campaign new it. the truth about the election lies when "all in" starts right now. good evening from new york. the president of the united states met with democratic legislators today to pull off the most incredible act of sorcery since lyndon jonsson. he did those with large majorities joe biden doesn't have. joe biden is trying to do that holding a series of meetings in the oval office with democratic lawmakers trying to work through the deep divisions within his party, trying to push through not only the $1 trillion physical infrastructure bill that passed with bipartisan majority, but also the $3.5 trillion social safety net and climate package. we have no idea if be can do it. here is how i have come to think about where democrats are right now. if you are confused about where they are, you are not alone. i follow this for a living. i am lost. honestly, i am trying very hard to understand. here is the big picture. twice in my life, democrats have come in with a new presidential administration controlled both chambers of congress and in both cases they have gotten their butts kicked in the midterms. happened with bill clinton in 1994. barack obama in 2010. most recently, it happened to republicans, too, under donald trump. . >> the republicans are in charge. democrats are in a daze. the country is in for a ride in a new direction. it's one of the most radical political shifts of the 20th century. >> the surge, american voters sweep republicans into office. the gop takes command of the house. >> the president will have to work in the framework of a divided government. democrats riding high after winning the house and republicans expanding their senate majority in the midterm elections. >> under the conditions we have, which is partisan polarization and something called thermostatic public opinion. you are probably goes to lose one or both houses in the midterms. electoral politics isn't binary. margins matter. take a small or huge hit, a big loss or a small loss. the key thing to understand is that presidential approval rating has a big impact on the midterms. the website 538 writes, presidential proval rating has been a decent indicator of what will happen. in the last four, the incumbent president's disapproval rating was higher than his approval and in all four cases the president's party lost a block of house seats. because of that, democrats have a short amount of time to effectively govern. you have to understand the clock is running on unified governance. not going to last forever. how do you best use that precious time and power that you have? you get one year every ten, let's say. one out of every ten years. i would argue the most important thing to do to make the president successful, since the midterms end up being a referendum on the president. pass his agenda. when you think about the up pop ooh -- the unpopular things donald trump did, his lowest approval rating came in december of his first year in office. keep in mind what was going on. republicans had failed to repeal the affordable care act. they were working to pass a big unpopular tax cut for the wealthy and corporations. there was not a ton of public support for the legislation. it looked like they might not be able to do it. success matters. when trump signed the bill a few days after that, approval low point, his approval went up. it never got that low again until after he was voted out of office. it was not enough to save him from losing the house in the midterms. the republicans did gain three seats in the senate. 2018 could have been worse for republicans if trump faced that midterm with a 37% approval rating. we renting similar days for joe biden. very different president. different agenda. we are talking political. last month, biden's approval rating turned negative. there's a bunch of explanations for that. the delta variant is killing 2,000 people a day. i think it's hard to argue that is purely joe biden's fault. he is president in charge. his approval rating dropped after he pulled u.s. troops out of afghanistan. the country fell to the taliban basically overnight. also long drawnout legislative battles don't poll well. that's what democrats are trying to pull off. every congressional democrat in the different factions, moderate, progressive, whatever they call themselves, they need to understand for their political self interest and any goal of improving the country, failure here is not an option. everyone has to get on the same page. they need to consider what they want to do with their limited time in power to change people's lives and the structure of government and deliver in a way that is going to endure after they left. the clock is ticking. everyone should bake that in. again, we go back to the last unified government. the affordable care act it did that. more than ten years after it passed, the number of americans without insurance is lower than when obama took office. after countless republican attacks and the removal of the mandate, it is still there. surviving time and time again. you know what? the republicans did that with their one big domestic legislative priority. they cut the corporate tax rate from 35% all the way down to 21% under trump. guess what? it's going to be hard to jack it back up to 35%. these big things tend to stick. that was the priority for republicans. cut corporate taxes and make it stick. get people health insurance and make it stick. that's why the biden infrastructure and spending bills are so important. we said this before on this program. everyone talks about the price tag. the price tag is meaningless with the context of