480 erase upwards of seven hundred million dollars in medical debt 0:04:10.480 --> 0:04:13.480 for three hundred thousand people, and over and over again, 0:04:13.520 --> 0:04:17.520 you start to come up against the hard issues of politics, 0:04:17.640 --> 0:04:21.120 the decisions that policymakers make that too often put the 0:04:21.200 --> 0:04:23.080 kinds of kids that I was trying to serve behind. 0:04:23.520 --> 0:04:25.640 And so for me, a lot of this work is 0:04:25.680 --> 0:04:29.880 about trying to lead in politics that centers the people 0:04:29.960 --> 0:04:32.200 that we say we care the most about, which is 0:04:32.200 --> 0:04:35.160 our children. It doesn't matter who their parents are, what 0:04:35.200 --> 0:04:36.920 they do for work, what side of the tracks they 0:04:36.920 --> 0:04:39.680 grew up on. I think we want in America where 0:04:39.720 --> 0:04:42.280 every single kid has the best shot at a dignified life, 0:04:42.600 --> 0:04:45.400 And for me, that's personal right. I got to have 0:04:45.480 --> 0:04:48.400 these amazing opportunities that kids growing up just fifteen minutes 0:04:48.400 --> 0:04:50.080 away from me did not get to have, and I 0:04:50.080 --> 0:04:52.560 think America would be a better place if every kid 0:04:52.640 --> 0:04:55.599 got those same opportunities, and that we build our government 0:04:55.680 --> 0:04:58.080 around them, And so for me, this run for office 0:04:58.520 --> 0:05:01.400 is about trying to have the conversation that I think 0:05:01.400 --> 0:05:03.000 sits at the core of politics, who are we and 0:05:03.279 --> 0:05:06.400 who do we want to be around centering those folks 0:05:06.400 --> 0:05:08.240 in the kind of public policy that would dignify them. 0:05:08.520 --> 0:05:13.599 Look, I mean, I think it's pretty clear healthcare depends 0:05:13.600 --> 0:05:16.480 on your status, right how good your healthcare is, if 0:05:16.480 --> 0:05:19.840 you've got the ability to find specialists, if you've got 0:05:19.880 --> 0:05:24.000 the and sometimes that's sometimes it's financial, sometimes it's time, 0:05:25.720 --> 0:05:30.000 it's it's it's location, it's geography, it's all of these things. 0:05:30.600 --> 0:05:34.480 So obviously to me, I now understand why you're a 0:05:34.520 --> 0:05:37.279 Medicare for All persons, right, which is that this is 0:05:37.360 --> 0:05:40.880 about You've got to rip off the class issue when 0:05:40.880 --> 0:05:43.520 it comes to healthcare, because right now, your health outcome 0:05:43.600 --> 0:05:48.080 depends on your status on the economic ladder almost more 0:05:48.120 --> 0:05:51.200 so than it does race or gender. Is that is 0:05:51.200 --> 0:05:52.680 that fair? Yeah? 0:05:52.680 --> 0:05:55.240 And Chuck, I'll just you know, take it a step further. 0:05:55.920 --> 0:05:59.039 You and I might have the same insurance and I 0:05:59.200 --> 0:06:03.920 just know enough people that I could get access to different. 0:06:03.800 --> 0:06:05.960 Right, you make the right phone call, who know the 0:06:06.040 --> 0:06:08.480 right person? Look, I experienced this firsthand. My dad was 0:06:08.520 --> 0:06:11.920 on the liver transparent list and couldn't get on the list. 0:06:12.120 --> 0:06:14.680 And it turns out and I remember that same year 0:06:14.680 --> 0:06:15.920 when he was on it, and this is way back 0:06:15.960 --> 0:06:18.440 in the late eighties early nineties, like Mickey Mannel got 0:06:18.520 --> 0:06:21.680 three livers or two livers, if I'm not mistaken, and 0:06:21.720 --> 0:06:24.600 it was like, well, you know his doctor, and then 0:06:24.640 --> 0:06:28.520 you learn it's everybody's on the same list. But does 0:06:28.560 --> 0:06:31.560 your doctor know how to word it correctly? Sometimes it's 0:06:31.560 --> 0:06:33.600 not even the right call, it's do you know how 0:06:33.640 --> 0:06:35.560 to word it in such a way that it gets 0:06:35.600 --> 0:06:37.320 you higher on the list, right? 