Podcasts about McCarthy

Judicial Watch's Tom Fitton suggests defunding the prosecutions of President Trump and other Americans, defunding the censorship of tens of millions of Americans, defund the invasion at our southern border and protect the military from the Marxist propaganda forced on them. The secret Congress doesn't want you to know is that everything they hate in the Biden Administration they could defund in the next two weeks. The Democrat Party is contending with a rising Communist wing that is throwing all rules out the window. They want to overthrow the institutions and we're funding it. Where is the opposition in both parties? House Republicans say they're against it yet they're funding it. Fitton says we need to stop the damage now. We can't wait til next year to stop President Trump from being thrown in jail, we can't wait til next year to stop the censoring of Americans and we can't allow another 1-2 million people to cross our southern border. Where is the urgency? Fitton asks if you think Joe Biden is a crook, why is Congress even voting? Why wouldn't they take advantage of the continuing resolution and be willing to shut down the govt. unless he resigns? Fitton urges people to call Congress and tell them to rein in the Deep State and ask how they're going to make sure this corruption is defunded and defanged: Call 202-225-3121. There's a test coming up for the leadership in the House and one of the outcomes could be a new Speaker. Kevin McCarthy is taking the same position as Nancy Pelosi saying under law, we can't have full access to J6 videos. Fitton says it's terrible McCarthy is hiding this information from the American people, doing just what Pelosi did.GUEST: TOM FITTON, JUDICIAL WATCHSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

0:00 - McCarthy on budget showdown 7:12 - Sen. Sling Blade, spokesman for the working man…now with porn mustache 27:05 - Dan had a star sighting yesterday... former IL Gov Pat Quinn! 47:26 - Senior Fellow at the Cato Institute & a former Special Assistant to President Ronald Reagan, Doug Bandow, explains what he would do as a member of the Homeland Intelligence Experts Group... just as soon as his invite arrives in the mail. Check out Doug's recent piece for The American Conservative  Failed Empire 58:31 - DayQuil & The COVID vaccine  01:19:09 - THE PURGE/THE REVOLT: K-12 African American Immersion Schools 01:37:15 - Founding Member of the Capitalist Pig hedge fund and Fox News Contributor, Jonathan Hoenig, shares what he believes will happen at the Fed policy meeting and translates Sen Fetterman's comments to the UAW strikers. Take a look at Jonathan's most recent book  A New Text Book of Americanism: The Politics of Ayn Rand 01:52:57 - Illinois State Rep 8th district, LaShawn Ford, defends no cash bail in IL "judges now have full discretion" For more of LaShawn's work for IL District 8 visit lashawnkford.comSee omnystudio.com/listener for privacy information.

09/20/2023 PODCAST Episodes #900 - #902 GUEST: Phill Kline, Jackie Colbeth, Morgan Griffith, Bob Good, Sheriff David Clarke + YOUR CALLS! at 1-888-480-JOHN (5646) and GETTR Live! @jfradioshow #GodzillaOfTruth #TruckingTheTruth   Want more of today's show? Episode #900 GOP, RIP Episode #901 McCarthy Has Been Completely Cut Out Of House Negotiations-Members Took Control Episode #902 Sheriff Clarke Blasts Senate Giving Blank Check To Ukraine   https://johnfredericksradio.libsyn.com/

It's Wednesday, time for David Waldman, Greg Dworkin and KITM, your source for Canadian pirate information and news. We have talked on the subject, and I posted a few links yesterday, but more needs to be said. It turns out that despite American's comprehensive and detailed knowledge of pirates, Vikings and such, some are still unaware that these swashbuckling heroes might also be Canadian. For instance, there's Peter Easton, warlord, gangster, and profit center of the North Atlantic. Proof that a rising tide raises all boats, unless you crossed him, then he sunk yours. Also, Pirate-Canadian Maria Lindsey Cobham, Pirate Queen. And who can forget “Roaring” Dan Seavey, who pirated Americans and Canadians alike? Yarr! Eh? Republicans (and Democrats) wonder if Kevin McCarthy should be made to walk the plank, even as the Gop House sinks beneath the waves. McCarthy's last words will be “Regular order!” while the rest of the Republican rats have already picked out shores to swim to. Don't expect our Navy to fish out the treacherous picaroons. Meet The Press and moderator Kristen Welker failed in their interview of Donald Trump… or they did exactly what they had planned to do. Larry David asked Elon Musk “Do you just want to murder kids?” and discovered that Elon has a wide range of other interests, including mass disinformation and trolling. Nikki Haley warns that supporting unions will only make unions stronger. Just look at how emboldened UAW president Shawn Fain has become! Auto workers have successfully employed union jujitsu on selected auto plants. 3 fake electors want to make a federal case out of their subversion charges. Fake elector Cathy Latham used to hate politics. She'll really hate prison. Gen Z influencers moonlight as Ken Paxton's astroturf support. Meanwhile, special elections continue to go really, really well for Democrats.

SEASON 2 EPISODE 39: COUNTDOWN WITH KEITH OLBERMANN A-Block (1:43) SPECIAL COMMENT: NOW the Deep State has done it! NOW the Deep State has made its 27-Dimensional Chess move to cement the place of THE conspiracy in place and it will be left only to a few patriots and the Dilbert Guy to carry the torch of truth. Because WE knew it didn't add up because Ray Epps had never been charged and now the evil genius bastards have CHARGED RAY EPPS. He could get up to 90 days and be fined maybe 500 dollars! American! The conspiracy to frame Donald Trump is the greatest conspiracy in the history of the world and it was designed to make it look like Trump lost the 2020 election and destroy Jon Voight's chances of winning a Lifetime Achievement Award at the Oscars and make Joe Rogan look stupid. Well, MORE stupid. And then when the LEAK happened – the provocateur – the FBI plant who started it all and whose fault it all is – Ray Epps talked all the Trump supporters into going into the Capitol even though the other part of the conspiracy says everybody who went INTO the Capitol was Antifa - when it was revealed by the investigative team of Maria Bartiromo and Cat Turd that the feds left one nearly invisible loose thread – that the Deep State claimed Ray Epps wasn't a plant yet they never CHARGED Ray Epps, they suddenly DID charge Ray Epps yesterday and the masterminds behind this vast earth-shattering conspiracy decided to cover their tracks and silence all protest forever by…charging him with one misdemeanor count of disruptive conduct and he's pleading guilty today. And yet there it is, across Right Wing Looney Tunes land, the utter conviction, the absolute certainty from each of them that they alone have noticed that Epps was charged with one negligible offense and has seemingly already made a plea deal and that the rest of the world didn't notice – everybody but Catturd, who valiantly stood up and braved assassination probably by typing “You're not fooling anyone, Feds!" Oh god are they stupid. And The Stupid was all around the circuit yesterday: somebody used Matt Gaetz's printer to produce a copy of his resolution to oust McCarthy as Speaker, then left it in a Baby-Changing Station to be found by a reporter. Tim Scott was stupid enough to attack unions. Trump attacked Biden with the 25th Amendment and got everything ABOUT the 25th Amendment wrong. And 46 Republican Senators wrote a letter complaining about the relaxed attire rules in the Senate when the owner of their party wears bronzer, spray paints his hair, and lives inside a baseball cap. B-Block (19:52) THE WORST PERSONS IN THE WORLD: Peter Baker thinks the job of the president of the United States has actually been made tougher by something written by a guy who is evidently a columnist for The Washington Post. Add it to the list: Trump either doesn't know how the 25th Amendment work or thinks his cultists don't. And a Texas school district fires a teacher for reading The Diary of Anne Frank to 8th Graders because it was too sexy. C-Block (27:32) THINGS I PROMISED NOT TO TELL: My least favorite near-death experience? United Nations Week here in Fun City! My MOST favorite near-death experience? When the president of MSNBC chased me around the studios threatening to destroy me. God that was funny.See omnystudio.com/listener for privacy information.

To avoid a government shutdown, Congress has until the end of September to pass a new spending bill. Currently, House Republicans are unable to reach a consensus on defense spending and move forward with a proposed short-term solution. Speaker McCarthy's proposed GOP plan included approximately 8 percent in budget cuts, allocating no money for military aid to Ukraine but did provide funds to bolster border security measures. A procedural vote on Tuesday effectively defeated the GOP plan, with Republican lawmakers fighting internally about where spending is most needed. One of the few naysayers, Republican Congressman Matt Rosendale (R-MT), joins the Rundown to share why he is not worried about the possibility of a shutdown and why he lobbied against the continuing resolution. Seventy percent of Americans say transgender athletes should only be allowed to compete in sports on teams that match their birth gender. The issue has stirred controversy across schools in the United States, with some parents of female athletes voicing opposition to what they see as an unfair advantage, while more liberal countries have had the community argue this backlash is LGBTQ+ discrimination. The debate has the Biden administration in a difficult spot, with Press Secretary Karine Jean-Pierre telling FBN there is no "yes or no answer" for this issue. Meanwhile, 2024 GOP candidate Nikki Haley has called this the "women's issue of our time," criticizing the Biden administration for allowing "biological men to compete in women's sports." On the Rundown, FOX Business' Hillary Vaughn is covering this as part of FBN's weeklong series on "Education in America,'' and she breaks down the trans athlete controversy and how lawmakers are addressing these concerns. Plus, commentary from Hollywood actor and film producer, Kevin Sorbo. Learn more about your ad choices. Visit megaphone.fm/adchoices

Conservative commentator Ben Shapiro said that Donald Trump going after heartbeat laws is egregious. Mike shares his response to that and discusses why Trump talks about abortion the way that he does. California Gov. Gavin Newsom gave an interview to CNN where he made some alarming comments on abortion. He was not able to answer if abortion should be allowed up until birth. Also, House Speaker Kevin McCarthy dissed Ron DeSantis and said he is not on the same level as Trump. What do you make of McCarthy going all in behind Trump? Plus, President & CEO of the Ronald Reagan Presidential Foundation and Institute, David Trulio, joins Mike to discuss what we can expect at the 2nd Republican debate.See omnystudio.com/listener for privacy information.

