Bloomberg Businessweek: “CDC’s Total Overhaul Takes Shape”

Aired: September 15, 2025 | Hosts: Carol Massar, Tim Stenovec
Guests:

• Dr. Richard E. Besser, President/CEO of Robert Wood Johnson Foundation, former Acting Director of CDC
• Jessica Nix, Bloomberg News Health Reporter

Episode Overview

This episode probes the seismic changes underway at the Centers for Disease Control and Prevention (CDC) after new leadership at the Department of Health and Human Services (HHS)—notably under RFK Jr.—sparked widespread restructuring. Bloomberg’s Carol Massar and Tim Stenovec are joined by reporter Jessica Nix and former acting CDC director Dr. Richard Besser to unpack the causes and consequences of the CDC’s overhaul, the state of US public health, the political dynamics fueling division and distrust, and what the changes mean for future crises.

Key Discussion Points & Insights

1. The State of American Health & Healthcare System

• Dr. Richard Besser (03:13):
  • Calls the American health diagnosis “the right diagnosis”—the public is unhealthy, and the system is not functioning.
  • Points out access to healthcare is tied to employment, resulting in “millions of people...who don’t have access to high quality, comprehensive, affordable health care.”
  • Notes recent legislation is expected to cause “tens of millions of people” to lose healthcare.
  • Argues income/poverty and social factors are greater drivers of health than health care itself.

“We are seeing that in America the rates of chronic disease are extremely high, and we need to do more to address that. So I think that there probably is a lot of agreement around what the problem is. There is less agreement in terms of what the drivers of that are or what the solution should be.”
— Dr. Richard Besser (04:26)

2. The Overhaul of the CDC: Layoffs, Dismantled Divisions, and Loss of Expertise

• Jessica Nix (05:17):
  • Describes “a complete dismantle at the CDC” since RFK Jr. took over HHS.
  • Notes mass layoffs in divisions studying chronic disease, gun violence, injury prevention.
  • Mentions the disbanding of the vaccine advisory committee—the Advisory Committee on Immunization Practices (ACIP)—with members handpicked by RFK Jr.
  • Details recent chaos, including a shooting at CDC headquarters and the firing of a newly appointed CDC director over vaccine policy.

"So there’s so much confusion and chaos at the CDC that the actual work is not as able to get done because everyone’s gone."
— Jessica Nix (06:12)

3. What’s Being Lost — US and Global Impact

• Dr. Besser (06:56):
  • Calls current moves “the destruction of the world’s leading public health agency.”
  • CDC historically looked to as “a beacon for public health around the world”—not anymore.
  • Criticizes the firing of thousands of federal health workers, elimination of the Office on Smoking and Health (smoking = top cause of preventable chronic disease).
  • Compares to earlier reform attempts: “At the start of the Obama administration, there were efforts to look across the agency, where was it lacking, where could it do better.”
  • Notes that before COVID, CDC had strong bipartisan trust, but the pandemic heralded politicization, job losses, and public distrust.

"What we’re seeing here is the destruction of the world’s leading public health agency.... The CDC doesn’t just provide public health expertise for the United States. It had been looked at as a beacon for public health around the world. That’s no longer the case."
— Dr. Richard Besser (07:14)

4. Dismantling Vaccine Policy and Public Trust

• Key Developments:
  • Advisory Committee on Immunization Practices (ACIP) taken over and “dismantled” by new appointees.
  • CDC director fired weeks into her tenure for disagreements over vaccine policy.
  • Concerns vaccine policy is now piecemeal—states creating their own protocols for distribution, reimbursement, recommendations.

“The idea that we can’t look to the CDC because this advisory group has become so politicized, so staffed with people who have strong anti-vaccine agendas will put us at great risk.... This will lead people to be confused and it will lead some people to make a decision that I think is not good for the health of their families.”
— Dr. Richard Besser (14:01)

5. CDC Cuts: Consequences for Local Public Health

• Dr. Besser (11:13):
  • Cites real examples: health departments in Texas and Milwaukee calling CDC for help with crises (“lead in their water”) and finding there’s “no one there.”
  • Warns about “public health being invisible when it’s working properly”—damages only clear when failures and crises emerge.

