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\tJulie Rovner
\n\tKFF Health News<\/p>\n
\t\t\t \t\t\t \t\t\t \t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.\t\t<\/p>\n In his ongoing effort to reshape health policy, Secretary of Health and Human Services Robert F. Kennedy Jr. reportedly plans to overhaul two more government entities: the U.S. Preventive Services Task Force and the National Vaccine Injury Compensation Program. Ousting the existing members of the task force would give Kennedy a measure of control in determining the kinds of preventive care that are covered at no cost to patients in the United States. And while it’s unclear what the secretary would do to the vaccine injury program, Kennedy has made no secret of his belief that vaccines can do more harm than good.<\/p>\n Meanwhile, last week marked the 35th anniversary of the Americans with Disabilities Act, and President Donald Trump signed an executive order that would enable local and state governments to forcibly hospitalize some people who are homeless and struggling with mental health problems.<\/p>\n This week’s panelists are Julie Rovner of KFF Health News, Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Shefali Luthra of The 19th.<\/p>\n \t\t\t \tAnna Edney \t\t\t \t\t\t \t\t\t \t\t\t \tJoanne Kenen \t\t\t \t\t\t \t\t\t \t\t\t \tShefali Luthra \t\t\t \t\t\t Among the takeaways from this week’s episode:<\/p>\n Also this week, Rovner interviews George Washington University health policy professor Sara Rosenbaum, one of the nation’s leading Medicaid experts, to mark Medicaid’s 60th anniversary this week.<\/p>\n Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:<\/p>\n Julie Rovner:<\/strong> KFF Health News’ “Cosmetic Surgeries Led to Disfiguring Injuries, Patients Allege<\/a>,” by Fred Schulte.<\/p>\n Anna Edney:<\/strong> The Washington Post’s “Morton Mintz, Post Reporter With a Muckraker Spirit, Dies at 103<\/a>,” by Stefanie Dazio.<\/p>\n Joanne Kenen:<\/strong> ScienceAlert’s “New Kind of Dental Floss Could Replace Vaccine Needles, Study Finds<\/a>,” by David Nield.<\/p>\n Shefali Luthra:<\/strong> The New Yorker’s “Mexico’s Molar City Could Transform My Smile. Did I Want It To?<\/a>” by Burkhard Bilger.<\/p>\n Also mentioned in this week’s podcast:<\/p>\n \t\t\t\t\tclick to open the transcript\t\t\t\t<\/p>\n \t\t\t\t\t\tTranscript: Next on Kennedy’s List? Preventive Care and Vaccine Harm\t\t\t\t<\/p>\n [Editor’s note:<\/em><\/strong> This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]<\/em>\u00a0<\/p>\n Julie Rovner:<\/strong> Hello, and welcome back to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News, and I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, July 31, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So, here we go.\u00a0<\/p>\n Today we are joined via videoconference by Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine.\u00a0<\/p>\n Joanne Kenen:<\/strong> Hi, everybody.\u00a0<\/p>\n Rovner:<\/strong> Shefali Luthra of The 19th.\u00a0<\/p>\n Shefali Luthra:<\/strong> Hello.\u00a0<\/p>\n Rovner:<\/strong> And Anna Edney of Bloomberg News.\u00a0<\/p>\n Anna Edney:<\/strong> Hi.\u00a0<\/p>\n Rovner:<\/strong> Later in this episode we’ll have the second of our two-part series marking the 60th anniversary of Medicare and Medicaid, which was yesterday, for those keeping track. This week, Sara Rosenbaum of George Washington University, one of the nation’s leading Medicaid experts, takes us through the history of that program and what the next 60 years could bring. And if you want to hear more from both our Medicare and Medicaid experts, we’re going to put the full-length versions of both interviews together for a special episode later in August. But first, this week’s news.\u00a0<\/p>\n Before we start, I hope you’ll bear with me this week. I slipped and fell and broke my wrist. So my typing and some of my thinking skills are a little lacking at the moment. But on this week of the 35th anniversary of the Americans With Disabilities Act, which we will talk about in a few minutes, I am very grateful for all the various technological advances that are now available to those of us with disabilities, whether permanent or temporary, and which allowed the podcast to actually come to you this week. So, now, here we go.\u00a0<\/p>\n It was another busy week at HHS [the Department of Health and Human Services]. Secretary Robert F. Kennedy Jr., having already fired all the members of the vaccine advisory board, is reportedly now taking aim at the U.S. preventive health services task force. Now, this was not wholly unexpected. When the Trump administration switched sides on that lawsuit over the task force brought in Texas earlier this year, we assumed that RFK Jr. wanted to do something exactly like this. Right, Shefali?