| Speaker | Time | Text |
|---|---|---|
|
unidentified
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Auditorium. | |
| blame the light there. | ||
| This evening, Democratic Representative Latifah Simon hosts a town hall for constituents in Emeryville, California. | ||
| Some of the topics are likely to include the Republicans' tax and spending cuts bill, which recently passed in the House, and potential cuts to Social Security, Medicaid, and veterans' health care and services. | ||
| Watch the town hall live at 9 p.m. Eastern on C-SPAN. | ||
| C-SPAN now, our free mobile video app, or 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. | ||
|
unidentified
|
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. | ||
|
unidentified
|
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? | ||
|
unidentified
|
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 health care 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? | ||
|
unidentified
|
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, they're 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? | ||
|
unidentified
|
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? | ||
|
unidentified
|
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. | ||
| 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 202-748-8000. | ||
| 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 agency. | ||
| 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? | ||
|
unidentified
|
Governmental programs can always do better. | |
| And I think that whenever there's a new administration asking the questions of where are there 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. | ||
| As I said, I'm a pediatrician, and it's absolutely unbelievable that in America, the leading cause of death in children is now gun violence. | ||
| That's something where the government could do a lot to try and look at what things work in preventing gun violence in children and saving those lives and what things don't work. | ||
| But eliminating that opportunity will cost lives. | ||
| The National Institute on Occupational Safety and Health, NIOSH, that's part of CDC that is focused on ensuring that workers across America are safe and that workplace injuries are reduced. | ||
| Their budget has been slashed dramatically. | ||
| What does that say about how we value people who are hardworking in America and wanting to make sure that workplaces are safe? | ||
| These things are really concerning to me. | ||
| And at the Food and Drug Administration, the cuts are already concerning to me in terms of the FDA's ability to keep our food supply safe and keep the public safe from problems in what we purchase in the marketplace. | ||
| Well, I want to play you a portion of a hearing earlier this month. | ||
| This is Senator Lisa Blunt Rochester of Delaware asking HHS Secretary Robert F. Kennedy Jr. about who the current head of the CDC is. | ||
| Take a look. | ||
| In March, I wrote to you expressing my concern about the delayed meeting of the federal vaccine experts, otherwise known as ACIP. | ||
| The meeting of this committee is a key step in getting vaccines to millions of people from babies to seniors, and delays can have negative impacts on vaccine accessibility and affordability. | ||
| And while I'm glad that the meeting finally happened, we're quickly approaching flu season and the CDC still hasn't adopted the April recommendations. | ||
| And I can understand the delay given that there seems to be no current CDC director. | ||
| So in the spirit of radical transparency, my question is: who is the acting CDC director? | ||
| The acting director was Susan Menares, but she is now up for permanent director. | ||
| And so she's been replaced by Matt Basoli. | ||
| Does this person have a medical background? | ||
| I believe. | ||
| Or public health expertise. | ||
| He's a public health expert. | ||
| public health expert. | ||
| So the fact that the recommendations are kind of stuck is, and the fact that you kind of have... | ||
| Can I clarify something? | ||
| ASIP does not do the flu shot. | ||
| Yeah, I don't want to get away from that. | ||
| And those. | ||
| My question was more about do we have a CDC director? | ||
| And then I want to enter into the record information about what harms could be caused until we get one. | ||
| Dr. Besser, what do you make of that exchange? | ||
|
unidentified
|
Well, there's a lot to unpack there. | |
| I think it is critically important to have someone in the role of acting CDC director who understands public health. | ||
| I served in that role for the first five months of the Obama administration. | ||
| And I was put in that role because I had for four years been running emergency preparedness and response at CDC. | ||
| And they wanted someone in that role who knew how to respond if there was a public health crisis. | ||
| And at that time, there was. | ||
| The 2009 swine flu pandemic occurred. | ||
| I have great concerns about the lack of strong leadership at the CDC at this time. | ||
| You saw this week when Secretary Kennedy announced a change to COVID vaccination recommendations that with the head of the FDA and the head of the NIH, there was no one there from the CDC. | ||
| There was no mention of the CDC. | ||
