LIVE: Casey Means testifies at Senate confirmation hearing for surgeon general

[0:00] The Senate Committee on Health, Education, Labor, and Pensions will please come to order. [0:05] Hey, Dr. Means. [0:06] Hello. [0:06] You came in just as I walked away, so greetings. [0:10] I'm sorry to have missed shaking your hands down there. [0:12] Thanks for appearing before the committee and for your willingness to serve the people of the United States in this administration. [0:19] And by the way, congratulations on your baby. [0:22] Thank you. [0:22] It gives you a great perspective on life, and I trust all as well. [0:25] And for the diocese on both sides, well, we'll take a break at 11 to allow Dr. Means to care for her child. [0:37] So just a 15-minute break at 11. [0:43] You will be the nation's doctor. [0:45] We've got some serious health problems in our country. [0:48] High rates of mental health and substance use disorders, widespread chronic disease, reemergence of deadly outbreaks, [0:57] which are preventable by safe, effective vaccines, [1:01] but unfortunately, there's been a lot of promotion of vaccine skepticism. [1:06] At the same time, many Americans have lost faith in public health leaders since the COVID-19 pandemic, [1:12] and families can be confused by the whiplash of conflicting medical guidance. [1:17] President Trump is committed to rebuilding trust in our health institutions and restoring radical transparency, [1:23] and that should be how we protect children's health. [1:27] If you confirm, Dr. Means, you'll have an important platform as the nation's doctor. [1:30] Americans will look to you for clear medical guidance. [1:33] And if you confirm, Dr. Means, you'll have an important platform as the nation's doctor. [1:37] Your writings express concern regarding chronic disease, and you speak to mothers and their families. [1:43] The Surgeon General needs to be an effective and truthful communicator, a calming voice of reason, [1:49] a steady hand of experience at a time when so many, for whatever reason, sow distrust and confusion. [1:58] The Surgeon General must be someone who can execute on President Trump's commitment to restoring confidence in public health, [2:05] and to assure the American people that our institutions are making science-based decisions rooted in data that puts families' health first. [2:15] This is especially important as HHS undergoes substantial personnel and policy changes. [2:21] Dr. Means, it should be your mission and the mission of every HHS official to restore stability and assure Americans that protecting health is the top priority. [2:30] I look forward to learning more about your public health priorities and views. [2:34] With that, I recognize Senator Sanders. [2:35] Thank you. [2:38] Thank you, Mr. Chairman, and thank you, Dr. Means, for being here. [2:40] Congratulations on your baby. [2:43] Thank you. [2:45] Today, we are considering President Trump's nominee to be the next Surgeon General of the United States. [2:54] The Surgeon General is considered the nation's doctor, a trusted leader who tells the American people the truth about science and medicine. [3:04] Previous Surgeon Generals have warned the American people over the years about the dangers of smoking, drunk driving, loneliness, [3:12] drug use and alcohol use, providing recommendations based on scientific evidence, not ideology. [3:18] Dr. Means, you have made it clear to us that you believe it's time to, quote-unquote, make America healthy again. [3:25] That is a great slogan that I expect that everybody up here agrees with. [3:30] In America today, we have a very unhealthy society. [3:34] And there are a lot of reasons for that. [3:37] The chairman mentioned some of them. [3:39] But, perhaps the most important reason is that we have a health care system that is bright. [3:42] But, perhaps the most important reason is that we have a health care system that is bright. [3:44] that is bright. [3:44] That is bright. [3:45] that is dysfunctional and, in fact, is very cruel. [3:50] In America today, we spend over $5 trillion a year on health care. [3:56] Believe it or not, that is more than $15,000 for every man, woman, and child in our nation, [4:02] twice as much per person of nearly any other major country. [4:07] And yet, despite that huge expenditure, we remain the only major nation on Earth [4:15] that does not guarantee health care to all people as a human right. [4:21] The result? Over 85 million Americans are uninsured or underinsured. [4:27] More than a half a million Americans go bankrupt due to medically related debt. [4:33] And 68,000 Americans die every year because they cannot afford to see a doctor. [4:39] If anybody in the world thinks that that is a rational health care system, you're living on another planet. [4:43] In terms of life expectancy, [4:47] we live four years shorter on average than people in other countries. [4:52] As unacceptable as that is, if you are working class in this country, [4:56] you can expect to die seven years earlier on average than if you're in the top 1%. [5:01] Further, as bad as our overall health care system is, our primary health care system is even worse. [5:10] Today, tens of millions of people live in a community where they cannot find a doctor, [5:14] a dentist, or a psychologist, even when they have decent insurance, [5:19] while others can't. [5:19] While others wait months to get seen. [5:21] Yes, Mr. Chairman, we must make America healthy again. [5:26] Unfortunately, the problem is that since coming into office, [5:30] President Trump and Secretary Kennedy have done the exact opposite. [5:35] As a result of massive cuts to Medicaid and the Affordable Care Act, [5:39] 15 million people will be losing the health care they had. [5:44] Studies suggest that when you throw 15 million Americans off of health care [5:48] and make over a trillion dollars in cuts to Medicaid and the ACA, [5:52] around 50,000 of our fellow Americans will die unnecessarily each and every year. [5:58] Secretary Kennedy and the Trump administration continue to spread [6:01] dangerous conspiracy theories about vaccines, making it harder for Americans [6:07] to protect their children from deadly diseases. [6:10] I am having a hard time understanding how any of this will make America healthy again. [6:16] In my view, we need a Surgeon General who has the courage to take on President Trump [6:20] and Secretary Kennedy and say, no, [6:23] it is wrong to throw 15 million off of health care. [6:26] It's wrong to double premiums with 20 million more Americans. [6:29] It's wrong to spread misinformation about vaccines. [6:33] And that's just not me talking. [6:35] That's precisely what six former Surgeon Generals, three Republicans, [6:39] three Democrats who served under Trump, Obama, George W. Bush, Clinton, [6:44] and George H. W. Bush have told us. [6:46] In an op-ed they wrote in the Washington Post, that's what these guys wrote, [6:50] a few months ago they said, quote, [6:52] the actions of Health and Human Services Secretary Robert Kennedy Jr. [6:56] are endangering the health of the nation. [6:58] He has rejected science, misled the public, and compromised the health of Americans, [7:02] end quote. [7:03] That is Republicans and Democratic former Surgeon Generals. [7:06] So, Mr. Chairman, there is a lot to be discussed, [7:12] but I have very serious questions about the ability of Dr. Means [7:17] to be the kind of Surgeon General this country needs. [7:20] Thank you very much. [7:21] Dr. Marshall will introduce [7:23] the nominee. [7:24] Thank you, Mr. Chairman. [7:26] I'm certainly humbled and honored today to introduce Dr. Casey Means. [7:29] I want to thank you for joining us here this week. [7:33] I'm especially glad we're able to hold this meeting, which was long overdue. [7:37] But being in labor is one of the best excuses we've had to delay a hearing. [7:41] So, congratulations to your family. [7:44] We hope baby boy Phoenix, 17 weeks old today, is doing great. [7:48] And again, we appreciate you being here. [7:50] As my colleagues have already said, [7:54] today nearly 8 in 10 adults, representing almost 200 million people in this country, [7:59] live with at least one chronic disease, obesity, diabetes, heart disease, hypertension. [8:05] Our children, our children, the pride of this nation, the situation is equally alarming. [8:12] Approximately 20% of our youth are obese. [8:15] One in three adolescents aged 12 to 17 have prediabetes, one in three. [8:20] And when it comes to our mental health, at least one in five American adults, [8:25] 60 million people experience some form of mental illness each year. [8:29] Those are epidemic numbers. [8:31] We need a Surgeon General, the nation's doctor, to guide us back to health, [8:36] mobilizing science-based strategies to prevent disease, promote wellness, [8:41] and address these epidemics head on. [8:43] The Surgeon General serves as our country's chief health educator, [8:47] but more than an educator, a coach, a cheerleader, [8:51] providing evidence-based guidance to improve health and respond to crisis [8:55] while leading the U.S. public health system [8:57] and the health service commission core and advising on key policies. [9:02] Over the course of this process, I've truly enjoyed reading Dr. Means' books, [9:06] her publications, and getting to know her, [9:09] and hearing her thoughtful vision for improving the health of Americans. [9:13] Dr. Casey Means is a uniquely qualified, Stanford-trained physician [9:17] who began surgical training at Oregon Health and Science University, [9:21] where she excelled in clinical performance and patient care for underserved populations [9:25] before leaving that traditional system. [9:28] For many of us, she was disillusioned by its focus on treating symptoms [9:32] versus addressing the real causes. [9:34] She left it to champion preventive metabolic health. [9:39] She co-founded Levels Health using innovative glucose monitoring [9:42] to empower metabolic health insights [9:44] and authored the best-selling book, Good Energy, [9:47] which I'd recommend everybody on this committee to read [9:49] to better understand exactly who she is. [9:53] She offered science-based strategies to prevent chronic illnesses through lifestyle changes. [9:58] Dr. Means brings a forward-thinking vision, [10:00] focused on prevention, innovation, and patient empowerment. [10:04] She is a proven communicator. [10:06] She's appeared on over 200 podcasts. [10:10] She's a faculty course director at Stanford. [10:12] She's been featured in articles in The Wall Street Journal, Forbes, New York Times. [10:16] She inspires, educates on complex health issues. [10:20] She's poised to shift us from reactive sick care to proactive health care, [10:23] emphasizing metabolic health to truly make America healthy again. [10:28] Her entrepreneurial spirit and clinical background [10:30] will drive solutions, prioritizing outcomes over bureaucracy, [10:34] aligning with the making to make America a healthy movement again. [10:38] So that's my formal introduction from my heart. [10:43] Go back to our childhood and my childhood in the 1960s. [10:48] Everybody smoked. Everybody did. [10:51] But a surgeon general, Dr. Luther Terry, under LBJ, [10:55] had the courage to stand up and say, [10:57] smoking causes lung cancer. [10:59] He wasn't able to finish the job. [11:02] It was then under President Nixon that the next surgeon general . [11:05] And that's what I think Dr. Means can be. [11:08] I think that she . [11:13] No one can deny that. [11:14] And like I said before, we need a surgeon general who's more than an educator. [11:20] We need a coach. We need a communicator. [11:22] We need a cheerleader to address these chronic diseases. [11:26] And I believe that Dr. Casey Means is the person for the job. [11:29] Thank you, Chairman. [11:31] Thank you. [11:32] Dr. Means. [11:33] Thank you. [11:35] Good morning, Chairman Cassidy, Ranking Member Sanders, [11:38] and members of the Senate Health Committee. [11:40] I want to thank President Trump for nominating me to serve as Surgeon General [11:45] and for Secretary Kennedy for his support. [11:49] Thank you for also being willing to postpone this hearing. [11:52] When I went into labor five hours before the hearing started in October, [11:56] our precious baby boy was born on the hearing day. [11:59] As a physician, I have always been inspired that the root of the word healing means [12:05] to return to wholeness. [12:07] Nothing is more urgent than restoring wholeness for Americans. [12:11] Physically. [12:12] Mentally. [12:13] And societally. [12:14] We are now the most chronically ill high-income nation in the world. [12:19] We live shorter, sicker lives than peer high-income nations. [12:24] Today's children are projected to live shorter, sicker lives than their parents. [12:28] We spend trillions annually on reactive sick care. [12:33] Nearly 150 million Americans are on federal health care programs, [12:36] and we spend $50 billion per year on research. [12:40] Yet outcomes are worsening and disparities are widening. [12:44] Our nation is angry, exhausted, and hurting from preventable diseases. [12:52] Rates of high blood pressure, many cancers, autoimmune conditions, type 2 diabetes, [12:58] mental health disorders, dementia, neurodevelopmental challenges, and youth suicide [13:03] have all increased in the past two decades. [13:08] This public health crisis is touching every American family. [13:12] It is robbing our children of possibility, our workforce of productivity, [13:16] and our nation of security. [13:18] It strains our federal budget and dims hope for millions. [13:23] We must confront this epidemic through a vision grounded in science, dignity, [13:28] shared humanity, and a respect for freedom, not politicization and division. [13:35] Public health leaders must address the evidence-based, modifiable drivers of chronic diseases, [13:41] which include ultra-processed foods, industrial chemical exposure, lack of physical activity, [13:47] chronic stress and loneliness, and over-medicalization. [13:50] I've been asked to help our nation get healthy and answer the call of millions, [13:55] especially mothers who are begging for transparency and support. [13:59] That is what I'm here to do. [14:03] I believe that every American shares a core yearning to thrive and help their families thrive. [14:08] But we are asking people to make healthy choices in environments that are squarely structured against them. [14:15] Good policy and education can make health easier, more affordable, and more accessible. [14:20] I know our current leaders at HHS and across the federal government are committed to the ambitious policies [14:26] outlined in the MAHA strategy released last year that focuses on advancing research, [14:31] aligning incentives, increasing public awareness, and fostering private sector collaboration [14:36] to end the chronic disease epidemic. [14:39] Specific efforts are already underway to fund and promote more whole, healthy food for Americans, [14:44] address financial conflicts of interest in our agencies, fund research focused on disease prevention and reversal, [14:50] and make institutions accountable to measurable health outcomes for all Americans. [14:57] President Trump and Secretary Kennedy have invited a mature, candid, grand conversation [15:03] about how our medical education and fixing perverse incentives can pull us back from the brink. [15:10] And for this, I am profoundly grateful. [15:14] My professional history has prepared me to meet these very complex times [15:18] as an innovative, unifying, and practical leader [15:22] focused on reversing chronic disease. [15:25] Over the past 15 years, I have treated thousands of patients in clinics and operating rooms. [15:30] I have run my own medical practice and co-founded a health technology company [15:35] that empowers individuals with metabolic health data to address blood sugar dysregulation, [15:40] a problem now affecting over 50% of American adults and 30% of teens. [15:46] In this role, I recruited leading researchers from Yale, UCSF, Brigham Young University, [15:52] Cleveland Clinic, and more. [15:54] To support this effort, the company launched a 10,000-participant academic industry research collaboration [16:03] on early metabolic disease detection. [16:05] I have held biomedical research positions at the National Institutes of Health, [16:10] Stanford University, New York University, Oregon Health and Science University, [16:14] and published this biomedical research in leading medical journals. [16:18] I was recruited as a faculty course director at Stanford University [16:22] where I taught undergraduate and graduate students [16:24] on nutrition and health. [16:26] I have served as an associate editor of an international medical journal [16:31] focused on prevention and disease reversal. [16:34] I have spoken internationally on chronic disease [16:37] and wrote one of the most successful health books of the decade, [16:40] outlining a vision for reversing this epidemic [16:44] through personal empowerment, culture change, and policy reform. [16:49] I graduated from Stanford University with honors [16:53] and from Stanford Medical School [16:55] where I was inducted [16:56] by unanimous faculty vote into the Honor Society for Patient Care. [17:02] In conclusion, mental and physical health are unraveling [17:06] from shared root causes that we can fix. [17:10] Preventable heart disease, our number one killer in men and women, [17:15] is emblematic of a nation with a broken heart. [17:18] Diabetes, representing cellular energy collapse, [17:24] is draining our human potential. [17:26] Dementia, depression, and neurodevelopmental decline [17:29] reflect a society losing its mind. [17:32] Our bodies are telling us this current path is totally unsustainable. [17:36] There is another way, [17:37] a path that unites rigorous science [17:41] with reverence for our miraculous bodies and planet [17:45] and brings Americans and our medical institutions together [17:48] around actual healing and prevention. [17:51] This path is also economically sound [17:54] with the potential to save trillions of dollars annually. [17:57] As I sit here in the early months of motherhood, [18:02] I feel profound awe at the privilege we have as adults [18:06] to create a better world for future generations. [18:09] And that is why I'm here. [18:10] As Surgeon General, I would call on every American [18:14] and the Public Health Service to join in a great national healing, [18:18] one that halts preventable chronic disease, [18:21] makes healthy living the easiest choice, [18:24] honors the body's connection to the environment, [18:28] and puts America back on the road towards wholeness and health. [18:32] I look forward to answering your questions. [18:34] Thank you. [18:36] Thank you, Dr. Means. [18:39] I'll start. [18:41] If confirmed, you'll be the nation's doctor. [18:44] And to better understand your best medical opinion on various topics, [18:48] I'll ask you some things that have been of concern to this committee. [18:51] I have seven things to ask in five minutes, [18:54] so please be tight. [18:56] There won't be trick questions. [18:58] Do you believe that the abortion pill, Mifeprestone, [19:02] is safe and should be prescribed without an in-person vaccine? [19:07] And if so, what is the best way to prevent the spread of the virus? [19:11] Thank you so much, Senator Cassidy, for your question. [19:19] I think that every medication has its benefits. [19:23] I think that all patients need to have a thorough conversation with their doctor [19:27] and have true informed consent before taking any medication. [19:31] Should there be an in-person visit required? [19:36] The question of whether there should be an in-person visit [19:39] is out of the purview of the