Meidas Health, Episode 9: An Inside Look into RFK’s HHS (with Katherine Eban and Dina Doll)
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Hey, Midas Mighty. Welcome to Episode 9. This is jam-packed, as always, with some of the nation's best healthcare experts, minds, journalists, clinicians. You know, these people are not occupying the highest levels of government. We already know that. The federal government does not have the nation's best. So I'm bringing them right here directly to you on Midas Health.

Episode nine, we're going to start with Catherine Ebon, investigative reporter on the healthcare beat and science beat for Vanity Fair. She has her new investigative piece out, really detailing the rise of Kaylee Means, who is really the brains behind what's happening at HHS and really operating the levers behind the scenes. So,

Catherine Ebon's up first, and then we have somebody very familiar to the Midas Mighty, Dina Dahl, talking to us about the real world impacts of what we're seeing when it comes to cuts to the biomedical infrastructure here across the United States. What does this mean for everyday families? How do we talk about it? Because sometimes these cuts aren't impacting families.

say, standard of care or the medicines we can get patients at the bedside immediately. But we're going to see those impacts over the next, say, three to five years. She's going to help break that all down, help us think through how we talk and message on impacts to the government that we may not immediately feel. Really important topic. So without further ado, Catherine, and then followed with an expansive conversation with Dina Dahl, somebody you know really well. I'm really delighted to have a friend here.

a dear friend and an excellent, one of the nation's best health journalists, Catherine Yvonne of Vanity Fair. Catherine, thanks for being here. Hey, nice to be with you, Vin. Great to be here.

Catherine, we're going to, for our listeners, we're talking about your recent piece, investigative piece, titled The Maha Universe, the subtitle, The Dizzying Rise of Maha Warrior Kali Means, RFK Jr.'s Right Hand Man. Catherine, wondering if you can just distill down why you did the piece and its key takeaways. Yeah, sure. So, you know,

We have a whole new leadership now that is in charge of our public health apparatus. Obviously, the most visible person there is RFK Jr., but there are all kinds of people who are in there

shaping health policy, making decisions. And, you know, people really don't know who they are. So we decided to take a look at Cali Means. Why is he important? Well, he's the one who initially introduced RFK Jr. to Trump.

He said he had a vision in a sweat lodge that these two men should be connected. And he went to act on it. He roped in Tucker Carlson. They introduced the two men on the night of the day that Trump, there was the attempted assassination against, attempt against Trump in Butler, Pennsylvania. And then what happened in short order

Trump becomes president. RFK Jr. becomes the nation's health secretary. Cali Means becomes a special government employee and the right hand man to RFK Jr. And really, more importantly, perhaps the sort of shaper,

publicly of this thing called Maha, Make America Healthy Again. So I thought that by looking at Means and sort of his rise, where he'd come from, was a way, it was a window into the Maha movement, what its priorities are and what its impact potentially could be.

You know, it's interesting, just reading through, and everybody should go to VanityFair.com

and read this. Again, we're discussing the dizzying rise of Maha warrior, Cali Means, RFK Jr.'s right-hand man with author, investigative reporter on the science and healthcare beat, Captain Iban. Just in reading it, I was struck by the fact that I didn't know Cali Means. I didn't really know him at all prior to just the last few months. So his name has started popping up in ways that

were unexpected from a healthcare perspective. I didn't realize he was a former wedding dress entrepreneur, just going back to your article. So, you know, really interesting, unusual background to now be advising the nation's top health official. You know, you spoke to over 60 experts. I'm curious, those that know him well, you know, it strikes me that

there's a fair degree of opportunism. I think Steve Schmidt, his main mentor, really referred to it as well. It comes out very clearly that opportunism seems like it's something that he's leaned into a lot. Is that right? I'm just curious what you were hearing. Right. Well, I mean, you know, the whole question is,

is so Casey, who is his sister and Callie means wrote a what turned into a best selling book called Good Energy, which is about metabolic health. They did this, you know, sort of viral podcast tour. Tucker, Joe Rogan. And in the course of doing that, you know, and the two became very prominent.

You know, very quickly, like within a year. And in the course of doing that, Cali Means made a series of statements about really legitimizing why he had a righteous platform to talk about how to reform the nation's health. And the platform was that he was a lobbyist, a former lobbyist,

for big soda, Coca-Cola, big food, pharma. And he had been inside the room and seen all of this sort of illicit, corrupt dealing between how the sausage is made. Coca-Cola offering money to the NAACP to fight soda taxes and say any soda restrictions are racist.

So I was like, okay, so this guy's a former lobbyist. Let me look into this. And I started...

reaching out to former Edelman and Mercury employees, those are the two places where he could have witnessed what he claims to have witnessed. Those are where he works, his prior employers. Yeah. Yeah. They're PR firms, you know, where presumably he would have seen inside the room. Right. No.

Nothing that he describes lines up with what these folks told me, you know, that Mercury never represented Coke, never represented the American Beverage Association. Edelman never represented Coke because they represented Pepsi. They didn't represent the American Beverage Association. They didn't represent any of the coalitions that the American Beverage Association were funding.

And in fact, Callie Means was never a registered lobbyist. So I started talking to Steve Schmidt. I think our listeners will remember him as one of the co-founders of the Lincoln Project. Very, you know, a former Republican strategist who really turned against Trumpism and has been very vocal in calling it out.

He was Cali means mentor and boss for a long time at Mercury and then helped him get the job at Edelman. And he's saying now and you can he's done a whole sub stack on my story. He's saying that, you know, what Cali means is claiming never happened.

So why does this matter? Like if a guy potentially invents his credentials to be at the top of Health and Human Services, right? And in fact, he was one of the coordinators, lead coordinators of the the Maha Commission report.

