Will RFK Jr's Make America Healthy Again Get People Killed?

Summary

Bulwark Takes: Will RFK Jr's Make America Healthy Again Get People Killed?

Release Date: March 31, 2025

In this compelling episode of Bulwark Takes, host Sam Stein engages in a critical dialogue with Jonathan Cohn, a newly minted member of the FAM and author of "When Make America Healthy Again Actually Means the Opposite," published in his latest newsletter, The Breakdown. Together, they dissect the alarming shifts within the Department of Health and Human Services (HHS) under Secretary Robert F. Kennedy Jr., scrutinizing the potential ramifications for America's public health landscape.

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1. Scaling Back the Department of Health and Human Services (HHS)

Jonathan Cohn opens the discussion by outlining the Trump administration's broader agenda impacting federal agencies, with a particular focus on the HHS. Beginning in February, the administration initiated sweeping job cuts, eliminating all probationary employees and embarking on a second round of significant reductions.

"Secretary Robert F. Kennedy, Jr. announced a major overhaul of the entire department, which will include not just significant job cuts... reducing the agency from 80,000 employees to 60,000 employees. That's a 25% cut." [02:14]

These reductions are not merely numerical but also structural. Kennedy plans to consolidate smaller agencies within HHS into a single entity, ostensibly to enhance efficiency. However, Cohn expresses skepticism about the effectiveness and intention behind these moves.

"This is not what is happening here. This is not some thoughtful exercise." [03:18]

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2. The Role and Impact of SAMHSA in the Opioid Epidemic

The conversation shifts to the Substance Abuse and Mental Health Services Administration (SAMHSA), a pivotal agency in combating the opioid crisis. Cohn details SAMHSA's origins in the early 1990s and its expanded role over the past decade in response to the escalating opioid epidemic.

"SAMHSA is now, through a series of laws... put a lot of federal money behind these efforts." [05:51]

Key functions of SAMHSA include administering grants to states, conducting the National Survey on Drug Use and Health, and providing training and support to regional offices. These efforts have been instrumental in the recent decline in overdose deaths, which Cohn attributes to comprehensive federal initiatives.

"Making sure that Narcan gets to everybody... which is a game changer." [12:47]

However, the impending cuts threaten to dismantle these critical structures. Cohn warns that reducing staff and closing regional offices will disrupt the essential dialogue between federal agencies and local communities, undermining data collection and effective policy implementation.

"It's going to be harder to do that... it's just going to be harder to do that." [07:45]

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3. Diminishing Progress in the Opioid Fight

Reflecting on the progress made, Cohn acknowledges the significant strides in reducing overdose deaths over the past two years. However, he raises concerns that the current administration's rollback could reverse these gains.

"A lot of the federal government has really ramped up all this support... a lot of that is SAMHSA, and a lot of that is their guiding this." [12:56]

Stein parallels this issue with broader governmental shifts, noting a trend away from empathetic approaches towards more punitive measures.

"It's like, how much is healthcare in terms of our GDP? What is it? It's getting close to 20." [04:11]

This shift not only jeopardizes ongoing efforts but also signals a departure from the compassionate policies that initially garnered bipartisan support.

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4. RFK Jr.'s Reorganization and Its Implications

Under RFK Jr.'s leadership, the reorganization of HHS is not just a bureaucratic reshuffle but a pivot with profound consequences. Cohn highlights Kennedy's anti-vaccine stance and his strategic moves to undermine public health initiatives.

"In 10 different ways, he is just reorienting our public health infrastructure away from vaccines." [18:57]

Cohn critiques the administration's opaque decision-making processes, noting the lack of communication with HHS staff and the abrupt implementation of job cuts without clear directives.

"There was no notice, not even like." [07:45]

The removal of key figures, such as Peter Marks from the FDA, underscores a broader agenda to weaken regulatory oversight, raising alarms about vaccine safety and drug regulation.