what it does. one accurate way to think about the plan is that it would very slightly increase the overall federal government spending over the next ten years in order to revolutionalize our quality of life and wellness of our country and planet. to begin with as eric levitz points out, even though the price tag of $3.5 trillion sounds like a lot, it's over a decade. the reconciliation package isn't a $3.5 billion bill. the reconciliation bill would move the u.s. steps down the road to social democracy establishing a monthly child allowance, paid family leave, childcare subsidy and expansion of public health insurance. it would make obamacare cheaper. an extension of care for the elderly and universal kindergarten among other things. legislation would completely change the energy profile of the u.s. by imposing import fees on polluters, tax breaks for solar panels and electric vehicles. it will put requirements on electricity providers to use cleaner forms of energy. we talked about that on the program. that's all in this bill that's out there. the $3.5 trillion. we don't know if it's going to work. this could implode in a distant they're would be terrible for americans with climate but also for democrats' political future. the collapse of the clinton health care bill was the signature trauma for a generation of professional democrats. this could be the most impressive maneuver in half a century. all the democrats need to work together. like ben franklin told his fellow revolutionaries, we hang together or most assuredly we shall all hang separately. right now the different parts of the democratic caucus are not just in disagreement, they are in conflict. the moderates secured this promise of a vote on the bipartisan deal, the one that passed out of the senate by september 27th, that's a few days away. progressives say, we are not going to vote for that unless the full biden agenda reconciliation package has been passed. that looks unlikely. the chair of the progressive caucus said her caucus will vote down the bipartisan package. today, president biden hosted meetings with all these players to try to bring everyone together. the chair of the house progressive caucus met with president biden today in one of the meetings. she joins me now. it's good to have you. let's just for the next five, six minutes, we're going to put a bunch of stuff to the side, the debt ceiling and the funding the government bill. pretend that doesn't happen. okay? we're just going to talk about the build back better agenda. we will talk about the two pieces of legislation. the physical infrastructure bill with some climate stuff but not a ton. passed the senate. the full reconciliation package. what is the progressive caucus' posture at this moment on these pieces of legislation? >> thanks, chris, for having me on. our posture is that we are ready to deliver both pieces of legislation to the president's desk for his signature. i should be clear. the bipartisan infrastructure bill has some good things, some bad things for climate in particular, and then some things that are just missing. there are many in our caucus who don't want to vote for that. but the agreement that we secured is that if we get a reconciliation bill that addresses the things we talked about, paid leave, childcare, taking on housing, climate change, all of these important issues, then we will, as a complete caucus, we will be voting for the infrastructure bill. what we have said is, we need a little bit more time. if you remember, when the bipartisan infrastructure bill was being negotiated, we kept thinking it was done and then it wasn't done and then took another week and then another month. we are just saying, we need a couple of more weeks to be able to pull everybody together. because this is a pre-conference bill. that means, we're not doing something in the house, the senate is not going to pass. we have to be on the same page. we're ready to vote for both things. we're not going to vote for just one and then leave the fate of all the other things we talked about to -- up to chance. that's not going to happen. >> right. i want to be clear. let me just say that the substance of this -- i basically -- not that anyone necessarily cares what i think. i'm with you on the reconciliation package. i think it should be a package deal. there's a lot of great stuff in this. if i was in the congress, i would vote for it. that's my position. on the tactics, what you are saying is, it's a package deal. you don't want to get left holding the bag. let me explain the fear. the fear is the moderates jammed leadership to say we want a date certain, september 27, we're voting on the bipartisan bill. the fear is you pass that bill, it passed out of the senate, joe biden signs it and then, oh, were we doing something else, i forgot. that's your fear, right? that's what you are trying to avoid. >> that's exactly right. i want to go back one baltimore more step. the only reason the bipartisan bill passed out of the senate is because that was the commitment that was made to those senators. today, 11 progressive senators, sanders and warren and others, put out a statement saying let us be clear about where we are here. we voted for the bipartisan bill only, only, only because we were told and committed to that the two would move together. we support the progressive caucus in the house making sure that we now deliver on that promise. otherwise, you know what it's like. it's done. we are at the end of september. nothing gets done past a certain date in this year. certainly, nothing gets done in next year's election year. >> i