On this week’s special episode of Stay Tuned, Preet is joined by Andy Slavitt, whoserved as the Acting Administrator of Medicare and Medicaid Services during the last two years of the Obama administration. A healthcare industry veteran, Slavitt helped to salvage the maligned Healthcare.gov and worked to improve federal health care data analytics. Since leaving government, Slavitt has remained a critical voice in the battle for healthcare coverage, founding the non-profit United States of Care and the investment firm Town Hall Ventures in 2018. Since the outbreak of COVID-19, Slavitt has been on the front lines—working to acquire healthcare supplies for medical workers, helping to popularize #StayHome, and appearing on TV shows and podcasts to explain how we can flatten the curve.
To listen to Stay Tuned bonus content, become a member of CAFE Insider. Sign up to receive the CAFE Brief, a weekly newsletter featuring analysis of politically charged legal news, and updates from Preet.
And if you haven’t already, listen to this week’s full episode of the CAFE Insider podcast for free. Juliette Kayyem, President Obama’s Assistant Secretary for Intergovernmental Affairs at the Department of Homeland Security, joins Preet and Anne to discuss the many pertinent issues raised by the coronavirus. Sign up to receive a link to the episode at cafe.com/preet.
As always, tweet your questions to @PreetBharara with hashtag #askpreet, email us at staytuned@cafe.com, or call 669-247-7338 to leave a voicemail.
REFERENCES & SUPPLEMENTAL MATERIALS
THE INTERVIEW
“Andy Slavitt Can’t Stop: How a Health Care Wonk Became a Rabble-Rouser,Stat News, 5/25/2017
“One-on-One with Andy Slavitt, Board Chair & Founder, United States of Care,”Digital Health Today, 10/17/2018
“The Issue,”United States of Care, 2020
“What We Do,”Town Hall Ventures, 2020
TESTING:
Andy Slavitt, “Why We Don’t Have Enough Coronavirus Tests,”Medium, 3/24/2020
Andy Slavitt, “The Severity of the Next Several Weeks Depends on Our Actions Now,”Medium, 3/22/2020
“What Is R0?: Gauging Contagious Infections,”Healthline
HOSPITAL SUPPLIES:
“Our Mission,”Project N95, 2020
“Summary of Comprehensive Congressional Proposal for COVID-19,”United States of Care, 3/23/2020
Andy Slavitt, “The Outcry From Nurses and Doctors Over the Lack of Protective Gear Will be the Major Story Next Week,” Medium, 3/17/2020
ECONOMY:
Andy Slavitt, “Coronavirus isn't about Trump's stock market and 2020 odds. Or at least it shouldn't be,”USA Today, 3/2/2020
“Trump pushes a ‘return to work’ as Kudlow predicts coronavirus stimulus will fuel economic rebound,”CNBC, 3/24/2020
OBAMA ADMINISTRATION:
Sara Rosenbaum, “Medicaid's Role in Caring for Flint: An Update,”Commonwealth Fund, 3/10/16
“CMS Announces $66.1 Million to Support Zika Prevention & Treatment Services,”CMS.gov, 11/9/2016
“Slavitt Says Goodbye to CMS Staff as Obama Administration Gives Way to Trump,”Healthcare Innovation, 1/20/2017
“The Man Who Saved Healthcare.gov Wants a Bipartisan Solution to Healthcare,”Washington Post, 3/16/2017
Trump Appears to Throw Shade at Obamacare Site While Announcing National Emergency,”Daily Beast, 3/13/2020
“Ex-Obama official fires back: Trump was left with 'global health infrastructure,'”The Hill, 3/15/2020
EXTRAS:
Andy Slavitt on theAl Franken Podcast, 3/22/2020
Donald Trump on Mitt Romney’s Coronavirus Test,Twitter, 3/25/2020
“Sex and Coronavirus Disease 2019 (COVID-19),”NYC.gov, 3/21/2020
Bill Gates, “The Next Outbreak? We’re Not Ready,”TED, 3/2015
See omnystudio.com/listener for privacy information.
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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
Hi, this is David Rubinstein. The host of the New York, historical society's new podcast for the ages join me as I explore the rich and complex history of the United States with a nation's foremost historians and authors. Listen to for the ages, wherever you get your podcast, this episode is brought to you. My own up. Every bank says they ve got great Morgan's ranks.
Why are people paying billions of dollars and extra interest every year, because it's too hard to know what a great deal looks like for? You are unique scenario owner makes it easy to get the personalized data to help you make a smarter home financing decision, learn when a great
looks like for your mortgage, so you never ever pay bills. Your profile today, at owner, dotcom, equal housing, opportunity, M L, s idea number one. Four five await o five from Corfu. Welcome to stay too, I'm prefer. This is a point in time when I think people will regret if they haven't been doing everything
the thing they can the vast majority of us. Are you look back at this time, but not all of us
and we're all gonna lose people. We now that's Andy slab it
he served as the acting administrator of the centres for Medicare medicate services during the final two,
of the Obama administration. In that role he helped to salvage the affordable care act amid technical difficulties, with its website and fierce resistance from progression
Republicans slab. It has stayed in the healthcare fight during the Trump administration is hosted town halls across the country during the unsuccessful GEO, be attempts
repeal and replace the Asia and created a related fund town Hall Ventures to invest in promising healthier startups. He also launched a nonprofit United States of care which aids policy efforts to expand healthcare coverage to marginalized groups. Since the outbreak of the corona virus slept
has been a force on Twitter and on television, live tweeting meetings with policymakers, offering daily updates and pleading with Americans to hashtag stay home
We talk about all of this plus the wrenching trade off between people,
in the economy and saving lives, the good and the bad and the congressional stimulus bill
and the lessons he has learned from his time, responding to health crises on Capitol Hill, that's coming up stay tuned, hasty too.