"He's just reorienting our public health infrastructure away from vaccines." [18:57]

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5. Broader Consequences and Lack of Industry Pushback

One of the most striking observations in the episode is the surprising silence from major stakeholders, particularly Big Pharma, in response to these disruptions. Despite the pharmaceutical industry's vested interests in robust public health infrastructure, there is minimal resistance to the administration's dismantling efforts.

"The pharmaceutical industry would, like, freak out." [21:05]

Cohn speculates that this silence may be strategic, allowing the administration to enact long-term changes without immediate backlash. Additionally, cuts to the National Institutes of Health (NIH) and other research entities threaten to stifle innovation, potentially driving scientific talent away from the United States.

"This could really wreck the American ecosystem for developing new medical treatments." [20:29]

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6. Conclusions and Final Thoughts

As the episode draws to a close, Stein and Cohn express deep concerns about the future of America's public health systems. The dismantling of SAMHSA, HHS, and other critical agencies under RFK Jr.'s leadership not only threatens to reverse the progress made in combating the opioid epidemic but also endangers the broader landscape of medical research and public health.

"This is when you mentioned the Wall Street Journal editorial... where are these interest groups who would, in theory, you know, want to push back strong against some of this stuff?" [19:08]

The hosts urge listeners to stay informed and engaged, highlighting the urgent need to address these policy shifts to safeguard public health advancements.

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Notable Quotes:

• "We're going to do more with less." – Robert F. Kennedy Jr., Secretary of HHS [07:28]
• "It sent the message that we realize that this is a human tragedy and that people need help." – Jonathan Cohn [15:20]
• "He's just reorienting our public health infrastructure away from vaccines." – Jonathan Cohn [18:57]

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Key Takeaways:

• The Trump administration's ongoing efforts to reduce HHS's workforce and consolidate agencies are deeply impacting public health initiatives.
• SAMHSA, a cornerstone in the fight against the opioid epidemic, faces significant cuts that could derail progress made over recent years.
• RFK Jr.'s leadership has introduced policies that undermine vaccine safety and drug regulation, signaling a regression in public health priorities.
• The lack of opposition from influential sectors like Big Pharma raises questions about broader systemic challenges and the future of healthcare innovation in the U.S.
• The episode underscores the critical need for vigilant advocacy to protect and advance public health infrastructures against detrimental policy shifts.

For a deeper dive into these issues, listeners are encouraged to subscribe to Jonathan Cohn's newsletter, The Breakdown, and explore the full article, "When Make America Healthy Again Actually Means the Opposite."

Transcript

[Sam Stein]

Hey, guys, it's me, Sam Stein, managing editor at the Bulwark. And I'm joined by Jonathan Cohn, who is now 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. 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. 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. The micro elements here? What we're doing, that's scaling back and sort of the macro elements, what this symbolizes more broadly about the Trump agenda.

[Jonathan Cohn]

So, I mean, the micro elements are, you know, are part of the larger sort of project that the Trump administration is undertaking at hhs, specifically Department of Health and Human Services, but which is. And we'll get to the Secretary Robert Kennedy in a second. But, you know, you know, at the Department of Health and Human Services and throughout the federal government, which is, you know, these broad, sweeping job cuts, which started in February, you may remember, where they just got rid of all the probationary employees, and now they're kind of going through a second round of sort of more serious cuts.

[Sam Stein]

The riffs. The reduction in forces. Cuts.

[Jonathan Cohn]

Yeah, reduction in forces. And then at HHS, specifically last week, Secretary Robert F. Kennedy, Jr. Announced a major overhaul of the entire department, which will include not just significant job cuts. I mean, the idea is to basically reduce the agency, HHS as a whole, from 80,000 employees to 60,000 employees. That's a. That's a 25% cut. But in addition to that, they're reorganizing things, and they're taking a bunch of the smaller agencies inside it and sort of consolidating them and putting them into one agency.