0:06:37.400 --> 0:06:41.000 And that issue, Chuck, is exactly it, right, Like we're 0:06:41.120 --> 0:06:45.760 talking about differences at the elite opportunities of having health 0:06:45.800 --> 0:06:48.960 insurance in the first place, but the reality of it 0:06:49.000 --> 0:06:50.160 is that there are a lot of people who don't 0:06:50.160 --> 0:06:51.840 have health insurance at all, a lot of folks who 0:06:51.880 --> 0:06:54.600 have second class or third class healthcare citizenship through something 0:06:54.640 --> 0:06:56.000 like Medicaid kind. 0:06:55.800 --> 0:06:58.440 Of stuff basically, And that's it, you know, right, Yeah, And. 0:06:58.400 --> 0:07:00.680 Then even if you have private insurance, experience of that 0:07:00.800 --> 0:07:03.400 is getting worse and worse. I mean the deductible, the 0:07:03.440 --> 0:07:05.680 median and deductible, right, which is the money you pay 0:07:05.839 --> 0:07:07.880 to get access to the healthcare you already thought you 0:07:07.920 --> 0:07:10.520 paid for in the quote unquote premium every two weeks 0:07:10.600 --> 0:07:13.720 or four weeks. That median deductible for a family of 0:07:13.760 --> 0:07:16.280 four is about four thousand dollars. So you're doing the 0:07:16.280 --> 0:07:18.360 math right. That average family of four makes about eighty 0:07:18.360 --> 0:07:21.480 thousand dollars. That means they are forgoing a paycheck to 0:07:21.560 --> 0:07:25.240 get access to the health insurance that every paycheck has 0:07:25.240 --> 0:07:27.760 been garnished to pay for in the first place. That's 0:07:27.880 --> 0:07:30.200 if you have private health insurance. I mean, the system 0:07:30.320 --> 0:07:32.720 is so broken and you ask yourself why, Well, it's 0:07:32.760 --> 0:07:35.320 because everyone's got to get paid, right. The health insurance 0:07:35.320 --> 0:07:39.040 company gets paid, the hospitals get paid, the pharmaceutical or 0:07:39.080 --> 0:07:40.080 the medical device. 0:07:39.800 --> 0:07:40.720 Companies get paid. 0:07:40.920 --> 0:07:44.840 And I just think that in America, we ought to 0:07:44.880 --> 0:07:48.600 have a system where getting paid isn't the operative goal. 0:07:49.240 --> 0:07:51.600 It's that you get health care to the patient who 0:07:51.720 --> 0:07:52.120 needs it. 0:07:52.160 --> 0:07:54.880 And I trained as a doctor to practice in a 0:07:54.920 --> 0:07:57.000 system where I could take care of patients, not get 0:07:57.320 --> 0:07:58.600 huge corporations paid. 0:07:58.800 --> 0:08:00.240 And we don't have to live this way. But it's 0:08:00.280 --> 0:08:01.920 getting worse and worse and harder and harder. 0:08:02.040 --> 0:08:06.640 Deal with this Look, I'm it's a straw man argument. 0:08:06.720 --> 0:08:09.920 I'm not saying I ascribe to this argument. But you've 0:08:10.120 --> 0:08:12.760 been to medical school. You know the cost of medical school. 0:08:13.040 --> 0:08:15.960 That there's this belief that because it costs so much 0:08:16.000 --> 0:08:20.160 money to become a doctor, therefore doctors should expect to 0:08:20.200 --> 0:08:21.360 make a lot of money. 