I hope you and your loved ones are staying safe in this difficult time. There's a lot of
certainty right now and we're doing our
to try and make sense of the headlines with experts who can help cut through the noise to help bring some clarity.
making. This week's episode of the CAFE insider podcast, available for free to everyone and modem- and I spoke to our friend Julia. I am, she said,
as President Obama's assistant secretary for Inter governmental affairs at the Department of Homeland Security, in that
she oversaw. The response to the h want anyone pandemic and the BP oil spills she's. Currently, a professor at Harvard
national security, endless were CNN and she's been doing
Great Service in recent weeks, provide
incisive analysis of the corona virus crisis. Normally
ample portions of our conversation, but this week we're making the full episode free, just had a cafe dotcom, slash preach to sign up to receive the full episodes. That's Cathy dot com
a priest, and if you already receive cafe emails check your inbox, you should have received the link, stay healthy and stay safe.
my guess this week is Andy Slatted, the outspoken former acting administrators
the centres for medical care and medical services since the outbreak of the corona virus Pandemic
he's been invaluable voice and tracking the crisis offering daily updates on twitter and-
on cable news in part cast to help make sense of what is happening and how best we can collectively response slavic who jumped into government from the private healthcare sector to help salvage Obamacare knows first hand the difficulties of managed
federal help bureaucracy. We talk about his impressions of the Trump administrations, responds to corona virus, the challenges ahead, and what we can all do to support frontline
medical workers as they selflessly care for those suffering from coded nineteen. We also
about issues particularly pressing in New York and the importance of federal state collaboration to flattened the curve. That's coming up stay too,
Andy
I would thank you so much for being on the show in making the time great to be hurried after you, ve been busy. We have a telescope to talk about. I should know
we're listeners that we are recording this on the morning of Wednesday March, twenty fifth there's breaking news from the Senate. There appears to be
agreement on a package will talk about whether or not that I should get through whether the president will sign it. The present has been talking about calling court reopening the country by Easter week.
Talk about that too, but before we do any of that, I thought I'd. Ask you to talk about some of your background. How is it
You ended up caring about and being involved in the world of healthcare. I grew up in Chicago, went to college
my best friend from college? A pen was a pre man
the twenty nine. He called me one day with the twin one year: old, kids, and
owing to her aunt
but later he was dead and we just got me.
And we're living in California, and so
had his widow lean in there
one year olds move across the country,
and live with us in California, so lightly
First year, marriage. I had two wives
three kids, which is very overrated. If you ve never done that and really help to get back
Murphy and in the process learned a lot about what it's like to have a lot of.
nickel bills that you can afford to pay and tried to help us
that and on the heels of that I started a company.
we basically trying to help the under insured get lower
of care. This was back in the nineties when it was even a day
nothing thing lead to another. I did I'm running a quite a bit company and health care.
Overseeing the largest data and analytics businesses and health care
I know, a lot about health care and which is basically a corporate.
For a decade until one day and twenty thirteen and health care?
Gov was launched and crashed. I think most your letters probably remember that yet it didn't go very well, and I think the president made made an allusion to it recently at one of his briefings. Right yet was,
wasn't the best moment a wider. So what do I do
I picked up the phone and called why
thousand said: hey, you need help and unanimity.
like that. All these things can happen. You think it'll go and returned
Three days later, they announced
I was gonna, be the lead firefighter turning around healthcare dove, which of course,
Mr it's one thing, which is that I was the only person, the country that added stupidity, the car
and then at the amateur.
This conference emails that it would be fixed within five weeks and they admitted at me so that
led to five weeks of me, living in a hotel in one
in turn, in overseeing the pretty
demand command structure and overseeing out both the government workforce, the outside contractors, and about a couple hundred of my old people, and we did it. I mean I enlarged the illegal fixed in
Millions of people got health insurance and at the end of it all, they asked if I wanted to say about the term in the Obama administration. This was little of Tony fourteen
I ended up running centres for medical men
Kate services, which overseas digest the easier by like its name, implies Medicare American Alcinous vehemence.
Also, the cms right. Thank you for that.
To use an acronym
We agreed on time. It keeps saying that whole phrase over and over again so we hear about C
all the time explaining folks what that agency does
specifically in how it fits into the overall government, responds to the corona virus.
To a mess overseas about a quarter of a U S, budget over a trillion dollars, which is the programmes and Medicare Medicaid Children's health insurance programme an easier. So really, if you think about
I literally CMS is responsible almost like an insurance company,
for everybody and medical care and Medicaid making sure that they get their benefits.
and as a result of that, we mess is also the regulator of a number of things there. The regulator in in the case of coal
Eighteen very relevantly, the rules
around insurance and safety and many categories, oversee clinical labs, which are a critical part right now. What's going on,
nineteen oversee the safety of nursing homes, but but
so just oversee the rules of participation, how healthcare pay for,
in many many others they think so if there are levers, the deed Ministry,
and has in health care to affect the health care system, and they can affect everything
a lot of those levers urgency. A mass see a message
inside the Department of Health services alone.
With the CDC.
with an eye to eye with empty. I M
all run very, very separately, so dont
to give them, is a happy family, just think of them ass, sort of a category of things it report right now up to secretary outsiders are: are they away?
family
depends on the administration for sure
The emissions are so different that they're not Saddam
Definition a worrying family, but you know
day is filled with scientists. You'll see a mess is filled with your policy payment people
the CDC is filled with your public health people. So it's just very different types of people. When I was there,
Frances Collins, ETA by my age, Rob Killeth ahead of the FDA Tom Friedman. It was ahead of CDC and I work
friends and we try to do our best to communicate in and bring our
together only of crises like we didn't. Flemish Michigan or importer ego there's also FEMA, which a separate who should be deleted
see or should there not be any led? My answer is somebody did them will be in charge, so is adapter fatty acid vice President Pence, you know
It probably should be somebody you like in a general Mattis somebody who died, strong logistical control, the weight. The way it works is
disaster response. A disaster recovery entirely
within FEMA, except for pandemics,
officially sit within each age, ass, never there's a war room, etc with any dangers and would typically happens at the crisis, gets bad enough
as has happened was eager, is the White House set up its own? Can command structure that actually works? Well, because you need a really cool.
chain of command and control, and the White House did
nominal job, at least when I was there under Obama. Responding to that crisis, because decision guide may quickly
and the people in charge knew what they were talking about and everyone sorted took their orders and ran in these crises. Speed
your friend. Perfection is your enemy.