| And normally, vaccination recommendations would come from CDC based on the advice of an expert advisory committee. | ||
| It's the Advisory Committee on Immunization Practices or ACIP, as was mentioned. | ||
| By bypassing that body, we are missing a lot. | ||
| As a pediatrician, I always paid very close attention to the discussions and debates that took place on that committee. | ||
| That's the appropriate place to ask questions about who should be getting a particular vaccine, what are the benefits, what are the harms, what are the costs, what will happen if the vaccine is not available to children or adults this season. | ||
| Those are questions that the committee wrestles with. | ||
| And as a pediatrician, I always had great confidence then that the recommendation that came out of there was the best available recommendation. | ||
| That's not the case for what's happening right now. | ||
| The recommendation that came from Secretary Kennedy had no transparency, no information in terms of what was driving the decision to no longer recommend the COVID vaccine for pregnant women or healthy children. | ||
| And so as a physician, I'm left wondering: well, what's behind this? | ||
| Is it simply because this secretary is one of the nation's leading anti-vaccine proponents? | ||
| Or is there information that hasn't been shared that makes this a rational decision? | ||
| That's very concerning to me. | ||
| All right, let's talk to callers. | ||
| First off is Chuck in Charleston, West Virginia, Democrat. | ||
|
unidentified
|
Yes, good morning, Mimi, and good morning, Dr. Besser. | |
| I really admire the work that you've done. | ||
| Thank you for your service. | ||
| A few years ago, I retired after about, well, over 28 years working as an HIV prevention specialist for the West Virginia Bureau for Public Health. | ||
| So Dr. Anthony Fauci is kind of a hero of mine. | ||
| But the times in which we live right now, kind of depressing considering all the disinformation that's out there. | ||
| We have a health secretary, RFK Jr., who doesn't believe that HIV causes AIDS. | ||
| We have all kinds of misinformation going around, like people are still promoting ivermectin as a miracle cure for COVID. | ||
| And I keep on telling them, well, ibermectin is a very important medicine when it comes to treating certain parasitic infections, but it's not an antiviral drug. | ||
| And people say, well, I saw it online, so you know it's got to be true. | ||
| And in the age of social media, I don't, you know, it's, I mean, do you think, I guess my question to you is, are you optimistic that maybe we can restore the public's faith in public health professionals like you and Dr. Anthony Fauci, especially in the age of social media? | ||
| All right, Chuck, we'll take that up. | ||
|
unidentified
|
Chuck, thank you. | |
| Thank you for your question and thank you for your service. | ||
| You know, before I hit an answer to your question, I just want to reflect that I am very concerned that the cuts to CDC will impact communities like yours. | ||
| The vast majority of money that is sent to CDC is passed through to state and local health departments and it funds public health workers like yourself who are doing the frontline work that keeps people safe. | ||
| And by making these dramatic cuts to CDC, we are going to see fewer people in communities who are able to do things like prevent HIV, prevent tuberculosis, make sure that our swimming pools and restaurants are safe. | ||
| And that is greatly concerning. | ||
| You know, your question about trust is such an important one. | ||
| During the COVID pandemic, for the first time in my lifetime, we saw an intentional attempt by a president to demonize public health, make public health the enemy, rather than to support public health in its work to try and ensure that people across the country were safe, were healthy, were protected. | ||
| And we're seeing the consequences of that. | ||
| We're seeing a situation where how people view public health varies by political affiliation. | ||
| When I worked at the CDC, I spent a lot of time on Capitol Hill talking to representatives from both parties about the importance of our nation being safe and protected from both naturally occurring emergencies as well as intentional ones from terrorism. | ||
| And there was uniform support from both parties to ensuring that our country was safe and ready and prepared. | ||
| Now that's no longer certain, and we're seeing public health lifted up as the enemy rather than public health workers lifted up as our neighbors, our friends, our family members who are working to keep our country safe and healthy. | ||
| Let's talk to Deborah, who is in Westchester, Ohio, Republican. | ||
| Good morning, Deborah. | ||
| You're on with Dr. Richard Busser. | ||
|
unidentified
|
Good morning, and thank you for taking my call. | |
| This is a question that I have asked the C-SPAN guest numerous times in the past, and it has to do with the food program that we have for children and also for families. | ||
| I happen to be in a family situation where we owned a daycare, and I participated and ran the CACFP program for 12 years. | ||
|
unidentified
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And as you know, that program feeds our children nutritious foods. | |
