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[00:00:00]

This is the Fox News rundown extra. I'm Chris Foster. Dr. Marty Makary has become a regular on the podcast with periodic updates on the coronavirus fight. He's a Fox News medical contributor, author, surgeon and professor at Johns Hopkins University in Baltimore. Our last conversation had just too much in it to include in the regular podcast, including some non coronavirus talk about the Trump administration's drug pricing program and how health care costs are a big part of the Postal Service's struggles.

[00:00:29]

We thought it was all interesting enough to share the whole interview here. So now Dr. Marty Makary on the Fox News rundown extra.

[00:00:40]

OK, first, Dr. MacQuarrie, cases seem to be ticking down a little bit, but we're still averaging over the last week or so about a thousand deaths a day. We're six months in. Does any of this surprise you?

[00:00:54]

No, not really. This is what we expected, because when cases jump up and everybody says, hey, cases are up, but people are not dying, we know death is a lagging indicator. So unfortunately, we've seen deaths go up despite a global decline in cases, which is really good news. We've seen we've seen deaths go up in Tennessee, Illinois, Kentucky, Minnesota, even in Wyoming now that it is plateauing. But that bump in deaths over the last week has been very disappointing.

[00:01:28]

You know, this is what's going on around the country, around the world right now. We are seeing a lag to sort of a surge that's happened with reopening and we knew that was going to happen.

[00:01:39]

The goal is just to minimize that as much as possible are the United States, that is our deaths per 100 population, one hundred thousand of populations, and not just total cases, because obviously we have a lot more people than a lot of countries. But our deaths per capita or a lot higher than most countries, not as high as Peru, for example, which is crazy, but it's higher than most countries. And what do you attribute that to?

[00:02:04]

Well, I think we had highly variable adoption of best practices. Look, we're a very opinionated country. And when we as a public health community came out with recommendations, there was a lot of different opinions about whether or not to do these things. I mean, it took us a long time to adopt universal masking indoors in public congregate settings.

[00:02:27]

I think, you know, when you are are later in having an infection, the United States was later in getting the pandemic. Then you're pulling on the same global supply chain for reagents, for testing. And so we've seen a lot of demand for testing. I know the United States would have loved to had a ton of testing, but the reality is that you're pulling on the same global supply chain. So no matter what you do and how much money you throw at it, you really just cannot ramp up testing as much as you'd like.

[00:03:02]

Yeah, we're still not there. I mean, there are places where it takes on more than a week to get your results back, which means you may as well not to take it. You may as well not even take a test unless you're going to commit to staying inside for that week.

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Yeah. Now I can tell you that Admiral Jira and Brad Smith and others in the administration have been working their tail off and they have been in a position where they would have been willing to do everything humanly possible to get more testing in the United States. But you can only do so many things. And I think the reality is that testing it's you know, we have not had manufacturing set up in the United States for these reagents. We're dependent on many of these countries.

[00:03:44]

We've had many of our drugs manufactured in India and China. We just do not have a supply chain that's been set up for a crisis. And so now you have the blame game going around. Right. And remarkably, some people are using this as a political weapon.

[00:04:01]

I mean, there's this new 15 minute Abbott test that's been approved. There's another, I guess, like a pregnancy style test that's expected to arrive in a few weeks. So maybe, you know, maybe that will help. But you're right. I think there is obviously a lesson to be learned, whether it's learned and put into practice or not about getting our supply chain back home for these things.

[00:04:20]

Well, if you look at what some of the experts and I'm going to talk about my own community here, which is public health and health policy experts in academics, they were saying that the only way out of this is to hire billions of public health officials and to go out there and trace everybody as to where they had spent their time and then, you know, isolate and quarantine those individuals. Now, that's good public health practice and we should do that.

[00:04:50]

But the reality is that that is not how we dug ourselves out of the pandemic. That is not the reason why New York had dramatic declines after their pandemic surge.

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OK, we need to do it. It's important. We need to fund it.

[00:05:05]

But the idea of you remember that motto, testing, testing, testing, testing is not what got us out of the pandemic. Testing is important and it's necessary and it's helpful. But what got us out of the pandemic was best practices with universal masking and avoiding dense congregate settings. And if you look at a lot of the parts of the country now that are still struggling with the virus, look at the Rio Grande Valley of Texas where they're still getting hammered.

[00:05:33]

OK, there's a certain elitism to say, oh, if we just test and. Backtrace low income Americans who live in very dense housing because they're poor, that somehow we're going to rescue them from the pandemic. So there has been a certain elitism, which has been very disturbing to hear from the experts.

