CHRIS MATTHEWS, MSNBC HOST: -- desperate or when they`re out to seize more power, or are trying as I said to desperately cling to what power they have. If Trump has evidence he should produce it. If Director Comey does not have evidence, he should say so. This whole thing is unworthy of us as a country. Remember we all knew that. That`s HARDBALL for now. Thanks for being with us. "ALL IN" with Chris Hayes starts right now.
CHRIS HAYES, MSNBC ALL IN HOST: Tonight on ALL IN.
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: Don`t believe those phony numbers.
HAYES: Day 50 in the Trump White House.
SEAN SPICER, WHITE HOUSE PRESS SECRETARY: They may have been phony in the past but it`s very real now.
HAYES: From phony job numbers to more hiding and lying about collusion with a foreign government.
SPICER: No, no, no --
UNIDENTIFIED MALE: The person who is in line to be the National Security Adviser may need to register as a foreign agent. And that doesn`t raise a red flag?.
SPICER: No. It`s not a question of raising a red flag, John.
HAYES: Tonight an ALL IN special report. Falsehood and facts in the first 50 days of President Trump.
KELLYANNE CONWAY, DONALD TRUMP`S COUNSELOR: You`re saying it`s a falsehood and they`re giving Sean Spicer, our Press Secretary gave alternative facts to that.
HAYES: Including the massive emerging broken promises of Trumpcare.
TRUMP: Save Medicare, Medicaid, and Social Security without cuts.
HAYES: And new questions about whether team Trump knew Michael Flynn was a foreign agent. And an ALL IN America investigation. Why a single pharmacy in a small West Virginia town was shipped nine million pain pills in two years.
UNIDENTIFIED FEMALE: I would love to see the drug companies take responsibility.
HAYES: When ALL IN starts right now.
Good evening from New York, I`m Chris Hayes. And on this, the 50th day of the Trump administration, the White House is touting what it calls 50 days of action. With the President quote, "achieving results for the American people." And that is one way to look at it. We`ve seen something else in those first 50 days, something that was captured in this extraordinary moment at the White House today after Press Secretary Sean Spicer trumpeted a new jobs report showing the jobless rate had ticked down to 4.7 percent. You might recall that as a candidate routinely and repeatedly Donald Trump did not exactly put a lot of stock in the government`s jobs numbers.
(BEGIN VIDEO CLIP)
TRUMP: Don`t believe those phony numbers. When you hear 4.9 and 5 percent unemployment, the number is probably 28, 29, as high as 35. In fact, I even heard recently 42 percent.
(END VIDEO CLIP)
HAYES: OK. That`s not true but in light of those comments, Spicer was asked quite reasonably why would it be that the White House now takes the new job numbers seriously. And Spicer`s response along with the reaction of the journalists in the room provided a defining moment to mark this President`s first 50 days in office.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Does the President believe that this jobs report was accurate and a fair way to measure the economy?
SPICER: Yes. I talked to the President prior to this and he said to quote him very clearly "they may have been phony in the past but it`s very real now."
(END VIDEO CLIP)
HAYES: Did you hear that laughter? It wasn`t just Spicer, it was the reporters, too, and it was an acknowledgment of what everyone in that room almost certainly -- although certainly not everyone in this country -- has figured out. The White House is full of it. And they know it. And they know the reporters know it and they don`t care. You see, not a single thing that emanates from this White House can ever, ever be immediately believed or granted presumptive authority or assumed to be true. Not one thing. Not what the President says, not what Sean Spicer says or what officials say on the record or off the record, nothing, no matter how serious or how trivial. You simply cannot take any of it at face value and that is true no matter your politics or whether you support or oppose this President`s agenda. This White House has shown over its first 50 days that at the most fundamental level B.S. is part of its DNA and it started, of course, even before Donald Trump took office. Think back to the very first thing that Donald Trump said publicly in the Oval Office when he met with then President Obama during the transition.
