Who’s Community Health Centers’ Top Ally? Powerful House Leader Makes the Case

House Majority Whip James Clyburn

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Marianne O’Hare : Welcome to Conversations on Health Care. This week , we welcome
House Majority Whip, Congressman James Clyburn on the Cancer
Moonshot , community health center's growing role , and the Inflation
Reduction Act .

James Clyburn : For the f ir st time , Medicare's going to be able to negotiate lower drug
prices. That's a huge deal .

Marianne O’Hare : Lori Robertson joins us from FactCheck.org . And we end with a bright
idea , improving health and wellbeing in everyday lives. Now, here are
your host s , Mark Masselli and Margaret Flinter .

Mark Masselli : Our guest is the third highest ranking Democrat in the US House of
Representatives . But for many, he's at the very top when it comes to
advocating for accessible health care for all Americans. He's alwa y s
been an effective, influential, but he gained new prominence in 2020
by endorsing Joe Biden for President right before the South Carolina
primary, which then propelled Biden to winning the nomination.

Margaret Flinter: The Honorable James Clyburn is Hou s e Majority Whip, and represents
the people of the 6th Congressional District in South Carolina. And he
definitely has the ea r of the President and his team.

Mark Masselli: Congressman Clyburn, w elcome back to Conversations on Health
Care .

James Clyburn: T hank you very much for having me back .

Mark Masselli: As one of the biggest advocates in Congress for community health
centers, and we thank you for that support , a nd the over 30 million
Americans who are served by community health centers across our
coun t ry, thank you as well. Now, of course, your work is never done .
A key part of providing that kind of health care requires Congress to
pass the fiscal year 2023 budget . What's the latest ? Is the continuing
resolution going to happen?

James Clyburn: Well, y o u know, I started this battle -- I shouldn't call it battle , let's
just say this venture with the community health centers more than 50
years ago. I recall back when Senator Fritz Hollings wrote his book The
Case Against Hunger , we took that book as a f oun dation upon which
[ i naudible 0 0:01:57 ] comprehensive health care program, the
[inaudible 00:01:59 ] health care program there . And I've been on a
community health center journey ever since. And I've always had it as
my goal to try to ge t a communi ty health center that is located within
commuting distance of every American , and so every time legislation
comes forward on health care, I'm always trying to figure out how we
can get community health centers to benefit from this legislation . A nd
so it wa s in the R escue Act , the Inflation Reduction Act, the

House Majority Whip James Clyburn

infrastructure bill, you go through all those bills, and you will see
some attention being given to community health centers in order to
make them more efficient, more effective, and more equ itable in
c arrying ou t their duties and responsibilities.

And so I'm very, very pleased with what we've done. I am not pleased
to the extent that I'm satisfied with where we are , because we're not
where we need to be yet. But I'm a big believer in continu ing the
jou rney . I of ten tell people, if you go back and look at the Civil Rights
Act that we talk about so often , 1964 Civil Rights Act, that a ct didn't
come in one fell swoop . We got the ‘ 64 Civil Rights Act w ithdrawn in
the private sector. We didn't get voted until a year l ater. We didn't
get housing until three years later. And we didn't apply it to the public
sector until 1972. So it was an eight - year period . And so it is with
these community health centers. I am hopeful of building out
community healt h cente rs throughout the entire country to reach our
goal. I would say to people , “ Look at the Rescue A c t and see what
we're doing there. Look at the Infrastructure Bill , the Bipartisan
Infrastructure Bill we call it . Look at the Inflation Reduction Act , a nd
l et's see how this journey is going forward. ”

If you look at what we did with Medicare , for the first time Medicare
is going to be able to negotiate for lower drug prices. That's a huge
deal. Now , it's limited to certain pharmaceuticals , but we got to keep
w orking to expan d it to others. Putting the cap on insulin for Medicare
recipients , it would help about 3 million Medicare recipients. But we
got to keep working to put that cap for other people as well, such as
we tried to do when the bill passed the H ouse. So the commun ity
health centers , I think, especially when you look at the Infrastructure
B ill and see what we did, making the Internet broadband I guess is the
best way to put it , m aking broadband a big, big part of that so that we
can connect thes e c ommunity health ce nters to teaching hospitals
and other kind of entities to make them more efficient, make them
more effective, and make them more equitable , t his is a huge deal.
Not all we need to do , b ut we got to keep on work ing .

