Does the government… care about our health?
Serious question.
I mean we've seen how hard it works to make sure food is cheap.
Why doesn't it do the same thing for prescription drugs?
You know, if a bank fails, the government swoops in to save the day,
but if your heart fails, they feed you to the health insurance sharks.
That'll be ten grand.
Ooh! Twenty grand! Great work doc, what a day!
Or what about COVID-19?
I mean, do you remember what it was like when the pandemic first hit?
We were all trapped inside,
obsessively refreshing the COVID death count websites
and cheering out our windows for frontline workers
who didn't even have access to basic protective equipment.
-Thank you!
Who needs a mask when you've got clanging pots to comfort you?
Actually, if you were stuck inside you were lucky,
because a lot of people, like grocery workers were out there
risking their lives for minimum wage.
You want your body bag to be paper or plastic?
And as I watched the pandemic sweep across the country,
killing hundreds of thousands of Americans,
I couldn't help but wonder, where the hell was our government?
Why did we go months without adequate testing?
Why was there so little contact tracing?
Where was the giant government PSA campaign
telling us how to fight the virus?
I want you to wear a goddamn mask.
I've never felt more abandoned by the system
that I thought was supposed to protect me and my community.
So, what the hell happened?
I mean our government has literally wiped out entire diseases
that used to kill us in droves.
So, why couldn't it handle COVID-19?
-Take malaria.
Every year, it kills hundreds of thousands of people around the world.
Well here in America,
we generally only worry about it when we travel overseas.
Not many of us realize though, that up until the 1940s,
malaria was actually endemic to the United States!
I declare,
this mosquito-borne malaise is wreaking havoc on the entire South
and sickening hundreds of thousands of Americans every year.
Malaria!
No need to fret folks!
I'm from the government and I'm here to help.
We're going to train local health officials, drain mosquito breeding sites,
and spray millions of homes with good old American pesticide.
Ahh. Smells like Mom's home cooking.
In fact, we've created a brand new agency
with a specific mission of eradicating this pest borne plague.
The Centers for Disease Control.
Well, control it you did!
Malaria has disappeared like a summer breeze.
But are you sure this cloud of poisonous gas is safe?
Uh… Well, it did almost eradicate the Bald Eagle…
Luckily it is a resilient and majestic bird.
Bald Eagles!
And it wasn't just malaria,
the CDC worked to help virtually wipe out diseases
like the measles, tuberculosis and polio.
Americans literally think of these as old-timey illnesses now.
And even today, our government is investing massive resources
in developing the cures and treatments of the future.
The National Institutes of Health
is the largest public funder of biomedical research in the world.
I mean, name something that'll kill you
and the NIH has made you less likely to die from it.
Everything from breast cancer,
to diabetes, to hepatitis, to heart disease, even prostate cancer!
And today, at NIH's building 10, they're on the verge of straight-up curing
one of the most pernicious diseases in the country.
Thank you so much for having me. This place is like a cathedral.
It is, this is the largest research hospital in the world.
Has only about 200 beds, but every one of those
is occupied by somebody who's here on an experimental clinical trial.
So, funded by the taxpayers,
the first chemotherapy was done in this clinical center.
-The first… uh -Wow.
…treatment of depression for lithium, that was done in this clinical center.
The first gene therapy ever was done in this clinical center.
That's incredible, so patients come to this building
to get brand new treatments that you're just now inventing with them.
Do you know the disease called sickle cell disease?
Yes, I learned about it in school, it's a very… it's a very difficult disease.
It is. It's an inherited disorder,
primarily affects people whose ancestors came from Africa.
Now we've known the cause of sickle-cell for decades,
but we haven't really had an effective treatment.
But now, here in this very building
we're starting dare I say, to cure people.
-Really? -Not just help them, but cure them.
And I want to introduce you to two of the doctors that lead this.
I would love that, please, ple--
-Can we do that? Let's go. -Alright, let's do that.
Thank you so much.
-Hi there. -Hi.
-Hi, I'm Adam. -Dr. Fitzhugh, nice to meet you.