Now, the Maha Commission report was recently unrolled with great fanfare. This was a report that was laying out, allegedly with the best gold star science, gold standard science,

why our children are the sickest in a generation or multiple generations. But then it was uncovered that they were referencing fake citations. It was potentially AI-generated scientific citations to justify the claims that it was making, right? So, I mean, you and I know

I mean, what do you build science on, right? What do you build health policy on? You've got to build it on the truth. And so what is the truth? That's, you know, where people like me come in.

Well, it's interesting because in reading through your piece, a few sections really stood out to me to help give me a real sense or insight into who Kaylee Means is. And you talked about Steve Schmidt emphasizing as his mentor that he's an opportunist. The fact that he doesn't really have remotely any healthcare credentials, and yet here he is as the chief advisor to RFK,

There was two parts that stuck out to me. The first was when you were talking to, it looks like you were talking to sources at Mercury and Edelman and, you know, quote, the bigger his audience and the more means spoke.

the more bewildered his former colleagues and Mercury and Edelman said they became, as they recalled the largely administrative means had done Mercury, and the more benign PR he'd been asked, he'd been tasked with at Edelman. And this is in the wake of an episode with Tucker Carlson where he said a bunch of things about the beverage industry, as you had mentioned. That episode was the most shared podcast of 2024, making all these claims.

And then in this, you also then quoted a Mercury colleague saying, quote, I tried to scratch my brain and made a few calls to make sure I wasn't going crazy. And this is in reference, unquote, and this was in reference to conversations Means is stating he had with these entities that were conspiring to do nefarious things when it came to

beverage policy or Coca-Cola doing certain things behind the scenes with the American Diabetes Association. Apparently, and I want to make sure I'm correct here, his actual colleagues at these firms are saying that in no way, shape or form was he in any of these rooms involved in any of these types of conversations. But is that correct? That is correct. I mean, that is what they are saying. They are saying didn't happen here. Couldn't have happened.

Yeah. You know? Well, and I want to follow up on that. I just want to confirm that was correct because then later you say, just a few paragraphs later, quote, his early resume obtained by Vanity Fair displays a penchant for hyperbole, feels connected to this. He just describes a three-month White House internship. This really opened my eyes here as to who he is.

But he describes a three-month White House internship at the offices of presidential scheduling and correspondence at age 19 as follows, quote, acted as a liaison between the president and American soldiers in Iraq by analyzing and referring letters, emails, and comments from soldiers directly to the president, unquote.

You then go on to say a separate bullet point notes that he was, quote, the youngest White House intern selected in 2005, unquote. I get what you mean. There's a lot of things that people do in government, but that penchant to hyperbole seems like it was present at a very young age.

You know, I should add that, you know, Vanity Fair sent Callie five pages of written questions, entirely invited him to engage with us, you know, sit down with us and talk.

Basically, the two responses from him that we got, that we put in the piece, is that he stands by everything he said, but that he was also going to refer us to a lieutenant of his at one of these PR places to...

refute your BS smears. And so we reached out to that person and we didn't name them in the piece for privacy reasons, but we reached out to that person and then they responded back and said, you know, I looked at all the questions you sent to Callie and I really can't speak to the meetings. I can't.

I can't, you know, I can't comment on those because I don't know. So we, you know, we quoted that person in the story saying that. You know, I think it's, you know, there are many things can always be true at once. I mean, that's the thing about investigative reporting. And you really want to give people an opportunity to engage with you. It's, you know, it's...

It makes for the best journalism. It makes for the best story. It's the most fair. You know, but that's all we got back, you know, once we sort of laid out this fact pattern that we were going to report on. Now, I should add for your listeners that his sister, Casey Means, is now Trump's nominee for Surgeon General.

And we also reported in this story that she did not complete her surgical residency due to stress. She pulled out at the last moment. You know, now she has turned that into...

sort of the sibling equivalent of "I saw inside the room." Now she says, "Well, the entire, um, you know, the entire thing is corrupt, and we've got to just blow up the whole thing." But, you know, Vin, um, you are somebody who completed a surgical residency. I believe-- or a medical residency. So we know it can be done.

Gosh, you know, Catherine, you're opening up a can of worms for me here where there's so much. We could have this conversation for hours, but it's becoming clear, and I think you've done such a service with this piece because it's so, you know, for the general public, when they see somebody like,

Callie means on stage or at the side of RFK. He's well-spoken. He looks the part. You know, central casting to use a phrase from Trump.

President Trump, you know, there's so many things about the optics of what he's clearly nurtured and cultivated about his role, about the way he conducts himself that I think can fool a lot of people. Like, oh, this guy and he has credentials or where he went to school. It tells a certain story and a narrative. Right. And

I've realized just in my time as a doc that doesn't shy away from trying to lead with evidence, but has embraced that we have to be more public and vocal because that's the world that we live in. What I've noticed too is that there's the dark arts of persuasion and public persuasion. You actually talked about how Callie was really focused on public persuasion in various ways, but that it's really easy to fool people. Yeah.

And I've seen a lot of people in various parts of healthcare in a hurry trying to fool people as to their true expertise or lack thereof, try to shelter it, cover for it. And it's really easy to do that. And you've done, I think, all of us a service.

You know, it is. And let's not forget the first Trump's first surgeon general nominee was withdrawn because of a false claim about where she had completed medical school. That's right. Which is which is why Casey Means is now the surgeon general nominee. You know, so I think

I think one of the problems is, you know, people are so frustrated. They're so frustrated with our healthcare system, you know, me included. And there's stuff they really want to believe. Right. That's the thing. There's stuff they really want to believe. Sounds good. Sounds true. And then, you know, during COVID, as you well know, you just had this

people stuck at home who started doing their own research. And, you know, there's a lot of stuff you can find once you start doing your own research that isn't true. And that is part of, I mean, the piece tries to get into, that's part of the way we got here, really.

