October 1, 2025 • 25 mins
(October 01, 2025)
Government shutdown begins. Dr. Jim Keany, Chief Medical Officer at Dignity Health St. Mary Medical Center in Long Beach, joins The Bill Handel Show for 'Medical News'! Dr. Keany talks with Bill about nasal spray and covid, 99% of heart disease cases have a couple key risk factors you can control, and electrolyte beverages.
Government shutdown begins. Dr. Jim Keany, Chief Medical Officer at Dignity Health St. Mary Medical Center in Long Beach, joins The Bill Handel Show for 'Medical News'! Dr. Keany talks with Bill about nasal spray and covid, 99% of heart disease cases have a couple key risk factors you can control, and electrolyte beverages.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
You're listenings KFI AM six forty the Bill Handles show
on demand on the iHeartRadio f oh Man the door
fine handle here. Oh yes, it is a shut the
government down Wednesday, October one. And before I get into
that story, because it is big news, Amy, you're all
things Dodger Dodgers. What does a thirty five pound taco
(00:25):
cost at Dodger Stadium? Now that is a very good question.
Speaker 2 (00:28):
It's actually only one pound, but they're probably like a
hot dog is like seven bucks, but some of the
other stuff is like fifteen sixteen dollars.
Speaker 1 (00:38):
Yeah, but this is a hot dog that's three and
a half feet long. I mean they're making big, big portions.
Speaker 2 (00:45):
So oh yeah, they have a ginormous hot dog this
season that it's like this long. It's like sixteen sixteen
inches long. It's enough to feed like three or four people.
So my question is we just did the story on this.
It was just an and prices word not mentioned. No,
and she's not in there.
Speaker 1 (01:05):
You go and would you check out the prices of
the new stuff at Dodger Stadium.
Speaker 2 (01:10):
Oh, the big crunch taco, Yeah, the big twelve dollars
and thirty five cents plus facts.
Speaker 1 (01:15):
That's not bad.
Speaker 2 (01:15):
So that's the twelve inch taco and it's got a
pound of beef in it.
Speaker 1 (01:20):
Yeah, it's not bad, not bad, all right. And then
that super duper meat thing that has every kind of meat,
the brisket and the ribs and all that. I don't know. Oh,
are we talking about that instead of the government shut down?
What's more important? Huh? All right? Government is shut down.
As a matter of fact, Mike Johnson is now in
(01:40):
front of every camera out there talking about how the
Democrats shut down the government, and the Democrats are saying
the Republicans shut down the government. Well, first of all,
what is a government shut down? The government runs out
of money. One of the things about the way we Americans,
the way Congress spends money. Two things. Whenever there's a
national debt and we have to increase the national debt,
(02:02):
Congress has to vote. In other words, we have to
give ourselves permission to borrow money to make our cells solvent.
The other thing is the annual budget has to be
voted on, and unless Congress gives itself permission to spend
the money, there's no money to spend. And this is
(02:23):
where a shutdown occurs if the vote isn't taken. And
what happens is most of the time of vote is
not taken, and so both parties do what it's called
a continuing resolution. And what does that mean. That means,
tell you what, We're going to kick this thing down
the road. A week, two weeks, three months, whatever it is.
We'll keep everything copasetic, everything the same until we figure
(02:44):
out what our differences are. And that's what the Republicans
are asking for. Let's just keep everything the same. And
usually continuing resolutions happen, they happen all the time. Well,
the Democrats and the Republicans need the Democrats to make
this vote go so we can we as a country
can spend money and keep the government alive. Democrats are
(03:05):
saying no, not going to do it. So who is
shutting down the government? Well, technically speaking is the Democrats.
And what they're saying is that's it. We're done. We're
putting our left foot down and we are not going
to fund unless we get what we want. Now. Normally
(03:26):
that seems political posturing. I mean, come on, really, this
is not the time to deal with the differences you have.
There are times of what the Republicans are saying, we
have a lot of legitimate issues we have to talk about.
There is no question we have to negotiate. So let's
give ourselves another month and we'll pass this continuing resolution
(03:50):
to keep the government alive. And Democrats are saying no.
So technically, Democrats have stopped the government because the Republicans
want the government to continue working. However, the stakes are
so high when it comes to what the Democrats are
asking for. This has gone way beyond just a simple
(04:15):
argument between the Democrats and the Republicans. I mean it
is a big, big deal because the Democrats are saying, okay,
we're not going forward with any kind of budget unless
you protect the Affordable Care Act subsidies. They're about to expire.
(04:39):
And the Democrats are saying, you cannot have twenty million
people not having the subsidies under Obamacare. And the Republicans
are saying, we're going to let them expire. Tell you what,
we'll let them expire, and then we'll talk about whether
it include them or not include them, And the Democrats saying,
no chance. The expanded premium tax credits. This is a
(05:00):
big deal that lower health insurance costs for little and
millions of Americans. Well that's going away. And the Democrats
want to make this tax relief permanent, are saying, wait
a minute, you can't do this to Americans. In terms
of healthcare. Now, the Republicans, of course agree our healthcare
system is broken. That Democrats are saying, here is how
(05:21):
at least we protect people. The ACA Obamacare subsidies have
to continue on. We have to extend tax credits and
negotiate prescription drug prices. Will Trump's doing that, So I'll
talk about that a little bit later on. It is
really a mess. And herein lies the difference between a Republican,
(05:45):
a Trump controlled Republican legislature, and a democratic legislature. It's
a question of philosophy. What is more important to the
Trump administration? You have, border security is far more important
than any tax help for people who can't afford, for example,
(06:06):
health care. It's just not that important. And that is okay.