Margaret Flinter: We ll, we thank you for those efforts, Congressman . And I know that
you have had Republican champions to work with on legislation to
support community health centers as well, that really has
characterized the whole movement. But when we look at the
enormit y , the gravity of the ch allenges in health that face Americans,
and we look at some of these innovations that have been funded over
the last few years, and some of the needs , the children's mental
health crises and the possibility of meeting those needs i n s c hools, the
health car e workforce shortages and the possibilities of meeting that
through programs like you just described with the teaching health
centers, if you look into the future, are there particular areas that you
feel th e health centers need to ad d ress, and that you mi ght be able to

House Majority Whip James Clyburn

get bipartisan backing to really support, especially in our current
environment?

James Clyburn: Yes, I do. But I think what we've got to do is expand our focus a little
bit. If you are talking about making all of th ese programs more
efficie nt, more effective, then you've got to look at the delivery of
them as well. How do we get doctors and nurses and other public
health professionals out in these communities? Well, one of the ways
we'll do it is to look at what we'r e d o ing now w ith student debt
forgiveness for people who work in these kinds of facilities. Just look
wh at we've done since 2020 . The public service [inaudible 00:06: 5 2 ]
debt. Now remember , public service is not just if it's a public agency .
You can work for p rivate no nprofit, you can work for community
health centers, and other kinds of programs like that , a nd you can get
that debt that you incurred while going to college and your
professional skills. I mean, you can be a doctor with a full - fledged
degree , b ut if yo u w ork in these entities , work in these community
health centers, you can get some of that debt forgiven.

We have done in the last 10 months $10 billion in debt forgiveness for
150,000 , maybe 175,000 people. A lot of these people are working in
comm unity health centers. So I have said to the community health
centers all over South Carolina, “ Let's take a look at this. Look at the
people who are working for you. Let's get , make ourselves attractive
to them by offering them to come into these centers a nd get all of this
de bt f org iven. And they will find very meaningful and enjoyable life
experiences . A lot of these newer communities w ill welcome them
with open arms.

Mark Masselli: Congressman , let me shift the conversation a little . President Biden
rece ntly provided details abo ut the progress for the Cancer
Moonshot, the effort to cut cancer deaths in half . And so on we
understand he'll explain specifics about Federal funding to help us
reach this important goal. But does the Moonshot need more rocket
fue l in the form of fund ing as even some of t he cancer advocate s say
it does?

James Clyburn: Absolutely . And I think all of us are familiar with the emotional
attachment President Biden has to this. Biden was a very close friend
of my late wife, who suffered for 30 years with dia be tes , a nd finally,
that's what took her life. And they talked about his son , Beau, and the
Moonshot a lot. Because if you remember, Barack Obama first talked
about this and named Joe Biden to sort of get it going b ecause of his
person al experiences. Both m y p arents died from cancer, my mother
f rom multiple myeloma at a time when t here was absolutely no cure ,
a nd eight months from the diagnosis she was gone. My dad died from
prostate cancer. So cancer is a big, big deal , a nd there's not a single
fam ily in A merica that's not been touched by it. And we , for him to

House Majority Whip James Clyburn

make this kind of commitment to name the person with su ch a
sterling reputation to launch it , I think that we are going to get the
rocket fuel that's necessary to have a tremendo us , and I thi nk ,
succ essful blast off of this effort.

Margaret Flinter: And you're absolutely right , t here's not a family in America that hasn't
been touched by cancer. So , we are very excited about that. I wonder
if I c an turn to another topic, Congressma n . The De moc ratic Par ty has
seen really kind of a remarkable upswing and support following the
Supreme Court decision to reverse the Roe v . Wade Constitutional
right to an abortion. I think you made some headlines earlier this year
when you campaign ed for a n in cum bent anti abor tion Democrat and
said at the time that you don't think there ought to be a litmus test in
the Democratic Party. But it also seems at the same time that you and
Speaker Pelosi and the President are asking voters to apply a litmus
test to the Re publican ant i abortion candidates. Can you comment on
that for us ?

James Clyburn: Oh I will gladly comment on that . Look, my father was a
fundamentalist minister, and my mother was a beautician . They did
not agree on the whole subject of abortion . My mot her, yo u would
call a p ro, my dad was anti, but they both stayed married. My wife
and I didn't agree on a lot of things , b ut we’re still married 58 years by
reconciling those differences.

So , I don't agree with everything that every Democrat has to deal with
in h is or h er respective Congressional district. Now, the first thing you
got to do, if you're going to solve these problems, is be in position to
do that. And when you've got a candidate who is in your party,
especially an incumbent, and you hav e looked at his or he r district
and you know full y well that certain positions must be moderated ,
wh y is it that you see all of these Republicans now taking this
anti abortion stuff down off their website ? They're now moderating
their posit ions .