\u00a0<\/p>\n Luthra:<\/strong> We certainly did, because it wouldn’t have otherwise made a lot of sense to argue that they could continue to make recommendations unless, perhaps, RFK Jr. wasn’t going to listen to them. It just, once again, really bears noting that this was something many people discussed as a likely possibility, given his record, when he was nominated to be secretary. And there were some senators who suggested that perhaps he had made individual promises, commitments, to actually keep the expert panels in place. And here we are. He did not do that.\u00a0<\/p>\n Rovner:<\/strong> Yeah. And we should say he has, at least as of this moment, he has not yet fired all of the members, but certainly there are indications that he’s considering it. And obviously that was what they argued to the court, was that, Hey, it’s OK for the Senate not to confirm the members of this task force, because the secretary has control over them.<\/em> So here’s the secretary suggesting that he’s going to take control over them.\u00a0<\/p>\n Edney:<\/strong> And now the senators show support for the task force. It’s just this circle that keeps on going where they need to try to bolster the backing, but the writing was on the wall when they voted to confirm him.\u00a0<\/p>\n Rovner:<\/strong> Well, apparently the secretary isn’t finished with vaccine policy, either. He’s also taking aim at the 1980s-era Vaccine Injury Compensation Program, or VICP. That’s what provides a no-fault way for people injured by vaccine side effects to get compensation for those injuries. This program was literally created to prevent the vaccine industry from going out of business in the 1980s because it was being sued into oblivion. I know that RFK Jr. said the program is, quote, “broken” and he intends to, quote, “fix it.” But does anybody have any idea what he might be planning for it? I will remind people, like, I’m shouting into the wind, that this was an act of Congress created by Congress, reformed by Congress. I don’t know whether the secretary can just take it apart on his own.\u00a0<\/p>\n Kenen:<\/strong> He can try, or leave it intact but create some kind of barriers to filing, or\u2014\u00a0<\/p>\n Rovner:<\/strong> Actually, I think he wants to make it easier for people to get compensation.\u00a0<\/p>\n Kenen:<\/strong> He wants it easier to get compensation. We don’t know what it will do. But they keep finding workarounds or just ignoring things. So we can’t say we can or cannot do, because we don’t know what they’re going to do. But his whole health persona really is built on the fact that he believes that vaccines are damaging or dangerous and they kill more people than they save. And therefore, apparently all of us could just get a payout because we had a shot. But it’s not as much of a moneymaking business in general, not for a specific new shot, but vaccination is not as profitable as the public may perceive. Yes, the covid shots, there was some exceptional things about the speed and scale, etc.\u2014\u00a0<\/p>\n Rovner:<\/strong> Right. Because everybody got one at the same time.\u00a0<\/p>\n Kenen:<\/strong> And they’re subsidized, etc., or some of them were. So Anna knows more about this than I do. Basically, it was designed to both protect people who were \u2014 nobody, even the strongest pro-vaccine people, nobody denies that there is such a thing as an injury. They would say it’s rare and not autism, but when it is, it is rare, but someone should get compensation and the care they need.\u00a0<\/p>\n Rovner:<\/strong> And Anna, we’re really looking at the potential for some of these vaccine makers to just say, We’re going to wash our hands of making vaccines.<\/em> Right?\u00a0<\/p>\n Edney:<\/strong> Yeah, absolutely. The point of this program was to, like Joanne said, admit that there can be injury but to make it no-fault so that the vaccine makers could continue providing vaccines for the majority of people who respond well to them and to not be caught up in court battles for millions and billions of dollars all the time. And there may be some complaints, but it does seem that people, by and large, are able to get some compensation from this. And you mentioned covid vaccines. Those aren’t included in this program, so that may be something he is looking at, because they’re done through a different program, which is maybe some complaints about it or that it’s a little less likely to pay out or to give as much compensation. And so maybe a way of expanding it is to include the covid vaccines. But if it becomes that \u2014 Well, you can keep using this program, but we’re also going to make it easier to sue the vaccine makers<\/em> \u2014 we’re going to see the companies be wary of being involved in providing vaccines at that point.\u00a0<\/p>\n Rovner:<\/strong> Well, in still more vaccine-related news, the controversial head of the FDA’s [Food and Drug Administration’s] vaccine division resigned unexpectedly this week. Anna, tell us why Vinay Prasad was so controversial. And why did he leave after only three months on the job?