← How Is This Better?
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- [00:02]
A
Not all probiotics are created equal. New olly precise probiotics are expertly made with clinically studied strains for targeted benefits beyond digestion, like skin, health, metabolism, or even stress response. Find your precise probiotic at a Walmart near you. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. When it comes to public health these days, we're leaning real heavy on branding and falling flat on actual policy. We've got RFK Jr, an unabashed vaccine skeptic, conspiracy theorist, and now a podcast host leading the Department of Health and Human Services. We've got a quack daytime TV doctor, Dr. Oz, leading the agency's Medicaid and Medicare services division. In the words of Kendrick Lamar, crazy, scary, spooky, hilarious. Meanwhile, our healthcare system is sick. So while Trump keeps slamming Quarter Pounders and his flunkies simply talk about making America healthy again, but not doing anything to that end, I wanted to explore how we could actually fix this. I'm Akilah Hughes and today I'm excited to talk with Dr. Abdul El Sayed. Abdul is a physician, epidemiologist, and literally wrote the book on Medicare for all. He's also running for U.S. senate in Michigan. We had a wide ranging conversation about how Democrats can step up in this moment and what it will take to fix our truly, truly broken health care system. Abdul El Sayed, thank you so much, Kila.
- [01:40]
B
It's such a privilege to be with you in person. Of how many Covid era interviews did we do via Zoom?
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A
I think it was like every day. You were one of the co hosts, essentially.
- [01:48]
B
Yeah, basically like I came to give my update and then we would go off camera and then everybody be like, okay, I have an actual question.
- [01:55]
A
Yes, exactly. Like am I?
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B
I do a little house call.
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A
Exactly. So I mean, it's good to see you on the side of it. Good to see you as a candidate for our listeners. I guess, you know, explain who you are, why you're running, what you're running for, and you know, I guess what people where you're from care about.
- [02:12]
B
Yeah. So I'm Abdul El Sayed. I am running for US Senate, clearly because I have a name that is perfect for American politics, but I was never supposed to run for office. I, I think my immigrant parents tried to make sure that was the case when they gave me an 11 letter first name as that sounds that literally come out of parts of people's throats. Most people don't know they have. But I want to be a doctor my whole life and that's because I could go 15 hours to Egypt, where my folks immigrated from, or I could go 15 minutes into the city of Detroit and I could travel 10 years difference in life expectancy. Either way, wow. I want to do something about that. I went to medical school and came to realize that not only was our health care system not part of the solution, it was usually part of the problem. And decided instead to go into public health. I got the opportunity to rebuild Detroit's health department lead, Wayne County's Department of Health, Human and Veterans Services. Across our work, we did things like guarantee every child in the city a pair of glasses delivered at school for free. Within two weeks of a vision test, the program's done 50,000 pairs of glasses across the state, took on some of the biggest corporate polluters in our state, put air quality monitors all over our county, built a program to provide new small businesses free health insurance. After the Flint water crisis, we had every school daycare and Head Start tested for lead in the water, helped to rewrite the state's lead policies. We put Narcan in 100 vending machines all over Wayne county, helped to eliminate upwards of $700 million of medical debt in Wayne county, and love that work. But I'm never going to forget the day feels like 10 years ago is about a year and a half now when this administration froze federal funds, right? So wic, vaccines, federally qualified health centers. And I'm sitting in my office trying to figure out how to like make it all work with limited budget now. And I get a notification on my phone that our U.S. senator is retiring. If I were to be elected in this rule, I'd be the first Democratic doctor elected to the U.S. senate since 1969.
- [04:09]
A
Wow.
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B
First ever public health official elected to the U.S. senate. Now, if you've ever looked at RFK Jr. And then one of these, like, maybe we could use one of those right now.
- [04:19]
A
Yeah.
- [04:19]
B
So we're running to get money out of politics. Put money in your pocket, pass Medicare for all. I've been to 90 cities now, 300 public events across Michigan. And what I'll tell you is that we're building a movement that is about the hope and inspiration of what it looks like to take pain of this era and turn it into purpose for the future.
