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Transcript: Dr. Scott Gottlieb on “Face the Nation,” May 21, 2023

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The following is the transcript of an interview with Dr. Scott Gottlieb, former FDA commissioner, that aired on “Face the Nation” on May 21, 2023.


MARGARET BRENNAN: More than 130 medications are in shortage in the United States, including key cancer treatments according to the Food and Drug Administration. Joining us now to discuss it is former FDA commissioner, Dr. Scott Gottlieb, who is also a board member at Pfizer. Doctor, iIt’s good to have you back. I wanted to have you explain this because the American Cancer Society warned this week, it’s a serious and life threatening issue for cancer patients. How bad is this shortage and what’s causing it?

DR. SCOTT GOTTLIEB: Look, it’s bad. This is a long standing problem. There’s about 300 drugs in shortage right now, active shortages, and so that’s a high level, it’s the highest it’s been since 2014. But this has been a long standing challenge. I dealt with it when I was at FDA going back to around 2003. That’s how old this problem is and the issue is that this mostly affects sterile injectable drugs. That doesn’t mean that small molecule pill form drugs aren’t in shortage, but the majority of the shortages are around the sterile injectable drugs. The reimbursement for these drugs under government programs has been driven down very low, something above the marginal cost of manufacturing the drugs and that’s fine when it comes to a pill form drug where there’s not a lot that can go wrong, but when it comes to an injectable drug, you need to leave a margin in so people can reinvest in manufacturing facilities, make sure they’re high quality. They haven’t done that and things go wrong, and it results in shortages.

MARGARET BRENNAN: Well, I know the White House is looking at this issue. Something like 80 percent of manufacturing facilities are located outside the U.S., how do you ramp up domestic production?

DR. GOTTLIEB: Yeah, look, we’ve paid a high price for the low costs we enjoy. If you want to get manufacturing back into the U.S., you want companies to have a healthy margin that they can reinvest in the manufacturing facilities to make sure that they’re modern, you need to pay them to do that. And as long as we drive down the reimbursement for these generic drugs, you’re not going to have the money to reinvest in doing that. The White House is talking about more regulation, the generic manufacturers are calling for direct subsidies. I think we really need to create a market for high quality manufacturing, so you can allow generic manufacturers to make certain claims about the reliability and the quality of the manufacturing. And then for generic manufacturers that can make those claims, through maybe some third party certification, you pay them for that. You pay them for the fact that they have reliable manufacturing that might be domestic, that might be more modern, so it’s going to be more reliable and less prone to shortages.

MARGARET BRENNAN: Well, the federal government is capping the cost of certain drugs because of high costs to consumers. Is that going to add to this issue?

DR. GOTTLIEB: Look, the features under the Inflation Reduction Act will exacerbate this problem, because it’ll prevent these generic manufacturers from being able to take price increases. For example, if they enter a market for the first time, or they spend a lot of money upgrading a facility to be compliant with state of the art regulations, they’re not gonna be able to take a price increase to recoup some of those costs. So it’s going to come out of their own pocket. 50 percent of generic drugs right now in a generic portfolio lose money. So a generic manufacturer loses money on half of their drugs that they market. That’s not a sustainable business model. I think the administration under the IRA should carve out these old sterile injectable drugs entirely. They didn’t do that in the legislation. So it is going to exacerbate these problems.

MARGARET BRENNAN: Can they do that? Can the FDA do that? Who can do that?

DR. GOTTLIEB: Well the FDA- it’s going to take Congress. They did create provisions in the IRA to try to carve out some of these drugs, but the way they structured it, a lot of these sterile injectable drugs are still going to get caught in these price caps. And so it will take an act of Congress right now to modify the IRA to do that. I think people are looking at it. I think they recognize that there are structural features in this market that make this a recurring problem. This isn’t a new problem, it’s gotten worse over time. It’s going to take Congress stepping in to do something to change the way these drugs are paid for.

MARGARET BRENNAN: And that brings us back to a problem we talked about weekly in terms of getting things passed right now. I want to ask you about COVID because I’d be remiss if I didn’t acknowledge the end of the federal health emergency on May 11. What do you think the practical impact will be on people at home?

DR. GOTTLIEB: Well, I think the end of the public health emergency the practical impact is not going to be that significant to the average consumer. The administration took steps to extend certain things like telehealth, things that consumers were benefiting from. There is going to be an impact on Medicaid eligibility, you’re going to see some people lose their Medicaid coverage, and some people not get automatically re enrolled and they won’t know how to re enroll into that program. So there is going to be an increase in the uninsured as people get kicked off of the Medicaid rolls. Right now cases are down to very low levels, they’re probably going to pick up going into the fall, but their- hospitalizations, over 9000 hospitalizations last week, that’s a historical low through the pandemic. Excess deaths are back to the historical baseline, so things have improved dramatically. I do think cases are going to pick up as new variants start to emerge, but this will become a more manageable threat, hopefully.