Corey McCarthy continues to share his story of misdirection, redirection, redemption, and hope.

Molly Michael was an assistant to Donald Trump during his Presidency, and after he left the White House. She says he instructed her to say he knew nothing about boxes full of classified documents at Mar-a-Lago. A former White House colleague explains why Michael is such a credible witness in the case. Plus, can Kevin McCarthy keep his job? The House Speaker is facing increasing pressure to resign from the far-right of his own party, as his ordered impeachment inquiry into President Biden goes full speed ahead and a government shutdown continues to loom. And, how Prince William went incognito for a run through New York Central Park today, and no New Yorkers noticed.To learn more about how CNN protects listener privacy, visit cnn.com/privacy

Michigan Wolverines football coach Jim Harbaugh is back with the team following his self-imposed three-game suspension for alleged recruiting violations. As expected, he returns to a 3-0 team with the Rutgers Scarlet Knights in his cross-hairs for Michigan's Big 10 opener. Jim Harbaugh is the quarterback whisperer and JJ McCarthy could use him now following his 3 interception performance last weekend. During the Jim Harbaugh sabbatical, wide receiver Roman Wilson elevated his game. He has six touchdown catches in three games. Expect more of that between Wilson and McCarthy moving forward. Meanwhile, as the University of Michigan arch rival Ohio State University prepares for the Notre Dame Fighting Irish Saturday, the Buckeyes defense has played at a historic level. We will explore that further. Plus we have the latest news and notes around the Big 10.  Finally, we put out our weekly Big 10 Power Rankings on Locked on Big 10 with Craig Shemon.  Connect on Twitter:  https://twitter.com/talkbig10  Website: https://talkbig10.com     Follow & Subscribe on all Podcast platforms…  

Wojo joins us to talk about name suggestions for Heather's baby boy, the ongoing Mel Tucker situation at MSU, Dan Campbell's late-game management, his concerns about the Falcons, if Saturday was an all-time low for MSU Football, and J.J. McCarthy's performance against Bowling Green

@TheHeartlandPOD on Twitter and ThreadsCo-HostsAdam Sommer @Adam_Sommer85  (Twitter) @adam_sommer85 (Post)Sean Diller @SeanDillerCO   (Twitter and Post)https://heartlandpod.com/JOIN PATREON FOR MORE - AND JOIN OUR SOCIAL NETWORK!“Change The Conversation”Outro Song: “The World Is On Fire” by American Aquarium http://www.americanaquarium.com/Missouri's Fascist Display FalloutMissouri Sen. Bill Eigel a Gubernatorial candidate and Sen. Nick Schroer held a Freedom Fest (which cost $ to attend) in which they raffled off flame throwersThis included a demonstration of the flame throwersVideo showed what evoked for many people memories of Nazi book burning gatheringsAppears no books were harmed as they were burning a pile of cardboard and the “woke liberal agenda” in effigyAP good summary: https://apnews.com/article/fact-check-false-flamethrower-missouri-senators-books-ban-186453919126Another good one: https://scrippsnews.com/stories/missouri-lawmakers-deny-burning-books-in-viral-video/ Rowden: https://x.com/calebrowden/status/1704118480784523639?s=20Eigel then says he in fact is just fine with burning books and says he would burn books on the lawn of the governor's mansionThe cherry on tophttps://x.com/TheHeartlandPOD/status/1703956026939039838?s=20Real Housewives Of Presidential PoliticsFirst - I saw a Doug Burgum ad during monday night football and I about Burgumed in my pantsCalifornia also working to get Trump off ballot - follow up from last week talking 14th Amendmenthttps://www.politico.com/news/2023/09/18/democrats-effort-kick-trump-off-california-ballot-00116476From Article: Nine California lawmakers wrote a letter to Attorney General Rob Bonta over the weekend, arguing that Trump isn't eligible to be on the ballot for inciting an insurrection when a mob of his supporters attacked the U.S. Capitol on Jan. 6, 2021.The move, which comes amid several lawsuits to keep Trump off state ballots across the country, is unique because Bonta could use his standing as California's top law enforcement officer to expedite a state court ruling on the matter. Should the effort succeed, California could be the first state to bump Trump off its ballot, even if the ruling is ultimately overturned.Bonta would also be the country's first state attorney general to take a swing at knocking Trump off the ballot. The other cases rely on secretaries of state.Young Voters Back Uncle Joehttps://www.rawstory.com/young-voters-support-biden/From article: But as a young voter and host of "iGen Politics," Victor Shi observed, the same poll shows a record 65 percent support for Biden among voters under 30. For voters between 30 and 44, Biden enjoys 56 percent support. The lowest amount of support for Biden comes from those over 65.The official question read: "If next year's 2024 presidential election is between Joe Biden, the Democrat, and Donald Trump, the Republican, who would you vote for?"As goes Ohio's Senate Race So Goes The Nation?https://www.theguardian.com/us-news/2023/sep/18/sherrod-brown-democrat-ohio-senate-reelection?CMP=Share_iOSApp_OtherFrom Article: A Suffolk University poll in July had Brown in a statistical tie with the leading contenders for the Republican nomination. More than half of voters said they approved of the senator's job performance but, even among them, one in six said they were likely to vote for the leading Republican candidate.Brown's supporters say he unifies disparate Democrats and other voters in a way others in his party do not.

The NFL had another action packed weekend with some surprising 2-0 teams, even more surprising 0-2 teams and Puka MANIA taking over the world! You can purchase graded Jerry Rice rookie cards for the same price as Puka Donruss elite autos. What gives?!The NFL quarterback market is starting to become clear... who's hot and who's not? College football cards are also heating up as 2023 Bownan Chrome University features a fantastic checklist! There were 3 of the same Superfractors pulled in 2 different breaks this week. How does that happen? Imagine a box with 2 guaranteed autos yielding 60 of them? You might get that lucky, with this week's news about Bowman Chrome hot boxes. Hershey Haaland signed a card with the inscription, "The LeBron James of Soccer"... interesting! Also, Tyler and Lou's Jets got smoked by the Cowboys ... but they are set to return home to face off against Ryan's* Patriots this week. Can the Jets break their 14 game losing streak against the Pats? We'll see! Speaking of big games, Colorado is in Oregon this weekend as 21 point dogs... will they cover? Win outright? Tune in for all of this PLUS we answer 10 great questions from our audience, as well as an exciting latest launch! Time Stamps: 1:04 - What's on your mind (Tyler)6:44 - What's on your mind (Lou)9:29 - What's on your mind (Tyler 2)10:18 - What's on your mind (Ryan)15:00 - Any juice with NIL College Football cards?18:28 - NFL QB's who's up & who's down?28:03 - Puka Nacka Mania, what are we doing?!30:31 - Brian Robinson Jr & Bijon are GOOD!31:17 - Two of the same Superfractors pulled?! How?!32:29 - Bowman Chrome hot boxes.. 60 autos in ONE box?!33:26 - Is Hershey Haaland the "LeBron James of Soccer"?40:49 - Soccer update (Messi // World Cup Final stadium?)Q&A: 41:33 - Is Micah Parsons the best defensive player in the league?44:29 - Will Lou trade me Mark Andrews in the POTW fantasy league?44:54 - Does Ryan regret dropping Skyy Moore yet?45:11 - Buy, Sell, Hold - Burrow, Tua, Hurts?46:04 - At what point do we need a "Bengals Worry Meter"?46:53 - In terms of QB's, who is underpriced and who is overpriced?54:41 - Better buy - Jalen Hyatt or Zay Flowers?55:05 - On it Athletic College Football NIL Cards - Thoughts? 59:52 - Ryan's level of concern for a Michigan 3-peat after McCarthy's start?1:01:56 - Who wins this week, Pats vs Jets? Who is each team's current best player to collect?1:06:16 - Colorado Football - 21 point dogs?!1:09:37 - Latest Lauch----------------------------------------------------Follow 'Card Talk' on Twitter and Instagram @CardTalkPod. Join our NEW Facebook group: Facebook.com/groups/cardtalkIf you have a card question for us, email us at CardTalkPod@gmail.com, and it may be featured in the next episode.Subscribe to ONE37pm on Youtube: https://www.youtube.com/channel/UCKtW4czIzn-LW9IzG1h5kwAFollow @ONE37pm on Instagram: https://www.instagram.com/one37pm/​​​​ Follow @ONE37pm on Twitter: https://twitter.com/137pm​​​​ Follow @ONE37pm on TikTok: https://www.tiktok.com/@one37pm?See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Live from the Heart of America—I'm Steve Gruber— Your Soldier of Truth—the Tip of the Spear against socialists—here ready to fight for you from the Foxhole of Freedom—AND—please my friends REMEMBER TO THINK while its still legal—this is the Steve Gruber Show—   Here are 3 big things you need to know right now—   Number One— The soon to be fired head football coach at Michigan State University, Mel Tucker, who is accused of sexually harassing a rape survivor—decides to insinuate race may be a factor—   Number Two— Ford is laying off hundreds of workers who lack parts to build anything—and Chrysler could close 18 plants as a result of the UAW strike against the companies—what will GM do?   Number Three— There is a lot of anger in the halls of Congress these days and on the streets of America—   It seems the discontent is growing—and people are more frustrated by the day—and while the media might want you to think that its only the Republicans that are in disarray—the facts point to something else altogether—   But the GOP is certainly fighting an internal war—and the current battles are being fought over more spending being put forth in a continuing resolution to fund the government—as we as a nation have crossed the $33 Trillion dollar debt mark—   A deal cobbled together by House Speaker Kevin McCarthy fell apart Tuesday—as hardline conservatives are rejecting the deal as just more of the same—and I honestly think I have to agree with them—I mean when was the last time anyone in Washington from any Party actually cut spending in any meaningful way? Try never on for size—I mean not that I can remember—   Those opposed to just going along say the idea of Republicans once again signing on to a so-called clean continuing resolution to avoid a government shutdown—would once again leave the GOP emasculated—with not one bit of negotiating power left for them to use on anything—   One proposal put forth by the Freedom Caucus that found support from the more pragmatic Main Street Caucus would fund government for one month—BUT it comes with an 8% spending cut—and attaches a border security measure—BUT without the E-Verify portion—   And that sent some Republicans including several that one swing districts in New York last time around—to admit they will work directly with Democrats on a deal to avoid a partial Government shutdown that will come if a deal is not put together by September 30th—   All of this is being played out against the backdrop of Kevin McCarthy losing support of Republicans from all corners of the Party—   There are huge fractures that hardliners and moderates seem hard pressed to overcome—   But the hardliners are not apologizing—including some that have not been in Congress long—BUT have been abused in socialist countries previously—ones that say America is drifting far to the left—and it puts the entire country in peril if we do not right the ship and return to our roots of free-enterprise and capitalism—   But its not just the hardliners that are angry with Kevin McCarthy—   And remember it took how many votes for him to get the gavel? Was it 15—something like that—and in order for that to happen—you may recall McCarthy had to make a lot of promises—to just about everyone—and now those bills are coming due—AND its not just the Freedom Caucus folks demanding he honor the promises he made—BUT more mainstream conservatives are also voicing disapproval for his failure to deliver on what he said he would do—   BUT don't think for a second that its just the Republicans that are facing the winds of change—or more accurately huge storms inside their Party—   Democrats may want you to believe everything is running smoothly for them—BUT that is certainly not the case—   Fear is rising on the left—because Joe Biden is getting rejected in his re-election bid by more and more voters that pulled the lever for him in 2020—and are completely disenchanted with his performance in the White House—and that has some Democrats in a near full blown panic—because right now it looks clear that if the rematch with Donald Trump were held today—the 45th President would also become the 47th—and if Kamala Harris somehow gets the keys to Air Force One—Donald Trumps margin of victory would grow dramatically—   And if you factor in the Green Party candidate Cornell West—a far left activist and nut job—Trump wins by even a wider margin—so now the progressive power brokers are working frantically behind the scenes—desperately looking for a way out of this mess they created by anointing the senile but arrogant Joe Biden as Commander in Chief—   The only other Democrat in the race for the nomination in 2024 that has any significant support is RFK Jr. and the party bosses do not want him in power anymore than they wanted his father or uncle running the show—they just don't do as they are told and they have this annoying habit of supporting the Constitution and actually believing in America as a concept and as a great nation—and that government over-reach is the biggest threat to us all—even in the near term—   Meanwhile—the games with our elections are still being played in every single state that will allow for it—like Pennsylvania—where putting as many mail in ballots in circulation is key to gaming the entire system