[Sam Stein]

Let's pause for a second on that. Why. Why do that? I mean, 20,000 cuts is a lot. Now, I know obviously, prior administrations have looked for efficiencies. They've tried to do consolidation. Certainly in a sprawling bureaucracy like hhs, there's overlap, there's ways to do this, but that seems like cutting off a lot in hopes of gaining efficiency.

[Jonathan Cohn]

Yeah. I mean, look, nobody Would, you know, if the idea was to come in here and say, look, we're, you know, you look at the org chart for hhs and it's, it's, it's, you know, Byzantine and no, there's a million sub agencies. And actually Kennedy, you know, he gave a video speech where he was explaining what they were doing, and he made that point that, you know, the sort of attitude is we want to. Whenever we want to solve a new problem, we add a new agency. And then you blink. And now you've got all these bazillion agencies.

[Sam Stein]

Right.

[Jonathan Cohn]

So, I mean, there's absolutely a rationale for trying to, like, rationalize it. It might very well involve reducing staff. It might not. You know, and we can talk about that in a minute. Like, you know, sometimes if you want to be more efficient, you actually need more. More people. Not.

[Sam Stein]

Right.

[Jonathan Cohn]

More people. But, you know, they're not. This is not what is happening here. This is not some thoughtful exercise. And. Well, how do we sort of, you know, cleanly sort of combine, like, purposes? I mean, sometimes, you know, just to take one example, you know, you, you hear sort of consolidation. You think, well, maybe they can combine human resources, for example. Right. Does everybody. You know, and, and, and maybe you can. And, you know, to some extent, that's already true in a hhs, but, you know, sure. On the other hand, if you think about it, the person you're hiring to, say, work at the cdc, that's a pretty different skill set. Right. Than someone who's going to oversee Head Start. Right. Which is also.

[Sam Stein]

Yes, they're totally different skills. And you wouldn't want someone to handle economists.

[Jonathan Cohn]

You have, you know, you have a whole, you know, nih. Well, I mean, I look at it.

[Sam Stein]

The other way, though. It's like, how much is health care in terms of our GDP? What is it?

[Jonathan Cohn]

It's, it's getting close to 20. I forget where it landed last time, but, you know, almost a fifth of our six. Between a sixth and a fifth of our economy, okay?

[Sam Stein]

So the government, the amount of government resources you want should be corresponding to the size of the economy that it touches, and that's almost 20. You know, for talking about 20, doesn't strike me as crazy to put that many bureaucrats in charge of administering healthcare. Now, obviously, you want efficiency and so on and so forth. But let's talk about the opioid epidemic as a microcosm of what's happening here, because among the consolidations is samhsa, which is the Substance Abuse and Mental Health Services Agency. It's basically, you know, tasked with trying to help manage that epidemic. Tell us a little bit about the history of the agency, what it does, and I guess more to the point, what its recent successes have been.

[Jonathan Cohn]

Yeah, yeah. So, I mean, it's not that old. It came into existence in the early 1990s, sort of, and it's got both mental health and substance abuse in the name, and it has a fairly broad portfolio that deals with both of those. It really kind of about 10 years ago, as the opioid epidemic really started to get worse in this country and it got a lot of attention in Washington. This is sort of the late Obama era, there was a real sense that the federal government needs to sort of step in and do more here. And there's a whole variety of things. You know, we need to. First of all, we need to figure out what do we do to help people who are dealing with opioid addiction? What kind of programs? Do we need prevention? Do we need treatment? Do we need recovery? Do we need what's called harm reduction? And the answer from most of the people who study this is all you need? All.

[Sam Stein]

Yeah, all the above.