[00:05:58]

Schools have been open in some parts of the country for a couple of weeks now. In Florida, it's reported that a few thousand kids are infected, a few hundred have been hospitalized. Some districts in the Northeast, for example, are still trying to figure out what they're going to do when they reopen in a couple of weeks. What what are you seeing? What do you think about schools?

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I think schools are doing a tremendous job, taking a lot of precautions, and they should be open in any area without an active outbreak, OK?

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Colleges have been taking a lot of precautions.

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But but, Chris, where everything falls apart is with the parties, right?

[00:06:34]

OK, well, once once people are engaging these off campus congregate settings, it jeopardizes everything. And people say kids are kids. But you know what? Most kids are taking a lot of precautions and taking this seriously and kudos to them. Right. That's impressive.

[00:06:49]

But a small group are placing it that the entire student body at risk schools for kids, you know, up to high school age. We got to remember the data is pretty clear, about 100 hundred deaths of kids using a broad definition of kids as anyone from zero to 20. It's been one hundred deaths roughly since the beginning of the pandemic in the United States total.

[00:07:16]

So we've got to remember that that's comparable to seasonal flu, to viral meningitis, to pneumonia.

[00:07:22]

So we got to remember the consequences again and think about the elitism with a one size fits all policy. Kids in inner city Baltimore are not going to be as safe with schools closed being at home or on the streets as in Santa Barbara County. And so child abuse is a concern. Substance abuse, suicide rates, we've seen the calls go up on that stuff. So we've got to think about the entire picture. But kids should go to school unless there's an active outbreak.

[00:07:52]

Talk about this convalescent plasma thing that has has some people worked up. Stephen Hahn at the FDA the other day said, look, he kind of screwed up and maybe have overstated the benefits. But you say it's a perfectly good therapy.

[00:08:08]

Cash, convalescent plasma has been around for a century. They were using it in 1918 for the Spanish flu and for the CDC to finally say something that was long overdue and that is doctors are authorized to use it. That is, a patient doesn't have to be in a formal trial. They can use it if you don't have an infrastructure at your small community hospital to put a patient on a formal study that's paid for by a, you know, a grant, then the FDA authorization said, finally, you can use this, 70000 Americans have you have to have had convalescent plasma.

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And then somehow we're saying there's not sufficient data for an emergency use authorization. Again, some elitism coming from the academic centers saying we just don't know because we did not use the study design of giving some patients a placebo and comparing sick covid patients on placebo or nothing versus covid patients with the convalescent plasma and comparing mathematically the results. Well, guess what? When you have 70000 patients who have had this this therapy and impressive results, as we saw from the Mayo Clinic, which, by the way, reported on thirty five thousand of the patients, I don't speak for Johns Hopkins, but Johns Hopkins has had patients on convalescent plasma from early on.

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I mean, I think it's unethical to do a study where you put a sick covid patient on placebo, given that the learning that we've had from convalescent plasma being effective. And the reason it's effective is, as the study shows, it has antibodies in that plasma. And that's actually a bridge to the next step, which is going to be antibody therapies.

[00:10:01]

And I think they'll beat vaccines to market a little politics. President Trump now the Republican nominee. Once again, he's been talking about his accomplishments over the last week at the convention, he and his supporters. Have you worked on this price transparency and drug pricing reform program that the administration has put in place? Talk about that a little bit.

[00:10:24]

Yeah, I was really privileged to be invited by the White House to talk about the principles I laid out in the book, The Price We Pay, basically saying Americans deserve to know the price of services when they go for care.

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And the fundamental problem in health care and the reason it costs so much is that we have non-competitive markets. And when you have non-competitive markets, the temptation is to create rules and subsidies within those markets. But the fundamental reform we need is to transform our noncompetitive markets to open competitive markets. And that's what the president acted on, so I was privileged to be a part of a lot of those meetings, the president announced in November that hospitals are going to be required to show real prices, not inflated chargemaster prices, but real prices for common shockable services.

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And that's going to be revolutionary.

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Now, it doesn't take effect until early next year. The American Hospital Association didn't like it. Right, just like the food industry didn't like nutrition labels arguing that food prices were going to go up if we get nutrition labels. Well, guess what? We're sophisticated enough in health care. We can do this. And so the American Hospital Association sued the Trump White House to block price transparency. And a few weeks ago, the White House prevailed and the suit was thrown out in court.

