The following is a lightly edited transcript of the August 29 episode of theDaily Blast podcast. Listen to it here.
Greg Sargent: This is The Daily Blast from The New Republic, produced and presented by the DSR network. I’m your host, Greg Sargent.
The White House is saying that the director of the Centers for Disease Control, Susan Monarez, has been fired, ostensibly because she opposes Health Secretary Robert F. Kennedy Jr.’s anti-vaccine policies. This has prompted an extraordinary walkout at the CDC, which seems to be slipping into chaos as we record. At Thursday’s media briefing, White House press secretary Karoline Leavitt tried to spin this in a highly strange way. She tried to imply that this represented democracy in action, but she mangled key facts and couldn’t even explain in any serious way why this woman is being fired. We think this is revealing. It shows that the White House knows its position on vaccines is profoundly unpopular. Yet Trump has hitched himself, and sadly the rest of us, to an utter lunatic who’s trying to destroy one of the pillars of public health in this country. This will get worse for the White House. We’re talking about all this with the University of Michigan’s Don Moynihan, who writes a good Substack called Can We Still Govern? Don, thanks for coming on.
Don Moynihan: So happy to be here.
Sargent: So CDC Director Susan Monarez has been pressed for days by Kennedy and others internally if she would support rolling back some of the approvals for Covid-19 vaccines, according to The Washington Post’s reporting. She apparently was not willing to do that. So the White House has said she’s fired, but then her lawyers said only the president can fire her. And Don, as of now he hasn’t done so publicly. Maybe by the time people listen to this, it might’ve happened. So let’s assume, for this discussion, she’s likely out. Can you catch us up on the basics of this?
Moynihan: Yeah, it was pretty extraordinary what happened last night. Initially, the first we heard of this is HHS posted a tweet saying Monarez is out, doesn’t specify if she resigned or if she was fired. Then very shortly after, internal emails and public statements from other CDC leaders started to flow out where they were resigning in protest, pointing to the weaponization of the CDC, pointing to the practices of HHS Secretary RFK Jr. And then Monarez’s lawyer says, Hang on a minute, she hasn’t resigned. She hasn’t been fired. Only—and this is correct—only President Trump can fire her. Secretary Kennedy cannot. She’s the Senate-confirmed appointee and she has not received a letter saying that. We haven’t seen an update. And the latest thing that’s happened is that rank and file, these CDC scientists have walked out of their headquarters in Atlanta in protest of what’s going on. So it is this amazing uprising from the folks whose job is to protect us from serious diseases.
Sargent: It is amazing indeed. So at the White House press briefing, Karoline Leavitt was asked a very straightforward question: What did Monarez do wrong? Listen to this.
Karoline Leavitt (audio voiceover): Look, what I will say about this individual is that her lawyer’s statement made it abundantly clear themselves that she was not aligned with the president’s mission to make America healthy again. And the secretary asked her to resign. She said she would and then she said she wouldn’t, so the president fired her—which he has every right to do. It was President Trump who was overwhelmingly reelected on November 5. This woman has never received a vote in her life. And the president has the authority to fire those who are not aligned with his mission. A new replacement will be announced by either the president or the secretary very soon. And the president and secretary Kennedy are committed to restoring trust and transparency and credibility to the CDC by ensuring their leadership and their decisions are more public-facing, more accountable, strengthening our public health system, and restoring it to its core mission of protecting Americans from communicable diseases.
Sargent: So let’s break that up into two parts. First, note the claim that she’s never gotten a vote. Of course, the Senate voted to confirm her. But that aside, the game they’re playing here—the real game—is to try to claim that Trump is merely cleaning out the deep state. The unelected bureaucrats who are not aligned with what the people want. I think it’s going to be very hard, Don, for them to defend firing a health professional for the sin of not wanting to further damage our vaccine infrastructure.
Moynihan: Monarez has been actually pretty savvy in raising the conflict and salience around what is happening. And this is a position—she for sure is a political appointee that Trump can fire, but historically CDC directors are doctors or, in her case, a scientist. She’s an infectious disease scientist. And so it’s not really the type of position you want to hand to someone who doesn’t have some backing in that area. And it makes it a lot easier then, I think, to tell the public, Hey, diseases are serious things. We should have serious people trying to figure out those threats. And instead, we’re left with RFK Jr. And who knows what type of people who are advising him on things like vaccines.
Sargent: Yeah. And to get into this second piece of Leavitt’s thing, note how she’s keeping it very vague. Leavitt says Monarez was not aligned with the president’s agenda. But what that really means is she wants to follow science on vaccines and Trump does not. Leavitt doesn’t want to say directly that Monarez is resisting the dramatic rollback of Covid vaccines and probably much worse to come. I’m going to predict that you won’t hear the White House say straight out, Trump and RFK want to roll back these vaccine protections and these professionals who are resisting don’t. The White House can’t defend that. How do you see that unfolding?