I mean, that's welcome to America that we elected Donald Trump.
And that's the philosophy. So border security is far more important,
the military far more important. And if people lose their subsidies,
and if people can no longer afford under Obamacare, their coverage. Okay,
(06:30):
it happens, it's just not that important. And this is
where this is where the Democrats are saying, we're done
with this, We are completely done with this. We have
to have that in place. We have to keep those subsidies.
We have to help people. We have to help people
simply afford healthcare, health afford food under the supplemental what
(06:55):
do they call it, it's the SNAP program, supplemental nutrition
and basically food stamps, and those are going to be
cut under the Trump administration. And the Democrats saying you
can't do that, and how do they have the power
to do that? They say, we're not going to pass
the budget. That's what's going on. So it is a
very very big deal going on both sides. This is
(07:17):
an existential move in the United States to see which
way this country is going to move and where do
you go with that? Well, what you do is you
have a shutdown. That's where you go with it. Because
they can't agree to even keep the government moving. What
does that mean? Shutting down the United States? You know,
(07:37):
since nineteen seventy seven, we've had twenty of these where
the government simply runs out of money, doesn't run out
of money. You just can't spend the money because that's
the way the law works. And the biggest one, the
longest one. Most are shut down for a day or two.
The longest one was during Trump's first term, and that
was thirty five days. That really affected a lot of people.
(08:00):
So what does that mean governmental shutdown? It's a partial shutdown.
There are exempt workers and exempt departments. Let's start with
federal employees. As many as four million. We don't know
exactly how many, but as many as four million, including
some service members, are going to work but without a paycheck.
(08:22):
Hundreds of thousands airport security officers, air traffic controllers, some
members of the military are deemed essential workers and are
told to come back to work no pay, or we
don't know if they're ever going to get paid. That's
a whole nother story. Ice agents are going to go
without pay. They're going to be arresting illegal, undocumented folks
(08:46):
without getting paid. National parks probably close, Smithsonian museums are
going to close down. You're not gonna be able to
go to those because those are easy ones. That's just
us going to a museum. But on a much more
important and a deeper level, you've got two million troops.
(09:07):
American forces could be forced to work without pay. Hundreds
of members of the National Guard that even Trump is
deployed could be that could have to work without pay.
Federal contractors, hourly workers like janitor, security guards, they're not
required to work, and they're not guaranteed back pay. That's
(09:28):
the other one because heretofore, whenever there was a governmental shutdown,
everybody got back pay. Not so much anymore. They're not
guaranteed that. Now lawmakers are guaranteed their money. One hundred
and seventy four thousand dollars a year. Social Security Medicare Medicaid,
that's going to continue. However, those checks are going to
(09:52):
be slowed down because the workers that deal with those
checks are going to be furloughed and they're off the clock.
The Office of Management. Oh, let me go on. By
the way, Social Security Medicare, Medicaid, as I said, will
continue to be distributed. The FDA won't be able to
(10:15):
ensure meat, milk, and eggs of livestock are safe for
people to eat. So enjoy yourselves on recalls. Well, you
don't have to bother about recalls because you're going to die.
The OMB Office of Management and Budget has not given
a new estimat of how many federal workers are going
to go without pay or to be furloughed. And this
(10:36):
is the other thing that we have never heard before.
The President said during the shutdown, I'm going to furlough
people and they're done. They're without a job. That has
never happened before. OMB Director rus Vatt has threatened mass firings.
That's new. Okay, how about the Pentagon? Two million troops
(10:59):
work without starting next month. Most military folks will be
paid today because the government stopped today, so that those
checks will go through, or those wires are going to
go through. But after that it's up to both Congress
and the president. If Congress can't reach a deal in
(11:24):
the next few days, Defense Department personnel forced to go
to work without pay. And according to a contingency plan
that was posted by the Pentagon, and this was over
past weekend, all active duty troops, whether being paid or not,
are required to keep working. That is a problem because
(11:46):
they don't make enough money. About twenty five percent of
military families now experience food and security because of the
financial situation going on, and according to the National Military
family is Sociation. About twenty five percent of military families
report having less than five hundred dollars in savings and
(12:06):
if they're not getting paid. There were a couple of
stories yesterday about how they're in trouble. They're going to
have a hard time paying their mortgage, paying utilities. And
one of the things about buying food when you go
to the supermarket, they really want you to pay for
the corn flakes. They don't want to hear how you're
(12:28):
a governmental worker and you're not getting paid or you're
waiting for your paycheck. It just doesn't work that way.
How about the TSA well TSA checkpoints, those TSA agents
expected to work without pay during the shutdown. Commercial flights
are going to continue, but if you can believe it,
they're going to slow down. How much slower can you go?