Surgeon General's office, [19:42] but I do believe that every patient needs to have [19:45] a very thorough conversation with their doctor [19:48] before taking any medication. [19:50] Unfortunately, in our current healthcare system, [19:52] because of how overburdened doctors are, [19:54] this often doesn't happen, whether it's in person or online. [19:57] Do you believe that birth control is safe, [19:59] should be widely accessible, [20:01] including perhaps without a prescription? [20:03] I absolutely think that oral contraception should be widely accessible. [20:10] Just as I said with Mifeprestone, [20:12] I believe that especially when it comes to oral contraceptives, [20:15] we need to have patients having [20:17] a conversation with their doctor about risks and benefits. [20:20] Like all medications, oral contraceptives do have significant risk, [20:25] and we need to make sure that women are empowered [20:28] with information and informed consent before getting on a medication [20:31] that's often prescribed for several years without follow-up. [20:34] Tragically, next question, [20:36] we've had two children die from measles in West Texas. [20:40] We now have an outbreak of like 1,000 children almost [20:43] in the South Carolina area. [20:46] You're a mom. [20:47] We're on the verge of losing our measles elimination status. [20:51] Would you encourage other mothers to have their children vaccinated [20:55] against measles with the MMR vaccine? [21:00] Like you, I'm a physician. [21:01] I believe vaccines save lives. [21:03] I believe that vaccines are a key part of any infectious disease [21:08] public health strategy, and I would work with you, the CDC, [21:13] the NIH, ACIP, FDA. [21:15] But would you encourage mothers to vaccinate their children [21:17] with the MMR vaccine? [21:18] Seeing how we've had children die [21:20] and this outbreak in South Carolina? [21:22] I'm supportive of vaccination. [21:24] I do believe that each patient, mother, parent, [21:27] needs to have a conversation with their pediatrician [21:30] about any medication they're putting in their body, [21:32] in their children's bodies. [21:33] You're the nation's doctor. [21:34] Would you encourage her to have her child vaccinated? [21:36] I'm not an individual's doctor, [21:38] and every individual needs to talk to their doctor [21:40] before putting a medication in their body. [21:42] I absolutely am supportive of the measles vaccine, [21:45] and I do believe vaccines save lives and are important. [21:47] part of the public health strategy. [21:49] We've had a tough flu season this year. [21:51] Would you, as past Surgeon Generals have, [21:54] encourage Americans to get vaccinated [21:56] with the flu vaccine? [21:58] At the risk of sounding repetitive, [22:00] I do think it's very important as a physician [22:03] and to rebuild trust in public health [22:07] to make sure that patients are encouraged [22:10] to have informed consent with their doctor [22:13] before getting any medication. [22:15] I believe vaccines save lives. [22:17] I believe they're an important part of public health. [22:19] I also do not want to not encourage patients [22:21] to have a conversation with their doctor. [22:23] I think it's incredibly important, [22:24] and informed consent is going to be part of building trust [22:26] in public health. [22:27] We've had an outbreak of whooping cough in Louisiana, [22:31] a vaccine-preventable disease. [22:32] Children have actually died from it. [22:34] Think about it. [22:35] A child about the age of your child [22:38] dying from a vaccine-preventable disease, [22:40] and some have been scared to vaccinate their children [22:43] because they've been told incorrectly [22:45] that vaccines cause autism. [22:48] Do you believe that vaccines, [22:50] whether individually or collectively, [22:52] contribute to autism? [22:54] Senator Cassidy, you're a physician. [22:58] I'm a physician. [23:00] The reality is that we have an autism crisis [23:02] that's increasing, [23:04] and this is devastating to many families, [23:08] and we do not know, as a medical community, [23:11] what causes autism. [23:13] The administration has just committed [23:15] a huge amount of funding to look at the exposome [23:17] of all environmental factors [23:19] that could be contributing to autism, [23:21] and until we have a clear understanding [23:23] of why kids are developing this at higher rates, [23:26] I think we should not leave any stones unturned. [23:29] There's been a lot of evidence showing [23:31] that they're not implicated. [23:32] Do you not accept that evidence? [23:34] I do accept that evidence. [23:35] I also think that science has never settled, [23:38] and I think that the effort [23:40] to look at comprehensive cumulative exposures [23:44] of our exposome into what is causing autism [23:48] is important, [23:49] and I look forward to seeing those results [23:50] and sharing the best public health information [23:52] with the American people. [23:53] Well, I got through five out of my seven, [23:55] so thank you for cooperating. [23:57] Senator Sanders. [23:59] Thank you. [24:00] And like the Chairman, [24:01] I've got a lot of questions in a short period of time. [24:03] I enjoyed your opening remarks, [24:05] and I think you're right. [24:06] This is a country that is sick in many ways. [24:10] We need to focus on disease prevention [24:12] rather than spending a huge amount of money [24:14] on tertiary care, [24:16] and I've enjoyed and appreciated [24:18] some of the remarks you have made in the past, [24:20] so let me just see if we're on the same page here. [24:22] When I was sitting where Senator Cassidy is now, [24:25] I fought hard to have [24:28] much more substantive labeling on junk food. [24:32] In fact, it's my view [24:34] that we should not have [24:36] food manufacturers selling junk TV ads. [24:41] My understanding is you have come out against [24:45] junk food ads on television. [24:47] Is that correct? [24:48] Yes. [24:49] Can you just take 30 seconds to elaborate that? [24:51] Would you use your position to ban [24:53] junk food TV ads? [24:55] Thank you so much, Senator Sanders, [24:57] and I agree with you completely. [24:58] I think there is so much that we agree on [25:00] on these issues. [25:02] Just to be clear, [25:04] the Surgeon General's Office [25:05] does not have the purview to ban this. [25:08] But you have a voice. [25:09] Absolutely, and that's a voice [25:10] I would absolutely lend [25:12] to talking about the dangers of ultra-processed foods [25:14] and getting these advertisements off the TV. [25:16] This has long been a part of my message. [25:17] I talk about it in my book. [25:19] Senator Marshall mentioned early ago [25:20] the crisis we have in obesity, [25:22] childhood obesity, [25:23] and you have these manufacturers selling [25:25] sugar-laden products that cause obesity. [25:30] Yes. [25:31] So you will speak out, [25:32] and do I correct, [25:33] do I understand your view is [25:34] you would fight to ban TV ads of junk food? [25:37] I think you will be frustrated [25:39] by how much I will be talking about ultra-processed foods. [25:41] Good. [25:42] I won't be frustrated. [25:43] I'd be delighted. [25:44] All right, let me ask you another area [25:46] that we may have some agreement. [25:48] As you know, [25:49] the United States and New Zealand [25:51] are the only two countries in the world [25:53] that allow the pharmaceutical industry [25:54] to advertise on TV. [25:55] I believe we should ban those ads. [25:56] How do you feel? [25:57] I agree with you. [25:58] Okay. [25:59] I mean, [26:00] just to elaborate, [26:02] as you know, [26:03] but for anyone who might be listening, [26:04] about 65 to 70% of the calories [26:05] that our children are eating [26:06] are ultra-processed frankenfoods [26:07] made in factories [26:08] that are so disconnected [26:09] from their origin source [26:10] and nutritional value [26:11] that, you know, [26:12] we're putting [26:13] just a nutritionally devoid food [26:14] in our children. [26:15] And then, [26:16] we wonder why [26:17] we have to ban [26:18] those ads. [26:19] Well, [26:20] you know, [26:21] we have to ban [26:22] those ads. [26:23] We have to ban [26:24] those ads [26:25] because that's why [26:26] we have an obesity crisis [26:27] in children [26:28] and why chronic diseases [26:29] are rising [26:30] as early as [26:31] the toddler years. [26:32] No, you're right. [26:33] That's right. [26:34] My vision [26:35] in this role [26:36] is to get more [26:37] whole healthy food [26:38] on American plates. [26:39] And we spend a fortune. [26:40] A fortune. [26:41] We make people sick [26:42] and then we spend a fortune [26:43] trying to keep them alive. [26:44] All right. [26:45] Those are important areas [26:46] of agreement [26:47] and I appreciate that. [26:48] But I want to pick up [26:50] on an issue [26:51] that the chairman raised [26:53] and it's a terribly important one. [26:55] And that deals [26:56] with the fact [26:57] that the American Medical Association, [26:58] I think the answers [26:59] you gave us [27:00] were a little bit political [27:01] and not to the point. [27:02] The American Medical Association, [27:03] I don't know [27:04] if you're a member [27:05] of it or not, [27:06] is the largest [27:07] professional association [27:08] of physicians [27:09] representing [27:11] over 270,000 doctors. [27:12] And they wrote [27:13] in November [27:14] that quote, [27:15] an abundance [27:16] of evidence [27:17] from decades [27:18] of scientific studies [27:19] shows no link [27:20] between vaccines [27:21] and autism. [27:22] End quote. [27:23] In contrast, [27:24] Secretary Kennedy [27:25] has said quote, [27:26] I believe [27:27] that autism [27:28] does come [27:29] from vaccines. [27:30] End of quote. [27:31] Dr. Means, [27:32] who is right? [27:34] Is the AMA right? [27:35] Is the scientific community right? [27:36] Or is Secretary Kennedy right? [27:37] As I said [27:40] to Senator Cassidy, [27:44] we have a situation [27:45] where autism [27:46] is rising. [27:47] It is. [27:48] This is a huge problem. [27:49] It is. [27:50] But we don't want [27:51] conspiracy theories. [27:52] Absolutely. [27:53] I 100% [27:54] agree with you. [27:55] And also [27:56] as a biomedical researcher [27:57] and physician, [27:58] I am not going to sit here [27:59] and say [28:00] we should not [28:01] study something [28:02] in the future. [28:03] It's not a political answer. [28:04] We should study everything. [28:05] We should study [28:06] the different factors [28:07] that may be causing, [28:08] yeah. [28:09] I agree. [28:10] But you have scientific evidence, [28:11] the overwhelming [28:12] body of scientific evidence [28:14] says vaccines [28:15] do not cause autism. [28:17] I'm not, [28:19] so just to be very clear, [28:21] vaccines, [28:22] vaccine advocacy [28:23] has never, [28:24] or any anti-vaccine rhetoric [28:26] has never been [28:27] a part of my message. [28:28] I don't mention [28:29] the word vaccine [28:30] in my book. [28:31] That's not my core message. [28:32] I am not here [28:33] to complicate the issue [28:34] on vaccines. [28:35] And also, [28:36] I, [28:37] as a physician, [28:38] am very careful [28:39] with my words. [28:40] And I don't think [28:41] it's responsible [28:42] to say that we're not [28:43] going to study [28:44] when kids are getting [28:45] many medications. [28:46] I think it's important [28:47] to just keep it [28:48] on the table. [28:49] Last question. [28:50] I'm sorry, [28:51] running out of time. [28:52] We are the only major [28:53] country on earth [28:54] that does not guarantee [28:55] healthcare to all people [28:58] as a human right. [28:59] Dr. Means, [29:00] is healthcare [29:01] a human right [29:02] should the United States [29:03] guarantee healthcare [29:04] to everybody, [29:05] whether you're young, [29:06] old, rich, or poor, [29:07] you are entitled [29:08] to healthcare [29:09] as a human right? [29:10] Yes, no, maybe? [29:11] My focus [29:12] is on ensuring [29:13] that Americans [29:14] have access [29:15] to the best healthcare [29:16] in the entire world, [29:17] which, [29:18] as you talked about, [29:19] as I talked about, [29:20] as everyone who's spoken [29:21] has talked about, [29:22] is pretty much [29:23] the opposite [29:24] of what we have right now. [29:25] We spend 2x [29:26] every other country [29:27] in the world, [29:28] and we have the worst [29:29] I agree, [29:30] but is healthcare [29:31] a human right? [29:33] I think that [29:34] the United States [29:35] will be, [29:36] by your side, [29:37] trying to get [29:38] Americans access [29:39] to the best healthcare [29:40] in the world. [29:43] Thank you very much. [29:44] Senator Mullen. [29:45] Thank you, Chairman. [29:52] My green light was on. [29:53] I thought my mic was on. [29:54] I want to address [29:55] a couple things. [29:56] During the ranking members' [29:58] opening statement, [29:59] he talked about [30:00] misinformation [30:01] coming from [30:02] this administration, [30:03] and I just want to point out [30:04] that the [30:05] Biden Surgeon General, [30:06] Dr. Murthy, [30:07] was actually, [30:08] a court actually [30:09] ruled against him [30:10] in 2023, [30:11] the Fifth Circuit Court, [30:12] for trying to [30:13] censor free speech [30:14] on social media. [30:15] That's misinformation, [30:16] and so for us [30:17] to throw out [30:18] an accusation [30:19] like that [30:20] with no evidence [30:21] when the ranking member [30:22] was completely silent [30:23] when that took place, [30:24] it's really [30:25] some hypocrisy there. [30:26] When we start [30:27] talking about [30:28] healthcare [30:29] not being affordable, [30:30] the ranking member [30:31] and I actually [30:32] agree on that. [30:33] The problem is [30:34] you supported [30:36] that [30:37] and you [30:38] supported [30:39] that [30:40] and you supported [30:41] the [30:42] same tools [30:43] that got us to [30:44] where healthcare [30:45] is unaffordable [30:46] because ACA, [30:47] affordable healthcare, [30:48] which is completely [30:49] unaffordable, [30:50] has risen three times [30:51] faster [30:52] than inflation itself, [30:53] yet [30:54] we still support it. [30:55] Not we, [30:56] you, [30:57] the Democrats. [30:58] I support [30:59] a national healthcare program [31:00] which will cut [31:01] the cost of healthcare [31:02] for the person, [31:03] but you're attacking me. [31:04] You're going to attack me, [31:05] I'm going to respond. [31:06] I'm pointing out facts. [31:07] You can say what you want. [31:08] I'm just pointing out facts. [31:09] The fact is [31:10] that it has risen [31:11] three times faster [31:12] and we know it, [31:13] yet we still want to [31:15] sit here [31:16] and defend it. [31:17] The ranking member [31:19] wants us to talk about [31:20] all the death [31:21] that is supposedly [31:22] going to be happening [31:23] because of [31:24] President Trump [31:25] and [31:26] Secretary Kennedy [31:27] because how dare [31:28] they look at [31:29] a healthcare system [31:30] that is broken [31:31] and unaffordable [31:32] and try to make changes, [31:33] but yet the definition [31:34] of insanity is what? [31:35] Doing the same thing, [31:37] expecting different results [31:38] so we should just [31:39] sit here [31:40] and accept it [31:41] and how dare we [31:42] look into vaccines [31:43] to just simply [31:46] look to see [31:47] if maybe [31:48] vaccines [31:49] may be [31:50] a partial cause [31:51] to autism [31:52] when it's rising [31:53] at a rate faster [31:54] than any country [31:55] in the nation? [31:56] How dare us [31:57] look at science? [31:58] Oh my goodness. [32:01] Science is supposed [32:02] to be perfect? [32:03] I thought science [32:04] was always supposed [32:05] to be studied. [32:06] I'm four looking into it. [32:07] Is the father [32:08] of six kids? [32:09] Yeah, [32:10] I want to look into it. [32:11] I want to know [32:12] what's going on [32:13] and I will turn over [32:14] every stone [32:15] and so doctor means [32:16] thank you for saying [32:17] I want to turn over [32:18] every stone. [32:19] Good on you. [32:20] I'm not a doctor. [32:21] I'm not sitting here [32:22] trying to say [32:23] we shouldn't do something. [32:24] I'm saying [32:25] let's go after it. [32:26] Let's look at it. [32:27] Let's question [32:28] what we're doing. [32:29] Let's look at [32:30] the healthcare system. [32:31] We can agree on that one. [32:32] I just don't want [32:33] to socialize it, [32:34] but we can agree [32:35] that it is absolutely [32:36] not affordable, [32:37] 100% not affordable, [32:38] yet it was supposed [32:40] to be affordable. [32:41] That's what we sold [32:42] it for. [32:43] Scrap ACA. [32:44] Admit it doesn't work. [32:45] Admit you guys [32:46] made a mistake [32:47] and let's work [32:48] at something [32:49] with President Trump [32:50] to make affordable [32:51] healthcare healthy [32:52] and affordable [32:53] for everybody, [32:54] but there's zero chance [32:55] you guys could do that. [32:56] Zero chance. [32:57] Yet everybody [32:58] we bring up here [32:59] you guys chastise [33:00] for trying to make changes. [33:01] God forbid [33:02] we change [33:03] and go after [33:04] and try to fix [33:05] our broken system. [33:07] Anyways, [33:08] I ranted too long. [33:09] Let's talk about some. [33:10] Yes, you did. [33:11] I'm sorry. [33:12] I didn't ask [33:13] you to do that. [33:14] You're part of the problem. [33:15] You've been sitting [33:16] here longer than I've [33:17] even been alive. [33:18] This is your problem. [33:19] You should have [33:20] fixed this a long time ago. [33:21] You've been rel on it [33:22] so long. [33:24] What have you been doing? [33:25] I decided not to run [33:26] for Surgeon General. [33:27] You're the nominee. [33:28] I've decided not to accept [33:29] that nominee. [33:30] That is definitely [33:31] something we would [33:32] never accept. [33:34] Ma'am, [33:35] what's your passion [33:36] about healthcare? [33:37] What brought you [33:40] into this? [33:41] Thank you, [33:42] Senator Mullen. [33:43] For all of us, [33:46] I'm just going [33:47] to take a deep breath. [33:48] My vision [33:49] and for the future [33:50] of America [33:51] is to get more [33:52] healthy, [33:53] whole food [33:54] on Americans' plates [33:55] and to work [33:56] to systematically [33:57] encourage [33:58] our healthcare system [33:59] to focus [34:01] on the root [34:02] causes [34:03] of why [34:04] we are sick [34:05] and not just [34:06] reactive sick care. [34:07] This is my passion. [34:08] This is why [34:09] I was put [34:10] on this earth. [34:11] We have an incredible [34:12] healthcare system. [34:13] It's amazing. [34:14] It's produced miracles. [34:15] If we have [34:16] an acute issue, [34:17] absolutely [34:18] you want [34:19] to have [34:20] to be in America [34:21] to get that fixed. [34:22] But 90% [34:23] of healthcare costs [34:24] are now going [34:25] to chronic diseases. [34:26] And frankly, [34:27] having practiced, [34:28] I've seen thousands [34:29] of patients, [34:30] you know, [34:31] worked in this system [34:32] for almost a decade [34:33] in clinical medicine, [34:34] it's not [34:35] the focus [34:36] of what we [34:37] as doctors [34:38] are incentivized [34:39] to spend our time on. [34:40] It's not [34:41] what's reimbursed. [34:42] And this is a problem. [34:43] Medical education [34:44] doesn't focus [34:45] on these modifiable [34:46] root causes [34:47] of diseases. [34:48] The science [34:50] is telling us [34:51] through amazing [34:52] emerging work [34:53] in systems biology [34:54] and network biology [34:55] that the [34:56] physiologic causes [34:57] of the vast majority [34:58] of diseases [34:59] that are taking [35:00] American lives [35:01] and torturing [35:02] and shortening [35:03] our