And in addition to people being sick and thousands of people, we have had some deaths due to, you know, um, these, these recalls, uh, can you talk with us about what the situation is there and what it would look like to have a functional HHS during these times?

Yeah, I mean, you look at the departments under HHS, particularly the FDA, USDA, that might be under agriculture, but they are tasked with, like the whole of government is tasked with so many things in our daily lives.

One of them we should expect is that our food supplies are safe.

you know, that we don't have to think about it.

And I go back and forth because public health and the government related to public health should be out there communicating regularly with us about what they're doing and about, you know, kind of how they're keeping us safe.

But a lot of what they do should go sort of unnoticed.

You shouldn't have to think twice before you take a bite of a burrito with lettuce on it.

Why is it that this has not been as big of an issue? Because this is one of the things that really is impacting people's pocketbooks right now.

parents have the ultimate responsibility?

No, you're right in that way.

I love how you talk about this in sort of a gray area way, because it is very gray, right? There is no black and white.

I don't think you can look at this and say, this is all perfect and good and 100% of how we fix the problem, nor I would reject anyone who says, There is a chemical process that happens in the brain and social media.

The folks who design social media platforms know this.

Every ping, every like, every interaction, engagement triggers dopamine.

Dopamine is kind of that happy chemical in your brain.

Here it is.

What's going on?

Yeah, it is troubling.

I mean, my kids are all out of school, right? My last one's still in college, and so we didn't have to live through that.

And it's this, I mean, it's a constant back and forth and a struggle for, you know, allowing parents to make medical decisions for their kids and then kind of having school districts, and in this case, entire states, you know, try to ensure the safety and protection of all kids.

I think we've gone too far the other way, right? I...

it's tough because you're sending a big group of kids to a public school and if you are now you know allowing diseases to potentially pop up the kids who do have an immunocompromised state right uh are put at risk and so i just i think it's going to be this back and forth and i would urge the next administration coming in and the health department of that administration to really, really work to just increase vaccine rates, decrease the misinformation and disinformation.

So hopefully at least we can get parents to come to that decision on their own.

the these vaccine requirements um and and we don't need to linger on this but the vaccine requirements if you separate them that means five or six appointments a year yeah and who does that impact the most rural and poor families who cannot afford to take time off and who also simultaneously can't afford to get sick

Right

... listen, uh, there will be more people, you know, in the vaccine skeptic community that are gonna get pause and, and, and worry.

And yes, there are probably gonna be some decreased rates here and there.

But I, I, I feel like as doctors, we have now the opportunity again to push back against a would-be authoritarian, you know? And, and in many authoritarian movements in, in our na- in the history of the world, um, I, I'm writing about this right now, and, and if you look at, like, Pinochet's Chile back in the '80s, doctors, you know, jailed because they were, they were caring for dissidents, caring for enemies of the state.

Um, uh, we, we saw it in, in, in times across our history and, and, like, we're in, we're in a moment, we're in a moment where this administration wants to declare that they know best on everything, right?

Yeah.

And then, and then this stuff comes out, and Ron Johnson and Rand Paul and company, you know, try to use it as a weapon against a guy, again, an 85-year-old guy who, who was just trying to do the best job he possibly could in the most extreme conditions.

And I think did an amazing job.

Yeah.

And it made me think, listen, uh, there will be more people, you know, in the vaccine skeptic community that are gonna get pause and, and, and worry.

And yes, there are probably gonna be some decreased rates here and there, but I, I, I feel like as doctors, we have now the opportunity, again, to push back against a would-be authoritarian.

You know, in, in, in many authoritarian movements in, in our na- in the history of the world, um, I, I'm writing about this right now, and, and if you look at, like, Pinochet's Chile back in the '80s, doctors, you know, jailed because they were, they were caring for dissidents, caring for enemies of the state.

Um, uh, we, we saw it in, in, in times across our history and, and, like, we're in, we're in a moment, we're in a moment where this administration wants to declare that they know best on everything, right?

Yeah.

And then, and then this stuff comes out, and Ron Johnson and Rand Paul and company, you know, try to use it as a weapon against a guy, again, an 85-year-old guy who, who was just trying to do the best job he possibly could in the most extreme conditions and I think did an amazing job.