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So we're going to see it. This is real. This is big. And as President Trump has said, and I agree, this is bigger than health care itself. This is monumental in shifting markets and stopping the game of price gouging, which is a game that far too many Americans have been affected by for no good reason.

[00:12:08]

Now, the direct effect of all this, is it going to be on consumers? There's going to be on insurers or what? Or just how contracts are decided? Because if I if my kid goes into shock, I'm not driving from one hospital to the next price check. Right.

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So first of all, price transparency does not apply to the 20 percent of medical services that are emergent. So if you come in shot in the chest and I'm the surgeon on call, I'm not going to give you a price and we shouldn't. But 80 percent of medical care is shop able. And this action by the White House means that the secret negotiated discounts that insurance companies have with hospitals, that's going to be public information now. And so it's going to allow employers who often provide health care through health plans to their employees to get the same good deals.

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Right. You're going to have competitive markets now around the pricing of care and you'll actually actually see proxy shoppers, that is employers and health plans say, you know, I know in an emergency you're not going to shop for care, but we are going to select centers where we're going to give you incentives to use because they have honest billing, good prices and high quality. That's what we need in health care.

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And this is way off topic. But something you're obviously interested in. You have an op ed coming out about the post office, which some people don't realize that what really is killing them financially, it isn't their prices. It isn't their service has nothing do with their services. It's their legacy costs.

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Yeah, it's a labor problem. Health care is sucking money out of the post office because the post office has 80 percent of all their expenses going to labor costs. That means health care benefits. That and guess what? They're getting gouged on their health care benefits and on their drug pricing plans for their employees through this standard money games of medicine. So recognizing that a lot of money is getting wasted when we spend money on health care benefits and that the post office is spending 80 percent of all their money on labor costs, including health care, that's a lot that's a lot more than, say, FedEx, which only spends thirty six percent of their expenses on labor costs.

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And on top of that, the post office prepay billions of dollars towards health care benefits for the retirees. So, I mean, it's impossible for the post office ever to be profitable when health care is sucking money out of the system. And as Senator Paul has said, and unless they get their labor costs under control, there's no chance of a profit ever coming to fruition.

[00:14:54]

One more. We're seeing more protests in Kenosha, Wisconsin. We just had the Sturgis bike rally. Are the fears about all these gatherings for not? I know that there's been some cases traced to the Sturgis bike rally, but have we been more OK than we might have thought just by virtue of being outside?

[00:15:15]

Well, what we've seen with cases going up and down and undulating around the world is that when people start feeling confident, when they start feeling complacent about the pandemic, that's when we start seeing a bump. And if you look at what's happening nationwide, there's one clear, clear factor which predicts how many people are going to die from the infection, and that is how seriously people take it. And so when people loosen up and get overconfident, that's when we see bad things happening.

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Now, during the protests, if we can look back at Memorial Day, the protests nationwide did not directly. Caused a massive surge in cases nationwide, as a matter of fact, after the protests in the six weeks following throughout the month of June and the first half of July, we saw a massive decline in the north and a surge in the Sunbelt. And we know the protests were more common in the northern parts of the United States. We did, however, see small increases in places like Minnesota, where we know many of the protesters were not using precautions.

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Outdoors is safer than indoors. That's one of the Take-Home messages. But also complacency is one of the big risks, especially as we run the risk of colliding into the seasonal flu in November and December.

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Yet I guess you probably ought to remind people, get your flu shot.

[00:16:40]

It's a good time to get your flu shot. Looks like it's going to be very effective. And you know, the good news here, Chris, is that the country has been oddly complacent about our seasonal flu deaths each year. We had eighty one thousand just four years ago, and it's almost like nobody cared. Now people are taking it seriously in general. It's never going to be acceptable again in our lifetime for somebody to show up to work in the middle of a flu season, coughing and sneezing and slobbering.

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You know, luckily, we finally got the word out on good public health practices.

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Dr. Marty Makary, best selling author, a professor, surgeon with Johns Hopkins University, a Fox News contributor. Dr. Makary, thank you once again for coming on the Fox News rundown today. Great to be with you, Chris.

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I'm sure we'll do it again soon. Thank you. You've been listening to the Fox News rundown and stay up to date by subscribing to this podcast and Fox News podcasts, Dotcom and for up to the minute news, go to Fox News dot com. Did you hear the news? Now you can with instant updates from Fox News for Amazon, Alexa Jessee, Alexa Plane News from FOX in Fox News.

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