immune response against the wild type, the greater the secondary coverage you have against a wide array of variants, which is the reason why as we have reported in previous press briefings that when you look at particularly the double doses of primary and boost of the mrna vaccines, which we have the most data, there is rather good protection that spills over against multiple variants, so you can boost against the wild type and still cover variants, including 617. >> host: dr. anthony fauci just yesterday, during one of these covid briefings. dr. makary, can you put that in plain english and tell us whether you agree with it it? >> guest: i it debris with it, it might increase your body

level which could potentially help prevent against future infection. the question is do you need to do that? if the immunity protection that people have right now the standard two-dose regimen or had natural immunity and one dose which is generally what i recommend for people who had the infection, that immunity protection might be lifelong, so why are we talking about boosters? i think the booster conversation will likely be relegated to those who are older and don't mount good immune responses and the transplanted and immunosuppressed community. >> host: to nevada city, california, ken waiting to talk to you. you're on with dr. makary. >> caller: well you were worried about the u.s. health care system, the biggest, the most inefficient industry in america is the u.s. federal government. they've got their hands in everything, and you have people like dr. fauci that have their own interests. it's proven that's been help wanding the wuhan lab and

various -- he has his interests, so he's running -- anyway, the federal government as inefficient as they are and continue to get bigger and more inefficient, the health care system is going to be a mess forever, and that's all i have to say. thank you. >> host: dr. makary? >> guest: first of all i disagreed with dr. fauci on almost every strategy of the pandemic but i believe he has the best of intentions and loves this country. in terms of our health care system, it is spiraling out of control and going to take down the entire economy if we don't change our ways. health care spending is 48% of all federal spending. if you look the at the hidden ways we spend money on health care, for example, about 20% plus of our federal spending goes to social security checks. guess where seniors are spending their social security checks? half spend on copays, deductibles, coinsurance and

noncovered services. the defense department, the va benefits for federal workers, not just medicare and medicaid. in total it's 48% of all federal spending that goes to health care now so what are we talking about increasing that to, when we talk about fortifying our health care system? we've got to change our ways. we have to change the payment models. we have to start talking about treating the underlying problems that bring people to care and i'm just talking about preventative medicine and mammograms and what age you start. i'm talking about food as medicine and treating patients as a person and the conversations we're having now to treat more people with diabetes with cooking classes rather than just throwing insulin at them. we can't just keep throwing meds at the problem. we're the most medicated society in the history of the planet. medications doubled in the last ten years. we have to talk about school lunches as much as we talk about

baria trick surgery and talk about stress management and sleep science when we talk about high blood pressure instead of just throwing meds at the problem. with back pain talk more about ice and physical therapy, not just surgery and opioids. these are the conversations we're starting to have and this is the disruption in health care right now, that's exciting and it's taking place and it's going to fix health care not through legislation but by changing it from the ground up and that was why i was privileged to profile in the book "the price we pay." >> host: "the price we pay: what broke american health care and how to fix it" now out in paperback. by and large, americans haven't had to worry about the price we pay for covid treatments or shots but is it going to continue to be that way? should americans or when will americans start having to worry about the price we pay for that? >> guest: i think we need to change the lexicon. people say i didn't have to pay, medicare paid. that money comes from your tax

dollars. when we started saying for example that i didn't have to pay. my insurance company paid. guess where the money comes from that will fund the new alzheimer's drug at $56,000 per administration, with scant data to show any benefit. it was just approved by the fda. we've got to change the lexicon and recognize that when we're talking about health care spending, we're talking about subtracting money from worker wages in the united states, and when we're talking about addressing health care, we're really talking about giving small businesses the money that they deserve instead of the current model, where most businesses in the united states today are getting ripped off on their health care benefit design, something that they can change and restructure. >> key port, new jersey, this is edward. good morning, you're on with dr. makary. >> caller: thanks. one, i'd like to ask, when did copays and all this stuff become a thing in america?

like to me it seems like the biggest scam in the world, like no other industry would you pay for something that you pay to use. it's insane and my second question would be what justification does health care ceos making $14 million a year. shouldn't they be capped at $500,000 or some other percentage of money? it's so stupid they're denying people life-saving care and these guys are walking away with money they couldn't spend in a life time? thank you. >> guest: we have good people i'm convinced in health care at every level, in administration, insurance, the clinicians, nurses, but we've got good people working in a bad system. we're playing a silly game and it's not a system we designed. it's a system we inherited from a prior generation and that is jack up prices way high and then offer secret discounts to different selective groups and it's absurd. and it's resulting in a game