0:08:22.360 --> 0:08:24.480 And you know, if it was the doctor's pay that 0:08:24.600 --> 0:08:27.360 was the issue, we could have that conversation. That's not 0:08:27.400 --> 0:08:29.320 where the inflation in healthcare is. In fact, if you 0:08:29.360 --> 0:08:34.400 were to actually adjust a physician's pay for inflation between 0:08:34.440 --> 0:08:37.439 now in the nineteen nineties, it would be as if 0:08:37.480 --> 0:08:40.760 physicians took a collective thirty five percent pay cut. So 0:08:40.800 --> 0:08:43.640 it's not that physicians are getting paid so much. It's 0:08:43.640 --> 0:08:48.640 that health insurers and hospitals have colluded in a system 0:08:48.679 --> 0:08:51.839 where they can mutually gatekeep for each other to make 0:08:51.880 --> 0:08:54.840 sure that they extract more and more from us and 0:08:54.920 --> 0:08:57.280 more and more of the value in healthcare. So I 0:08:57.320 --> 0:08:59.440 don't want to Folks leave this conversation thinking, well, healthcare 0:08:59.440 --> 0:09:01.240 so expensive because those doctors get paid so much. 0:09:01.280 --> 0:09:02.400 That's just not what's happening. 0:09:02.840 --> 0:09:05.920 It's that those health insurance CEOs get paid so much. 0:09:06.320 --> 0:09:09.360 It's that those hospital CEOs get paid so much. It's 0:09:09.400 --> 0:09:11.920 that you have a system of mergers and acquisitions in 0:09:11.960 --> 0:09:14.760 healthcare that empower all of them to suppress people's wages. 0:09:15.280 --> 0:09:18.520 Just this weekend was at a nurse's strike in Flint, right, 0:09:18.640 --> 0:09:21.600 because they're not able to actually negotiate with their hospital 0:09:21.600 --> 0:09:24.000 because they're just so few players in town that if 0:09:24.040 --> 0:09:25.520 you're a nurse, you kind of got to work for 0:09:26.200 --> 0:09:29.520 one of two different corporations who collude together to suppress wages. 0:09:29.920 --> 0:09:32.640 It's the way that these really, really big players have 0:09:32.679 --> 0:09:33.199 come together. 0:09:33.320 --> 0:09:34.880 And this is the thing, Chuck is. 0:09:34.880 --> 0:09:38.120 I think people understand that, whether it's healthcare, or the 0:09:38.160 --> 0:09:41.080 price of keeping the lights on your utilities, or it's 0:09:41.160 --> 0:09:44.120 the price of a plane ticket, that you've got so 0:09:44.400 --> 0:09:47.880 few players, huge corporations that have been able to ineffect 0:09:48.000 --> 0:09:50.120 use their money to corrupt our political system to make 0:09:50.160 --> 0:09:52.679 sure that they end up getting paid more and you 0:09:52.760 --> 0:09:54.600 have to pay more for the things you buy from them, 0:09:54.640 --> 0:09:57.120 and you end up getting paid less for the work that. 0:09:57.080 --> 0:09:59.240 You have to do for them. That is the essential 0:09:59.320 --> 0:10:00.000 challenge of our lis. 0:10:00.120 --> 0:10:03.560 Some healthcare just happens to be the most obvious, most blatant, 0:10:03.720 --> 0:10:07.000 and frankly most corrupting and soddening version of all of it. 0:10:07.200 --> 0:10:09.439 Let me throw another strong man argument about the cost 0:10:09.440 --> 0:10:12.320 of healthcare with from the angle of the pharmaceutical companies 0:10:12.360 --> 0:10:15.439 that hey, it costs a lot of money to try 0:10:15.480 --> 0:10:20.760 to bring good prescription drugs to market. Therefore, there's a 0:10:20.800 --> 0:10:25.040 lot of drugs that fail and they've got to eat 0:10:25.080 --> 0:10:27.839 those costs. So when they have one that succeeds, it's 0:10:27.840 --> 0:10:32.200 got to pay for all the failures as well. What's reasonable? 