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health institute. welcome. guest: thanks for having me. host: talk to us about paragon health institute, your mission and funding. guest: paragon was founded about three and a half years ago, we are a policy research institute that is dedicated to evaluating how government programs are working and developing sense of reforms that empower patients and inform government programs by changing incentives, so that people are oriented and all of the actors are oriented, getting as much value out of a system as possible. we are a nonprofit, so we are funded by individuals and foundations. paragon takes no corporate funding. host: why did you feel the need to create paragon health? what are the issues you're are trying to solve? guest: health policy is the most important domestic policy issue facing the country.

it is a huge part of family budgets. it's a huge part of what the federal government does. it's a huge part of what states do. policies are not working for the american people. they are not working for patients. the quality of health care is underwhelming. they are not working for the hard-working american families and taxpayers that are financing these programs. there are a lot of things that are broken that need to be fixed. host: why is health care so expensive in this country and the quality is not there? guest: i could answer that for a long time. host: what's the biggest reason? guest: a lot of it goes back to the creation of medicare and medicaid in the 1960's. they used cost base reimbursement. hospitals were getting as much from the pair as they claimed their cost to be which led to an inflationary increase. we have separated the edge user

of health care from the price of those services. 90% of what we spend in health care comes from third-party payers. it comes from the government bureaucracy or it comes from health insurance companies. we have created this big wedge between the supplier, the producer of the service and the user of that service. and there is a lot of intermediaries in the process and some of them play valuable roles and some of them i think are less valuable. they have led to escalating costs over the past several decades. host: i want to play you a portion of rfk juniors confirmation hearing from yesterday. he talked to senators. this is senator michael bennet, a democrat of colorado, talking about his previous views on health issues. then i will get your response. >> did you say that covid-19 was a genetically engineered bioweapon that targets black-and-white people but spared ashkenazi, jews and

chinese people? >> i did not say it was deliberately targeted. i quoted an nih funded and nih funded study. >> did you say -- >> i quoted an in age study -- an nih study. >> i will take that as a yes. i have to move on. did you say that line disease is highly likely a materially engineered bioweapon? i made sure to put in the highly likely. did you say lime disease is a highly likely a materially engineered bioweapon. >> i likely -- >> i want them to hear it. did you say exposure to pesticides causes children to

become transgender? >> no. >> i have the record i will get to the chairman and he can make his judgment about what you said. did you write in your book that it is undeniable that african aids is an entirely different disease from western aids? yes or no. >> i'm not sure. >> i will give to the chairman, mr. kennedy. my final question, did you say on a podcast "i would not leave it, abortion, to the states." my belief is we should leave it to the woman. we should not leave it to the government, even if it is full term. >> i believe every abortion is a tragedy. >> did you say it, mr. kennedy? this matters, it doesn't matter what you come here and say that isn't true that is not reflective of what you believe that you have not said over decade after decade after decade. unlike other jobs we are

confirming around this place, this is a job where it is life-and-death for the kids that i used to work for in the denver public schools and for families all over this country that are suffering from living in the richest country in the world that can't deliver basic health care and basic mental health care to them! it's too important for the games you are playing, mr. kennedy. and i hope my colleagues will say to the president, i have no influence over him. i hope my colleagues will say to the president, out of 330 million americans, we can do better than this. host: what do you think of that? guest: it does not sound like senator bennet is ready to confirm mr. kennedy. i think the president selected mr. kennedy because of the compelling message around make america healthy again.

