1 00:00:06,716 --> 00:00:08,634 [light-hearted music plays] 2 00:00:18,311 --> 00:00:22,857 -[indistinct chatter] -[monitor beeping] 3 00:00:24,233 --> 00:00:26,944 [somber music plays] 4 00:00:29,447 --> 00:00:33,576 Does the government… care about our health? 5 00:00:34,243 --> 00:00:35,578 Serious question. [splutters] 6 00:00:35,661 --> 00:00:40,208 I mean we've seen how hard it works to make sure food is cheap. 7 00:00:40,291 --> 00:00:43,920 Why doesn't it do the same thing for prescription drugs? 8 00:00:44,587 --> 00:00:49,467 You know, if a bank fails, the government swoops in to save the day, 9 00:00:49,967 --> 00:00:54,347 but if your heart fails, they feed you to the health insurance sharks. 10 00:00:55,264 --> 00:00:57,058 That'll be ten grand. 11 00:00:57,517 --> 00:01:01,979 Ooh! Twenty grand! Great work doc, what a day! 12 00:01:03,106 --> 00:01:05,566 Or what about COVID-19? 13 00:01:06,067 --> 00:01:10,196 I mean, do you remember what it was like when the pandemic first hit? 14 00:01:10,279 --> 00:01:12,115 We were all trapped inside, 15 00:01:12,198 --> 00:01:15,618 obsessively refreshing the COVID death count websites 16 00:01:15,701 --> 00:01:19,080 and cheering out our windows for frontline workers 17 00:01:19,163 --> 00:01:22,375 who didn't even have access to basic protective equipment. 18 00:01:22,458 --> 00:01:24,252 -[crowd cheering] -[woman 1] Thank you! 19 00:01:24,335 --> 00:01:28,464 Who needs a mask when you've got clanging pots to comfort you? 20 00:01:29,215 --> 00:01:31,884 Actually, if you were stuck inside you were lucky, 21 00:01:31,968 --> 00:01:34,595 because a lot of people, like grocery workers were out there 22 00:01:34,679 --> 00:01:37,265 risking their lives for minimum wage. 23 00:01:37,348 --> 00:01:40,184 You want your body bag to be paper or plastic? 24 00:01:40,268 --> 00:01:41,394 [monitor flatlining] 25 00:01:41,477 --> 00:01:45,189 And as I watched the pandemic sweep across the country, 26 00:01:45,273 --> 00:01:47,859 killing hundreds of thousands of Americans, 27 00:01:47,942 --> 00:01:52,196 I couldn't help but wonder, where the hell was our government? 28 00:01:52,697 --> 00:01:55,366 Why did we go months without adequate testing? 29 00:01:55,449 --> 00:01:57,535 Why was there so little contact tracing? 30 00:01:57,618 --> 00:02:00,163 Where was the giant government PSA campaign 31 00:02:00,246 --> 00:02:01,873 telling us how to fight the virus? 32 00:02:01,956 --> 00:02:04,584 [male voice] I want you to wear a goddamn mask. 33 00:02:06,335 --> 00:02:10,298 I've never felt more abandoned by the system 34 00:02:10,381 --> 00:02:13,384 that I thought was supposed to protect me and my community. 35 00:02:13,885 --> 00:02:17,555 So, what the hell happened? 36 00:02:17,638 --> 00:02:21,642 I mean our government has literally wiped out entire diseases 37 00:02:21,726 --> 00:02:23,519 that used to kill us in droves. 38 00:02:23,603 --> 00:02:27,857 So, why couldn't it handle COVID-19? 39 00:02:29,942 --> 00:02:31,194 -[intriguing music playing] -Take malaria. 40 00:02:31,277 --> 00:02:35,072 Every year, it kills hundreds of thousands of people around the world. 41 00:02:35,156 --> 00:02:36,115 Well here in America, 42 00:02:36,199 --> 00:02:39,452 we generally only worry about it when we travel overseas. 43 00:02:39,535 --> 00:02:42,622 Not many of us realize though, that up until the 1940s, 44 00:02:42,705 --> 00:02:46,042 malaria was actually endemic to the United States! 45 00:02:48,169 --> 00:02:49,378 I declare, 46 00:02:49,462 --> 00:02:52,924 this mosquito-borne malaise is wreaking havoc on the entire South 47 00:02:53,007 --> 00:02:57,303 and sickening hundreds of thousands of Americans every year. 48 00:02:59,430 --> 00:03:02,308 [yells] Malaria! 49 00:03:04,977 --> 00:03:06,896 [woman 2] No need to fret folks! 50 00:03:06,979 --> 00:03:09,273 I'm from the government and I'm here to help. 51 00:03:09,357 --> 00:03:10,191 [bell dings] 52 00:03:10,775 --> 00:03:15,112 We're going to train local health officials, drain mosquito breeding sites, 53 00:03:15,196 --> 00:03:19,992 and spray millions of homes with good old American pesticide. 54 00:03:20,701 --> 00:03:23,287 Ahh. Smells like Mom's home cooking. 55 00:03:23,871 --> 00:03:26,874 In fact, we've created a brand new agency 56 00:03:26,958 --> 00:03:31,087 with a specific mission of eradicating this pest borne plague. 57 00:03:31,170 --> 00:03:33,839 The Centers for Disease Control. 58 00:03:33,923 --> 00:03:36,384 Well, control it you did! 59 00:03:36,467 --> 00:03:39,720 Malaria has disappeared like a summer breeze. 60 00:03:39,804 --> 00:03:41,889 [coughs] 61 00:03:42,682 --> 00:03:45,643 But are you sure this cloud of poisonous gas is safe? 62 00:03:45,726 --> 00:03:49,480 Uh… Well, it did almost eradicate the Bald Eagle… 63 00:03:49,563 --> 00:03:51,983 [bird chirping] 64 00:03:52,984 --> 00:03:56,904 Luckily it is a resilient and majestic bird. 65 00:03:57,738 --> 00:03:59,865 [yells] Bald Eagles! 66 00:04:04,287 --> 00:04:05,538 [intriguing music plays] 67 00:04:05,621 --> 00:04:07,248 And it wasn't just malaria, 68 00:04:07,331 --> 00:04:10,501 the CDC worked to help virtually wipe out diseases 69 00:04:10,584 --> 00:04:13,838 like the measles, tuberculosis and polio. 