don't think you are irrational to worry about getting screwed here. here is the two issues as i see it. seriously. one is, i feel like -- there's 271 democrats i think total between both houses, something like that. somewhere that ballpark. you need 268 to agree and all senators. are you talking to manchin? are you talking to sinema? this gamesmanship that's happening through leadership or through biden, it's like you have to get on the same page or none of this is happening. i'm not clear that's happening, you are having those conversations. >> yeah. the conversations were happening between house leadership, senate leadership and the white house. that's the pre-conferencing that's been going on. i am happy to sit down with senator manchin or anybody else in the senate. obviously, we work closely with our countcounterparts in the se. i work very closely -- i make sure that i am talking to, let's put it that way, with my more conservative democrat friends in the house. that's been my role is keep the progressive caucus together, make sure i understand where we are, leverage our power to get as much as we can possibly can get. that's what we said we would deliver to the american people. then also, i have spoken many times to josh gottheimer and others. i will say, there's a very small group of people -- i just would want to say there are many front liners in the most vulnerable districts across the country, people that actually would call themself moderate, and yet they want the full -- they are ready to vote on both bills. they are ready to vote on even a bill that is the $3.5 trillion with the things we have put in there. i want to be clear that these -- this small group of people are not representative of really moderate democrats in the toughest districts. that's why i like to say -- i don't think you can say that moderates are against this. that's not what's going on here. we have the vast majority of the democratic caucus on board with getting these two bills done. >> you are correct about that. you have a very difficult task. everyone there has a difficult task. we will check in with you. thank you very much. >> thank you, chris. sahil kapur has covering this in real time. i was going to ask one baltimore more question but we had to let her go. here is the problem for the progressives. they care more than the joe manchins of the world. the idea is, well, if we don't get this full package, then we're not going to get the bipartisan bill. i think a lot of people are like, well, okay, fine, then we pass nothing. it's not clear that that's a credible threat to joe manchin and chris continue sinema. >> i think what progressives are trying to do is not tank the infrastructure bill but to reorder this power dynamic within the democratic party where especially in previous house democratic majority, progressives get roled at the end of the day. they wanted the public option. they had to choke it down and deal with anti-abortion language at the end of it. what your previous guest and others are trying to do is reorder that. they believe they have the party base on their side, the country on their side. they think if they don't get the transformational programs, when are they going to have a chance? this could go down in flames. this could be a massive error. they think it's worth the gamble and trying to get these major programs on health care, universal pre-k and climate change done. >> they were right about increasing subsidies. people that cut the subsidies were wrong. the bill would have been more popular if everyone listened to the progressives. thank you so much. if the best way for democrats to survive the midterms is to keep president biden's approval ratings up it would make sense to help pass popular legislation. do what the people put you in office want you to do. where are a handful of democrats threatening to sink one of the most popular agenda items yet? i will explain after this. fter . i just heard something amazing! now for the first time one medication was approved to treat and prevent migraines. nurtec is the first and only option proven to treat and prevent migraines with one medication. onederful. one quick dissolve tablet can start fast and last. don't take if allergic to nurtec. the most common side effects were nausea, stomach pain, and indigestion. with nurtec odt, i treat migraine my way. what's your way? ask your doctor about nurtec to find out! is mealtime a struggle? introducing ore-ida potato pay. where ore-ida golden crinkles are your crispy currency to pay for bites of this... ...with this. when kids won't eat dinner, potato pay them to. ore-ida. win at mealtime. tonight... i'll be eating a buffalo chicken panini with extra hot sauce. tonight... i'll be eating salmon sushi with a japanese jiggly cheesecake. jolly good fire nas... yeah? spare a pound? what? you know, bones, shillings, lolly? lolly? bangers and mash? i'm... i'm sorry? i don't have any money. you don't look broke... my rocket is skint! so...i know you and george were struggling with the possibility of having to move. you don't look broke... how's that going? well we found a way to make bathing safer with a kohler walk-in bath. it has the lowest step-in of any bath. it has handrails, a wide door, and textured surfaces. so it gives you peace of mind. and you would love the heated backrest -and the whirlpool jets -and the bubblemassage. and it was installed quickly and conveniently by a kohler-certified installer. a kohler-authorized dealer walked us through every step in the process and made us feel completely comfortable in our home. and, yes, it's affordable. looking