host: which we will talk about. i want to ask you do you believe he is qualified for the position? guest: i do. he was selected by the president. host: do you believe he is qualified because he was selected by the president or because of his qualifications? guest: i think both. it is a really important position. i think that mr. kennedy brings attributes and skills to that position that are going to be a good fit. host: make america healthy again. walk us through some of those key points. guest: i think it is diagnosing the state of american health. if you look at many measures of american health, one of the principal ones being life expectancy, we have been in decline. starting in 2014, for three straight years, life expectancy in the u.s. decline. and then of course, we had the pandemic and the tragedy around the pandemic. life expectancy is lower now

than it was a decade ago. i think you have an increase in many chronic diseases. diabetes, obesity. i think during the hearing yesterday, there were about two out of three americans who struggle with obesity or being overweight. and there are problems with children, too. american health has stagnated the last 15 years. i mean, public policy has failed to recognize that. there have been different things in health policy, and that brings us back to it matters for american health. host: we will take your calls with brian blase.

democrats, (202)-748-8000. independent, (202)-748-8002. republicans, (202)-748-8001 republicans., what regulation do you think is needed right now? guest: it overlaps with the usda and the guidance that the federal government puts out. host: with help to consumers. guest: yes, one of the main problems and that advice put out was back to what was created several decades ago. and it really overplayed problems with that and what we learned now from nutrition sciences with that guidance to

be an american families. we did not need to have high sugar, excess sugar is what is problematic. if i'm looking at from what they should do first, we should look at what information they need to dole out to provide americans with better information. host: going back to chemicals such as food dyes and preservatives, do you feel that is something that they should mandate be out of our food supply? guest: i think they need to process that and weigh the pros and cons. i know that the fda just grand fru -- baned red dye 33 starting in 2027, and it seems like there is bipartisan agreement on certain food

additives that should be removed. that's not my area of expertise, so in order to process it, you need to understand the science. ultimately, he said i'm fine with people who go to mcdonald's to have cheeseburger and coke, it is about making sure americans have the information any to make the best decisions possible for them. host: and you agree that it should be the same with vaccines? that you should make whatever choice on vaccines without the government telling you these are the vaccines that are recommended or required? guest: well, i think there are differences with the covid vaccine and the requirements with the covid vaccine. host: so leaving aside the covid vaccine because that is a newer one, but if we looked at polio -- measles -- guest: from listening to his

testimony yesterday, he endorsed the measles vaccine. i don't think there is mention on whether or not american should take those. host: let's start with our callers. caller: good morning. my statements are, first, we have plenty of money in our health care system. the problem is we have stockholders because it was just left for people who pay the bill. i'm 76 years old on medicare, handicapped now. on oxygen 24 hours a day, and the health care benefits have fallen apart and not being able to get the things i need. we have plenty of money with health care, it is just you make

no profits off of health care. health care should go all to the people. my second one is, i question your views of how you think that mr. kennedy is qualified because just 100 years ago, we would say he was a salesman. we cannot really depend on what he says because he will not even admit to the things he said in the past because it is not carried today because he's trying to get a job in the trump administration. if you try to get a job and someone else's administration, he would be singing a different song. i would not trust this man. my family does not trust him. host: catherine, we will get a

response. guest: on topic number one, i agree there is plenty of money in the health care system. i think the prophets are fine, the prophets are actually good. we would like to have a profit motive and suppliers to make a profit by providing better health care services by developing innovative products to get them to consumers. but the prophets that many in the health care industry get now are not the result of providing value to consumer, they are about how much lobbying power they have in washington, so a lot of these groups, insurers, hospitals, to get more money from the government than they do the private sector, and the resources that are allocated for them are more a function of the lobbying power of individuals that the organizations have rather than the value they provide. on mr. kennedy, he would be an

appointee for president trump, so on areas they disagree, abortion is one of them. the president sets the policy agenda, and his appointees, the cabinet officials, and all the people who work in the white house, they have to follow the agenda that the president puts out. the president was elected, he got 77 million votes. and part of that was an embrace of this make america healthy again movement, which was really spearheaded by robert kennedy. host: sarah is next in edgewater, maryland, independent. caller: you mentioned earlier that there was a die removed from the food --dye removed from the fda. they have no for decades that that is cancer in a box, and the question is why would they allow