[Jonathan Cohn]

And so SAMHSA is now, through a series of laws, starting with something that was signed at the end of the Obama presidency in 2016, put a lot of federal money behind these efforts, and then, you know, gave SAMHSA most of the responsibility for administering them. So SAMHSA is there, right? I mean, it's in charge of giving grants out to the states. States come, you know, they say, we're going to spend this money, you know, on these programs. SAMHSA administers it, but also watches to make sure there's sort of, these programs are sort of working and doing best practices. There's not waste in fraud. Another really important function of SAMHSA is it conducts the national. I'm going to get the name wrong, but there's a survey.

[Sam Stein]

We'll edit it out. Don't worry.

[Jonathan Cohn]

There's a. Another really important function for SAMHSA is it is in charge of the gold standard national survey of drug abuse in this country. And that is incredibly important for crafting policy. Right. Because, you know, you want to know what kinds of drugs are people using, where, who's using them, right.

[Sam Stein]

If you're fighting an epidemic, you need to know the stats behind the epidemic you're fighting. Right? Basic one on one, right?

[Jonathan Cohn]

The basic, you know, information is the basic foundation of your strategy. So they do that. They do a lot more also, you know, they do things like they provide training for workers. They maintain these regional offices to really.

[Sam Stein]

So what are the, what are the consolidations that are happening now?

[Jonathan Cohn]

So it's, you know, it's hard to know. And this is, you know, Sam, you know this from trying to report this. One of the crazy things about what's going on in the Trump administration, it's not like they really tell you what they're doing. You have to know it together, which.

[Sam Stein]

Is, in fact, and in fact they don't tell the people they are employing what they're doing. I talked to a number of HHS folks who were like, first I heard about this was through press reports. Like, did not talk. Yeah. They just not, did not communicate to staff anyways. Yeah. So we don't really know is the end of it. Like, we don't, we don't know.

[Jonathan Cohn]

And I'll mention we're recording this at 10:30 in the morning. I will say that last I heard, you know, Kennedy announced this reorganization including, you know, 10,000 new job cuts on, what was it, Thursday or Wednesday? As of this morning, the HHS people I knew had not yet heard who was getting fired. They were still waiting. There was no notice, not even like.

[Sam Stein]

The first press story was Thursday morning. People were waiting for guidance. And I guess they've had to wait through the weekend to know if they're going to be fired or not.

[Jonathan Cohn]

Yeah, they're going to have their jobs. They're going to have a job. So I mean, there's the job cuts in general, but in addition, they are again, you know, sort of slimming down some of the agencies and consolidating some of them. They're also closing about half of these regional offices. And you know, the argument, you know, they haven't said much. Right. I mean, there was this video from Kennedy. There was like a statement put out at one point, like a one page fact sheet. And you know, it just said, look, this will make operations more efficient. Kennedy had this line, we're going to do more with less. Right. You know, which again, you know, sure. Okay. How you know are, you know, and they haven't specified exactly what's going to get cut, but you can kind of get a sense that like, you know, again, there's a version of reorganizing HHS and reorganizing samhsa that probably makes sense. But number one, it's certainly not this dramatic. And number two, you'd want to know that it was being done carefully. And the best proof that it's not being done carefully is to look what they already did in that sort of first round of firings. When they did the probationary, they basically de facto, like, just shut down two of the regional offices because there was no one left in them at that point.

[Sam Stein]

What happens when a regional office is shut down?

[Jonathan Cohn]

So, you know, the regional offices, they're not that big. So these are part of the HHS has regional divisions. So this is sort of the SAMHSA division within the regional office. And, you know, it's a handful of employees. It's not a lot of people, but over the course of the year, they visit communities constantly to sort of, you know, in a kind of sort of circular conversation that is going on between samhsa, the agency that's providing this money, and the people on the ground, the people who are using it to provide services. And there's this, you know, back and forth, you know, what are you seeing on the ground? Tell us. So we know how to sort of better allocate money going forward. Then the people on the ground are like, you tell us, what do you want to see? What are, you know, we're, I'm a, I'm the state, you know, I live in Michigan, right? So I have this state mental health department here. I don't have probably the resources or the time to be keeping up with the latest research, the latest scientific research. So I need that from the national office. So, but, you know, I can read that on a website if they summarize it, but it's a big difference if the regional guy comes to me and we can talk about it and they say, see, you're doing it this way. You really want to do it this way.