good, george! we just want to spend as much time as possible in our home, and with our grandkids. they're going to be here any minute for their weekly spa day. ooh, that bubblemassage! have fun! stay in the home and life you've built for years to come. call... to receive one-thousand dollars off your kohler walk-in bath. and take advantage of our special offer of no payments for eighteen months. after last year's elections some moderate democrats were angry with the progressive wing. democrats kept the majority in the house, but they had a net loss of ten seats. there's hang wringing afterwards. some folks in the house democratic caucus thought the messaging on police and de-funding the police was to blame. to be clear, no one introduced legislation to de-fund the police. there weren't any votes on the record. it was a slogan, a call, a demand that was being made in the streets by activists and protesters and other people in the wake of the murder of george floyd at the hands of a police officer and amidst the once in a generation protest movement. it's true that the slogan itself is not very popular when you poll it. a poll found that just 18% of americans support the movement known as de-fund the police. even among democrats, just 34% support it. the people saying, that's not a popular slogan, they're not wrong. without taking a position here one way or the other, let's stipulate there are things that might be good policy that might be unpopular. then there are things that are good policy that are popular and part of politics, but part is for politicians to sort of figure out how to bring those two things together. to find stuff that's both popular and good. take the most popular policy right now. according to data scientist daft -- data scientist david shore, the most popular policy is allowing medicare to negotiate prescription drug prices. it's the number one policy of 194 that he has tested. it's in the multi-trillion dollar bill the democrats are proposing. the big reconciliation package with climate stuff and the safety net stuff. three house democrats are threatening to kill it. those three members have received a combined $1.6 million in campaign donations from the pharmaceutical industry. get this. they will not face a backlash. no skin off their nose. opposing this is way less popular than any protester slogan. it's nuts. amy klobuchar reintroduced legislation to allow medicare to negotiate prescription drug prices. she joins me now. senator, i think of you both based on your official political voting score and the campaign you ran for president as sort of in the center of the democratic caucus. if you were mapping it. what do you say to people who are opposing this provision to allow medicare to negotiate with drug companies? >> well, first, let's get to the facts. we have 46 million seniors that would benefit from this. the entire country would benefit. right now, there's no other country that pays more for prescription drugs than we do. yet, it's our taxpayers that have funded so much of this research. they should be sharing in the success of the companies. that is my argument. there is a ban in legislation. a lot of people don't see why this is ridiculous. a ban on negotiating for medicare to negotiate cheaper drug prices on behalf of the seniors of this country. that is simply what we are trying to change. i would note, this is not really a liberal/moderate divide. there are a few we hope to work with. but for the most part, liberal democrat democrats, moderate democrats and some republicans support medication negotiation for prices for seniors. why? 20% of seniors are actually not taking drugs they should take because they are too expensive. we continue to see escalation of prices that simply feeds the profits of big pharma. >> in terms of the three members and the opposition, pharma is dead set against this. they are lobbying hard. you know this. people are like, we're not against that. we have our own bill. it's a little different. everyone wants this. that's what's happening here. how do you deal with that sort of i think somewhat disingenuous argument? >> we have bills that have been vetted that some of the people have actually voted for in the past. we know that it will bring in hundreds of billions of dollars to help people in this country and bring costs down. we know that it's going to save lives. they know that. people can negotiate things, sure. i do know that president biden in his state of the union -- i was sitting right up there in the front row. he made this one of the centerpieces of his agenda for bringing costs down. i know it was genuine. right now, a number of the members are meeting with him through the day, through tomorrow. i believe we are going to get this done. i just think enough is enough. failure is not an option. we have to bring down the cost of prescription drugs for the people of this country. the nerve pain drug, up nearly 50% in just the last five years. seniors saving insulin drops in a vial because they can't afford it. trying to ration their drugs. this shouldn't happen where we funded a vast majority of the research. >> one thing that's striking about this debate is, i have been covering this for 15 years i want to say. i can't believe it hasn't happened yet. the reason is basically the pharmaceutical companies don't want it to happen. i can't come up with another reason. am i wrong? >> you look at the numbers, this isn't one of those, well, one side says one side says. if you look at where people are on this, they don't buy the bogus counterarguments. they know that there's actually