Howie Kurtz on fellow Republicans trashing McCarthy over spending bill, DeSantis telling conservatives Trump will fail them on abortion issues and Democrats having building concerns over Biden's age. Follow Howie on Twitter: @HowardKurtz For more #MediaBuzz click here Learn more about your ad choices. Visit megaphone.fm/adchoices

On this episode of the MeidasTouch Podcast, Ben, Brett and Jordy discuss a series of deranged interviews and speeches by Donald Trump, in which he admitted to various crimes, lied to the American public, and showed severe cognitive decline. We also dissect the media's coverage of these moments and show how they enable fascism. Meanwhile, House Republicans are in complete chaos with a government shutdown around the corner a full-blown revolt within McCarthy's caucus. Texas AG Ken Paxton was acquitted in his impeachment trial following tampering by Donald Trump — that he admitted to. We've got the receipts. We'll also discuss the Biden administration's securing of the release of 5 American citizens wrongfully detained in Iran and much more.  DEALS FROM OUR SPONSORS: Miracle Made: Upgrade your sleep with Miracle Made! Go to TryMiracle.com/MEIDAS and use the code MEIDAS to claim your FREE 3 PIECE TOWEL SET and SAVE over 40% OFF. Manukora: Head to manukora.com/meidas or use code MEIDAS to automatically get a free pack of honey sticks with your order — a $15 value! Remember to subscribe to ALL the Meidas Media Podcasts: MeidasTouch: https://pod.link/1510240831 Legal AF: https://pod.link/1580828595 The PoliticsGirl Podcast: https://pod.link/1595408601 The Influence Continuum: https://pod.link/1603773245 Kremlin File: https://pod.link/1575837599 Mea Culpa with Michael Cohen: https://pod.link/1530639447 The Weekend Show: https://pod.link/1612691018 The Tony Michaels Podcast: https://pod.link/1561049560 American Psyop: https://pod.link/1652143101 Burn the Boats: https://pod.link/1485464343 Majority 54: https://pod.link/1309354521 Political Beatdown: https://pod.link/1669634407 Lights On with Jessica Denson: https://pod.link/1676844320 Uncovered: https://pod.link/1690214260 Learn more about your ad choices. Visit megaphone.fm/adchoices

[00:00:00] Robert O'Brien [00:18:25] Sen. John Cornyn (R-TX) [00:36:47] Mark Levin [00:55:10] Rep. Mike Johnson (R-LA) [01:06:00] Simulcast with Varney & Co. on FOX Business [01:13:31] Jackie DeAngelis [01:31:55] Gary Myers Learn more about your ad choices. Visit megaphone.fm/adchoices

Let's talk about McCarthy math.... --- Send in a voice message: https://podcasters.spotify.com/pod/show/beau-of-the-fifth-column/message Support this podcast: https://podcasters.spotify.com/pod/show/beau-of-the-fifth-column/support

The top news stories for 9/19/23Expat Money Summit: https://2023.expatmoneysummit.com/?ref=aw521Support the show: Antiwar.com/donate BUY MERCH: https://merchengine.com/collections/antiwar-comContact the show: News@antiwar.com Sign up for our newsletters: Antiwar.com/newsletter Support the show: Antiwar.com/Donate Watch on YouTube: https://www.youtube.com/channel/UCuGQ0-iW7CPj-ul-DKHmh2A/videosWatch on Odysee: https://odysee.com/@AntiWarNews:fWatch on Rumble: https://rumble.com/c/c-1996424  

AP Washington correspondent Sagar Meghani reports on Congress-Budget.

Senator Joseph McCarthy was one of the most notorious politicians in American history. He made wild accusations, ruined the lives and careers of countless people, and stained American politics with investigative tactics similar to those in Stalin's Soviet Union. Just as important, however, was McCarthyism. Professor Philip Nash explains all in this gripping episode that has all sorts of parallels to politics in today's America. Episode 529.This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/5455565/advertisement

Jim Harbaugh joins us to talk about his return to the Michigan sidelines for game day, J.J. McCarthy's turnovers against Bowling Green, and the Wolverines' Big Ten three-peat quest

Rutgers started out last year going 3-0. Then only found one win the rest of the way. My guest today says this years team has a completely different vibe though. How different? We'll find out Saturday in The Big House. With us today is Rutgers beat writer Pat Lanni from NJ.Com and The Newark Star-Ledger

Michigan football certainly didn't look like the No. 2 team in the nation on Saturday when it beat Bowling Green, 31-6. But was it really as bad as it felt watching the game unfold? Yes, J.J. McCarthy played poorly, but there's plenty of reasons to think things went better than it appeared as well as reasons for optimism moving forward. Then, we go around the Big Ten and react to the big games in the conference. Support Us By Supporting Our Sponsors! Betterhelp This podcast is sponsored by BetterHelp.If you're thinking of starting therapy, give BetterHelp a try. Visit BetterHelp.com/lockedoncollege today to get 10% off your first month.  Birddogs Go to birddogs.com/lockedoncollege or enter promo code LOCKEDONCOLLEGE for a free water bottle with any purchase. You won't want to take your birddogs off we promise you. Jase Medical Save more than $360 by getting these lifesaving antibiotics with Jase Medical plus an additional $20 off by using code LOCKEDON at checkout on jasemedical.com. Athletic Brewing Go to AthleticBrewing.com and enter code LOCKEDON to get 15% off your first online order or find a store near you! Athletic Brewing. Milford, CT and San Diego, CA. Near Beer. Gametime Download the Gametime app, create an account, and use code LOCKEDONCOLLEGE for $20 off your first purchase. LinkedIn LinkedIn Jobs helps you find the qualified candidates you want to talk to, faster. Post your job for free at LinkedIn.com/LOCKEDONCOLLEGE. Terms and conditions apply. FanDuel Make Every Moment More. Right now, NEW customers can bet FIVE DOLLARS and get TWO HUNDRED in BONUS BETS – GUARANTEED. Visit FanDuel.com/LOCKEDON to get started. FANDUEL DISCLAIMER: 21+ in select states. First online real money wager only. Bonus issued as nonwithdrawable free bets that expires in 14 days. Restrictions apply. See terms at sportsbook.fanduel.com. Gambling Problem? Call 1-800-GAMBLER or visit FanDuel.com/RG (CO, IA, MD, MI, NJ, PA, IL, VA, WV), 1-800-NEXT-STEP or text NEXTSTEP to 53342 (AZ), 1-888-789-7777 or visit ccpg.org/chat (CT), 1-800-9-WITH-IT (IN), 1-800-522-4700 (WY, KS) or visit ksgamblinghelp.com (KS), 1-877-770-STOP (LA), 1-877-8-HOPENY or text HOPENY (467369) (NY), TN REDLINE 1-800-889-9789 (TN) Learn more about your ad choices. Visit podcastchoices.com/adchoices

An apology can mend old wounds, reunite people, and heal communities. Despite the potential power it can have, a good apology is hard to find. There's a simple structure to a good apology we should all have memorized along with the traits of a bad apology that will only lead us into pain and misery. In this episode, we're going to the apology experts for guidance, Marjorie Ingall and Susan McCarthy, authors of the book “Sorry Sorry Sorry: The Case for a good apology” and founders of SorryWatch.com. Marjorie and Susan teach us how to make a good apology and give examples of bad ones. Learning this essential skill will help you preserve and strengthen the most consequential relationships in your life. What could be more important?