(12:51):
Thirteen thousand air traffic controllers work without pay. It just
goes on and on. And we don't even know how
many people are going to be cut. And a couple
things that have never happened before, and that is, well,
I do one thing. We don't know how many you
are going to be let go, let me permanently, and
(13:15):
we don't know to what extent and how many people
are going to be paid and not pay. It's the
Justice Department, a high percentage of activities of employees no
pay but continue to work. Civil litigation that's going to
stop cold. Criminal cases will go forward, but civil litigations
(13:35):
that does not involve the safety of human life or
protection or property that's going to be stopped cold. And
the last time out of the twenty eighteen twenty nineteen
shut down, this was the longest that we had under Trump,
the DOJ had to cancel sixty thousand immigration hearings. Yeah. Man,
(13:58):
that's good news around. All right, it is time for
our medical segment, which we do every Wednesday with doctor
Jim Keeney, Chief Medical Officers for Officer for Dignity Saint
Mary Medical Center in Long Beach. Good morning, Jim, Good
morning Bill. Haven't talked in a while. Gone with on
(14:21):
vacation and I was on a cruise ship and I
was hoping that some people were going to get into
nova virus or they were gonna get COVID and die.
But nothing, just nothing.
Speaker 3 (14:33):
Wow. Yeah, well that sounds like a good vacation.
Speaker 1 (14:36):
Then yeah, well only what Yeah, And in front of
this is something that's fairly new in front of every
eating establishment. Uh, there is a little sanitation uh you know,
purel little station, and man, they push it really hard.
So maybe that seems to be the answer. Okay, talking
about COVID, all right, can nasal spray protect you from COVID?
(15:00):
Let's talk about that for a moment.
Speaker 3 (15:03):
Sure, So there are a couple of naval sprays being
developed that would block COVID in different ways. Right, So
there's one that kind of creates this coating. They call
it pathogen capture and neutralization spray, and it coats the
nasal passages to trap viruses and bacteria before they can
reach yourselves. So you know a lot of times the
(15:25):
virus comes in through your nose or even more commonly
probably through your eyes, and then your tears carry it
down into your nose and it gets absorbed and then
that's how it gets into your body. So this would
block that. The second spray is already an anti histamine
on the market, a zalestine and if an anti histamine spray,
(15:46):
but they're looking at right now phase two human clinical trials,
and that seems to block the way. You know, the mechanism.
Remember there was that area of it. The virus attaches
and it's a receptor and this thing blocks that receptor.
Speaker 1 (16:01):
Hey excuse me, Oh well, I don't know what just happened.
Are you familiar with the political aspects of this, and
I know that's not your wheelhouse, but I don't know
if you've heard buzz throughout the medical world, and that
is the anti vaxxers dealing with this as opposed to vaccine.
(16:24):
Is there enough of a difference that it can be
argued this isn't even close to a vaccine, so even
don't worry about it. Your thoughts on that.
Speaker 3 (16:32):
Yeah, I mean the sense of studies aren't done. We
really don't know yet. So right now, vaccines are the
strongest defense against you know, getting severe COVID or long COVID.
It doesn't necessarily stop you one hundred percent from getting COVID,
but it does improve the outcomes. And then you know this,
I would compare more to masking. Right this is blocking
(16:53):
the virus from getting into your body. And right now
we know that the masking works in especially in crowded
and vironment to reduce your risks. So people who are
at high risk and they don't have a choice and
they have to go shopping or you know, go to
a doctor's appointment and take the bus or something like that.
They need a way to protect themselves at masks right
(17:13):
now is their best bet. But these sprays could be
an alternative.
Speaker 1 (17:18):
Yeah, we see very few masks, and it's always Asians
who wear masks. I don't know if you've noticed that.
There must be some cultural thing about masking, but I
noticed that it's going down, down, down. I just got
my COVID shot and my flu shot because I get
every vaccine under the planet. And now you and I
(17:40):
have talked about this because you you actually contracted COVID
what eight times? Do I have that right?
Speaker 3 (17:46):
Yeah? Yeah, yeah, yeah, eight times and got four vaccines.
So again, you know, everybody can say, well, okay, i'll
see a code vaccine doesn't work. You got COVID eight times.
But I know ever was hospitalized. I never really missed
a lot of work. I usually was back. The longest one,
which was the most severe one, probably a week was
(18:09):
I was sick and then I was better. Most of
them was two to three days. But yeah, I don't know,
you know, And so like I said, I talked to
it and it's textually to these specialists, and he said, well, obviously,
you know you're getting you're not getting the protection completely
from this vaccine, so it's really up to you as
to whether you want to continue getting boosters. But you know,
I feel like I gave it so often now I'm
(18:30):
getting boosted every time I get the infection.
Speaker 1 (18:34):
Are you concerned about long COVID at all? And with
would that help you make up your mind about COVID shots?
Speaker 3 (18:44):
Yeah, I mean no, I'm definitely concerned about long COVID.
It seems like a high percentage of people have it,
and you know so, But again, I've had four vaccines,
so in a way, I'm somewhat vaccinated now. The boosters
are just to try and remind your immune system, and
like I said, my immune system seems to be getting
reminded every you know, every twelve months or so, so
(19:09):
the booster seems irrelevant in my case. But like I said,
that's why people should go talk to their doctor make
their own individual recommendations. I'm still happy I got the
shot and the three boosters, but and I'd do it
again if I was going to start all over again,
But at this point, it just doesn't seem to make
sense for me. If you know, maybe if I went
(19:30):
two or three years with no with no COVID, I
would say, all right, you know what, I haven't had
COVID for three years. I better get a booster.