| But the most important thing is it develops a healthy palate for our children. | ||
| They don't get cookies, cakes, and ice cream or any of that counting toward the nutritional requirements or the reimbursement by the government. | ||
|
unidentified
|
It's a well-run program. | |
| But at the beginning of the Obama administration, they took all of the requirements off and allowed cakes, cookies, candies, everything. | ||
| Any food was acceptable. | ||
| Now we have an epidemic of obesity in the United States. | ||
| I was appalled. | ||
| And I can't believe that you, as a doctor, wouldn't be jumping up and down and be against adding all of that back. | ||
| Now we have $300 billion we spend every year on diabetes. | ||
|
unidentified
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We have pre-diabetic children. | |
| And at the daycares, I'm just, you know, we worked so hard to encourage our children to eat fruits and vegetables, and they loved them. | ||
|
unidentified
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When they were prepared without all the sugar and everything else, we introduced all those good foods for our children. | |
| Why aren't we taking, I would think that right now we should all be wanting to take sugary soft drinks, cakes, and all of that off of SNAP because we never had it until the beginning of the Obama administration. | ||
| All right, Deborah, let's get an answer. | ||
|
unidentified
|
Deborah, thank you for your question and raising an important issue. | |
| It is so important that everyone in our country has access to healthy food, fresh fruits and vegetables. | ||
| One of the things that is in this bill that's moving through Congress is a dramatic cut to food assistance for lower-income people in our country. | ||
| And that raises big concerns to me in terms of people's ability to get healthy food. | ||
| One of the things that I wonder whether there's the opportunity for people to work across parties on is our school lunch program. | ||
| Our school lunch program provides the majority of calories for millions and millions of children in our country. | ||
| And if we really took on that program and tried to shape it along the lines you're talking, where children were being given access to fresh fruits and vegetables, to real food, not to ultra-processed food, we would see a change in the health and the nutrition of children in our country. | ||
| During COVID, for the first time in my recollection, the government removed the requirements for access to the school lunch program so that all children were given access to school lunches. | ||
| If we funded that program at a proper level, if we provided through the Department of Education resources so that schools had real kitchens and could prepare food instead of just having to open food that was already prepared and was so processed, we would see an improvement in children's health. | ||
| And so, you know, this is an area where maybe there's an opportunity to work together. | ||
| It will cost money. | ||
| And at a time where the administration is looking to cut the budget in order to fund these crazy tax breaks, I don't know if that's possible, but we do have a secretary who talks about the importance of getting ultra-processed foods out of diets. | ||
| The school lunch program would be a great place to look to see could we get that done. | ||
| And do you also welcome the initiative to get food dyes out of the food system? | ||
|
unidentified
|
Well, I think that from my perspective, the more people can eat fresh, real food, the better. | |
| And fresh, real food should not have food dyes in it. | ||
| Any dye that Is being put into a food should have to go through proper testing. | ||
| And there are lots of loopholes that allow food dyes to get through programs that really should no longer exist. | ||
| So I am all for providing the opportunity for people to eat real food. | ||
| But I can tell you that the best way to give people the opportunity to buy real food is to ensure that people have the income to do so. | ||
| In America today, buying fresh fruits and vegetables is a lot more expensive than buying processed food that isn't as good for you. | ||
| That would take raising the minimum wage, ensuring that people have what they need to be able to provide that food. | ||
| The reason that so many people are eating fast food in America is that it's one of the cheapest ways to feed a family, and that shouldn't be the case. | ||
| Let's go to Jamestown, North Carolina, line for Democrats. | ||
|
unidentified
|
Gil, you're on. | |
| Good morning. | ||
| It's a privilege to speak with you, Dr. Besser. | ||
| I believe that you were also the director of the CDC, is that correct? | ||
| I was the acting director for about five months in 2009. | ||
| And particularly your service as a pediatrician. | ||
| I wanted to make a couple of quick points. | ||
| Just recently, there was a study published in Nature regarding pancreatic cancer and mRNA vaccines. | ||
| And it was a very small study. | ||
| But as you know, with pancreatic cancer, the standard treatment has been surgery, chemotherapy, and radiation. | ||
| The survivorship is only 13% after five years. | ||
