Government Shutdown Ripples Through Health Care Sector

Senate Democrats are again urging Republicans to negotiate extending enhanced Obamacare premium tax credits, buoyed by sweeping gubernatorial elections in Virginia, New Jersey and a mayor’s race in New York City. Following this week's elections, Sen. Bernie Sanders (I-VT) said lawmakers’ government shutdown fight should continue unless President Donald Trump and House Speaker Mike Johnson (R-LA) commit to extending the ACA credits.
Dr. Susan J. Blumenthal has served under four US presidents, having achieved the rank of Rear Admiral (Ret.) with the US Public Health Service, is a former Assistant Surgeon General, and was the nation's first-ever Deputy Assistant Secretary for Women's Health. She currently works as a visiting professor with the MIT Media Lab. Dr. Blumenthal examines the impact of the ongoing government shutdown on the nation's millions of health-benefit recipients, and also details some of her advanced research on key issues affecting women's health -- particularly breast cancer. Dr. Blumenthal speaks with Norah Mulinda and Bailey Lipschultz on Bloomberg Businessweek Daily.

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Episode Transcript

Speaker 1 (00:02):
Bloomberg Audio Studios, Podcasts, radio News. You're listening to Bloomberg
Business Week with Carol Masser and Tim Steneveek on Bloomberg
Radio Right now.

Speaker 2 (00:14):
We wanted to dig into time now for BusinessWeek Women's
Health segment, where we focus on key issues in developing
technologies impacting both the present and future of women's health
around the world. We're joined today by doctor Susan Blumenthal.
She's a former assistant US Surgeon General and the first
ever Deputy Assistant Secretary for Women's health. Right now, she's

(00:35):
a visiting professor at the MIT Media Lab in Washington.
Doctor Bloomenthal, thank you so much for joining us today.
We wanted to talk, of course, about your work in
women's healthcare, but we also wanted to take a moment
to discuss what's going on with the US government shutdown.
What's been the impact, what have you been hearing on
the ground.

Speaker 3 (00:52):
Well, I think the impact is having a tremendous concern
for health. As the great poet Emerson and once said,
the first wealth is health, and that's the foundation of
a healthy life. You know, before the Affordable Care Act,
there were fifty million uninsured Americans. A person went bankrupt
every thirty seconds. In the United States. Thanks to the

(01:12):
Affordable Care Act, we now have the lowest rate of
uninsured people in history eight percent. However, if with the
shutdown in place, and if the tax credits for the
marketplaces are not extended, then we have twenty four million
people at risk of paying twice as much for their premiums,

(01:33):
a rise of one hundred and sixteen percent, and you know,
an estimated four million could go uninsured. That's just not
acceptable in the United States. It also has a tremendous
economic impact because ninety nine percent of businesses in America
are small businesses. That's thirty five million small businesses in America,

(01:56):
and ten million of those small businesses, you know, have
the owners and the employees rely on the Affordable Care
Act premiums, these tax credits, So that means that, you know,
this could be a huge increase in premiums for these
small businesses and could affect their economic well being. It

(02:19):
means that four hundred and fifty thousand small businesses would
become ineligible for those tax credits if they're not extended.
And that's what the shutdown is all about and why
it's so difficult, is you know, this healthcare question is
really on the table.

Speaker 1 (02:37):
Yeah, a lot of uncertainty around what the next steps
are for the shutdown, But I want to focus on
your experience. You've been at the forefront of women's health
for thirty years, serving under four US presidents. What was
a landscape like for women's health and women's health research
back when you started government?

Speaker 3 (02:55):
Well, when I started, there were no women's health reports
or conferences. Women were not in the clinical trials. So
our work was to expose those inequities in the early
nineteen nineties, and then in nineteen ninety three I was
appointed the first Deputy Assistant Secretary for Women's Health. You know,
we then built infrastructure for women's health in all of

(03:16):
the governments at NIAG, CDC, FDA, women's health offices were there.
We made sure that women and minorities were included in
the clinical trials. Today at the NIH, fifty two percent
of all clinical trial participants are women. However, NIH supported
studies are only ten percent of all clinical trials, so
we have a long way to go. And there are

(03:37):
many issues that affect women that have not been studied adequately,
like autoimmune diseases, eighty percent of autoimmune diseases occur in women.
These are diseases like diabetes type one, Chogrin's disease, lupus, scleroderma,
and so we need to focus more on those illnesses
and diseases that disproportionately affect women and women, and diseases

(03:59):
that affect women differently, like heart disease. Many people don't
know that heart disease is the number one killer of women,
but the symptoms may present differently. So we need to
train physicians to be sensitive to those differences and to
develop treatments that may be somewhat different for them.

Speaker 2 (04:17):
Well, last month, October was Breast cancer Awareness Month. Can
you talk to us a bit about your work on
this disease in particular in terms of improving early detection.

Speaker 3 (04:28):
Absolutely well, one out of eight women will develop breast
cancer in their lifetimes. It is the most common cancer
for women next to skin cancer. But you know, we
need to find it early. And momography. When I was

(04:48):
working in the nineties in this area, mimography was a
forty year old technology. Then it's now a seventy year
old technology, but forty year old technology. Three out of
four lesions I found were benign, and it missed twenty
percent of cancer. So I thought, we can see the
surface of the Mars with a Hubble telescope and see
missiles twenty thousand miles away in distance, guies, why can't
we better detect small lesions in women's breast right here

(05:11):
on Earth. So here's what I did. I called the
Director of the CIA, the head of NASA, generals at
the DoD who worked in research, and I asked them
if they had imaging technology that we could apply to
finding breast cancer early, and they said they did, and
we put our nation's top radiologists together with their top
imaging scientists, and out of that came digital momography, because

(05:34):
then mimography was an X ray, so digital mimography computer
assistant diagnosis, which was one of the very first applications
of AI artificial intelligence to health and three D medical imaging.
And so we got a peace dividend out of our
national investment in defense. And I say, what, you know,
what better you know investment could there be than to

(05:57):
save the lives of women everywhere. You know, as a
result of these improvements in early detection of breast cancer
and also better treatments, we have seen a remarkable decline
in death from breast cancer since nineteen ninety of forty
four percent. So again, with the twenty first century tools

(06:19):
like AI and new technologies that are being applied to
the fire against breast cancer, I'm very hopeful that we
will bring those death rates down even more so. And
you know, if you find breast cancer early, there's a
ninety five percent five year survival rate, so we can
cure this.

Speaker 1 (06:37):
Disease, Doctor Blumenthal in just about thirty seconds, what are
some of the top kind of initiatives that are top
of mind or areas of research that you're paying attention
to again just about thirty seconds.

Speaker 3 (06:49):
Well again, at the MIT Media Lab, we're focusing on
a breast patch, an ultrasound patch that you can put
in a bra and it can be remotely monitored for
dense breast tissue. Ultrasound is a very important new technology
to use. So and also we want to look at
women in midlife, looking at menopause and new interventions there

(07:09):
to make sure that the bonus years of life we've
gained in this century are truly better years of life,
productive years of life, healthy years of life. Thank you
for the opportunity of joining me today.

Speaker 2 (07:20):
Thanks so much for joining us. Of course, that's doctor
Susan Blumenthal, former Assistant US Surgeon General and the first
ever Deputy Assistant Secretary for Women's Health.