I, it's such a good point. I, I, there's, I think so many things can be true at the same time, exactly to build on what you just said, Catherine, which is, you know, I say this as a pulmonologist, it is, I care for patients that end up in an intensive care unit, right? Clinical life in some cases, often because of proximal failures and

the primary healthcare system or in broader access to care, which results in delayed diagnosis, or they're frustrated, they don't take a medication, whatever it is, because of cost-related considerations. And then things cascade because of the inefficiencies and frustrations in our healthcare system. And then lo and behold, they end up in, say, my ICU or another ICU somewhere in the United States that could have been prevented.

30% of our healthcare dollars are spent in the last few weeks of life. People are dying in intensive care units across the United States. So I see this directly in a variety of different ways. And yet, while that's true, it can also be true that

everything that undergirds how we practice the field of medicine is still built on fundamental truths and facts of science that I think does not then mean that because our health system has complexities that what undergirds medical education and the provision of care somehow is flawed.

Right. Because to me, that's still the gold standard. Biomedical research is still the gold standard. And yet it is also true that the way in which we've structured our healthcare system and the various powerful lobbies that exist, which by the way, uh, both parties that have been in power have, have helped to continue and to sustain. There are real problems there. There's no question. And yet, you know, assassinations of chief executives, putting forth the surgeon general that, uh,

doesn't have an active medical license or completed a residency. Cali means advising the nation's highest official. These are overreactions and I think distortions that are addressing a problem or addressing the wrong problem. These are solutions that are not going to actually tackle the problem that is upsetting people, which should upset people, but these are not the right solutions.

You know, that that's exactly right. I mean, the thing is, is like these totalizing claims of corruption, wall to wall corruption. All the federal health bureaucrats are corrupt. They're all lazy. We should just get rid of all of them. We've got to, you know, blow the whole thing up and, you know, thereby purge from the federal government, you know,

you know, decades of deep knowledge, you know, not just about, you know, I mean, about everything, about stuff that Maha created,

really says that they care about very much, you know, good nutrition, you know, excellence in nutrition and, you know, chronic disease. I mean, that stuff got blown up, too. Well, you know, and when I look at Cal and the story that you told about the mean sicklings and what I've seen them do, you talked about, you know,

Again, I'm reading segments or parts of your incredible investigative piece, but I encourage readers or listeners to go and actually read the full piece. There was a part in the beginning of this piece that talks about a really aggressive posture that Kayleigh Means took at a political summit, healthcare summit in April. I'm wondering if you can...

So summarize that for our listeners. Yeah. So, you know, Politico Summit, he was being interviewed by Dasha Burns. And basically, he just turned it on the audience and said, you know, all of the lobbyists in this room are laughing because that we have the sickest kids in the world, which is like, you know, just...

so over the top. I mean, there were lots of people in the room. Many of them were not lobbyists, A. And B, do we have the sickest kids in the world? I don't know. We've got a lot of sick kids all over the world who don't have nearly the resources that many of us do. So it just was really striking, but it was quite strategic because that is...

That is the justification for the changes that they are making and for what they are dismantling, right? That's how they're justifying it. And you really need to pull that apart. It's very hard, even as a journalist, to wrap one's mind around what is getting dismantled right now. Oh, yeah. I mean...

It's the classic floating the zone strategy. None of us really keep up and I think we're all losing things because we're key pieces in data inputs. I mean, to emphasize, because I've gotten this question a lot, do we have the world's sickest kids? The answer is absolutely not. We're fortunate and there's data for listeners that want data to cite data.

University of Washington does a global burden of disease study. You can Google University of Washington global burden of disease study and actually look at visuals.

All of this is data-driven that shows that the sickest kids, sadly, but perhaps not surprisingly, are in Sub-Saharan Africa and parts of Asia where life expectancy is, in some cases, half of what it is in the United States. And so do we have problems? Yes, we do. Do we have the world's sickest kids? Thankfully, we do not. They exist in places for which USAID, which effectively no longer is operating,

was doing its quick work. And so the irony here is that here we're talking sort of a broader point is I hate that this is the reaction, but my reflex is to always smirk when I hear what Maha stands for because there's the Maha Commission report that you talked about that Kelly Gates helped to put together.

talks about the environment around us and how the environment around us is unhealthy. Yeah. Yet the Trump administration's EPA is pursuing a 55% budget cut to the EPA and a regulatory stance.

We talk about wanting to address problems for the world's sickest kids, supposedly, and yet we're defunding and deprecating USAID. There is an inconsistency between the branding of MAHA and the policies that this administration is pursuing. And so I think it's important for everybody to recognize that because back to the piece, Kayleigh Means is in RFK, obviously, and the president is

really good at one thing, if you ask me in particular, which is they get, they're really good at getting attention. Absolutely. And they're very good. And Kaylee means, you know, I think he's 39. I was trying to piece things together based on when he graduated or got his first job. So, you know, potentially, you know, very much still in the early phases of his career, but strikes me that

for four years, pointing the finger, saying we're all corrupt,

questioning everything because science is the art of the science. Medicine is the art of medicine. Nothing's perfect. Nothing's known. There's always uncertainty with every fact because that's just, unfortunately, that's the world that we live in. There's imperfections to our knowledge, but we use our best judgment. But it strikes me that building an identity, saying that, oh, well, why don't you know that fact better?

with 100% confidence, not 99%. What are you hiding with that 1%? Always asking questions, probing. Why don't we know this fact? What's that doctor hiding? Or castigating a group of leaders at the political summit in early April saying that we're all in on it together. That's one way to build a brand and to carry yourself for a few years. And that's exactly what he seems like he's doing.

Well, yeah. And, you know, you build a coalition based on mistrust and based on the notion that all the other folks and everybody but us is colluding and hiding stuff from you. And we're the folks, we're the truth tellers, we're the radical truth tellers. We're going to come in, we're going to burn down what was because it wasn't working for any of you. And then we're going to have this sort of

paradise of healthy food and you know you know freedom medical freedom and it all sounds great but you know

What's the reality? Like you do have to, it's really easy to destroy stuff and you need to replace it with something. I mean, it's really hard to build stuff, you know? And now, you know, we're in a situation where RFK Jr. has said, we're going to be telling everybody what the causes of autism are in September. And we're the first people who have really looked at it

all the scientists who have been studying autism for their whole careers are like, huh? You know, they're saying they're the first people who have ever tackled, you know, nutrition and healthy eating. And like, I'm thinking back, I'm like, wait a second, wasn't didn't Michelle Obama have her, you know, organic garden and her let's move campaign. So, yeah.