What we have now is something less than that we have.
Or of different agencies and immaterial president many material in the sense that
will not necessarily stay with the same
the error message, depending on who talks to last, you ve got a unique event
faction led by Larry COD Low, whose argue
strenuously that the damage
Saving lives is not worth it to the economy. Well, add that to help bird
We're gonna like a lot of things, I think, but the president is expressing- and I I've heard this from a lot of very
smart people active in the economy and the markets at some point
You have to ask yourself whether the shot down is doing more harm than good any good,
terms, perhaps even in health terms and
yet not the elder expert. You got help. People like Doktor veggie
who are trustworthy and and and straight shooters.
It will probably tell him what you think you think he needs to hear, but
may not be listening at any particular day, and then you have
Emma who is used responding to local disasters, but can be quite helpful here. You ve got
just what has some resources in what would need them
when the somebody needs to come together and say this whole command and control structure
we're gonna bring all of these resources in essence to their bessys, not all there
that differently than when I did turn you wanna talk about it
although in a bigger scale, and use that
the key to all the people on the ground.
resources and allocate resources quickly to the people on the ground and state
in hospitals and so forth, but I've been talking with the White House every day,
multiple times a day. Putting the team working on this and
I have a lot of sympathy for what the going through, because it is a crisis that they were prepared for that
Obama Administration left in place in infrastructure trumped up that away and
there are now starting from scratch. I would love to spend
why the time focused on terms bad decisions. But the truth is
you have to navigate from where you are that were you
She were, and so I'm trying out the door,
the that's about it here
The latter I want. I want to focus on some of those things, but first I will give you the floor,
We need to respond to something that the President keep saying, and I've heard
a number of times, have some version of we inherited a very obsolete system. This was assisting that was out of date obsolete or it was
That was never meant to take care of the kind of quantity, the number of people that were talking.
millions and millions of people you can respond to that. I care
you bet, I probably won't, because it's the wrong time.
argument and nearest
I can tell this spreads pretty much evenly.
between republican and undemocratic democratic Republican. I think someone should write a big report in committee.
That's what this is all said and done. I will just tell you that
You'd facing a linear pandemic. It's one thing
when you're chasing something this growing exponentially like this is, and we can talk to what that means,
We think of it as a number of your singer. Tb every day are doubling about
every two and a half to three to four days- and I
and by the accounts. That means case codes then
really really really important to be heard of it. It's kind of like enough
borrow a thousand dollars from a low shark in the door
between paying him off on time or waiting. A number appear
to pay him off and finding out that you dont over a thousand dollars. Anyone your fifty thousand dollars, because the interest rates, bloody, thirty percent
That's what it means to be behind in a crisis like this, and so the server
weeks, two months where
the rest of the world was looking at. What was happening in China was really a great time to start
building supplies masts,
ventilators getting hospitals ready getting
DR tracing ready getting too
ready and that
ass time those two weeks are going to be to it.
Will never be able to catch up, and I think they can have a big impact on the under body count if the past right now, but it's it's really the most ITALY. The thing that I think system then keep people up at night. I appreciate you took and are taken
the heroic, has restored the middle of a crisis. When you say that you talk to folks at the White House that might come as a surprise to some people cause. I know the president has said when asked the question: have you thought about calling some of your predecessors? He basically dismisses that notions is not only to do that, and so it's interesting at least to me that there are people in the White House talking to a former Obama official. Who can you say
who you're talking to other kinds of people you're talking to an what exactly the mood is over there
Yes, I would say- and I dont want to reveal any of the conversations, because I don't think they were had with me under the auspices of them being public, but I think you could think about the people on the task force and you can think about
of his closest closest advisers? And you can you can use your imagination as the current that many of them as it is they who who that might be. But I think I like, I hope, by the time we get to the fall, were able to go back to politics as usual.
and be at each other's throats and beyond cable tv obsessing over the political landscape or whatever,
yeah right now, we're not in a democratic verses Republican were in a way must be.
These kind of thing is this: the Maastricht is China. Illimitable is factors restriction, right, yeah, yeah, well, that that's true too,
I think the point is, and I say this not just deep- and I say this about, and I know this is true about you.
and I say this, but anybody listening. This is the point in time when I think people will regret if they haven't been doing every single.
Will they can the vast majority of us? We can look back on this time, but not all of us
and we're all gonna lose people. We know we're going to have the largest body count in our history. Rivalling the nineteen eighteen flew we're gonna have horrific scenes on television. It hospitals are only used to seeing in foreign countries far far away from us, but you're saying-
that's gonna, be true to steal a sense of the scale, your time it is EU think that will be true. Even if we do everything we can right now with respect it, distancing measures and everything else.
I think that is our best hope right now. It's a really interesting question. You asked pre because
If we do it right, it is incredibly,
The feeling in one regard were used to doing things that are reinforcing. We do them. We see the benefits of those act,
but we just did some real time data. We took a look at two location, Santa Clara California, in Miami date Florida. The reason we looked at those two cities is because
declarative just go then area put in place very strict stay at home, ass to stay home rules,
Gee Mammy date was to be kind little more lax anymore late to it.
and we looked at the data and the data we looked at was real time. Loading of temperature data from people's thermometers that load the cloud and we compared to average temperatures you inspector inclusive,
and we draft the decisions that were made politically, such as those
bars. Restaurants, closing schools having people stay home and use
A sharp drops in the number of cases with this disease in Santa Clara compared to floor
so scientists talk about something called and are not enough.
You go back on his way back as a hate, throwing legal people. If people don't know what that means.