70 00:04:13,921 --> 00:04:17,466 Americans literally think of these as old-timey illnesses now. 71 00:04:18,467 --> 00:04:22,263 And even today, our government is investing massive resources 72 00:04:22,346 --> 00:04:25,641 in developing the cures and treatments of the future. 73 00:04:28,227 --> 00:04:29,979 The National Institutes of Health 74 00:04:30,062 --> 00:04:34,608 is the largest public funder of biomedical research in the world. 75 00:04:34,692 --> 00:04:36,485 I mean, name something that'll kill you 76 00:04:36,569 --> 00:04:39,405 and the NIH has made you less likely to die from it. 77 00:04:39,488 --> 00:04:41,073 Everything from breast cancer, 78 00:04:41,157 --> 00:04:45,995 to diabetes, to hepatitis, to heart disease, even prostate cancer! 79 00:04:46,078 --> 00:04:51,500 And today, at NIH's building 10, they're on the verge of straight-up curing 80 00:04:51,584 --> 00:04:54,837 one of the most pernicious diseases in the country. 81 00:04:58,591 --> 00:05:01,469 [Adam] Thank you so much for having me. This place is like a cathedral. 82 00:05:01,552 --> 00:05:05,639 It is, this is the largest research hospital in the world. 83 00:05:05,723 --> 00:05:08,142 Has only about 200 beds, but every one of those 84 00:05:08,225 --> 00:05:11,937 is occupied by somebody who's here on an experimental clinical trial. 85 00:05:12,021 --> 00:05:14,398 [Francis Collins] So, funded by the taxpayers, 86 00:05:14,482 --> 00:05:17,443 the first chemotherapy was done in this clinical center. 87 00:05:17,526 --> 00:05:19,278 -The first… uh -[Adam] Wow. 88 00:05:19,362 --> 00:05:23,491 …treatment of depression for lithium, that was done in this clinical center. 89 00:05:23,574 --> 00:05:27,078 The first gene therapy ever was done in this clinical center. 90 00:05:27,161 --> 00:05:29,580 [Adam] That's incredible, so patients come to this building 91 00:05:29,663 --> 00:05:33,876 to get brand new treatments that you're just now inventing with them. 92 00:05:33,959 --> 00:05:36,295 Do you know the disease called sickle cell disease? 93 00:05:36,379 --> 00:05:39,173 Yes, I learned about it in school, it's a very… it's a very difficult disease. 94 00:05:39,757 --> 00:05:41,634 It is. It's an inherited disorder, 95 00:05:41,717 --> 00:05:44,720 primarily affects people whose ancestors came from Africa. 96 00:05:44,804 --> 00:05:48,015 [Francis Collins] Now we've known the cause of sickle-cell for decades, 97 00:05:48,099 --> 00:05:50,935 but we haven't really had an effective treatment. 98 00:05:51,018 --> 00:05:53,813 But now, here in this very building 99 00:05:53,896 --> 00:05:57,608 we're starting dare I say, to cure people. 100 00:05:57,691 --> 00:06:00,778 -[Adam] Really? -Not just help them, but cure them. 101 00:06:00,861 --> 00:06:04,657 [Francis Collins] And I want to introduce you to two of the doctors that lead this. 102 00:06:04,740 --> 00:06:06,075 I would love that, please, ple-- 103 00:06:06,158 --> 00:06:07,368 -Can we do that? Let's go. -[Francis Collins] Alright, let's do that. 104 00:06:07,451 --> 00:06:08,661 [Adam] Thank you so much. 105 00:06:08,744 --> 00:06:11,205 [soothing music plays] 106 00:06:15,042 --> 00:06:16,585 -Hi there. -[woman 3] Hi. 107 00:06:17,211 --> 00:06:19,004 -Hi, I'm Adam. -Dr. Fitzhugh, nice to meet you. 108 00:06:19,088 --> 00:06:20,131 [Adam] Very nice to meet you. 109 00:06:20,214 --> 00:06:21,173 And John Tisdale. 110 00:06:21,257 --> 00:06:22,716 -[Adam] Very nice to meet you. Can I sit? -[John Tisdale] Nice to meet you. 111 00:06:22,800 --> 00:06:24,093 -[Dr. Fitzhugh] Yes, that'll be great. -[Adam] Great. 112 00:06:24,176 --> 00:06:27,847 [Adam] So in America, hundred thousand people living with this disease right now, 113 00:06:28,430 --> 00:06:30,808 and you're working on… curing it? 114 00:06:30,891 --> 00:06:32,434 -[Dr. Fitzhugh] Yes. -[John Tisdale] That's our goal. 115 00:06:32,518 --> 00:06:34,019 We're trying to give them a whole new life. 116 00:06:34,103 --> 00:06:36,105 How does it work? How do you do it? 117 00:06:36,188 --> 00:06:39,358 [Dr. Fitzhugh] The type of transplant that I do is where you take the stem cells, 118 00:06:39,441 --> 00:06:42,319 which are the seeds of the bone marrow which make red blood cells. 119 00:06:42,403 --> 00:06:43,779 We take them from a family member. 120 00:06:43,863 --> 00:06:45,656 Ideally those stem cells will grow and make 121 00:06:45,739 --> 00:06:47,158 normal red blood cells and cure the patient. 122 00:06:47,241 --> 00:06:51,203 That's amazing. That's… that could change so many lives. 123 00:06:51,287 --> 00:06:52,580 Yeah, it's really incredible. 124 00:06:52,663 --> 00:06:56,292 When I first started my training, in the 90s, 125 00:06:56,792 --> 00:06:58,335 we had exactly zero drugs. 126 00:06:58,419 --> 00:07:01,422 The one thing that we can do, and could do well then, 127 00:07:01,505 --> 00:07:02,840 is to treat pain. 128 00:07:02,923 --> 00:07:04,300 We weren't even doing that. 129 00:07:04,383 --> 00:07:07,720 It didn't seem like anyone was doing anything for sickle cell disease. 130 00:07:07,803 --> 00:07:08,721 [Adam] There's a lot of diseases 131 00:07:08,804 --> 00:07:11,682 that have less than a hundred thousand Americans that suffer-- 132 00:07:11,765 --> 00:07:12,683 [John Tisdale] That get a whole lot more. 133 00:07:12,766 --> 00:07:13,684 -Yeah. -Yeah. 134 00:07:13,767 --> 00:07:16,145 [Adam] Why is that? Is it possibly because of the folks that… 135 00:07:16,228 --> 00:07:19,565 who suffer from it the most in America are of-- is it an equity issue? 