And he will att- attest, and we all will [laughs], never...

Right

... weren't vaccinated.

If you look at partisan leanings of people and, and deaths in COVID, they track with, uh, not getting vaccinated, and they track with increased mortality, right? Republican counties, Republican areas, higher mortality.

This is after.

Now, the, the healthcare system in the US is so screwed up that the deaths in the US early on were, were very significant, mostly in, in what now, you know, very blue areas, urban, uh, uh, areas, uh, places where people had to go and, and go to their jobs, you know, essential workers.

Um, a- and the healthcare system itself has failed people for generations, and COVID opened that, opened that sore up and let us all see it.

And then again, after vaccination, those excess deaths were happening in the Republican areas-

Yeah

The Republicans and people like Aaron Rodgers and the anti-vaxxers, they've just been running wild with lies about Dr. Fauci and COVID lately.

They have.

And if you look at the post-vaccination period of COVID, probably a quarter million excess deaths of people who didn't have to die because they weren't vaccinated.

If you look at partisan leanings of people and deaths in COVID, they track with not getting vaccinated and they track with increased mortality.

Right.

Republican counties, Republican areas, higher mortality.

This is after now the health care system in the U.S. is so screwed up that the deaths in the U.S. early on were very significant, mostly in in what now very blue areas, urban areas, places where people had to go and go to their jobs, you know, essential workers and the health care system itself has failed people for generations and COVID open that open that sore up and let us all see it.

300

Tell us, do you think that's like, and how do you talk about the damage that's been done to just the miracle that is public health vaccinations? Yeah.

Yeah.

And we try to have on Paging America experts from time to time.

We're going to have a public health expert this week.

Kind of part of that is talking about how do we rebuild that trust, right? At one point, people lined up to get the polio vaccine because it was like considered a godsend, right? This was a miracle to not have this debilitating disease.

And yeah, like you said, we have more measles cases this year, I think for the past 30 years, 35 years, something like that.

It's tough.

And it's

Is it?

Yeah, well, I mean, a lot of this probably stemmed from Elizabeth Warren questioning RFK Jr. in his Senate hearings about the cost of a drug, pantoprazole, and how it was $12 at Costco, and it was hundreds of dollars, and that's where we got into all the percents and 600% and all that.

And they teamed up with Mark Cuban, right, who has an online pharmacy that delivers discounted generic drugs.

I mean, as far as I can tell, I've gone on the site, like, yes, people can get their drugs cheaply, but, you know, TrumpRx basically gets agreements with manufacturers to get people to buy branded drugs, right, brand-name drugs that cost an astronomical amount of money.

And now what they've done is said, okay, well, we're going to link you to Mark Cuban's site.

So, I mean, it's essentially just a site trafficking platform that can route people into this place they could have gone all along.

So, again, it's it feels like and we've talked about on Paging America, the president's poster, Republican poster, Tony Fabrizio told them you guys are getting killed on health care.

How worried are you about the state of affairs when it comes to public health in this country right now?

... we're at right now with respect to the parasite and the disease.

Yeah.

I mean, uh, cyclosporiasis, right, caused by the parasite cyclospora.

Uh, and, and it, it's a disease that last year, last year was pretty indicative of, of previous years.

I think they had 50 or 60 cases in the state of Michigan.

We're over 4,000 now.

It's hard.

Like, how does, just on a personal level, like, how, how are you sitting with it?

Let's start off with the banks.

Man, man.

Yeah.

I mean, it's rough.

I mean, I think you said three states.

I think they now have likely cases in 34 different states.

They've now said in four of the states, including Michigan, traced it to lettuce, shredded lettuce at Taco Bell.

And then, you know, I've had people who are smart people saying, well, why would Donald Trump say that if there was something wrong with him? And so he just

that the cdc was supposed to be monitoring for and checking on and i and oops they got rid of that last year and so now we're not checking on it or we weren't checking on it as much as we should have been and now they really are and there are now thousands of cases around the country in like 30 states at this point but good to see you dr rob what do you think about all this

Yeah, good to see you, Jim.

I mean, it's tough, right? I mean, cyclospora, you know, the explosive diarrhea people are seeing in Michigan.

Last year, we saw 60 cases.

That's pretty typical.