This is all about this thing called the airlock in reducing the are not, and if you can do that, you can actually see dramatic. They improve results, as I understand it, the are not is is a reference to the average number of people that any infected person will then
the disease onto a right of veto. Right but finish my earlier point, the people in San Francisco or not
the horror show at the hospitals in Santa Clara, I should say they did have. The first death in the country
And the guy religion early and governors who has done a great job, but
now that the peoples
just a thing why we're locked down? What's the point at the point is the point: they are the reason
that we are seeing- and we are likely to see
better results in San Francisco because a what
doing the problem is: when they look at the window, you don't see that if they could be telling
hoarded to Seattle and your great now, that's it ah, and if they keep watching tv, they're gonna get it the all too apparent
right. I've heard other people mention this as well. If everyone
down in do you're supposed to do. You won't see as much tragedy as you might have. Otherwise, at the end,
which will say well, why do we have to do that?
very reason why you, seeing you know better landscape right,
We both countries, doubters people who
really value independence. We
suspect of government were not comply. It add under the fact that the point you made earlier that we hardly know what's truth from fiction at
to the fact that we don't have a context for this, because this is an invisible enemy and
ITALY for younger people. This feels like it's the flu and I don't know who carriers are and then
the scientists made me late last night that I support
it was true, but when he said it, I felt smart because I've been claiming it and cable tv
our brains. Don't work exponentially.
his work linearly so
We are used to taking action and making
address when I used to taking action and seeing it get away from us
swimming after a steamboat. You can be
fifteen feet away. You can swim fifteen feet, you're, no longer fifteen feet away when it when you get there you're much further
and our brains, I have a hard time understanding that so all this kind of level
the economic exploitation in the social dislocation has people spent around. So the present keeps talking about
We worry, he has about the cure being worse than the problem and at the time
taping he's been talking about calling for reopening the country, but I guess he means the cessation of social distancing into the same scale.
Freeing up of businesses etc, and he is now set a sort of aspirations aspirational. Not. He speaks about a pretty flatly Easter, because
thanks are some symbolic virtue to Easter. That's three weeks away the less than three weeks away. When you talk to folks, if it's ok, we asked this question. If you'd answered we talked
folks around the president. Are they have the same view, because I hear reports that they are not that debt Easter seems too soon yeah. I don't think I've met anybody who thinks that is based on
science and I'm not sure whether he said that had a spur them
meant or whether or not you in it
anybody but
scientists are referring to this. Is
used or massacre. He said: he'd, like hundreds of people, are thousands of people to sit next to each other in church, it'll be beautiful
You know you're just here's. My message to people, there's gonna be many ministers
life. There's are many many happy occasions in your life. This is a time of some sacrifice,
and I understand that- and we understand, then the president- doesn't you know
believe he's trying to do his best. This is lousy situation, but he doesn't make decisions for us
your best off listening to your local health commissioner, in this particular area,
we should, then you are the President and whether Europe
voter or not whether you like him, I don't like him. None of that matters under that's. The point is that the person who I think you should stick your family and your communities fit
I've, never trust me I'd. I dont and I won't, but a lot of people will be important for public policy that people get the present to back off
at Easter and ended- and if so, how do you go about persuading the president who thinks a particular way about things in this particular focus so that lots and lots of peace
won't defy what their governors are major saying and follow what the present ice data saying so in the
things I have this group of people that I talk to, that our scientists and risk managers, homeland security, people and summits
direct voice. Some videos alighted texting, an email one of the people.
On their who, I would call I would say here:
It is dark cloud on this topic and maybe it's dark.
I have ever met my life.
we won't have him ownership. Do you don't even talk to him?
he says not a word.
Andy. He will
This is the body bags, there's no way he's going be able to go through with it and
yeah he's talking about a period of time work, and I don't know that
because I think we're going. This is happening in different cities at different times
It's happening in New York right now,
and he may just sort of like right off New York urine as he's gonna, be
Nobody can leave New York, but the problem is going.
Going to happen everywhere and ever should? I should explain something
pre, there's a lot of data thrown around that's a lot of
happy to go. I think most people know a lot of these. Things is now a virus. We don't have immunity. How contagious?
is the arena, which is perfectly explained in the disease
lethal. Two three types of people.
people who are older people who are not less
older, but have compromise immune systems or chronic conditions are predestined. Existing conditions, the third one
is the one that's gonna kill the most people. In my opinion, that's the risk factor of being in a community if doesn't have any more intensive care unit beds or venom
there's so people who can live a long lived my life and if they were to get over nineteen during a period of time when it was said
coming and going fairly reasonably underneath the capacity for medical system would be fine, they might have a visa,
bad viral flu or pneumonia, but they emit need, be hospitalized. Then Lady Buddy, it's the many many people would survive
but she fatality rate, as they call it see of our view. One of the referendum is going to be much much higher because by
when there's a mad rush of people and of hospitals, we will have
what is your doctors and nurses for reasons of people well understand at this point
a shortage of ventilators,
and the shortage of rooms to take care of them in the inner cities. So I think the point is
The stay home isn't about avoiding
diseases out about beating the disease. It's about two things about giving our health care system a break in these workers, a break so that they can handle what
at them without giving their scientists in time, because our scientists will do a lot of great things, but we need to give him some time and trouble. You're no rational,
so, let's let us start by the Easter scenario for a moment of people really understand how dangerous it is, what the presidency saying Ipod,
equally. If on Easter, we stop doing all these things. We were doing in New York in and allay and in other places around the country. Would the next two weeks look like how would it overwhelm the healthcare system in this country if we just went back to normal and through
I'm gonna take this come away them. This prejudices tenderly as possible, because these are scary numbers, but I'll tell you
governor Cuomo has, I think many people are seeing is doing about as good a job as you can imagine levelling with people telling them the actual sitting.
asian being very insistent.
But also doing it in a way which respects their psyche, and he said oh he's these.
recited data, which I can talk about, because I had to send to me about ten days before from the mayor's office in the same data these been referring to, which is therefore by three thousand hospital beds. I see a beds in Europe and the projection is at an April there are going to have. They can have as many as thirty the need for thirty five thousand or more beds with with vents, and that means that
they will have to make decisions if things go at its current pace and who lives in who dies? Now, because it is a two week lag and because people asymptomatic for a while,
We're gonna be dealing with some of that, but the question is
two weeks from now,
could be better or worse
wait for now
better or worse, and if it's better
We get a shot if it's worse than its demonstrated gonna be exponentially worse because aren't I
in a place like New York, which is densely populated,
can be over six without any of these measures. We need our lot to start
get to one in below for us to have the ability to beat this thing without it being us.