136 00:07:20,149 --> 00:07:23,277 I think that's an easy question to answer yes to. 137 00:07:23,360 --> 00:07:26,113 Almost every patient that you meet with this disease 138 00:07:26,697 --> 00:07:30,868 has had the encounter that they go to the ER, writhing in pain, 139 00:07:30,951 --> 00:07:34,580 only to be denied the very treatment they need. 140 00:07:34,663 --> 00:07:37,875 Well if I imagine government science, I imagine you know, 141 00:07:37,958 --> 00:07:39,752 I don't know, big particle accelerators and things, 142 00:07:39,835 --> 00:07:43,672 I don't necessarily imagine, oh, you're caring for people. 143 00:07:43,756 --> 00:07:46,926 Like, you're working for the government but you're caring for people one-on-one. 144 00:07:47,009 --> 00:07:49,512 [Dr. Fitzhugh] The patients that are eligible are able to come to the NIH 145 00:07:49,595 --> 00:07:53,265 and as long as they're eligible, they get, everything's provided for free. 146 00:07:53,349 --> 00:07:55,476 So I love that too, that we can pretty much, 147 00:07:55,976 --> 00:07:58,312 we don't have to ask about insurance or citizenship, 148 00:07:58,395 --> 00:07:59,855 we can take care of everybody. 149 00:07:59,939 --> 00:08:03,317 [John Tisdale] And in fact, we have a patient, in the clinic now 150 00:08:03,400 --> 00:08:08,322 who was on the gene therapy protocol, that I need to go see. 151 00:08:08,405 --> 00:08:09,240 [Adam] That would be amazing. I'd 152 00:08:09,323 --> 00:08:10,574 -love to do that if we could. -[John Tisdale] Okay, let's do that. 153 00:08:10,658 --> 00:08:12,284 Dr. Fitzhugh, it was incredible meeting you. 154 00:08:12,368 --> 00:08:13,494 -[Adam] Thank you so much. -Very nice to meet you too, Adam. 155 00:08:13,577 --> 00:08:14,995 -[Adam] Yeah. Alright, let's go. -[Dr. Fitzhugh] Take care. 156 00:08:15,079 --> 00:08:16,997 -[John Tisdale] Hello! How are you? -Hi, Dr. Tisdale. 157 00:08:17,081 --> 00:08:19,124 -It's so nice to meet you Clevetta. -[Clevetta] Hi Adam, nice to meet you. 158 00:08:19,208 --> 00:08:24,129 So before um, the transplant I was really sick. 159 00:08:24,213 --> 00:08:30,302 I was up to… almost 30 ER and hospital visits in a year. 160 00:08:30,386 --> 00:08:35,891 [Clevetta] And then I was introduced to NIH and the transplant. 161 00:08:35,975 --> 00:08:39,937 I prayed about it. It was very risky you know, 162 00:08:40,020 --> 00:08:42,815 but I decided to go along with it 163 00:08:43,482 --> 00:08:45,818 and I feel so much better. 164 00:08:45,901 --> 00:08:50,114 I haven't been in the hospital since 2019. 165 00:08:50,197 --> 00:08:55,035 What does it feel like to, you know, be not just cured yourself 166 00:08:55,119 --> 00:08:59,081 but to be a part of this giant project to cure so many other people. 167 00:08:59,164 --> 00:09:00,332 To be on the forefront of that? 168 00:09:02,084 --> 00:09:06,922 Honestly, it's scary, [chuckles] but whether or not it worked for me, 169 00:09:07,006 --> 00:09:13,053 I did it for the future, you know, generations who it may help. 170 00:09:13,137 --> 00:09:15,306 Clevetta, it's… it's amazing talking to you. 171 00:09:15,389 --> 00:09:17,141 Thank you-- Thank you so much for taking the time. 172 00:09:17,224 --> 00:09:19,560 [Clevetta] Thank you, I appreciate everything. 173 00:09:19,643 --> 00:09:22,313 Thank you for speaking with me, 174 00:09:22,396 --> 00:09:27,443 for coming, for introducing the transplant to the world. 175 00:09:28,068 --> 00:09:29,111 [soothing music plays] 176 00:09:29,194 --> 00:09:30,529 Isn't that incredible? 177 00:09:31,572 --> 00:09:35,075 Can you imagine growing up with an incurable disease, 178 00:09:35,159 --> 00:09:38,871 being turned away and dismissed by the medical establishment. 179 00:09:39,371 --> 00:09:43,125 And then one day, miraculously, you're cured! 180 00:09:43,208 --> 00:09:46,629 Not by some faith healer waving a crystal in your face… 181 00:09:46,712 --> 00:09:48,756 -This crystal will align your chakras. -[soothing music plays] 182 00:09:48,839 --> 00:09:50,966 -Okay, thank you very much. -It will set your moons forth. 183 00:09:51,050 --> 00:09:52,468 Thank you, no. Uh… 184 00:09:53,052 --> 00:09:55,054 But by your own government, 185 00:09:55,137 --> 00:09:58,349 inviting you to take part in a generational effort 186 00:09:58,432 --> 00:10:01,518 to end your disease for everyone. 187 00:10:02,019 --> 00:10:06,190 You know, they say the only two things that are certain are death and taxes 188 00:10:06,273 --> 00:10:07,650 but it turns out 189 00:10:07,733 --> 00:10:11,111 that our government's been using the one to fight the other. 190 00:10:11,195 --> 00:10:12,738 [grunts] 191 00:10:12,821 --> 00:10:14,990 And, at least partly because of their efforts, 192 00:10:15,074 --> 00:10:18,494 over the last century American life expectancy 193 00:10:18,577 --> 00:10:21,538 has increased by 30 goddamn years! 194 00:10:22,039 --> 00:10:27,544 So, maybe the government does care about our health? 195 00:10:27,628 --> 00:10:29,755 [pensive music plays] 196 00:10:29,838 --> 00:10:33,634 But hold on, if the government is so amazing at curing diseases, 197 00:10:33,717 --> 00:10:36,178 how the hell did it totally fuck up the-- 198 00:10:36,261 --> 00:10:38,097 [shouting] Pandemic! 199 00:10:38,180 --> 00:10:40,391 [alarm blaring] 200 00:10:40,474 --> 00:10:44,978 When COVID-19 hit, our government seemed to go totally haywire. 