I think we're up to 4,000 now in Michigan that have been identified.

And so it's truly incredible.

and i so basically that we were monitoring for this and they said oh you know we're just cutting we're cutting government waste and you know yeah why why do we need to look for parasites in in the food you know it'll just be fine

What do you think about all this?

Yeah.

Good to see you, Jim.

I mean, it's tough, right? I mean, Cyclospora, you know, the, the explosive diarrhea people are seeing.

In Michigan last year, we saw 60 cases.

That's pretty typical.

This, I think we're up to 4,000 now in, in Michigan that have been identified.

Mm

And he keeps saying this.

Yeah, it has nothing to do with intelligence or IQ.

It's cognitive function, right? It's basic things, naming animals, repeating numbers and words and drawing a clock.

I mean, people saw it, right? People can find it anywhere they want.

Nothing to do with intelligence.

You know the news, right? You know how reporting works.

I know medicine.

And you just as you and I were talking about this the other day, how is this not a bigger story that the president of the United States keeps taking cognitive tests? That seems to be that should really raise alarm bells, it seems to me.

Yeah.

But Trump seemed to say, like, he passed another one or he aced another one, as if just taking it over and over and over is, is continuing to prove how, how smart he is.

And, and he keeps lying about what it is, and it still goes back to that same question of why are they administering a cognitive test to an individual unless there are concerns about his cognitive function? And then why are they administering more than one cognitive test unless there were concerns with the first one or the second one? Like, I...

It's hard to know.

I mean, we know his former doctor, uh, you know, uh, r- uh, was it, uh, Jackson, Robbie Jackson, the Texas congressman?

Yeah

...

so Republicans have been very good at messaging over the years, right? They've not, in my opinion, not so good at the, the, the, the legislating part, and particularly policies when it comes to healthcare, but the messaging of freedom, right? And of, of, of, of individual responsibility and, and, and security and all those words.

Yeah.

It's an annual exam, but it's happening more than annually, so that's a little strange.

Un- unless you have a medical condition they're monitoring, you know, it, it shouldn't be just routine exams every six months or so.

And the, the whole cognitive test piece, I still just can't understand exactly where they are.

'Cause it's unclear from the report if they did another cognitive test.

They basically said in the report they were reporting on, you know, everything over the last year or, or some, or some period of time, not just that exam.

Yeah.

But Trump seemed to say, like, he passed another one or he aced another one, as if just taking it over and over and over is, is continuing to prove how, how smart he is.

Is it?

Yeah, well, I mean, a lot of this probably stemmed from Elizabeth Warren questioning RFK Jr. in his Senate hearings about the cost of a drug, pantoprazole, and how it was $12 at Costco, and it was hundreds of dollars, and that's where we got into all the percents and 600% and all that.

And they teamed up with Mark Cuban, right, who has an online pharmacy that delivers discounted generic drugs.

I mean, as far as I can tell, I've gone on the site, like, yes, people can get their drugs cheaply, but, you know, TrumpRx basically gets agreements with manufacturers to get people to buy branded drugs, right, brand-name drugs that cost an astronomical amount of money.

And now what they've done is said, okay, well, we're going to link you to Mark Cuban's site.

So I mean, it's essentially just a site trafficking platform that can route people into this place they could have gone all along.

So again, it feels like – and we've talked about on Paging America, the president's pollster, Republican pollster, Tony Fabrizio, told them you guys are getting killed on health care.

How worried are you about the state of affairs when it comes to public health in this country right now?

All right.

F, B, A, C, M, N, A, A, J, K, L, B, A, F, A, K, D, E, A, A, A, J, A, M, O, F, A, A, B.

All right, good.

Yeah

... on Substack as well.

You know, certainly every week on Thursdays, Paging America podcast comes out with myself and our chief of staff at the Committee to Protect Healthcare, Miles Baker, kinda coming at it from the political side, and we're exploring the, the, the politics, uh, of healthcare and how we build power for patients.

But then, yeah, we wanna, uh, you know, also bring to individuals, uh, who are listening and watching, uh, reliable information.

You know, kind of dismantling the, the, the disinformation that is out there when it comes to vaccines and, and abortion pills.

Very good

...

this MoCA is how people refer to it.