congressional budget office score. they may not know this, but there shows that this would not reduce new drug comes out or innovation or jobs. people intuitively understand that we are paying too much for these drugs and that it's going to the coffers of the drug companies. this is long overdue. it should have been included in the affordable care act. it was too hard to get the votes. now is the time. we have to stop admiring this problem and tweeting about it and actually do something about it. we have a unique opportunity to do that. >> senator klobuchar, thank you for your time tonight. >> thank you, chris. as the white house fights to enact the president agenda, which could create improvements, it's worth looking back at the fight over the signature legislation from the last time, the last time a democrat was in the white house. that's, of course, the affordable care act. jonathan cohen is one of the most dogged reporters of the aca. he talked me to talk about the life and near death and near death again of the law and what its fate is now. it's out wherever you get your podcasts. still to come, proof the trump campaign new the dominion conspiracy theories were nonsense. why did they let rudy giuliani keep pushing them? 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the dictator who had been dead for seven years meddled from beyond the grave, which is untrue. we know thanks to a defamation lawsuit against the trump campaign that while they were pushing those conspiracy theories, members inside the trump campaign knew they were a lie. this is an internal memo assembled by trump staffers on november 14, five days before. look on the first page. dominion has no direct ties to venezuela. i don't think they really proofread. that was put together five days before they went on tv claiming otherwise. this is the latest string of information we are learning about how the trump campaign was willing to lie and do anything and everything necessary to claim the election was rigged, even though they knew it wasn't. a former u.s. attorney for the eastern district of michigan joins me now. i don't think it matters that much. but what's interesting to me about this memo is i think there's a question of lying or deluded. did they buy their own nonsense here? were they so far gone that they thought the ghost was inside the machines changing vote counts or were they lying? this is pretty good evidence in the lying column. >> i agree. i think there's real significant to the fact that there's proof of a lie. until now, there had been a question that when donald trump was pressuring the georgia secretary of state, did he believe it? i think we have evidence he did not. he knew it was fraudulent. yet, persisted in the claims it was fix and corrupt and rigged. this could be evidence that investigators could use, whether it's the january 6 committee or prosecutors in georgia or maybe even at the department of justice can use to show that there was some evidence to commit voter fraud here. >> this comes out of a defamation lawsuit, which they are going to have their hands full on. we should say that what's also striking about there is the reason they were able to compile this -- i don't think these were high level campaign staffers. the reason they were able to compile it was the lies they were saying were so consistent over time, they kept hitting the same points. someone says, can we pull together whether this is true or not? here is giuliani at the presser talking -- offering one of the lies. take a listen. >> you should be more astounded by the fact that our votes are counted in germany and in spain by a company owned by affiliates of chavez and moderna? >> i did not. you can read about it in this memo. they anticipated the talking points. this is five days before they go out and say this stuff. >> yeah. as corey lewandowski made clear, there's no law against lying to the public and saying things on television or in public remarks. but there is a penalty for telling lies when it happens in court. we have seen that happen here in michigan and other states where sydnee powell and others have filed lawsuits on the basis of these lies. in some of the lawsuits they have been sanctioned. rudy giuliani has been suspended from the practice of law. this memo is a really important piece of evidence that shows knowledge and intent to defraud. >> these companies have sued for defamation. i know slander well, because you have to as a reporter. what is the standard in defamation? >> well, when it comes to matters of public officials and public figures -- i suppose doe -- dominion may qualify for that. either you knew the claim was false or that you acted with reckless disregard as to whether it was false. here i would think in a lawsuit, they would have to show, what was their basis for believing this true? this memo strikes me as a smoking gun to show they knew it was false or they at least acted with reckless disregard as to whether it was true. it seems that by whatever standard, this is a very important piece of evidence in the defamation lawsuit. >> thank you very much. don't go anywhere. scott gottlieb spent two years as the head of the fda under donald trump. he is here to shed light on the failed covid response and how we can prepare for the next pandemic ahead. pandemic ahead u want to put outt snacks that taste great, and come straight from the earth. and last time i checked, pretzels don't grow on trees. just saying. planters. a nut above. ♪♪ just saying. i thought i was managing my moderate to severe crohn's disease. then i realized something was missing... ...me. my