201 00:10:45,562 --> 00:10:49,525 [Adam] The CDC and the FDA wasted time developing flawed tests 202 00:10:49,608 --> 00:10:51,652 instead of approving working ones. 203 00:10:51,735 --> 00:10:54,905 The Department of Homeland Security was seemingly nowhere to be found. 204 00:10:54,988 --> 00:10:56,740 We didn't even take basic steps, 205 00:10:56,824 --> 00:11:00,661 like developing a national testing or contact tracing plan. 206 00:11:01,662 --> 00:11:04,206 People died as a result. 207 00:11:04,707 --> 00:11:06,250 According to expert models, 208 00:11:06,333 --> 00:11:09,169 if the federal government had deployed a coordinated response, 209 00:11:09,253 --> 00:11:12,715 it could have saved hundreds of thousands of lives. 210 00:11:13,215 --> 00:11:16,635 So again, what the hell happened? 211 00:11:17,761 --> 00:11:23,809 [orchestra playing] 212 00:11:24,393 --> 00:11:27,396 Well, think of the government as an orchestra. 213 00:11:33,110 --> 00:11:35,487 And the president as its conductor. 214 00:11:35,571 --> 00:11:36,864 [orchestra stops] 215 00:11:44,288 --> 00:11:47,666 [orchestra plays] 216 00:11:49,585 --> 00:11:53,881 In order for them to play beautiful music together, you need two things, 217 00:11:53,964 --> 00:11:57,342 qualified, competent public servants sitting in these chairs 218 00:11:57,426 --> 00:12:02,055 and a conductor who's dedicated to helping them all play together on cue. 219 00:12:02,723 --> 00:12:07,019 But when the pandemic hit, we had a different kind of conductor. 220 00:12:07,978 --> 00:12:08,812 You mind if I take over? 221 00:12:09,897 --> 00:12:11,940 -How hard could this be? -[orchestra stops] 222 00:12:12,024 --> 00:12:13,734 Oh boy, we got a lot of instruments here. 223 00:12:13,817 --> 00:12:15,110 Do we need all of these? 224 00:12:16,111 --> 00:12:19,114 The Trump campaign explicitly ran on a platform 225 00:12:19,198 --> 00:12:22,284 of eliminating government departments and personnel. 226 00:12:22,367 --> 00:12:25,662 And when Americans voted for it, they were true to their word. 227 00:12:25,746 --> 00:12:27,456 The Homeland Security Advisor, 228 00:12:27,539 --> 00:12:31,293 a position created specifically to handle threats like a pandemic, 229 00:12:31,376 --> 00:12:33,587 was effectively eliminated. 230 00:12:34,379 --> 00:12:36,465 [Adam] Yeah. Go, go, go. 231 00:12:37,007 --> 00:12:41,178 The National Security Council Team devoted to pandemic response was fired. 232 00:12:41,929 --> 00:12:43,347 Get out of here. Go! 233 00:12:43,430 --> 00:12:46,141 Go! Come on! Yeah. Bye-bye! Bye-bye. 234 00:12:47,267 --> 00:12:48,393 You know what else was cut? 235 00:12:48,477 --> 00:12:52,231 A project called "Predict", which tracked animal diseases 236 00:12:52,314 --> 00:12:55,776 and was supposed to serve as a pandemic early warning program, 237 00:12:55,859 --> 00:12:57,986 but nope! Bet you didn't predict that. 238 00:13:00,155 --> 00:13:02,616 [drums beating loudly] 239 00:13:03,367 --> 00:13:05,577 [Adam] Even the CDC was sidelined 240 00:13:05,661 --> 00:13:08,872 after it communicated a bit too loudly with the public. 241 00:13:08,956 --> 00:13:10,832 -Hey you! Pipe down! -[drums stop] 242 00:13:15,671 --> 00:13:17,631 [drums beating quietly] 243 00:13:17,714 --> 00:13:21,301 This happened across the entire federal government. 244 00:13:21,385 --> 00:13:24,930 By 2020, 80% of senior officials had left. 245 00:13:25,013 --> 00:13:26,974 The administration hadn't even advanced 246 00:13:27,057 --> 00:13:29,518 a nominee for a 150 crucial positions. 247 00:13:29,601 --> 00:13:32,521 And much of the government's pandemic response structure 248 00:13:32,604 --> 00:13:33,772 had been dismantled. 249 00:13:36,692 --> 00:13:39,945 So, what went wrong with COVID-19? 250 00:13:40,028 --> 00:13:45,409 Well, if you don't hire enough musicians, if you cut entire sections, and if the 251 00:13:45,492 --> 00:13:47,494 whole thing is conducted by someone who, 252 00:13:47,995 --> 00:13:50,747 let's face it, doesn't really care a lot about music? 253 00:13:50,831 --> 00:13:52,916 Well, you're not going to get a symphony, 254 00:13:53,000 --> 00:13:55,210 you're going to get a cacophony. 255 00:13:57,754 --> 00:13:59,673 -[orchestra plays out of tune] -Ugh! 256 00:14:04,261 --> 00:14:06,638 The federal response was so discordant, 257 00:14:06,722 --> 00:14:11,893 the job of handling the pandemic was left to individual cities and states. 258 00:14:11,977 --> 00:14:14,021 But sadly, this same tune 259 00:14:14,104 --> 00:14:17,899 was being played by politicians on the local level too. 260 00:14:19,818 --> 00:14:24,489 You might not even know they're there but in your state, county, town or city, 261 00:14:24,573 --> 00:14:28,869 there's a local public health department that's working hard to protect you. 262 00:14:28,952 --> 00:14:32,956 They do things like inspect restaurants to stop food borne illnesses. 263 00:14:33,457 --> 00:14:35,959 Educate the public on how to prevent STDs. 264 00:14:36,043 --> 00:14:39,588 [comical music plays] 265 00:14:44,760 --> 00:14:46,261 And, during the pandemic, 266 00:14:46,345 --> 00:14:50,557 they were responsible for everything from distributing vaccines to testing. 267 00:14:50,641 --> 00:14:53,143 [groans, snorts] 268 00:14:53,226 --> 00:14:55,479 Yo, thank you for your thoroughness. 269 00:14:55,562 --> 00:14:57,397 Oh God, I think he touched the brainstem. 