lives, [35:04] even in our children, [35:05] are connected [35:06] by shared physiology [35:07] and shared root causes. [35:08] We need to upgrade [35:09] the paradigm [35:10] of the American [35:11] healthcare system [35:12] to educate [35:13] and treat [35:14] in that way. [35:15] It is by far [35:16] the most efficient [35:17] way to treat, [35:18] of course, [35:19] shared root causes. [35:20] We're going [35:21] to be able [35:22] to stop [35:23] the whack-a-mole [35:24] medicine [35:25] that's not working [35:26] for us [35:27] and that is so costly. [35:28] And so my passion [35:29] is to help work [35:30] with the AMA, [35:31] work with medical schools, [35:32] work with Democrats, [35:33] Republicans, [35:34] all sorts of agencies [35:35] across the government [35:36] to ensure [35:37] that we really [35:38] move the needle [35:39] on shifting [35:40] the American healthcare [35:41] system [35:42] towards root causes. [35:43] I know we can do it. [35:44] There's political will. [35:45] It's what Americans want. [35:46] Even the medical schools [35:47] are on board, [35:48] but we need a vision [35:50] to do it. [35:52] Thank you, [35:53] Mr. Chairman. [35:54] Thank you, [35:55] Dr. Means, [35:56] for being here. [35:57] Let me start [35:58] with this. [35:59] You called birth control [36:00] pills, [36:01] and I'm going [36:02] to quote, [36:03] a disrespect of life. [36:04] And you said [36:05] Americans, [36:06] quote, [36:07] use birth control [36:08] pills like candy. [36:09] You also claimed, [36:10] contrary to established [36:11] science, [36:12] that hormonal [36:13] birth control [36:14] has, [36:15] quote, [36:16] horrifying [36:17] health risks [36:18] for women. [36:19] Now, [36:20] here are the facts. [36:21] There are decades [36:22] of evidence [36:23] showing that [36:24] every one [36:25] of these birth control [36:26] methods [36:27] is safe [36:28] and effective. [36:29] So, [36:30] I wanted to ask you, [36:31] help me understand, [36:32] should women trust [36:33] the FDA, [36:34] which approved [36:35] all 18 methods [36:36] of birth control [36:37] after a very [36:38] rigorous look [36:39] at the evidence, [36:40] or should they trust [36:41] your statement [36:42] that there are [36:43] horrifying [36:44] health risks [36:45] to birth control, [36:46] which contradicts [36:47] that evidence? [36:48] Thank you, [36:49] Senator Murray, [36:50] for your question. [36:53] I'm curious [36:54] if you're aware [36:55] of what the side effects [36:56] of hormonal contraception [36:57] are. [36:59] I'm curious [37:00] if you are [37:01] with the FDA [37:02] that went through [37:03] all of these [37:04] and rigorously [37:05] looked at them, [37:06] or as Surgeon General, [37:07] if you're going [37:08] to tell the truth [37:09] to the American people. [37:10] I absolutely believe [37:11] these medications [37:12] should be accessible [37:13] to all women. [37:14] And also, [37:15] all medications [37:16] have risks [37:17] and benefits, [37:18] and in our current [37:19] medical climate, [37:20] with the burden [37:21] on doctors, [37:22] we do not have, [37:23] doctors do not have [37:24] any risk [37:25] to women. [37:26] And so, [37:27] I think that's [37:28] what I'm trying to say [37:29] in this conversation. [37:30] Some of the horrifying [37:31] side effects [37:32] of birth control [37:33] that I have mentioned [37:34] include blood clots [37:35] and stroke risk [37:36] in women [37:37] who have clotting disorders, [37:38] who are smokers, [37:39] who have obesity. [37:40] So is it general? [37:41] No, [37:42] it's not general. [37:43] I'm speaking, [37:44] I'm very careful [37:45] with my words, [37:46] and when I say those comments [37:47] which are taken out of comment, [37:48] out of context, [37:49] I'm speaking about [37:50] particular women [37:51] that can be hurt [37:52] if there is not [37:53] a thorough conversation [37:54] with their doctor [37:55] and know whether [37:56] they are at higher risk [37:57] for side effects [37:58] when prescribed [37:59] the medication. [38:00] Saying that is one thing, [38:01] but saying on, [38:02] you know, [38:03] different shows [38:04] that birth control pills [38:05] are a disrespect [38:06] of life [38:07] is very different. [38:08] I believe, [38:09] I am passionate [38:10] about women's health, [38:11] and I think [38:12] it is disrespectful [38:13] to women. [38:14] Saying that people [38:15] use birth controls [38:16] like candy [38:17] is very different [38:18] than what you just said. [38:19] We prescribe [38:21] a huge amount [38:22] of hormonal contraception [38:23] to women [38:24] and I do not believe [38:25] most of those conversations [38:26] have informed consent [38:27] because of the pressures [38:28] that doctors are under [38:29] because of our broken [38:30] health care system. [38:31] I want what's best for women [38:32] as do you, [38:33] and I want every woman [38:34] who could be at risk [38:35] for a side effect [38:36] to know. [38:37] Let me move on. [38:39] If a woman died [38:40] from a stroke [38:41] or a blood clot [38:42] because they did not [38:43] have a thorough conversation. [38:44] Thank you for your answer. [38:45] You made that clear. [38:46] Let me go to another question. [38:47] Tracy Beth Hogue, [38:49] she's an anti-vaccine skeptic. [38:51] She was elevated [38:52] by the Trump administration [38:53] to speak [38:54] and serve [38:55] as the top [38:56] drug regulator [38:57] at FDA. [38:58] She made comments [38:59] last week [39:00] casting doubt [39:01] on the safety [39:02] of RSV vaccines [39:03] for baby. [39:04] As you sure know, [39:05] RSV can be deadly [39:06] even for healthy [39:07] full-term infants. [39:08] Do you believe [39:09] that Dr. Hogue [39:10] is wrong [39:11] to question [39:12] the safety [39:13] of RSV vaccines? [39:14] I have not [39:16] read that article [39:17] or seen that quote. [39:18] I would need to know [39:19] what she said [39:20] before I commented [39:21] on that. [39:22] Well, you do know [39:23] that RSV [39:24] is the leading cause [39:25] of breast cancer [39:26] in the United States. [39:27] I do. [39:28] I have a 17-week-old [39:29] and I'm very aware [39:30] of that. [39:31] You hear her statement. [39:32] As Surgeon General, [39:33] would you contradict it? [39:34] I certainly [39:35] have absolutely [39:36] no issue [39:37] having very frank [39:38] conversations [39:39] with anyone [39:40] in the administration [39:41] if I believe [39:42] that their statements [39:43] are misguided [39:44] in some way [39:45] or not fully informed. [39:46] That's not [39:47] a conversation [39:48] I would have publicly first. [39:49] I would have a private [39:50] and direct conversation [39:51] with anyone [39:52] in the administration [39:53] if I felt [39:54] that my statements [39:55] were at risk. [39:56] I also want [39:57] to ask you [39:58] about maternal health. [39:59] Mental health conditions [40:00] are the leading cause [40:01] of maternal death [40:02] in the U.S., [40:03] including suicide [40:04] and overdose deaths. [40:05] In her comments [40:06] last week, [40:07] Dr. Hogue, [40:08] same woman, [40:09] also expressed [40:10] concern [40:11] about the safety [40:12] of the antidepressants [40:13] during pregnancy. [40:15] Specifically, [40:16] she called out [40:17] SSRIs, [40:18] the most commonly [40:19] prescribed type. [40:20] Do you believe [40:21] that SSRIs [40:22] are dangerous [40:23] for pregnant women? [40:25] Well, [40:26] I don't have [40:27] a broken record [40:28] here, [40:29] but I do believe [40:30] that every medication [40:31] has risks [40:32] and benefits, [40:33] and you need [40:34] to have a nuanced conversation [40:36] with your doctor [40:37] before starting a medication. [40:38] That is, [40:39] I think, [40:40] the most responsible [40:41] position [40:42] for any doctor [40:43] to share. [40:44] Well, [40:45] strong evidence [40:46] has shown [40:47] that SSRIs [40:48] are safe in pregnancy. [40:49] Most do not [40:50] increase the risk [40:51] of birth defects. [40:52] Certainly. [40:53] But untreated depression [40:54] in pregnancy [40:55] puts women at risk. [40:56] So, [40:57] I believe [40:58] that SSRIs [40:59] are safe [41:00] for all Americans. [41:01] Okay. [41:02] Well, [41:03] if confirmed [41:04] as Surgeon General, [41:05] it will be your job [41:06] to give accurate [41:07] and up-to-date [41:08] health information [41:09] to the American people. [41:10] I assume you will [41:11] take that responsibility [41:12] seriously. [41:13] I absolutely do, [41:14] and I also believe [41:15] that the American people [41:17] are looking [41:18] for a more nuanced [41:19] conversation [41:20] about health, [41:21] and I believe [41:22] that that will help [41:23] restore trust [41:25] in public health. [41:26] Thank you. [41:27] I also want [41:28] to thank [41:29] Assistant Secretary of Health, [41:30] Dr. Brian, [41:31] Christine, [41:32] for being here. [41:33] Thank you [41:34] for your service. [41:35] Dr. Means, [41:36] I've listened to you [41:37] and your brother, [41:38] Callie, [41:40] and I know he's here today [41:41] on, [41:42] I don't know [41:43] how many tens [41:44] and tens [41:45] of podcasts [41:46] I've listened to. [41:47] I learned a whole lot [41:48] because I grew up [41:49] in the health business. [41:50] I was a coach [41:51] 35 years. [41:52] It was all about nutrition. [41:53] So, [41:54] the question [41:55] I want to ask you [41:57] is how do we get around this? [41:58] In the medical field, [41:59] when we train [42:00] our doctors, [42:01] we don't teach anything [42:02] about nutrition. [42:03] Everything's about [42:04] a priority, [42:05] and those priorities [42:07] are fine, [42:08] but we need [42:09] to teach [42:10] our doctors [42:11] and nurses [42:12] about nutrition, [42:13] about what [42:14] to put [42:15] in their body. [42:16] This epidemic [42:17] we have going [42:18] on chronic disease [42:19] as we've all talked about [42:20] is out of control [42:21] and getting worse. [42:22] So, [42:23] how do you prioritize that? [42:24] Thank you so much, [42:25] Coach, [42:26] and [42:27] I really, [42:29] really enjoyed [42:30] knowing you [42:31] throughout this process. [42:32] Thank you. [42:33] This is so key, [42:34] what you're talking about, [42:35] reforming [42:36] medical education [42:37] to focus [42:38] on root causes, [42:39] and one of the key root cause [42:40] modifiable factors [42:41] of chronic disease [42:42] is nutrition, [42:43] as we all know. [42:44] There has been [42:45] incredible momentum [42:46] already [42:47] in the administration [42:48] towards making this possible, [42:49] starting with [42:50] the Dietary Guidelines [42:51] for America, [42:52] which came out [42:53] about a month ago. [42:54] This is the first time [42:55] we've had a full-throated [42:56] denunciation [42:57] of ultra-processed food, [42:58] and [42:59] I think this is historic. [43:00] The federal government [43:01] says that out loud. [43:02] What that is going to do [43:04] is impact [43:05] medical education. [43:06] It's going to impact [43:07] procurement regulations [43:08] for billions [43:09] of meals [43:10] served [43:11] and paid for [43:12] by federal dollars [43:13] every year. [43:14] We're going to see [43:15] real food, [43:16] more real food, [43:17] less ultra-processed food [43:18] going into [43:19] the National School Lunch Program, [43:20] prisons, [43:21] hospitals, [43:22] and other federally funded [43:23] organizations. [43:24] This, [43:25] I think, [43:26] it's a point [43:27] that gets lost [43:28] a little bit, [43:29] that by just changing [43:30] that, [43:31] we're going to trickle down [43:32] into billions [43:33] and billions [43:34] of healthier meals [43:35] for Americans. [43:36] I think that's step one. [43:37] I think, [43:38] secondarily, [43:39] we've got [43:40] Dr. Marty Makary, [43:41] an absolute hero, [43:42] who is approaching [43:43] the grass loophole, [43:44] the generally recognized [43:45] as safe loophole [43:46] through the FDA. [43:47] This is a program [43:48] where companies [43:49] have essentially [43:50] been self-reporting [43:51] the safety [43:52] of the ingredients [43:53] that they're putting [43:54] in their foods [43:55] with very, [43:56] very little oversight, [43:57] which has led to [43:58] literally [43:59] thousands of chemicals [44:00] in our food system [44:01] that we don't know [44:02] what they are [44:03] or what they're doing [44:04] to our body. [44:05] By addressing [44:06] this loophole [44:07] and starting to be, [44:08] have much more scrutiny [44:09] about what's going [44:10] into our food, [44:11] this is going [44:12] to trickle down [44:13] to affect medical education, [44:14] affect culture, [44:15] affect what companies [44:16] are putting in the food. [44:17] The zeitgeist [44:18] is going to shift [44:19] about a lot of this [44:20] because we're going [44:21] to start to have transparency [44:22] about what is even [44:23] in our food system. [44:24] Additional things [44:26] are happening [44:27] that are just incredible [44:28] around food. [44:29] There was just [44:30] $700 million [44:31] of food [44:32] that was produced [44:33] by the Department [44:34] of Agriculture. [44:35] We're going to have [44:36] more investment [44:37] in research [44:38] and studying [44:39] of soil health, [44:40] water quality, [44:41] nutrient density [44:42] of food [44:43] and how that's affecting [44:44] our health. [44:45] That's going to trickle [44:46] into medical education. [44:47] There's a whole [44:48] person health initiative [44:49] at the NIH [44:50] that's being put forward [44:51] by Dr. J. Bhattacharya, [44:52] who's doing [44:53] an incredible job. [44:54] That's going to study [44:55] the systems biology [44:56] perspective [44:57] of the body, [44:58] not isolated silos, [44:59] but the whole body health. [45:00] And when we look at the body, [45:01] like that, nutrition has to play into it. So this is just, you know, four or five of some of the [45:06] stones that are being moved right now that all will lead to nutrition being a bigger part of [45:12] our healthcare system. I think where I can help on that is elevating the work that's being done, [45:17] having conversations, again, across the whole medical community to help us in a really positive [45:23] and unifying way move towards a more root cause approach to health. You think that will be a hard [45:28] item to push in our medical schools about nutrition? I've had conversations with a number [45:33] of deans of medical schools who are very, very passionate about this issue. They want to change. [45:40] It feels hard because we have this behemoth healthcare system that operates a certain way, [45:45] but right now there's cultural momentum, there's political will, and I think the time is now to make [45:51] generational changes that are going to have a huge impact on all Americans. And I also think it's an [45:55] issue that all of us can work on. [45:58] Together, it's non-controversial, it's positive, it's unifying, and I think that's what we need [46:03] right now for Americans. It's all about educating people, and sometimes people don't want to be [46:09] educated, but I think the Surgeon General and our whole Department of Health and Human Services, [46:16] I think everybody's on board with that. And if we do that, what Senator Sanders was talking about, [46:22] about the five trillion dollars a year we spend, we can't afford to do that anymore. I mean, [46:26] we have to stop, and the root cause is education. [46:29] We have to educate people. Thank you very much. [46:31] Senator Baldwin. [46:33] Thank you, Mr. Chairman, and thank you, Dr. Means, for being here today. [46:37] You spoke in your opening statement about building trust, building trust in public health. [46:45] And you also made, I think, a passing reference to conflicts of interest within agencies in HHS. [46:55] So I want to ask you a few questions on that point. [46:59] Dr. Means, you've promoted a lab testing company, Genova Diagnostics, [47:07] which is backed by private equity and may charge customers several hundred dollars for its services. [47:15] Before you began promoting their tests on social media, the company agreed to pay [47:21] 43 million dollars to resolve allegations that it had billed for medically unnecessary [47:29] lab tests and violated the False Claims Act. [47:33] You personally accepted $10,000 from this company. [47:39] And I want to ask you whether you were aware of Genova Diagnostics' prior violations [47:45] and the settlement when you started promoting their services. [47:49] Thank you, Senator Baldwin, and also thank you so much for meeting with me beforehand. [47:54] I really enjoyed our conversation. [47:59] Frankly, I was not familiar with that settlement. [48:01] There's a particular test that they make about nutrient quality that I find very compelling [48:07] because I do think we need to understand a little bit more transparently [48:11] about how the nutrients from our food are affecting our health. [48:15] And I would just highlight that I have worked extremely closely with the Office of Government Ethics [48:19] over the last several months and taken this process very seriously. [48:23] I've signed a letter that outlines how to rectify any potential conflicts. [48:27] And I know you're going to divest your stocks in the future. [48:29] Absolutely. [48:31] And all sorts of health-related and non-health-related entities. [48:37] But it's troubling because the surgeon general must be someone that the public can trust [48:43] and someone who does their homework before accepting money or lending credibility to a company. [48:51] And for me, this raises questions about your judgment. [48:55] It does not inspire confidence that you're here to make Americans healthy. [48:59] Right. [49:01] When you accept money to promote a company who's had to pay a settlement because of violating the False Claims Act. [49:13] Dr. Means, you have also promoted a range of supplements, including those that claim to promote longevity and detoxification. [49:23] You made at least $325,000 from promoting supplements since the beginning of 2024. [49:29] According to information provided to this committee. [49:35] This includes nearly $135,000 for a so-called longevity supplement [49:41] and $46,000 for wellness teas and elixirs. [49:45] Both of which can cost upwards of $100 a month for somebody consuming them. [49:51] Your company, Levels Health, offers continuous glucose monitoring [49:57] and AID monitoring. [49:59] And a full membership, and I'm not sure what all a full membership involves, [50:05] but costs $1,500 a year. [50:09] And that's about a whole month's average rent for a one-bedroom apartment in Milwaukee, Wisconsin. [50:15] So do you really believe that most Americans can afford to spend upwards of $1,500 a year [50:21] on your supplements and programs? [50:23] And is that one of your solutions to our nation's health problems? [50:27] Thank you. [50:29] Thank you for the question. [50:31] I certainly don't think every American needs to be wearing a glucose monitor. [50:37] I think that we have a monumental blood sugar problem in this country [50:42] that underlies most of the leading cause of death in this country. [50:46] Dementia, cancer, diabetes, heart disease, stroke, [50:52] are all connected by metabolic dysfunction and elevated blood sugar. [50:56] And my work on using entrepreneurship as a tool [51:00] to bring and study new tools that can help us understand our blood sugar better, [51:06] I believe, I'm very proud of. [51:09] And as I mentioned in my opening statement... [51:13] Thank you for that statement and those observations. [51:15] Dr. Means, you say you want to address... [51:17] And that research that we've done with the company is meant to benefit all Americans. [51:21] And