S o yes, I did. Nancy Pelosi, yo u cannot say that she is anti abortion, she
also supported Henry Cuellar , the candidate that you are referring to ,
b ecause it is a number that we need to maintain if we're going to stay
in charge with the majorit y t o ge t these problems s olved . So I am very
pro choice. I'm the father of three daughters, and they call me daily.
And I'm not going to do or say anything that will stop the telephone
call from coming.

Mark Masselli: That's great. You're always trying to fin d t he seam of opportu nity
where you can wo rk together with people , a nd we appreciate that.
Let me just focus on something you were talking about a little earlier
about prescription drugs. The President and the Democrats are taking
a victory lap for pas sing th e Inflation Reduct ion Act. And as you k now,
drug makers are still upset about the part of the act that aims to

House Majority Whip James Clyburn

reduce prescription drug costs . And the industry says , and I quote,
“ Will lead to fewer new treatments , and doesn't do nearly enough to
addre ss t he real affordabil ity problem facing pa tients at pharmacies. ”
I'm wondering if we could get your response to that statement .

James Clyburn: I'm not too sure I kn o w exactly what that means . I know this . I know
that the costs of pharmaceuticals need t o be re ined in. I know wh at
my late wife went through for 30 years with the price of insulin.
Insulin has been around for more than a hundred years, and we have
done the research that t he pharmaceutical companies can still make
money with a $35 per month ch eck . So why wa s my late wife ’s insulin
bill $ 800 a month ? She was a full shot a day diabetic . When you've got
people cutting pills in half , passing up insulin treatments in order to
afford meals , that should not be in this country.

And so nobody is more supporti ve o f t he pharmac eutical industry
than I am , because that's where the research has got to be made . I
support their research. In fact, the Medical University of South
Carolina named their research center in my honor because of the
work I've been doing so t hat we can get a h andle on cancer, get a
handle on diabetes, multiple sclerosis , and cystic fibrosis , and all of
these things that still plague us. We have to depend upon the
pharmaceutical industry to get that done. But at the same time, they
have to look a t th is cost , a nd they've got to deal with the issue of why
it is that it's costing so much for these things here in the United States
of America , a nd you go one step out of the country at our northern
border and i t ’ s costing dramatically less . There is som ethi ng that has
to be reined in here , a nd I think that all of us need to commit
ourselves to doing it .

Margaret Flinter: Well , Congressman , the recently passed legislation that Mark referred
to , also includes billion for environmental justice block grants , and w e
ha ve all been riveted by read ing and watching or living through what's
been happening in Jackson, Mississippi, in a Black majority community
when the infrastructure for safe water has been neglected, and it
collapses . It reminds us of what went on in Fl int, Mi chig an just a few
years a go. And we wonder, do you think we're really looking at
systemic racism in the water infrastructure in the United States , a nd is
this legislation going to go far enough to treat this not as an isolated
problem, but as a coun try wid e pro blem?

James Clyburn: We're doing a lot funding - wise . That's not been a problem in Jackson,
Mississippi . That was not the problem in Flint, Michigan . We talk
about Flint, the Highland Park, Michigan right next door, i n fact I'm
going to be in Mic hig an, and I'm going to deal wit h this issue there
b ecause I think it needs to be dealt with . The policies that we have ,
t hey put politics above people . Political decisions le d to that problem
in Flint when they change d the source of the water , a nd then ma ny

House Majority Whip James Clyburn

people k n e w . There have been indictments coming out of that. And a
lot of people say the Governor of Michigan should pay a price for
making some criminal decisions . In Mississippi, the Governor vetoed
legislation that would have solved much of th e pr obl em in Jacks on,
Mississippi . A nd that, to me, is what the problem is . No, we aren't
getting enough funds out there to do it all , b ut we are getting enough
funds out there to prevent some of this from occur ring until we can
fix the bigger problem. Bu t yo u a ren't going to do it i f you've go t the
governor making political decisions, veto ing the stuff because it's 8 2%
African - American community. That's the only reason it's there. And
there's nobody in America who would believe that if the capital of
Mississ ippi we re 82% wh ite they would have t his problem . I don't
believe anybody would believe that.

Mark Masselli: Congressman, Bipartisan Congress did pass a gun safety bill . B ut we
still lack comprehensive gun control legislation, including a ban on
military style sem i - a utoma tic rifles and univer sal background checks.
Can you tell us if voters put Democrats back in power c an they expect
further action on guns?