270 00:14:58,398 --> 00:14:59,232 But shockingly, 271 00:14:59,316 --> 00:15:03,779 these essential public workers have been disappearing before our eyes. 272 00:15:03,862 --> 00:15:07,032 Budget cuts sponsored by both Republicans and Democrats 273 00:15:07,115 --> 00:15:12,663 have led to the elimination of 56,000 local public health jobs since 2008. 274 00:15:12,746 --> 00:15:18,335 Oh no! I'm getting cut! Tell my wife I never loved her! 275 00:15:19,962 --> 00:15:21,088 This is batshit! 276 00:15:21,171 --> 00:15:24,591 Those politicians never would have voted to defund the fire department, 277 00:15:24,675 --> 00:15:27,803 but they sure had no problem eviscerating public health. 278 00:15:27,886 --> 00:15:30,973 So, you want to know why America botched the pandemic? 279 00:15:31,056 --> 00:15:32,975 Experts believe that we went into it 280 00:15:33,058 --> 00:15:37,354 with 300,000 less public health workers than we needed. 281 00:15:37,854 --> 00:15:39,147 What must it have been like 282 00:15:39,231 --> 00:15:41,775 to be responsible for the health of your community 283 00:15:41,858 --> 00:15:43,402 with that few resources? 284 00:15:45,529 --> 00:15:49,032 [country music plays] 285 00:15:56,581 --> 00:15:58,375 [Adam] Hey! I'm here to see Shawanda. 286 00:15:58,458 --> 00:16:00,043 Give me one moment, I'll go back and get her. 287 00:16:00,127 --> 00:16:01,378 Awesome. 288 00:16:01,461 --> 00:16:02,921 -Hi! -[Adam] Hi! 289 00:16:03,005 --> 00:16:03,964 Adam, how are you? 290 00:16:04,047 --> 00:16:05,590 [Adam] Thank you so much for having me. 291 00:16:05,674 --> 00:16:06,633 [Shawanda] Would you like to come on back to my office? 292 00:16:06,717 --> 00:16:08,343 [Adam] Yeah, let-- Show me around a little bit. 293 00:16:08,427 --> 00:16:12,723 Mr. Burns had showed me some of your um, YouTube videos and I saw them. 294 00:16:12,806 --> 00:16:13,640 [Adam] Oh you did? 295 00:16:13,724 --> 00:16:16,309 Kind of funny but uh… but it was nice. 296 00:16:16,393 --> 00:16:17,519 You thought they were kind of funny. 297 00:16:17,602 --> 00:16:19,104 -They were. -Okay good. 298 00:16:19,187 --> 00:16:20,605 Tell me a little bit about Lowndes County. 299 00:16:20,689 --> 00:16:22,774 Basically, Lowndes County's a rural area. 300 00:16:22,858 --> 00:16:25,193 -There's no hospitals here. Um… -Wow. 301 00:16:25,277 --> 00:16:28,447 There's no big restaurants like McDonald's or anything like that. 302 00:16:28,530 --> 00:16:30,907 So like, we're the only County Health Department here. 303 00:16:30,991 --> 00:16:31,950 What do you all do here? 304 00:16:32,659 --> 00:16:34,119 -What we don't do here? -[Adam laughs] 305 00:16:34,953 --> 00:16:36,955 [Shawanda] We do a lot um, family planning. 306 00:16:37,039 --> 00:16:38,999 We have WIAC, which is, women, health and-- 307 00:16:39,082 --> 00:16:40,751 Women, Infants and Children. Um… 308 00:16:41,376 --> 00:16:43,587 -We do a lot of testing here. -Yeah. 309 00:16:43,670 --> 00:16:45,756 With the CDC, with the STD program. 310 00:16:45,839 --> 00:16:48,175 We do vital records here as well. 311 00:16:48,759 --> 00:16:49,760 -Birth certificates? -Birth certificates. 312 00:16:49,843 --> 00:16:51,636 Birth certificates, death certificates. 313 00:16:51,720 --> 00:16:55,015 If the County Health Department, Lowndes County Health Department was not here, 314 00:16:55,098 --> 00:16:55,932 where would they go? 315 00:16:56,016 --> 00:17:00,228 Yeah. I did read that in Alabama that, 316 00:17:00,312 --> 00:17:02,522 you know, over ten years, before the pandemic, 317 00:17:02,606 --> 00:17:06,234 that staffing at Public Health Departments was cut by like a third. 318 00:17:06,318 --> 00:17:09,029 -Oh I feel like it cut more than a third. -Yeah? 319 00:17:09,112 --> 00:17:12,616 [Shawanda] Some days we have 40, 50 people coming in for one program, 320 00:17:12,699 --> 00:17:14,201 so, they got to wait. 321 00:17:14,284 --> 00:17:15,452 -Right. -[Shawanda] That's the barrier. 322 00:17:15,535 --> 00:17:18,455 If we had the proper staffing, they wouldn't have to wait. 323 00:17:18,538 --> 00:17:20,749 Well, let me ask about COVID-19. 324 00:17:20,832 --> 00:17:21,917 There were parts of the pandemic 325 00:17:22,000 --> 00:17:24,127 where this was one of the hardest hit spots in the country 326 00:17:24,211 --> 00:17:25,253 -at that point in time. -Mm-hm. 327 00:17:25,337 --> 00:17:27,464 [Adam] You're the only folks around for miles 328 00:17:27,547 --> 00:17:29,341 and everyone's looking to you, what was that like? 329 00:17:29,424 --> 00:17:30,675 Scary. 330 00:17:30,759 --> 00:17:31,843 Um… 331 00:17:31,927 --> 00:17:33,845 You know, some people is coming from everywhere, 332 00:17:33,929 --> 00:17:35,138 not only just for this county. 333 00:17:35,222 --> 00:17:37,182 When they couldn't get any other place they would wanna come here. 334 00:17:37,265 --> 00:17:40,769 Were you having to pull extra hours to handle this or what? 335 00:17:40,852 --> 00:17:42,938 I was working clerk, that means I was doing intake, 336 00:17:43,021 --> 00:17:46,817 then I was doing a manager's job which is the office manager's job, 337 00:17:46,900 --> 00:17:50,695 and then now I'm the director so now I am doing the director's job. 338 00:17:50,779 --> 00:17:52,739 What powers you through to do that? 339 00:17:54,116 --> 00:17:55,158 Yeah? 340 00:17:55,242 --> 00:17:57,786 If I can help a person put a smile on their face 341 00:17:57,869 --> 00:18:01,373 and um, be able to get what they need, I mean, it's awesome. 