Very nice to meet you.
And John Tisdale.
-Very nice to meet you. Can I sit? -Nice to meet you.
-Yes, that'll be great. -Great.
So in America, hundred thousand people living with this disease right now,
and you're working on… curing it?
-Yes. -That's our goal.
We're trying to give them a whole new life.
How does it work? How do you do it?
The type of transplant that I do is where you take the stem cells,
which are the seeds of the bone marrow which make red blood cells.
We take them from a family member.
Ideally those stem cells will grow and make
normal red blood cells and cure the patient.
That's amazing. That's… that could change so many lives.
Yeah, it's really incredible.
When I first started my training, in the 90s,
we had exactly zero drugs.
The one thing that we can do, and could do well then,
is to treat pain.
We weren't even doing that.
It didn't seem like anyone was doing anything for sickle cell disease.
There's a lot of diseases
that have less than a hundred thousand Americans that suffer--
That get a whole lot more.
-Yeah. -Yeah.
Why is that? Is it possibly because of the folks that…
who suffer from it the most in America are of-- is it an equity issue?
I think that's an easy question to answer yes to.
Almost every patient that you meet with this disease
has had the encounter that they go to the ER, writhing in pain,
only to be denied the very treatment they need.
Well if I imagine government science, I imagine you know,
I don't know, big particle accelerators and things,
I don't necessarily imagine, oh, you're caring for people.
Like, you're working for the government but you're caring for people one-on-one.
The patients that are eligible are able to come to the NIH
and as long as they're eligible, they get, everything's provided for free.
So I love that too, that we can pretty much,
we don't have to ask about insurance or citizenship,
we can take care of everybody.
And in fact, we have a patient, in the clinic now
who was on the gene therapy protocol, that I need to go see.
That would be amazing. I'd
-love to do that if we could. -Okay, let's do that.
Dr. Fitzhugh, it was incredible meeting you.
-Thank you so much. -Very nice to meet you too, Adam.
-Yeah. Alright, let's go. -Take care.
-Hello! How are you? -Hi, Dr. Tisdale.
-It's so nice to meet you Clevetta. -Hi Adam, nice to meet you.
So before um, the transplant I was really sick.
I was up to… almost 30 ER and hospital visits in a year.
And then I was introduced to NIH and the transplant.
I prayed about it. It was very risky you know,
but I decided to go along with it
and I feel so much better.
I haven't been in the hospital since 2019.
What does it feel like to, you know, be not just cured yourself
but to be a part of this giant project to cure so many other people.
To be on the forefront of that?
Honestly, it's scary, but whether or not it worked for me,
I did it for the future, you know, generations who it may help.
Clevetta, it's… it's amazing talking to you.
Thank you-- Thank you so much for taking the time.
Thank you, I appreciate everything.
Thank you for speaking with me,
for coming, for introducing the transplant to the world.
Isn't that incredible?
Can you imagine growing up with an incurable disease,
being turned away and dismissed by the medical establishment.
And then one day, miraculously, you're cured!
Not by some faith healer waving a crystal in your face…
-This crystal will align your chakras.
-Okay, thank you very much. -It will set your moons forth.
Thank you, no. Uh…
But by your own government,
inviting you to take part in a generational effort
to end your disease for everyone.
You know, they say the only two things that are certain are death and taxes
but it turns out
that our government's been using the one to fight the other.
And, at least partly because of their efforts,
over the last century American life expectancy
has increased by 30 goddamn years!
So, maybe the government does care about our health?
But hold on, if the government is so amazing at curing diseases,
how the hell did it totally fuck up the--
Pandemic!
When COVID-19 hit, our government seemed to go totally haywire.
The CDC and the FDA wasted time developing flawed tests
instead of approving working ones.
The Department of Homeland Security was seemingly nowhere to be found.
We didn't even take basic steps,
like developing a national testing or contact tracing plan.
People died as a result.
According to expert models,
if the federal government had deployed a coordinated response,
it could have saved hundreds of thousands of lives.