(BEGIN VIDEO CLIP)
TRUMP: This was a meeting that was going to last for maybe 10 or 15 minutes and we were just going to get to know each other, we had never met each other. I have great respect. The meeting lasted for almost an hour and a half.
(END VIDEO CLIP)
HAYES: It`s a total trivial thing. How long the meeting was supposed to last, and yet Trump could not stop himself from lying about it.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: Donald Trump mentioned that this was originally supposed to only last 10 to 15 minutes. Is that true? And why would it go on so much longer than that?
JOSH EARNEST, WHITE HOUSE FORMER PRESS SECRETARY: The President had allotted more time on his schedule for that meeting than just 10 to 15 minutes.
(END VIDEO CLIP)
HAYES: Now fast forward to inauguration day, day one of 50, remember how it rained that day? It started pretty much right when the President started to speak and continued through his speech. It`s something anyone who was there could verify with one notable exception.
(BEGIN VIDEO CLIP)
TRUMP: God looked down and he said "we`re not going to let it rain on your speech." In fact, when I first started I said, oh, no, first line I hit -- got hit by a couple of drops. And I said, oh, this is -- this is too bad. But we`ll go right through it. But the truth is that it stopped immediately. It was amazing. And then it became really sunny. Then I walked off and it poured right after I left.
(END VIDEO CLIP)
HAYES: That, too, was just completely made up. Just like Spicer`s claim the crowd at Trump`s inauguration was the biggest ever.
(BEGIN VIDEO CLIP)
SPICER: This was the largest audience to ever witness an inauguration period, both in person and around the globe.
(END VIDEO CLIP)
HAYES: No, not true, on the left is a picture of President Obama`s inauguration in 2009, on the right, that photo with far fewer people, that`s President Trump`s inauguration. And that was just the start. That was day one through four of the Trump administration`s ceaseless assault on the truth. Or, to put it another way --
(BEGIN VIDEO CLIP)
CONWAY: Don`t be so overly dramatic about it, Chuck. What -- you`re saying it`s a falsehood and they`re giving Sean Spicer, our Press Secretary gave alternative facts.
(END VIDEO CLIP)
HAYES: The alternative facts are used to discuss relatively trivial matters like the size of Donald Trump`s win.
(BEGIN VIDEO CLIP)
TRUMP: People came out and voted like they`ve never seen before, so that`s the way it goes. I guess it was the biggest electoral college win since Ronald Reagan.
(END VIDEO CLIP)
HAYES: Not true. They`re also deployed for more serious issues like the absurd claim that anti-Trump protesters are being paid.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Do you sense that there`s an organized pushback and people are being paid to protest?
SPICER: Absolutely. I mean, protesting has become a profession now. They have every right to do that, don`t get me wrong. But I think that we need to call it what it is. It`s not these organic uprisings that we`ve seen through the last several decades. You know, the Tea Party was a very organic movement. This has become a very paid, Astroturf-type movement.
(END VIDEO CLIP)
HAYES: Alternative facts are even used to gen up anti-immigrant sentiment with lies about refugees and references to terror attacks that never happened.
(BEGIN VIDEO CLIP)
TRUMP: You look at what`s happening last night in Sweden, Sweden, who would believe this? Sweden?
CONWAY: Two Iraqis came here to this country, were radicalized and were the master minds behind the Bowling Green massacre.
(END VIDEO CLIP)
HAYES: There was no Bowling Green massacre. Now, we can`t possibly go through all the examples. Huffington post counted what it said were 100 lies from the Trump team in just the first 36 days, but the lesson of these first 50 days is clear. The White House, the office of the President, has become an unreliable narrator. A source of information that you just cannot trust. And it matters when a President falsely claims that millions are voting illegally, throwing the integrity of the entire electoral system into question and when an administration misleads the public about contact with Russia and when, without evidence, the President of the United States accuses his predecessor of illegally wiretapping him sending Capitol Hill on what by all accounts is an absolutely wild goose change. Today, White House officials told the A.P. the President got that claim from Breitbart News which had written up a rant from a right wing radio host. And they placed that Breitbart piece in Trump`s daily reading pile, the official said, and the President was off. And there`s a good chance that`s what happened but of course, it`s hard to say because that claim itself comes from a White House official and as these 50 days have shown, that means none of us should take it at vase fall.