There's just, you know, there's a big smoke screen here. And the question is, like, what's behind it? Yeah. I mean, that was my read of the Maha Commission report. It was characterizing problems,

that we've known existed for decades. This focus on ultra processed foods, none of that's new. We've all known that. Yeah. And whether, I mean, expert that Cayley means is basing his entire egg-dentity on claiming the real experts in the room or don't have

the American people's best interests at heart, that he's somehow a whistleblower. I loved right below the subtitle on the landing page of your article, a quote from his former boss and mentor, Steve Schmidt, quote, Kayleigh Means is not a whistleblower. He is an opportunist peddling junk science to make millions. I mean, that kind of says it. And that is one top line summary of one of the big themes in your piece is that

he is claiming to call out and to be sort of sounding a warning sign or sounding the alarm here on all the ways in which there's collusion. And in reality, what he's doing is he's using this moment and he's manipulating people. Yeah. And he's elevating his personal brand and that of the sisters. And I mean...

I will say, again, to their credit, they've managed to do that at very high levels. And I think one thing I really like that you said too is it is very easy to break things. And it's really hard to build things, especially in healthcare, really hard. And what comes of this? Because I'm sure you got the same request here. What is the Maha Commission report saying?

going to do. And I didn't see any solutions here, but it strikes me that we're talking about ultra processed foods. Well, there's a whole playbook. My wife's a pediatrician. We talk about this a lot is there is a playbook. It's difficult to scale because it requires resources on the ground for schools and for communities. There's a playbook to encourage healthier eating amongst kids. Well, actually, I will say this, which is, you know, the the Biden administration did have

a food is medicine initiative. And one of the things that they were doing was allowing states to use Medicaid dollars for targeted nutrition programs and to make available particular healthy foods for certain blocks of patients who needed it. And you know what happened? They came in and they dismantled that.

Of course. They dismantled that program, which would seem to be perfectly in line, actually, with their priorities. Exactly. I am curious to see the convergence of reality with the marketing of Maha. The reality is everything that they're doing seemingly is at odds with the Maha agenda. How can you do things without resources? And so at a very top line,

addressing a lot of these things either is going to require pitched warfare with entrenched lobbyists, which has been fought time and time again. I think about President Trump's efforts to draw attention to drug pricing and the executive order versus what the Biden administration did, I thought very effectively through the Inflation Reduction Act. They actually legislated change via Congress. The Trump administration's carrying that forward.

It's very easy to issue executive orders and to do news conferences and to issue a commission report and to go to the political summit and point the finger at everybody. It's a lot harder to govern and actually pass laws

that are going to change something that's not working over the course of time. And that's what they're not doing. But they're really good at the marketing. Well, but let's talk for one second, which we haven't mentioned what they are doing. This one big, beautiful bill that they have, their tax reconciliation bill, which passed the House and now has to face a gauntlet in the Senate. But that is going to

potentially majorly slash Medicaid. And their constituents, MAHA diehards are going to feel that. We're going to have hospital closures. We're going to have, by one estimate, 13 million people lose health insurance. So that is what they're trying to legislate.

You know, I, a hundred percent. And just as we're, as we're, I know we're coming up on time here. What I do want to close with is your thoughts on communication. You're, let's see, one of our nation's leading healthcare investigative journalists for an amazing company, Vanity Fair and Condé Nast. And I, you know, we were having this conversation earlier, Catherine, we've had this for over the course of months now is, you know,

They're really good at telling a story and they're really good at harnessing anger and outrage, appropriately so. There's a lot of appropriate anger and outrage. COVID enhanced it. What they're not good at at all is actual policy change that's going to improve people's lives. I think about, I get asked a lot,

you know, from other colleagues in media and elsewhere, you know, Vin, how should we be talking about what's happening to the NIH and what's happening to our biomedical infrastructure? And, you know, my response typically is something along the lines of telling a story about how Govee and Ozempic are now available to many more Americans than, say, even a few years ago. But the fact that they even exist was...

trials and tribulations and the American government over the course of two decades plus saying, you know what, we're going to fund investigational research in the early 2000s into this new disease or therapeutic category that no private sector company has any incentive to do so because at that time it was viewed as random and completely off, you know, high risk, potentially no reward type proposition. And

And who stepped in? It was the United States government through the NIH to say, you know what, maybe something's interesting here. Perhaps we should fund it, even if it's high risk, potentially unclear reward. There is no other entity that's willing to tolerate that level of risk to reap incredible rewards for humanity through medical innovation than the NIH and the US government. That does not exist anywhere from a governmental standpoint, anywhere else in the world. And when I think about it,

what's happening and the changes that are being wrought now and how we communicate them, I really think we need to be leaning into storytelling and doing what they do so effectively on the GOP side, which is to say, you know, nobody, everybody wants available information

a chemotherapeutic agent that their loved one may need in a few years that's probably no longer going to be available at the frequency and level at which it's available now because our pipeline is going to run dry because we don't have the human capital, we don't have the investment capital on what's going to be required over the next 10 years. But I'm wondering your thoughts on communication, where Democrats are struggling,

Yeah. And where they're succeeding. And I think this is sort of the success story of Kaylee Means and his sister and RFK more broadly is they're very good at telling stories.

Right. So, I mean, look, it is, you know, you talked, you mentioned this sort of flood the zone problem and everybody, I mean, our brains are just breaking. There's too much to process. There is too much being pulled apart. We have our information ecosystem is completely fragmented. So it's super hard to break through all of that, you know,

The power of individual stories, I still believe that that does break through. Not always, but it does. And I'll just give you one example from my own reporting. You know, I did a story. This was when they went in and they...