0:10:32.240 --> 0:10:34.920 What should be what should be the expectation on that 0:10:35.080 --> 0:10:37.880 part of the cost of healthcare, because that's a contributor. 0:10:38.679 --> 0:10:40.440 Yeah, and Chuck, I'd say that's a fair argument. 0:10:41.080 --> 0:10:45.240 If the marketing budget at almost every fortune five hundred 0:10:45.240 --> 0:10:48.080 pharmaceutical company wasn't larger than the research and development budget, 0:10:48.520 --> 0:10:51.600 so you know, you know, fewer glossy adds on TV, 0:10:51.880 --> 0:10:54.439 more research and development, then maybe I could like squint 0:10:54.440 --> 0:10:56.440 and see the point. But the hard part is that 0:10:56.480 --> 0:11:00.600 in this country we pay exorbitantly more for pharmaceuticals than 0:11:00.920 --> 0:11:04.840 other countries, and the difference is that, frankly, our government 0:11:05.040 --> 0:11:07.360 is barred in most cases from being able to negotiate 0:11:07.400 --> 0:11:10.360 those prices downward. And if you look at how much 0:11:10.440 --> 0:11:12.760 their CEOs make, how much their c suite makes, how 0:11:12.800 --> 0:11:17.520 much they return in stock buybox. I worry right that 0:11:17.760 --> 0:11:22.160 too often the ways that these corporations work is about 0:11:22.160 --> 0:11:25.160 trying to play finance games around having to sell you 0:11:25.200 --> 0:11:28.200 pharmaceuticals that you don't have a choice about where you 0:11:28.280 --> 0:11:31.079 get them. And of course, you know, we can nerd 0:11:31.120 --> 0:11:32.440 out here a little bit, right, but we know that 0:11:32.480 --> 0:11:36.920 pharmaceuticals are right the classic, as we say, inelastic demand curve. 0:11:36.920 --> 0:11:39.280 That's a fancy economics way for saying there are things 0:11:39.280 --> 0:11:41.160 you kind of have to buy when you need them, right. 0:11:41.280 --> 0:11:44.520 So unfortunately, they've always played this game where they just 0:11:44.640 --> 0:11:47.320 raise their prices because they can, because you're going to 0:11:47.320 --> 0:11:50.600 buy those medications anyway, because it's literally life and death captive. 0:11:50.760 --> 0:11:53.440 And so, you know, it's a challenging situation that we 0:11:53.480 --> 0:11:56.160 have in this country because the fact that healthcare has 0:11:56.200 --> 0:11:59.920 become so expensive for so many people has actually undermined 0:12:00.080 --> 0:12:02.640 trust in medicine and public health or at large. It's 0:12:02.679 --> 0:12:04.920 the reason that the likes of an RFK junior can 0:12:04.960 --> 0:12:08.000 go light all of HHS on fire, because folks know 0:12:08.160 --> 0:12:11.000 that they couldn't get the medications they needed in the 0:12:11.000 --> 0:12:13.840 context of disease they knew they had, and then all 0:12:13.840 --> 0:12:16.480 of a sudden, we're inventing new vaccines for a disease 0:12:16.520 --> 0:12:17.000 that didn't. 0:12:16.840 --> 0:12:18.880 Exist a year ago, and we're saying, here, take these 0:12:18.920 --> 0:12:19.240 for free. 0:12:19.320 --> 0:12:21.360 And they're like, look, I know I need insulin, but 0:12:21.400 --> 0:12:22.920 nobody's ever come up to me and be like, here, 0:12:22.960 --> 0:12:25.240 take the insulin for free, right, And so it's kind 0:12:25.280 --> 