Crypto Assets are the future! Start your journey today!https://tinyurl.com/2juppzunUse Code: REDPILL78 for $50 in Free CryptoThe House has scheduled the first impeachment hearing, Gaetz tells McCarthy to put up or shut up & Democrats are getting screwed by other Dems at the ballot box!

TOP NEWS | On today's Daily Signal Top News, we break down:   The United Auto Workers union is officially on strike against Ford, General Motors, and Stellantis. The House Oversight and Accountability Committee is taking a closer look into FEMA's response to the catastrophic wildfires in Hawaii last month. House Speaker Kevin McCarthy did […]

House speaker Kevin McCarthy announced the opening of an impeachment inquiry into President Biden, but members of the Freedom Caucus—a group of right-wing Republicans with a taste for dramatic, extreme actions—had already moved on to fighting the next spending bill, potentially steering the government to another shutdown.  Guest: Jim Newell, Slate's senior politics writer. If you enjoy this show, please consider signing up for Slate Plus. Slate Plus members get benefits like zero ads on any Slate podcast, bonus episodes of shows like Slow Burn and Dear Prudence—and you'll be supporting the work we do here on What Next. Sign up now at slate.com/whatnextplus to help support our work. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Kevin McCarthy, Speaker of the House, discusses various topics including the impeachment inquiry into Joe Biden, funding fights on Capitol Hill, and the challenges Republicans face in the current political environment. McCarthy emphasizes the importance of honesty, accountability, and passing appropriation bills to avoid government shutdowns. He criticizes the Biden administration's handling of immigration and highlights the potential legal challenges faced by Donald Trump. The Truth with Lisa Boothe is part of the iHeartRadio Podcast Network - new episodes debut every Monday & Thursday.Follow Clay & Buck on YouTube: https://www.youtube.com/c/clayandbuckSee omnystudio.com/listener for privacy information.

House speaker Kevin McCarthy announced the opening of an impeachment inquiry into President Biden, but members of the Freedom Caucus—a group of right-wing Republicans with a taste for dramatic, extreme actions—had already moved on to fighting the next spending bill, potentially steering the government to another shutdown.  Guest: Jim Newell, Slate's senior politics writer. If you enjoy this show, please consider signing up for Slate Plus. Slate Plus members get benefits like zero ads on any Slate podcast, bonus episodes of shows like Slow Burn and Dear Prudence—and you'll be supporting the work we do here on What Next. Sign up now at slate.com/whatnextplus to help support our work. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Scott discusses the top business news stories for the day.

Monday, September 18, 2023 Subscribe: Get the Daily Update in your inbox for free 1/ Kevin McCarthy's latest short-term funding proposal to avert a government shutdown doesn't have enough votes to pass. McCarthy can only lose four Republican votes on a continuing resolution deal without relying on Democratic support. However, m... Visit WTF Just Happened Today? for more news and headlines, brought to you by Matt Kiser. The WTFJHT Podcast is narrated and produced by Joe Amditis.

House speaker Kevin McCarthy announced the opening of an impeachment inquiry into President Biden, but members of the Freedom Caucus—a group of right-wing Republicans with a taste for dramatic, extreme actions—had already moved on to fighting the next spending bill, potentially steering the government to another shutdown.  Guest: Jim Newell, Slate's senior politics writer. If you enjoy this show, please consider signing up for Slate Plus. Slate Plus members get benefits like zero ads on any Slate podcast, bonus episodes of shows like Slow Burn and Dear Prudence—and you'll be supporting the work we do here on What Next. Sign up now at slate.com/whatnextplus to help support our work. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Kevin McCarthy, Speaker of the House, discusses various topics including the impeachment inquiry into Joe Biden, funding fights on Capitol Hill, and the challenges Republicans face in the current political environment. McCarthy emphasizes the importance of honesty, accountability, and passing appropriation bills to avoid government shutdowns. He criticizes the Biden administration's handling of immigration and highlights the potential legal challenges faced by Donald Trump. The Truth with Lisa Boothe is part of the iHeartRadio Podcast Network - new episodes debut every Monday & Thursday.See omnystudio.com/listener for privacy information.

@TheHeartlandPOD on Twitter and ThreadsCo-HostsAdam Sommer @Adam_Sommer85  (Twitter) @adam_sommer85 (Post)Rachel Parker @msraitchetp   (Post) Sean Diller @SeanDillerCO   (Twitter and Post)Special guest: Don Looney @telecomdonhttps://heartlandpod.com/JOIN PATREON FOR MORE - AND JOIN OUR SOCIAL NETWORK!“Change The Conversation”Outro Song: “The World Is On Fire” by American Aquarium http://www.americanaquarium.com/TALKIN' POLITICST/FBoebert can salvage herself enough to win in Coloradohttps://www.politico.com/news/2023/09/13/lauren-boebert-maga-colorado-election-00113943This comes at the same time Boebert is kicked out of a theater for vaping, being loud while and dancing… oh and cranking her date's hog while he gets a handful of c-cup she gets kicked out and flips the bird and plays the “do you know who I am” cardShe also lied, and then whoops - there was videoColorado Newsline story from a couple weeks back with poll showing Frisch with a 2 point lead: https://coloradonewsline.com/briefs/adam-frisch-leads-rep-lauren-boebert-by-2-points-in-democrats-campaign-funded-poll/Axios calls it a deadlock - probably a good description given how 2022 ended in recount with very narrow margin for Boeberthttps://www.axios.com/local/denver/2023/08/22/lauren-boebert-adam-frisch-2024-poll-colorado Yeah No…Human rights limited in Red States https://missouriindependent.com/2023/09/15/missouri-lags-behind-most-states-for-childrens-rights-advocacy-group-finds/From article: Human Rights Watch, measured every state's laws against the standards of the Convention on the Rights of the Child, an international treaty that the U.S. has not ratified.The organization examined every state's laws on child marriage, corporal punishment, child labor and juvenile justice.No state received an A or B grade. Missouri and 15 other states received an F grade - Mississippi was dead last, New Jersey was firstReally a larger human rights issue in states like MOhttps://www.politico.com/news/magazine/2023/09/13/dobbs-pregnancy-maternal-health-00115561Note for Rachel: “New data reveals an unexpected consequence of these developments” UNEXPECTED BY WHOM, POLITICO?DeSantis using same kind of anti-public health BS https://www.semafor.com/article/09/15/2023/desantis-camp-bets-on-covid-lgbt-backlash-to-return-to-2024-relevanceAnti-LGBTQ ad DeSantis is running Iowa https://youtu.be/N58q7-hUWj4?feature=sharedYeah, Yeah!Nashville progressives take the day with Freddie O'Connell's election as mayorFrom TN Lookout: https://tennesseelookout.com/2023/09/14/freddie-oconnell-wins-nashville-mayoral-election-in-landslide-victory/Nice follow up from our discussion about Gloria Johnson's chance in the TN senate raceFrom article: O'Connell grabbed 64% of the vote, while his opponent, former Republican strategist Alice Rolli, snagged 36%. A total of 114,103 people voted in the runoff.Buy or Sell…The GOP's continued push on impeaching Biden is a plus for DemsKen Buck (notably of House Freedom and sedition caucus) on CNN says McCarthy KNEW he didn't have the votes to open inquiry, says at least 20 GOP members in house would vote NOSo much of it is tied to Ukraine too, almost feels as much about discrediting support for Ukraine as it is attack on Biden?Ukraine senator support story: https://www.kansascity.com/news/politics-government/article279264219.html?ac_cid=DM847839&ac_bid=-320453519McCarthy seems to know it's super dumb, may be its a trade off to keep form a shutdown on funding which would probably be really, really super dumbGood NPR article on risks for GOP here https://www.npr.org/2023/09/16/1199818085/republicans-impeachment-polling-biden-mccarthyThe Big OneGoogling Google… no really, it's worth a google. Or a bing. Or an ask jeevesGoogle is going on trialSEMAFOR article: https://www.semafor.com/article/09/12/2023/google-antitrust-trial-opens-usA massive antitrust trial opens against Google and its parent company Alphabet Tuesday. The trial, brought by the U.S. Justice Department, alleges that the tech giant used its power to squash any competition, illegally making itself the default search engine on many apps and services.VOX article: https://www.vox.com/technology/2023/9/11/23864514/google-search-antitrust-trialBork-ing of corporate oversight in the 1980s: https://en.wikipedia.org/wiki/The_Antitrust_Paradox

J.J. McCarthy threw three interceptions in UM's uninspiring 31-6 win over Bowling Green

It was a week of continuing hot action in the Trump prosecutions, combined major lawsuits not involving the former President. An awesome set of guests–Peter Baker, Erin Burnett, and Josh Marshall–join Harry to break it all down, starting with the odiferous indictment of Hunter Biden on rarely brought charges following a political outcry from House R's. They then take up impeachment, McCarthy's feckless week, Romney's parting broadsides against the GOP, and the landmark antitrust case v Google.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

On this Kings of the North, Doug Lesmerises and Bill Landis preview 6 huge games in Northern football, including Ohio State-Notre Dame, Colorado-Oregon and Penn State-Iowa. All eyes will be on the North on Saturday.But first, they look at troubles in Southern football; shout out at couple MAC teams and a one-man Syracuse offense; make claims about Indiana football and the national title; rank the best Northern teams with a new No. 1; and list the 10 best Northern QBs, including diving into Sam Hartman vs. J.J. McCarthy, and Kyle McCord vs. Drew Allar.Thanks for listening to Kings of the North.