Joining me now, Joy Reid, host of MSNBC`s "A.M. JOY." And John Dean, former White House Counsel to President Richard Nixon. And Joy, I`ll start with you on the -- you know, the wiretapping to me was the most extreme version of this.
JOY REID, MSNBC ANCHOR: Yes.
HAYES: Thousands of hours -- tens of thousands of labor hours in newsrooms, on Capitol Hill, around all of our sort of political media complex have been devoted to getting to the bottom of this tweeted claim when it was obviously just, for lack of a better word, B.S. from an article he read.
REID: Yes. And you know what, as you were going through that sort of opening and litany, it just -- it occurred to me sitting here that wait a minute, what we`re watching in the Trump administration sort of a show within a show, right? So the first show has an audience of 62 million people who voted for Donald Trump. He`s putting on a performance for them of doing the things that he said he`s going to do and being their President, and he wants to look good to them. And so he`ll say "I`m going to build a big beautiful wall, Mexicans are going to pay for it. Oh, they`re not going to pay for it? I never said that, Mexico was never going to pay for it, you`re going to pay for it but you`ll going to love it, it going to be beautiful." So he`s putting on a show for them, but then you also have this other show happening where Donald Trump`s staff, his team, Sean Spicer, all of these guys who work for him, are putting on a show for him.
HAYES: Right. Exactly right.
REID: Because HE is not entertained. I don`t know if they know what he`ll do and he`ll get angry if Sean Spicer doesn`t come out and say that was the biggest inaugural crowd ever, he`s on thin ice. So they all have to perform. And it seems that part of the performance has been to feed the paranoia of the President who says "why are my numbers so low? Why don`t people believe me." They slip those Breitbart articles and they say, "Mr. President, it isn`t you, it`s Obama,
HAYES: Right.
REID: Obama is wiretapping you." They keep him paranoid and part to entertain, mollify and calm and soothe him. That is terrifying.
HAYES: Right. And it means -- it means, John, that -- first of all the things -- the information that goes into the President is unreliable, as Joy is pointing out, right? That`s part of the problem. The information that comes out of the President is unreliable to the point where, you know, the credibility of the office will matter at some point when there`s -- you know, the President needs to say something about the North Korean weapons program or some international crisis or just speak with some sort of level of trust to the American people about an outbreak of a disease or natural disaster, there`s no reason at this point to trust anything that he said.
JOHN DEAN, RICHARD NIXON`S FORMER COUNSELOR: Absolutely not. And it`s -- he`s really put the Presidency and the ship of state, if you will, on unchartered route. We don`t know where this can lead because as Joy said, there`s a lot of theater going on here. The first time, I appreciated or understood the way people looked at the Presidency was during Watergate. And after my testimony, and people came out and made the oddest comment, they said "we enjoyed your show." And I didn`t understand it. But a lot of people see this sort of thing as pure theater. So while we`ve had this before, we`ve never had it as compressed, we`ve never had the underlying falsehoods that are just building and -- on each other. It`s a very crumbly foundation. And the point you make is well taken. There`s going to be a time he needs the credibility and he has none.
HAYES: You know, you just mentioned his supporters. And one of the things I think, that can get lost in all of this of the 50 days, the tumult and all these stories and the sort of crises, tumult crises. That actually his approval has been quite stable. You know, tracking poll over the last month, Trump at 43 percent a month ago, 42 percent today. And that`s like -- you know, he got 46 percent of the vote. So it`s -- he is not popular. He is voted in by a minority of people, but those people -- it`s something like he`s going down. It`s like, they`re still there and part of what I think, this President is doing is asserting the primary right to describe reality over and above any other interlocutor or source. That`s a key part of what this White House wants to do.