0:12:26.720 of weird to me that you all don't give me 0:12:26.760 --> 0:12:29.400 the drugs for the diseases I know I have, when 0:12:29.400 --> 0:12:31.960 all of a sudden, you're giving me the vaccine for 0:12:32.000 --> 0:12:34.000 a disease I don't yet have that didn't exist a 0:12:34.080 --> 0:12:36.760 year ago. And it's the way that we've kept healthcare 0:12:37.000 --> 0:12:39.840 that people know they need out of their hands because 0:12:39.880 --> 0:12:42.840 the prices are so expensive. That has really undercut the 0:12:42.880 --> 0:12:45.480 knees out of the public health arguments that folks like 0:12:45.559 --> 0:12:47.440 me have been making for a very long time. 0:12:47.559 --> 0:12:50.119 And it's sad to watch a guy like RFK. 0:12:50.000 --> 0:12:53.080 Junior, who shouldn't have his hands on, frankly, anything having 0:12:53.120 --> 0:12:55.120 to do with science and health in this country now 0:12:55.160 --> 0:12:59.240 come and use that very premise to destroy so much 0:12:59.320 --> 0:13:00.400 of what's so many many. 0:13:00.200 --> 0:13:01.160 People have tried to build. 0:13:02.040 --> 0:13:04.880 Actually broaden that issue out a little bit in this respect, 0:13:04.920 --> 0:13:08.920 which is you were practicing medicine sort of at the 0:13:09.760 --> 0:13:15.280 arguably at the beginning stages of when doctor Internet would intervene. Right, 0:13:15.440 --> 0:13:17.960 your patient would come in and say, hey, I read this, doctor, 0:13:17.960 --> 0:13:21.280 what can you tell me about this? Right? And now, 0:13:21.320 --> 0:13:24.400 of course, doctor Internet is a gigantic problem, and it's 0:13:24.400 --> 0:13:27.960 so much bigger, and it's created this misinformation is sort 0:13:27.960 --> 0:13:30.640 of now it's becoming public policy and public health. But 0:13:32.960 --> 0:13:35.560 when did you first start to notice that this was 0:13:36.040 --> 0:13:38.600 that essentially, and I think you know what I mean 0:13:38.640 --> 0:13:42.040 when I say doctor Internet, right, where this was really 0:13:42.080 --> 0:13:44.160 starting to get into the way of healthcare. 0:13:44.920 --> 0:13:46.720 Yeah, So I want to be clear, I took my 0:13:46.800 --> 0:13:48.840 career right as soon as I graduated med school into 0:13:48.880 --> 0:13:52.079 public health, so I didn't practice day to day. I'll 0:13:52.120 --> 0:13:55.800 tell you though, that the impact of the Internet, frankly, 0:13:55.840 --> 0:14:04.520 the impact of algorithmic amplification of of health information, I think, 0:14:04.559 --> 0:14:08.800 really started to take hold in the early twenty tents. 0:14:08.840 --> 0:14:10.400 I mean, you had the advent of Facebook. 0:14:10.559 --> 0:14:12.320 I remember being one of the first ten thousand people 0:14:12.360 --> 0:14:14.880 on Facebook when it came to my university my freshman year, right. 0:14:15.360 --> 0:14:19.240 And then that when I graduated college, went mobile on 0:14:19.520 --> 0:14:22.200 the new invention called the iPhone, and I think at 0:14:22.240 --> 0:14:25.680 that point the Internet company started to realize that they 0:14:25.720 --> 0:14:29.880 could sustain your attention on that device by feeding you 0:14:30.000 --> 0:14:35.320 things they knew would create some sort of emotional response. 