RIFT, R-I-F, redundancy, they cut all of the 10,000 employees from HHS and other agencies. And it was just mayhem. It was just like everything was disappearing, programs were being cut, nobody knew what was going on. I did a story. It was just about this one guy at FDA

whose job, whose expertise was in keeping, was manufacturing sterility, making sure that manufacturing processes were sterile. So he was the guy who basically made sure that you didn't get eye drops that blinded you. Yep. You know? And I just wrote about this one guy.

I didn't write about 10,000 people who lost their jobs. I wrote about him and it broke through.

Um, you know, so people really care about their health if they if they can latch on to a change that really matters to them. Like nobody wants to go blind from contaminated, you know, bacterial laden eye drops. Um, but but how you get to that, you know, and that is really like.

There are very few people, I think, who are very good at scissoring through all the noise. You know, and journalists have to get better at it. I have to get better at it. We all have to get better at it. And God knows the Democratic Party has got to get better at it, you know, because we're, you know, it's like the truth is just getting, you know, scientific integrity is just getting steamrolled.

Well, you know, there's just, it drives me just off the wall is I, there is no accountability mechanism for an, for a profession like healthcare medicine more broadly that is requires so much in the way of credentials, so much in the way of certifications and, and board exams and,

There's shockingly little for so many, for the gauntlet that is required to become a practitioner of medicine or healthcare. There's such little in the way of accountability if you err or deviate or go off track or claim to be somebody that whose voice should be heard to then guide policy. Shockingly little. You know, here we are saying-

You have to go through these 20 steps to be credible and safe to be a practitioner in the field. But oh, by the way, you can go on TV or you can be at the lectern of Health and Human Services leading that agency, and you don't have to be accountable to anybody or an agency, much less a certification body, much less the American people. You can say whatever you personally believe is true, even if it isn't true.

And that has to change. In addition to us communicating better, I also think we need to create... There has to be guardrails for behavior. And...

Otherwise, to me, the discrepancy between what we expect of our practitioners and what is allowed to occur without any accountability, that's not going to last. There is a friction that's happening. And I'll tell you, I'll speak on behalf of my fellow clinicians. Outside of the edge cases that I think are populating the administration right now, so-called doctors in name only, like Casey means,

There is a lot of anger and outrage. I can tell you this because I've heard it from large entities like...

name the medical organization, you name it, frontline nurses, frontline physicians, no one appreciates what's happening. And what they're doing right now is they are creating a unified front amongst the people that they should be most accountable to, which is outside of the American people, which is the people that are delivering care across the country. There is outrage being built and it is unified. Again, aside from the edge case individual,

That is an actually certified practicing physician. Nobody likes what's happening right now. And I think there will be blowback is my belief. And my hope is that we get smarter about creating accountability mechanisms. And as you said, really, I think very thoughtfully, just get better at communicating and breaking through the noise and your...

Your example that you cited, I saw that, Catherine, and I thought that was so darn effective because that scared me. I was like, my God. People really need to understand what's being lost. So how do they understand what's being lost? Generally, people understand what's being lost when it affects them personally.

Right. I mean, I sadly I think, you know, if this bill goes through and these Medicaid cuts go through, people are really going to feel it. I mean, you can spin a lot of stuff, but you there's like stuff that is unspinable.

you don't have health insurance and you can't go see a doctor. Or you go to the grocery store and the prices are a lot higher regardless of what's being claimed. So there are some sort of baseline reality principles here that cannot be spun. But the tragedy is going to be that may hit after it's too late because...

this bill passes and people have lost their health insurance. You know, we've got to see. But it's just, you know, we're living in such a fragmented ecosystem that people don't know what to believe.

I'm going to give that. I'm going to let that serve as the last word. The dizzying rise of Maha warrior Kaylee Means, RFK Jr.'s right-hand man. Go read it in Vanity Fair. I'm so delighted to have investigative reporter on the healthcare and sciences beat, Catherine Yvonne with us, dear friend. Catherine, thanks for being here.

Awesome to chat with you, Vin. Always. I'm excited to have a conversation with somebody that's very familiar to all of the Midas Mighty.

Dean Adal, leading legal expert across our country, frequent Midas Touch contributor. Dean is going to talk to us about all the ways in which she and her own family have seen the real impacts of all the cuts that we're seeing to the NIH and to other research funding for healthcare purposes across

the ways in which those cuts are actually translating to real impacts on families and especially her family. And it's a sensitive topic. She's going to share what she feels comfortable sharing. But I thought we don't talk enough about the real world impacts of a lot of what's happening. It's important to really crystallize that. And so without further ado, I'm going to bring Dina on. Dina, thank you for being here and for just giving us some of your time this morning.

It's so good to be here. I love your work. And I was so excited when I heard this was launched because there are so many horrible things Trump is doing to our country, but we can't lose sight of what he's doing to our health.

You can have problems in your life, but then when something happens to your health, all the rest goes away. It's like the core to our being and it affects us regardless of income and age and where we live. And so I'm so glad that you're devoting this time to that. It's very, very important. Well, I'm hoping this is the first of many conversations we have for Midas Health. And Dean, I think we're having this conversation today

at a really important time. About a month ago, for all our listeners, you and I first got to chat, and you told me about something that's an illness that struck a loved one in your family. And before I kick it to you to just tell us what you feel comfortable sharing, it's important to realize there is a series of headlines that the Trump administration is trying to drive

in the healthcare space, much less across every industry.

And they did it today with this prescription drug pricing plan that is really nothing but a rebrand. And for those that didn't catch it, an executive order was announced today by the Trump administration, by President Trump, stating that he is going to ask pharmaceutical companies to voluntarily reduce prices on some of the most expensive medications that they sell in the United States. This is a problem that has long existed in our country.