Speaker 1 (19:37):
Interesting. And is that because of the time you spend
in the er, I think so? Yeah.
Speaker 3 (19:43):
I mean we were getting exposed constantly. You know, you
try your best, Yeah, you do what you can, but
it's so busy it's just hard not to get exposed.
And then you know, you walk into a room for
somebody that has a broken toe and you know, you think, okay,
it's probably safe here, and they start hacking up along.
That happens all the time. So this is part of
the job.
Speaker 1 (20:03):
You can pretend you're Asian at Costco and wear a
mask that works, well.
Speaker 3 (20:07):
I did I always wear a mask?
Speaker 1 (20:09):
Yeah?
Speaker 3 (20:10):
Well not and that you're right. I mean, if I
walked into somebody with no symptoms and then you know,
you're right, sometimes I wouldn't wear a mask.
Speaker 1 (20:18):
Jim. Ninety nine percent of heart disease cases have a
risk factor that we can actually address. We can do
something about before the heart disease or the heart attack hits.
You want to share that information with us.
Speaker 3 (20:32):
Sure, And I'll tell you this is a surprising study
because we'd had some pretty good earlier studies, the Framingham study,
one called inter Heart that had thirty thousand patients across
fifty two countries, and what those showed is about ten
to twenty percent have no risk factors when they have
a heart attack. So we always walked around saying, look,
(20:52):
you got to be aware, you could have even you
have no risk factors, you could have a heart attack. Well,
it turns out this kind of puts a finer point
one that number one. I should tell you about the study.
It was done mostly with Korean patients, six hundred thousand
Korean patients, and that's because the ability of big data.
You know, they don't have the same hip hop protections,
(21:12):
so they can look across the entire country and get
data where we don't have that ability in the United States.
So there's one thousand patients from the US and six
hundred thousand from Korea. So this is basically a Korean study.
And what they looked at was they said, look, we're
not just going to look for the diagnosis the doctor
actually calls it diabetes or high blood pressure. We're going
(21:35):
to look for your whole medical record and see if
you have high blood pressure or see if you have
diabetes or elevated blood sugars. So it didn't depend on
the diagnosis. And what this found was that when you
do that, then you're going to find that that ninety
nine percent of people have either high blood pressure, high cholesterol,
diabetes or pre diabetes. And so they do actually have
(21:57):
risk factors, and maybe those those very minimal. So maybe
the doctor ignored it because their blood pressure wasn't too
high or their cholesterol wasn't that high, but even these
minimal elevations seemed to contribute to being at risk for
heart disease.
Speaker 1 (22:12):
Is there any i issue as to Asian cultures Japanese?
We heard about the Japanese studies where lifestyle and diet
changes them in terms of their percentage of heart disease, cancers, etc.
Simply because they are like you know, the commercials for
that yogurt company where you had this village in the
(22:33):
Carpathian Mountains where everybody lived to be two hundred years old.
Do they take that into effect?
Speaker 3 (22:41):
I mean in the study, they did not take that
into effect. What they were looking at the end point
was did you have a heart attack or didn't you?
And so these are people who did have a heart attack.
But you're right, I mean there are Asian cultures like
Japan where the heart attack rate is much lower than
it is in the US, and that's you know, we
can call that a weakness for this study. Is you know,
(23:03):
is it does it apply to the US as much
as it applies to Koreans, because you know, we do
have it. It's a different gene pool overall, and a
different environment and other different factors. So it definitely a
weakness of the study, but at the same time interesting
study because it's a high power as far as the
(23:23):
number of patients that they looked at. Still an observational study,
meaning you're going into the data and observing it. You're
not actually doing a prospective study where you predict what
might happen and you change that one variable on the
person and you see if it happens. That's the best study.
This is is observational, but at the same time, you know,
a very powerful study and in contradiction to those previous
(23:44):
studies that show that hey, you could have a heart
attack without any risk factors.
Speaker 1 (23:48):
Yeah, in terms of studying genes in Asian cultures, they
don't have a whole lot of immigration, you know, relative
to Western culture, relative the United States, where we're one
huge melting plot. Does that skew studies when you have
a specific population that just doesn't do a lot of mixing.
Speaker 3 (24:09):
Yeah. Absolutely, So that's why where they do the study
is important. And even within the US, I mean, we
have so many different cultures here in so many different
ways that people you know, eat or live, or their
activity levels. You know, it's much different I would imagine
in Minnesota in the winter than it is in Florida.
So you know, even within the US, you got to
(24:31):
look at where these patients came from. Was there a
good diverse mix. There's a lot that goes into analyzing
a study deciding does that the results from this study
really apply to my patients? Does it really apply to me?