Jim Harbaugh and the Michigan Wolverine's Quarterback JJ McCarthy had a "Semi Final vs. TCU" melt down on Saturday in what could have been an upset, if not for a struggling third string quarterback, in the Michigan vs. Bowling Green match up. Was it just a bad week for Go Blue? Or is JJ massively overrated? Also, Kyle McCord and the Ohio State Buckeyes were hot in a week where most were not. Does Ohio State Football Coach Ryan Day have a stud in the making in Columbus? Or was Saturday fools gold against a bad Western Kentucky offense?   MENACE COFFEE! https://menace2coffee.com/ Go to my sponsor: https://aura.com/menace to get a 14 day free trial and see if your personal information has been leaked online Go to my sponsor: https://www.bluechew.com/ Get ONE MONTH FREE (Pay $5 for Shipping) and try Blue Chew today! TRY MIRACLE MADE SHEETS NOW! https://trymiracle.com/MENACE MANSCAPED:  20% OFF with FREE SHIPPING! Screenshot your order for a chance at a FULL REFUND! https://www.manscaped.com/ #manscaped FREE CASH BONUS WITH MyBookie: https://mybookie.website/Menace2Sports The BEST Athletic wear you will find anywhere: https://mikeydapparel.com/ VIP Subscribers: https://www.patreon.com/menace2sports - Custom RSS Feed (Straight to your phone - No iTunes or Spotify) - Exclusive Content, Shows and Videos - Exclusive Call-In Ability for Live Shows - Starting at $5 a month! For the FULL Landscape of College Football, tune in:http://www.menace2sports.com https://podcasts.apple.com/us/podcast/menace2sports-with-zach-smith/id1464558838 Follow our show on social media: Tik Tok: https://www.tiktok.com/@menace2sports Twitter: https://twitter.com/Menace2Sports Instagram: https://www.instagram.com/menace2sports/ Undisputed Best Sports Handicapping Tool in the WORLD: http://www.patreon.com/menace2picks College football is a game of explosive plays, immense passion, and endless thrills. Every Saturday during the college football season, the spirit of competition and excitement take the field as the nation's top student-athletes battle for gridiron glory. The powerhouses in college football are teams like Alabama, LSU, Ohio State, Clemson, and Florida, all of whom compete in the fiercely contested NCAA Football Bowl Subdivision. Whether it's a hard-fought rivalry, chaotic scene in the stands, or an unbelievable touchdown grab, college football fans of all ages, backgrounds, and regions experience the same passion and intensity each week. From the blue-blooded programs to the rising stars, college football will always be the people's game. Ohio State Football is one of the most successful college football programs in history. With a total of 8 National Championships, the Buckeyes have established themselves as a powerhouse in the NCAA. Led by head coach Ryan Day, Ohio State has become known for its hard-hitting, aggressive defense and a high-octane offensive attack. While their recent success has been rooted in their strong recruiting class and their 2014 national championship, the program has a long and storied history in the college football world. On any given Saturday, the OSU faithful can be found inside the famous Ohio Stadium cheering on the scarlet and gray. Regardless of the opponent, each game brings out the passion and excitement that Ohio State fans are so well known for. Follow the Buckeyes and join the Buckeye Nation in their quest to reach another championship. Go Bucks!

This time in the podcast - John chats with Dr. Tracey Pearson about House Speaker Kevin McCarthy's attempt to have an impeachment inquiry for President Biden. They also discuss Tommy Tuberville's antics, and why Trump is waiving a speedy trial in the Georgia RICO case. He plays clips from McCarthy and Rep. Adam Schiff. They takes calls from Dave in Washington, Mark in South Dakota, and Bill in New Jersey. Next he talks with democratic strategist Max Burns about Kevin McCarthy and Trump's troubles. And then, listener calls about life from Lou in Indiana and Stephen in Kentucky.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Welcome aboard the Acela, listeners. Today on the FiveThirtyEight Politics podcast, we are taking a break from the campaign trail and heading to Washington, D.C., where there's quite a lot going on. House Speaker Kevin McCarthy announced last week that Republicans are opening an impeachment inquiry into President Biden. There are also just 12 days until a possible government shutdown. And some Republicans are threatening McCarthy's speakership. Politics reporter Leah Askarinam and POLITICO Playbook co-author and ABC News contributor Rachael Bade join Galen Druke to discuss. They also play a round of "Quiz of the Union," where they try to put this year's higher-than-usual number of strikes in the context of public opinion. Learn more about your ad choices. Visit megaphone.fm/adchoices

Despite many conservatives speaking out against it, House Speaker Kevin McCarthy is not ready to give up on a GOP deal that would fund the government before it runs out of money by the end of the month. CNN Political Director David Chalian explains the tricky situation McCarthy is in. Even if this short-term spending bill did pass through the House, it doesn't include key aspects the White House and Senate want.To learn more about how CNN protects listener privacy, visit cnn.com/privacy

See omnystudio.com/listener for privacy information.

The House is quickly running out of time to fund the government and Republican leadership is starting to feel the heat. The House GOP has unveiled a short-term spending plan, but it has been met with skepticism and resistance from many members of the party. Emily Brooks from The Hill breaks down what's in the plan, McCarthy's strategy, and why Republicans are divided. See omnystudio.com/listener for privacy information.

Dwight Eisenhower ascended to the presidency when the United States was in the grips of a red scare - a red scare fanned by Wisconsin Senator Joe McCarthy. As McCarthy exploited the public fear to steal the spotlight with hundreds of unfounded accusations of communist sympathies, Eisenhower, and three future presidents then in the Senate, had to grapple with the moral and societal threat of McCarthy to the republic, and what they were willing to do to stop him.New York Times best-selling author Larry Tye, author of Demagogue: The life and long shadow of Senator Joe McCarthy, discusses the origins of the McCarthy era, its costs, and what it took to end it.  Support the show