James Clyburn: Yes, we do. I represent the entire peninsula of Charleston, South
Carolina . Emanuel AME ch urch is in my district . Those nine poor so uls
that lost their lives there, I knew seven of them personally . This is a
very, very personal issue with me. And I think if we are going to
continue to pursue gun safety laws, nobody is trying to violate the
Seco nd Amendment. But this notion that the First Amendment of free
speech can have constraints on it, but the Second Amendment t o own
a gun, cannot have constraints , that is foolhardy. And if you read
some of the Supreme Court decisions, Scalia, the late Just ice , nobody
wa s more conservative , I thought when he was there , tha n he was . He
made it very clear that the Second Amendment has constraints.

And Democrats are committed to having good, sa fe gun laws in order
to protect people. And there is no argum ent tha t can be made for an
assault weapo n being in the hands of an 18 - year - old without the
proper background checks. In fact, they shouldn't have them at all .
We should outlaw as we did before the assault weapons being on our
streets. So yes, Democra ts by and large . There's not a 100% of
Democra ts that are for t his, and there ’ s not a 100% of Republicans
that are against it. So what we've got to do is reach out across the
aisle in a bipartisan way to ban these weapons in the hands of people
on the streets.

Ma rgar et Flinter: Co ngressman, you also c hair the Select Subcommittee on the
Coronavirus Crisis , which just released a report , and it presented
extensive new evidence of the Trump White House's pressure
campaigns that targeted the Food and Drug Administration 's
C oro navirus re sponse. We certainly heard about pressure with CDC.

House Majority Whip James Clyburn

What safeguards is your subcommittee thinking about that might be
put in place to protect FDA and CDC going forward from that kind of
pressure?

James Clyburn: The fact of the matter is thi s f its into a la rger scheme. While we are
seeing the Coronavirus subcommittee , a lot of the previous
administration's personnel were dedicated to circumvent the law ,
t hey were dedicated to ignoring standards, doing things that didn't
make a whole lot of sense when it come s to health care , it w as this
whole notion that democracy is no longer a pursuit of the American
people , but autocracy ought to be the order of the day . And so these
kind of autocratic decisions that were made when it came to heal th
c are , the whole herd im munity notion , making recommendations for
health care , or attacks on th is virus that made absolutely no sense ,
t his kind of craziness seemed to have overtaken Washington for a
brief moment in time.

Let's hope that that's been ar rest ed now , a nd that we can begin to get
back on to our pursuit of a more perfect union, let the professional
decisions on health care [inaudible 00:20:31] the doctors, the nurses,
the people who have committed their lives to making sure that
people stay well . Thes e a re the people t hat we ought to be li stening
to . And so what we have uncovered with this committee was that the
profit motive overtook everything. Autocracy seemed to have seeped
into the system , a nd we will be making recommendations at the en d
of the year as to what we t hink needs to be done to protect against
this going forward.

Now, at the same time, you got Bennie Thompson on January 6
Committee , pursuing the same kind of efforts as it relates to
democracy as a whole. And then , hopefu lly th e Justice Department
w ill do its job in weeding o ut this cancer that has seeped into our
system. So , we need more than one Moonshot to take place if we're
going to continue this pursuit of a more perfect union.

Mark Masselli: Congressman, we hate to ask an yone an age question. But you
probably have seen the latest CBS News poll that found 73% of
Americans want age limits for elected officials. I'm wondering if that
outcome surprised you . What does it say about how we think about
the skills and va lues of older Americans to se rve in all kinds of roles?

Jame s Clyburn: Well , you know , it didn’t surprise me at all. But I will say this, I think
that when it comes to carrying out public service , t here must be a
healthy balance in knowledge and strength . It's bib lical. My grandson
is running my reelection campaign , because he has the strength to do
so. But I don't think he can do as well as he can, without the
knowledge that he gets from his Granddaddy. So I just believe that
there must be this healthy balance of str ength and knowledge, a nd
you find it in the Democ ratic Party. If you think for one moment that

House Majority Whip James Clyburn

Nancy Pelosi makes all the decisions in the party , you have never met
Hakeem Jeffries, or many of the others in our caucus because we are
a round the table with a he alth y b alance of wisdom and s trength.

Margaret Flinter: Congressman Clyburn, we want to thank you for your public service ,
for your commitment to health care. And thank you to our audience
for joining us to listen today. You can learn more about Conversati ons
on Health Care and sign u p for our updates at www.chcradio.com .
Congressman Clyburn, a pleasure to have you here, and an honor --

James Clyburn: Thank you.

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Mark Masselli: At Conversations on Health Car e, w e want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Robertson is an award - winning journalist , and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate for voters that aim to reduce the level of deception in U.S. Polit ics.
Lori, what have you got for us this week?