\u00a0<\/p>\n Edney:<\/strong> Yeah, this was a huge amount of drama at the FDA. So Prasad himself can be a polarizing figure. He has been at UCSF [the University of California-San Francisco] for a long time and gained prominence as someone who criticized the agency for what’s called accelerated approvals, getting certain drugs, particularly cancer drugs, quickly to patients even when they hadn’t proven necessarily that they worked. And he criticized that program. He got to the FDA. He was head of the vaccines division, which also covers biologic drugs. And under this division was a drug made by a company called Sarepta. Every one of their drugs that has come to market has had a lot of drama surrounding it because these are drugs for very, very sick, usually young boys who have Duchenne muscular dystrophy, and it’s a huge parent population that wants these drugs, even when maybe they don’t always show that they work very well.\u00a0<\/p>\n Well, a few kids have unfortunately died while taking these drugs in recent months, and so the FDA was looking at that, and it came out that there was another death in a clinical trial of an older gentleman, and no one knew definitely if it was related to the drug. And so once that became public, it’s not like the FDA or the company came out with it, but once it became public, the FDA kind of seemed to overcorrect and try to have the drug be paused, and then maybe take it off the market. And so Vinay Prasad was at the center of this debate. Already he was disliked by some of [President Donald] Trump’s higher-up people, particularly Laura Loomer. We may have heard her name before.\u00a0<\/p>\n Rovner:<\/strong> We have.\u00a0<\/p>\n Edney:<\/strong> She goes after some nominees, successfully in many cases. And Rick Santorum also got involved at this point. He has a daughter with a rare disease and didn’t like the way that this rare-disease drug was being treated. So essentially Prasad, who clearly for the last several years has only wanted to be at the FDA, has left after three months, was pushed out after three months.\u00a0<\/p>\n Rovner:<\/strong> Wow. It’s quite the drama. I’ll link to a story<\/a> or two if you actually want to go deeper.\u00a0<\/p>\n Kenen:<\/strong> But one of the criticisms that Laura Loomer had is that he used to be a Democrat.\u00a0<\/p>\n Edney:<\/strong> Right.\u00a0<\/p>\n Kenen:<\/strong> Well, that would also apply to RFK Jr.\u00a0<\/p>\n Edney:<\/strong> Right. That’s true.\u00a0<\/p>\n Rovner:<\/strong> It would. Oh, I’m sure the drama, both at FDA and at HHS writ large, is far from over. Well, speaking of turning the clock back, President Trump issued a new executive order that would end the, quote, “housing first” policy that has driven homelessness strategy since the late 1990s. I guess this is also not a surprise. Trump complained repeatedly on the campaign trail about how homeless encampments were destroying cities. We’ve had a recent Supreme Court case on this, but this new policy seeks to not just allow but encourage localities to force at least some homeless people off the streets and into residential treatment. I imagine this is going to make for another long line of lawsuits, right?\u00a0<\/p>\n Kenen:<\/strong> Well, there’s housing first itself. It’s not without controversy. There’s a philosophical divide. Housing first means you house people and then you deal with their social and economic and physical and psychological and drug abuse, etc. Get a roof over their head and then you deal with everything else. Other people say, No, get them into treatment and stabilize them, and then you put them in housing, and they have to \u2026<\/em> Housing first has been the dominant philosophy in addressing homelessness in recent years. That’s a different debate. This is, like, put them in an institution against their will, which the courts have power to do in limited cases. There are times when a court can say, This individual doesn’t want to be hospitalized, but for their own safety they really need to be.<\/em> But that’s one by one and not that common, and it’s limited. I believe it’s 30 days. I might be wrong about that.\u00a0<\/p>\n But this is a whole different thing. It’s a combination of this, We’re going to force them into institutional settings for treatment, whether they want it or not,<\/em> combined with the Supreme Court decision of about a year ago allowing cities and local government, not just cities but governments, to forcibly clear away, to dismantle encampments, to force people out. So you have it coming from both the administration’s policies and the court decisions. This creates a whole \u2014 and housing money is being cut. Housing assistance is being cut. So you really have this tremendous shift in how we approach homelessness at a time when homelessness is high, while homelessness has been high. And nobody’s saying that there’s not a mental health component for some, but by no means all, people who are homeless. But this is not in accord with how the health and homelessness advocacy and treatment world has been approaching it. This is a significant shift.