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unidentified
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Here's a look at some of our live coverage on C-SPAN today. | |
| At 11 a.m. Eastern, Air Force Secretary Troy Menck will deliver the commencement speech at the U.S. Air Force Academy. | ||
| Then Press Secretary Caroline Levitt briefs reporters at the White House at 1. | ||
| Later, at 4, a conversation on regional immigration programs at the American Enterprise Institute. | ||
| And former National Security Advisor Jake Sullivan will discuss the ways foreign policy can improve Americans' daily lives. | ||
| Hosted by the Chicago Council on Global Affairs at 6.30. | ||
| These events will be live here on C-SPAN. | ||
| You can also watch on our C-SPAN Now app and online at c-SPAN.org. | ||
| Welcome back. | ||
| Joining us to talk about the Trump administration and public health is Dr. Richard Besser. | ||
| He's former acting director of the CDC and currently president and CEO of the Robert Wood Johnson Foundation. | ||
| Dr. Besser, welcome to the program. | ||
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unidentified
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Thanks, Mimi. | |
| It's great to be here. | ||
| So remind us about your public health background and what you're currently doing and the mission of your organization. | ||
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unidentified
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Well, I have spent my entire career in public health. | |
| By training, I'm a general pediatrician and I practiced pediatrics for more than 30 years. | ||
| But I've worked in public health as an academic doing research. | ||
| I was at the CDC for 13 years, initially as a disease detective and then working on a wide range of issues, including emergency preparedness and response. | ||
| I was the acting director at the beginning of the Obama administration. | ||
| And then I was in journalism like you. | ||
| I was at ABC News as the chief medical editor for eight years. | ||
| And now at the Robert Wood Johnson Foundation, we focus on a future where health is no longer a privilege, but a right for all. | ||
| And our work is about supporting grantees around the country who are trying to ensure that everyone has what they need to thrive and to lead a healthy life. | ||
| And Robert Wood Johnson, is it just focused on health or do you support other initiatives? | ||
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unidentified
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Well, we focus on health, but our focus is very broad. | |
| So we look at all of the conditions in people's lives that either provide opportunities for health or create barriers to health. | ||
| So conditions in communities, whether they're jobs and good schools and transportation, taxes, whether families have the resources they need to provide for their children, and our health care system in a big way, looking towards a future in which everyone is treated with respect by the healthcare system, where our public health system provides people in all communities what they need to thrive. | ||
| Well, President Trump's administration has proposed several cuts to staff and to the actual budget of several agencies and departments related to public health. | ||
| What would you say is your biggest concern? | ||
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unidentified
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Well, you know, as I said, I worked at the CDC for 13 years, and we as a nation had the gold standard of governmental public health systems. | |
| Our federal system includes the CDC, it includes the Food and Drug Administration, the National Institutes of Health. | ||
| We had incredible resources to be able to support health here in America as well as around the globe. | ||
| The cuts that have come through already, there are more proposed, but already the government has taken out of these agencies critical staff that now leave us as a nation vulnerable. | ||
| We have a Secretary of Health who talks about the importance of addressing chronic disease, and that is so important, but at the same time, eliminated the Office on Smoking and Health at the CDC. | ||
| And smoking is the leading preventable cause of chronic disease. | ||
| We have an office or had an office at the CDC that was focused on lead poisoning prevention. | ||
| The city of Milwaukee is fighting a lead poisoning issue in their schools. | ||
| They called CDC, and CDC did not have people there to help support that effort. | ||
| Those are just a couple examples of the challenges that are now faced by the indiscriminate slashing of positions that are so important to protecting health in every community in America. | ||
| The budget bill that has just passed the House includes cuts to Medicaid. | ||
| The Washington Post has this headline. | ||
| Trump and GOP's tax bill would force cuts to Medicare, according to the CBO. | ||
| What kind of impacts do you think this can have on public health as a whole? | ||
| And does it just impact the people that would no longer have their health insurance? | ||
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unidentified
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Yeah, I mean, this is, to me, this strikes me as one of the cruelest things the government is trying to move forward. | |
| We are the only wealthy nation that doesn't ensure that every citizen has high quality, comprehensive, affordable health care. | ||
| The Affordable Care Act went a long way to closing the gap by providing access to health care to so many more people, millions of more people. | ||
| This bill, if it goes forward, the Congressional Budget Office estimates that over 7 million people will lose their Medicaid. | ||