And it's because the reason we pay more as Americans for pharmaceuticals, especially branded pharmaceuticals, is because we do not directly negotiate pricing on those medications with pharmaceutical companies. And oh, by the way, that just changed last year with the Inflation Reduction Act and the Biden administration not saying, hey, let's do executive in an executive order.

but do the more responsible thing that actually is substantive, which is actually pass legislation that has statutory impact through congressional approval. They propose legislation to allow Medicare to directly negotiate pricing on the 10 most commonly used and most costly drugs amongst Medicare beneficiaries, that those pricings are going to go into effect in 2026. The Trump team likes that program. They're going to expand it.

It's going to go into 2027 thereafter, impact the pricing of drugs like GLPs, those popular weight loss drugs. But this took work. This was substantive work that took years to develop. Dr. Meena Seshakami on episode five, she was actually the architect of that program with her team.

It wasn't an executive order that was just marketing and political saber rattling. It took time and it was the real deal. And I say that because we see this all the time with the Maha agenda and RFK and what he's doing, which is effectively rebrand things that we've been talking about all the

for decades, ultra-processed foods, eat healthy, work out more, try to focus on prevention. None of this is new, but they're making it seem like what they're doing here is revolutionary. And this is where I thought this conversation is going to be so important. What they're really doing behind the scenes, again, is marketing, rebranding, but they're defunding our research institutions, vital therapeutics for which in five to 10 years when we need those vital therapeutics for

treating Alzheimer's or the next cancer, we're not going to have them. But it's not just five to 10 years down the road. It's now. And I was wondering, Dina, if you could share your perspective on this and what you've seen in your own family. Well, I mean, unfortunately, my story is...

an unusual story. And if you spoke to any number of the Armidas mighty, they would have the same story. And I'm just talking to you because as you said, I'm already a contributor. And so it's like easier to have that conversation than to pull all the people out there. But the fact of the matter is,

you know, a close, somebody very close to me, way too young in that category that they're saying it's prevalent, the 40 and under, this 40 and under way before screening, finding cancer and finding it so advanced that it has spread, you know, to the point of a stage four cancer. And that's just like a devastating diagnosis for anybody to get at any age. But for this to be happening so much to young people and it to be happening to

you know, to somebody so close to me, I became very involved in, you know, finding doctors and doing my own, you know, what I'm sure a lot of family members do become like their own mini doctors going online, reading those NIH studies. And, you know, we have made a lot of advancements and, and

every disease really in this country, in cancer, especially the last few years, it's amazing amount, you know, the treatments that these doctors we've been talking about, like one of them was just approved like a year and a half ago. I mean, we're like on the cusp of so much discovery that, you know, for all those people. And really, I really felt the need to talk about this because of the fact that like,

this is so prevalent and it is so painful. You know, life is already hard enough as it is. People get afflicted, you know, or getting diagnosed all the time with cancer, with Alzheimer's, with diabetes, heart disease. It's,

so difficult as it is. And then Trump makes it so much more difficult where he's when he's slashing universities because he thinks that he's trying to end the woke agenda. But instead, our country universities is the basis for our research.

This is where the treatments that we need for our friends and family members to come from. You know, when he takes away slashes Social Security Administration, he's also slashing disability and all those same people who have just been diagnosed and can't work are relying on those checks. You know, I mean, he's taking away Medicaid. You know, I think about this, like the people on Medicaid who are literally in the middle of just receiving these diagnosis and don't know

if they're going to be able to get treatment in a few months, it's so devastating that, that, you know, that's why I wanted to, you know, kind of give even a small voice because I know there's so many people suffering already. It's already so hard to have somebody get a diagnosis like that. And, and there is a crisis in this country among young people with cancer. I mean, this is well before screenings are in place. There's no genetic data.

I mean, for some people there might be in my situation, there was no genetic component. I mean, this is dire and the, the, especially a young person needs that next discovery needs that result of that next clinical trial. You know, I mean, you want their lifespan to be, you know, plus 70 years, they need that next thing. And he's literally taking money out of, uh,

these cures. And that is like so sick on a level I can't even describe. Like that's so depraved, but that is what is happening. And without your conversation, it's happening in the dark.

because he's doing so many other outrageous things like the Qatari jet, you know, and they're also big and shiny and they're easy to talk about. And unfortunately, our topic is sad and nuanced and it is not getting talked about enough. But it's affecting people, frankly, a lot more than the Qatari jet, as awful as that also is. We can chew gum and walk at the same time. Dina, tell me more about

you know your loved one um getting a late stage diagnosis for a difficult condition i'm sure a lot of our listeners um know someone maybe have been personally affected by cancer in some way and i think what ends up happening often is and i've seen this all the time is you know you

In many cases, you'll get the ping from your MyChart over the weekend from a Friday scan. And then you'll read or you'll have a friend in many cases will read it and call me and say, hey, I got this in my MyChart. This is an amigram or it could be a colonoscopy. And it suggests that something's wrong. And then you have to wait weeks potentially. And then you'll start to see an oncology follow up.

automatically made without any human being actually communicating to you why you see that in your sort of your next steps and your next visits. And it becomes rapidly clear without somebody giving you any details or context that something's wrong. And sometimes it can be weeks before you even get that initial appointment in person to discuss, okay, something indeed is wrong. Let's start chemo. But then at that point,

waiting weeks. And I can't tell you how many times people have gotten the news through a MyChart email notification. But there's delays in diagnosis. There's delays in getting access, as you point out.