REID: Yes. He`s still the star of "the apprentice," it`s still his show. The thing that`s actually kind of disturbing is the way he stays at 42 percent is because among everyone else, he`s got a terrible underwater approval rating but among republicans he`s still up there in high 80, 88 percent and he`s higher than Ronald Reagan. How is he doing that? Because his show for them is bread and circuses. What`s the most cynical thing he`s done so far is to say I have to ban people from these seven Muslim countries, it`s urgent, I`ve got to do it now. And then when he gets rejected by the courts, the second version of this ban actually can wait because he`s getting -- you know, lauded by the press and so while he is being applauded --
HAYES: Right.
REID: -- it`s not so urgent. It can wait now.
HAYES: Literally the day they put it out he said we had to rush to put it out.
REID: Had to do it quick.
HAYES: It was supposed to then the second version, the 2.0 was going to come out the day after his speech to congress and we heard from reporting it was delayed a day so he could soak up the adulation.
REID: So he could soak up the applaud. And the -- and the other part it`s cynical and really -- you know, sort of frightening is that the bread and circuses for his base includes the persecution of people they fear, the persecution of Muslims is part of the bread and circuses, the persecutions of immigrants, throwing out dreamers from the country, people that it`s easy for his base to hate and to fear. That is part of the show he gives them instead of giving them substantive things like, I don`t know, health care.
HAYES: And, John, to the point about health care, what also strikes me here is that this is entirely independent from politics or ideology in this sense that you could believe in abortion should be criminalized or that abortion should be universally accessed by women. You could believe that we should scrap Medicaid or have that we should have Medicare for all. Whatever your political beliefs the basic facts of the matter about the world and the White House choosing to miss-describe them constantly has nothing to do with that. That`s just a central defining feature right now of our politics.
DEAN: He seems to be an empty vessel into which he`s allowing others to pour thoughts and a program if you will. He -- we know he came with very little conviction. He`d been on all sides of most issues as we knew from the campaign and now it seems he`s going to play to at least part of the hard right, part of the middle right. He`s all over the lot. He has no real philosophy or core beliefs so this is another problem where his credibility is going to hurt him. Where -- I have no idea what it`s like in private meetings with the man or private telephones, if people accept him, but based on what he`s saying publicly, there is no public credibility in what he`s doing.
HAYES: And finally Joy, I want to talk about this story. Roger Stone who is a Trump confidante, he acknowledge today that he had exchanges with Guccifer 2.0, who`s largely believed to be a front for Russian intelligence. One of the DNC -- early DNC hackers, right? Said they were innocuous. The reason I think this relates to what we`re talking about here is that, there`s a swirling sense of -- set of suspicions about possible collusions with the Russians, et cetera,
REID: Sure.
HAYES: Which may prove to be nothing or may prove to be something massive. But right now the problem is any denial just can`t be viewed by anyone credibility.
REID: Right. Because you already made I think, the central point. You can`t believe anything they say, except you might be able to leave a couple of things Roger Stone has said, and he said them over and over to lots of reporters, that he had a back channel to WikiLeaks. The OCCOM`s razor explanation for what happened in the -- during the election is that Russia decided to attack our elections and that someone, more than one person probably in Trump world knew about it. If this person, Roger Stone who`s been a Trump consigliore since the `80s, connecting him to Russia since Vladimir Putin was in the KGB. Then if he says he had a back channel, I think he might want to believe that. He might want stop saying that.
HAYES: Well, the question is, what can you believe? Joy Reid and John Dean, thank you both. Appreciate it.
Up next, 50 days of facts continues. NBC News has now confirmed Donald Trump brought a paid agent of a foreign nation to top secret intelligence briefings. More hiding and lying about collusion of the foreign government and more questions about what Mike Flynn was up to. We are back in just two minutes.