[Sam Stein]

Or, Jonathan, just, just replace it with some AI bot. Yeah, that's what happens.

[Jonathan Cohn]

It's play.

[Sam Stein]

No, it's bad. I, I, I, I understand why, but it fits with the pattern of you don't fund these surveys, you don't get information, you don't have regional offices, you don't get information. It's sort of a depriving them of on the ground information. As they go about trying to do this. Let's put it in the macro, which is that we've made some progress on the opioid fight. And it's kind of been remarkable because it was this really glaring, horrible issue that was hitting the country. We know this because it was really a lot of what politics was focused on, frankly, during the early Trump years. I remember being in Manchester, New Hampshire, just decimated by the opioid epidemic. And this was what Trump was focusing on when he Was running the primaries there. Are we risking that progress now? And if so, why?

[Jonathan Cohn]

The background here, right, is that about two years ago, things started to turn around. And in the last year, things seem to be really, like, the number of overdose deaths are plummeting.

[Sam Stein]

What do they. What do people attribute to. Why do we have a turnaround? What is the common theory here?

[Jonathan Cohn]

So, I mean, we can't be sure yet. And, you know, that's the nature of public health. This is happening now in real time. And if you talk to the sort of people studying this, the first thing they'll tell you is, we're not sure. And it's probably a bunch of different things. And you can tick off the factors, you know, and it's everything from the fact that, like, the purity of the fentanyl available on the street has changed. Um, there's been, you know, there's the morbid explanation. There's a really morbid explanation, which is that if you think about deaths of despair, that basically this is sort of burning itself out as the people most susceptible to the level of, you know, overdosing and dying die off. And. And that. That's, you know, that's. That's a real possibility. So, I mean, you have that kind of group of factors there, and, you know, they'll be studying this in ten years from now. You know, we'll have a more definitive look, look at that, hopefully. But everybody who looks at this, I think most everybody, I don't say everybody, but certainly everyone I talk to, says, look, you can't. You know, the fact that the federal government has really ramped up all this support and really kind of provided all this extra money, a lot of, you know, even just making sure that, you know, Narcan gets to everybody.

[Sam Stein]

The medicine given to people who've OD'd.

[Jonathan Cohn]

Yes. If you can OD, it keeps you alive, you know, and you can get, you know, the emergency care you need then, which is a. Which is a game changer, right, for this and getting that out to everybody and not just getting it out there, but, you know, getting the awareness out there so people know it's out there and getting, you know, you know, the first responders and all of that. And that has, you know, made a big difference. And it, you know, a lot of that is samhsa, and a lot of that is their guiding this. And they're. And they're. They're, you know, you know, sort of driving this process. And again, let's be clear, are they perfect? You know, could they do a Better job at some things. I'm sure they could. You know, someone wants to sort of do a sort of careful study of that and then come out with some changes. Great. That's clearly not what's going on here. And that's the danger. You cut all these people, you cut the regional offices, you cut the data. It's just going to be harder to do that. You were joking before, like, well, an AI bot could do that. I actually think that's what they think. I mean, I'm not kidding.

[Sam Stein]

Oh, I wasn't. I was. I was not joking. I actually think that's what they think. I think they'll get enough. They, they probably believe they can get enough data inputs and put into some AI bot and it will tell them with some precision, you know, these therapeutic methods work better than others, these interventions work better than others. We can, you know, cut some samps off just. Because if we're just getting data inputs anyway, why do you need people to actually go out into the field? It's all data driven. And look, there might be, I'm not gonna. There might be something to that. I don't want to discount that. Like, it's possible. We live in reality where that is, you know, an achievable way to run this. But it's a, it's a gamble. It's a real gamble and you're risking real progress. And I'm surprised, I suppose, because as a strictly political matter, this has been something that Trump has been so passionate about and so focused on, hyper focused on. And Kennedy too, who has been open about his own struggles with addiction. For him to do this seems, I don't know, I have trouble figuring out what the explanation is for this.