342 00:18:01,456 --> 00:18:03,792 Thank you for being here and doing this work. [chuckles] 343 00:18:03,875 --> 00:18:04,918 I'd love to meet Dr. Thomas, 344 00:18:05,001 --> 00:18:06,962 do you think it'd be okay if I went over there and said hi? 345 00:18:07,045 --> 00:18:09,131 -[woman 4] It's okay, just relax, okay. -[Adam] Okay. 346 00:18:09,214 --> 00:18:11,675 Pull your mask down. Up. Well, come on. 347 00:18:11,758 --> 00:18:13,260 Close your lips please. 348 00:18:14,469 --> 00:18:15,929 [Adam] I'm gonna see Dr. Thomas in a second? 349 00:18:16,012 --> 00:18:18,974 You are going to see Dr. Thomas, he's the only doctor in the county. 350 00:18:19,057 --> 00:18:19,808 What is that like? 351 00:18:19,891 --> 00:18:23,436 Have you ever heard the phrase cool as a cucumber? 352 00:18:23,520 --> 00:18:25,147 -[laughs] -[woman 4] That's Dr. Thomas. 353 00:18:25,230 --> 00:18:27,858 He loves his clients and his clients love him as well, so. 354 00:18:27,941 --> 00:18:29,693 It was so wonderful meeting you. 355 00:18:29,776 --> 00:18:31,611 Alright, take care. Alright. 356 00:18:31,695 --> 00:18:33,280 -[Dr. Thomas] Adam? -[Adam] Dr. Thomas! 357 00:18:33,363 --> 00:18:34,197 [Dr. Thomas] How are you doing? 358 00:18:34,281 --> 00:18:36,408 Tell me a little bit about yourself and the clinic. 359 00:18:36,491 --> 00:18:39,077 Been in practice since 1986, 360 00:18:40,078 --> 00:18:43,957 I finished Tuscaloosa Family Practice residency in Tuscaloosa. 361 00:18:44,040 --> 00:18:48,003 Now I understand this is a federally qualified-- What is it? 362 00:18:48,086 --> 00:18:49,254 Federally qualified health center. 363 00:18:49,337 --> 00:18:52,340 They basically will fund a certain amount of money 364 00:18:52,424 --> 00:18:55,635 and then we're responsible for making sure that all people are seen. 365 00:18:55,719 --> 00:18:58,889 In other words, if they don't have insurance, we will see them. 366 00:18:58,972 --> 00:19:01,683 It's um, can be difficult at times but, 367 00:19:02,184 --> 00:19:06,438 right now we're trying to make sure that everybody is covered in terms of COVID. 368 00:19:06,521 --> 00:19:08,190 You had a real outbreak here. 369 00:19:08,273 --> 00:19:09,357 -I saw that at one point, -[Dr. Thomas] Yes. 370 00:19:09,441 --> 00:19:12,319 the positivity rate for test was like 35%. 371 00:19:12,402 --> 00:19:13,778 -[Dr. Thomas] Yes. It is. -That's so high. 372 00:19:13,862 --> 00:19:17,490 I was actually quarantined for about 14 days. 373 00:19:17,574 --> 00:19:20,243 You're the only doctor in town and you were quarantined? 374 00:19:20,994 --> 00:19:23,371 My nurse practitioner was here so she had my back. 375 00:19:23,455 --> 00:19:25,123 -[Dr. Thomas] She had my back. Yeah. -She had your back but you weren't 376 00:19:25,207 --> 00:19:26,333 able to see patients during that time? 377 00:19:26,416 --> 00:19:28,460 -[Dr. Thomas] Right, right. -[Adam] Wow. 378 00:19:28,543 --> 00:19:30,212 -You also practice in Montgomery? -Yes. 379 00:19:30,295 --> 00:19:31,296 How often do you do that? 380 00:19:31,379 --> 00:19:33,465 I'm going up there every day after I finish here. 381 00:19:33,548 --> 00:19:36,301 Would it be okay if I tagged along with you and we could talk more in the car? 382 00:19:36,384 --> 00:19:38,511 [Dr. Thomas] Like you to see some of the countryside, it's beautiful. 383 00:19:38,595 --> 00:19:40,055 [soothing music plays] 384 00:19:40,138 --> 00:19:41,890 [Adam] How did you start doing this work? 385 00:19:41,973 --> 00:19:43,808 [Dr. Thomas] I decided I wanted to be a doctor 386 00:19:43,892 --> 00:19:48,188 but, I didn't really want to be responsible for saying you can't be seen 387 00:19:48,271 --> 00:19:50,065 because you don't have enough money. 388 00:19:50,607 --> 00:19:53,485 There was an organization called the National Service Corps. 389 00:19:53,568 --> 00:19:55,987 [Dr. Thomas] Once you completed your residency, 390 00:19:56,071 --> 00:19:58,740 you would try and match with a community health center, 391 00:19:58,823 --> 00:20:01,868 or Indian Reservation or prison system, 392 00:20:01,952 --> 00:20:03,245 anything that… 393 00:20:03,328 --> 00:20:04,496 -Was not covered-- Where there's -[Adam] Where there's need. 394 00:20:04,579 --> 00:20:05,538 need, exactly. 395 00:20:05,622 --> 00:20:07,374 [Adam] So this is a government program, "We'll 396 00:20:07,457 --> 00:20:10,752 pay your medical tuition if you go somewhere 397 00:20:10,835 --> 00:20:13,171 where they really need doctors such as Lowndes County." 398 00:20:13,255 --> 00:20:15,507 -And that's how you ended up here. -[Dr. Thomas] Exactly. Right. 399 00:20:15,590 --> 00:20:18,093 -That's an amazing program. I… [chuckles] -[Dr. Thomas] It is, 400 00:20:18,176 --> 00:20:19,469 -it is. -I had no idea that it existed. 401 00:20:19,552 --> 00:20:21,096 [Dr. Thomas] I think it started in 1970. 402 00:20:21,179 --> 00:20:25,100 When President Reagan was elected he cut the program. 403 00:20:25,642 --> 00:20:30,605 Do you feel that the government cares about the health of Americans 404 00:20:30,689 --> 00:20:32,065 as much as it should? 405 00:20:32,148 --> 00:20:36,820 I think there's certain ones in government who do care and others who… 406 00:20:38,947 --> 00:20:39,823 it's not their priority. 