So again, what the hell happened?
Well, think of the government as an orchestra.
And the president as its conductor.
In order for them to play beautiful music together, you need two things,
qualified, competent public servants sitting in these chairs
and a conductor who's dedicated to helping them all play together on cue.
But when the pandemic hit, we had a different kind of conductor.
You mind if I take over?
-How hard could this be?
Oh boy, we got a lot of instruments here.
Do we need all of these?
The Trump campaign explicitly ran on a platform
of eliminating government departments and personnel.
And when Americans voted for it, they were true to their word.
The Homeland Security Advisor,
a position created specifically to handle threats like a pandemic,
was effectively eliminated.
Yeah. Go, go, go.
The National Security Council Team devoted to pandemic response was fired.
Get out of here. Go!
Go! Come on! Yeah. Bye-bye! Bye-bye.
You know what else was cut?
A project called "Predict", which tracked animal diseases
and was supposed to serve as a pandemic early warning program,
but nope! Bet you didn't predict that.
Even the CDC was sidelined
after it communicated a bit too loudly with the public.
-Hey you! Pipe down!
This happened across the entire federal government.
By 2020, 80% of senior officials had left.
The administration hadn't even advanced
a nominee for a 150 crucial positions.
And much of the government's pandemic response structure
had been dismantled.
So, what went wrong with COVID-19?
Well, if you don't hire enough musicians, if you cut entire sections, and if the
whole thing is conducted by someone who,
let's face it, doesn't really care a lot about music?
Well, you're not going to get a symphony,
you're going to get a cacophony.
-Ugh!
The federal response was so discordant,
the job of handling the pandemic was left to individual cities and states.
But sadly, this same tune
was being played by politicians on the local level too.
You might not even know they're there but in your state, county, town or city,
there's a local public health department that's working hard to protect you.
They do things like inspect restaurants to stop food borne illnesses.
Educate the public on how to prevent STDs.
And, during the pandemic,
they were responsible for everything from distributing vaccines to testing.
Yo, thank you for your thoroughness.
Oh God, I think he touched the brainstem.
But shockingly,
these essential public workers have been disappearing before our eyes.
Budget cuts sponsored by both Republicans and Democrats
have led to the elimination of 56,000 local public health jobs since 2008.
Oh no! I'm getting cut! Tell my wife I never loved her!
This is batshit!
Those politicians never would have voted to defund the fire department,
but they sure had no problem eviscerating public health.
So, you want to know why America botched the pandemic?
Experts believe that we went into it
with 300,000 less public health workers than we needed.
What must it have been like
to be responsible for the health of your community
with that few resources?
Hey! I'm here to see Shawanda.
Give me one moment, I'll go back and get her.
Awesome.
-Hi! -Hi!
Adam, how are you?
Thank you so much for having me.
Would you like to come on back to my office?
Yeah, let-- Show me around a little bit.
Mr. Burns had showed me some of your um, YouTube videos and I saw them.
Oh you did?
Kind of funny but uh… but it was nice.
You thought they were kind of funny.
-They were. -Okay good.
Tell me a little bit about Lowndes County.
Basically, Lowndes County's a rural area.
-There's no hospitals here. Um… -Wow.
There's no big restaurants like McDonald's or anything like that.
So like, we're the only County Health Department here.
What do you all do here?
-What we don't do here?
We do a lot um, family planning.
We have WIAC, which is, women, health and--
Women, Infants and Children. Um…
-We do a lot of testing here. -Yeah.
With the CDC, with the STD program.
We do vital records here as well.
-Birth certificates? -Birth certificates.
Birth certificates, death certificates.
If the County Health Department, Lowndes County Health Department was not here,
where would they go?
Yeah. I did read that in Alabama that,
you know, over ten years, before the pandemic,
that staffing at Public Health Departments was cut by like a third.
-Oh I feel like it cut more than a third. -Yeah?
Some days we have 40, 50 people coming in for one program,
so, they got to wait.
-Right. -That's the barrier.
If we had the proper staffing, they wouldn't have to wait.