[Jonathan Cohn]

Yeah. You know, one interesting thing I do think is worth noting, I went back and read some of Trump's rhetoric from this. In his first term, when he was talking about this, he gave this speech and I talked about this in the article 2017 at the White House. And it was very moving speech, you know, certainly by his standards. And it really, if you read the speech and you watch it, it's what you would expect a president to say. I had a lot of empathy for it, which, you know, let's face it, with Trump is not a thing you get with him from, you know, so it's very rare.

[Sam Stein]

So. Yeah, very rare.

[Jonathan Cohn]

But there was, you know, and you know, he talked about his, you know, his brother had an alcohol problems and he talked about being connected to that. And, you know, who knows how, you know, I'm not going to speculate on how much of this was heartfelt and how much was this, you know, political or whatever. But it sent the message that, you know, we realize that this is a human tragedy and that people need help. Whatever else we're doing to the supply of drugs and law enforcement, we need to be focusing on helping these people. And if you listen to the rhetoric now, he still talks about fentanyl all the time, but now it's always 100%. It's like foreign menace. We need to close the border. We need to get tough with our allies about cutting down on the fentanyl trade.

[Sam Stein]

You can make the same point about criminal justice reform. The first administration was first step back. That was like their big. We've done the first step back. We're going to have people reintegrate into society. We're going to give people second chances. Now it's all just throw them out, throw them out of the country. It's a totally different approach. It's kind of interesting to see how they've just gone completely away from that. I don't know if I want to call it moderate, but it was definitely more empathetic approach.

[Jonathan Cohn]

It was like his version of compassionate conservative.

[Sam Stein]

Yeah, it was, in a way. All right, last thoughts on RFK specifically. He's been at the helm for a couple weeks now. I saw the Journal, you know, wrote a op ed, or I should say an editorial saying our worst fears have been realized. I know that's mostly on the vaccine stuff and measles, which remains a big problem in West Texas. What's your impression about what he's been up to and sort of why he's doing this reorganization and how he's conducted himself in this post?

[Jonathan Cohn]

Yeah, yeah. So, I mean, it's a little hard to know with the reorganization part. What's him and what's Doge and what's coming from the White House? I mean, there's, you know, I think we. I try to always keep in mind with this administration in particular, there's usually layered agendas. Right. You know, things going at the same time. I think his agenda very clearly is what we thought it was gonna be. I mean, there's no surprise here. I mean, he's an anti vax guy and you look right. I mean, this is not a secret. I mean, the only person who seems to have sort of believed he changed his stripes was Senator John Bill Cassidy, who made that big speech. Well, because you remember in the confirmation hearings, he was all about, oh, he really gave Kennedy a hard time. About the vaccine stuff for listeners, if you don't know. Cassidy is a physician and a serious guy on these issues, by the way, on health care issues. He really does take them seriously. And then he voted for CAD and Anna. He said, well, we had these long talks and he assured me and I'm going to be, you know, I'm going to be in on all these major decisions on vaccines. And instead, you know, there's just this long list of actions he's taken. The most recent of which was the one over the weekend where it came out that he pushed out from hhs, from fda, a guy named Peter Marks, really kind of senior internationally known figure on vaccine safety and drug safety, played.

[Sam Stein]

A very big role in Operation Warp Speed, which may have contributed to his downfall with Kennedy. So.

[Jonathan Cohn]

Right. And you know, we can talk about that more some other time. But I mean, just you just look at these and you add them up and you know, you know, in 10 different ways, he is just reorienting our public health infrastructure away from vaccines. I mean, it's as clear as day. There's no mystery here. There's no hidden agenda. There's no dog whistling even. I mean, it's right out there.