Getting are not down to down to one
It will have. They got it down to one point three after they did very strict measures. I think
somewhere still over to the difference between our two and over.
just over one, and one is dramatic.
And we control that that's the kind of
Fighting thing is
rosy the perimeter style we
troll the war effort here, because we will in fact people
we don't know we infected aviation,
people that are invited? I don't know where they were infected, because this is this disease
he's very systematically in much of the population, but Prince Charles has no idea. The royal family put out, they dont know where he got it and they don't know who is given a two or possibly given it too. I didn't hear that. Does he have the earth? Yes, I thought I saw this morning, but also other Mitt Romney tested negative to which the president tweeted something sarcastically unprecedentedly shockingly, but it is it possible
So it's Elizabeth, a second thought experiment, not a total back to normal on Easter. Do you hear some people saying and it sounds reasonable to allay person, not someone of yours,
and to say look there's some places where,
Can it be bad. Word is bad like New York, but there are other places: Autonoe Utah, Idaho Montana, I'm gonna pick less densely populated states,
where they can go about business in a more normal fashion and you isolate spy,
and you do a sort of balance. Is that a possible strategy or does not work either actually have a lot of sympathy? I respect for that. Our
it would have to have a couple of other attachment points to it, but
reason I do is not necessarily from pure public health standpoint, but because epidemiologists say that you can tell somebody something's offals about to happen and ask them to make preparations for.
Two weeks and if it doesn't happen, they really
are to lose faith and then they letter
their guard, and then, when it comes to them, they don't listen in its tragic
member northern ITALY which is a whore
In southern ITALY, are very
different right now and we live in a very big geographic country. So,
I said earlier about respecting your local health. Commissioner.
hey, that's true. Unless you live in taxes or stated, I think, being a little bit misguided here,
The idea that we should have different strategies for different parts of the country is something that I think makes certain nonsense and then, secondly, the president, while I dont think he's obviously you'll sane, wise things. What I think the president should do in should want to do is tell people what the path out is as best he knows using actual facts.
scientists, because I think people understood not understanding how long was avoided alarm makes them restless makes them want to jump out, makes the stock market restless in any right, of course, that a bad
how many people out of work can also have negative effects, and there can be mental health issues and suicides and all those in cinema
thing he's a very being their thoughtful about it.
But maybe we're in more about him. Of course, I don't. I don't know, but I can say that if I were on the task force inside the Obama administration right
we would also be having conversations about what are those
heart ways to begin and water.
What are the characteristics we would need to see to open up the economy and I've been working on, something which is
If the president said it would allow me to say you know,
things will open up? It's not a date that
starts out a holiday. It's when our great american companies and start to produce enough of acts.
and when we have enough surveillance, because we have enough tests to do. I am
The challenge american industry and I will use the defence production act to get us there as quickly as possible, but stay too.
this is gonna, be
six years world war to this
gonna be
the thing that come next year
You know,
penny and where you live will be able to move out of this, what we're gonna do it intelligently, and I ask you to stick with me: that's the right message, attempting speaking someone like you, who is both a health care policy expert and your also to use a technical, Fraser Finance Guy. So you know something about the economy discussed further to what you said.
right. Now what can we expect in terms of the smartest balancing act between averting enow outright depression, but also keeping it?
when safe or those two things in inextricably intertwined well
the short term gdp or growth or anything that allows us to feel personally financially healthy, can come from a few different places. If kept them for business, it can come from consumer spending
I could go from government spending so in the short term,
we need massive amounts of government spending
trillion dollar bill that got to
agreement last night and hopefully will go and get side will not be the last one. But these are things that will stimulate the economy and pumping money into people's pockets, who need them not necessarily
businesses, but small businesses, individuals, making them feel secure. That will work for a time. It's not the economy. We want long term its anti can. We were gonna have long term.
We need to be able to do that in the short term, and then you don't to some extent the economy is driven not just by actual fact, but by perception that expectation,
so demonstrating. We have this thing under control. I guarantee you the stock market, which Trump watches and I'm not going to say it's unimportant, but I'm just going to say that the most important thing with the stock market, what do we think, will
a greater impact on the stock market, telling people that they can go back to work as absolutely for option b.
A dramatic reduction in case causing death tolls its option b, my view when the Sun
We believe that there is an end in sight.
And they were beating this and the people are staying home in that we ve pulled together and that we can get through this
That'll be better news for everybody in ITALY
everybody hope. Do you think that the government has the ability to do the kinds of things you can do, giving people cash
and giving people loans and all those things are worth talking about in this two trillion dollar bill and in future bills to they have enough time to do that in the short term, so that we get to the point where we have option b and the case counts come down dramatically. Do they have the ability to help us get to the other side before the economy craters among businesses, making predictions I'm here really trying to to chart the best course and looking at a bunch of other people's predictions? But I'd say
The short term pain right I mean if you ve, had a work right now. You're worried about your job,
or your savings are evaporating. It's not even right to say: will it get bad? That's it! That's it. That's celebrate situation
for you but figuring out how to get through it, for let's call it
outside up to eighteen months with some spurred
of activity in the meantime and by the way, please, I don't think it's just the economy mean when, when people's favoured sports teams
aren't they can't ever beer with a friend. If that's the thing and
their favorite tv, shows and movies art on you, the kinds of things that the strong
does from the hard things in life are also not happening. You know it's it's hard, and so this impatience did. He feels myths votes felt by a lot of people.
Of all parties, will everybody wants it to be over with, but the truth is it'll get over with faster. If we,
do some of the things that have been done in South Korea and other places and
just we just needed a scientist time to catch up. So we can. Let me to it this way. If he's
did. You have a small business you,
open it up. You can open it up it. Here's what you have to do.