this to be included when they know that because there have been cases that have caused cancer, and then the second thing is health care in america, call it profit care. as you said, there is such a thing that there's a lot of fraud and abuse going on, and, you know, if you look at every major insurance company that offers medicare, they have actively defrauded the federal government by tens of billions of dollars and have gotten away with it, and there have been absolutely no consequence. the government should shutdown an insurance company when the actively defrauded the federal government. why do companies continue to offer medicaid advantage plans and they have defrauded? that, i think should be addressed, and the last thing i wanted to stay here, a lot of

the offices today do not do their billing anymore, and experience this by talking to people who work for these outside companies that do the bills for the doctor office, and there was a lot of fraud involved in that, too. employees get incentivized by adding additional cost to the bill by adding procedures and changing the coding that is being used so that they can make more money, -- guest: let me focus on the middle of your comment on fraud, waste and abuse. i agree there is a tremendous amount of fraud, waste and abuse in our health care. that goes back to what i mentioned. there is a lot throughout the health care sector with all of the individuals. on medicare advantage, there are

more than 30 million seniors right now enrolled in medicare advantage, it is more than half of all medicare enrollees who have chosen medicare advantage, and what medicare advantage is, it is a senior on medicare who chooses to get their benefits offered through health plan, they get their traditional benefits of hospital care and medicare advantage plans can offer benefits like dental, vision, and benefits that seniors value, so i think there is value in medicare advantage. that said, i think there are ways to improve medicare advantage. a comprehensive report was put out last year on ways we think the medicare advantage program could be improved. they hit on one thing you mentioned, the insurer profiting.

the main issue of controversy there is around it's risk adjustment program where insurers get paid more based on having sicker enrollees, and that has given the incentive to diagnose all conditions of the enrollees, and in many cases, they have diagnosed and exaggerated in order to get more money from the government, and we think that is a real problem and something that the government should look to address. host: let's talk to lynn next, republican, north carolina. caller: good morning. i was watching yesterday with bobby kennedy, and i'm always taken back when he gets drilled by these immigrants. they have a frigate meltdown. elizabeth warren, it seems like

it is a democratic party that just give the man a break. give the man a chance to answer the question. they just keep going on and on and on. what president trump is trying to put in place is a warning to let everyone know about the number three red dye that bobby has known for many years. i could be wrong on that, but there is no telling what we don't know. i think with his health condition that he had studied, this has been his cup -- cup of tea, so to speak, he has done his research and written six books on nutrition. he is very active, and he is exactly right. i'm always envious of seeing people in china being so much smaller than the people in the

united states, i only wish i could be a size three again. there are things i could do myself, but i also know that president trump is trying to get these warnings out, get his cabinet in place to give them a warning. not to tell you that you cannot go to mcdonald's, it is a choice thing, just like your amendments one that gives you the right to speak. it is a choice thing, but know what you are eating and drinking because sometimes there are harmful side effects. as far as the health system, the last caller was right, it is crazy. they have been added to jobs, to other companies, and there are ways to cut the spending, which, in the long run, has helped the

consumer, and give them a chance and spend like 10 days. there is no sense in the attitude of the grilling and the screaming. guest: like the previous caller mentioned with the billing structure, i agree. just to step back and give you context on the department of health and human services, it is a massive federal department with 80,000 employees. if you think about the federal budget, the medicare program, the medicaid program run through the department of health and human services, and you have got all the public health agencies. nih, fda, cdc, so it is impossible for anyone man on the planet to know everything about the health care programs

that are managed by the department of health and human services. so you have got a set of other people who have been selected by president trump, dr. oz, mahdi bagheri, fda, and these are very serious for minded individuals that i think are going to be great leaders at the individual agencies within hss and provide recommendations both to the secretary, as well as to the president. host: you mentioned it he thousand employees at hhs, are you concerned at all about the potential cuts in the federal workforce in that department impacting the services they are able to give to the american people? guest: so, it is a tough question to sort of evaluate right now because we don't know with the exact impact is going