The system for coordinating organ donations and transplants in the United States is broken, according to experts who have testified over the course of many years to Congress. In this episode, hear their testimony about what is wrong with the current system and then we'll examine the bill that aims to fix the problems. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via Support Congressional Dish via (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Background Sources August 3, 2022. Senate Finance Committee. Lenny Bernstein and Todd C. Frankel. August 3, 2022. The Washington Post. February 10, 2020. Senate Finance Committee. The Bill Audio Sources July 20, 2023 Senate Committee on Finance, Subcommittee on Health Care Witnesses: LaQuayia Goldring, Patient Molly J. McCarthy, Vice Chair & Region 6 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Matthew Wadsworth, President and CEO, Life Connection of Ohio Raymond J. Lynch, MD, MS, FACS, Professor of Surgery and Director of Transplantation Quality and Outcomes, Penn State Health Milton S. Hershey Medical Center Donna R. Cryer, JD, Founder and CEO, Global Liver Institute Clips 30:40 Sen. Ron Wyden (D-OR): HRSA, the Health Resources Agency, is on track to begin the contract process this fall and we're just going to be working here to complement their effort. 36:30 Sen. Chuck Grassley (R-IA): In 2005, I started the investigation of the deadly failures of UNOS, the monopoly tasked with managing the US organ donation system. Since then, more than 200,000 patients have needlessly died on the organ waiting list. There's a reason that I call UNOS the fox guarding the hen house. For nearly two decades, UNOS has concealed serious problems [at] the nation's organ procurement organizations, known as OPOs, instead of working to uncover and correct the corruption. This human tragedy is even more horrific because many of these deaths were preventable. They were the result of [a] corrupt, unaccountable monopoly that operates more like a cartel than a public servant. 44:45 LaQuayia Goldring: As a toddler, at the age of three, I was diagnosed with a rare kidney cancer that took the function of my left kidney. And when I was 17, I went back into complete renal failure and I received a first kidney transplant at that time. Unfortunately, in 2015, I went back into kidney failure. And at that time, I wasn't ready for another transplant, but I didn't have a choice but to go back on dialysis. I've been waiting nine agonizing years for a transplant, dependent upon a dialysis machine five days a week, just to be able to live. I was told that I would receive a kidney transplant within three to five years. But yet I am still waiting. I am undergoing monthly surgeries just to be able to get my dialysis access to work so that I can continue to live until I get a transplant. The UNOS waitlist is not like one to 100, where everybody thinks you get a number. I'm never notified on where I stand on the list or when I will get the call. I have to depend on an algorithm to make the decision of what my fate will be. 47:55 LaQuayia Goldring: Just a few weeks ago, a donor family reached out to me to be a directed kidney donor, meaning they chose me specifically for a kidney transplant. But unfortunately, due to the errors in the UNOS technology, I was listed as inactive and this was a clerical error. And all that they told me was this was a clerical error, and they could not figure out why I was inactive. But when it came down to it, I'm actually active on the transplant list. 51:45 Molly McCarthy: The Federal monopoly contractor managing the organ donation system, UNOS, is an unmitigated failure. And its leadership spends more time attacking critics than it does taking steps to fix the system. I've seen this firsthand in my five years as a patient volunteer with the OPTN and three years ago, I stepped into the role of Vice Chair of the Patient Affairs Committee, or PAC. 53:45 Molly McCarthy: Further, I have been called by a board member telling me to stop focusing on system outage and downtime of the UNOS tech system. He told me that having downtime wasn't a big deal at all, "the donors are dead anyway." That comment speaks volumes to me about the lack of empathy and respect UNOS has for donor families. 55:00 Molly McCarthy: Congress needs to break up the UNOS monopoly by passing 1668, ensuring that HHS uses its authority to replace UNOS as its contractor. 1:00:15 Matt Wadsworth: Break up the OPTN contract and allow for competition. 1:00:40 Matt Wadsworth: I commend this committee for introducing legislation to finally break up this monopoly and I stand ready to work with you in any way possible to ensure that this bill passes. It's the only way this industry will be able to save more patients' lives. 1:02:10 Dr. Raymond Lynch: I want to differentiate between organ donation, which is the altruistic decision of the donor patient and their family, and organ procurement, which is the clinical care provided by OPO staff. This is what turns the gift of donation into the usable organs for transplant. Organ procurement is a clinical specialty. It's the last medical care that many patients will ever receive. It's reimbursed by the federal government and it's administered by OPOs that are each the only provider in the territory to which they hold federal contracts. Right now patient care delivered by OPOs is some of the least visible in American healthcare. I can't tell you how many patients were evaluated by OPO workers in the US in 2022. I can't tell you how many patients were examined, or how many families were given information about donation, or how many times an OPO worker even showed up to a hospital to do this clinical duty. This lack of information about what OPO providers actually do for patients is a root cause of the variability in rates of organ procurement around the country. My research has shown that what we call OPO performance is a measurable restriction on the supply of organs that results in the unnecessary deaths of patients with organ failure. For example, if the lowest performing OPOs from around the country had just reached the national median over a recent seven year period, there would have been 4957 more organ donors, yielding an estimated 11,707 additional organs for transplant. Because many OPOs operate in a low quality data environment and without appropriate oversight, almost 5,000 patients did not get adequate organ procurement care, and nearly 12,000 other patients did not receive life saving transplants. 1:03:55 Dr. Raymond Lynch: OPO clinical work is currently not visible, it's not benchmarkable, and it's not able to be adequately evaluated, analyzed, or compared. However, much of the hidden data about how OPOs provide care to patients is known to one entity and that entity is UNOS. 1:05:20 Dr. Raymond Lynch: We need a new network of highly skilled specialist organizations, each attending to areas of expertise in the management of the OPTN contract. 1:21:15 Sen. Marsha Blackburn (R-TN): When we look at OPTN, and look at the Securing Organ Procurement Act, the bill would strip the nonprofit requirement for the manager of the Organ Procurement and Transplantation Network, which would open the door for profiting from organ procurement and donation. And to me, this is something that I think many people really fear, especially people that are on a waitlist. And so what I would like for you to do is to address that and address those concerns. And why or why not you think the Act has it right. Dr. Raymond Lynch: Thank you, Senator. I think it's unfortunate that people would be afraid of that and it needs to be changed. Many of the patients that you referenced are waitlisted at for-profit hospitals. For-profit is a part of American healthcare. And I can tell you that our not-for-profit entity doesn't work. And there are for-profit hospitals and for-profit transplant centers that do work. So patients don't need to be afraid of that. They do need to be afraid of the status quo. 1:28:30 Sen. Ben Cardin (D-MD): Ms. Cryer, do you have any views as to why it's much lower percentage chances for a racial minority to be able to have a transplant? Donna Cryer: Yes. And it really does come down to UNOS not doing its job of overseeing the organ procurement organizations. We know from many studies that black and brown communities donate organs in the same percentage they are the population. So it is not a problem of willingness to donate. It is a problem, as Miss Goldring was starting to discuss, about UNOS not ensuring that OPOs go out into the communities, develop relationships far before that horrible decision is needed to [be] made to donate the organs of a family member. 1:56:45 Sen. Elizabeth Warren (D-MA): And among the many reforms the legislation would support HRSA's proposal to break up the OPTN monopoly contract into multiple smaller contracts, which would allow some competition and allow the best vendors in the business to manage different parts of the transplant network operation. That means hiring IT experts to do the IT. It means hiring logistics experts to do logistics, and so on. 1:57:15 Sen. Elizabeth Warren (D-MA): UNOS does not want to lose control, so they're pushing to have the government limit eligibility only to nonprofit vendors that have worked in the past on organ donation, meaning, for instance, that the IT company that is hired to run OPTNs computers systems would have had to have worked on an organ transplant network in the past and be a nonprofit. So Ms. McCarthy, the requirement UNOS wants would seem to make it so that only one organization could apply for the new contract: UNOS. 1:58:35 Sen. Elizabeth Warren (D-MA): Right now, Congress has an opportunity to root out corruption in this system, but if we don't act before the current contract expires we won't have another shot for years. August 3, 2022 Senate Committee on Finance Witnesses: Brian Shepard, CEO, United Network for Organ Sharing (UNOS) Diane Brockmeier, RN, President and CEO, Mid-America Transplant Barry Friedman, RN, Executive Director, AdventHealth Transplant Institute Calvin Henry, Region 3 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Jayme Locke, M.D., MPH, Director, Division of Transplantation, Heersink School of Medicine, University of Alabama at Birmingham Clips 36:15 Sen. Ron Wyden (D-OR): A 1984 law created the first computerized system to match sick patients with the organs they need. It was named the Organ Procurement and Transplantation Network. Someone needed to manage that system for the whole country, so the government sought to contract an organization to run it. UNOS was the only bidder for that first contract in 1986. The contract has come up for bid seven other times, UNOS has won all seven. Today, the network UNOS overseas is made up of nearly 400 members, including 252 transplant centers, and 57 regional organizations known as Organ Procurement Organizations, or OPOs. Each OPO is a defined geographic service network. Families sitting in a hospital room thinking about donating a loved one's organs does not have a choice of OPOs. 37:40 Sen. Ron Wyden (D-OR): Between 2010 and 2020, more than 1,100 complaints were filed by patients and families, staff, transplant centers, and others. The nature of these complaints runs the gamut. For example, in a number of cases, OPOs had failed to complete critical mandatory tests for matters like blood types, diseases, and infection. Our investigation found one patient died after being transplanted with lungs that a South Carolina OPO marked with the wrong blood type. Similar blood type errors happened elsewhere and patients developed serious illness. Some had to have organs removed after transplant. Another patient was told he would likely die within three years after an OPO in Ohio supplied him with a heart from a donor who had died of a malignant brain tumor. UNOS did not pursue any disciplinary action. In a case from Florida, another patient contracted cancer from transplanted organs and the OPO sat on the evidence for months. In total, our investigation found that between 2008 and 2015, and 249 transplant recipients developed a disease from transplanted organs. More than a quarter of them died. 38:55 Sen. Ron Wyden (D-OR): Delivering organs has been another source of life threatening errors. We found 53 such complaints between 2010 and 2020, as well as evidence that this was just the tip of the iceberg. In some cases, couriers missed a flight. In others, the organs were abandoned at airports. Some organs were never picked up. Many of these failures resulted in organs being discarded. 39:20 Sen. Ron Wyden (D-OR): It's reasonable to assume that many more errors are going unreported. Why? Because filing official complaints with UNOS appears to accomplish zero productive oversight or reform. Organ transplant professionals repeatedly told the Finance Committee that the complaint process was, and I quote here, "a black hole." Complaints went in, UNOS went quiet. In interviews with the Committee UNOS leaders have dragged their feet, dodged tough questions, and shifted responsibility onto others. investigations and disciplinary measures rarely amount to much more than a slap on the wrist. Only one time -- just once -- has UNOS recommended that an OPO lose their certification. 