- [04:37]
A
Being a political outsider can make the road to victory more difficult. But in recent years, it's actually been a superpower. In fact, it was Donald Trump's inexperience that Led people to vote for him. And like John Russell said, just the last episode, there's space on the left to update the party and bring more voices into the conversation. With that in mind, you know, how dare you show up with Hasan Piker? You know, as you know, he is like for some reason, kryptonite to the main mainstream media. But for all of us in reality, it makes plenty of sense that he would want to campaign with you. So you want to talk a little bit about how that came to be?
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B
Well, I'll tell you this. I made a critical error, which is that I got frame mocked by a guy who's like 64 and built like a refrigerator.
- [05:26]
A
Yeah.
- [05:28]
B
A right wing rag called me a pocket sized manlet.
- [05:31]
A
Oh my gosh.
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B
Which I was like, wow, that's.
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A
Yeah, incel culture has completely crossed over.
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B
I got claviculared.
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A
Yes.
- [05:39]
B
No, but look, Hasan commands an audience of young people who feel locked out of our politics because, well, they are locked out of our politics because our political conversation doesn't actually include people like them or their problems. And then you've got the folks at, you know, the traditional mainstream media who tut, tut at anybody who would pay attention to somebody who wants to have a political conversation that is about ending corporate domination of our politics, keeping our money here at home, guaranteeing health care. Now, do I agree with everything Hassan has said? No. Do I agree with everything you have said?
- [06:11]
A
Probably not.
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B
Probably not. I mean, in your case, maybe. No. At this point. At this point, you're going to get the Hassan treatment. Said this exactly one time in 1993. She was like 10. Yeah.
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A
She was a baby.
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B
She was just born. So look, you know, it's crazy to me because you would have thought coming out of 2024 and the whole should have gone on Rogan discourse.
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A
Yes.
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B
That Democrats had learned their lesson that going on a platform or engaging with a creator does not automatically mean that you endorse everything they've said.
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A
Right.
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B
It means that you would like to have a conversation with them to reach an audience about what you'd like done. And then my bigger question is this. At the core of our democracy is the idea that we can create a politics that actually answers questions.
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A
Yeah.
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B
But if you're telling me that I can't go talk to that group of people, what is their pathway back into our democracy?
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A
Right.
- [07:00]
B
Because what I'm trying to do is create a pathway back into a discourse that is about what we can do about the problems we face. I don't know. I Just find the whole thing overblown. Especially since Vice President Harris invited Hasan to stream from the DNC back in 2024.
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A
Right.
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B
So I'm like, what's the difference? What is it about me that is different from her? And what is it about the. I don't know, consonance of our positions on the fact that maybe instead of sending our money abroad to drop bombs on other people's kids, we could keep it here to spend on our kids? Is not a crazy thing to say.
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A
Not at all.
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B
And it's funny because, like, when people start saying that that's out of the mainstream, part of me is like, well, this is why nobody listens to you anymore.
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A
Right? Because like, the mainstream to them is just the media, like anyone you speak to. I mean, the polling shows people overwhelmingly don't support what we're doing right now and are looking for change. We'll be right back. I want to talk a little bit more about Medicare for All. You obviously wrote the book Talk about Medicare for All.
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B
She's speaking my language, guys.
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A
Yes, absolutely. And I.
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B
That's my j.
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A
You know, I'm a youngish woman. I'm still of childbearing age. It is terrifying to me, the trajectory that the country is on, healthcare wise. Obviously, like black maternal mortality rates are in the toilet. And there seems to be like no plan to address even greater issues. Right. Like basic care. There are hospitals closing in rural areas. When you hear all of this, when you see all of this, even just as your position as a doctor, what does that make you feel? And then I guess, can you talk a little bit about, like, what you would hope to. What the kind of change you'd like to bring about when you're in the Senate.
- [08:30]
B
I come at all these questions from the same vantage point, which is the curiosity of that kid going 15 hours or 15 minutes. A lot of all of my career has been about trying to ask the question, what could you do about it? Yeah, I became a doctor because I thought by learning how to heal what was happening in people's bodies that that's what I could do about it. Only to realize that the system itself was part of the problem. And then you start getting curious about what makes people sick in the first place. The vile juxtaposition and the intersection of racism, of misogyny, of classism and anti poor policy all hit hardest in black communities. When you think about that statistic you just named, the fact that black moms are three to four times as likely to die in and around childbirth than Their white counterparts, their babies two to three times as likely to die before their first birthday. If that is not the foundational stain on our society, I don't really know what it is. Talking about babies and moms, like, if you can't protect them, like, what are we even doing here? So Medicare for All would be the most important single thing that we could do to provide the kind of health care to people who have been locked out of the system. Right now you got Medicare and Medicaid, a program for seniors or a program for low income people. Medicaid reimburses at nearly half the rate of private health insurance. That means that if you are somebody who healthcare system stereotypes as being a Medicaid patient, they think of you as being a customer that pays 50%.