“When there’s a crisis in a community and public health can’t respond, then you will see it. And then, hopefully, people in their communities will say, this doesn’t work for us.”
— Dr. Richard Besser (11:48)

6. Partisanship, Communication Failures, and Trust

• Why the Division? (12:04-13:25)
  • Trust in CDC was strong before COVID, including through H1N1, when both parties avoided politicizing the response.
  • COVID response was politicized; public health officials were silenced, guidance changes interpreted as incompetence.
  • Once trust is lost, “it’s extremely hard to get it back.”

“You need active communication to build trust and maintain trust. And once you’ve lost trust, it’s extremely hard to get it back.”
— Dr. Richard Besser (13:17)

7. The Future of Public Health & Fragmentation

• Jessica Nix (15:42):

  • Predicts “a state by state approach to public health,” especially regarding vaccine policy.
  • CDC can no longer provide the “nationwide view,” leading to disparities in access, recommendations, and insurance coverage.

• Insurance Uncertainty (16:17):

  • Without CDC endorsement, insurers face ambiguity: will they cover vaccines recommended on the state level, or not at all?

“As of this year, insurance companies are still going to cover vaccines, but health experts have been telling us and in our reporting that the cost of a vaccine is probably less than the cost of the illness that you’re going to get later on and then your hospital bill and everything else.”
— Jessica Nix (16:32)

Notable Quotes & Memorable Moments

• “The big question is what are the drivers of [America’s ill health]? … Some of the biggest drivers of health have to do with income and whether someone has the income to be able to afford healthy, nutritious food, [and] the leisure time to be able to get physical activity.”
  — Dr. Besser (03:36)

• “There’s so much confusion and chaos at the CDC that the actual work is not as able to get done because everyone’s gone.”
  — Jessica Nix (06:12)

• “We need to rebuild trust. We have as our Secretary of Health one of the nation’s leading anti-vaccine advocates, and someone who has demonstrated no respect for the Centers for Disease Control and Prevention.”
  — Dr. Besser (08:56)

• “The CDC doesn’t just provide public health expertise for the United States. It had been looked at as a beacon for public health around the world. That’s no longer the case.”
  — Dr. Besser (07:14)

• “It’s only when [public health is] not working properly and then gets stressed. So whenever there’s a crisis in a community and public health can’t respond, then you will see it.”
  — Dr. Besser (11:42)

• “The idea that we can’t look to the CDC because this advisory group has become so politicized...will put us at great risk.”
  — Dr. Besser (14:01)

Timestamp Guide to Key Segments

• 03:13–04:49: Dr. Besser lays out the fundamental health challenges in the US
• 05:17–06:23: Jessica Nix describes what’s happening inside the CDC: layoffs, loss of expertise, chaos
• 06:56–09:13: Dr. Besser assesses the CDC’s destruction and what’s being lost globally
• 09:35–11:05: Implications of the overhaul for US/global pandemic response
• 11:13–12:04: Local public health impacts and examples of real-world gaps
• 12:20–13:27: Examining why trust in the CDC has eroded post-COVID
• 13:42–15:02: The state and fate of vaccination policy in the US
• 15:42–16:55: Jessica Nix and Carol Massar on what’s next for American public health policy and insurance

Conclusion

This episode offers an urgent, insider look at the CDC’s current crisis and transition—tying broad healthcare realities to the granular fallout of hasty restructuring and politicization. The discussion underscores how the CDC’s fate will shape not only America’s preparedness for future pandemics, but the everyday health and safety of its people and the world. The loss of central leadership and national coordination signals increased confusion, state-by-state disparities, and uncertain insurance coverage going forward. The question animating the episode: Can trust, expertise, and public health cohesion be salvaged, or are we witnessing the irreversible fracturing of a historic institution?