Speaker 1 (24:45):
Okay? Jim, chief medical officer for Dignity Saint Mary Medical
Center in Long Beach. We'll catch you again next week,
probably talk over the weekend too. So Jim, as always,
I say goodbye and go kill someone okay, okay, take
care Bill always always, by the way, that's how I
end conversations when we talk on the phone and we
(25:05):
see each other and we'll have meals together. I hang
out with Jim, and that's, you know, goodbye, James. Enough,
you say the same thing to me when we get
off the phone. No, no, because you're already doing it okay,
because you've been listening to the Bill Handle Show. Catch
My Show Monday through Friday, six am to nine am,
and anytime on demand on the iHeartRadio app.
You're listenings KFI AM six forty the Bill Handles show
on demand on the iHeartRadio f oh Man the door
fine handle here. Oh yes, it is a shut the
government down Wednesday, October one. And before I get into
that story, because it is big news, Amy, you're all
things Dodger Dodgers. What does a thirty five pound taco
(00:25):
cost at Dodger Stadium? Now that is a very good question.
Speaker 2 (00:28):
It's actually only one pound, but they're probably like a
hot dog is like seven bucks, but some of the
other stuff is like fifteen sixteen dollars.
Speaker 1 (00:38):
Yeah, but this is a hot dog that's three and
a half feet long. I mean they're making big, big portions.
Speaker 2 (00:45):
So oh yeah, they have a ginormous hot dog this
season that it's like this long. It's like sixteen sixteen
inches long. It's enough to feed like three or four people.
So my question is we just did the story on this.
It was just an and prices word not mentioned. No,
and she's not in there.
Speaker 1 (01:05):
You go and would you check out the prices of
the new stuff at Dodger Stadium.
Speaker 2 (01:10):
Oh, the big crunch taco, Yeah, the big twelve dollars
and thirty five cents plus facts.
Speaker 1 (01:15):
That's not bad.
Speaker 2 (01:15):
So that's the twelve inch taco and it's got a
pound of beef in it.
Speaker 1 (01:20):
Yeah, it's not bad, not bad, all right. And then
that super duper meat thing that has every kind of meat,
the brisket and the ribs and all that. I don't know. Oh,
are we talking about that instead of the government shut down?
What's more important? Huh? All right? Government is shut down.
As a matter of fact, Mike Johnson is now in
(01:40):
front of every camera out there talking about how the
Democrats shut down the government, and the Democrats are saying
the Republicans shut down the government. Well, first of all,
what is a government shut down? The government runs out
of money. One of the things about the way we Americans,
the way Congress spends money. Two things. Whenever there's a
national debt and we have to increase the national debt,
(02:02):
Congress has to vote. In other words, we have to
give ourselves permission to borrow money to make our cells solvent.
The other thing is the annual budget has to be
voted on, and unless Congress gives itself permission to spend
the money, there's no money to spend. And this is
(02:23):
where a shutdown occurs if the vote isn't taken. And
what happens is most of the time of vote is
not taken, and so both parties do what it's called
a continuing resolution. And what does that mean. That means,
tell you what, We're going to kick this thing down
the road. A week, two weeks, three months, whatever it is.
We'll keep everything copasetic, everything the same until we figure
(02:44):
out what our differences are. And that's what the Republicans
are asking for. Let's just keep everything the same. And
usually continuing resolutions happen, they happen all the time. Well,
the Democrats and the Republicans need the Democrats to make
this vote go so we can we as a country
can spend money and keep the government alive. Democrats are
(03:05):
saying no, not going to do it. So who is
shutting down the government? Well, technically speaking is the Democrats.
And what they're saying is that's it. We're done. We're
putting our left foot down and we are not going
to fund unless we get what we want. Now. Normally
(03:26):
that seems political posturing. I mean, come on, really, this
is not the time to deal with the differences you have.
There are times of what the Republicans are saying, we
have a lot of legitimate issues we have to talk about.
There is no question we have to negotiate. So let's
give ourselves another month and we'll pass this continuing resolution
(03:50):
to keep the government alive. And Democrats are saying no.
So technically, Democrats have stopped the government because the Republicans
want the government to continue working. However, the stakes are
so high when it comes to what the Democrats are
asking for. This has gone way beyond just a simple
(04:15):
argument between the Democrats and the Republicans. I mean it
is a big, big deal because the Democrats are saying, okay,
we're not going forward with any kind of budget unless
you protect the Affordable Care Act subsidies. They're about to expire.
(04:39):
And the Democrats are saying, you cannot have twenty million
people not having the subsidies under Obamacare. And the Republicans
are saying, we're going to let them expire. Tell you what,
we'll let them expire, and then we'll talk about whether
it include them or not include them, And the Democrats saying,
no chance. The expanded premium tax credits. This is a
(05:00):
big deal that lower health insurance costs for little and
millions of Americans. Well that's going away. And the Democrats
want to make this tax relief permanent, are saying, wait
a minute, you can't do this to Americans. In terms
of healthcare. Now, the Republicans, of course agree our healthcare
system is broken. That Democrats are saying, here is how
(05:21):
at least we protect people. The ACA Obamacare subsidies have
to continue on. We have to extend tax credits and
negotiate prescription drug prices. Will Trump's doing that, So I'll
talk about that a little bit later on. It is
really a mess. And herein lies the difference between a Republican,
(05:45):
a Trump controlled Republican legislature, and a democratic legislature. It's
a question of philosophy. What is more important to the
Trump administration? You have, border security is far more important
than any tax help for people who can't afford, for example,
(06:06):
health care. It's just not that important. And that is okay.
