Two pivotal moments shaped American healthcare: the creation of Medicaid in 1965 and the signing of the Affordable Care Act in 2010. While the ACA slashed the uninsured rate by nearly half, the system remains fragile. In this episode “Insuring America’s Poor”, George Washington University Professor Sara Rosenbaum—a key architect of Medicaid expansion, CHIP, and the Vaccines for Children program—reflects on her career and issues a stark warning. She joins me to discuss the catastrophic implications of the One Big Beautiful Bill Act of 2025 and how it threatens to destabilize healthcare for millions of millions of middle- and low-income Americans.

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In the 1980s, pediatricians often were called to evaluate febrile children for meningitis—a disease that could mean lifelong disability, or death. Today, that scene is dramatically less common, thanks to public health interventions championed by the CDC and lifesaving vaccines recommended by the Advisory Committee on Immunization Practices. Dr. Anne Schuchat paused her clinical career to join CDC’s Epidemic Intelligence Service, which turned into decades of leadership at the CDC, including serving as Principal Deputy Director and twice as Acting Director. From solving outbreaks to leading astoundingly successful efforts to reduce bacterial meningitis in infants through vaccination and coordinated clinical care, Dr. Schuchat’s work reflects the power of sustained, collaborative, evidence-based public health action.

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Dr. Sharon Balter, physician and poet, reflects on her career leading outbreak responses at the CDC and the public health departments of New York City and Los Angeles. Drawing on her experiences at the Federal level and in the United States’ two largest local public health jurisdictions, she offers a rare insider perspective on the strengths and complexities of the U.S. federated public health system.

Amid unprecedented challenges facing the field, she also delivers an optimistic message about careers in public health, offering perspective, reassurance—a much-needed balm for a frustrated workforce.

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After attaining zoology and medical degrees, Dr. Jay Butler’s medical career took an unexpected turn when he discovered the world of public health through the CDC’s Epidemic Intelligence Service. That discovery set him on a path that led to impactful roles with the Alaska Department of Health, the Alaska Native Tribal Health Consortium, and the Centers for Disease Control and Prevention in Atlanta.

In every position, Jay sought out the latest crisis and in the spirit of the CDC’s mission, “ran to the fire.” His long and diverse career has given him a unique perspective on how public health agencies can collaborate with each other and with communities to advance health.

Now preparing to begin a new chapter as Dean of the University of Alaska College of Health, Jay reflects on the lessons, challenges, and motivations that have shaped his public health journey—and his drive for personal growth that keeps him motivated and continuously learning.

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In the early 1990s, a devastating outbreak of contaminated beef led to kidney damage and death among children, sparking a call to action on food safety. In response, the CDC, USDA, FDA, and several state health departments launched FoodNet in 1995—a surveillance system designed to monitor the incidence and severity of foodborne illnesses across the United States.

Dr. Kirk Smith, an epidemiologist, veterinarian, and director of Minnesota’s FoodNet site, he shares his insights from decades of work protecting the nation's food supply. Dr. Smith discusses how FoodNet works, best practices in food safety, and a particularly unusual and interesting Salmonella outbreak in an elementary school.

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Dr. Tom Frieden has led public health institutions through some of the most defining moments of our time—from his stewardship of New York City’s Department of Health to his leadership of the Centers for Disease Control and Prevention. In his new book, The Formula for Better Health: How to Save Millions of Lives—Including Your Own, he distills decades of experience into a powerful approach: See·Believe·Create.

Dr. Frieden explains how rigorous surveillance and data serve as public health’s superpower, allowing leaders to identify urgent needs, design effective programs, and measure life-saving impact. As President and CEO of Resolve to Save Lives, he works on a global scale, advancing efforts to prevent millions of premature deaths by treating hypertension and promoting healthy eating.

Through his optimistic and action-oriented perspective, we are reminded that—even amid today’s challenges—public health can transform and thrive.

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For over two decades, Dr. Sara Cody devoted her career to protecting the health of her community as the Public Health Director for Santa Clara County. Her leadership was tested in early 2020, when COVID-19 arrived in her county—one of the first in the United States to detect community spread. As the virus spread rapidly, Dr. Cody faced the daunting task of making life-altering decisions with limited information, uncertainty, and intense scrutiny.

Drawing from her formative years as a member of the CDC’s Epidemic Intelligence Service, Dr. Cody shares how investigating outbreaks of contaminated apple juice and raw milk taught her the fundamentals of field epidemiology, including collaboration between government agencies and communities. Dr. Cody’s story is one of a deep sense of duty to community and an inside look at what it means to lead in local public health when decisions have enormous consequences.

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In the shadow of the HIV epidemic, Drs. Bill Clapp and Jim McAuley faced a growing tuberculosis crisis in the United States as frontline clinicians and public health experts. In this episode, they discuss the science behind TB control, the values that guided their mission-driven work in government health systems, and the faith that sustained their commitment to service.

Bill, a pulmonologist, cared for patients in one of Chicago’s impoverished neighborhoods before transitioning to public health and eventually returning to clinical medicine at Cook County Hospital. Jim, an infectious diseases physician, trained at the CDC, helped build TB control programs in Chicago and Africa, and now serves as Clinical Director at the Whiteriver Indian Hospital in Arizona. They share how medicine, public health, and faith intertwined in shaping lives devoted to healing and service.

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