0:14:35.440 --> 0:14:37.560 And health information is one of those things, because of course, 0:14:37.560 --> 0:14:39.840 you want to keep yourself super healthy, and you know, 0:14:39.880 --> 0:14:42.080 it's kind of a broken system, and all of the 0:14:42.120 --> 0:14:45.560 exorbitant ways it's broken can wow and astound, and so 0:14:45.840 --> 0:14:48.640 this was bound to go viral on the internet when 0:14:48.640 --> 0:14:50.200 I think about you know, I graduated in med school 0:14:50.200 --> 0:14:53.160 in twenty fourteen, and I remember having conversations with patients 0:14:53.280 --> 0:14:55.200 whose care I was involved in as a medical student, 0:14:55.400 --> 0:14:57.320 and already they'd say, well, I googled my symptoms and 0:14:57.320 --> 0:14:59.680 here's what I found. But when I talked to my 0:14:59.800 --> 0:15:03.480 call in practice, they tell me that the real like, 0:15:03.520 --> 0:15:05.600 the moment that all of this started to really really 0:15:05.640 --> 0:15:12.600 take off, was in the early twenty twenties during the pandemic, right, 0:15:12.640 --> 0:15:14.680 And that was a moment where folks were really paying 0:15:14.720 --> 0:15:17.440 attention to health and healthcare because it was in the news. 0:15:17.720 --> 0:15:20.800 Folks felt like they had zero control over their circumstances, 0:15:20.840 --> 0:15:23.640 and that the powers that be didn't give them the 0:15:23.760 --> 0:15:26.040 kind of confidence that they wanted to be able to 0:15:26.040 --> 0:15:28.360 have the kind of control that they needed in this 0:15:28.440 --> 0:15:32.160 really scary moment. And I think it opened Pandora's box 0:15:32.160 --> 0:15:34.960 in a way where you had a profound platforming of 0:15:34.960 --> 0:15:37.280 folks like RFK Junior in ways that they hadn't had 0:15:37.280 --> 0:15:38.000 in the past. 0:15:38.240 --> 0:15:41.440 So talk to me about some ways to look this 0:15:41.520 --> 0:15:44.760 is a this is a crisis. I think it's a crisis. 0:15:45.400 --> 0:15:48.480 I'm shocked that there aren't more people alarmed at what's 0:15:48.480 --> 0:15:50.840 happening at the CDC. When I say more people inside 0:15:50.840 --> 0:15:54.200 the Republican Party sort of whatever's left of the non 0:15:54.240 --> 0:15:57.640 Trump wing of the party, I mean, this is a 0:15:57.720 --> 0:16:00.680 national security problem. This is a risk to our economy, 0:16:01.520 --> 0:16:04.520 let alone an actual risks to both young and old. 0:16:04.680 --> 0:16:07.040 Right that the ones that are most likely to fall 0:16:07.120 --> 0:16:09.440 victim to a virus or a disease that we had 0:16:09.640 --> 0:16:12.280 once IRAQ hated are those with weaker immune systems again, 0:16:12.600 --> 0:16:17.720 children or elderly. And you've been in the space of 0:16:17.760 --> 0:16:22.120 public health, you saw the distrust grow. Do you have 0:16:22.200 --> 0:16:24.920 good best practices that you think would help restore trust 0:16:24.960 --> 0:16:27.200 if you were put in charge of the CDC tomorrow. 0:16:27.600 --> 0:16:30.120 You know, you would have to work on trying to 0:16:30.160 --> 0:16:32.640 build trust. What does that look like? What are some 0:16:32.720 --> 0:16:38.240 good what are some good ideas that you've put into 0:16:38.240 --> 0:16:41.520 practice that that has helped at least in one on 0:16:41.520 --> 0:16:42.240 one conversation. 0:16:43.440 --> 0:16:46.360 Yeah, I'll say a couple of things. Number one. You know, 0:16:46.360 --> 0:16:46.800 it's funny. 0:16:46.880 --> 0:16:50.480 I have two terminal degrees in health. I graduated in 0:16:50.480 --> 0:16:53.000 medical school. I did a PhD in public health. And 0:16:53.080 --> 0:16:55.080 if I walk up to people and say, well, as 0:16:55.120 --> 0:16:57.920 a double doctorate your doctor, doctor play to you, they 0:16:57.920 --> 0:16:59.280 consider and call you doctor doctor. 