| 4 million people who are getting some help in the marketplace with their health insurance plans will lose that and are likely to lose health insurance. | ||
| And this is to pay for tax cuts for corporations and wealthy people. | ||
| It's important to recognize, though, that these are not the only people who are going to be impacted by these dramatic cuts. | ||
| And they're largely cuts by putting in place red tape paperwork that people would need to do every month to demonstrate that they qualify for these programs that they're qualified for. | ||
| People in states that have tried this, what happens is that hardworking Americans who just don't have the time or don't have the computer access to meet these requirements end up losing their insurance. | ||
| They've never seen that these work requirements actually lead to more people working. | ||
| But Medicaid is also the lifeline to so many hospitals around our country, in particular in rural America. | ||
| So by putting in these cuts to Medicaid, what we expect to see are the closure of rural hospitals across America. | ||
| So individuals who have insurance, who aren't losing insurance, are going to have to drive much further to get their services. | ||
| And you know that when someone is having an emergency health event, having to drive further can be a life or death situation. | ||
| So this is real. | ||
| This is something that the Senate will be addressing, and hopefully, they'll make the right decision on this because it will impact every community in America in a very grim way. | ||
| Now, the Republicans have made the argument that the people that are losing Medicaid are people that should have never been on Medicaid to begin with. | ||
| You mentioned work requirements that would kick in for able-bodied people without dependents. | ||
| There's also the issue of undocumented immigrants being on Medicaid, including this bill would penalize states that offer Medicaid to undocumented children. | ||
| What are your thoughts on that as far as should they be on it to begin with? | ||
| Is there another way to provide for those children aside from taxpayer funding? | ||
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unidentified
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Yeah, I mean, your first point about people who never should have been on it is just not true. | |
| We fund a lot of research in this area, and the vast majority of people who are considered able-bodied and aren't working are women between the ages of 50 and 64. | ||
| So, older women who have significant care responsibilities, either for children or for elderly parents. | ||
| So, they would be kicked off of this. | ||
| But there are a lot of people in America who are working two, three jobs that don't have health insurance with them. | ||
| Minimum wage jobs. | ||
| You know, we're one of the only countries that has an employer-based health care system. | ||
| So, if your job comes with health care benefits, that's great. | ||
| If it doesn't, well, then you're in trouble. | ||
| And for some, that means that you are dependent on government support. | ||
| And that is a challenge. | ||
| If you're working three jobs and you have to certify every month that you're working those jobs and bring in your paperwork, that will be a real challenge. | ||
| And what we've seen in the past is that people will lose health care. | ||
| When that happens, it's not that people stop getting sick. | ||
| They're going to still be sick. | ||
| In general, people will show up in the ER in the emergency room sicker than they otherwise would have. | ||
| And those costs are passed from the federal government to the state government. | ||
| So, we are going to see state budgets that are challenged by this because of the increased costs that are now with the state for providing those health care services. | ||
| If you'd like to join our conversation with Dr. Richard Besser, President and CEO of the Robert Wood Johnson Foundation, you can. | ||
| The numbers are by party. | ||
| Democrats are on 202, 748, 8,000, Republicans 202, 748, 8001, and Independents 202, 748, 8,002. | ||
| Dr. Besser, I'll just put on the screen the 2026 proposed budget cuts for the health agencies. | ||
| So, the NIH, the National Institutes of Health, would be cut $18 billion, bringing it down to $27 billion. | ||
| The CDC would be cut by $3.6 billion, and the substance abuse and mental health services would be cut by $1 billion. | ||
| I wonder what your initial reaction is to the concept that this is waste that is being cut out of the system. | ||
| And do you think that there is waste that could be cut out of the public health system? | ||
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unidentified
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Governmental programs can always do better. | |
| And I think that whenever there's a new administration asking the questions of where there are opportunities to cut costs and maintain or improve services, but that's not what's been happening here. | ||
| We've been seeing indiscriminate cuts in the past. | ||
| There had always been widespread support for the National Institutes of Health. | ||
| The National Institutes of Health is so critical to looking for treatments and cures for diseases. | ||
| Diseases do not lay out by party lines. | ||
| And so it's an area where there has always been bipartisan support. | ||
| So to see these kinds of cuts will impact our ability to be the world's leader in developing new treatments, a new understanding of diseases. | ||
| Those $3 billion cuts to the Centers for Disease Control and Prevention will be devastating. | ||
| A lot of cuts to the injury center, which focuses on things like motor vehicle accidents and prevention. | ||
| It does work, not enough, or did work, but not enough, on gun violence prevention. |