You have to take everybody's temperature as it
in the door and
You can only have say fifty percent of the commission.
they used to have a first
if anybody has a fever day,
to voluntarily
to a fever tent that we set up now
in China, they wouldn't say voluntarily and I think they be much more effective because you have a lot more compliance, but in this country maybe that's not possible.
and if you protect, you can wait. It out figure out where we have it and you have enough testing and then not for nothing. Worse than have lots of them
people who are have them immunity, because they have done this before and those people can be out the public square mesh into being a lot of people right. If this is spreading,
much as the scientists and doctors say, but I guess all this is premised on something. You said a second
and I've never understood with great clarity. If this is true or not, is it the case in your understanding that someone has had the virus and resolved either
freedoms or not, will then be able to resist covered nineteen going forward right. So the reason that
Reliable, get straight answers, because this is.
of a virus, and nobody can be absolutely one hundred percent certain. Having said that
I have not talked to a scientist who doesn't believe that you'll
eleven unity, at least from the stream and of course you You'Ll- need to test
have a test again and then have, and then everybody tests which will test whether or not you ve got that immunity, but people
pretty certain people feel pretty optimistic, that there will be immunity and reports. What we hear
people say someone got it twice.
they are more likely to be testing errors than they are to be the truth. So that's the case, and we don't know for sure
That's good, that's very good news, because it gives us a lot more flexibility and elaborate show how far away from you think,
the time when we can have a system through which we can figure out who-
communities are those people can at least be comfortable and confident go back to work. I'm not sure. I know
we are working on it now. This is
understanding that. I am happy to have contradicted by anybody who is heard from her an actual expert. Instead of someone like me who just talks to experts a lot, but my sense from talking to people is it's not very complex,
to do doing it at mass scale, takes some time
Doing away with you ensure that it safe to do so
Will you ensure that people are using it all of those things
at the time, but for
When I hear the FDA is doing a very good job. Approving these kinds of things.
and working cooperatively to get these kinds of things done, so my sense is that it will be coming.
Shortly, but I wish I could tell you- which hardly was I just I just here- you're not gonna, say Easter,
I was giving you the option if we were having this afternoon after a couple cups of coffee. I would inform you my back what about what about an evening after a couple of beers, then you might at Easter. You know.
Red wine, as did my thing in then
been lately. I've been just staring fearing added and I've never even had a chance to open it, because I'm I've spent somebody caused by that automatically here. This is maybe a little bit
feel free, but you just you mentioned it. So if people who were not in New York appreciate that
non essential. Business has been shut down, one of the best
since that remains open throughout the state in Europe are liquor and
stores that had been deemed essential, when you make a bet that only
is less amusing, then that did you see the air? The thing
by the New York City Health Department on whether it safe to have sex, no, I didn't know the first line. Is
Generally, you are you're savers, sex partner, locate must move on from any look. I think I think that is the point you just wait is exactly the answered
gave to the question which, if we didn't stop living
We should in turn it alcoholics, but if this
if I give you pleasure in life by all means, laugh
they have a glass of wine. Give someone joy, do something nice for somebody whatever it is. It makes you feel.
That safe
the memories in the stories coming over this period of time, when it's over
this is the reason for there not to be great memories and I think
I hope everyone is able to look back and say they did everything they could
we're very likely to all know people who we lose to this to this illness,
and it is doing a lot of sadness. But nobody
we feel guilty for finding those plans
the life out, I'm home my wife and a home right now with our two sons, and it gives me.
men's pleasure that their stuck with me
it doesnt developments pleasure? But I about the fact that, like this,
can't, go out and see their friends and their opinion with your dad and Naples annoy stupid jokes. So for me like that's away,
where I saw someone tweet recently that the Corona
send the compelled quarantining it will. Shortly.
he'll, which of us our gourmet cooks and which of us are alcoholics,
right or is my wife said
they'll be both a baby boom and a divorce boom. I agree with those sentiments about new living lighting and take a moment of joy. When you can find them, I will go back to some of the other concrete things.
That need to be done to avoid the worst case scenario, so you mention the defence production ACT and we ve been talking about it for the last couple of weeks? Are people pulling their hair out over
presidents seeming unwillingness to use the defence production act to get our best and biggest companies to make ventilators, which are the things that will save a lot
lives. So this is a place where I'm going to call the present to account, as I said, I'm taking the train to take somewhat of a moratorium on just taking shots at the stuff. He does to hurt people, but this is something that each
held accountable for those on the form of the White House this morning and they said
and they can you build a website that compels people to donate ventilators I've who have extra ventilators.
And I believe we did the same thing within ninety five mask someone. We ve got a lotta mass alot of people and I said,
sure I'm happy to do it, but is this? I have step towards saying,
if you're in a location or you're a veterinarian, the other lesser need in Europe needs. Thirty thousand is, as governor Coma said. Ventilators suggests
basically say: sorry, guys we're gonna, take these and will give him back and
like well. We might do that, but maybe you can have this voluntary thing going and so in this
I think a reality to be afraid there that that is getting in the way.
you see owes are, I think, whispering and trumps ear there.
That would be a bad move today that they don't want to think about the do this stuff and-
be honest. I don't think there's any greater honour, then being
to be part of the solution, and we can only play-
I had a it for yesterday that the twenty fourth around
Why we are running into natural limits, on the amount of tests that we can produce in the region,
his when you get behind all of it.
And for all we need to be able to get somebody test. Everybody in the country multiple times, not just your people, symptoms
and went out with only test frontline workers and the recently
and it turns out, is there are these things called eighty eight hundred liquid transport robots
that there's only a number of and will be about
a small number of in the United States- and we can make more of them- we can make pots more of them
and that's the thing that getting in the way I was having enough tests and you know
if this were a decisive more time president,
we would be on day ten of that happening.