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A
Wow.
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B
So think about what that means in terms of discriminating against those people in the healthcare system.
- [09:58]
A
Right.
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B
Imagine what would happen if everybody had full healthcare citizenship and what that would mean for being able to go and get the healthcare you needed. Because it's not just what happens during childbirth, it's what happens in the nine months before that. And if you're told that you're a second class healthcare citizen, you're less likely to go and get prenatal care. You're less likely to get early diagnosis on anything that could complicate your pregnancy. And Medicare for All would solve that because now you've got a way in and what it would feel like for everyone. Even if you're not somebody who's ever thinking about having a kid, imagine the safety and security of knowing that in your back pocket you hold a card that you get the day you were born that does not expire until you expire, hopefully after a long healthy life at 120 years old, that guarantees you entry to health care that you might need without having to worry about what it's going to cost you on the way out.
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A
Yeah.
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B
We have, as a country $225 billion in medical debt. That is more than the GDP of half of all the states in the country.
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A
Wow.
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B
That is a policy choice we make. So personally, I don't give a damn how much the CEO of a local health insurer makes. I don't give a damn how much the CEO of a doctor makes. I give a damn about whether or not somebody who is sitting outside that hospital gets to walk in, get the health care they need when they need it.
- [11:15]
A
Yeah.
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B
Medicare for all would do that. And anybody who's telling you that we cannot have that either has cozied up to the health insurance corporations or the pharmaceutical corporations or is too weak to fight them.
- [11:26]
A
Absolutely. And so when you look at, I guess, the landscape for the Senate race that you are in, you know, and other elections that have happened more recently, 2025 in November, special elections since there is this shift. Right. There is a new kind of candidate that I think is emerging to the forefront. You know, obviously here in New York City, Zoran Mamdani has done incredible things in such a short time, just 100 days. I'm curious, you know, I guess, comparing your race to someone like Zoran's, what are the priorities in your district, the state of Michigan, and I guess, how do you see, I don't know, your tenure going, given, given the Trump administration, given the war, given everything that is happening? Like, what do you see your first 100 days looking like?
- [12:13]
B
So, you know, for us, we're running on money out of politics. Money in your pocket. Medicare for all. What does that mean? That means ending corporate contributions in politics writ large. That means abolishing all of the infrastructure by which they've used their money to influence elections. Super PACs, 501C4s, 527s, all of these loopholes that allow very, very rich people to dominate our politics. It means standing with unions, empowering unions in every place and space in our economy. It means investing in small businesses instead of big corporations. It means taxing billionaires their wealth. Right. Because if you tax a billionaire at 8%, Akilah, you know what? They still are billionaires.
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A
Yes. Still doing better than me.
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B
Kids, kids, kids, kids. Kids are still going to eat. Right. Maybe you could pay your fair share so everybody else.
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A
Yeah.
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B
Can send their kids to good schools.
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A
Exactly.
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B
And it means keeping our money here at home. I don't believe in blank checks to foreign militaries. Right. And that includes Israel, but also includes Egypt, where my folks immigrated from. And then Medicare for all. That's that, that, that unmet promise, that should be an obvious thing if you live in the richest, most powerful country in the world.
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A
Yeah.
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B
And across Michigan, I've been to 90 cities now, 300 public events. No matter where you go, people talk about the same issues. The hard part in a place like Michigan. Right. At least in New York, like, you're constantly exposed to other people.
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A
Yeah.