55:05 Diane Brockmeier: We must update the archaic technology system at UNOS. As OPOs, we are required to work with UNOS technology DonorNet every day. DonorNet is outdated, difficult to us,e and often slow to function when every minute counts. Manual entry subjects it to error and OPO and Transplant Center staff are not empowered with the right information when time is critical. I did serve in leadership roles on the OPO Committee from 2017 to 2022. Committee members and industry leaders voiced repeated requests to improve DonorNet. The consistent response was UNOS IT did not have the bandwidth to address this work. The limitations of the UNOS technology are delaying and denying transplants to patients that are dying on the waitlist. Poor technology impacts the disturbingly high kidney discard rate in the United States, where one in four kidneys never make it to a patient for transplantation. Critical time is lost due to the inefficiency of DonorNet, wasting time on offers that will not be accepted. Of course an available organ should be offered to the patient in this sequence. However, far too much of the matching, particularly on older donors and organs that are difficult to place, are left to the individual OPOs and transplant centers to find each other despite, rather than facilitated by, UNOS technology. Mid-America Transplant intentionally identifies surgeons who accept kidneys that have been repeatedly turned down many times. These are life saving options for those patients. In May of 2022, one of these patients was number 18,193 on the list. Relying on DonorNet alone, that kidney would never had been placed and the chance to save a life would have been wasted. 55:20 Diane Brockmeier: UNOS lacks urgency and accountability around identifying and remediating this preventable loss of organs, and they are not required to publicly report adverse events when patients are harmed, organs are lost, or the quality of patient care is deemed unsafe. UNOS does not require clinical training, licensure, or certification standards for OPO staff delivering critical patient care. In this environment, who's looking out for the patient? Who's being held accountable for poor patient care? No OPO has ever actually been decertified, regardless of its performance or its safety record. 57:55 Diane Brockmeier: When an OPO goes out of sequence to place an organ that would otherwise be thrown away, UNOS requires an explanation; however, when organs are recovered and discarded, you must remain silent. 58:05 Diane Brockmeier: We must remove conflicts to ensure effective governance. From 2018 to 2020, I served as a board member for the OPTN. Serving on the board of the OPTN automatically assigns membership to the UNOS board. My board experience revealed that at times UNOS actions are not aligned with its fundamental vision of a life saving transplant for everyone in need. How can you fairly represent the country's interest and a contractor's interest at the same time? 58:35 Diane Brockmeier: Board members are often kept in the dark about critical matters and are marginalized, particularly if they express views that differ from UNOS leadership. Preparatory small group calls are conducted prior to board meetings to explore voting intentions, and if the board member was not aligned with the opinion of UNOS leadership, follow up calls are initiated. Fellow board members report feeling pressured to vote in accordance with UNOS leadership. 59:10 Diane Brockmeier: To protect patients, I urge Congress and the administration to separate the OPTN functions into different contracts so that patients can be served by best-in-class vendors, to immediately separate the boards of the OPTN and OPTN contractors, and to ensure that patients are safeguarded through open data from both the OPTN and OPOs. 1:00:45 Barry Friedman: Approximately 23% of kidneys procured from deceased donors are not used and discarded, resulting in preventable deaths 1:00:55 Barry Friedman: Organ transportation is a process left to federally designated Organ Procurement Organizations, OPOs. Currently, they develop their own relationships with couriers, rely on airlines, charter flights, ground transportation, and federal agencies to facilitate transportation. In many cases, organs must connect from one flight to another, leaving airline personnel responsible for transfers. While anyone can track their Amazon or FedEx package, there is currently no consistent way of tracking these life saving organs. 1:01:45 Barry Friedman: Currently there is no requirement for OPOs to use tracking systems. 1:02:20 Barry Friedman: I also believe there's a conflict of interest related to the management of IT functions by UNOS, as the IT tools they offer transplant centers come with additional costs, despite these being essential for the safety and management of organs. 1:02:35 Barry Friedman: UNOS is not effectively screening organ donors so that they can be quickly directed to transplant programs. UNOS asks centers to voluntarily opt out of certain organs via a filtering process. As a result, OPOs waste valuable time making organ offers to centers that will never accept them. Time wasted equates to prolonged cold ischemic time and organs not placed, resulting in lost organ transplant opportunities. 1:03:10 Barry Friedman: Due to the limited expertise that UNOS has in the placement of organs, it would be best if they were no longer responsible for the development of organ placement practices. The UNOS policy making [process] lacks transparency. Currently OPTN board members concurrently serve as the board members of UNOS, which creates a conflict of interest that contributes to this lack of transparency. UNOS committees are formed in a vacuum. There is no call for nominations and no data shared with the transplant community to explain the rationale behind decisions that create policy change. 1:11:35 Dr. Jayme Locke: The most powerful thing to know about this is that every organ represents a life. We can never forget that. Imagine having a medication you need to live being thrown away simply because someone took too long to get it to you. Your life quite literally in a trash can. Organs are no different. They too have shelf lives and they are measured in hours. Discarded organs and transportation errors may sound abstract, but let me make this negligence real for you. In 2014, I received a kidney that arrived frozen, it was an ice cube you could put in your drink. The intended recipient was sensitized, meaning difficult to match. The only thing we could do was tell the waiting patient that due to the lack of transportation safeguard, the kidney had to be thrown in the trash, the final generous act of a donor in Maryland. In 2017, I received a kidney that arrived in a box that appeared to have tire marks on it. The box was squished and the container inside had been ruptured. We were lucky and were able to salvage the kidney for transplant. But why should luck even play a role? 1:12:45 Dr. Jayme Locke: In one week, I received four kidneys from four different OPOs, each with basic errors that led to the need to throw away those life saving organs. One due to a botched kidney biopsy into the kidneys collecting system, another because of a lower pole artery that had been cut during procurement that could have been fixed if someone involved had assessed the kidney for damage and flushed it before packing, but that didn't happen. Two others arrived to me blue, meaning they hadn't been flushed either. 1:13:15 Dr. Jayme Locke: Opacity at UNOS means that we have no idea how often basic mistakes happen across the country, nor can we have any confidence that anything is being done to redress such errors so they don't keep happening. 1:13:40 Dr. Jayme Locke: Women who have been pregnant, especially multiple times, are harder to match, contributing to both gender and racial disparities in access to transplant. This is a very real example of how a constrained pool of organs and high discards disproportionately hurt women and women of color, who are more likely to have multiple pregnancies. 1:14:25 Dr. Jayme Locke: Number one, immediately separate the OPTN board from any of the boards of any contractors. Number two, bring in real experts to ensure our patients are served by the best of the best in each field, separating out key functions of the OPTN, including policy, technology, and logistics. And number three, ensure that patients are safer by holding all contractors accountable through public adverse event reporting and immediate redressing of problems. 1:22:00 Sen. Chuck Grassley (R-IA): The system doesn't seem to be fair to racial minorities or people living in rural communities. So what are your efforts underway to understand the root causes and help make the system fairer to patients on the waiting list to explain the factors that result in the disparity for minorities in rural populations in the process? And how can the federal government address a problem if we have to be involved in addressing it? Dr. Jayme Locke: One of the most important things that we don't currently do is we don't actually account for disease burden in terms of examining our waiting lists. So we have no way of knowing if we're actually serving the correct people, if the correct people are actually making it to the waiting list. Disease burden is super important because it not only identifies the individuals who are in need of transplantation, but it also speaks to supply. So areas with high rates of end stage kidney disease burden, like the southeastern United States are going to have much lower supply. And those waiting lists predominantly consist of African American or Black individuals. So if you want to make a truly equitable organ system, you have to essentially get more organs to those areas where there are higher disease burdens. I think the other thing is that we have to have more focus on how we approach donor families and make sure that we have cultural competence as a part of our OPOs, and how they approach families to ensure that we're not marginalizing minority families with regard to the organ donation process. 1:30:00 Brian Shepard: The OPTN IT system that UNOS operates has 99.99% uptime. It is a highly reliable system. We are audited annually by HRSA.... Sen. Ben Cardin (D-MD): My information shows it's had 17 days down since I think 1999. That's not correct? Brian Shepard: In 23 years, yes, sir. Sen. Ben Cardin (D-MD): Okay, well, every day there's a loss of life, isn't it? Brian Shepard: That's the total amount of time over the couse of -- Sen. Ben Cardin (D-MD): I hope our national event system isn't down 17 days a year. Brian Shepard: The system has never been down for a day. And to my knowledge, and I have not been at UNOS since 1999, there's been maybe one event that was longer than an hour, and that was three hours. But the total amount of time since 1999 -- Sen. Ben Cardin (D-MD): So you're satisfied with your technology? You think you have the right technology? You're satisfied with your tracking systems now? You think everything is okay? Brian Shepard: We constantly improve our technology. We're subjected to 3 million attempts a day to hack into the patient database and we successfully repelled them all. So we are never satisfied with our technology, but we do maintain 99.99% uptime. We disagree with the USDS analysis of our systems. 1:37:25 Brian Shepard: If you're asking whether UNOS can prevent an OPO from operating or for being an OPO -- Sen. Rob Portman (R-OH: Well not prevent them, but require them to do something .You don't have the ability to require them...? Brian Shepard: The peer review process has significant persuasive authority, but all the payment authority and all the certification and decertification authority live at CMS. 1:39:00 Sen. Rob Portman (R-OH: Do you think there should be tracking of organs in transit? Brian Shepard: I think that's a very beneficial thing. UNOS provides an optional service that a quarter of OPOs use. Many OPOs also use other commercially available trackers to do that. There is not a single requirement to use a particular system. 1:41:55 Sen. Elizabeth Warren (D-MA): Mr. Shepherd, you are the CEO of UNOS. We have documented these problems and you've received more than 1000 complaints in the last decade alone. So tell me, in the 36 years that UNOS has had the contract to run our national organ system, how many times has UNOS declared its OPO Members, any OPO members, not in good standing. Brian Shepard: Two times, Senator. 1:43:20 Sen. Elizabeth Warren (D-MA): How many times has UNOS put an OPO on probation? Brian Shepard: I don't know that number off the top of my head, but it's not a large number. Sen. Elizabeth Warren (D-MA): It's not large, in fact it's three. 1:45:20 Brian Shepard: Approximately 10% of the budget of this contract is taxpayer funded. The rest of that is paid by hospitals when they list patients. 1:49:30 Sen. Todd Young (R-IN): Once an OPO is designated not in good standing, Senator Warren referred to this as toothless. It does seem toothless to me. I'll give you an opportunity, Mr. Shepherd, to disabuse me of that notion and indicate for me what penalties or sanctions are actually placed on an OPO when they are designated not in good standing. Brian Shepard: The statute does not give UNOS any authority to offer sanctions like that. The certification, decertification, payment authorities belong entirely to CMS. UNOS's statute doesn't give us the ability -- Sen. Todd Young (R-IN): So it is toothless in that sense. Brian Shepard: It is designed to be, by regulation and contract, a quality improvement process, in contrast to the oversight process operated by a federal agency. 