I mean, that's welcome to America that we elected Donald Trump.
And that's the philosophy. So border security is far more important,
the military far more important. And if people lose their subsidies,
and if people can no longer afford under Obamacare, their coverage. Okay,
(06:30):
it happens, it's just not that important. And this is
where this is where the Democrats are saying, we're done
with this, We are completely done with this. We have
to have that in place. We have to keep those subsidies.
We have to help people. We have to help people
simply afford healthcare, health afford food under the supplemental what
(06:55):
do they call it, it's the SNAP program, supplemental nutrition
and basically food stamps, and those are going to be
cut under the Trump administration. And the Democrats saying you
can't do that, and how do they have the power
to do that? They say, we're not going to pass
the budget. That's what's going on. So it is a
very very big deal going on both sides. This is
(07:17):
an existential move in the United States to see which
way this country is going to move and where do
you go with that? Well, what you do is you
have a shutdown. That's where you go with it. Because
they can't agree to even keep the government moving. What
does that mean? Shutting down the United States? You know,
(07:37):
since nineteen seventy seven, we've had twenty of these where
the government simply runs out of money, doesn't run out
of money. You just can't spend the money because that's
the way the law works. And the biggest one, the
longest one. Most are shut down for a day or two.
The longest one was during Trump's first term, and that
was thirty five days. That really affected a lot of people.
(08:00):
So what does that mean governmental shutdown? It's a partial shutdown.
There are exempt workers and exempt departments. Let's start with
federal employees. As many as four million. We don't know
exactly how many, but as many as four million, including
some service members, are going to work but without a paycheck.
(08:22):
Hundreds of thousands airport security officers, air traffic controllers, some
members of the military are deemed essential workers and are
told to come back to work no pay, or we
don't know if they're ever going to get paid. That's
a whole nother story. Ice agents are going to go
without pay. They're going to be arresting illegal, undocumented folks
(08:46):
without getting paid. National parks probably close, Smithsonian museums are
going to close down. You're not gonna be able to
go to those because those are easy ones. That's just
us going to a museum. But on a much more
important and a deeper level, you've got two million troops.
(09:07):
American forces could be forced to work without pay. Hundreds
of members of the National Guard that even Trump is
deployed could be that could have to work without pay.
Federal contractors, hourly workers like janitor, security guards, they're not
required to work, and they're not guaranteed back pay. That's
(09:28):
the other one because heretofore, whenever there was a governmental shutdown,
everybody got back pay. Not so much anymore. They're not
guaranteed that. Now lawmakers are guaranteed their money. One hundred
and seventy four thousand dollars a year. Social Security Medicare Medicaid,
that's going to continue. However, those checks are going to
(09:52):
be slowed down because the workers that deal with those
checks are going to be furloughed and they're off the clock.
The Office of Management. Oh, let me go on. By
the way, Social Security Medicare, Medicaid, as I said, will
continue to be distributed. The FDA won't be able to
(10:15):
ensure meat, milk, and eggs of livestock are safe for
people to eat. So enjoy yourselves on recalls. Well, you
don't have to bother about recalls because you're going to die.
The OMB Office of Management and Budget has not given
a new estimat of how many federal workers are going
to go without pay or to be furloughed. And this
(10:36):
is the other thing that we have never heard before.
The President said during the shutdown, I'm going to furlough
people and they're done. They're without a job. That has
never happened before. OMB Director rus Vatt has threatened mass firings.
That's new. Okay, how about the Pentagon? Two million troops
(10:59):
work without starting next month. Most military folks will be
paid today because the government stopped today, so that those
checks will go through, or those wires are going to
go through. But after that it's up to both Congress
and the president. If Congress can't reach a deal in
(11:24):
the next few days, Defense Department personnel forced to go
to work without pay. And according to a contingency plan
that was posted by the Pentagon, and this was over
past weekend, all active duty troops, whether being paid or not,
are required to keep working. That is a problem because
(11:46):
they don't make enough money. About twenty five percent of
military families now experience food and security because of the
financial situation going on, and according to the National Military
family is Sociation. About twenty five percent of military families
report having less than five hundred dollars in savings and
(12:06):
if they're not getting paid. There were a couple of
stories yesterday about how they're in trouble. They're going to
have a hard time paying their mortgage, paying utilities. And
one of the things about buying food when you go
to the supermarket, they really want you to pay for
the corn flakes. They don't want to hear how you're
(12:28):
a governmental worker and you're not getting paid or you're
waiting for your paycheck. It just doesn't work that way.
How about the TSA well TSA checkpoints, those TSA agents
expected to work without pay during the shutdown. Commercial flights
are going to continue, but if you can believe it,
they're going to slow down. How much slower can you go?