to be of that order. i know there is a severe problem of government workers, and that is one of the issues trying to be addressed, 6% of federal workers are back at the office full-time. i do think some of the work that cmh do, yeah, you need to have scientists there, you need to have evaluators there. i do not know. host: jeff, pennsylvania, democrat. caller: i wanted to know if you promote the restrictions of people with the government food stamps about restrictions, whether it is ice cream, because we have an overweight president that drinks cans of diet soda a day and is addicted to fast

food. i work out, have low blood sugar , a lot of these people voted for him. these are people he hurts the most. host: jeff, are you on snap? caller: yes, i work out and i should be entitled to do whatever i would like. host: currently, there are restrictions on what you can buy, you cannot buy soda? or are there no restrictions? caller: exactly, so they are imposing all kinds of things. like i said, trumpers are really trying to hurt us and he is drinking 18 diet sodas. host: about the restrictions on food stamps. guest: so, there is a policy debate now on whether the snap program and enrollees in the program should be restricted from using that benefit on

sugary sodas, sweets, really substantial percentage of the spending on that program goes to the consumption of those products. there is also a sense that money is fungible, people will use their own money on those products. i myself, my view, is that it is ok for the government to place restrictions on a government benefit, so if the government studies this and thinks there is a problem with too much overconsumption of sugar, soda, and sweets, which there is in the country that places limits on that welfare benefit, then that sounds like reasonable public policy to me. host: another jeff, new york, independent. caller: i would like to point out to you that you said there

is no disagreement apparently between people understanding the vaccine, but that is not true. mr. kennedy has been opposed to those specific vaccines, and he said so with his own words to recount what he has said and talked about consumption with that, and then he changed his mind suddenly, and he is a very dangerous man to have as hss secretary. a very great concern, for example, that it could turn into a pandemic at one point, but would be like somebody like robert f kennedy junior in

charge of the vaccine program at a time when we need to save millions of lives? guest: i don't think so. what he said yesterday as he is pro-vaccine, pro-polio, pro-measles, i take him at his word that he is in favor of all of those vaccines, and i know marty, carrie, who was nominated, is also pro-vaccine. he said they will follow the science and make the recommendations that are ultimately in the best interest of the american people. host: he did say a lot of the hearing that he will follow good science. is that problematic that maybe people have different ideas of what good science and that sciences? guest: clearly, if you just look at the experience of the pandemic, there were a lot of government recommendations that came out from the closing of

schools to the six foot distance guidelines that had no basis, but were promoted at the time, but i think science is a process and evolving, it is evaluating what evidences, and i think there are good studies that are well-designed that have control groups that you can draw definitive movements from, and there are studies that are much weaker and they may come to a conclusion, but because of the study design, you cannot really draw the conclusion. host: alex, washington, d.c., republican. caller: thank you for taking my call. i have a phd in sciences, i think that robert kennedy is a good choice only for the purpose of radical transparency. i think there has been a massive loss of trust, and a lot of that is well-founded, and the people opposing him, i just think that

they need to understand when you have previous discussions, the 50/50, or if it comes out of china, you may never know, and then they go publicly to say that they did not come out of china, and the conspiracy theory, the new head who is actively censored by the previous head of nih, that would be anthony fauci, these are the things that are the seeds that so distressed, and we had to latch onto that and realize that they need to have transparency if they are ever going to regain their credibility. and they need to push back against that. i think that c-span can help in terms of getting the document, whether it is the grant that looks a lot like the dramatic

sequence of covid-19, and it just shows that there is a lot of evidence and they have not really been forthcoming. if they do that, we can trust experts again, so thank you. guest: i think he makes reasonable points. there is a severe lack of trust in public health authorities, largely because of the pandemic response, and transparency in public health and more broadly throughout the health sector and people have more confidence in the recommendations from experts. host: brian blase his former white house economic national advisor in the first trump >> washington journal continues. host: welcome back. we