As it is right now. I talk to people who say I can make these things
So let us tell me they're gonna buy them because I dont know who's gonna have money, the hospitals don't have money, it is a government, gonna guarantee them, and if I were the president
I would have been very simple. I would say I am play.
the purchase order for five
thousand ventilators in two billion.
and maybe five masks, here's the price go, and I would
call all the basic view. Friends who have these factories and I would give them the capital to convert their factories I'll get the goat
and I would go to do photo apps and all these factories is their producing these things and they would get them just
can the FEMA team of getting these boats to the house was a need to get it
to win. We night, I don't I make us, is a win win. I don't know that the president has a very strong ideology, business or otherwise. So I feel like that. Theory misses the mark a little bit that there's there's something.
Missing its ideology in the sense that it doesn't feel or something
pro business I'll give you another ideological thing,
The last night I was working on this and I
they don't know the outcome, but when we
vigour we too
Ah, the labs. We would pay fifty two dollars protest at a minimum and guess what we had enough tests we tested
people in that turned out to be very wise. The Democrats
proposed the same thing so by women?
care and
that occur, administrations that we're gonna pay. Fifty two dollars for everybody and Medicare, which was great
last week it was brilliant and I applaud them for that. What I propose that they do. We say that not just for people in medical,
but for anybody any tat, anybody in the country we're gonna, pay fifty two dollars. The Democrats said great, I'm on board
the Republicans in Congress in that field
step, two Medicare for all- and so we do want to
so we're gonna have current quota market price paid,
which essentially will mean
is much much less production, and so I said to the White House, whose talking to the Republican, a ghost
Can you remind them that the way people pay for now is as a person
the genetic here so we are not,
fully adding men here the equation, but it was baffling to me that, even in the midst of
public health crisis there are people,
whether it's in the White House or staffers or anyone Emma thing it doesn't exist in a democratic side either. So
making a judgment, but in the
the bomb is there still people say up
You know what we could have more tests, but if it's a step
Medicare for all
I will be sorry later. So, let's not do it don't go back to
to the ventilators in New York issue and the governor has said very plaintively. Incredibly, we need at least thirty thousand be said something a minute ago that made me wonder something
it is to have an overall shortage of ventilators in the country. Has elapsed, lament
and or is it that we have a misallocation of ventilators, and there are three
instead of sitting somewhere where they're not gonna, be needed immediately, and if we brought in New York to fill the need so
pending and our people do the hashtag stay home if they dont do it at all. We're short,
probably we probably have one ventilator
we, people who need one and
I want to tell you that I try to say this gently, but there are papers going around the deity and eighty just right now and what are the ethics of and of making the decisions to deny people act
as to ventilator. So the numbers are that we are
short, we know we may be have sixty five thousand working ventilators in hospital.
And we could have a need for five or six hundred thousand so there is,
absolute shortage, no question about it in the: U S and had ended other parts of the world and in massive amounts of demand, made just couldn't make him fast enough, which is why you, whenever
doing it, but that doesn't mean that
about because every ventilator your gets,
is a lifesaver, so you'll make them
just as in the world to say: hey if you ve got an excess among ventilators in your community. Now we will,
I ask you to send us to New York, and then you get asked manufacturers to build the capacity in the meantime, so I've I've just been asked to go, make that played a bunch of hospitals and of course you know, they're gonna
rightly say? But it's gonna come here. What's gonna happen and
remained doesn't have the trust to demonstrate that they can move. These things around quickly
move personnel on quickly. I wonder
I'm more lives. You, president, by saying you could try, say gently, there's! No!
to my mind, is generally to say it. You have a car
nation of in a clear math and predictably, no, we don't want
in the business of predicting lots of different things, but some things I think every expert can predict, and that is a shortfall in terms of ventilators, followed by the
given that if you dont have not ventilators lotta people going to die and strange and disturbing and upsetting tree
has to take place, and then you also have which
Different nourishing might not have had is a clear mechanism for causing those things to be made and guaranteeing a market. So I know the life of me
I do understand why we're not in a better spot. I did want to talk about the congressional package. The seems to have been agreed to have you had a chance to look at the major provisions. Do you have a reaction to it? Overall, I haven't seen the last.
version. I've been really fixated on a couple of elements, but I would say they said everything. I've seen it was worth the two days absolutely worth the today's. It took to get this package down and out it's going to provide a lot more help to people who needed, but I think the message
progress needs to be you're, not done you're, not going to be done is to train is known of its own.
money and there's just the situation on the ground is going to change it if you're interested pre, I put out to a group that I found it. A five point plan for Congress did Organizations United States CARE, said: U S of carried out or a five point plan. How Congress really needs to step in and an end to help people it. So there is a lot of things need to be done.
Clearly for frontline healthcare workers. If we don't address, we have talked about the other, the show, but even perhaps greater than vents
figuring out how to address the needs of our basically frontline warriors there in an ineffective military. This we're gonna, lose them not so much in the sentence of death but lose them from the workforce. Is there
it- sicker, insecure, frightened, eyes and others a term for this, I'm assuming that there there's some are not type of
here, there would be associate with every healthcare workers. You lose, there's a ripple effect on how many patients can be served and and made well right, absolutely
I call for a five thousand dollars a month payment to every hope, frontline enough go worker and first responders
the country because of the massive need that we have to have them have thy segregated child care for them to get through. What is gonna be a time when they're getting operating without the kind of equipment we need- and I expected punch me
at the president. He wants to you he's trying on the label of war time, president like that label. I'd love him be war time, president, but that means he needs arms.