(12:51):
Thirteen thousand air traffic controllers work without pay. It just
goes on and on. And we don't even know how
many people are going to be cut. And a couple
things that have never happened before, and that is, well,
I do one thing. We don't know how many you
are going to be let go, let me permanently, and
(13:15):
we don't know to what extent and how many people
are going to be paid and not pay. It's the
Justice Department, a high percentage of activities of employees no
pay but continue to work. Civil litigation that's going to
stop cold. Criminal cases will go forward, but civil litigations
(13:35):
that does not involve the safety of human life or
protection or property that's going to be stopped cold. And
the last time out of the twenty eighteen twenty nineteen
shut down, this was the longest that we had under Trump,
the DOJ had to cancel sixty thousand immigration hearings. Yeah. Man,
(13:58):
that's good news around. All right, it is time for
our medical segment, which we do every Wednesday with doctor
Jim Keeney, Chief Medical Officers for Officer for Dignity Saint
Mary Medical Center in Long Beach. Good morning, Jim, Good
morning Bill. Haven't talked in a while. Gone with on
(14:21):
vacation and I was on a cruise ship and I
was hoping that some people were going to get into
nova virus or they were gonna get COVID and die.
But nothing, just nothing.
Speaker 3 (14:33):
Wow. Yeah, well that sounds like a good vacation.
Speaker 1 (14:36):
Then yeah, well only what Yeah, And in front of
this is something that's fairly new in front of every
eating establishment. Uh, there is a little sanitation uh you know,
purel little station, and man, they push it really hard.
So maybe that seems to be the answer. Okay, talking
about COVID, all right, can nasal spray protect you from COVID?
(15:00):
Let's talk about that for a moment.
Speaker 3 (15:03):
Sure, So there are a couple of naval sprays being
developed that would block COVID in different ways. Right, So
there's one that kind of creates this coating. They call
it pathogen capture and neutralization spray, and it coats the
nasal passages to trap viruses and bacteria before they can
reach yourselves. So you know a lot of times the
(15:25):
virus comes in through your nose or even more commonly
probably through your eyes, and then your tears carry it
down into your nose and it gets absorbed and then
that's how it gets into your body. So this would
block that. The second spray is already an anti histamine
on the market, a zalestine and if an anti histamine spray,
(15:46):
but they're looking at right now phase two human clinical trials,
and that seems to block the way. You know, the mechanism.
Remember there was that area of it. The virus attaches
and it's a receptor and this thing blocks that receptor.
Speaker 1 (16:01):
Hey excuse me, Oh well, I don't know what just happened.
Are you familiar with the political aspects of this, and
I know that's not your wheelhouse, but I don't know
if you've heard buzz throughout the medical world, and that
is the anti vaxxers dealing with this as opposed to vaccine.
(16:24):
Is there enough of a difference that it can be
argued this isn't even close to a vaccine, so even
don't worry about it. Your thoughts on that.
Speaker 3 (16:32):
Yeah, I mean the sense of studies aren't done. We
really don't know yet. So right now, vaccines are the
strongest defense against you know, getting severe COVID or long COVID.
It doesn't necessarily stop you one hundred percent from getting COVID,
but it does improve the outcomes. And then you know this,
I would compare more to masking. Right this is blocking
(16:53):
the virus from getting into your body. And right now
we know that the masking works in especially in crowded
and vironment to reduce your risks. So people who are
at high risk and they don't have a choice and
they have to go shopping or you know, go to
a doctor's appointment and take the bus or something like that.
They need a way to protect themselves at masks right
(17:13):
now is their best bet. But these sprays could be
an alternative.
Speaker 1 (17:18):
Yeah, we see very few masks, and it's always Asians
who wear masks. I don't know if you've noticed that.
There must be some cultural thing about masking, but I
noticed that it's going down, down, down. I just got
my COVID shot and my flu shot because I get
every vaccine under the planet. And now you and I
(17:40):
have talked about this because you you actually contracted COVID
what eight times? Do I have that right?
Speaker 3 (17:46):
Yeah? Yeah, yeah, yeah, eight times and got four vaccines.
So again, you know, everybody can say, well, okay, i'll
see a code vaccine doesn't work. You got COVID eight times.
But I know ever was hospitalized. I never really missed
a lot of work. I usually was back. The longest one,
which was the most severe one, probably a week was
(18:09):
I was sick and then I was better. Most of
them was two to three days. But yeah, I don't know,
you know, And so like I said, I talked to
it and it's textually to these specialists, and he said, well, obviously,
you know you're getting you're not getting the protection completely
from this vaccine, so it's really up to you as
to whether you want to continue getting boosters. But you know,
I feel like I gave it so often now I'm
(18:30):
getting boosted every time I get the infection.
Speaker 1 (18:34):
Are you concerned about long COVID at all? And with
would that help you make up your mind about COVID shots?
Speaker 3 (18:44):
Yeah, I mean no, I'm definitely concerned about long COVID.
It seems like a high percentage of people have it,
and you know so, But again, I've had four vaccines,
so in a way, I'm somewhat vaccinated now. The boosters
are just to try and remind your immune system, and
like I said, my immune system seems to be getting
reminded every you know, every twelve months or so, so
(19:09):
the booster seems irrelevant in my case. But like I said,
that's why people should go talk to their doctor make
their own individual recommendations. I'm still happy I got the
shot and the three boosters, but and I'd do it
again if I was going to start all over again,
But at this point, it just doesn't seem to make
sense for me. If you know, maybe if I went
(19:30):
two or three years with no with no COVID, I
would say, all right, you know what, I haven't had
COVID for three years. I better get a booster.
Speaker 1 (19:37):
Interesting. And is that because of the time you spend
in the er, I think so? Yeah.