407 00:20:41,199 --> 00:20:44,911 Sometimes politicians are of the impression that, 408 00:20:45,704 --> 00:20:49,666 those who are in poor health are responsible for themselves. 409 00:20:49,749 --> 00:20:51,876 If you've never been poor, 410 00:20:51,960 --> 00:20:57,173 or you've never had to decide whether I can't eat and go see the doctor, 411 00:20:57,257 --> 00:20:59,384 if you haven't faced that then you really don't… 412 00:21:01,052 --> 00:21:02,846 understand that position. 413 00:21:05,765 --> 00:21:09,352 You know, we keep having this tiresome debate in this country 414 00:21:09,436 --> 00:21:12,272 over how much the government should be involved in healthcare. 415 00:21:12,355 --> 00:21:16,067 When, in reality, if it weren't for government health workers 416 00:21:16,151 --> 00:21:17,861 like Shawanda and Dr. Thomas, 417 00:21:17,944 --> 00:21:21,406 there'd be no healthcare in Lowndes County at all. 418 00:21:21,906 --> 00:21:25,493 And yet they're still being starved of the resources they need 419 00:21:25,577 --> 00:21:27,203 to keep their community safe. 420 00:21:27,787 --> 00:21:29,914 Is it any wonder that, as I'm recording this, 421 00:21:29,998 --> 00:21:34,044 Alabama has one of the lowest COVID-19 vaccination rates in the country? 422 00:21:34,544 --> 00:21:39,257 I mean, why aren't we investing in basic public services like this? 423 00:21:41,468 --> 00:21:45,055 You know, I remember my mom telling me when I was a kid 424 00:21:45,138 --> 00:21:46,931 that the government was wasteful 425 00:21:47,015 --> 00:21:50,643 and that the private sector was much more efficient at getting things done. 426 00:21:51,144 --> 00:21:52,312 And looking back on it now, 427 00:21:52,395 --> 00:21:54,481 that was kind of a weird comment coming from her 428 00:21:54,564 --> 00:21:57,150 because she was a public school teacher. 429 00:21:57,233 --> 00:22:00,236 She was educated at a State University. 430 00:22:00,320 --> 00:22:01,863 Her dad, my grandfather, 431 00:22:01,946 --> 00:22:04,949 he got his education paid for by the GI Bill. 432 00:22:05,450 --> 00:22:08,661 Our entire family benefited from government support. 433 00:22:09,162 --> 00:22:10,830 So where did she get the idea? 434 00:22:10,914 --> 00:22:12,248 Where do we all get the idea 435 00:22:12,332 --> 00:22:15,335 that the government is some useless bureaucracy 436 00:22:15,418 --> 00:22:17,545 that needs to be dismantled? 437 00:22:17,629 --> 00:22:19,214 [tape rolling] 438 00:22:19,297 --> 00:22:23,676 [Adam] For much of the 20th century, there was a consensus in America 439 00:22:23,760 --> 00:22:27,514 that a strong capable government was a good thing to have. 440 00:22:27,597 --> 00:22:32,644 Folks! Behold the eighth wonder of the world: Uncle Sam. 441 00:22:32,727 --> 00:22:36,689 [crowd claps] 442 00:22:36,773 --> 00:22:41,152 Marvel as your government stabilizes the banking system. 443 00:22:41,736 --> 00:22:43,321 [crowd astonished] 444 00:22:43,404 --> 00:22:46,950 -Boggle, as he sanitizes the food supply! -[crowd claps] 445 00:22:49,077 --> 00:22:52,080 That's right, a healthy government needs a healthy society. 446 00:22:52,163 --> 00:22:53,665 [crowd astonished] 447 00:22:54,958 --> 00:22:56,584 But in the wake of the Civil Rights Movement, 448 00:22:56,668 --> 00:22:59,087 some Americans began to resent the fact 449 00:22:59,170 --> 00:23:01,047 that the government was now providing assistance 450 00:23:01,131 --> 00:23:03,675 to Black and Brown citizens as well. 451 00:23:03,758 --> 00:23:07,554 And they started blaming the welfare state for the nation's economic woes. 452 00:23:07,637 --> 00:23:08,346 Uh-oh. 453 00:23:08,429 --> 00:23:10,181 Not so sure about that, are we folks? 454 00:23:10,265 --> 00:23:13,143 And don't look now, but the economy is beset 455 00:23:13,226 --> 00:23:15,186 by inflation, stagnation 456 00:23:15,270 --> 00:23:19,941 and unemployment that ol' Uncle Sam is struggling to fix! 457 00:23:20,567 --> 00:23:23,153 Boo! Boo I say! 458 00:23:23,236 --> 00:23:24,946 Oh, what's this? 459 00:23:25,446 --> 00:23:28,658 We got some wealthy business-backed groups raising a ruckus. 460 00:23:28,741 --> 00:23:30,410 Here, boo this man! 461 00:23:30,493 --> 00:23:32,287 They're paying think tanks and colleges 462 00:23:32,370 --> 00:23:35,039 to pass along the notion that the government sucks eggs. 463 00:23:35,123 --> 00:23:38,334 Yes, yeah. Boo him students! Boo! 464 00:23:38,418 --> 00:23:40,461 The free market is the solution to all our problems. 465 00:23:40,545 --> 00:23:44,174 [crowd] Boo! 466 00:23:44,257 --> 00:23:45,717 [crowd] Boo! 467 00:23:45,800 --> 00:23:51,139 Soon, politicians from both parties were talking about downsizing the government. 468 00:23:51,222 --> 00:23:53,349 But these trends really came to a head 469 00:23:53,433 --> 00:23:56,728 in the campaign of one of the most popular presidents of all time 470 00:23:56,811 --> 00:23:59,355 and not just because he once starred in a movie with a chimp. 471 00:23:59,439 --> 00:24:01,524 [marching band music plays] 472 00:24:02,775 --> 00:24:03,943 You know folks, the 473 00:24:04,027 --> 00:24:06,988 nine most terrifying words in the English language are, 474 00:24:07,071 --> 00:24:09,657 "I'm from the government and I'm here to help." 475 00:24:09,741 --> 00:24:11,201 [crowd laughs] 476 00:24:19,918 --> 00:24:23,254 It's alright friend, you won't feel a thing. 