(COMMERCIAL BREAK)
HAYES: New developments on former National Security Adviser Michael Flynn appear to show the White House once again caught in a lie. This week Flynn registered retroactively with the Justice Department as a foreign agent for lobbying, and I quote here, "it could be construed to principally benefited the Republic of Turkey." This was for work that done from August to November last year in exchange for $530,000. It all happened while Flynn was still a top adviser for the Trump campaign. Here`s White House Press Secretary Sean Spicer being asked about the matter yesterday.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Was the President aware that Lieutenant General Michael Flynn was acting as a foreign agent when he appointed him to be the National Security Adviser?
SPICER: I don`t believe that that was known.
(END VIDEO CLIP)
HAYES: I don`t believe that was known. To reiterate here for a minute, the White House Press Secretary said he did not believe the President knew about Flynn`s work as a foreign agent which, frankly, seems incredibly unlikely. And here`s why. On November 18th of last year, Congressman Elijah Cummings sent a letter to Vice President Mike Pence stating quote "Lieutenant General Flynn`s general counsel and principal confirmed that they were hired by a foreign company to lobby for Turkish interest." That letter from Cummings came less than a week after a pair of news stories detailing the fact that Flynn`s company was lobbying for a firm with ties to the Turkish government. Today the A.P. reports the Trump transition team knew before inauguration day that Flynn might have to register as a foreign agent. In fact, among those told of Flynn`s lobbying work was Don McGahn, Trump`s Campaign Lawyer who served in the transition and later became White House counsel. Today Sean Spicer continued to insist the President had no knowledge of Flynn`s lobbying and it did not concern the transition team.
UNIDENTIFIED MALE: Can you say that the President was informed at all about this arrangement?
SPICER: No.
UNIDENTIFIED MALE: That he`s to register as a foreign agent?
SPICER: No.
UNIDENTIFIED MALE: But how did that not raise a red flag? I mean, you have the other attorney calling the transition saying that --
(CROSSTALK)
SPICER: No. John. You already got your question John. John, we`re doing one question --
UNIDENTIFIED MALE: But this is an important point --
SPICER: Hold on. No it`s not John.
UNIDENTIFIED MALE: -- because you have an attorney calling the transition saying that --
SPICER: No, no, no.
UNIDENTIFIED MALE: The person who is in line to be the National Security Adviser may need to register as a foreign agent. And that doesn`t raise a red flag.
SPICER: No. It`s not a question of raising a red flag, John. It`s a question of whether or not they gave him the advice that they`re supposed to. Which is, it is not up to them to make decisions as to what you need to do or not do.
UNIDENTIFIED MALE: Let me just start to clarify. The transition officials were not overly concerned by his relationship?
SPICER: That`s not a question of overly concerned, Glenn. The question is, did they provide him the avenue that they were supposed to? Which is, did they tell him to seek counsel? And they did and that`s what`s supposed to happen. That`s it, plain and simple.
(END VIDEO CLIP)
HAYES: Joining me now, Matthew Rosenberg, who covers Intelligence and National Security for the New York Times. And Matthew, it strikes me as fairly unusual that an individual who would be in classified intelligence briefings that are given to the nominee of a major party as Lieutenant General Flynn was, would be at the same moment they are receiving what is essentially some of the most classified information of the U.S. government acting as a foreign agent for a foreign government.
MATTHEW ROSENBERG, NEW YORK TIMES JOURNALIST: I don`t even know where to start with this whole Flynn episode. I mean, throughout the summer, he is on the campaign trail saying, you know, presenting himself as the honest angry general who`s set to clean up this corrupt Washington National Security establishment that can`t protect America. And when he`s criticized by former colleagues in the military for being overly partisan - - and he did this in an interview with me in October -- he says," you know, they`re out there joining corporate board using their former titles to do that. But I can`t do that. I want to be -- I`m not making money because I`m so honest and because I want to help this country." He actually said to me on October 16th, when he was most the way through making a half million dollars, he said to me, "I would love to be making some money. I wish I could stop what I`m doing." I mean, I don`t even know where to start with that.