\u00a0<\/p>\n Rovner:<\/strong> And as you point out, this is a health and social service issue, too, because we are seeing money cut and money diverted that, basically this executive order will say, We’re going to give more money to localities that sort of handle this the way we want and less money to others.<\/em> So I imagine this is going to have trickle-down effects for some time to come.\u00a0<\/p>\n Kenen:<\/strong> Yeah. And the clearing the encampments is going on, and we should know it’s not only a conservative state. California has done it. Other states have done it. So the idea of dismantling these \u2014 we’ve all seen these encampments \u2014 that is happening in various places in the country already, and this is sort of an extra step. It’s not only do you clear them, but this would envision forcing them into treatment, often in an institutional setting.\u00a0<\/p>\n Rovner:<\/strong> Well, meanwhile, as I mentioned at the top, this week marks the 35th anniversary of the Americans With Disabilities Act, which I also covered, by the way. Secretary Kennedy spoke at an event marking the occasion on Monday. But an awful lot of the disability community is up in arms about the cuts to Medicaid, which they say will roll back much of the progress the movement has made in the past three and a half decades, much of it for people getting in-home types of assistance. And yet the ADA was pushed hard and signed by a Republican administration, that of President George H.W. Bush. Is this yet another formerly Republican priority being kind of tossed out the window?\u00a0<\/p>\n Luthra:<\/strong> I think to your point, a lot of things that used to be bipartisan in the health policy world are not anymore. The other example is something like Title X, and it’s just we have really seen this shift of things that used to be broadly uncontroversial, because the health implications are clear, become much more so and largely become rejected by Republicans in a way that is just really, really different from what you might’ve imagined even, I don’t know, 10, 15 years ago.\u00a0<\/p>\n Rovner:<\/strong> And my favorite piece of Title X trivia: It was signed by Richard Nixon, but it was sponsored in the House by then-Rep. George H.W. Bush. So he both sponsored Title X, the Family Planning Program, and signed the ADA into law. Boy, it feels like a million years ago and not 35.\u00a0<\/p>\n Well, moving on to health care costs. It is tariff week in Washington \u2014 again \u2014 and not surprisingly, prescription drugs are a big part of that conversation. The trade deal that President Trump announced with the EU while he was in Scotland last weekend includes a 15% tariff on brand-name prescription drugs imported from Europe. That will include things like, I don’t know, the blockbuster weight loss drug Ozempic? Anna, how does Trump think this is going to eventually lower drug prices in the U.S.? It sounds like it’s just going to raise them.\u00a0<\/p>\n Edney:<\/strong> Yeah. I think most people agree with your sentiment that it’s going to raise them. I think a lot of this is focused on bringing drug-making back to the United States and trying to get companies to do more of that here. Whether you see that from brand-name companies seems like it could be really difficult. I know Botox is made in Ireland, and this is a facility where, because it’s essentially a toxin, a very deadly toxin if released\u2014\u00a0<\/p>\n Rovner:<\/strong> Yes, it’s botulism.\u00a0<\/p>\n Edney:<\/strong> Right. This is a facility that is highly guarded. A colleague of mine wrote a story on it many years ago now, but you had to go underground. They’re not just moving this thing over to the United States. So I think for brand-name drugs that it’s going to be particularly difficult to lower the prices based on tariffs, or to say We’re moving production over here<\/em> in any capacity. So what the thinking of how exactly this works or is beneficial will be interesting to see, because they’re also still doing \u2014 this would not apply to these \u2014 but they’re doing this national security assessment for tariffs on drugs from other places and trying to figure out if there’s a national security reason to be putting tariffs on them. For the most part, when drug quality comes into question, it’s not usually the European drugmakers that we’re concerned about.\u00a0<\/p>\n Rovner:<\/strong> And we’re still waiting to hear about the generic-drug makers in India and China, right?\u00a0<\/p>\n
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\n\t\t\t\tRead Anna’s stories.\t\t\t<\/a><\/p>\n<\/p>\n
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\n\t\t\t\tRead Joanne’s bio.\t\t\t<\/a><\/p>\n<\/p>\n
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\n\t\t\t\tRead Shefali’s stories.\t\t\t<\/a><\/p>\n\n
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