MARGARET BRENNAN: Dr. Gottlieb Thank you always for your time. We’ll be right back.



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Sen. Tammy Duckworth says Pete Hegseth is “flat-out wrong” about women in combat roles

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Sen. Tammy Duckworth says Pete Hegseth is “flat-out wrong” about women in combat roles – CBS News


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Democratic Sen. Tammy Duckworth of Illinois, a combat veteran of the Iraq War, tells “Face the Nation” that Pete Hegseth, President-elect Donald Trump’s pick to lead the Defense Department, is “flat-out wrong” in his assessment that women shouldn’t be in combat roles.

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Sen. Duckworth says Trump defense secretary pick is “flat-out wrong” about women in combat roles

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Democratic Sen. Tammy Duckworth said Sunday that Pete Hegseth, President-elect Donald Trump’s pick for defense secretary is “flat-out wrong” in his view that women should not serve in the military in combat roles. 

“Our military could not go to war without the women who wear this uniform,” Duckworth said on “Face the Nation with Margaret Brennan.” “And frankly, America’s daughters are just as capable of defending liberty and freedom as her sons.”

Trump tapped Hegseth, a former Fox News host and Army veteran who served in Iraq and Afghanistan as his pick to head the Defense Department earlier this month. The 44-year-old has drawn criticism for his stance on women in combat roles, along with his level of experience. 

Duckworth, who in 2004 deployed to Iraq as a Blackhawk helicopter pilot and sustained severe injuries when her helicopter was hit by an RPG, outlined that women who serve in combat roles have met the same standards as men, passing rigorous testing. She said Hegseth’s position “just shows his lack of understanding of where our military is,” while arguing that he’s “inordinately unqualified for the position.”

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Sen. Tammy Duckworth on “Face the Nation with Margaret Brennan,” Nov. 24, 2024.

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“Our military could not go to war without the 220,000-plus women who serve in uniform,” Duckworth said. She added that having women in the military “does make us more effective, does make us more lethal.”

Hegseth has also drawn scrutiny amid recently unearthed details about an investigation into an alleged sexual assault in 2017. Hegseth denies the allegation and characterized the incident as a consensual encounter. The Monterey County district attorney’s office declined to file charges as none were “supported by proof beyond a reasonable doubt.” His lawyer has acknowledged that Hegseth paid a confidential financial settlement to the woman out of concern that the allegation would jeopardize his employment. 

Duckworth, an Illinois Democrat who serves on the Armed Services and Foreign Relations Committees, said it’s “really troubling” that Trump would nominate someone who “has admitted that he’s paid off a victim who has claimed rape allegations against him.”

“This is not the kind of person you want to lead the Department of Defense,” she added. 

The comments come after Trump announced a slew of picks for top posts in his administration in recent days. Meanwhile, one pick — former Rep. Matt Gaetz for attorney general — has already withdrawn his name from consideration after he faced intense scrutiny amid a House Ethics Committee investigation and a tenuous path to Senate confirmation.

While Duckworth acknowledged that she’s glad her Senate Republicans “held the line” on Gaetz and also elected Sen. John Thune as leader over a candidate favored by many in Trump’s orbit, she said she’s “deeply concerned” her Republican colleagues will green light Trump’s nominees. 

“From what I’m hearing from my Republican colleagues on everything from defense secretary to other posts, it sounds like they are ready to roll over for Mr. Trump,” Duckworth said. 

But Duckworth didn’t rule out supporting some of the nominees herself during the Senate confirmation process, pledged to evaluate each candidate based on their ability to do the job, and their willingness to put the needs of the American people before “a retribution campaign for Mr. Trump.”

Meanwhile, a CBS News poll released on Sunday found that 33% of Americans say Hegseth is a “good choice” for defense secretary, including 64% of Trump voters. But 39% of Americans said they hadn’t heard enough yet about the pick. More broadly, Americans generally say they want Trump to appoint people who’ll speak their minds and who have experience in the field or agency they’ll run.

Sen. Rand Paul, a Kentucky Republican who also appeared on “Face the Nation” on Sunday, said he believes that Hegseth can run the massive Defense Department, despite his lack of experience managing a large organization. Though he did not address Hegseth’s comments about women in combat roles, Paul said he believes the “vast majority of people” support leaders who are picked based on merit, citing Hegseth’s criticism of the Pentagon for what he says has been a move away from merit-based hiring and toward hiring based on “racial characteristics.”