Speaker 3 (19:43):
I mean we were getting exposed constantly. You know, you
try your best, Yeah, you do what you can, but
it's so busy it's just hard not to get exposed.
And then you know, you walk into a room for
somebody that has a broken toe and you know, you think, okay,
it's probably safe here, and they start hacking up along.
That happens all the time. So this is part of
the job.
Speaker 1 (20:03):
You can pretend you're Asian at Costco and wear a
mask that works, well.
Speaker 3 (20:07):
I did I always wear a mask?
Speaker 1 (20:09):
Yeah?
Speaker 3 (20:10):
Well not and that you're right. I mean, if I
walked into somebody with no symptoms and then you know,
you're right, sometimes I wouldn't wear a mask.
Speaker 1 (20:18):
Jim. Ninety nine percent of heart disease cases have a
risk factor that we can actually address. We can do
something about before the heart disease or the heart attack hits.
You want to share that information with us.
Speaker 3 (20:32):
Sure, And I'll tell you this is a surprising study
because we'd had some pretty good earlier studies, the Framingham study,
one called inter Heart that had thirty thousand patients across
fifty two countries, and what those showed is about ten
to twenty percent have no risk factors when they have
a heart attack. So we always walked around saying, look,
(20:52):
you got to be aware, you could have even you
have no risk factors, you could have a heart attack. Well,
it turns out this kind of puts a finer point
one that number one. I should tell you about the study.
It was done mostly with Korean patients, six hundred thousand
Korean patients, and that's because the ability of big data.
You know, they don't have the same hip hop protections,
(21:12):
so they can look across the entire country and get
data where we don't have that ability in the United States.
So there's one thousand patients from the US and six
hundred thousand from Korea. So this is basically a Korean study.
And what they looked at was they said, look, we're
not just going to look for the diagnosis the doctor
actually calls it diabetes or high blood pressure. We're going
(21:35):
to look for your whole medical record and see if
you have high blood pressure or see if you have
diabetes or elevated blood sugars. So it didn't depend on
the diagnosis. And what this found was that when you
do that, then you're going to find that that ninety
nine percent of people have either high blood pressure, high cholesterol,
diabetes or pre diabetes. And so they do actually have
(21:57):
risk factors, and maybe those those very minimal. So maybe
the doctor ignored it because their blood pressure wasn't too
high or their cholesterol wasn't that high, but even these
minimal elevations seemed to contribute to being at risk for
heart disease.
Speaker 1 (22:12):
Is there any i issue as to Asian cultures Japanese?
We heard about the Japanese studies where lifestyle and diet
changes them in terms of their percentage of heart disease, cancers, etc.
Simply because they are like you know, the commercials for
that yogurt company where you had this village in the
(22:33):
Carpathian Mountains where everybody lived to be two hundred years old.
Do they take that into effect?
Speaker 3 (22:41):
I mean in the study, they did not take that
into effect. What they were looking at the end point
was did you have a heart attack or didn't you?
And so these are people who did have a heart attack.
But you're right, I mean there are Asian cultures like
Japan where the heart attack rate is much lower than
it is in the US, and that's you know, we
can call that a weakness for this study. Is you know,
(23:03):
is it does it apply to the US as much
as it applies to Koreans, because you know, we do
have it. It's a different gene pool overall, and a
different environment and other different factors. So it definitely a
weakness of the study, but at the same time interesting
study because it's a high power as far as the
(23:23):
number of patients that they looked at. Still an observational study,
meaning you're going into the data and observing it. You're
not actually doing a prospective study where you predict what
might happen and you change that one variable on the
person and you see if it happens. That's the best study.
This is is observational, but at the same time, you know,
a very powerful study and in contradiction to those previous
(23:44):
studies that show that hey, you could have a heart
attack without any risk factors.
Speaker 1 (23:48):
Yeah, in terms of studying genes in Asian cultures, they
don't have a whole lot of immigration, you know, relative
to Western culture, relative the United States, where we're one
huge melting plot. Does that skew studies when you have
a specific population that just doesn't do a lot of mixing.
Speaker 3 (24:09):
Yeah. Absolutely, So that's why where they do the study
is important. And even within the US, I mean, we
have so many different cultures here in so many different
ways that people you know, eat or live, or their
activity levels. You know, it's much different I would imagine
in Minnesota in the winter than it is in Florida.
So you know, even within the US, you got to
(24:31):
look at where these patients came from. Was there a
good diverse mix. There's a lot that goes into analyzing
a study deciding does that the results from this study
really apply to my patients? Does it really apply to me?
Speaker 1 (24:45):
Okay? Jim, chief medical officer for Dignity Saint Mary Medical
Center in Long Beach. We'll catch you again next week,
probably talk over the weekend too. So Jim, as always,
I say goodbye and go kill someone okay, okay, take
care Bill always always, by the way, that's how I
end conversations when we talk on the phone and we
(25:05):
see each other and we'll have meals together. I hang
out with Jim, and that's, you know, goodbye, James. Enough,
you say the same thing to me when we get
off the phone. No, no, because you're already doing it okay,
because you've been listening to the Bill Handle Show. Catch
My Show Monday through Friday, six am to nine am,
and anytime on demand on the iHeartRadio app.
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