symptoms were keeping me from being there for her. so, i talked to my doctor and learned humira is the #1 prescribed biologic for people with crohn's disease. the majority of people on humira saw significant symptom relief in as little as 4 weeks. and many achieved remission that can last. humira can lower your ability to fight infections. serious and sometimes fatal infections, including tuberculosis, and cancers, including lymphoma, have happened, as have blood, liver, and nervous system problems, serious allergic reactions, and new or worsening heart failure. tell your doctor if you've been to areas where certain fungal infections are common and if you've had tb, hepatitis b, are prone to infections, or have flu-like symptoms or sores. don't start humira if you have an infection. be there for you, and them. ask your gastroenterologist about humira. with humira, remission is possible. ♪♪ (girl 1) feeling lost...help? 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a little judgy, don't you think? that's weird. so weird. early last year when the threat of covid was just starting to emerge, there was a small set of voices that demonstrated vision and judgment about the course of the pandemic that i began to really rely on them. one of them, somewhat surprisingly, was a former member of the trump administration, who before the u.s. reported its very first covid death wrote a piece that we must act now to prevent an american epidemic. dr. scott gottlieb served for nearly two years as trump's food and drug commissioner. he is one of the rare conservatives who has remained sensible, clear-eyed and data driven about the pandemic. now he has a new book out called "uncontrolled spread: why covid-19 crushed us and how we can defeat the next pandemic" where he provides key details about what went wrong, particularly at the agency level that made the country so vulnerable to this virus. dr. scott gottlieb joins me now. it's good to have you, doctor. i sort of followed your work and have benefitted from it. so thanks for coming on the program. i want to ask what was your first uh-oh stomach drop moment in 2019 or 2020 about this? >> yeah, i remember it vividly. it was martin luther king day weekend, and the reporting overnight had gone from 50 cases that were being reported in wuhan of severe pneumonia to 200. an all the cases being reported were people hospitalized with very severe conditions. whenever you see that you worry that's just the tip of the iceberg. if 200 people are hospitalized with very severe pneumonia, there must be hundreds if not thousands of people with milder symptoms who are going unreported, because it's unusual to see a respiratory pathogen that just causes severe pneumonia. so i made a phone call that day to joe grogan, head of domestic policy council in the white house to address my concerns and urge him to reach out to health an human services to get a coordinated briefing together because i knew it was going to be important that the different agencies start to coordinate a response. he actually followed up on that. he asked for that briefing that day. and that actually what triggered a phone call between the secretary that day and the president. it was the first time that the secretary briefed the president. he called him while he was on the golf course to brief him for the first time on the unfolding situation in wuhan. i believe that the phone call that grogan had made to the department is what triggered that subsequent phone call. >> you write in the book about that key period late february. to me, the key day is nancy's briefing where i'll never forget it coming in here. i talked to my principal about remote school. this is late february. you write about the fallout. trump was upset with the cdc briefing in february, warning that community spread was all but inevitable. the federal health officials stopped announcing new covid mitigation measures for a full two weeks. if the mere hint of mitigation prompted markets to swoon, it would be carnage if they did the measures messonnier suggested. how costly was that? >> yeah, people in the administration refer to it as the lost two weeks. i was talking to people over the time period. the president put the vice president in charge of the response at that point, but they did it sort of reassessment of where they were. it wasn't until another two weeks that they started to take more aggressive actions. it was very costly. this was at the point when the epidemic really was exploding inside the u.s. we just didn't know it. the other component of that messonnier brief, she said that community spread was all but inevitable. but in that same briefing which got less attention, she said there was no community spread at this time, which we now know wasn't true. there in fact was a lot of community spread of the virus already under way. >> part of that was the fact that the testing was broken from the beginning. and this is a real institutional failure. i mean, there is layers to the failure that happened here. but cdc really botched the testing. they basically said we're going to issue our own test, and then those tests didn't work. how do you understand that failure, why it happened? >> yeah, it wasn't just the failure of the cdc to be able to design, deploy their own tests. the idea was that they were going to design a test, they had access to the virus samples, so they would design a test. that would manufacture it as small scale and deploy to it the public health labs. there is 100 public health labs in this country, each capable of doing about 100 tests a day. that's 10,000 tests