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B
And so you have a sense of the lives they live in. A place like Michigan is a very, very big state. And there's this trick politicians have played, which is to make people think that if you live up north in the Upper Peninsula, that your Problems are categorically different than somebody in Detroit or somebody in Flint or somebody in Grand Rapids or somebody in the Upper Mitten. And it turns out that people talk about the same problems in the same ways. So my job is to build a bridge between those folks to be like, hey, y', all, we can have nice things. We just can't do it alone. And if we can't stop blaming each other for what we don't have and start realizing that none of us have because of somebody in D.C. then I worry about whether or not we're gonna get there. So for me, look, I'm gonna be, God willing, elected to the US Senate as a senator is a very different job than as a mayor or a governor. Your job is to do two things. It's to sponsor and vote on legislation and help confirm members of the judiciary and the executive branch. And then it's also to persuade. So what I'm not gonna do is stop campaigning. What I am gonna do is take my campaign for the ideas I want to drive into public policy. I'm going to take it up and down the state of Michigan, frankly. I'm going to be having this conversation nationally, because my conversation is not with 99 other senators, so the 350 million people who elected all of us. And then second, it really depends on am I elected in a majority where we can govern, or do we have to continue to resist? Right. And of course, we're going to be resisting this Trump administration for the first two years anyway. But there's a very different kind of resistance when you're in the majority, because then you can bring everything to a stop. You can start investigating what they're doing. You can start driving legislation and forcing this executive branch to respond. If we're in the minority, then at that point, it's, how much sand can I throw in the gears of an evil administration that is misappropriating our tax dollars to drop bombs on other people's kids, to weaponize ICE against the Constitution itself, and thinking about all the things I can do to stop them from succeeding in an anti American crusade, that they're fighting to waste our tax dollars to do things that are not in our interest.
- [15:16]
A
And, I mean, I think it's important, you know, to remember the midterms of 2018, right. Like it did actually start to sway the opinions of the nation. That's when we get the impeachments. We get a lot going into, you know, the 2020 election. And so I guess, like, with these midterms coming up Are you reflecting on any of that at all? Are you feeling, like, more pressure to, you know, overperform because we need these majorities so desperately, or.
- [15:42]
B
You know, the hard part about politics is that the things that you are doing as an individual in this work, they don't always map to the things that we need to do collectively. To me, my job in the next four months is to build an indelible relationship with the voters in my state. That's my job. It's to understand their pain, to understand how it shows up in their life, and to turn that pain into purpose. If they elect me to serve them for the next six years, then my job is to keep listening and doing the work that they're asking me to do, working alongside other colleagues. The emergent outcome of that is that as a collective country, we can move in the other direction. My part, though, is to keep having that conversation. And, you know, most people know politicians from talking. Obviously, I'm talking here. But the thing that we do best when we do it best, is that you should be really good listener, a really good viewer, the ability to read between the lines and what somebody's not telling you, Building relationships where people can hold you accountable to the things that they're asking for. Because the last thing I want to do is, you know, they ship me off to D.C. right, and I lose touch with the people I need to. I need to serve. And the thing I'm actually most worried about is this is weird thing in American politics where we turn our politicians into celebrities. And the thing about it is, when you meet a celebrity, you normally don't go up to him and be like, yo, man, this is the worst thing in my life.
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A
Right, right, exactly.
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B
You're, like, cheesing in like a selfie.
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A
Exactly.
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B
I don't ever want to be that guy. I want to be the kind of person where somebody who's got an issue in their life pulls me aside and says, hey, I want you to know this is what I need you to work on. And sometimes what happens is it's those leaders on the ground in the community who can read between the lines and be like, hey, this is what this person's not telling you.
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A
Yeah.
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B
This person just went through a terrible divorce, lost their health care.
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A
Yeah.
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B
This person over here is struggling to provide for a kid with special needs. This one over here, they just went bankrupt, lost their job. I just always want to be accountable to that. Right. This is a service job at the end of the day. And it's the same work that I'm hoping I get to show up to do. When I sign up to be a doctor, people bring you their pain, and then they rely on you to share what we can do to turn that pain into healing and into purpose.
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A
Well, at the beginning of our conversation, you mentioned RFK Jr. Famously not a doctor.
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B
Famously not a doctor. Dude goes. He's like. He's the one guy who actually went swimming in Schitt's Creek.
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A
Yes. Yes.
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B
Took his grandkids. I was like, bro, it's one thing if you want to make a dumbass decision.
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A
Right.
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B
It's another entirely if you want to take your grandkids.
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A
Right. And now he's taking the country.
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B
So we're all swimming.
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A
We're all swimming in Schitt's Creek today.
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B
Without. Without a paddle?