Well, let me ask about COVID-19.
There were parts of the pandemic
where this was one of the hardest hit spots in the country
-at that point in time. -Mm-hm.
You're the only folks around for miles
and everyone's looking to you, what was that like?
Scary.
Um…
You know, some people is coming from everywhere,
not only just for this county.
When they couldn't get any other place they would wanna come here.
Were you having to pull extra hours to handle this or what?
I was working clerk, that means I was doing intake,
then I was doing a manager's job which is the office manager's job,
and then now I'm the director so now I am doing the director's job.
What powers you through to do that?
Yeah?
If I can help a person put a smile on their face
and um, be able to get what they need, I mean, it's awesome.
Thank you for being here and doing this work.
I'd love to meet Dr. Thomas,
do you think it'd be okay if I went over there and said hi?
-It's okay, just relax, okay. -Okay.
Pull your mask down. Up. Well, come on.
Close your lips please.
I'm gonna see Dr. Thomas in a second?
You are going to see Dr. Thomas, he's the only doctor in the county.
What is that like?
Have you ever heard the phrase cool as a cucumber?
-That's Dr. Thomas.
He loves his clients and his clients love him as well, so.
It was so wonderful meeting you.
Alright, take care. Alright.
-Adam? -Dr. Thomas!
How are you doing?
Tell me a little bit about yourself and the clinic.
Been in practice since 1986,
I finished Tuscaloosa Family Practice residency in Tuscaloosa.
Now I understand this is a federally qualified-- What is it?
Federally qualified health center.
They basically will fund a certain amount of money
and then we're responsible for making sure that all people are seen.
In other words, if they don't have insurance, we will see them.
It's um, can be difficult at times but,
right now we're trying to make sure that everybody is covered in terms of COVID.
You had a real outbreak here.
-I saw that at one point, -Yes.
the positivity rate for test was like 35%.
-Yes. It is. -That's so high.
I was actually quarantined for about 14 days.
You're the only doctor in town and you were quarantined?
My nurse practitioner was here so she had my back.
-She had my back. Yeah. -She had your back but you weren't
able to see patients during that time?
-Right, right. -Wow.
-You also practice in Montgomery? -Yes.
How often do you do that?
I'm going up there every day after I finish here.
Would it be okay if I tagged along with you and we could talk more in the car?
Like you to see some of the countryside, it's beautiful.
How did you start doing this work?
I decided I wanted to be a doctor
but, I didn't really want to be responsible for saying you can't be seen
because you don't have enough money.
There was an organization called the National Service Corps.
Once you completed your residency,
you would try and match with a community health center,
or Indian Reservation or prison system,
anything that…
-Was not covered-- Where there's -Where there's need.
need, exactly.
So this is a government program, "We'll
pay your medical tuition if you go somewhere
where they really need doctors such as Lowndes County."
-And that's how you ended up here. -Exactly. Right.
-That's an amazing program. I… -It is,
-it is. -I had no idea that it existed.
I think it started in 1970.
When President Reagan was elected he cut the program.
Do you feel that the government cares about the health of Americans
as much as it should?
I think there's certain ones in government who do care and others who…
it's not their priority.
Sometimes politicians are of the impression that,
those who are in poor health are responsible for themselves.
If you've never been poor,
or you've never had to decide whether I can't eat and go see the doctor,
if you haven't faced that then you really don't…
understand that position.
You know, we keep having this tiresome debate in this country
over how much the government should be involved in healthcare.
When, in reality, if it weren't for government health workers
like Shawanda and Dr. Thomas,
there'd be no healthcare in Lowndes County at all.
And yet they're still being starved of the resources they need
to keep their community safe.
Is it any wonder that, as I'm recording this,
Alabama has one of the lowest COVID-19 vaccination rates in the country?
I mean, why aren't we investing in basic public services like this?
You know, I remember my mom telling me when I was a kid
that the government was wasteful
and that the private sector was much more efficient at getting things done.
And looking back on it now,
that was kind of a weird comment coming from her
because she was a public school teacher.