What are you seeing now? What is your family seeing now in terms of just getting access to, say, experimental therapies? Have you noticed or have you seen other friends not be able to enroll and say the next clinical trial for an experimental therapy for a difficult disease? What are you seeing on the ground? I mean, this is so new of a diagnosis. I'm talking about like less than two months or right around that. Thankfully, we're not yet to the point of...

trying to enroll in a clinical trial because you really, you do that once you've exhausted the standard of care treatments, as you know, as a doctor. So we're not like in that, but you know, as somebody who is always looking to the future, those regardless of whether or not you need it or not, that is the next step.

treatment, right? That you're looking for, even if you're not enrolled in that clinical trial. I mean, clinical trials, I'm sure you've talked about before, whatever, is where we get our next treatments. If you're not enrolled in it, you're going to benefit from it, hopefully, right? If you're either approved or eliminated, it's like a benefit from it. And to your point, though, about that link,

to the being notified. I mean, that's like a whole other conversation or also not. It just shows how dysfunctional our medical system is, the insurance, because I feel like I've almost noticed more about insurance

You know, we've had situations where multiple doctors wanted different types. That's the other thing, too. You think even a cancer diagnosis is going to be like, oh, like everyone's going to agree. And that's not the case. We found different competing treatment, you know, recommendations, which was confusing. And also one doctor saying, oh, I don't I don't order that type of follow up, you know, scan because, you

the insurance doesn't usually cover it, right? And that's really disturbing when your healthcare in such a serious situation is being determined by healthcare. And sometimes, you know, when you are getting what they think is an early stage cancer diagnosis, they don't even do like a full PET scan to see where else it is in your body. You know, I mean, our insurance dictates that.

And unfortunately, like the course of treatment for a lot of these things, which, you know, you got to think what's going on there, right? Well, and to, Dina, to build on your point, and I'm sure this is, I can't tell you how many times I've seen this where,

We already sort of know as docs, medicines and art, there's never certainty on anything. And I think the incumbent administration and their secretary of health takes uncertainty on medical facts because there's uncertainty on everything. We don't know anything 100%. That's just the nature of the medical profession. You use your best judgment. Every quote unquote fact has a level of uncertainty to it. And

And they weaponize that fact and say that, well, gosh, folks like myself and others are hiding something from you because why don't we know how this chemotherapy is going to be responding or how somebody will respond to this version of chemo to 100% certainty? Nothing is certain in American medicine or in any version of medicine because that's just the nature of the art. It's all to say, exactly to your point,

We're always operating in gray areas. And yet sometimes it's very clear what a patient needs, which is, yeah, they need that full body MRI. Or yeah, they need that PET scan. And oh, by the way, they needed it last week. And no, we don't need to start with an x-ray and then get a CT and then get an MRI and then get a PET scan. We can skip right ahead. And the maddening nature of prior authorizations was insurrected.

Wow. So many of us have gone through is emblematic of that. And it's part of the reason why there's a lot of anger towards health insurance companies. There's no, give me what I need now, what my doc thinks with a level of certainty that's high, I need now. Why do we have to go through step therapy?

Oh, yes. I mean, I'm just going to jump in because I've just barely been to this. Right. I mean, there's people out there who have dealt with this for years for chronic illnesses. I'm just starting out and I can't. I mean, it's so difficult for somebody to get a diagnosis.

right? Such as this, having, you know, young family dealing with it and then to deal with insurance company, the prior authorization, the timing of the treatment, the timing of the scan, as you say, and when time is,

like you feel like you're fighting, right? It's like, it's like a quicksand, you know, and it's like, it's who's going to be able to be faster, the disease or you, and you have this insurance company in the way slowing it down. I mean, I don't know how anybody does this when they're by themselves, you know, here I am like a legal train. Like it's my like job to like talk to people and negotiate on the, on the phone. And,

And I just think, gosh, there's like a single woman, there's a single mother out there who is working a job, dealing with a diagnosis, having to deal with, you know, her child, having to deal with, you know,

the social security office, having to deal with the insurance. Like we, this should not be the case, you know, in this country. Like it is too hard. Like we need community. We need support. Thankfully, some people have it, but those, those that don't,

Oh gosh. Like, I'm just like, if anybody else is watching that, like more power to you, hang in there, like stay hopeful. Like if you're dealing with something like this kind of by yourself, like, you know, just hang in there. I know. I think that's a reassuring set of words here, Gina, from a voice that I know our viewers are and our listeners, for those that are listening in, um, uh,

will be warmed and reassured just to hear those coming from you. I want to go back to the origin of this conversation, which was how do you deal with a difficult diagnosis that's unexpected for a loved one at this moment? And what I think, and Dean, I want to get your thoughts on this. A question I get a lot is,

from the doctor side is what are all the impacts from NIH cuts to our research establishment? What does this mean for American families? And are we making a big deal or were we just wasting a bunch of money? And if you were following Elon Musk and the Doge team in the early days of this administration, you'd think some people would be fooled to think, well, gosh,

Why is Harvard and all these gleaming institutions getting all this money? And why can't they just do it because on their own, they have these multi-billion dollar endowments. Why are we spending all this taxpayer money towards research efforts? And I mean, it was mastery manipulation of a narrative. And I'd say to everybody listening in that we're not going to see

the real-world impacts of these cuts and people and scientists moving to places like Denmark that are actively recruiting. You may have seen the prime minister doing an active recruitment over the weekend for American scientists looking for greener pastures. We will not see the impacts of these, in my view, these cuts for another five to 10 years when the next greatest therapeutic that we were expecting because of our amazing medical innovation establishment

We were going to expect that in 10 years. We're no longer going to get that in 10 years because of the real world impacts of what's happening right now. People leaving, budgets being cut, people saying, you know what, I don't need this. I'm going to go to the private sector, whatever it is. But I'm wondering, that's my view as a doc, but you as a legal expert and as a loved one to somebody that's battling a serious illness, how are you viewing it? I mean, as a loved one, I'm viewing it as we cannot accept that.

and that Trump does back down when pressed. Look what's happening with the tariffs, right? He went from 150% to 30% on China because the stock market tanked and enough people were upset for losing money. If everybody watching this says,

spread this, shared it, talked about this, because I'm telling you, a lot of people don't actually realize what Trump is doing to science research. Like I've talked to Democrats who are like, oh, wait, what? What is he doing? Like people need to know. And if they know when they go to that town hall, start asking about this.

start calling their Congress people, start making this an issue. If we make it a loud enough issue, he does back down when it starts to affect him. And it only will affect him if people are loud enough. So I would say we can't, we don't have the luxury as loved ones of accepting the five to 10 year thing. We have to make this happen.

an issue and an unrelenting issue. And it's an issue that crosses all political, you know, spheres. We can make this an issue that is loud enough to be heard, but it does take us being loud. And that's really why I wanted to have this conversation with you. That's why I think it's so important that you're doing this. And I feel like we, you know, let's let this be the start.

of a movie uprising on this.