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A
Yes, without. And you know it is. Can you describe the frustration you must feel as someone who actually, like, went to medical school, cares about, you know, the health of not only, you know, the country, but, like, your constituents, people who are without health care. And we have somebody who's not only, like, feeding misinformation, but profiting on along the way and doing his own podcast about it now? I guess. So, I mean, what do you. How. How do we get back on track when it comes to things like the CDC and the NIH and, you know,
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B
RFK Jr. You know, I think one thing that might help is like, electing someone to the US Senate who knows how this is supposed to work.
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A
Yeah.
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B
Because we don't have that right now at all. But, you know, I got a lot of rage for RFK Jr. And his grift and his bullshit and his lies. I got a ton. And that's productive enough. But honestly, I'm more interested in structurally, how do we fix the problem? RFK Jr doesn't exist in a vacuum. He exists in a system where people stopped trusting science and healthcare for reasons. One of them is that we who do science too often came to science from a position of condescension. And that's a problem. Like, if the federal government, meaning the taxpayers of this great country, fund you to do work, you owe it to them to explain what you're doing and why. And I think we didn't always do that as well. The second thing is this. You do this amazing science funded by the American public that leads to these incredible miracles, and then we sell those miracles off to big corporations who drive up their costs so that half the public can't actually access them. I remember being in the height of the pandemic Back when you and I having, like, daily conversations.
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A
Yes.
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B
And I was in the city doing an event about the vaccine, and this gentleman comes up to me, like, doc, I'm take the vaccine. Look, I trust you. Like, I remember when you were a health director. Like, I trust you, but I do have to ask you something. I was like, what's that? He's like, you all are trying to tell me to take a vaccine that didn't exist a year ago for a disease that didn't exist a year ago, and I don't even have the disease. I've been diabetic my whole life. Where are you when I can't afford my insulin? Where are you to make sure I can have a medication that existed for 100 years.
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A
Yeah.
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B
For a disease I actually have. And at that moment, I was like, damn.
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A
Yeah. Dragged.
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B
And so part of the issue is that people stopped trusting pharma not because pharma made bad drugs. It's because they made good drugs and made them too expensive for you to have. It's not that far of a leap, though, when you got somebody like RFK Jr. Who's like, what if the drugs are bad, too? He's been able to prey on structural failures in our health care system, the fact that we have not been really good at teaching and explaining science, and the fact that the products of science are out of reach for the most, the broader proportion of the public. So people ask me, like, you're a public health guy. Why are you so focused on Medicare for All? Because I'm a public health guy because I want people to be healthy. I want people to trust the system that so many people put blood, sweat, and tears into building to keep us all safe. And the reason I'll trust it is because these big corporations are now profiting off of these incredible discoveries because they make the prices so insanely high. So until you feel like you have access to the system, you're gonna find ends around the system. And if this guy tells you there's another way, like, eating beef tallow.
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A
Right, Right.
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B
Or whatever else.
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A
If only. It was just that.
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B
If only, but also, like, don't eat beef tallow. Like, I'm like, y'. All. Like, this is exactly what you don't do. Like, saturated fat is bad for you. Like, this is. This is something we actually know.
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A
Yes.
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B
Like, and then.
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A
And then they're like, no, no, no, no. But I put it on my fries.
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B
I mean, it's delicious. Don't get me wrong. Like, if you want to have fries, fry Them in beef tallow because they're delicious. But generally, if you want to be healthy, probably shouldn't eat that many fries, right?
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A
Yeah, exactly.
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B
Generally.
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A
Still part of this.
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B
Frying them in beef tallow doesn't make fries all of a sudden. Healthy. Like, this is insanity. Like, and that's just the, like, the tip of the iceberg. Also, who. Who lives in jeans?
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A
I know.
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B
I mean, can you imagine the chafing?
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A
It's so weird. Everything about him is just like, cartoon evil. Because, I mean, it makes me not want to go to the gym. Repugnant. I just feel like, wear regular clothes. Be like.
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B
Also, what dose of testosterone do you think he's on?
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A
I mean, the highest. The highest. And not the highest, legal. The highest. All of it. I mean, he sounds like he's melting.
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B
Sounds like he's melting. And then also, like, you gotta wonder. I mean, his, you know, this is a PG rated pod. But like, sometimes I'm wondering. I was like, bro, his, like, his testicles haven't been asked to do anything natural for like 50 years.
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A
Right?
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B
They gotta be like raisins at this point.