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Israeli strike kills Lebanese soldier as Hezbollah fires at least 185 rockets at Israel

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Hezbollah fired at least 185 rockets and other projectiles into Israel on Sunday, wounding seven people in the militant group’s heaviest barrage in several days, in response to deadly Israeli strikes in Beirut while negotiators pressed on with cease-fire efforts to halt the war.

Meanwhile, an Israeli strike on a Lebanese army center killed one soldier and wounded 18 others on the southwestern coastal road between Tyre and Naqoura, Lebanon’s military said. Israel’s military expressed regret and said the strike occurred in an area of combat against Hezbollah, adding that its operations are directed solely against the militants. The strike was under review.

Lebanon Israel
Rescue workers search for victims at the site of an Israeli airstrike that hit central Beirut, Lebanon, Saturday, Nov. 23, 2024.

Hussein Malla / AP


Israeli strikes have killed over 40 Lebanese troops since the start of the war between Israel and Hezbollah, even as Lebanon’s military has largely kept to the sidelines.

Lebanon’s caretaker prime minister, Najib Mikati, condemned it as an assault on U.S.-led cease-fire efforts, calling it a “direct, bloody message rejecting all efforts and ongoing contacts” to end the war.

“(Israel is) again writing in Lebanese blood a brazen rejection of the solution that is being discussed,” a statement from his office read.

The strike occurred in southwestern Lebanon on the coastal road between Tyre and Naqoura, where there has been heavy fighting between Israel and Hezbollah.

Hezbollah began firing rockets, missiles and drones into Israel after Hamas’ Oct. 7, 2023, attack out of the Gaza Strip ignited the war there. Hezbollah has portrayed the attacks as an act of solidarity with the Palestinians and Hamas. Iran supports both armed groups.

Israel has launched retaliatory airstrikes since the rocket fire began, and in September the low-level conflict erupted into all-out war, as Israel launched waves of airstrikes across large parts of Lebanon and killed Hezbollah’s top leader, Hassan Nasrallah, and several of his top commanders.

Hezbollah fired a total of around 160 rockets and other projectiles into Israel on Sunday, some of which were intercepted, the Israeli military said.

Israel Lebanon
Israeli police bomb squad inspect the site after a missile fired from Lebanon hit the area in Petah Tikva, outskirts of Tel Aviv, Israel, Sunday Nov. 24, 2024.

Oded Balilty / AP


Israel’s Magen David Adom rescue service said it was treating two people in the central city of Petah Tikva, a 23-year-old man who was lightly wounded by a blast and a 70-year-old woman suffering from smoke inhalation from a car that caught fire. The first responders said they treated three other people in northern Israel, closer to the border, including a 60-year-old man in serious condition.

It was unclear whether the injuries and damage were caused by the rockets or interceptors.

Israeli airstrikes early Saturday pounded central Beirut, killing at least 20 people and wounding 66, according to Lebanon’s Health Ministry.

Israeli attacks have killed more than 3,500 people in Lebanon, according to Lebanon’s Health Ministry. The fighting has displaced about 1.2 million people, or a quarter of Lebanon’s population.

On the Israeli side, about 90 soldiers and nearly 50 civilians have been killed by bombardments in northern Israel and in battle following Israel’s ground invasion in early October. Around 60,000 Israelis have been displaced from the country’s north.

The Biden administration has spent months trying to broker a cease-fire, and U.S. envoy Amos Hochstein was back in the region last week.


U.S. envoy says there is “real opportunity” to end fighting between Israel, Hezbollah

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The European Union’s top diplomat called for more pressure on both Israel and Hezbollah to reach a deal, saying one was “pending with a final agreement from the Israeli government.”

Josep Borrell spoke Sunday after meeting with Mikati and Lebanese Parliament Speaker Nabih Berri, a Hezbollah ally who has been mediating with the group.

Borrell said the EU is ready to allocate 200 million euros ($208m) to assist the Lebanese military, which would deploy additional forces to the south.

The emerging agreement would pave the way for the withdrawal of Hezbollah militants and Israeli troops from southern Lebanon below the Litani River in accordance with the U.N. Security Council resolution that ended the 2006 war. Lebanese troops would patrol the area, with the presence of U.N. peacekeepers.

Lebanon’s army reflects the religious diversity of the country and is respected as a national institution, but it does not have the military capability to impose its will on Hezbollah or resist Israel’s invasion.



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