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Transcript
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SPEAKER 1
Hey guys, it's me, Sam Stein, Managing Editor at The Bulwark, and I'm joined by Jonathan Cohn, who is now a member of the FAM, officially, since he put out his first newsletter. The Breakdown came out on Sunday. If you haven't seen it, you should subscribe. The piece is great. I encourage people to read it.
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It's titled, When Make America Healthy Again Actually Means the Opposite. And you and I were talking about, through the course of the week, about why we wanted to do this piece, but I thought you captured the essence of it, which is the opioid epidemic, which fueled so much of Trump's rise.
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It was such a huge focus for him and to a degree, a success of his first administration. What we've seen so far in the first two months is scaling back of our investments in fighting it. Can you talk a little bit about both the micro elements here, what we're doing that's scaling back,

Explore the Trump administration’s controversial changes at Health and Human Services (HHS), including major job cuts, the reorganization under Robert F. Kennedy Jr., and their impacts on public health, opioid crisis response, and vaccine policy.

When ‘Make America Healthy Again’ Actually Means the Opposite https://www.thebulwark.com/p/when-make-america-healthy-again-actually-means-opposite-rfk-trump-opioid-overdose-hhs-samhsa-painful

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Discussion about this video

Reddit has this list of all the divisions and branches of CDC that are being eliminated: https://www.reddit.com/r/fednews/comments/1jorwjs/rif_notice_received_this_morning_by_cdc_comrade/

The cuts to NCIPC could directly affect me, since my research mostly falls in the area of injury prevention. Note that the Freedom of Information Act Office is one of those being cut - another attempt to avoid accountability.

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The GOP have been working to this day since Reagan, to make government small enough to drown in a bathtub so that it can't regulate the wealthy, who are viewed as god's elect, for those religious, or more industrious, for those secular. They want health care to be run by for-profit death panels because it means more profits for their donors. Big Pharma will research only those areas that provide larger potential profits. It is that simple.

Blue states will do better than Red, as we do now, and the US as a whole will lose intelligent people because they will not risk being in a country run by the Taliban and oligarchs. They have other choices.

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Everybody who has worked for the federal government for any length of time has heard “We’re going to do more with less” (or some variation of that, such as “work smarter, not harder”) at some point. I’ve never seen that work, however. With less, you get less.

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Such an informative discussion...thank you! I'd not considered the silence from Big Pharma to what RFKJR is doing with all the cuts to NIH and vaccine sabotage. It's devastating that such a powerful lobby would remain so silent...

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Feels like they could use this approach for all kinds of abuses: they remove fingernails, hang and quarter a pedophile, convicted pedophile. No mistake there - they did it to a real pedophile

People say, isn't that a cruel and unusual punishment, isn't that torture, isn't that against treaties America signed and the constitution and X number of other laws?

They could just reply "it is DISGUSTING TO ME that you defend a known pedophile! Why do you defend child abusers?"

Why not?

Can't they break every law they want now as long as they do it against "bad people" and then bludgeon any critics with how bad the people are they're mistreating?

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We just need to keep pointing to their mistakes - in their haste, they are hanging people who turn out to have been falsely accused. If they skip due process, such mistakes are inevitable.

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HHS RIFs rolled out overnight, people are showing up to work this morning and being turned away at security when their badges don't work. Best info currently on r/deptHHS for details, some scientists and statisticians are saying they were RIFfed.

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Can Sam, Tim and JVL, Sarah, Bill and the rest of you please stop prefacing every comment on DOGE with "we all want government to be efficient" or any other such blather? PLEASE. By doing so with such frequency you validate the existence and work of DOGE, and support the premise that aggressive, blunt-knifed cuts were required.

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Johnathan Cohn is very impressive. I'm really looking forward to his insights.

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I worked on an opioid grant a couple of years ago. The national team (project officers and science officers) were extremely helpful in pulling together resources and connecting us to other states and locals who were having success or working on similar projects in their own jurisdictions. CDC supports states and locals in collaborative partnerships and ensures that innovative successful programs are shared so that others can adopt them. Many of the newer approaches try newer drugs to provide longer lasting medications so that people can make it to their appointment without relapsing. These programs cost money and without them people will die.

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RFK is a person who attributes his academic success to his use of heroin. Heroin. And he's supposed to manage substance abuse programs, including those regarding opiate use? The worm in his brain is doing his thinking for him.

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He says the brainworm died - I think it died of starvation.

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A PSA: I went to the pharmacy today and got an MMR booster on the advice of my doctor. I’m in my mid-50s and a blood test titer indicated that two of the three (measles, mumps, rubella) was so low that I would NOT be immune. IFF our government was still normal and IFF our Dept of HHS was not being overseen by a dipshit that thinks castor oil and pixie dust will keep you safe from measles, I bet they’d be encouraging old people like me to check out their resistance levels, but…

If you’re a legit doctor, I’d love to hear your viewpoint, because I’ve only been a doctor on stage…no ACTUAL qualifications…like everyone in TrumpWorld.

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Will we be studying this (reduction in opioid deaths) ten years from now? Who will do the studying? Who will be left? Why do people keep acting like this is normal and/or that everything will go back to normal? The people who are in power now do not want to study this. They do not want data. They do not want information. They do not want facts. Especially if the average jane and joe can learn about it.

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Over the past decade, my institute has earned a lot of money doing opioid research. Some of our funding has come from lawyers who are suing opioid makers on behalf of state and local governments. Some funding has come directly from state and local governments. I'm sure funding will continue to be available as long as the opioid crisis continues.

But the data we use for this research come mostly from federal sources. Even a lot of state-level data get filtered through NCHS or AHRQ, which standardize and harmonize the state data before releasing it to researchers. I remember the old days, when I received data directly from state governments, and I had to expend a lot of effort ironing out the state idiosyncrasies.

If we are fortunate, the states will form consortiums to replace some of the work being dropped by the federal government. That, of course, would require higher state taxes, so it is not a certainty.

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From what I understand, vaccines are very low margin products for these pharma companies. Simple profit motive could be keeping them quiet. If RFK Jr. makes their vaccines invalid, and to get re-certified is laborious it will let them renegotiate for higher margins.

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Low margin (most of them) or high margin, it doesn’t really matter when you only get one dose per year, per decade or per life. They’re not anywhere near as profitable as daily Ozempic. Vaccine production has been heavily subsidized for a long time. In fact, at one point vaccine production was financially subsidized by some of the states.

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I like having someone on the healthcare beat. I have the uneasy feeling it’s going to become more and more critical during this dystopian assault on our futures.

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Why do we keep asking that question when we all know the answer?

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