that's what I want to tie up in my remaining 12 seconds. [51:25] Dr. Means, you say you want to address chronic disease, [51:29] but I think that a lot of low-income adults have two or more chronic conditions. [51:35] They need an affordable solution. [51:39] Groceries are too expensive. Healthcare is too expensive. [51:43] Health insurance premiums have skyrocketed because of Republicans' refusal [51:47] to extend the tax credit and cuts to Medicaid. [51:51] And 15 million Americans are losing their health insurance. [51:55] People cannot afford their prescription drugs. [51:59] The healthcare system is broken. [52:01] But it seems to me that you've spent your career sort of making money [52:05] off the flaws in the system. [52:07] And I'm left wondering how the American people are supposed to trust you [52:11] to put their health and safety first, not profits. [52:15] Those are incorrect characterizations. [52:17] I appreciate your comments. [52:19] And I do look forward to working with you on your priorities. [52:24] And I absolutely am committed to giving Americans [52:28] the best public health information possible. [52:30] And like the comments I made prior, [52:32] I think some of the movement in our administration towards making [52:36] healthy food more accessible are going to impact all Americans [52:40] in a very positive way. [52:42] And I look forward to helping on that and many other issues [52:44] that make healthcare accessibility much easier for all Americans. [52:49] Senator Husted. [52:51] Thank you, Mr. Chairman. [52:53] Dr. Means, thanks for being here today. [52:55] I'm going to try to get through pesticides and mental health [52:57] for our children if I could. [52:59] I want to thank you for what you're trying to do [53:01] to raise awareness about healthy eating, healthy foods. [53:03] And since your nomination, I know I've had a lot of questions [53:07] from farmers and the agriculture community in Ohio [53:09] about your comments on pesticides. [53:13] And you will not regulate pesticides in your role, [53:17] but your views will impact American consumers [53:19] and what they believe about what's healthy and good for them. [53:23] What is a pesticide? [53:25] I would just put a little poster up here. [53:28] And why do we use them? [53:30] This is the kind of thing we try to prevent. [53:32] This is an earworm. [53:34] This is the kind of thing that destroys our crops [53:36] all across the country. [53:38] Corn, wheat, soybeans, fruit and vegetables. [53:42] If we fail to use proper pesticides, [53:46] it will drive down yields of 20 to 50 percent, [53:50] even more for fruits and vegetables, [53:52] the very things we want people to eat more of, [53:54] which will restrict the supply chain, [53:58] make food less accessible, [54:00] and more expensive if we can't have proper crop yields [54:04] and use more land, more resources, et cetera. [54:06] And so given all those facts [54:08] and given what the concerns are, [54:10] please just share your views on pesticides [54:12] for what they mean to the average consumer of food [54:16] in our grocery stores. [54:18] Thank you, Senator Husted. [54:20] And thank you so much for meeting with me [54:22] prior to this hearing. [54:26] This is a very complex issue. [54:28] And what I would just want to start by saying [54:30] is that I have the utmost respect for the American farm. [54:32] And I think just like doctors, [54:35] farmers are in an impossible situation right now [54:39] where we have developed an agriculture system [54:43] that is dependent on chemicals that are toxic [54:48] to have an affordable food supply. [54:50] And that's not good for farmers. [54:52] It's not good for consumers. [54:54] It's a complex issue. [54:56] And obviously changing anything overnight [54:58] would be devastating to the American farmer [55:00] and the American consumer. [55:02] With that said, this administration is committed to understanding [55:04] how it's affecting our bodies [55:06] and how cumulative exposures to various chemicals [55:08] in our environment is affecting us. [55:10] And that is a core, profound, [55:13] long-term deep passion of mine [55:15] as someone who thinks about [55:17] how our environments [55:19] and the system that we live in [55:21] is affecting our health [55:23] in the midst of this [55:25] monumental chronic disease epidemic. [55:27] And certainly pesticides, herbicides, [55:29] insecticides is something we need to look into [55:31] as part of that cumulative exposure. [55:33] So it's a complex issue. [55:35] And I think it's important [55:37] for consumers, especially mothers, [55:39] because we want to have the safest water [55:41] and the safest food supply [55:43] in terms of what's on it. [55:45] But I understand the nuance of these issues [55:47] and that changes need to be made thoughtfully [55:49] with full respect for American farmers [55:51] and the constraints that they're under. [55:53] And also eventually we are going to need to move [55:55] towards a more sustainable way [55:57] of growing our food [55:59] that decreases our reliance on toxic chemicals [56:01] that ever are hurting human health. [56:03] I think there are [56:05] incredible movements happening [56:07] within the administration, [56:09] like I mentioned the $700 million [56:11] going towards regenerative agriculture transitions, [56:13] precision agriculture, [56:15] and the private sector collaboration [56:17] that may be using technology [56:19] to help be more precise [56:21] with pesticide spraying. [56:23] And I think those are all positive developments. [56:25] But at the end of the day, [56:27] we do need to understand [56:29] how these chemicals are affecting our bodies [56:31] and work towards creating the safest food system. [56:33] Great. I have one more. [56:35] I'm going to ask all three of them [56:37] to give you a chance to respond. [56:39] Do you believe that smartphones and social media [56:41] are negatively impacting the health [56:43] of America's children? [56:45] What age should a child have access [56:47] to a smartphone and social media? [56:49] And what would you recommend [56:51] banning smartphones in America's schools? [56:53] I believe that [56:56] the research is showing [56:58] that the impact of social media [57:00] on children is profound [57:02] and negative. [57:04] And we need to take great efforts to protect children [57:06] from premature use of technology [57:08] that is associated with [57:10] mental health issues and depression. [57:12] And it's a strong concern of mine. [57:14] At what age does the research say [57:16] that we should [57:18] give a child access to a smartphone? [57:20] I don't have the answer to that question. [57:22] I don't know if an exact number is known. [57:24] But I think in light of how quickly [57:26] things are moving with technology [57:28] and social media [57:30] and how rapidly things are changing, [57:32] we need to, as parents, [57:34] communities, schools, and a government, [57:36] exert an abundance of caution [57:38] and be very proactive [57:40] about making sure we're protecting [57:42] children and their mental health. [57:44] I hope you'll spend some time [57:46] talking about this issue in your role [57:48] as Surgeon General, because [57:50] if you go to a school that's banned smartphones, [57:52] they will tell you it has a profound [57:54] difference on the mental health [57:56] and the educational environment [57:58] in those schools. So thank you. [58:00] Thank you. [58:02] We'll now go to Senator Murphy [58:04] and for the awareness of the members. [58:06] We'll take a 15-minute break [58:08] for the benefit of Dr. Means [58:10] and, more importantly, the benefit of her child. [58:12] And then we'll return 15 minutes as said. [58:15] Thank you, Mr. Chairman. [58:17] Good morning, Dr. Means. [58:19] Dr. Means, are you familiar with [58:21] FTC policy that requires [58:23] those who are recommending [58:25] products online [58:27] to disclose their [58:29] financial connection to those companies? [58:31] In particular, [58:33] the document from the FTC says this. [58:35] If you endorse a product through social media, [58:37] your endorsement message [58:39] should make it obvious [58:41] when you have a relationship with the brand. [58:43] Are you familiar with that? [58:45] Certainly. [58:47] So, as you know, [58:49] there is a pending complaint [58:51] regarding your failure [58:53] to adhere to those guidelines [58:55] that basically makes [58:58] the contention [59:00] and this committee has [59:02] verified the data [59:04] that underlies their complaint [59:06] that you routinely [59:08] initiated this policy [59:10] and that, in fact, [59:12] in the majority of your posts [59:14] for many of the products you recommend, [59:16] you did not [59:18] transparently [59:20] reveal your financial connection. [59:22] Let me give you an example. [59:24] That's false. [59:26] I'll give you an example. [59:28] There's a prenatal vitamin [59:30] called WeNatal. [59:32] Your filings [59:34] before this committee [59:36] show that you started receiving [59:38] compensation [59:40] in the spring [59:42] of 2024. [59:44] And yet, [59:46] in September of 2024, [59:48] you posted a video [59:50] saying that you had no financial relationship [59:52] to the company, just a big fan. [59:54] And then, in October, [59:56] you said, not sponsored, [59:58] just love these. [1:00:00] But, in fact, you have [1:00:02] documentation before this committee [1:00:04] that showed when you said those things, [1:00:06] you had a financial relationship. [1:00:08] You had already started receiving [1:00:10] money from that company. [1:00:12] So, you weren't telling the truth [1:00:15] when you said you were [1:00:17] just a fan. You were actually receiving money, correct? [1:00:19] In any [1:00:22] post where I said I am not receiving money, [1:00:24] I had not been receiving money at that time. [1:00:26] But you had received partnership [1:00:28] fees for this particular [1:00:30] prenatal vitamin. [1:00:32] In fact, prior to [1:00:34] September and October, you had [1:00:36] posted partnership links in which [1:00:38] you get compensated based upon [1:00:40] click-throughs, correct? [1:00:43] I'm happy to look at whatever documentation [1:00:45] you're talking about, but I do not, [1:00:47] it's incorrect and it's a false [1:00:49] representation. And just to be very clear, [1:00:51] I've spent the last several months [1:00:53] working with the Office of Government and Ethics [1:00:55] to be fully compliant [1:00:57] with this process. I take it very [1:00:59] seriously. Before, during, [1:01:01] and after, if I am in office, I will be in [1:01:03] full compliance with the Office of Government and Ethics. [1:01:05] I think, as I've talked about, conflicts of interest [1:01:07] are incredibly important to [1:01:09] rectify if we're in public service. [1:01:11] And I am fully committed to [1:01:13] continuing to work with them. [1:01:15] So let me give you some other examples. [1:01:17] Function Health, which is your lab [1:01:19] testing platform, data shows [1:01:21] that you disclosed your partnership [1:01:23] with them less than a third of the [1:01:25] time that you recommended their services [1:01:27] online. Genova [1:01:29] Diagnostics, [1:01:31] you disclosed your sponsorship [1:01:33] in only two of the nine times [1:01:35] that you promoted Genova. [1:01:37] Daily Harvest, you disclosed your [1:01:39] sponsorship in only three of the [1:01:41] fourteen posts [1:01:43] recommending [1:01:45] that product. Zen Basal [1:01:47] Seeds, you disclosed your [1:01:49] partnership only two out of the [1:01:51] thirteen times that you [1:01:53] recommended the product. [1:01:55] This seems systemic. It seems that [1:01:57] in the majority of instances [1:01:59] in which you were, as a medical professional, [1:02:01] recommending a product, [1:02:03] you were hiding the fact [1:02:05] that you had a financial [1:02:07] partnership. You seem [1:02:09] to be in regular, willful [1:02:11] violation of the FTC [1:02:13] rules. That is concerning [1:02:15] as someone who agrees with Senator Cassidy [1:02:17] that our focus has to be on [1:02:19] restoring trust [1:02:21] in the medical profession. And [1:02:23] yet, over and over again, you seem [1:02:25] to be at scale recommending [1:02:27] products without telling [1:02:29] your followers. And you have [1:02:31] 200,000 newsletter subscribers. You have [1:02:33] almost a million Instagram followers. [1:02:35] And in only three [1:02:37] out of fourteen times on Daily Harvest [1:02:39] when you were promoting [1:02:41] Daily Harvest, you disclosed [1:02:43] that you're getting paid by them? [1:02:45] It sounds like you have a lot to say about this issue, [1:02:47] and I would be very interested to see how your staff [1:02:49] looked at this data. I [1:02:51] have a strong feeling that the way in which [1:02:53] they gather this data is [1:02:55] done intentionally [1:02:58] to create these claims that you're [1:03:00] making. I have the [1:03:02] backup here. [1:03:04] I mean, will you acknowledge that in many [1:03:06] instances [1:03:08] when you were promoting these [1:03:10] products, you did not disclose [1:03:13] that you had a financial relationship? [1:03:15] I don't think that's true. [1:03:17] And if it has happened, if it [1:03:19] inadvertently has happened, [1:03:21] I would rectify that immediately. [1:03:23] However, [1:03:25] I would be interested to see how [1:03:27] your staff gathered this data. [1:03:29] And I will conclude by saying that I take [1:03:31] I'll send this to all the committee members. [1:03:33] I mean, it's pretty incontrovertible evidence. [1:03:35] I take conflicts of interest incredibly seriously. [1:03:37] I work diligently [1:03:39] with the Office of Government Ethics to make sure [1:03:41] that conflicts are addressed thoroughly. [1:03:43] The committee will stand in recess for 15 minutes. [1:03:48] Thank you. [1:22:10] Thank you for everybody being back. [1:22:13] Senator Marshall defers to Senator Collins. [1:22:15] Thank you, Mr. Chairman. [1:22:18] Welcome, Dr. Means. [1:22:20] Addiction [1:22:24] and drug overdoses [1:22:26] are a major problem [1:22:28] for families and communities [1:22:30] in my state of [1:22:32] Maine and across [1:22:34] the nation. I am [1:22:37] concerned that [1:22:39] in your book on [1:22:41] good energy [1:22:43] that you urge [1:22:45] readers to consider [1:22:47] psilocybin [1:22:49] assisted therapy. [1:22:52] You also [1:22:54] said that you were inspired [1:22:56] to try [1:22:58] psychedelics in what [1:23:00] I can only describe [1:23:02] as an internal voice [1:23:04] that whispered, it's time [1:23:06] to prepare. [1:23:09] Illicit drug use remains [1:23:11] a huge problem in [1:23:13] this country, and this [1:23:16] didn't happen in your teen years. [1:23:18] According [1:23:20] to your book, [1:23:22] in 2021, [1:23:24] you began using [1:23:26] illicit psychedelic [1:23:28] mushrooms. [1:23:30] My questions to you [1:23:32] are twofold. [1:23:34] One, do you stand [1:23:36] by what you said [1:23:38] in your book [1:23:40] encouraging people to [1:23:42] try psychedelics? [1:23:45] And second, [1:23:47] as Surgeon General, [1:23:49] should you be confirmed, [1:23:51] how would you speak to the American [1:23:53] people about the use of illicit [1:23:55] drugs? Thank you so much, [1:23:58] Senator Collins, and I also [1:24:00] thank you sincerely for engaging [1:24:02] so deeply with my work and [1:24:04] learning about me. [1:24:07] This is a very important question, [1:24:09] and I would start by just saying [1:24:12] that I believe what I would [1:24:14] say as a private citizen is [1:24:16] in many cases different than [1:24:18] what I would say as a public health official. [1:24:20] Joining a team where the purpose [1:24:22] of this role is to communicate absolutely [1:24:24] the best evidence-based science [1:24:26] to the American people to keep [1:24:28] them safe, thriving, and healthy. [1:24:30] And when it [1:24:32] comes to psychedelic [1:24:34] therapy for mental health issues, [1:24:36] I think the science is still emerging, [1:24:38] and so it would certainly not be [1:24:40] a recommendation to the [1:24:42] American people to do that under no [1:24:44] circumstances. I do believe [1:24:46] that there is [1:24:48] exciting work being done in this area [1:24:50] that needs to continue [1:24:52] on psychedelic [1:24:54] therapies for PTSD [1:24:56] in veterans, for mental health [1:24:58] issues, and [1:25:00] some of the researchers who are doing this work [1:25:02] have said it's some of the most promising and exciting of their [1:25:04] entire careers. So I look forward to following that, [1:25:06] but to be very clear, under no circumstances [1:25:08] would I recommend that to the American [1:25:10] people in this role. Our [1:25:12] illicit drug use [1:25:14] problem in our country is [1:25:16] monumental and severe, and I [1:25:18] look forward to working with you on [1:25:20] these issues that are so important. [1:25:23] What did you mean by [1:25:25] saying that you heard [1:25:27] an internal voice whispering [1:25:29] to you saying it's time [1:25:31] to prepare? [1:25:33] Yeah, in that passage of the book I'm referring [1:25:35] to [1:25:37] my mother's passing, which happened [1:25:39] she got a diagnosis of [1:25:41] pancreatic cancer about a week [1:25:43] after that [1:25:45] experience, and in my [1:25:47] meditations and prayers at that [1:25:49] time, I was having a deep sense [1:25:51] that something ominous was [1:25:53] coming, and [1:25:55] so that's what that's referring to. [1:25:57] I think [1:25:59] when I speak of spirituality [1:26:01] and [1:26:03] you know, I do believe [1:26:05] Americans are [1:26:08] ready to hear about spirituality as it pertains [1:26:10] to medicine. Eighty percent of Americans [1:26:12] are spiritual or religious. There's [1:26:14] amazing evidence coming out of Columbia University, [1:26:16] the lab of Dr. Lisa Miller, that spirituality [1:26:18] has a large impact on us, and it's a [1:26:20] huge impact on health outcomes, [1:26:22] and you know, so certainly that's a personal [1:26:24] anecdote, but [1:26:26] you know, I [1:26:28] again, I'm committed [1:26:30] to sharing only the best [1:26:32] solid science with Americans [1:26:35] on how to be healthy. [1:26:37] I understand [1:26:40] totally what you're saying [1:26:42] about spirituality, [1:26:44] and I'm sorry about the loss of [1:26:46] your mother. It's the link to [1:26:48] illicit drugs that I'm [1:26:50] having a hard time with, but [1:26:52] I have very little time left, [1:26:54] so I want to go to [1:26:56] another issue, and that [1:26:58] is in the staff interview [1:27:00] when you were talking about [1:27:02] wasteful spending, [1:27:04] you referred [1:27:06] specifically to money that [1:27:08] NIH spent on [1:27:10] Alzheimer's research [1:27:12] that, quote, proved to be [1:27:14] fraudulent, and you were [1:27:16] referring to the amyloid [1:27:18] plaque research [1:27:20] replication issue, [1:27:22] that was discussed in [1:27:24] the New York Times. [1:27:26] That story, however, [1:27:28] has been largely [1:27:30] debunked and countered, [1:27:32] so I just want [1:27:34] to make sure that I know for certain [1:27:36] whether you are [1:27:38] for vigorous research [1:27:40] on looking at a [1:27:42] wide variety of [1:27:44] factors when it comes to [1:27:46] Alzheimer's disease and [1:27:48] other dementias. Unquestionably, [1:27:50] full-throatedly, yes. [1:27:52] This is one of the most devastating [1:27:54] diseases facing Americans today. [1:27:56] It's one that I'm very passionate about, [1:27:58] particularly in light of [1:28:00] research showing that early [1:28:02] onset Alzheimer's dementia [1:28:04] in as early as the 50s [1:28:06] is starting to