Moynihan: I think you’re right. And I think they will use abstractions like “Make America Healthy Again” or not aligned with the president’s values. But look, these agencies are public agencies. They have mission statements that were written into statute. They are answerable to Congress. And part of the reason Menares was fired is she consulted with Bill Cassidy about what was going on. And when you get down to the nuts and bolts, the president is not actually a king here. He cannot mandate exactly how the CDC operates without consulting with Congress. And if I was in Congress, if I was Bill Cassidy, I would be saying, What the hell is going on here? Why are we not allowed to talk to senior officials about the ways in which they are managing public money?
Sargent: Let’s talk a little bit about what’s going on with the Covid vaccine right now. The Food and Drug Administration this week approved updated Covid vaccines but it authorized the vaccines for people who are 65 and older and said younger people would only be eligible if they have an underlying medical condition. And apparently still some people with certain conditions, if they’re unhealthy in various ways, can get it with a doctor’s consultation or something like that. Can you talk about where we are on that? It’s a pretty dramatic move on FDA’s part, isn’t it?
Moynihan: Yeah, in practical terms, it dramatically limits access to the vaccine. And this really is conflicting with something that RFK Jr. promised, which is that anyone who wanted a vaccine could get a vaccine. Really, at this point, if you’re over 65, it’s going to be feasible to get a vaccine. For everyone else, it’s going to be a lot harder. You may have to talk to a doctor to be able to access it. And we know that in practice, if you put these administrative burdens in place, that’s going to lower take up or access to these public services. Now that’s a political decision. RFK Jr. is deeply skeptical about vaccines; that is one thing we know true out his entire career. It’s not necessarily an evidence-based decision. And I think that was the crux of his disagreement with Monarez.
Sargent: And Monarez was saying that the science doesn’t dictate this at all, meaning doesn’t dictate what RFK is doing with the Covid vaccine. That led to the firing. I want to return to a point you made earlier about the president not being a king here. He has a lot of power over the bureaucracy, but it’s not absolute. This is the crux of the issue. These agencies were created by acts of Congress and they have missions that were at least to some degree defined by Congress. And when Karoline Leavitt goes out there and tries to imply that when they’re tearing the place down, they’re merely doing this in keeping with what the people want, she’s essentially saying that Trump’s been given enormous power by the people to do things that really run roughshod over what Congress intended these agencies for, correct? Can you talk about that?
Moynihan: Yeah, that is correct. And I think it is emblematic the broader governing philosophy of Trump. This can be framed in terms of unitary executive theory if you want to rely on conservative legal thinking or the way in which Trump says it himself which is I’m the president, I get to do what I want. It is a vision of the presidency where the president is the personification of the executive branch and he gets to have the final word on everything federal agencies do. And that is a really radical departure from how we’ve thought about American government for the last 250 years. It cuts out Congress in a fundamental way.
Sargent: Yes, and I think you’re getting at the very key thing that’s revealed in this Karoline Leavitt diatribe or whatever the hell it was. She’s trying to cast this as democracy in action. And it may fool some people, but the truth of the matter is what she’s actually saying is she’s defending a vision of maximal presidential power that really cuts down dramatically the role of Congress in setting how our government works and what its goals are and how it’s going to function. I think it’s hard to imagine that if Americans understood what that vision actually is that they would be fooled by rhetoric like Karoline Leavitt’s.
Moynihan: Yeah, it’s a version of democracy where you say the only election that matters is the presidential election. Congressional elections don’t matter. It’s a version of democracy that says even if you’re making unpopular decisions, they’re still justified because you’re president. And it’s also a version of democracy that eats at any other sources of democratic legitimacy. And again, you point it to statutory language. There are also standards that these federal scientists have to follow in how they evaluate information that have been embedded over time by Congress. Those are other forms of democracy. Those are forms of democracy that historically have actually been pretty effective in making America a superpower over the course of the last 70 or 80 years. And now we’re just seeing an abandonment of all of those other forms of democracy in favor of centralizing authority in the hands of the president, which, to me, feels very at odds with the basic civic textbook understanding of how the founders designed American democracy.
Sargent: Right. The Senate voted to confirm this head of the CDC and senators are elected as well. And so when Karoline Leavitt cavalierly says she never got a vote, she’s essentially cutting Congress out entirely from the process.
Moynihan: Yeah. If the only person who’s democratically legitimate in your country is the President of the United States, you do you don’t actually have a democracy. You have a monarchy. If the only person who can legitimately exercise power is one individual then that person is a de facto king. They are not part of a democratic order.
Sargent: And that is their vision. I want to read a remarkable quote from Dr. Richard Besser, a former acting head of the CDC. “As bad as things have been since January, the firing of thousands of federal health workers, extreme budget cuts, the ongoing assault on our nation’s vaccination system, what we saw yesterday was another level entirely, an extraordinary and systematic dismantling of the very top of our nation’s public health system.” Don, that’s amazing stuff. You have experts wondering whether the CDC will ever recover. Will it?