1:51:15 Sen. Todd Young (R-IN): To what extent is UNOS currently tracking the status of all the organs in transit at any given time? Brian Shepard: UNOS does not coordinate transportation or track organs in transit. We do provide a service that OPOs can use to use GPS trackers. Some of the OPOs use ours and some use other commercially available products. Sen. Todd Young (R-IN): So why is it, and how does UNOS plan to optimize organ delivery if you don't have 100% visibility into where they are at any given time? Brian Shepard: I think that the GPS products that we offer and that other people offer are valuable, they do help in the delivery of kidneys. Only kidneys travel unaccompanied, so this is a kidney issue. But I do think that GPS trackers are valuable and I think that's why you've seen more and more OPOs use them. 1:52:50 Sen. Ron Wyden (D-OR): Mr. Shepherd has said twice, with respect to this whole question of the power to decertify an OPO, that CMS has the power to do it. UNOS also has the power to refer an OPO for decertification under the OPTN final rule. That has been done exactly once. So I just wanted it understood with respect to making sure the committee has got what's really going on with respect to decertifying OPOs. 2:00:15 Dr. Jayme Locke: Obviously people have described that we have about a 25% kidney discard, so one in four. So if you look at numbers last year, these are rough numbers, but that'd be about 8000 kidneys. And really, I think, in some ways, these are kind of a victim of an entrenched and cumbersome allocation algorithms that are very ordinal, you have to go sort of in order, when data clearly have shown that introduction of multiple simultaneous expiring offers would result in more efficient placement of kidneys and this would decrease our cold ischemia time. 2:00:50 Dr. Jayme Locke: So if you take UNOS's organ center, they have a very rigid system, for example, for finding flights and lack either an ability or interest in thinking outside the box. So, for example, if there are no direct flights from California to Birmingham, Alabama, instead of looking for a flight from San Francisco to Atlanta, understanding that a courier could then pick it up in Atlanta and drive it the two hours, they'll instead put on a flight from SFO to Atlanta and allow it to go to cargo hold overnight, where it literally is rotting, if you will, and we're putting extra time on it. Sen. Ron Wyden (D-OR): Just to make sure everybody gets this. You're saying you've seen instances of something being put in cargo hold when it is very likely to rot? Dr. Jayme Locke: That is correct. So if the kidney arrives after 10pm at the Atlanta airport, it goes to cargo hold. We discovered that and made calls to the airlines ourselves and after several calls to the airlines, of course they were mortified, not understanding that that was what was happening and actually had their manager meet our courier and we were able to get the kidney out of cargo hold, but this went on before we figured out what was happening because essentially they fly it in, it sits in cargo hold, it comes out the next morning to catch the next flight. Instead of thinking outside the box: if we just get it to Atlanta, it's drivable to Birmingham. And those hours make a difference. Sen. Ron Wyden (D-OR): That sounds way too logical for what UNOS has been up to. 2:03:05 Sen. Ron Wyden (D-OR): Miss Brockmeier, UNOS has developed this organ tracking system. Do you all use it? I'm curious what you think of it. Diane Brockmeier: Thank you for the question, Senator. We did use and participate in the beta pilot through UNOS and made the decision to not move forward using their product, and have sought a commercial alternative. Sen. Ron Wyden (D-OR): And why was that? Diane Brockmeier: Part of the issues were some service related issues, the lack of the interconnectivity that we wanted to be able to facilitate a more expedited visual tracking of where the organ was. Sen. Ron Wyden (D-OR): Was the tracking technology low quality? Diane Brockmeier: Yes, sir. 2:11:25 Sen. Ron Wyden (D-OR): All right, let's talk for a moment about the boards that are supposed to be overseeing these, because it looks to me like there's a serious conflict of interest here and I'll send this to Ms. Brockmeier, and perhaps you'd like to get to it as well, Mr. Friedman. The Organ Procurement and Transplantation Network, which is the formal title of the organ network that operates under federal contract administered by HHS, and UNOS, which is the contractor that operates the network and controls information about the network, have the same boards of directors, despite efforts by the government to separate them. That means the people who look out for the best interests of UNOS, the multimillion dollar nonprofit, are the same people who look out for the interests of the entire organ transplant network. Sure sounds like a conflict to me. 2:12:55 Diane Brockmeier: I think there should be an independent board. I think the division of the responsibilities of the board and by the inherent way that they're structured, do pose conflicts. It would be like if you had an organization that was a supporting organization, you'd want to hold it accountable for its performance. And the current structure really limits that opportunity. 2:19:50 Dr. Jayme Locke: And if you think about IT, something as simple as having a system where we can more easily put in unacceptable antigens, this was a debate for many years. So for context, we list unacceptable antigens in the system that allows us to better match kidneys so that when someone comes up on the match run, we have a high probability that there'll be a good tissue match. Well, that took forever and we couldn't really get our unacceptable antigens in, so routinely people get offered kidneys that aren't going to be a match, and you have to get through all of those before you can get to the person that they really should go to. Those are simple examples. But if we could really have transparency and accountability around those kinds of things, we could save more lives. 2:23:10 Sen. Ron Wyden (D-OR): Mr. Shepherd told Senator Warren that only 10% of UNOS funds come from taxpayer money and the rest comes from fees paid by transplant centers who add patients to the list. But the fact is, Medicare is the largest payer of the fees, for example, for kidneys. So we're talking about inefficiency, inefficiency that puts patients at risk. And certainly, taxpayer dollars are used to cover some of these practices. May 4, 2021 House Committee on Oversight and Reform, Subcommittee on Economic and Consumer Policy Witnesses: Tonya Ingram, Patient Waiting for a Transplant Dr. Dara Kass, Living Donor and Mother of Transplant Recipient LaQuayia Goldring, Patient Waiting for a Transplant Steve Miller, CEO, Association for Organ Procurement Organizations Joe Ferreira, President, Association for Organ Procurement Organizations Matt Wadsworth, President and CEO, Life Connection of Ohio Dr. Seth Karp, Director, Vanderbilt Transplant Center Donna Cryer, President and CEO, Global Liver Institute Clips 5:15 Tonya Ingram: The Organ Procurement Organization that serves Los Angeles, where I live, is failing according to the federal government. In fact, it's one of the worst in the country. One analysis showed it only recovered 31% of potential organ donors. Audits in previous years found that LA's OPO has misspent taxpayer dollars on retreats to five star hotels and Rose Bowl tickets. The CEO makes more than $900,000. Even still, the LA OPO has not lost its government contract and it has five more years to go. 30:00 Rep. Raja Krishnamoorthi (D-IL): Unusual among Medicare programs, their costs are 100% reimbursed, even costs unrelated to care. So, extravagant executive compensation and luxury perks may be passed off onto the taxpayer. 46:55 Dr. Seth Karp: We have 10 hours to get a liver from the donor to the recipient, and about one hour to sew it in. For heart, we have about six hours. Time matters. 47:55 Dr. Seth Karp: Last year, I had the opportunity to co-write a viewpoint in one of the journals of the American Medical Association with TJ Patel, former Chief Data Scientist of the United States. In that article, we provided evidence that the metrics used to judge the performance of organ procurement organizations are basically useless. Until the recent OPO Final Rule, performance was self-reported, and OPO employees admitted to having gamed the system. When threatened with decertification, one of the OPOs themselves successfully argued that because the performance data were self reported and unaudited, they failed to meet a reasonable standard and the OPO should not be held accountable. In other words for decades, the metrics supposed to measure performance didn't measure performance, and the results have been disastrous, as you have heard. 49:45 Dr. Seth Karp: Whenever I, and quite frankly most everyone else in the field, gives a talk on transplantation, we usually make two points. The first is that organ transplantation is a miracle of modern medicine. The second is the tragedy that there are not enough organs for everyone who needs one. I no longer use the second point, because I don't believe it. Based on my work, I believe that there are enough organs for patients who require hearts, lungs, and probably livers, and we can make a huge improvement in the number of kidneys available. In addition to improving OPO performance, new technologies already exist to dramatically increase the organ supply. We need a structure to drive rapid improvement in our system. 54:00 Joe Ferreira: One common misconception is that OPOs are solely responsible for the entire donation and transplantation system, when, in fact, OPOs are the intermediary entity and their success is highly dependent on collaborations with hospitals and transplant programs. At the start of the donation process, hospitals are responsible for notifying any OPO in a timely manner when a patient is on a ventilator and meets medical criteria to be an organ donor. Additionally, transplant centers must make the decision whether to accept or decline the organs offered by OPOs. 57:55 Matt Wadsworth: As geographic monopolies, OPOs are not subject to any competitive pressure to provide high service. As the only major program in all of health care 100% reimbursed for all costs, we do not face financial pressures to allocate resources intelligently. 1:02:10 Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, I'd like to turn to you. You run the OPO called the Nevada Donor Network. I have your OPO's 2019 financial statement filed with the CMS. It appears that your OPO spent roughly $6 million in 2019 on administrative and general expenses. Interestingly, in 2019, I see your OPO spent approximately $146,000 on travel meetings and seminars alone. And your itemization of Administrative and General has an interesting line item for $576,000 for "ANG". It took me a minute but that means you have an "Administrative and General" subcategory in your "Administrative and General" category. Very vague. Now Mr. Ferreira, I was informed by Mr. Wadsworth, a former executive of yours at the Nevada Donor Network, that your OPO has season tickets to the NHL's Las Vegas Golden Knights, isn't that correct? Joe Ferreira: That is correct, Mr. Chairman. Rep. Raja Krishnamoorthi (D-IL): And you also have season tickets to the Las Vegas Raiders too, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And according to Mr. Wadsworth and others, your OPO took a board retreat to Napa Valley in 2018. Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And Sonoma in 2019, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, what you're spending on the Raiders, the Golden Knights, Napa Valley and Sonoma have one thing in common: they have nothing to do with recovering organs. 1:10:30 Dr. Seth Karp: In 2019, there were six heart transplants that were performed using donors after circulatory determination of death. And I don't want to get into the technical aspects of that. But in 2019, that number was six. In 2020, that number was 126. This is a new technology. This is a way that we can increase the number of heart transplants done in United States dramatically. And if we think that there were 500 patients in the United States waiting for a heart in 2020, 500 patients that either died or were delisted because they were too sick, and you think in one year, using a technology, we got another 100 transplants, if we could get another 500 transplants out of that technology, we could almost eliminate deaths on the on the heart transplant waiting list. That technology exists. It exists today. But we don't have a mechanism for getting it out to everybody that could use it and it's going to run itself through the system, it's going to take too much time. 1:24:05 Rep. Andrew Clyde (R-GA): You know, I'm a little disappointed that we're discussing race as a factor in organ transplant. We're all one race in my opinion; color makes no difference to me. We're the human race. And to me, the interjection of race into this discussion is very concerning. Discrimination based on race was outlawed almost 60 years ago through the Civil Rights Act of 1964. Now, I'm not a medical doctor, and I have very little knowledge of medicine. But last year, there was an article that came out in LifeSource and it says, "Does my race and ethnicity matter in organ donation?" And so my question here is for Dr. Karp. In your experience, would you agree that a donor's organs are more likely to be a clinical match for a recipient of the same ethnicity? Could you comment on that? Is that actually a factor, or not? I mean, we're all human beings, we all, you know, have similar bodies. Dr. Seth Karp: Yes. So there definitely are certain HLA types that are more common. That is race-based. So the answer to that question is yes. Rep. Andrew Clyde (R-GA): Okay. All right. And so if you have more of one particular race, more donations of one particular race, then naturally you would have more actual matches of that particular race. Is that correct? Dr. Seth Karp: That would tend to be the case. Rep. Andrew Clyde (R-GA): Okay. All right. All right. Okay, that's just a question that I wanted to clear up here. 1:34:20 Donna Cryer: We'd like to see investments in languages that are spoken by the community. Educational resources should be, as required by law, for those with limited English proficiency. They should be in the languages spoken by the community. They should be hiring diverse staff to have those most crucial conversations with families. The data shows, and certainly experience and common sense shows as well, that having people of color approaching families of color results in more donations. Executive Producer Recommended Sources Music by Editing Production Assistance