She was educated at a State University.
Her dad, my grandfather,
he got his education paid for by the GI Bill.
Our entire family benefited from government support.
So where did she get the idea?
Where do we all get the idea
that the government is some useless bureaucracy
that needs to be dismantled?
For much of the 20th century, there was a consensus in America
that a strong capable government was a good thing to have.
Folks! Behold the eighth wonder of the world: Uncle Sam.
Marvel as your government stabilizes the banking system.
-Boggle, as he sanitizes the food supply!
That's right, a healthy government needs a healthy society.
But in the wake of the Civil Rights Movement,
some Americans began to resent the fact
that the government was now providing assistance
to Black and Brown citizens as well.
And they started blaming the welfare state for the nation's economic woes.
Uh-oh.
Not so sure about that, are we folks?
And don't look now, but the economy is beset
by inflation, stagnation
and unemployment that ol' Uncle Sam is struggling to fix!
Boo! Boo I say!
Oh, what's this?
We got some wealthy business-backed groups raising a ruckus.
Here, boo this man!
They're paying think tanks and colleges
to pass along the notion that the government sucks eggs.
Yes, yeah. Boo him students! Boo!
The free market is the solution to all our problems.
Boo!
Soon, politicians from both parties were talking about downsizing the government.
But these trends really came to a head
in the campaign of one of the most popular presidents of all time
and not just because he once starred in a movie with a chimp.
You know folks, the
nine most terrifying words in the English language are,
"I'm from the government and I'm here to help."
It's alright friend, you won't feel a thing.
This message was so popular,
it helped Reagan win one of the largest Electoral College victories
in recent American history.
Patient, Uncle Sam, 200 years old, mostly white.
Suffering from laziness, waste and a bad case of pork belly.
The American people have asked us for a government-ectomy,
and we're gonna give it to them. Scalpel.
Alright, let's see here.
We'll just cut the housing department by 70%
and staff it with a bunch of anti-housing capitalists.
That's got it.
Then we'll disembowel the regulations on the mortgage industry here.
Oh, don't worry.
I'm sure that the free market can prevent a housing crisis by itself.
And let's just reduce these taxes over here.
Heck, while we're at it, let's just gut the whole dang IRS.
This philosophy, that the free market should be trusted over the government
to solve all our problems became so popular,
the Democrats started adopting it as well.
When President Clinton was elected, he cut welfare and financial regulations.
"The era of big government is over." Pass me that scalpel Ronny.
And, despite its efforts to push back against this trend,
even the Obama Administration felt it necessary to compromise with the market
when reforming health care.
"That's why our health care law relies on a reformed private market,
"not a government program."
In the end,
this anti-government philosophy produced exactly what it intended,
a government that's weaker, less effective.
Less able to protect us in the ways only it can.
There we are Uncle Sam. Isn't that better?
You know, maybe it's hard to believe
but I wasn't always the prime physical specimen I am today.
In my 20s, I didn't care about my body at all.
I was doing three stand-up sets a night,
smoking a pack a day and drinking too much.
I treated my body like shit…
Okay, you guys suck.
What else, what else?
Until it couldn't do shit.
And our government is kind of the same way.
How can it care for us if we don't care for it?
But you know, we don't have to treat our governing body this way.
My own journey from boozed-up schlub
to the paragon of fitness you see before you,
began when I started listening to my body.
And in that same way we could start paying attention
to what our government actually does every day.
We could support its immune system by investing in public health again,
we could feed it healthy funding
and exercise its muscles by making sure it has a…
well-trained staff or whatever.
Okay, the metaphor is breaking down a little bit, but,
if we did do all these things
we could end up with a government that's strong enough
to support us in the ways that matter most.
Ha-ha-ha!
But, that's easy for me to say, here on Netflix.
And dramatized with a couple of incredibly hunky actors.
It's a lot harder for us as a society to do in the real world.
How exactly do we reverse this tide?
How do we heal our government so it's as fit as we need it to be?
How do we take these ideas and actually use them
to make change?