Moynihan: It may take generations. And the thing that really should worry everyone is that it’s not just the CDC. So for example, yesterday FEMA employees were put on administrative leave for writing a letter outlining to the public just how bad things have become within FEMA. EPA employees have been put on administrative leave for the same reason. Agency after agency, you see these federal professionals who know that they’re risking their jobs coming out to the public and saying, Things are really bad here, you should be paying attention to how bad things are going. And at some point, things will start to break.
Sargent: Well, to go bigger picture here, the White House seems to be betting that they can get away with these moves by invoking unelected bureaucrats as a villain. But, and this is something that will appeal to you as the author of a Substack about this topic, I strongly suspect that people understand the need for a professionalized civil service and very much value having medical professionals running public health. Can you talk about those bigger things that are at stake here?
Moynihan: Yeah, one thing we can see is that when you ask the public, Do they prefer a more politicized way of managing government organizations or a more professionalized approach? and that’s the choice that we’re looking at here, the majority tends to prefer a more professionalized approach. That doesn’t mean that they want professionals to have the final say or make the decisions on everything, but they want professionals to be free to give expert-based, evidence-based advice to elected officials and ultimately then allow those elected officials to make the final decisions. And we are straying away from that point because now the professionals feel like if I provide evidence-based information, I’m at risk of getting fired. And that’s what it means to have this politicized bureaucracy whose primary goal is to serve the administration rather than to serve the public.
Sargent: To serve one man rather than serve the public, right?
Moynihan: With Trump being the personification of the administration, the state is him in their worldview.
Sargent: Absolutely. And that’s basically what Karoline Leavitt set up there. Just to close this out, though, I think there’s actually a key point to be made here about what the public really wants. And there seems to be a built-in assumption—on the part of Trump and his political advisers but also on the part of some Democrats and liberals—that it’s so easy to demonize government, that all they have to do is just scream deep state and they can get away with pretty much anything. But this is a really crystal-clear example of a situation where I think that isn’t going to happen. People want professionals running public health. They understand the need for that. Public health is one of the pillars of American greatness, isn’t it, Don? Isn’t that really what’s at stake here—whether they can get away with demonizing government quite that easily or alternatively whether the people are really going to essentially see through it and understand what’s at risk of being lost here?
Moynihan: I think this is an issue that goes back to the 1970s where you see both parties bashing bureaucracy and bashing government. Over time, we see this decline in trust and bureaucracy and it was mostly pretty harmless when no presidents were actually doing much about that rhetoric or acting upon it. Trump really is acting on the anti-government rhetoric in a profound way. And so for Americans, I think we’re going to be in a period of hopefully civic education about what the bureaucracy actually does.
And it can get really bad. We just passed the twentieth anniversary of Hurricane Katrina, which I think was the single most important event in tanking the second term of the Bush administration, where the public got to see up close, Oh, competence really does matter for these public organizations. If we run into another public health emergency—God forbid, another pandemic in the next year or two—and we’ve had a period where CDC leadership has been taken out, where funding for MNRA vaccines has been eliminated, where you basically have cranks running the advisory boards of essential public health functions, it’s going to be a very bitter pill for the public to swallow and a very grim way of learning—again—what it is that these public agencies do.
Sargent: Really critically put. I just want to point out that your parallel to Katrina could actually spool out in other ways as well in the following sense. You could really see the incompetence issue and grotesque mismanagement issue becoming much, much bigger in the public mind precisely because they’re throwing the public health system into chaos. And in many ways, that could be politically a whole lot worse than Katrina because Katrina, as awful as it was, was an event in one place in the country that highlighted horrible bureaucratic mismanagement, catastrophic mismanagement. But the public health system faltering for Americans and then that getting pinned on Donald J. Trump?
Moynihan: Yeah, public health operates on this just broader scale where it’s so embedded into our everyday lives that we just don’t pay attention to it until it starts to go wrong. That’s true of a lot of governments as well. But if you look at the Trump administration, we’re going to be looking at a battle probably between RFK Jr. and Elon Musk for who has racked up the most deaths around the world. Elon Musk, by eliminating USAID, killed a tremendous amount of very inexpensive but very effective public health, which millions could potentially die from. RFK Jr., again, if we have other significant public health events and he has basically stopped the CDC and HHS to prepare for those, could have blood on his hands. We’re not talking about in the dozens or hundreds or thousands, but tens of thousands and potentially even millions.
Sargent: I think that’s exactly right. And I think that’s a preview of some really, really bad stuff to come, and that it will get hung around Donald J. Trump’s neck. Don Moynihan, thanks for coming on, man. Great to talk to you.
Moynihan: My pleasure. Thank you.
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