HAYES: So you -- so you`re talking -- I mean, this is the other point here that I think is key. This is a retroactive registration, he is not telling anyone at the time while he`s doing this. I mean, presumably, you know, I don`t know what`s in the Presidential daily -- in the Presidential daily briefing or what the briefing is being presented to the nominee of Donald Trump but there might be information there that would be useful if you`re angling to promote the interests of the Turkish government.
ROSENBERG: Absolutely. And he may be seeing this information and then he`s advising a candidate and then a President-elect through the lens of what his commitments are elsewhere. I mean, this is a classic conflict of interest situation. So yes, his contract ended on November 16th, and he was then nominated till November 18th. But throughout November well before the election, he was Donald Trump`s top National Security Adviser and to not disclose this, it just seems part of a pattern where, you know, the White House says no, no, no, no, no and then they are forced to admit something and they say not much here and then it gets worse and worse and worse.
HAYES: And a crucial point here. You know, there`s a form called the SF86 which -- people that are going in through to go through the clearance process have to fill out, and one of the sheets asked these questions about whether you`ve been the representative of a foreign government or foreign agent, etcetera, presumably he had to file that during the transition, everyone does the SF86`s. Either he lied on it or the White House saw and knew at the time because it was on the form and they were fine with it.
ROSENBERG: We`re confident that he told the White House, his lawyer told the White House about this arrangement and wondered whether it would be a problem during the transition. He would have already had the security clears clearance as the former Director of the Defence Intelligence Agency, so it`s not clear he needed a new one, but it`s not clear what he told the defense Intelligence Agency about his relationship. And we should also note that in September, he filed what`s called an LDA, which is a lobbying form, you get the file if -- you know, you representing a foreign company or foreign non-government organization. But I`ve spoken to lawyers about this and the way it works is that once the thinnest connection to a foreign government shows up, that means some low-level official shows up at a single meeting, you`re going to have to do the registration that he did today, which is a much higher level to say you`re a foreign agent. So if you`re filing something in September but you know that you`re a foreign agent and you`re not filing the foreign agent form, that looks -- there`s something there. That looks like a possible attempt at to deceive.
HAYES: That`s an excellent point. And let`s also remember this is an individual who wrote an op-ed saying the U.S. should extradite the chief domestic political enemy of the President of -- a man by the name of Fethullah Gulen who`s a cleric, who lives in the Poconos and that`s a long other story. That he knew -- I mean, writing that op-ed is signal to everyone he knew where his bread was being buttered. He knew for whom he was working.
ROSENBERG: Absolutely. And he didn`t tell anyone. So that op-ed was in the hill and the hill today or yesterday had to append a little note on to that op-ed in its archive saying neither General Flynn nor his representatives disclosed this information when the essay was submitted.
HAYES: Right.
ROSENBERG: So not only was he representing somebody else and go ahead out and making a case for them, he was not saying that he was being paid to do so.
HAYES: Right. All right. Matthew Rosenberg, thanks for joining us.
ROSENBERG: Thank you.
HAYES: Still to come, candidate Donald Trump promised no cuts to Medicaid. President Donald Trump is now supporting a plan that would gut Medicaid. The jaw-dropping betrayal on a promise that will devastate millions ahead.
(COMMERCIAL BREAK)
HAYES: President Trump spoke frequently during the campaign about combatting the opioid addiction for the healthcare bill that Trump is pushing with gut treatment prediction other mental health treatment. Here`s Congressman Joe Kennedy III establishing that fact, the GOP lawyer in a hearing on the bill.
(BEGIN VIDEO CLIP)
REP. JOE KENNEDY III (D), MASSACHUSETTS: So when we look at those health benefits, whether it`s mental health care or potentially for other health conditions, that is no longer essentially covered or required to be covered by this version of this text, is that not correct?
The text before us does remove the application of the central health benefits for the alternative benefit plans in Medicaid.
KENNEDY: Sorry, does what? I apologize, I just didn`t get it. I`m sorry, sir, I genuinely didn`t hear -- it does what?
UNIDENTIFIED MALE: It does remove the application of the central health benefits on the alternative benefit plan.