rise at a significant [1:28:08] rate. [1:28:10] I believe that we need to be [1:28:12] studying, like you said, all the [1:28:14] different medical, genetic, [1:28:16] lifestyle, environmental factors [1:28:18] that can be contributing to this. [1:28:20] When I look at the research that [1:28:22] I'm very excited to elevate in the [1:28:24] conversation, if I'm confirmed, [1:28:26] I'd point to the Lancet study from [1:28:28] 2024 about the modifiable risk [1:28:30] factors for Alzheimer's dementia, [1:28:32] which I'm sure you're familiar with, [1:28:34] which showed that with 14 modifiable [1:28:36] factors, we could reduce [1:28:38] 45% of Alzheimer's [1:28:40] dementia cases. This is incredible. [1:28:42] This isn't really the type of research [1:28:44] that we've been hearing from the medical community. [1:28:46] We hear a lot about drugs. We hear a lot about [1:28:48] interventions that slow decline once [1:28:50] we're sick, but that's the type of research [1:28:52] from the Lancet, major medical [1:28:54] journal, that I really look forward to [1:28:56] elevating and supporting [1:28:58] further research [1:29:00] like that that can really help Americans [1:29:02] be empowered to prevent this disease [1:29:04] when we can. Thank you. [1:29:08] Senator Kim. Thank you, Chairman. [1:29:10] Thank you for coming out and congratulations [1:29:12] on the new baby. [1:29:14] I wanted to just ask [1:29:16] you about the role of the Surgeon General, [1:29:18] the different aspects of it. [1:29:20] One of it is about issuing [1:29:22] public health advisories, is that correct? [1:29:24] Yes. [1:29:26] I wanted to just ask, are you currently able [1:29:28] to write prescriptions for patients? [1:29:30] I have not been seeing patients over the [1:29:32] last several years, and so [1:29:34] I currently, with the status [1:29:37] of my license that I voluntarily put on [1:29:39] an active status, which I'm sure what you're getting at, [1:29:41] cannot prescribe a [1:29:43] prescription right now. However, if I were to [1:29:45] work with the Oregon Medical Board [1:29:47] to reinstate that, [1:29:49] it's very possible to do. [1:29:51] Is that something [1:29:54] you're planning to do? [1:29:56] I'm planning on prescribing [1:29:58] prescriptions to Americans. [1:30:00] Are you planning to reactivate your license? [1:30:02] My path in medicine, [1:30:04] I spent [1:30:06] four years [1:30:08] doing surgeries and seeing patients [1:30:10] in clinics, and that one-to-one [1:30:12] medicine, [1:30:15] it's valuable, but [1:30:17] my path took me down a different road [1:30:19] to have a one-to-many approach to affect the [1:30:21] root cause of why we're sick in America. [1:30:23] So you're saying you're not [1:30:25] going to pursue reactivating your medical license? [1:30:27] Is that correct? [1:30:29] I do not plan to reactivate my [1:30:32] because I'm not going to be seeing patients [1:30:34] in this role. [1:30:36] It would not make sense to do that. [1:30:38] In fact, [1:30:40] for physicians, [1:30:42] if I could just clarify, because this has been a point of [1:30:44] severe misinformation from the media, [1:30:46] for any doctor in a state [1:30:48] where you are required to put your license on an [1:30:50] active that you're not seeing patients, I would imagine [1:30:52] that many physicians [1:30:54] in public health service who aren't seeing patients [1:30:56] would have to put their license on an active status [1:30:58] because they are not seeing patients [1:31:00] unless they choose to continue to do so while in office. [1:31:02] So another important role here, [1:31:04] I just want to kind of clarify because [1:31:06] you're saying you're not [1:31:08] currently able to practice medicine, you're not [1:31:10] currently able to write prescriptions because you're [1:31:12] saying you're not going to be seeing patients in this [1:31:14] job. Another big role [1:31:16] of the work that you're [1:31:18] doing is to be a leader of the commission [1:31:20] corps, is that correct? So I [1:31:22] guess I wanted to just dive into [1:31:24] this because with the commission corps, [1:31:26] it's saying as the commission corps [1:31:28] officer of the U.S. public health [1:31:30] services, keeping professional [1:31:32] licensure and certification up to date is [1:31:34] mandatory. So I guess I just [1:31:36] wanted to get a sense of how you're [1:31:38] squaring this here. Well, I do have a medical [1:31:40] license right now. It [1:31:42] is voluntarily placed on inactive status [1:31:44] because I'm not actively seeing patients at this [1:31:46] time. The [1:31:48] HHS [1:31:51] and Admiral [1:31:53] Brian Christine have testified in front of this [1:31:55] committee that I am eligible to serve as the medical [1:31:57] director of the HHS. But how does that square the [1:31:59] president's nominee? [1:32:01] It says keeping a professional [1:32:03] licensure and certification up to date is mandatory. [1:32:05] Is yours up to date? I have an active [1:32:07] medical license that is [1:32:09] unexpired right now. [1:32:11] Admiral Christine has testified that [1:32:13] I'm eligible to serve in this role. I'm the [1:32:15] president's nominee for surgeon general and further [1:32:17] questions about that will have to go to that. So if [1:32:19] you were to expand that, would you say that [1:32:21] with the others [1:32:23] in the commission corps, do you think [1:32:25] we should remove the mandatory licensure [1:32:27] for them to be able to [1:32:29] participate in the corps? That's not a question [1:32:33] that I've considered. I don't think it's actually [1:32:35] relevant to this particular [1:32:37] hearing. Well, it's relevant insofar as I'm [1:32:39] just trying to think through if you're in this job, [1:32:41] you know, how are you going to be [1:32:43] proceeding, you know, and what kind of [1:32:45] advice you're going to be able to give to the American people [1:32:47] and the credibility that they will [1:32:49] have in understanding what your advice [1:32:51] is. Also in terms of, you know, if you are a leader [1:32:53] of the commission corps, I'm trying [1:32:55] to get a sense, are you going to deprioritize [1:32:57] having an active license [1:32:59] in the same way that, you know, you [1:33:01] believe that you can do the job of a surgeon general [1:33:03] without having an active license? [1:33:05] Do you believe that that is the case for [1:33:07] others in the commission corps, that they can do their [1:33:09] job without having an active [1:33:11] license? Senator Kim, I'm a [1:33:13] medical doctor. I graduated from Stanford [1:33:16] University School of Medicine. I have [1:33:18] a medical license. My [1:33:20] professional history is a feature. It's not a bug. [1:33:22] I have had a unique history [1:33:24] that has merged entrepreneurship, [1:33:26] public health advocacy, faculty, [1:33:28] course direction at Stanford [1:33:30] University, as well as being an [1:33:32] editor of a medical journal and a biomedical researcher. [1:33:34] And in these complex times for American [1:33:36] health care, that type of multidisciplinary [1:33:38] history is going to be extremely valuable for the [1:33:40] American people. I don't discount your [1:33:42] accomplishments and your education, [1:33:44] but what I'm trying to get a sense [1:33:46] of here is your ability to [1:33:48] be able to engage with our current [1:33:50] medical professionals, to show [1:33:52] respect. I practiced medicine. [1:33:54] I owned my own medical practice, and [1:33:56] I've seen thousands of patients, and I did over [1:33:58] four years of surgical training, which is [1:34:00] more than many of our past surgeon general [1:34:02] roles completed, who did medical [1:34:04] specialties. I have completed [1:34:06] extremely thorough medical [1:34:08] training, and I have the [1:34:10] ability through these experiences to [1:34:12] communicate [1:34:14] excellent public health information, and I really [1:34:16] look forward to working with the commission corps. [1:34:18] This is an incredible group of people, 5,000 [1:34:20] uniformed officers who are committing [1:34:22] their lives to helping the American people, and [1:34:24] personally, just to share a little bit of a vision [1:34:26] for that. I agree with that. I just want to say the signal that is being [1:34:28] sent is one that I think we [1:34:30] have to look at, and with that I'll yield back. [1:34:32] Could I? Yes, ma'am. [1:34:36] This incredible group of officers [1:34:38] has traditionally been deployed for [1:34:40] public health emergencies [1:34:42] like natural disasters and infectious [1:34:44] disease, and I think there's a huge opportunity to actually [1:34:46] work with these members who [1:34:48] are interested in approaching [1:34:50] the chronic disease epidemic, which has not traditionally [1:34:52] been part of their role, and I think that bringing [1:34:54] that perspective and the demonstrated [1:34:56] history of [1:34:58] work in this area is actually going to be a [1:35:00] really positive development for the commission corps, [1:35:02] and I thank you for your questions. [1:35:04] Dr. Means, I should have said this earlier, [1:35:06] is your family behind you? Yes. [1:35:08] Would you please introduce? [1:35:11] I'd be happy to. [1:35:13] This is my stepmom, [1:35:15] Kathy, my dad, [1:35:17] Grady, my incredible [1:35:19] better half and husband, [1:35:21] Brian Nickerson, my best [1:35:23] friend of 20 years, Fiona Biles, [1:35:25] my sister-in-law, Leslie [1:35:27] Voorhees, and somewhere in [1:35:29] here is my brother, Callie, [1:35:31] and also my cousin, [1:35:33] Fleet White, and [1:35:35] my wife, Adrienne, who I don't think is here, but yes. [1:35:37] Well, I couldn't help noticing how proud [1:35:39] the people look behind you, so I said, [1:35:41] you know, let us put two and two together, so [1:35:43] anyway, thank you, and thank you all for being here. [1:35:45] Thank you. Thank you very much, Senator Cassidy. [1:35:47] Senator Marshall. [1:35:49] Thank you, Chairman. Before I begin my [1:35:51] question, Mr. Chairman, I ask unanimous consent [1:35:53] to submit this statement from Stanford [1:35:55] School of Medicine supporting [1:35:57] Dr. Means' nomination and recognizing [1:35:59] her as an outstanding [1:36:01] student to the record. Without [1:36:03] objection. Dr. Means, do you have a medical license [1:36:06] I do. Thank you. [1:36:08] Just wanted to make sure we clarified [1:36:10] that as well. I've had one for [1:36:12] 11 years. Exactly. [1:36:14] Dr. Means, there's so many things that [1:36:17] you could focus on. You know, [1:36:19] narrow it down to what would be, if you [1:36:21] could accomplish one thing, what might it be, [1:36:23] and it's hard not to get into two and [1:36:25] three, but just share a little bit what's on your heart [1:36:27] and your goals. What's your mantra going to be? [1:36:29] Thank you. Thank you, Senator Marshall. [1:36:31] My dream [1:36:36] for this role is [1:36:38] first and foremost to [1:36:40] help, nudge, [1:36:42] push, inspire our [1:36:44] healthcare system towards focusing on root [1:36:47] causes and the reasons why [1:36:49] we're getting sick, moving towards a [1:36:51] real healthcare system and not [1:36:53] just a reactive sick care [1:36:55] system, which is of course also going to [1:36:57] lower costs monumentally and [1:36:59] unburden, I think, American taxpayers and doctors. [1:37:01] I want [1:37:03] to see affordable, [1:37:05] accessible, real, [1:37:07] nutritious food for all Americans [1:37:09] because we know that nutrition and food [1:37:11] is one of the key, [1:37:13] most important drivers of [1:37:15] chronic illness or of health [1:37:17] and we're not eating real food. We're eating [1:37:19] 70% ultra-processed food right now [1:37:21] and there are structural barriers to making that [1:37:23] possible that good policy [1:37:25] and reform in the healthcare system can [1:37:27] fix and I believe there's political will [1:37:29] and cultural momentum to do so [1:37:31] and I look forward to being a leader in that. [1:37:33] And I would say lastly, [1:37:36] a key passion of mine is to understand [1:37:38] how the cumulative [1:37:40] burden of the [1:37:42] exposures we have in our environment [1:37:44] across food, water, [1:37:46] air, soil, [1:37:48] the products we're putting in and on our bodies, [1:37:50] how these are affecting our health. [1:37:52] We know that these diseases [1:37:54] are going up rapidly and of course [1:37:56] genetics have not changed over the past [1:37:58] 20, 30, 40, 50 years. It's [1:38:00] environmental exposures that are making us sick [1:38:02] and we [1:38:04] have not prioritized studying that [1:38:06] and the NIH and the Maha movement [1:38:08] is focused on looking at this and [1:38:10] I think this is going to be [1:38:12] a rapid accelerant [1:38:14] of understanding why we're sick and how to [1:38:16] heal. [1:38:19] Thank you. You and I are both concerned about the mental health [1:38:21] epidemic but especially in our youth [1:38:23] and I'm not expecting [1:38:25] you to commit to this today but at least [1:38:27] to seriously consider [1:38:29] what type of warning label we should [1:38:31] put on social media and at what [1:38:33] age. We have tobacco warnings [1:38:35] that it could be hazardous to your health [1:38:37] that alcohol could be [1:38:39] hazardous to your health and my [1:38:41] humble opinion, social media [1:38:43] for all of us but [1:38:45] especially young minds can be [1:38:47] hazardous to your health. [1:38:49] So I'm asking you if you would just consider [1:38:51] putting some type of a [1:38:53] surgeon general's worry [1:38:55] concern about social media for [1:38:57] especially our young adults [1:38:59] teenagers health. [1:39:01] Thank you. This is an area where [1:39:03] I believe the last surgeon general also did [1:39:05] incredible work and [1:39:07] you know obviously researchers and thinkers [1:39:09] like Jonathan Haidt are doing great work [1:39:11] on this and getting really the message [1:39:13] out there into culture of the problems [1:39:15] and I am committed to working [1:39:17] with you and truly [1:39:19] anyone within the medical establishment [1:39:21] the tech world and [1:39:23] the government [1:39:25] to make sure that we're protecting children [1:39:27] from harms of social media [1:39:29] and of excess [1:39:31] screen use. You know when we think about [1:39:33] the world we want to see [1:39:35] for our children I think all of us [1:39:37] know that we want to see our children [1:39:39] outdoors feeling safe playing [1:39:41] in the sunshine. [1:39:43] Joyful interacting with other children [1:39:45] thriving [1:39:47] playing [1:39:49] and that's [1:39:52] the world that I vision for my child [1:39:54] and for all American children and I think part of [1:39:56] getting to that vision [1:39:58] is making sure that we're being [1:40:00] very judicious about how we address [1:40:02] digital technology [1:40:04] use and of course making sure that children [1:40:06] are prepared to use technology thoughtfully [1:40:08] and responsibly but making [1:40:10] sure that [1:40:12] when there's evidence showing which I believe there is [1:40:14] that social media [1:40:16] and premature use of these programs is hurting [1:40:18] their mental health that we take action on it. [1:40:20] Thanks. Let's talk about nutrition [1:40:22] for a second through your eyes. [1:40:24] I think we all [1:40:26] acknowledge that America [1:40:28] needs to eat better but not everyone [1:40:31] can afford to go to whole foods. [1:40:35] Carbohydrates are cheap, processed foods [1:40:37] are typically cheaper [1:40:39] but how do we help [1:40:41] the masses? This is [1:40:44] the most important question because obviously if it's not [1:40:46] the easiest and the most accessible choice [1:40:48] it's not going to be sustainable for all Americans [1:40:50] which is what we need. This is why [1:40:52] I'm so supportive of some of these systemic changes [1:40:54] that are happening. So the dietary guidelines for America [1:40:56] like I mentioned just by changing [1:40:58] that and calling out [1:41:00] no more ultra processed foods [1:41:02] full throatedly which is what [1:41:04] they did, this is going to feed [1:41:06] into billions and billions [1:41:08] of meals per year of changing procurement [1:41:10] towards local organic whole foods [1:41:12] for kids, military, prisons [1:41:14] hospitals, organizations that are getting [1:41:16] federal dollars. So that's going to make billions [1:41:18] of meals more accessible for people [1:41:20] through federal dollars. Additionally [1:41:22] with the [1:41:25] GRAS loophole [1:41:27] that the [1:41:29] FDA is addressing, Dr. Marty [1:41:31] Macari, this is going to mean that we can't [1:41:33] even necessarily put some of these chemicals [1:41:35] in our food. And then at the NIH [1:41:37] they are going to be studying this [1:41:39] more thoroughly. And so I think [1:41:41] all together this is going to trickle into a [1:41:43] safer, healthier food system for Americans [1:41:45] that's going to be more affordable. I would also just mention [1:41:47] that the federal dollars are going to [1:41:49] be going towards healthier food. [1:41:51] And I think that's going to have a huge impact [1:41:53] on actually getting healthier food to low income [1:41:55] communities because if the dollars are flowing [1:41:57] there towards healthier food [1:41:59] the brands and the companies [1:42:01] are going to bring their food there. [1:42:03] Thank you Dr. Means. I look forward to supporting your nomination. [1:42:05] Thank you so much Mr. Chairman. [1:42:09] Thank you Mr. Chairman and thank you [1:42:11] so much Dr. Means for being here [1:42:13] for your family and congratulations [1:42:15] on the birth of your son. [1:42:17] If you are confirmed [1:42:19] you know that you will [1:42:21] be America's [1:42:23] top doctor and [1:42:25] as such [1:42:27] people will be looking to you for [1:42:29] scientifically accurate [1:42:31] health guidance. So I wanted [1:42:33] to drill down a little bit more [1:42:35] to understand your views [1:42:37] on vaccines and the [1:42:39] science supporting [1:42:41] Secretary Kennedy's [1:42:43] vaccine vision. [1:42:45] And I know you said earlier [1:42:47] that this really isn't [1:42:49] a part of your core message [1:42:51] but I know [1:42:53] that you've talked about it [1:42:55] before whether it's in [1:42:57] on podcasts or [1:42:59] you know [1:43:01] on articles or tweets and so [1:43:03] again I just wanted to [1:43:05] drill down a little bit more [1:43:07] on that and I know [1:43:09] previously you stated that [1:43:11] hepatitis B vaccine [1:43:13] giving it to a baby born to [1:43:15] hepatitis B negative [1:43:17] parents is absolute insanity. [1:43:19] And I think [1:43:21] you did an analogy [1:43:23] to it being criminal. [1:43:26] I was really pleased to hear you say [1:43:28] so strongly here today [1:43:30] that vaccines save lives [1:43:32] that [1:43:34] you support the [1:43:36] vaccinations for children [1:43:38] and so [1:43:40] my first question is [1:43:42] if a mother is hepatitis B [1:43:44] positive is providing [1:43:46] the vaccine [1:43:48] at birth [1:43:51] the most effective way [1:43:53] to prevent transmission to the baby? [1:43:55] So again if a mother [1:43:57] is hepatitis B [1:43:59] positive is providing the vaccine [1:44:01] at birth the most effective [1:44:03] way to prevent transmission [1:44:05] to the baby? [1:44:07] I believe certainly that is the most effective [1:44:09] way. Again I would just say [1:44:11] obviously the patient should talk to their doctor [1:44:13] but yes that's a pretty clear case [1:44:15] where certainly that would have a [1:44:17] huge impact. Thank you for your response. [1:44:19] It appears [1:44:21] even as we're talking about [1:44:23] the secretary's [1:44:25] vision [1:44:27] for vaccines in this country [1:44:29] that he has basically searched [1:44:31] the globe to find [1:44:33] things to justify his [1:44:35] harmful unpopular vaccine [1:44:37] policies and just a [1:44:39] few weeks ago we had Dr. Bhattacharya [1:44:41] here the head of NIH [1:44:43] and we got into a [1:44:45] dialogue even with the chairman about [1:44:47] using Denmark [1:44:50] as our peer [1:44:52] to make these kind of discussions [1:44:54] these kind of decisions [1:44:56] on December 20 [1:44:58] December 18, 2025 [1:45:00] the CDC [1:45:02] announced funding for a study [1:45:04] in Guinea-Bissau [1:45:06] a West African [1:45:08] country with just over [1:45:10] 2 million people. The CDC [1:45:12] funded study proposed [1:45:14] withholding the hepatitis [1:45:17] B vaccine birth [1:45:19] dose from half of the [1:45:21] newborn infants in the trial [1:45:23] without screening all mothers [1:45:25] for hepatitis B and as you [1:45:27] know as a doctor that when babies [1:45:29] are exposed to the virus [1:45:31] at birth they can face [1:45:33] very high risk of liver [1:45:35] damage or cancer later in life [1:45:37] so as a doctor [1:45:39] and as a mom would you [1:45:41] agree that it is unethical [1:45:43] and dangerous to withhold [1:45:45] a life saving vaccine [1:45:47] from babies at risk of a [1:45:49] preventable disease? [1:45:51] These are obviously [1:45:55] extremely important issues [1:45:57] I am not familiar with the [1:46:00] announcement that you just talked about [1:46:02] But hypothetically [1:46:04] just as a scientist [1:46:06] is it unethical to [1:46:08] withhold life saving [1:46:10] vaccine for a [1:46:13] baby? I think that in the case [1:46:17] where standard of care [1:46:19] is to give a vaccine and that's the [1:46:21] gold standard [1:46:23] I have trouble imagining a scenario [1:46:25] where a study would be [1:46:27] able to withhold that [1:46:29] treatment but again [1:46:31] I am not familiar with the study [1:46:33] that you are talking about [1:46:35] Again study is out there [1:46:37] but when a safe effective [1:46:39] vaccine is available [1:46:41] I think [1:46:43] not just as a doctor but as a human [1:46:45] we want to make sure that [1:46:48] I don't believe that [1:46:50] Dr. Jay Bhattacharya or the HHS [1:46:52] would be interested in withholding [1:46:54] We will make sure you get the study [1:46:56] because what is interesting is that [1:46:58] the researchers are also Danish [1:47:00] which is kind of interesting to me [1:47:02] And also sometimes the devil is in the details [1:47:04] and I think I would want to look into this myself [1:47:06] But as surgeon general [1:47:08] it would be your responsibility to [1:47:10] act legally and ethically [1:47:12] so you might oversee [1:47:14] comprehensive scientific reports [1:47:16] and oversee the commission [1:47:18] the commissioned core [1:47:20] who will conduct research [1:47:22] and care for patients throughout the world [1:47:24] Would you advise against a study [1:47:26] or refuse to conduct a study [1:47:28] with serious ethical implications [1:47:30] even if the secretary [1:47:32] or the administration [1:47:34] pressured you to? [1:47:37] Certainly as a physician [1:47:39] as a person, as a mother [1:47:41] ethical concerns are a top priority to me [1:47:43] protecting patients, protecting children [1:47:45] I [1:47:47] am a strong-willed person [1:47:49] who has no problem having direct conversations with anyone [1:47:51] and I would not hesitate to have [1:47:53] direct private conversations with anyone [1:47:55] about ethical concerns [1:47:57] and also I do not believe that the secretary [1:47:59] or anyone in the administration would ask me [1:48:01] to do something unethical [1:48:03] We will follow up with you on that particular study [1:48:05] I thank you so much for your indulgence [1:48:07] Mr. Chairman [1:48:09] and this is a vital kind of question [1:48:11] for the foundation of this position [1:48:13] So thank you and I yield back [1:48:19] Thank you Mr. Chairman [1:48:21] Dr. Means, the surgeon general is [1:48:23] first and foremost the chief spokesperson [1:48:25] for American's health [1:48:28] Wouldn't you agree? [1:48:30] You would be the first Maha surgeon general [1:48:32] What is the public not hearing [1:48:34] that you are uniquely qualified [1:48:36] to communicate to them? [1:48:38] Well first I would say that I think that [1:48:41] for anyone [1:48:43] who has not read [1:48:45] the Maha strategy that came out at the end of last year [1:48:47] it's a document that everyone should read [1:48:49] because it outlines [1:48:51] an unbelievably [1:48:54] positive, comprehensive [1:48:56] forward thinking way [1:48:58] of addressing the root cause of why we're sick [1:49:00] It's a profound document [1:49:02] I think it's groundbreaking [1:49:04] and many of the pieces [1:49:06] from that strategy document [1:49:08] are already way out of the barn [1:49:11] and wins are happening already [1:49:13] that are going to make healthcare [1:49:15] and food more affordable [1:49:17] and accessible for [1:49:19] all Americans [1:49:21] and so I'm [1:49:23] just very supportive of the work [1:49:25] that's being done [1:49:27] and I do think it's a huge [1:49:29] sea-chain shift from what we've heard [1:49:31] from prior administrations in my lifetime [1:49:33] or at least since I became [1:49:35] interested in the biomedical sciences [1:49:37] when I was 20 years ago [1:49:39] I have not heard [1:49:41] at the federal level [1:49:43] this sort of just [1:49:45] impassioned, brave [1:49:48] approach to talking about [1:49:50] busting through [1:49:52] industry [1:49:54] potentially conflicts [1:49:57] conflicts in our research [1:49:59] the corporate capture of our agencies [1:50:01] and our health [1:50:03] organizations and just saying [1:50:05] we're not going to stand for this anymore [1:50:07] we're going to put American health first [1:50:09] and not just in a reactive way but in a proactive way [1:50:11] and just say that [1:50:13] I think we're going to see monumental progress [1:50:15] over the next several years [1:50:17] and my deep hope is to be a unifying [1:50:19] practical messenger that [1:50:21] brings people together around issues [1:50:23] that I think every family cares about [1:50:25] there's not a person in this room who doesn't have a family member [1:50:27] or a friend or know a child [1:50:29] who's dealing with a chronic health issue [1:50:31] and we know that [1:50:33] our environment is contributing to these [1:50:35] and we need to make it systemically [1:50:37] and structurally easier for people to be healthy in this country [1:50:39] and that's what the Maha... [1:50:41] strategy [1:50:43] as articulated by President Trump and Secretary Kennedy [1:50:45] these aren't [1:50:47] these aren't partisan [1:50:49] themes or strategies [1:50:51] these are ideas that are [1:50:53] broadly supported by the vast majority of Americans [1:50:55] right? yes [1:50:58] you've raised awareness about [1:51:00] metabolic syndrome [1:51:02] how diabetes, stroke [1:51:04] heart disease and their risk [1:51:06] factors interact [1:51:08] what do people need to know about metabolic syndrome [1:51:10] and why isn't our healthcare system [1:51:12] preventing these diseases [1:51:14] thank you for that question [1:51:16] this is one of my favorite topics in the world [1:51:18] metabolic dysfunction and metabolic syndrome [1:51:20] is referring to [1:51:22] not to get too technical here [1:51:24] but fundamentally it's the way our cells [1:51:26] make energy and power themselves [1:51:28] we have trillions and trillions of cells in our body [1:51:30] they all need energy [1:51:32] to work properly [1:51:34] without that we'd fall apart [1:51:36] unfortunately [1:51:38] the vast majority of American adults now [1:51:40] have metabolic dysfunction [1:51:42] 93% of Americans [1:51:44] adults have at least one [1:51:46] biomarker of metabolic dysfunction [1:51:48] meaning there's this fundamental [1:51:50] whole body [1:51:52] cellular energy production problem [1:51:54] that we know is [1:51:56] deeply related to our diet and our lifestyles [1:51:58] that then underlies [1:52:00] diseases emerging all over the body [1:52:02] things like dementia, cancer [1:52:04] chronic liver disease [1:52:06] diabetes [1:52:08] obesity, heart failure [1:52:10] heart disease, stroke, etc [1:52:12] and so this is the systems [1:52:14] biology approach that I'm talking about [1:52:16] that our healthcare system is not currently [1:52:18] incentivized to look at the body as a whole system [1:52:20] we have over 100 medical and surgical [1:52:22] subspecialties and they are incentivized [1:52:24] to look at one small part of their body [1:52:26] we need to bust that open [1:52:28] look at the body as a system [1:52:30] take the latest research on this [1:52:32] unified sort of approach [1:52:34] to health and then start to [1:52:36] transform clinical practice into that way [1:52:38] if we do that [1:52:40] we can help people earlier understand [1:52:42] what's going on in their body [1:52:44] and hopefully prevent some of these [1:52:46] catastrophic diseases [1:52:48] as people get older [1:52:50] there's nothing partisan about that right? [1:52:52] no [1:52:54] something else I don't think is partisan [1:52:56] you've been outspoken about the infertility crisis in America [1:52:58] more and more couples have trouble conceiving [1:53:00] and so many women struggle to have [1:53:02] healthy pregnancies [1:53:04] why is that? [1:53:06] infertility is going up in our country [1:53:08] male and female infertility [1:53:10] it's going up about 1% per year [1:53:12] 1% of women globally have [1:53:14] a type of condition [1:53:16] that can lead to infertility called polycytic ovarian syndrome [1:53:18] this is a disease I'm very passionate about [1:53:20] because it actually goes hand in hand with [1:53:22] metabolic dysfunction [1:53:24] there's certainly genetic aspects to it [1:53:26] but many lifestyle features as well [1:53:28] right now the current [1:53:30] standard of care for PCOS [1:53:32] is to prescribe medications [1:53:34] for the metabolic dysfunction [1:53:36] and for the hormonal imbalances [1:53:38] but what the research has actually showed us [1:53:40] good research is that [1:53:42] very targeted interventions on our diet [1:53:44] for instance [1:53:46] there's a particular study I'm thinking of [1:53:48] that did a ketogenic Mediterranean diet [1:53:50] in about 16 weeks [1:53:52] nearly all participants in the study [1:53:54] reversed their PCOS markers [1:53:56] just with a dietary intervention [1:53:58] that's one study [1:54:00] I'm not saying that should be the gold standard [1:54:02] however this is not information we're hearing [1:54:04] it's not information we're giving to women in OBGYN's office [1:54:06] and I think that's really [1:54:08] something we need to change [1:54:10] we need to give people empowering information about how to take their health [1:54:12] thank you my time has expired [1:54:15] for the record [1:54:17] I'm just being a little heavy because we're running out of time [1:54:19] and for the record [1:54:21] what Rochester is bringing up was a CDC study [1:54:23] by press reports [1:54:25] which bypassed the career scientists [1:54:27] but was pushed by the director's office [1:54:29] it was later suspended because [1:54:31] Guinea-Bissau said it was unethical [1:54:33] at which point the Trump administration pulled it back [1:54:35] so just for the record [1:54:37] and next will be Senator Kaine [1:54:40] thank you Mr. Chair [1:54:43] in a news report on January 7 [1:54:45] just a month or so ago [1:54:47] Secretary Kennedy stated [1:54:49] quote there is no evidence [1:54:51] no evidence [1:54:54] that the flu vaccine prevents serious disease [1:54:56] or that it prevents [1:54:58] hospitalization or deaths in children [1:55:00] do you agree with that statement [1:55:02] Senator Kaine [1:55:06] as I've said [1:55:08] I believe vaccines save lives [1:55:10] and are an important part of our [1:55:12] I'm not asking about the general [1:55:14] I heard that testimony earlier [1:55:17] but the statement is there is no evidence [1:55:19] that the flu vaccine [1:55:21] and I want to be scrupulous about this [1:55:23] prevents serious disease [1:55:25] or that it prevents hospitalization [1:55:27] or death in children [1:55:30] you're an MD [1:55:32] your qualifications have been much discussed earlier [1:55:34] do you agree with the statement [1:55:36] that there's no evidence [1:55:38] that the flu vaccine prevents serious disease [1:55:40] or that it prevents hospitalizations [1:55:42] or death in children [1:55:44] I have not personally seen that quote [1:55:46] or that article [1:55:48] I would want to review it before I comment on that [1:55:50] I would like to introduce for the record [1:55:52] an article CBS News [1:55:54] RFK Junior says it may be better [1:55:56] if fewer children receive the flu vaccine [1:55:58] dated January 7, 2026 [1:56:00] without objection [1:56:02] let me set aside the quote [1:56:04] and set aside Secretary Kennedy [1:56:07] and set aside the article [1:56:09] do you believe that there is evidence [1:56:11] that the flu vaccine prevents serious disease [1:56:13] and prevents hospitalization [1:56:17] or deaths in children [1:56:19] I believe that all patients [1:56:21] should talk to their doctors [1:56:23] that's not what I'm asking you [1:56:25] your qualifications have been much discussed [1:56:27] there is a mountain [1:56:29] of evidence about this [1:56:31] do you believe [1:56:33] that there's no evidence [1:56:35] that the flu vaccine has efficacy [1:56:37] in reducing serious injury or hospitalization [1:56:39] I [1:56:45] this is an easy one doctor [1:56:48] this is an easy one [1:56:50] I support the CDC's guidance on the flu vaccine [1:56:52] and I will always be working with the CDC [1:56:54] ACIP and the agency [1:56:56] so you believe it is an efficacy [1:56:59] to reduce hospitalization [1:57:01] is or is not [1:57:03] you believe it is [1:57:05] as I said I support the CDC's guidance [1:57:07] let me just say [1:57:09] do you think the flu vaccine reduces the risk [1:57:11] of hospitalization or serious injury [1:57:14] I've said it [1:57:16] I believe vaccines save lives [1:57:18] the flu vaccine [1:57:20] the flu vaccine [1:57:22] does it reduce the risk of injury or hospitalization [1:57:24] at the population level [1:57:26] I certainly think that it does [1:57:28] let me introduce for the record if I can [1:57:30] your chair [1:57:32] CDC seasonal flu vaccine effectiveness studies [1:57:34] dated May 30, 2025 [1:57:36] from the CDC that goes into this in some detail [1:57:38] without objection [1:57:41] this is not a hard question [1:57:43] I answered your question [1:57:45] I know it [1:57:47] three minutes in [1:57:49] you answered a question [1:57:51] that has a very simple yes [1:57:53] or it had a very simple no [1:57:55] to the proposition stated by the secretary [1:57:57] that there is no evidence [1:57:59] the secretary said there is no evidence [1:58:01] that this is effective [1:58:03] and yes after three minutes you [1:58:05] acknowledge that at a population level [1:58:07] I haven't seen that report [1:58:09] but you know about the flu vaccine [1:58:11] if I had a nickel for every time I was misquoted [1:58:13] in the media I'd be a very wealthy woman [1:58:15] I would like to understand what his comments were [1:58:17] I'm not asking you about the quote [1:58:19] I'm asking you about something in your remit [1:58:21] the effectiveness of the flu vaccine [1:58:23] alright let me ask you this [1:58:26] do you believe it's important to continue to work [1:58:28] to reduce youth smoking [1:58:32] certainly President Trump has said it's [1:58:34] a priority to support moms [1:58:36] including supporting families that may need IVF [1:58:38] do you support that position [1:58:40] I know the administration is strongly in favor of IVF [1:58:42] and I think people should have access [1:58:44] to the best quality fertility treatments [1:58:46] and also my core message has been [1:58:48] about how we are missing [1:58:50] the mark on our fertility conversation [1:58:52] I just was asking about IVF [1:58:54] and finally the secretary and the president [1:58:56] talked about radical transparency in healthcare [1:58:58] do you believe in that [1:59:01] ok then I'm very puzzled [1:59:03] not by you but I'm puzzled about why the [1:59:05] administration eliminated the CDC office [1:59:07] on smoking and health [1:59:09] it was the only federal entity [1:59:11] running the campaign to reduce [1:59:13] to promote smoking cessation [1:59:15] they eliminated it [1:59:17] they've eliminated whole programs at the CDC [1:59:19] working on maternal health [1:59:21] including the center tasked with [1:59:23] publishing data on the effectiveness of IVF clinics [1:59:25] they've eliminated the CDC's [1:59:27] Freedom of Information Act office [1:59:29] they've repealed the Richardson waiver [1:59:31] thus reducing public participation [1:59:33] in the creation of HHS rules [1:59:35] I'm glad that you support smoking cessation [1:59:37] I'm glad you support [1:59:39] work on IVF [1:59:41] I'm glad you support radical transparency [1:59:43] I'm puzzled by why the administration doesn't yield back [1:59:45] Senator Hawley [1:59:48] Thank you very much Mr. Chairman [1:59:51] Dr. Means good to see you [1:59:53] congratulations on your nomination [1:59:55] congratulations also on the birth of your child [1:59:57] I'm the father of three if you're like me [1:59:59] I suspect you've had a tremendous career already [2:00:01] but I suspect maybe that your family [2:00:03] will end up being [2:00:05] the most significant thing you do [2:00:07] I was just thinking [2:00:09] I have three as I said [2:00:11] my youngest is now five Abigail [2:00:13] I left the house the other day [2:00:15] she had our Labrador [2:00:17] not a very well behaved dog I will say [2:00:19] she had our Labrador there in the kitchen [2:00:21] had his paw stretched out and was painting his toenails pink [2:00:23] so anyway you've got that to look forward to [2:00:25] congratulations again [2:00:27] can I just ask you [2:00:29] from a health perspective [2:00:31] can we think about AI just for a second [2:00:33] I want to get your views on this [2:00:35] this is sort of a cutting edge issue obviously that's evolving [2:00:37] by the day [2:00:39] data centers [2:00:41] we've got more data centers in this country I think [2:00:43] than almost anywhere else they're proliferating [2:00:45] they're needed we're told for AI development [2:00:47] and so on [2:00:49] my question to you is about the health effect of data centers [2:00:51] here's what I'm asking [2:00:53] when I am home in Missouri I get asked a lot now [2:00:56] by folks all across the state [2:00:58] maybe especially in rural areas like where I grew up [2:01:00] where there are more and more data centers [2:01:02] they say we're worried about the health effects [2:01:04] we're worried about contaminants in our water [2:01:06] we're worried about [2:01:08] a digital cancer alley [2:01:10] we've had some reports [2:01:12] of migraines [2:01:14] vertigo, nausea [2:01:16] chronic sleep disruption from residents [2:01:18] not necessarily people who work at a data center [2:01:20] but just residents in the area [2:01:22] now all of this is anecdotal [2:01:24] I haven't seen any studies on it but that's getting to my question to you [2:01:26] is this something that we should be looking into [2:01:28] should we be looking at [2:01:30] the health effects [2:01:32] the wellness effects of data centers [2:01:34] I'm talking about these massive [2:01:36] massive centers [2:01:38] where residents are