today a modern day health care business model of price gouging and that comes with predatory billing. the insurance companies sometimes have no way to manage these high prices except to do cost sharing and that is to ask the individual patient to pay a part of that care. it's not working very well. people are getting frustrated. >> host: what is the most common surgery at johns hopkins? >> guest: pancreatic auto transplant procedures. we work as a team on that procedure. >> host: what is the cost of one of those? >> guest: i don't know. this is a procedure that we pioneered and we have an arrangement through maryland which has regulated prices and i think that says a lot about health care today, that we're that disconnected from the pricing of those procedures. >> host: don is next out of hampton, virginia, good morning. >> caller: good morning. i'm so glad you're on. i have seen you on other shows and i totally agree with your

thinking. i'm 80 years old and refuse to get the vaccine. i don't have any faith in it and its a rush thing and not fda approved and so many people in congress are not even taking it. i think the health care system is good in some aspects because i have medicare, and i am military, so i am well covered, but my doctor that i've had for 25 years believes in personal relationships with his patients and always stressed to me about natural immunity, which i have tried to do all my life, and eat right and he's always recommended vitamin d from 2,000

to 5,000. i am very healthy at 80 years old because i eat right. i eat the bad stuff, i eat the good stuff, but if people would build their own immunity system and eat right, you wouldn't worry about that. >> host: dawn, let dr. makary jump in. >> guest: even with the best natural immunity eating well people can be susceptible to the virus and the virus selectively affects those with a comorbidity, clustered in older folks. if somebody has not had the infection and documented to have the infection i remember the covid vaccines because 300 million people have received u.s. approved covid vaccines with zero serious adverse reported in the mrna vaccines and less than one in a million complication with the j.&jadenovecto viral vaccine.

i i had food is important and we'll start talking about inflammation in the future. 50 years from now when we ask how is your health, we'll be describing your inflammatory state. is it high, medium or low? we'll be modifying that by the food that we eat. >> host: fred in fulton, new york, why don't we test more and publicize more how many do have immunity? >> guest: i think our public health officials have ignored natural immunity all together. let me know if you hear dr. walensky or fauci talk about natural immunity from prior infection with an estimate of how many of the unvaccinated or u.s. population has it? we don't. we hear about vaccinated and unvaccinated. we need to talk about the immune and nonimmune and i go through that data in the "wall street journal" today. >> host: the opinion pages of the wall street purnl headline of the column "the power of natural immunity." we hear from rich in

broadheadsville, pennsylvania, good morning. >> caller: yes, hey, good morning. thanks for taking my call. what's up, doc? >> guest: good morning. >> caller: one thing you made a comment on was about the, you know, other diseases, cancer, or alzheimer's or whatnot. why after all of these years the billions of dollars we still don't have a vaccine that we can say treat this for your lung cancer or pancreatic cancer, i just lost a friend of mine i found out three years ago died of pancreatic cancer but yet in less than a year we were able to design the vaccine which my wife and i both have and we golt the vaccine, they were able to get that in less than a year. and it's like mary anne williamson said during the debates it's not a health care system. it's a sick care system. i like your comments and your

opinion on that, it's not a health care, it's a sick care. >> guest: sorry about your friend. i've treated a lot of people with pancreatic cancer and et cetera a a tough cancer. i agree. we need to start talking about health and not just the stuff that has nothing to do with health and that's by the way about a third of all spending on health care goes to things that have nothing to do with health care. we're spending too much time on the stuff on the periphery of health care. we need to start addressing the underlying issues and mac our research systems move fast and efficient just like with the mrna covid vaccine. my research team at johns hopkins worked with many funding agencies. the slowest and most difficult are always the federal agencies, not the private agencies. it takes the nih years to adjudicate funding.

it is clunky. they look for small discoveries and no big ideas and no surprise with $40 billion of spending that goes to the budget of the nih the top research discovery we had in the field of cancer a few years ago was a drug that increased survival by a few months with no increase in the cure rate. that's a pretty bad return on investment. we need to start funding the big ideas. >> host: the big ideas beyond health care from "the price we pay" out in paperback, this in the future we have to adapt our peacetime research systems to meet the demands of war. viral pandemics are not the only health emergency we need to be prepared for, fires, hurricanes, mass shootings will all require a more agile and resilient health care response." >> guest: that's right. we had medical journals that took six months to review articles on covid. we had institutional review boards at hospitals that met monthly to decide whether or not

we can do research on topics related to covid. hospital capacity, they were so slow and look, why did we think what was happening in italy was not going to happen in the united states? somehow this idea of american exceptionalism has crossed over into national arrogance that somehow american immune systems were stronger and there is a denial early on of community transmission, even from our top public health leader dr. fauci. we didn't hear any of those alarms getting sounded and as a result we were unprepared for the pandemic. there were a lot of mistakes and i don't think it's productive to go back and play a blame game. in the book "the price we pay" here are the lessons to create a better health care system, faster and more responsive so we can pivot quickly for a national emergency of any kind, be it a mass shooting or a natural disaster. >> host: justut