a day. that's nowhere what was needed. we needed to get the commercial manufacturers engaged from the outset. someone from early january inside the administration needed to say we need more testing and needed to get the large scale manufacturers in the game. cdc was not going to be able to fill the testing void. >> this is a question that doesn't directly bear on your considerable expertise in a variety of areas, but i'm going to ask it. we're approaching 700,000 americans that we've lost to this thing. we're losing 2,000 human lives a day. are you surprised that it hasn't done more to shake up our politics, that it hasn't done more to overcome some of the vaccine resistance and hesitancy we've seen and some of the rhetoric we've seen about masking and mitigation measures? >> i think we've become somewhat anesthetized to the death and disease, quite frankly, because it's grown slowly over time. if we had 2,000 deaths a day a year ago, it would have been a far greater tragedy in the minds of many people than it is right now, because we've become more complacent to the risks. so that is deeply unfortunate. i will say from the standpoint of the achievement of getting people vaccinated, now fully 77% of all adults over the age of 18 have had at least one dose of vaccine. most of them will complete the series. that's a remarkable achievement. i think the biden administration has done an outstanding job rolling out this vaccine. we've gotten a lot of adults vaccinated. we still need to do more. i think we need to get to 80, 85%. but 77% is a remarkable achievement over this time period. >> can you imagine a threshold in which we're not having a brutal winter? >> yeah, i can. i think on the back end of this delta wave, we're going to have so much immunity in the population, either from vaccination or people who acquire immunity that we're unlikely to see a dense wave of infection this fall, winter, unless we get a new variant that pierces the immunity offered by vaccination. i think on the back end of this delta wave, this may be our last major surge of coronavirus. >> from your lips to god's ears. pfizer is one of the manufacturers of vaccine, obviously, and one of the fears right now is that the longer this transmits around the world, the likelihood of new variants as well as the sort of humanitarian tragedy. pfizer has opposed coming out various ways of waving intellectual property regulations to make the vaccine manufacturable in other countries. why shouldn't bit the case at this point pfizer, moderna, other drug companies who made billions of dollars and have produced a very good product, to be clear, that that is essentially open sourced so that the world can produce it at the lowest possible marginal cost to get as many people vaccinated as possible? >> look, the patents around the mrna technology are owned by many different companies and across license. a lot of them are actually owned by japanese firms. the key is trying to make supply available. pfizer has made a billion doses available to low income countries, has moved facilities into south africa, has partnered with a facility in south africa in that continent. i think that's really going to be the solution, trying to get manufacturing stood up in other parts of the world and get supply into other parts of the world. right now if you look at the supply over the next 12 months, we may have between 10 and 15 billion doses available over the next 12 months. the real issue is going to become distribution, getting the resources on the ground to deliver vaccine in very augustus austere settings. the supply is going to be there. >> are we better prepared now for a future pandemic. obviously sars happened in the early part of the century. we're now dealing with covid. it seems to me all but certain, i think a lot of people think this now, that i will see another one of these in my lifetime. are we better prepared now? >> only in so far as we recognize our vulnerabilities. we haven't started to address them. we have systemic weaknesses in the structure of our response in this country that made us successively vulnerable to this pandemic. we haven't fixed those. we don't have an operational agency capable of mounting a national level response. well don't have an agency capable of collecting and analyzing information and offering guidance in a realtime fashion to inform realtime policy making. well relied on the cdc to do that. the cdc does many things very well, but they can't respond to a fast-moving crisis. and i think we wrongly assumed they have that capability. they don't. we're going to need to build it into that agency. we can't build a new agency. we're going to need to reform and build out the cdc to address this crisis. >> i think that's very astute. scott gottlieb, thanks for making time tonight. >> thanks a lot. that is "all in" on this wednesday night. "the rachel maddow show" starts right now. good evening. >> good evening. thanks to you at home for joining us this hour. happy to have you here. we have following breaking news out of the great state of alaska where alaska's republican governor mike dunleavy has just announced that alaska has now become the second state in the country to declare that all its hospitals statewide will now be shifting to crisis standards of care. what that means in english is that hospital care is now being rationed at hospitals in alaska. in practical terms, that means that people who are less likely to survive get moved down the priority list in terms of whether or not they get an icu bed, whether or not

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