I want to read a few things to you. I'm just drawing them up here. 75% Dina, of more than 1600 readers, scientists to the major scientific periodical nature, one of the most prestigious medical journals, scientific journals that exist in the world. 75% of US scientists were polled. I think there was over 1600 that were polled. 75% of them who then

of the US scientists who answered that survey said that they were going to, are considering leaving the United States. 1200 of the 1600 that responded to the survey said, you know what? Yeah, we're thinking about taking a fellowship in Europe or in China or in India to continue our studies or in some cases to actually get a job in biomedical innovation. That's a stunning number. We're losing talent

That isn't suddenly going to say, Hey, Oh yeah, let me come back in three years. If we have a new president, because you have no, we have no guarantee that this is not going to be a 48 year thing. And who wants that uncertainty when you're raising a family, building a career, you can't afford that. And, but I thought that was interesting. And, um,

Yeah. And I think we are unique in this country in that way. Like when we are making it so there, I think there's like so many less PhDs, right. That have are allowed. And there's so many visas from around the world's canceled regarding the PhDs. So we're hitting them there. We're hitting the cutting of the research universities, but America is unique in that we don't have government research labs.

We use our universities as research labs. Like in Russia, they have government research labs. But so for people listening who maybe don't quite get the tie,

First of all, nothing happens without government money. My dad, who was an economist, he worked as a he immigrated to this country, but became an economist and worked in the Department of Health under Carter, was like nothing gets innovated in this country without government money. So first of all, you got that. And then you have the fact that the government money isn't going, quote, to the government lab less like in D.C.,

It's going to the research. We have always acted, our research universities have been our government essential, if you think about it in that respect, research universities. So that's why this, you are literally cutting the like,

the backbone of our research when you cut to universities. Absolutely. And as you're talking, thank you for that. JAMA, Journal of American Medical Association, released earlier this month, just actually four days ago. They are, you and I, Dina and I were talking about this to all our listeners about a month ago. Is anybody keeping track

of what's actually happening and the impact because they're flooding the zone. So much is happening every day. It's easy to get lost. Well, gosh, are we sure we're documenting and cataloging all the cuts? And so then we can actually understand the impact of it so that if you're a voter in 26 or 28, you can understand, okay, this is what I'm voting for. Do I like it or not? Because I think part of this is going to be

Do they or do they not want to be talking about this? The impact of the cuts to somebody potentially with a stage four diagnosis of cancer. Oh, and they're going to have less therapeutic options potentially when they need it in five years. Who wants that? Who's voting for that?

I'm not sure anybody wants to vote for that. But a headline here, the Trump administration terminated $1.81 billion in NIH grants in less than 40 days, including $544 million in as of yet unspent funds. That was according to an analysis published just last week, Thursday, in the Journal of the American Medical Association. That is stunning because that's money that researchers, some of the best in the world, thought they already had secured

for additional studies, for additional clinical trials, and now they're taking it back. We're losing these people. They're not coming back or they're leaving the field entirely. That's going to harm all of us. That's not a Republican or Democrat issue. That is a short-term political consideration that will harm us all.

Absolutely. And we have the money. I mean, the budget, if you look at the chart, they're taking money from the Department of Health, you know, and they're adding it to the Department of Defense, the Pentagon, never mind the tax cuts to the rich. But they are literally allowing people to die.

And cures are so close to cures for Alzheimer's. There's so many cures we're like on the cusp of. They're literally taking that money and putting it to weapons of war or tax cuts for the rich. It's not that we don't have the money. It's where they are putting it.

That's right. Well said. I want to give you really well said, and I think we need to have this clear discussion because I venture a guess. We're not going to reach 100% of people on any topic, healthcare or not. I suspect though, I have a lot of friends on the center right political spectrum, people that were in the George W. Bush administration, others. I respect that we have different points of view, but I respect them as people. We can disagree, but not be disagreeable.

And my view is that probably 75% of people would want the investments in place for therapeutics or their loved one to have if they should need it. It's just connecting the dots between this policy action and, oh, you're saying that that's what could happen down the road. Oh, I didn't realize that. That's what I think what you've done for us is you made that clear. And I really appreciate that. But I wanted to give you the floor for any final thoughts. Yeah.

You know, I think you're absolutely right. I mean, the problem, I think, most of the time with Republicans is they don't care about the issue unless it happens to them. And the sad reality is everybody is touched by these diseases, everybody, regardless of Democrat and Republican. And I do think if people were educated and informed about the fact that Trump is literally taking money that will cure people,

or give them treatments that will improve their quality of health across the board for all diseases, I think we would have the pushback that could then save science here in America. I agree. I agree. And you've been a really powerful voice on all issues to remind us touch. I'm thrilled.

that you've joined me in sort of our inaugural phase here, Dina. Thank you so much. And just to say, just to put a fine point on this, Maha is a rebranding effort on topics that we have been talking about for decades. And all they're doing is they're putting a shiny object, shiny branding effort on what is a series of destructive policies that will not allow them to achieve anything that they so glibly talk about. That's what Maha is.

depriving your loved ones of critical experimental therapies down the road five, 10 years from now, that's what they're doing as well. They just don't want you to realize that. But Dina, thank you so much for joining us. I'm so grateful to you. Well, thank you so much for having me. You're really doing such amazing work here. I've always admired your work and, and I'm so grateful for it. So grateful for you to shine a light on, on such an important issue.

Thanks, J-Nam. Talk to you soon. Appreciate you.

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