jobs with all the equipment. They need misread battle maps in its be decisive,
We need to get everybody moving and it needs to be much more skeptical when people tell him that there's hope he needs to say that's great, but I got a plan for what I see in front of me
Well, you, the present, doesn't understand a lot about war and in particular he does understand a lot about generals and animals. We had Admiral James to redesign the show some weeks ago and he was observing
In a word, but draws the president to this idea of war and generals, is that things there macho when their strength and their bellicose and what he fails to understand that the best generals and top military leaders in history are actually very intellectual and very thoughtful and very deliberate and care about data and science, and those are not things at the present- seems much care about. He likes that the title of generally likes the title
of war time, president, but not much else about that. What do you think the onset of the krona virus and the response
in America says about the health care system and what are the lessons for healthcare system, obviously, that infrastructure that we need just hasn't been built and we haven't been prepared and go back and if it, if you, if you haven't watched a TED talk from Bill gates and twenty fifty image, I think many people have seen as other boats might ask our home, who is a famous editing, allergist invasive Minnesota, there's other folks, of course,
In retrospect, everything looks predictable right. A month ago there were five people predicting this, I'm sure many more will say that they did, but we were so completely unprepared. As you know, we build stockpiles of oil for crises. We built
stockpiles of war military planes? I imagine then we need. Although someone contradict me who knows what about military aviation, but our stockpile of both logistical support, people and the kind of equipment we need
was just not there. Then we throw that healthcare system which it which it
the good day, doesnt work incredibly well, so we have you out of this. I have hope, but not necessarily confidence that people will take some lessons. I think other big picture
thing a pre is. I really worry about
anxiety and mental health effects of this time. We
PTSD is a real thing.
We know that families are going through
lot of uncertainty, both how financial and otherwise
Your mind me saying that we're gonna get start a podcast held in the bubble
really for families that are going through this period of time of uncertainty. Trying to get me
facts as well as some hope in some
enjoyment,
Some waivers romanticize overrun
Besides view of you know, I've gotta
Churchill's bugger together and getting through this I'm fifty three,
you. I've never been asked to sacrifice the damn thing in my life and I think most of us have it
our older generation has a network.
to give up. I'm I'm I'm living two hundred, I'm just that. I don't care what they encountered says. So, if I have to spend eighteen months
with her in another city and may not be
the seer Armitage.
Mr View, that eighteen month as a great deal,
the talk to her on the phone everyday and video chat and play
were games
and that's a very, very short period of time, because she did she spent
that way more time in their tell me that my spine, my
we'll drive from school look nice. So if we thought you know, we all got that can go through the days. Were
where we want to cower under the bed, but we
gave each other's backs and so
If I do that on Monday, you say
Oh come on any to get through. This didn't then tuesdays your they preach, and I said I call you want to say a day. I I got a guy to pre, then you gotta get out. Did you can help other people and it's gonna be the kind of time? Do you think that this experience that America is going through an end will continue? Go through for awhile will cause the country to be more receptive to things like Medicare for all. I think a combination of this experience and the younger generation are gonna be a really interesting combination for our future. I would hope that people see the wisdom
of making sure that every single person in this country doesn't have to worry about their health care needs. And if there is a lesson, is driven home in a public health, an epidemic when something highly contagious.
Maybe a lesson oughta, be that just because you're healthy, if you're
he's got a school somewhere. You gotta work with someone who can afford to take care of themselves. Maybe that's not gonna be
for you either, and so, if that lesson gets through to people
I don't know it's better care for all or whether it's some other form a universal coverage, theirs,
five ways to do it. None of them perfect-
all of them better than we have today, and I think we talk about the cost of this thing in it of doing something.
That ain't right now we have people voting to spend trillions and trillions of dollars in emergency situations, which I think we d better.
but next time around just making sure
people do not have to worry about the payment side of this? Yet so so here
Question next question in which you have somewhere to a beautifully suppose hypothetically
we have an election and on the same date as it's been specified for and Joe Biden wins the election.
and he wants to enact some more sweeping health care.
she not gonna, be able to do it because we spend our money on this. No, I think I think that
the Bernie Sanders Plan is that plan is
very, very, very expensive,
declared the votes in the Senate. Even Bernie Sanders were to become president for that to be an actor
I actually think out some level. Bernie knows that I am not suggesting innocent believe in it, but I think he believes he's gonna pull the country in a direction for us to get to somewhere else doing what I think Joe Biden would like to do, which is to say hey. If you want Medicare, you can have it. If you want to keep your player coverage, you can.
Have it in those sorts of things that are terribly expensive in the scheme of the kind of money we throw around in Congress? Ella organ
still need to stimulate. The economy is probably likely that health care is gonna, be one of the things that we can do to stimulate the economy
are we gonna get out of this ok and be the same country. We're gonna, get out of the question:
is how many lives are? We gonna lose along the way and we have
more to say about that. Then the president or anything
any mayor so loud of their powers that our hands are. We gonna be the same country. Now I dont it will be the same country. Will
be better in some degree and worse. In some degree, I think that's probably the the right way to look at it. You will we.
the same people. I can't imagine that any of us will be the same. People will think about things differently, things that you
deeply about a new year's Eve. I'm really stressed about going into twenty twenty. Those are less important now, perhaps with the exception of whose president that they may be just as important,
well now as it was before, but but for most of the things we worry about in their day to day lives. Those got knocked out IRAN and helped us three priorities and that's not a good thing or a bad thing if it means that were taking some things often,
list the. Maybe we should need to worry about any means.
grab for getting some perspective on life. That is welcome in his home
it also means that there is a bit scary because
were much more precarious than we ever knew
So we had a false sense of security living in this country. Particularly,
any slab at. You have been very informative, very generous with your time.
So I will let you go see him get on the phone with the White House and tell them to get some more goddamn ventilators to New York. I get home. I beg you, Sir extra time. Don't you agree?
The conversation continues for members of the Cathy Insider Community to hear the statement
honest with Andy Slab it and get the exclusive weekly Cathay insider podcast and other exclusive content heads Cathay dot com slash inside.
right now you can try a cafe insider membership free for two weeks at cafe: dot com insider! Well, that's it for this episode of stay tuned, thanks again to my guest, Andy Slavitt. If you like what we do rate and review the show on Apple podcasts or wherever you listen, every positive review helps new listeners, find the show. Send me your questions about news, politics and justice tweet them to me at three with the hashtag or you can call and leave me a message at six hundred and sixty nine. Two hundred and forty seven seven thousand three hundred and thirty, eight at six, six thousand nine hundred and twenty four preet or you can send an email to stay tuned at cafe dot com,
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Transcript generated on 2021-09-17.