0:17:00.040 --> 0:17:02.800 Yeah, but that's actually not the play. 0:17:03.000 --> 0:17:04.920 Most often it's like, hey, look, I'm a father of 0:17:04.920 --> 0:17:06.480 a seven year old and a two year old. I 0:17:06.520 --> 0:17:08.359 also happen to have a medical degree in a PhD 0:17:08.440 --> 0:17:10.879 in public health, and I've worked as a health commissioner. 0:17:10.880 --> 0:17:13.280 But as a father, let me tell you what I 0:17:13.320 --> 0:17:15.520 was so excited to do when my kids turned one. 0:17:15.880 --> 0:17:17.600 Who's give them these vaccines? Why? 0:17:17.640 --> 0:17:20.480 Because I've seen what it looks like when somebody gets measles. 0:17:20.840 --> 0:17:22.560 I know what it looks like to see a kid 0:17:22.640 --> 0:17:25.560 struggling to breathe because they got the flu. And I 0:17:25.600 --> 0:17:28.000 don't hesitate to get my kids vaccinated. Now you do you, 0:17:28.400 --> 0:17:30.000 But let me just tell you what I did with 0:17:30.440 --> 0:17:32.680 the things that I know. I think that's Number one. 0:17:32.680 --> 0:17:35.960 We need to communicate as people before we communicate as experts, 0:17:36.000 --> 0:17:37.879 because the. 0:17:37.359 --> 0:17:40.000 Lead with doctor, doctor, They're literally not going to listen 0:17:40.000 --> 0:17:41.359 to you, Right, that's what you're concerned. 0:17:41.440 --> 0:17:44.600 Right. If I have to choose between doctor and dad, 0:17:44.880 --> 0:17:47.800 I'm going to pick dad every single time. Number Two, 0:17:48.280 --> 0:17:50.880 I think we need to recognize that there is no 0:17:50.960 --> 0:17:53.640 difference in the minds of most people between health care 0:17:53.720 --> 0:17:56.879 and public health. And I think people are really frustrated 0:17:56.880 --> 0:17:58.920 by health care, and that bleeds into whether or not 0:17:58.960 --> 0:18:02.120 they're willing to to trust public health. And I think 0:18:02.160 --> 0:18:04.160 we need to be very, very smart in public health 0:18:04.200 --> 0:18:07.240 about advocating for a health care system that gets people 0:18:07.280 --> 0:18:10.040 the medications they need when they need them, that does 0:18:10.080 --> 0:18:11.720 not cost them an arm and a leg. It is 0:18:11.760 --> 0:18:13.400 a crazy thing that in this country, if you get 0:18:13.400 --> 0:18:15.680 cancer two thirds of the time, you are going to 0:18:15.800 --> 0:18:19.240 end up in some sort of bankruptcy. That's a crazy thing. 0:18:19.640 --> 0:18:21.480 And I think that's a public health issue. And I 0:18:21.480 --> 0:18:24.680 think when people don't see us talking about the obvious 0:18:24.760 --> 0:18:27.000 things they have to deal with every single day. They're 0:18:27.040 --> 0:18:29.560 less likely to listen when we come to them in 0:18:29.600 --> 0:18:32.320 the moment of crisis and say, hey, we really need 0:18:32.320 --> 0:18:33.840 you to pay attention to us. They're going to say, 0:18:33.880 --> 0:18:36.159 where were you when I was struggling for my insulin? 0:18:36.200 --> 0:18:38.680 Where were you when my mom got sick with cancer 0:18:38.880 --> 0:18:40.760 and we lost our home over it? And I think 0:18:40.760 --> 0:18:42.200 we've got to be able to say we were right 0:18:42.240 --> 0:18:45.080 there and we were working on the problem. I think 0:18:45.080 --> 0:18:48.119