around [2:01:40] that live around the area [2:01:42] what do you think about this [2:01:45] first of all thank you so much for your question [2:01:47] your kind words about family [2:01:49] it's an interesting question [2:01:51] and it's one that I'm so glad you're sharing [2:01:53] it's not one that I've actually thought much about [2:01:55] in this specific context [2:01:58] but [2:02:00] a core and passion of mine [2:02:02] and what I hope to bring to the role [2:02:04] is really advocating for understanding [2:02:06] how our environmental exposures [2:02:08] are affecting our health [2:02:10] the whole person health initiative [2:02:12] and [2:02:14] through Dr. Jay Bhattacharya's work [2:02:16] to look at how these cumulative environmental exposures [2:02:18] are affecting our health [2:02:20] and that's something that I hope to champion in this role [2:02:22] and so this would certainly fit squarely [2:02:24] within that category [2:02:26] and I'd love to chat with you more about this [2:02:28] if I'm confirmed [2:02:30] good I look forward to that [2:02:32] I'm glad to hear you say that [2:02:34] you have been just an incredible champion [2:02:36] for looking at these environmental factors [2:02:38] as well as diet and the other things that you've been talking about [2:02:40] you're a scientist [2:02:42] and this is all [2:02:44] what I'm hearing is anecdotal [2:02:46] I think what I read in the press is anecdotal [2:02:48] but maybe we do need a study on it [2:02:50] there's a significant [2:02:52] a sufficient number of these centers [2:02:54] and they're not going to be fewer [2:02:56] there's going to be a lot more everywhere [2:02:58] and the level of concern I hear [2:03:00] from working people [2:03:02] these are just normal people [2:03:04] they're showing up to work [2:03:06] they're trying to raise their families [2:03:08] and they're concerned for their health [2:03:10] tell them because I'm not a physician [2:03:12] I'm not a scientist [2:03:14] but I do think maybe the time has come to say [2:03:16] we're going to take this seriously [2:03:18] I mean we'll look at it [2:03:20] and we'll figure out what the truth is [2:03:22] and we'll figure out if the things that we need to do [2:03:24] to protect the health of our folks [2:03:26] so I'm glad to hear you say that you would make that a priority [2:03:28] and I look forward to working with you on that [2:03:30] can I introduce you here in just the few [2:03:32] seconds that I have remaining [2:03:34] 90 seconds or so to a young man [2:03:36] whose name was Adam Rain [2:03:38] I think we may have a poster of him behind me [2:03:40] he was 16 years old [2:03:42] when he was groomed [2:03:44] by an AI chat bot [2:03:46] into committing suicide [2:03:49] I think do we have [2:03:51] yeah there he is [2:03:53] Adam was just an incredible kid [2:03:55] I've gotten to know his parents [2:03:57] he was a rock star athlete [2:03:59] he was a terrific student [2:04:01] and he started using an AI chat bot [2:04:03] chat GPT in this case [2:04:05] it's all a matter of public record [2:04:07] he started using a chat bot to do homework [2:04:09] and over time this chat bot introduced him [2:04:11] he committed suicide multiple times [2:04:13] the chat bot told him every time [2:04:15] don't tell your parents he didn't [2:04:17] he was very close to his parents before this I should say [2:04:19] I've met them they're wonderful people they've testified [2:04:21] eventually the chat bot instructed him [2:04:23] how to take his own life [2:04:25] and he did it using precisely the method [2:04:27] that the chat bot recommended [2:04:29] now I'm sad to say I've talked with [2:04:31] too many parents [2:04:33] whose stories parallel that one [2:04:36] my question to you is [2:04:38] is it time to study the effect of AI chat bot [2:04:40] companions for minor children [2:04:42] he's not even a college student yet [2:04:44] he's a kid bright kid great kid [2:04:46] but still a kid [2:04:48] is it time to study the effects [2:04:51] when it comes to mental health and wellness [2:04:53] on these AI chat bot companions for minors [2:04:55] and please be quick with your answer [2:04:57] because we're running late [2:04:59] well it's obviously a complex question [2:05:01] and a tragic story that you're sharing [2:05:03] and especially hits so hard [2:05:05] as a new mother [2:05:07] I think that you and I are in complete alignment [2:05:09] that children's health [2:05:11] and protecting minors [2:05:13] is of paramount importance [2:05:15] I think a country that doesn't protect its children [2:05:17] you know has gone off course [2:05:19] and it's a top priority of mine [2:05:21] to do everything that we can [2:05:23] to make sure children are healthy and safe [2:05:25] good I look forward to working with you on this [2:05:27] thank you Mr. Chairman [2:05:30] Senator also Brooks [2:05:32] thank you so much Chair Cassidy [2:05:34] for hosting today's hearing [2:05:36] Dr. Means welcome [2:05:38] thank you so much for being at this hearing [2:05:40] and congratulations again on your beautiful beautiful baby [2:05:42] I want to first begin by the places where we agree [2:05:44] you agree that industry [2:05:46] should not have undue influence [2:05:48] over our health policies [2:05:50] in fact you have written [2:05:52] that when pharmaceutical companies [2:05:54] have a direct line to network television [2:05:56] through advertising [2:05:58] and I quote you say [2:06:00] they can have influence over what messages [2:06:02] are emphasized on the news [2:06:04] and what is deemed misinformation or truth [2:06:06] now can you confirm that those are your words [2:06:08] that sounds like something I would say [2:06:10] I'm sorry [2:06:12] that sounds like something I would say [2:06:14] you have been compensated [2:06:16] have you ever been compensated for [2:06:18] platforming spotlighting or highlighting companies [2:06:20] in your newsletters or podcast appearances [2:06:22] yes [2:06:24] okay so for example [2:06:26] not podcast but in my newsletter [2:06:28] I've had newsletter sponsors for my newsletter yes [2:06:30] okay for example energy bits [2:06:32] have you received compensation from a company [2:06:34] called energy bits [2:06:36] yes okay and in your newsletter [2:06:38] the very same one where you rail out against [2:06:40] pharmaceutical advertising [2:06:42] you acknowledge that energy bits sponsored your newsletters [2:06:44] and I wonder were you aware [2:06:46] that the better business bureau found [2:06:48] that that company energy bits failed to [2:06:50] provide substantiation for health related [2:06:52] and environmental claims and [2:06:54] recommended that it discontinued doing so [2:06:56] Senator also Brooks [2:06:58] I take conflicts very seriously [2:07:00] I've worked diligently [2:07:02] with the office of government ethics [2:07:04] to make sure we've looked at all [2:07:06] potential conflicts of interest [2:07:08] have signed a letter had been cleared [2:07:10] and have signed a letter stating [2:07:12] my commitment to divestments [2:07:14] and of course during my time [2:07:16] if I am confirmed in office I would take [2:07:18] no money from any company [2:07:20] let me just ask you to add a little bit more here [2:07:22] I know the time is tolling [2:07:24] were you aware that this same company was served notice [2:07:26] under California's proposition 65 [2:07:28] law alleging that their products [2:07:30] contain lead above the allowable [2:07:32] levels were you aware of that [2:07:35] again I just want to reiterate [2:07:37] in this office I will not be taking [2:07:39] any financial compensation from any companies [2:07:41] I will be complying with the office of government [2:07:43] ethics thoroughly before during and after [2:07:45] my time in office and I'm very committed to that [2:07:47] okay let me ask you about another company [2:07:49] have you ever received compensation from a company [2:07:51] called peak yes [2:07:53] okay and in your newsletter number 33 [2:07:55] you acknowledge that peak has sponsored you [2:07:57] now were you aware that this company [2:07:59] was served notice under California's [2:08:01] proposition 65 for containing [2:08:03] and failing to disclose that lead [2:08:05] above the allowable amounts of carcinogen [2:08:07] and reproductive toxin was present [2:08:09] I just want to repeat [2:08:13] I've worked with the office of government ethics [2:08:15] I am not going to be taking any financial compensation [2:08:17] already so this is an ethics [2:08:19] we're talking about conflicts and [2:08:21] I have been cleared by the office of government ethics [2:08:23] through an exhaustive process [2:08:25] I have signed a letter that I will be fully compliant [2:08:27] and this is before [2:08:29] during and after the term I take it very seriously [2:08:31] and I'll work closely with them to make sure there are no conflicts [2:08:33] the point here is that you've [2:08:35] received compensation from these companies [2:08:37] including daily harvest [2:08:39] where this company was subject [2:08:41] to an investigation by the [2:08:43] food and drug administration after hundreds [2:08:45] became seriously ill [2:08:47] after consuming the product [2:08:49] and these are companies that you have received [2:08:51] money from they've been investigated [2:08:53] and you are railing [2:08:55] out against pharmaceutical companies [2:08:57] that you say are [2:08:59] advertising these products that [2:09:01] mislead the public and yet [2:09:03] you've received compensation from companies [2:09:05] and you've [2:09:07] promoted them in your newsletter [2:09:09] and you're doing the same thing the pharmaceutical companies [2:09:11] are doing by [2:09:13] advertising and influencing people [2:09:15] for these products [2:09:17] that have been deemed to be unsafe [2:09:19] for the public now let me just [2:09:23] move on as well to vaccinations [2:09:25] I want to just [2:09:27] you tweeted that [2:09:29] you believe the hepatitis B vaccine [2:09:31] at birth is a crime [2:09:33] that is what you tweeted do you recall tweeting that [2:09:35] that is not the full tweet [2:09:39] I actually do have the tweet I can [2:09:41] provide it for you [2:09:43] I have a copy of it here [2:09:45] where you say that [2:09:47] vaccinating that you believe [2:09:49] the hepatitis B vaccine is a [2:09:51] crime and I wonder if you [2:09:53] believe that how is it that vaccinating [2:09:55] children against hepatitis [2:09:57] could be a crime I support [2:10:00] vaccines I believe vaccines save lives [2:10:02] I believe they are a key part of [2:10:04] our public health strategy [2:10:06] I also believe that this administration [2:10:08] is committing to making sure we have the [2:10:10] safest vaccine schedule in the [2:10:12] world and that we are [2:10:14] continually studying the vaccine schedule [2:10:16] vaccine injuries making sure we're eradicating [2:10:18] conflicts of interest in vaccine research [2:10:20] and doing gold standard science on [2:10:22] vaccines these are all things that I [2:10:24] support [2:10:26] and I think there's a nuanced conversation [2:10:29] that American families are looking to have [2:10:31] about shared clinical decision making with their [2:10:33] doctors about specific vaccines [2:10:35] that their children may not be [2:10:37] as seriously at risk for [2:10:39] and I think that [2:10:41] that is the nature and the thrust of my comments [2:10:43] let me just follow I know my time [2:10:45] has expired you have spoke [2:10:47] on this panel about neurotoxin [2:10:49] metals and vaccinations yet [2:10:51] you have promoted [2:10:53] it through a brief research [2:10:57] okay just this last sentence here you [2:10:59] you through a brief search of the products that you've [2:11:01] made money off of in your newsletters many [2:11:03] of them have been found to contain the same [2:11:05] neurotoxins that you claim are in these [2:11:07] vaccinations I yield thank you thank you [2:11:11] Mr. Chairman Dr. Means welcome [2:11:13] to the committee here I'm going to stick [2:11:15] with vaccines here because [2:11:17] I am [2:11:19] on I'm red [2:11:21] is it better better better better yeah [2:11:23] just too far away sorry about [2:11:25] that sticking with vaccines [2:11:27] you have stated that there is quote growing evidence [2:11:29] that the total burden of the current [2:11:31] extreme and growing vaccine schedule [2:11:33] is causing health declines [2:11:35] in vulnerable children and [2:11:37] so I've heard your [2:11:39] comments to several of my colleagues here [2:11:41] today so I want to drill down more [2:11:43] specifically to the hepatitis [2:11:45] B vaccine [2:11:47] my state of Alaska has had a very [2:11:49] long history with this [2:11:51] including early [2:11:53] childhood immunization campaigns [2:11:55] that were targeted specifically [2:11:57] to Alaska native [2:11:59] communities we were seeing [2:12:01] some just really startling [2:12:03] issues with regards to [2:12:05] liver disease in [2:12:07] native children and so it [2:12:09] was a pilot project decades ago [2:12:11] that allowed for [2:12:15] critical timely vaccinations [2:12:17] for these native children in the [2:12:19] outlying areas [2:12:22] it made a [2:12:24] remarkable difference in Alaska [2:12:26] and I think other [2:12:28] other states [2:12:30] other other [2:12:32] countries look to that [2:12:34] as an example [2:12:36] we you have [2:12:39] expressed the skepticism [2:12:41] about the hep B vaccine [2:12:43] for for newborns [2:12:45] and I [2:12:47] need to try to understand [2:12:49] your thinking on that [2:12:51] given the medical consensus [2:12:53] that this vaccine prevents [2:12:55] this serious liver disease [2:12:57] and liver cancer that [2:12:59] we again were able to demonstrate [2:13:01] in real time [2:13:03] real life [2:13:05] with that recommendation [2:13:07] and now [2:13:09] the [2:13:11] view that you seem to be taking [2:13:13] on this is [2:13:15] it is not necessary [2:13:17] for newborns [2:13:20] thank you Senator Murkowski [2:13:23] for being willing to want to clarify this [2:13:25] with me and also thank you for meeting with me [2:13:27] I really enjoyed our conversation in October [2:13:29] with you and your staff [2:13:31] I think these [2:13:35] the concerns and comments that you're sharing [2:13:37] I think they're incompletely [2:13:39] representing my views [2:13:41] and so I'll take the opportunity to share [2:13:43] this is an effective vaccine [2:13:45] I think it's a very important vaccine [2:13:47] obviously Senator Cassidy knows better than anyone [2:13:49] given his work [2:13:51] this is a vaccine that has saved [2:13:53] thousands millions of lives [2:13:55] I don't know the exact number [2:13:58] but I do think that [2:14:00] this administration is committed to [2:14:02] making sure we have the safest vaccine schedule [2:14:04] and that parents have the opportunity [2:14:06] to have shared clinical decision making [2:14:08] on specific vaccines with their doctor [2:14:10] so they can make the best decisions for their family [2:14:12] this is not a condemnation of the vaccine generally [2:14:14] which I am very supportive of [2:14:16] however I do believe that [2:14:18] the thrust towards parents wanting to have [2:14:20] the ability to have [2:14:22] shared clinical decision making with their doctor [2:14:24] is important [2:14:26] when there are [2:14:28] conditions like hepatitis B [2:14:30] where there's differential risk amongst different populations [2:14:32] so you have [2:14:35] to be very careful [2:14:37] about that [2:14:39] and I think that [2:14:41] the reason that [2:14:43] we said that the hepatitis B vaccine [2:14:45] is [2:14:47] you stated this [2:14:49] in response to a question on a TV show [2:14:51] is for a sexually transmitted disease [2:14:53] and an IV drug user disease [2:14:55] which of course babies are not going to be exposed to [2:14:57] and one of the things that we have [2:14:59] certainly seen [2:15:01] with hepatitis B [2:15:03] recognizing that it's this blood borne pathogen [2:15:05] of sexual contact [2:15:07] or drug use [2:15:09] in western Alaska where we see [2:15:11] hepatitis B as endemic [2:15:13] we find that it's being spread through mosquito bites [2:15:15] where a child is itching it [2:15:17] itching an arm [2:15:19] ordinary household community contact [2:15:21] whether it's sharing food [2:15:23] toothbrushes [2:15:25] and minor injuries [2:15:27] and so this is where [2:15:29] many in my state are looking at this [2:15:31] and saying [2:15:33] we have been able to turn the corner on this [2:15:35] and we're no longer seeing children [2:15:37] with liver cancer [2:15:39] with this liver disease [2:15:41] and it is because [2:15:43] the hepatitis B vaccine [2:15:45] has been made available [2:15:47] to them [2:15:49] with their doctor [2:15:51] but if you're an Alaska native population [2:15:53] that has been [2:15:55] systematically [2:15:57] impacted [2:15:59] in a way that we've now seen a marked difference [2:16:01] it seems to me that's where you should be directing it [2:16:03] I'm well out of time sir [2:16:06] thank you [2:16:12] Senator Hickenlooper [2:16:14] Ms. Means congratulations on your birth [2:16:17] as I know from [2:16:19] two experiences that is about the most [2:16:21] magical time you can ever have [2:16:24] we know that many Americans [2:16:26] struggle with the issues around [2:16:28] infertility [2:16:30] medical intervention often is necessary [2:16:32] according to the American [2:16:34] College of Obstetrics and Gynecology [2:16:36] by the age of 30 [2:16:38] fertility in women starts to decline [2:16:40] it gets more rapid [2:16:42] the rate of decline gets more rapid [2:16:44] throughout the decade [2:16:47] for families like mine [2:16:50] where a childbirth [2:16:53] would have been impossible without IVF [2:16:55] I think it's [2:16:57] potentially damaging [2:16:59] to widely spread a message that [2:17:01] if only we made lifestyle changes [2:17:03] we too could conceive naturally [2:17:05] I think that people that are struggling [2:17:08] with [2:17:10] infertility [2:17:12] sometimes feel that if they only made lifestyle changes [2:17:14] the world would open up [2:17:16] and I guess [2:17:18] my question then is [2:17:20] how much time should a woman of childbearing age [2:17:22] take to [2:17:24] self-reverse [2:17:26] a fertility struggle [2:17:29] that may ultimately serve as further setback [2:17:31] to them growing their family [2:17:33] and I again say this as [2:17:35] someone who [2:17:37] we did use IVF [2:17:39] as you're aware [2:17:41] and it was a [2:17:43] transformational [2:17:45] it wouldn't have been possible without that [2:17:47] so how long [2:17:49] should people wait [2:17:51] before making that decision [2:17:54] Thank you Senator [2:17:56] for this very thoughtful question and also for meeting with me [2:17:58] in October [2:18:00] I of course can't answer [2:18:02] for a specific [2:18:04] time period that someone should wait [2:18:07] but the broader message [2:18:09] which is I think one that we probably agree on [2:18:11] is that the American people [2:18:13] deserve to and I think [2:18:15] want to have information from medical authorities [2:18:17] about what is possible [2:18:19] and what the evidence shows [2:18:21] in terms of [2:18:23] what environmental factors [2:18:26] are affecting these really important issues in our life [2:18:28] like fertility [2:18:30] like we've talked about earlier [2:18:32] infertility is going up about 1% a year [2:18:34] in both men and women [2:18:36] male and female infertility [2:18:38] and the key medical conditions [2:18:40] that are causing infertility [2:18:42] we know are lifestyle related [2:18:44] certainly that does not mean [2:18:46] that all infertility cases can