| But in this study, the end was small, but all of the individuals are surviving past four years. | ||
| Secretary RFK Jr., I believe, has no idea or no appreciation for mRNA research. | ||
| And it was published in Nature, and RFK Jr. wants to have studies published out of some journal of the CDC. | ||
| I mean, this boggles my mind. | ||
| And regarding the comment by George Satyana, I believe if we don't learn from the past, we're doomed to make the mistakes of the future. | ||
| My last point, which I wanted to present, is regarding mRNA vaccines, particularly with the bird flu, H5N1, where it's now going to, the Trump administration and RFK Jr. are not, have rescinded funding for the vaccines against H5N1. | ||
| And if this emerges, and if we see a pandemic with H5N1, it's going to make COVID seem like a drop in the ocean. | ||
| It's going to be catastrophic. | ||
| And I just don't understand this essentially ignorance about mRNA vaccines. | ||
| And just lastly, this is just my opinion. | ||
| I think that this is the present administration's vendetta against Dr. Fauci, as a previous caller mentioned, and a vendetta against Moderna. | ||
| Why there is this animus against this research that's going to help millions of people just boggles my mind. | ||
| All right, Gil. | ||
| Go ahead, Dr. Besser. | ||
|
unidentified
|
Well, Gil, thanks for your question. | |
| There's a lot there that we could talk about. | ||
| The first point I want to make is that One of the biggest and most important accomplishments of the first Trump administration was its commitment to the rapid development of vaccines against COVID. | ||
| It was miraculous that within a year of a new virus being on the scene that was causing devastated illness, we had multiple safe and highly effective vaccines against COVID. | ||
| The reason that was possible was decades of investment in the NIH to develop the mRNA technology. | ||
| That allowed for these vaccines to be developed so incredibly quickly. | ||
| Your point about flu is a really good one. | ||
| There has been the hope that mRNA technology could be used to develop safe and effective flu vaccines and potentially flu vaccines that cover more than one strain. | ||
| One of the things that we would love to see is what's called a universal flu vaccine, one that would last for not just one season, but protect you in the way that a measles vaccine does, potentially for life. | ||
| And mRNA technology is one of the ways to go at that. | ||
| I am greatly concerned when you have such a strong anti-vaccine advocate as Secretary of Health, what that would mean for our ability to be ready should this bird flu strain morph into a pandemic strain. | ||
| I led emergency preparedness and response at CDC for four years during the Bush administration. | ||
| And that was a period where there was also concerns about strains of flu that were circulating in birds. | ||
| And Mike Levitt, who is the Secretary of Health, charged us at CDC and across government with developing national plans for bird flu pandemic response. | ||
| And he sent a leader to every single state to hold a flu summit. | ||
| I went to Mississippi and Alaska. | ||
| Other people went to other states. | ||
| But the goal was for the whole nation to be ready for a pandemic. | ||
| We're not seeing those kinds of efforts right now as there's concern about a bird flu strain that's circulating. | ||
| It's more of a head-in-the-sand approach. | ||
| And that will not be, that will not serve us well when the next pandemic comes. | ||
| There's no telling whether this will be that strain, but it is telling that there will be future pandemics that face our country. | ||
| Dr. Busser, I'm not sure if you're aware of this, but this is in Politico yesterday. | ||
| It says, RFK Jr. threatens to bar government scientists from publishing in leading medical journals. | ||
| It says that the health secretary says that the New England Journal of Medicine, the Journal of the American Medical Association, and the Lancet are in bed with pharma. | ||
| What do you think of that? | ||
|
unidentified
|
Well, I think it's another attempt to control information, to prevent people from seeing good science. | |
| You know, I've published in the New England Journal and in JAMA, and they are some of the, and Lancet I haven't published in, but these are some of the most respected journals that are out there. | ||
| They're doing a better job at disclosure so that you can see where funding has come for different researchers. | ||
| That's really important. | ||
| It's important to know who funds the studies that you're reading and reviewing. | ||
| That can help in your interpretation. | ||
| But to say that an anti-science Secretary of Health will do a better job at providing unbiased information is really ludicrous. | ||
| Here's Denise, an independent in North Branford, Connecticut. | ||
| Good morning. | ||
|
unidentified
|
Good morning. | |
| I would like to know if glyphosate on the immune system. | ||
| Did you hear that, Dr. Besser? | ||
|
unidentified
|
Yeah, I think your question is an important one. | |
| It's so important that any chemicals that are used in the environment are safe. | ||
| And your question about glyphosate I'm going to mispronounce it. | ||
| Your question is an important one. |