It's probably the most common cognitive test that physicians, uh, or other providers administer to patients when there's a concern about their cognition.

You know?

All right

... people can search this out online.

You can find them everywhere, uh, particularly nowadays.

Can you speak to this?

Yeah.

I mean, it, it certainly speaks to what a lot of us have been thinking, right? It's been a pretty rocky road for her since the confirmation hearings in February, and it seemed that Susan Collins and Lisa Murkowski were not quite on board.

And then, you know, Cassidy has been speaking out, and, and I know Trump really went after Cassidy when he posted about this, kind of basically blaming him.

It's a good thing that Casey Means won't be surgeon general, right? She's not a, not a actively licensed physician, has some very kooky views on, on, you know, kinda, kinda coming from that MAHA movement, and really shouldn't be someone representing, you know, the public health infrastructure as America's top doc, so to speak.

Uh- So, and you asked about the new nominee, uh, Dr. Nicole Safier.

Listen, I mean, when [laughs] we have Donald Trump president, when we have a Republican Senate, we're going to get somebody that, you know, maybe you, uh, maybe me, uh, we won't exactly agree with everything that they bring to the table.

... and HHS.

I think it was both- maybe might've been both, but, uh-

Couple vaccines.

It showed in healthy adults a 50% reduction in hosp- in ER visits and hospitalizations.

And, uh, it was, it was due to be published in the, uh, MMWR, Morbidity and Mortality Weekly Reports.

It's like the weekly publication of the CDC that doctors and health departments all look at to see, like, what's the lay of the land.

And this is a non-controversial study.

It's the same techniques, the same types of data they've used for vaccines all along, respiratory virus, uh, vaccines in particular, flu, now COVID.

I want undocumented people to have health insurance so if, uh, you know, so I don't have to pay for them if they go to the ER.

And that this may come back to haunt us, that the, the, the seeds that are being laid now could be 10, 15 years from now, could really boomerang and hit us in the face badly.

Yeah, I mean, the reason he's in charge, and we talk about it on our podcast, on Paging America, it has nothing to do with health or his views on health.

It...

Some components of the MAGA movement do have to do with people wanting to seek healthier options for food or, or, or additives or what have you.

But MAGA, uh, for RFK Jr. and for Trump, is about coalition building, right? It's about a political movement, uh, being pulled into m- uh, MAGA to allow Donald Trump to win the presidency, and the reward for that is RFK Jr.

getting to do...

And he said it, "No other president would let me do some of the things that I've been doing" [chuckles].

You know, sure, fewer additives, healthier foods, why not?

And, and, and with something that's totally preventable because of-

Totally preventable.

Uh, I mean and, and Senator Cassidy, Dr.

Senator Cassidy is a gastroenterologist.

He said it.

He treated people with liver disease from hepatitis, chronic Hepatitis B infection.

And we went from in the, in the tens of thousands of cases of, of kids with, uh, hep B, uh, you know, to dozens, dozens of cases by vaccination.

Yeah.

Yeah.

He, he is the ultimate purveyor of conspiracy theories now.

And, and I mean, we saw it all during COVID, with the vaccine, with treatments.

Anytime you'd want to put a swab in someone's nose, you know, literally half the time you'd get questions.

"Well, is there COVID on that swab? Because I read that there was." Well, I think when Donald Trump has his big megaphone and this stuff gets shared everywhere, I haven't worked a shift since this happened, but I'm anticipating, uh, you know, wanting to give a kid some Tylenol for fever, and the last thing Donald Trump said in his press conference was, "Don't let them give it to your kids.

Don't give it to your kids." It's, it had nothing to do with what they, even with the BS that they were talking about throughout the conference, about it's-

Yeah.

...

Can you, can you break down what this decision actually means for patients, especially immunocompromised and high-risk Americans?

Yeah, I mean, supposedly, right, it's now been authorized for people over 65, people with at least one preexisting condition.

But it, it's gonna be more difficult to get for everybody.

Certainly for folks like me who, who don't have a preexisting condition, who aren't over 65.

Um, you know, it's gonna be really difficult unless your doctor will be willing to prescribe it off the label, and, and doctors do that.

But you're never gonna walk into your local pharmacy and get it that way.

And many health systems aren't gonna allow folks to get it.

Yeah.