477 00:24:23,338 --> 00:24:25,506 [Adam] This message was so popular, 478 00:24:25,590 --> 00:24:29,260 it helped Reagan win one of the largest Electoral College victories 479 00:24:29,344 --> 00:24:31,095 in recent American history. 480 00:24:31,930 --> 00:24:34,599 [Ronald Reagan] Patient, Uncle Sam, 200 years old, mostly white. 481 00:24:34,682 --> 00:24:38,978 Suffering from laziness, waste and a bad case of pork belly. 482 00:24:39,687 --> 00:24:42,523 The American people have asked us for a government-ectomy, 483 00:24:42,607 --> 00:24:44,776 and we're gonna give it to them. Scalpel. 484 00:24:44,859 --> 00:24:47,070 Alright, let's see here. 485 00:24:47,153 --> 00:24:50,615 We'll just cut the housing department by 70% 486 00:24:50,698 --> 00:24:54,285 and staff it with a bunch of anti-housing capitalists. 487 00:24:55,495 --> 00:24:56,746 That's got it. 488 00:24:57,538 --> 00:25:01,876 Then we'll disembowel the regulations on the mortgage industry here. 489 00:25:02,460 --> 00:25:03,378 Oh, don't worry. 490 00:25:04,128 --> 00:25:08,925 I'm sure that the free market can prevent a housing crisis by itself. 491 00:25:10,426 --> 00:25:13,888 And let's just reduce these taxes over here. 492 00:25:15,014 --> 00:25:19,477 Heck, while we're at it, let's just gut the whole dang IRS. 493 00:25:20,979 --> 00:25:24,774 This philosophy, that the free market should be trusted over the government 494 00:25:24,857 --> 00:25:28,236 to solve all our problems became so popular, 495 00:25:28,319 --> 00:25:31,114 the Democrats started adopting it as well. 496 00:25:31,197 --> 00:25:35,243 When President Clinton was elected, he cut welfare and financial regulations. 497 00:25:35,326 --> 00:25:39,455 [Bill Clinton] "The era of big government is over." Pass me that scalpel Ronny. 498 00:25:40,164 --> 00:25:44,127 And, despite its efforts to push back against this trend, 499 00:25:44,210 --> 00:25:48,589 even the Obama Administration felt it necessary to compromise with the market 500 00:25:48,673 --> 00:25:50,466 when reforming health care. 501 00:25:50,550 --> 00:25:54,512 [Barack Obama] "That's why our health care law relies on a reformed private market, 502 00:25:54,595 --> 00:25:56,097 "not a government program." 503 00:25:56,806 --> 00:25:58,308 In the end, 504 00:25:58,391 --> 00:26:03,646 this anti-government philosophy produced exactly what it intended, 505 00:26:03,730 --> 00:26:06,649 a government that's weaker, less effective. 506 00:26:06,733 --> 00:26:11,738 Less able to protect us in the ways only it can. 507 00:26:11,821 --> 00:26:15,992 There we are Uncle Sam. Isn't that better? 508 00:26:18,870 --> 00:26:19,954 [sighs] 509 00:26:20,038 --> 00:26:21,914 You know, maybe it's hard to believe 510 00:26:21,998 --> 00:26:26,127 but I wasn't always the prime physical specimen I am today. 511 00:26:26,210 --> 00:26:29,047 In my 20s, I didn't care about my body at all. 512 00:26:29,130 --> 00:26:30,923 I was doing three stand-up sets a night, 513 00:26:31,007 --> 00:26:33,718 smoking a pack a day and drinking too much. 514 00:26:33,801 --> 00:26:36,012 I treated my body like shit… 515 00:26:36,095 --> 00:26:38,097 [coughs] Okay, you guys suck. 516 00:26:38,681 --> 00:26:40,558 What else, what else? 517 00:26:40,641 --> 00:26:43,102 [Adam] Until it couldn't do shit. 518 00:26:43,186 --> 00:26:46,314 -[speaker shrilling] -[coughing ] 519 00:26:46,397 --> 00:26:49,567 And our government is kind of the same way. 520 00:26:49,650 --> 00:26:53,071 How can it care for us if we don't care for it? 521 00:26:53,571 --> 00:26:57,742 But you know, we don't have to treat our governing body this way. 522 00:26:58,284 --> 00:27:00,453 My own journey from boozed-up schlub 523 00:27:00,536 --> 00:27:02,872 to the paragon of fitness you see before you, 524 00:27:02,955 --> 00:27:06,084 began when I started listening to my body. 525 00:27:06,167 --> 00:27:08,586 And in that same way we could start paying attention 526 00:27:08,669 --> 00:27:11,839 to what our government actually does every day. 527 00:27:11,923 --> 00:27:16,052 We could support its immune system by investing in public health again, 528 00:27:16,135 --> 00:27:18,137 we could feed it healthy funding 529 00:27:18,221 --> 00:27:21,599 and exercise its muscles by making sure it has a… 530 00:27:21,682 --> 00:27:23,893 well-trained staff or whatever. 531 00:27:23,976 --> 00:27:26,938 Okay, the metaphor is breaking down a little bit, but, 532 00:27:27,021 --> 00:27:28,773 if we did do all these things 533 00:27:28,856 --> 00:27:31,776 we could end up with a government that's strong enough 534 00:27:31,859 --> 00:27:34,570 to support us in the ways that matter most. 535 00:27:34,654 --> 00:27:36,656 Ha-ha-ha! 536 00:27:37,490 --> 00:27:38,616 [bell dings] 537 00:27:41,619 --> 00:27:45,873 But, that's easy for me to say, here on Netflix. 538 00:27:45,957 --> 00:27:49,961 And dramatized with a couple of incredibly hunky actors. 539 00:27:50,044 --> 00:27:55,049 It's a lot harder for us as a society to do in the real world. 540 00:27:55,550 --> 00:27:58,928 How exactly do we reverse this tide? 541 00:27:59,011 --> 00:28:02,140 How do we heal our government so it's as fit as we need it to be? 542 00:28:02,223 --> 00:28:06,144 How do we take these ideas and actually use them 543 00:28:06,227 --> 00:28:07,687 to make change? 544 00:28:14,569 --> 00:28:19,365 [light-hearted music plays]