Lori Robertson: As the virus that causes COVID - 19 has evolved, the vaccines have
become less effective in preventing symptomatic infection, but they remain hi ghly ef fective in preventing severe disease and dea th. We've
seen several examples of anti - vaccine influencers misrepresenting this
shift by falsely claiming that it means the vaccines don't work. The
fact is viruses mutate or change as they replicate. Th e va cci nes made
by M o derna, P fizer, BioNTec h , and Jo hnson & Johnson , we re highly
effective in preventing both symptomatic infection and serious illness against early strains of the virus. Large clinical trials showed that the ability to prevent symptomatic i llne ss was high, but the vacc ines are
now less eff ective against infection from the currently circulating
sub variants of the Omicron variant.

That's why the FDA authorized new booster shots formulated to specifically provide protection against two Omicron sub va riants. The
boosters b ecame available in Sep tember . Dr. Peter Hotez , co - director
of the Center for Vaccine Development at Texas Children's Hospital ,
told us that COVID - 19 vaccine effectiveness has shifted with each new
variant of the virus. Waning eff ecti ven ess is due to both cha nges to
the virus , a nd the natural decline in the potency of vaccination over
time, which happens with most vaccines.

The CDC has noted this waning immunity and its recommendations for booster doses. The agency says that being up -to-d ate with
vaccination , o ffers significant protection against severe disease . Being
up - to - date means that you've gotten the primary series of vaccine
doses and any boosters that are available for your age group . For
March 20

th st
through May 31 of this year , h ospitalization rates f or

House Majority Whip James Clyburn

unvaccinated ad ults , were 3.4 times higher than the rates for
vaccinated adults. As for the new Omicron specific boosters, the CDC
recommends the Pfizer - BioNTech version for those 12 years of age
and older , and the Moderna ver sion fo r those 18 and older .

And that's my f act check for this week. I'm Lori Robertson, M anaging
Editor of FactCheck.org.

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Margaret Flinter : FactCheck.org is committed to factual accuracy from the country's
major political players , and is a project o f th e A nnenberg Public Policy
Center at th e University of Pennsylvania. If you have a fact that you'd
like checked, e mail us at www.chcradio.com . We'll have
FactCheck.org's Lori Robertson check it out for you here on
C onv ersations on Health Ca re.

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Ma rgaret Flinter: Each week , Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. It's no secret
that baby boomers are aging in large numbers , a nd that means tha t
t hose suffering from ag e- related dem entia are on the rise as well.
Four million Americans live with Alzheimer's disease , and we know
that number will double by 2025 , no cure and few drugs that can
stave off its devastating effects. Daniel Cohen has de vise d a tool that
is improvin g the experi ence for these patients whose quality of life
declines along with the loss of brain function. He wondered “ What
will happened if you provide i Po ds for patients in nursing homes th at
are loaded with their own persona l pl a yl ist of the songs they loved
when t hey were younger ?” In his first pilot program called Music and
Memory , p atients in a nursing home were given the iP o ds with their
own personalized song list , and the results , instantly noticeable .
Patients went from bei n g non communicative and disengaged to being
animated and engaged. Patients like Henry featured in this
documentary on the program called Alive Inside .

Daniel Cohen: Do you like music?

Henry: Yeah, I'm crazy about music . And you play beautiful music, be auti f ul
sound s.

Daniel Cohen: But, what was your favorite music when you were young?

Henry: I guess Cab Call o way w as my number one ba nd , yeah , yeah , like .

Daniel Cohen: What's your favorite Cab Calloway song?

Henry: Oh, “I'll Be Home For Christmas . You can plan --

M arga ret Flinter: Cohen explai ns one of the theories as to why this program works so

House Majority Whip James Clyburn

well.

Daniel Cohen: The reality is because our memories of music are co - located in the
brain with our autobiographical memories , w hen you play a song
that’s familiar, you're kick in g off memories that you had . We've done
some research , and the feedback from the frontline , from the nursing
homes , and from the staff is that their ability to provide care is
facilitated , and so that allows them to get the ir job done , to pay
attention to al l the residents as muc h as possible , and that's been a
big win as well.

Margaret Flinter: A simple personalized application for a readily available piece of
technology that could dramatically impact the quality of dementia
patients ’ lives , n ow , that' s a bri ght idea.

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Mar k Masselli: I'm Mark Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health.

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Marianne O’Hare : Conversations on Health Care is recorded in the Knowledge and
Technology Center Studio s in Middl eto wn , C onnecticut, and is
bro ught to you by the Community Health Center , now celebrating 50
years of providing quality care to the underserved , where health care
is a right not a privilege, www.chc1.com and www.c hcradio.com .

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