[Sam Stein]

It's actually pretty. It's pretty much Occam's razor. Honestly. It's like we, this is who he is and he's doing what he wants to do. And we, and anyone who thought it would be otherwise kind of deluded themselves.

[Jonathan Cohn]

Yeah, yeah. I do think, I do think going forward, one interesting question is going to be, this is freaking. This is when you mentioned the Wall Street Journal editorial.

[Sam Stein]

Yeah, okay, let's. Let's noodle on this because I've had conversations where people have been, why isn't like Big Pharma the biggest, baddest influence group in Washington, D.C. like, why are they not making more of a stink? Where is their influence? I mean, the Wall Street Journal editorial board is influential, but it's different. And my question has been, yeah, where are these interest groups who would, in theory, you know, want to push back strong against some of this stuff?

[Jonathan Cohn]

Yeah, well, that's a really good question.

[Sam Stein]

Made for another newsletter.

[Jonathan Cohn]

Another newsletter. They have mostly been sort of, you know, playing, you know, been quiet. I did see some comments. There were some comments just since Marx got pushed out. There was a great article on Stat News, which is one of my favorite publications, which covers the healthcare sector, quoting a bunch of biotech executives who were very upset. And I think you combine that with the cuts to medical research through nih which is, you know, potentially can have a devastating effect on the future of scientific research in this country, which is a whole other conversation.

[Sam Stein]

Right.

[Jonathan Cohn]

And I think it's finally dawning on people in this sector that, holy cow. Like, we. This could really wreck the American ecosystem for developing new medical treatments. And it's, I gotta say, just like, as someone who has followed debates in this sector for a long time, Sam, you know, this, you know, whenever, you know, the topic of, you know, of having, you know, drug, you know, having the government do something about prescription drug prices came up. Right. You know, having the government negotiate drugs.

[Sam Stein]

Yeah.

[Jonathan Cohn]

Never. We. Any small steps towards that. The pharmaceutical industry would, like, freak out.

[Sam Stein]

Freak.

[Jonathan Cohn]

And like, if you even touch, you know, you can give the government a little bit of influence over drug prices. It's going to kill innovation, which was, you know, wildly overstated.

[Sam Stein]

Yes, but. But definitely was the case. Yeah. Right.

[Jonathan Cohn]

Right. So here we have, like, a true existential threat and they're nowhere. I can't.

[Sam Stein]

It's unbelievable to me. I don't. I honestly don't understand it. Like, and it's. It's. It's the academia. I mean, they're going to drive scientists out of this country. They are already. It's the biomedical research, which big pharma actually benefits from in very tangible ways. It's all these weird regulatory moves. It's the revamping of ahs in mysterious ways. And I mean, that industry could very well be in for a huge, huge disruption if not. If they're not already. And yet we sit here and they're barely making a noise, as far as I can tell.

[Jonathan Cohn]

Yeah. Yeah. We'll have to see if that changes. And just a side note here, I would just remind people that maybe people are listeners, being sophisticated, bulwark followers that they are. This probably occurred to them already. But it's kind of a weird thing when you're sort of whole, you know, your whole shtick is make America great again, and you're basically undermining the one place in terms, you know, the one thing at which the United States is clearly unquestionably a world leader, which is, you know, medical innovation. This. I mean, the amount of damage being done. The Washington Post had a story a couple days ago. They looked at how much money, like, it's already down 60%. Like, all right, sort of the money goes.

[Sam Stein]

That's crazy. I remember. I remember. And we'll end here. I remember the sequestration days with Obama where It was a 5% cut and people were freaked. I mean, totally freaked, and rightfully so. All right, Jonathan, we got in it there. Great first piece. Really fantastic. We'll be obviously talking throughout the next couple weeks about all this stuff, but thank you for doing this. I encourage everyone to read it. Subscribe to the Breakdown, which is his new newsletter. We'll talk to you later.