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A
Yes, exactly. I mean, everything. I think he looks like, do you remember Stretch Armstrong? And then there was the Stretch monster.
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B
Yes. But like, if you aged the Stretch monster.
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A
Yes. And I'm like. And I just feel like it's interesting that he is leading on health more than anything, because I'm like, listen, you don't look that healthy. If I wake up tomorrow and I look or sound like RFK Jr saying what he's saying.
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B
Commit me just taking a spoon of beef tallow.
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A
Exactly. Just spooning the beef tallow and eating dead bears that I found. I mean, all of this is like, sort of cartoonishly evil at this moment. And I think that, like, people are really looking for just an alternative to system. So, like, being an outsider coming to politics, that might be the only crossover you have with Donald Trump. I mean, is there. You know what I mean? Like, you're coming into a system that is broken, that is like, I think, dying to be reborn with different people, different perspectives, you know, how do you, I guess, like, square that with the fact that there are no doctors in the Senate? Like, are you. Are you going to be lonely there?
- [23:41]
B
I'm be lonely there for a lot of reasons. Let's be clear. Yeah, you imagine, like, just, you know, the one upside, like, everybody's like, oh, the job, it's going to be great. I'm like, the job's going to suck.
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A
Yeah.
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B
I mean, there's Nothing about this job that I'm like, oh, yeah, that sounds awesome.
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A
Right.
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B
Like, the work is meaningful. The one upside is there's a gym.
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A
Yeah.
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B
But then, like, think about it, like, Lindsey Graham at the gym.
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A
Yeah.
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B
Probably got the shortest shorts in the whole gym.
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A
Yeah. Right.
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B
And they probably. He's probably the guy at the gym who doesn't wipe the thing down after he's done.
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A
He doesn't.
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B
You know, it's like. It's like, rack your weights, bro.
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A
Anyway, I mean, at least. At least it won't be Mitch McConnell. Would you there. We can all look forward to that. We could all look forward to him not being there.
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B
I don't think he's been in the gym for all of us.
- [24:19]
A
Right. I think it would be a real hazard for everyone.
- [24:22]
B
But, yeah, I'm probably gonna be lonely for, like, it's gonna be me and Bernie. And look, I'm not going there to make friends. I want to be friendly. But I also recognize that, like, we got work to do. I also think that, again, my conversation is just not with the other senators. If I have an opportunity to have a broader conversation with the American public about who we are and who we want to be, what we really want here, like, what is it that we all think about when we look our kids or our nieces and nephews or our loved ones in the eye and then how do we lead from that position? That's what I'm focused on. See what I mean? And, you know, my hope is that throughout my career, like, if I can do one thing in this country, it is going to be to give people the security of knowing they can get the health care they need to deserve without having to worry about, like, if I can get one thing done. And that's worth the price of admission to me. Right. So, you know, I got. Fortunately, I'm from Michigan. My family's from Michigan. I'm going to spend all my weekends in Michigan.
- [25:16]
A
Yeah.
- [25:17]
B
And that's good. But, like, in the four days that I'm in D.C. i'm just going to try and avoid the machines that Lindsey Graham uses. I'm like, damn, he hit the bench. It was chest day.
- [25:25]
A
Exactly. Everything is sticky in here. What happened? Well, thank you so much for being here. We really appreciate it, and we really hope that, you know, there's some change coming to Washington.
- [25:36]
B
Yeah, well, we're trying our best. My hope is that when I get elected, you all don't ask, how is this better?
- [25:42]
A
Thank you. A perfect button, like I said at the top The American healthcare system itself is sick. But it's not an accident. It's a design. And thankfully, designs can be changed. This one has to be. But we need people and lawmakers who know how and are willing to change it. Look, whether Abdul heads to the Senate or not, something's gotta give. How Is this Better? Is a production of Courier. It's written and hosted by me, Akilah Hughes. It is produced by Devin Maroney. Video editing is by Shane Verkus. The rest of the team at Courier includes Marianne Kuga, Sam Hollows, and Charlotte Robertson. Please subscribe to follow how is this Better? On all the platforms, YouTube, Apple Podcasts, Spotify, et cetera. And tell someone about your favorite episodes. If you're interested in sponsoring episodes or giving us products to try and try to sell, reach out to advertise@couriernewsroom.com. thanks for listening and until next time, see ya.