be reversed by lifestyle changes [2:18:48] and also it is [2:18:50] the onus is on our medical authorities [2:18:52] to make sure Americans are seeing that information [2:18:54] clearly and loudly [2:18:56] and in an empowered way [2:18:58] and that we then use policy [2:19:00] and medical education [2:19:02] to make systemic changes [2:19:04] that make those choices easier [2:19:06] more accessible and affordable for Americans [2:19:08] and that's really my message [2:19:10] patients deserve to know what the data is showing [2:19:12] and not just a myopic view [2:19:14] on technological [2:19:16] or medical or surgical interventions [2:19:18] they deserve to know the breadth of the spectrum [2:19:20] and you know from working with [2:19:22] thousands and thousands of [2:19:24] both levels members [2:19:26] and also in my clinical practice [2:19:28] I believe that people [2:19:30] don't feel discouraged by understanding [2:19:32] what the evidence based levers are [2:19:34] for how they can impact their own health [2:19:36] I think they're looking for that right now [2:19:38] and it's a yes and answer [2:19:40] I think IVF is miraculous [2:19:42] I think it should be widely accessible [2:19:44] and with that said [2:19:46] I also think we need to give patients [2:19:48] the best public health information about [2:19:50] these conditions [2:19:52] that are plaguing our population [2:19:54] Let me switch tack here [2:19:58] and talk a little bit about autism [2:20:00] because obviously [2:20:02] I don't think we definitively know [2:20:04] what causes autism [2:20:06] I think we agree on that [2:20:08] certainly I applaud any [2:20:10] fact based effort [2:20:12] to get a better understanding [2:20:14] of that diagnosis [2:20:16] you stated that the cause of autism [2:20:18] is very likely to be multifactorial [2:20:20] and anyone who [2:20:22] claims to believe [2:20:24] that it can be just only one factor [2:20:26] is mistaken [2:20:29] so I guess the question is [2:20:31] are those who believe autism is singularly [2:20:33] caused by vaccines [2:20:35] including some of those currently serving [2:20:37] at the Department of Health and Human Services [2:20:39] by that calculus are they incorrect? [2:20:41] You know I can't speak for [2:20:46] every person who's made a comment about [2:20:48] autism and vaccines [2:20:50] I know that people are [2:20:52] in pain looking at [2:20:55] the childhood chronic disease epidemic [2:20:57] and the rising rate of childhood [2:20:59] neurodevelopmental diseases [2:21:01] and they're looking for answers [2:21:03] and I think that [2:21:05] I certainly can't speak for anyone [2:21:07] who's spoken out about vaccines and autism [2:21:09] however I would assume that [2:21:11] most people understand that [2:21:13] health is [2:21:15] there's multifarious things that impact [2:21:17] every medical condition [2:21:19] and are trying to understand [2:21:21] if there's a contribution from [2:21:23] a significant number of medications [2:21:25] that our children are getting to this disease [2:21:27] and that's why I think [2:21:29] that the research that the administration [2:21:31] or the grants that the administration [2:21:33] has recently enacted [2:21:35] I believe for about 50 million dollars [2:21:37] to study root causes [2:21:39] of autism and specifically environmental [2:21:41] factors [2:21:43] and I think we should all look forward [2:21:45] to the results of those studies [2:21:47] and hopefully we can help children through that [2:21:49] I appreciate that and I look forward to that [2:21:51] science being the north star [2:21:53] of those investigations [2:21:55] Thank you [2:21:57] Thank you Dr. Means [2:21:59] Thank you for being here and congratulations [2:22:01] Thank you [2:22:03] You have spoken extensively [2:22:05] including earlier in this hearing [2:22:07] about the root causes of [2:22:09] chronic diseases [2:22:11] and the harmful impacts of unhealthy [2:22:13] foods and environmental toxins [2:22:15] and this is an area where [2:22:17] you and I may have some common ground [2:22:19] over a decade ago [2:22:21] I called on the EPA [2:22:23] to review the safety of pesticides [2:22:25] and their link to [2:22:27] cancer [2:22:29] so yes or no Dr. Means [2:22:31] do you agree with the scientific research [2:22:33] that glyphosate [2:22:35] one of the key ingredients [2:22:37] of the most widely used weed killer [2:22:39] Roundup is harmful to humans [2:22:41] I certainly have [2:22:45] significant concerns about [2:22:47] many of the environmental chemicals [2:22:49] that are used in our agriculture system [2:22:51] of which glyphosate is one of them [2:22:53] and I think they need to be significantly [2:22:55] more robustly studied [2:22:57] so that we can understand the cumulative impact on health [2:22:59] according to your blog post [2:23:01] of August 19, 2024 [2:23:03] and I have this here [2:23:05] you wrote [2:23:07] the World Health Organization [2:23:09] has explicitly stated [2:23:11] that glyphosate [2:23:13] damages our DNA [2:23:15] and probably causes cancer [2:23:17] so I request unanimous consent [2:23:19] to submit the blog post [2:23:21] thank you [2:23:23] you also wrote [2:23:25] that there are [2:23:27] billions of people impacted [2:23:29] by the sublethal [2:23:31] chronic impacts [2:23:33] these are toxic substances [2:23:36] you wrote [2:23:38] so I agree with your concerns [2:23:40] about glyphosate [2:23:42] we should prioritize protecting people [2:23:44] from harmful chemicals [2:23:46] not pushing them [2:23:48] yet last week [2:23:50] Donald Trump signed an executive order [2:23:53] to promote production of [2:23:55] glyphosate based herbicides [2:23:57] just a few months before [2:23:59] the Trump administration filed a brief [2:24:01] report arguing that [2:24:03] Monsanto, one of the main producers [2:24:05] of glyphosate [2:24:07] should be shielded from lawsuits [2:24:09] from Americans [2:24:11] who develop cancers from being exposed [2:24:13] to glyphosate [2:24:15] containing Roundup [2:24:17] which is a weed killer [2:24:19] instead of fighting for families with cancer [2:24:21] the Trump administration is fighting [2:24:23] against them [2:24:25] so again back to you [2:24:28] yes or no [2:24:30] we are promoting the production of glyphosate [2:24:32] which you yourself have said [2:24:34] likely causes cancer [2:24:36] will put American families health at risk [2:24:38] Senator Markey [2:24:41] you and I both know [2:24:43] that these issues around agriculture and health [2:24:46] are extremely complex [2:24:48] and are affecting farmers, consumers [2:24:50] food producers, food accessibility [2:24:52] my understanding of the executive order [2:24:54] is that the thrust of this [2:24:56] has to do with national security [2:24:58] and decreased resilience and reliance [2:25:00] on foreign countries [2:25:02] and the tools that farmers are currently using [2:25:04] right now [2:25:07] but these are things [2:25:09] these are cancer inducing [2:25:11] chemicals [2:25:13] according to your own statements [2:25:15] we must as a country move away [2:25:17] from using toxic inputs in our food supply [2:25:19] and we must [2:25:21] study these chemicals more to understand [2:25:23] their effects [2:25:25] I am very gravely concerned about [2:25:27] the health impacts of these chemicals [2:25:29] I understand that [2:25:31] doctor I'm just trying to help you to agree with yourself [2:25:33] in the past [2:25:35] but Trump is contradicting you [2:25:38] our food system is dependent currently on these chemicals [2:25:40] there is a good faith movement towards [2:25:42] moving our food system towards regenerative agriculture [2:25:44] and precision application of pesticides [2:25:46] I believe [2:25:48] in good faith that is happening [2:25:50] within this administration [2:25:52] I do also believe that we must do that [2:25:54] it's not good faith [2:25:56] he's arguing that there should be an immunization [2:25:58] of Monsanto [2:26:00] that's not good faith [2:26:02] that's just siding with [2:26:04] the chemical manufacturing company [2:26:06] that is in fact causing the cancers [2:26:08] so [2:26:10] don't you think it does put people [2:26:12] families at risk if these chemicals are in [2:26:14] the system [2:26:16] that's been your position historically [2:26:18] I think there's grave issues with these chemicals [2:26:20] I think that we are in a very complicated moment [2:26:22] for agriculture and food [2:26:24] we cannot overturn the entire agriculture system [2:26:26] overnight that would hurt farmers [2:26:28] it would hurt food prices [2:26:30] this is a national security decision [2:26:32] that's not what the Trump administration is saying [2:26:34] as a physician and as a surgeon in general [2:26:36] my focus would be on making sure [2:26:38] that we are protecting American consumers [2:26:40] and their health and making sure [2:26:42] that we are having transparent honest conversations [2:26:44] I'm disappointed to see you back away [2:26:46] from your efforts [2:26:48] I am not in any way backing away from this issue [2:26:50] it is a core passion of my life [2:26:52] Secretary Kennedy has already backed away [2:26:54] from his prior statements [2:26:56] that glyphosate is a carcinogen [2:26:58] and a quote likely culprit [2:27:00] behind chronic diseases in the United States [2:27:02] that's a total U-turn [2:27:04] on the health risk of glyphosate [2:27:06] a total U-turn by Kennedy [2:27:08] and you're in his agency [2:27:10] thank you [2:27:12] could I respond [2:27:14] the administration has put down in very clear writing [2:27:16] through the Maha strategy [2:27:18] that we are going to study [2:27:20] the chemical inputs of our food supply [2:27:22] we are going to make sure American consumers [2:27:24] are protected [2:27:26] and that we are entering an era [2:27:28] where we are going to prioritize helping farmers [2:27:30] move to more sustainable farming practices [2:27:32] I think those are all good things [2:27:34] that are extremely important [2:27:36] both for our planet and our health [2:27:38] and I'm going to be a champion on that issue [2:27:40] the Maha movement is not happy with the Trump executive order [2:27:42] that's the reality [2:27:44] thank you Mr. Chairman [2:27:47] taking the Chairman's prerogative [2:27:49] I've listened obviously to everyone [2:27:51] I have a couple follow ups [2:27:53] when you speak of shared decision making [2:27:55] as regards immunization [2:27:57] right now the doctor speaks with the mom or the dad [2:27:59] as regards should the child be vaccinated [2:28:01] there's nothing like takes the parent out of the room [2:28:03] and gives the child the shot [2:28:05] and they discuss it and they give it [2:28:07] are you speaking about something more [2:28:09] than what is currently used [2:28:11] I think Senator Cassidy [2:28:13] I think that in our current landscape [2:28:16] of our healthcare system [2:28:18] robust thorough conversations [2:28:20] about informed consent [2:28:22] so that should happen [2:28:24] so are you speaking of a formal consent form [2:28:28] no I'm speaking of generally [2:28:30] that we need to unburden our doctors [2:28:32] to make sure we are having conversations [2:28:34] that address all parent concerns [2:28:36] that don't shame parents and that honor [2:28:38] we need robust and nuanced conversations [2:28:40] about medical decisions for our children [2:28:42] but that happens [2:28:44] so you're advocating for something different [2:28:46] I think my pediatricians tell me [2:28:48] they routinely have these conversations [2:28:50] are you advocating for something different [2:28:52] than what my pediatricians say [2:28:54] they routinely have [2:28:56] if these pediatricians are doing that [2:28:58] I commend them and I think that's fantastic [2:29:00] and I think we need to support doctors [2:29:02] but are you advocating for something different [2:29:04] than current [2:29:06] than the doctor saying I think your child needs the hepatitis B vaccine [2:29:08] when the child passes through the birth canal [2:29:10] they are exposed to the same secretions [2:29:12] that they would be through intercourse [2:29:14] by the way when they're a teenager [2:29:16] they may have intercourse [2:29:18] with someone who is a chronic carrier [2:29:20] now is the perfect time [2:29:22] and it's safe [2:29:24] now would you ask for something more than that [2:29:26] or I'm not quite clear [2:29:28] because it seems as if status quo [2:29:30] is not adequate [2:29:32] and that's what I'm trying to understand [2:29:34] I support the CDC's recommendations [2:29:36] on the vaccine schedule [2:29:38] but I'm asking [2:29:40] what I'm trying to get at [2:29:42] are you asking for a formal [2:29:44] informed consent as if somebody [2:29:46] is going for bypass surgery [2:29:48] or somebody is going for an appendectomy [2:29:50] for an immunization [2:29:54] I'm not necessarily advocating for that [2:29:56] I think that you and I both know [2:29:58] from clinical practice [2:30:00] that the constraints on doctors are monumental [2:30:02] and many American parents [2:30:04] are frustrated by what they feel like [2:30:06] is lack of transparency [2:30:08] on the issue of vaccines and I think doing what we can [2:30:10] as medical leaders [2:30:12] so what would that be [2:30:14] it's encouraging a culture shift towards making sure [2:30:16] that we're respecting parent [2:30:18] questions, choices [2:30:20] I don't see that culture lacking [2:30:22] and so that's where [2:30:24] when I speak to the pediatricians [2:30:26] they emphasize that they spend a lot of time [2:30:28] discussing immunizations [2:30:31] I spoke to a physician [2:30:33] leader of a major medical organization [2:30:35] last week who in his morning clinic [2:30:37] saw 28 patients [2:30:39] I think you know exactly [2:30:41] what I'm talking about that the physicians [2:30:43] are very overburdened [2:30:45] in that case I'm sure the nurse extender [2:30:47] the physician extender would be having the conversation [2:30:49] I mean we both know that there's [2:30:51] other ways to communicate [2:30:53] and so [2:30:56] I'm not sure I know [2:30:58] what you're advocating for [2:31:00] which of course gives pause [2:31:02] broadly speaking I am very supportive [2:31:04] of what's been laid out by this administration [2:31:06] in regard to vaccines which is that [2:31:08] we want to make sure that for all of our vaccines [2:31:10] we're pursuing gold standard [2:31:12] placebo controlled trials [2:31:14] that we are robustly and transparently [2:31:16] studying vaccine injury [2:31:18] that we're making sure that conflicts of interest [2:31:20] in any of the research around vaccines [2:31:22] are addressed and understood [2:31:24] that post licensing [2:31:26] data is transparent [2:31:28] and shared with the American people [2:31:30] and that we work towards a healthcare system [2:31:32] where doctors have more time [2:31:34] and ability and incentive to spend more time with patients [2:31:36] for the sake of both the doctors and the patients [2:31:38] those are all common sense things that I agree with [2:31:40] Now the secretary suggested that the fact that [2:31:42] the American system gets five bucks more [2:31:44] for vaccinating a child [2:31:46] reflects a conflict of interest [2:31:49] that would incentivize them to vaccinate [2:31:51] a child [2:31:53] and the conflict of interest being pejorative [2:31:55] if you will [2:31:58] would that kind of outcomes measurement [2:32:00] with the aligned incentive [2:32:02] to promote immunizations [2:32:04] be considered something negative [2:32:06] Senator Cassidy I want to just back up [2:32:09] and broadly just reassure you that [2:32:11] this is not an issue that I intend to [2:32:13] complicate or [2:32:15] bring an agenda on vaccines [2:32:17] this has not been the core of my issue [2:32:19] as I said I support the initiatives [2:32:21] that the administration is putting forward [2:32:23] to hopefully restore [2:32:25] trust in public health [2:32:28] through increased transparency [2:32:30] and through placebo controlled trials [2:32:32] I'm sorry [2:32:34] and you've made that point [2:32:36] you've presented very well by the way [2:32:38] let me just compliment you [2:32:40] it's clear that your concerns about metabolic disease [2:32:42] are very important [2:32:44] do you agree with [2:32:46] the need for universal hepatitis B immunization [2:32:48] I think right now [2:32:51] any parent in America can walk into their [2:32:53] pediatrician's office and get access [2:32:55] to the hepatitis B vaccine [2:32:57] for their child if they want it [2:32:59] and my understanding is that [2:33:01] that all insurers have agreed [2:33:03] to continue with cost sharing on that vaccine [2:33:05] I accept that but as universal [2:33:07] hepatitis B immunization [2:33:09] irrespective of what age the vaccine [2:33:11] would be given [2:33:13] in your mind is that an important goal [2:33:15] it is accessible to every American family [2:33:17] that's not what I'm asking [2:33:20] is it an important goal [2:33:23] I think it is important [2:33:25] an important vaccine it's a life saving vaccine [2:33:27] I also think that parents autonomy [2:33:29] and family autonomy [2:33:31] no one is arguing that [2:33:33] universal and parent autonomy [2:33:35] but [2:33:37] broadly speaking [2:33:40] I believe that parents [2:33:43] want to have a good faith [2:33:45] conversation without shame [2:33:47] with their doctors about vaccines [2:33:49] and that we need to move toward a medical culture [2:33:51] where that's possible [2:33:53] and I genuinely believe that will help restore [2:33:55] trust in public health [2:33:57] right now that's not the current culture of medicine [2:33:59] but the question is [2:34:01] because we want to support parents [2:34:03] the question is [2:34:05] is universal hepatitis B immunization [2:34:07] an important goal [2:34:11] I feel like we're going in a semantic loop here [2:34:13] do you want to define for me [2:34:15] exactly what you mean by universal [2:34:17] should we be promoting to parents [2:34:19] that for the long term safety [2:34:21] of your child [2:34:23] she or he should be vaccinated for hepatitis B [2:34:25] at some time in their youth [2:34:27] at some time in their youth [2:34:29] at some time in their youth [2:34:31] I think that's an important recommendation [2:34:33] and is [2:34:35] okay so universal [2:34:37] is that to say that you agree [2:34:39] that universal hepatitis B immunization [2:34:41] is a goal we should be shooting for [2:34:43] I think there are many parents [2:34:45] and I think the administration [2:34:47] question whether this vaccine is necessary [2:34:49] for all children on the first day of life [2:34:51] but certainly if we're talking more broadly [2:34:53] about [2:34:55] about promoting universal vaccination [2:34:57] in children at some point in childhood [2:34:59] I think that's a worthy goal [2:35:02] okay and I'll just note that [2:35:04] among some populations [2:35:06] in Hawaii up to 10% of the folks [2:35:08] are chronically infected [2:35:10] and of course we know that one of those [2:35:12] may eventually marry someone who's not [2:35:14] so if they're not immunized [2:35:16] and they marry someone who's chronically infected [2:35:18] then you're more likely to have [2:35:21] acute infection in the person [2:35:23] who's chronically infected [2:35:25] and that's a very Hawaii specific [2:35:27] but it of course can occur anywhere [2:35:29] thank you very much for your testimony [2:35:31] thank you Senator Cassidy [2:35:34] for any senator wishing to ask additional questions [2:35:36] questions for the records will be due [2:35:38] 5 p.m. Thursday February 26 [2:35:40] thank you again for being here [2:35:42] the committee stands adjourned