KENNEDY: It does remove them?
UNIDENTIFIED MALE: Correct.
KENNEDY: Including mental health.
UNIDENTIFIED MALE: Yes.
KENNEDY: Thank you.
HAYES: Congressman Joe Kennedy joins me to talk about Trumpcare next.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
TRUMP: Save Medicare, Medicaid, and Social Security without cuts. Have to do it. Get rid of the fraud, get rid of the waste and abuse, but save it. People have been paying in for years and now many of these candidates want to cut it.
(END VIDEO CLIP)
HAYES: Candidate Donald Trump`s promise on the day he announced his run for president, no cuts to Social Security, Medicare, Medicaid.
But in the American health care act, Trumpcare, there are, guess what, cuts to Medicaid, not just cuts to Medicaid, big cuts to Medicaid. House Speaker Paul Ryan went on conservative Hugh Hewitt`s radio show today to brag about the scale of the cuts to Medicaid framing them as enormous historic cuts.
(BEGIN AUDIO CLIP)
REP. PAUL RYAN (R-WI), SPEAKER OF THE HOUSE:: We`re talking about hundreds of billions a year throughout the country. This is -- this is so much bigger by orders of magnitude than welfare reform, because let me describe exactly what this bill does for conservatives. This is why I`m so excited about it, and this is why I think people need to see the forest for the trees.
We are de-federalizing an entitlement, block granting it back to the states and capping its growth rate, that`s never been done before.
(END AUDIO CLIP)
HAYES: And when Hewitt asked Ryan about the possibility of the Congressional Budget Office coming out with a number that 15million people will lose insurance under the GOP health care bill, Speaker Ryan responded with this.
(BEGIN AUDIO CLIP)
RYAN: You`re never going to win a coverage beauty contest when it`s free market versus government mandates. Our goal is not to show a pretty piece of paper that says we`re mandating great things for Americans.
(END AUDIO CLIP)
HAYES: Joining me now, Congressman Joe Kennedy III of Massachusetts, a member of the House, Energy and Commerce Committee.
You`re shaking your head. What do you think about that line from Paul Ryan?
KENNEDY: It`s not who we are as a nation. It`s not what health care is all about. Health care, at its most basic, health care is about taking care of those among us in their time of need. That is what health care is. That is what health care does. And why I think so many of us are so upset is we have got essentially what is really a massive tax cut to the wealthy on the backs of hardworking families that are working paycheck to paycheck and costing 15 million people their health care, all in the name of health care reform. It`s outrageous. And it`s just, it`s not who we are as a country.
HAYES: I want to focus on that exchange you had, because I think one of the things that folks have not -- have underappreciated is what Paul Ryan boasted about. This is a huge cut to Medicaid over time. And one of the things it does is that it delays them and then caps them so over time they get more and more severe. So in the early years, people don`t recognize but the folks that need it most, say mental health, addiction treatment, folks in West Virginia where 30 percent of the folks are on Medicaid, like, they are going to take it on the nose.
KENNEDY: Absolutely. Absolutely. And, look, we tried to expose this a bit in our hearing over the course of those 27, nearly 30 hours that we were in that room together. And it was abundently clear that, one, most of my republican colleagues didn`t understand what the bill did, and, two, that for those that are in need, for families that are working paycheck to paycheck, who have operated under the idea, the value that we have as a country, that in your time of need we will care for each other, that they`re going to take it on the chin.
And what this does, if you look at the technicalities of it, is it erases, it rescinds these essential benefits for folks on Medicaid, preserving them for everybody else, and tries to pass off a huge tax cut literally on their backs. And so for folks that are looking at it for maternal care, for folks that are looking for mental health care, and opioid addiction care, and ambulatory care, and basic wellness and prevention services, all of those are now at risk.
And our colleagues try to say, well, there`s additional funding that is set aside that might be able to cover it. One, the funding isn`t anywhere close to covering it; and, two the whole point behind the Affordable Care Act was making sure that everyone across the country got the care they need when they needed it.
And, again, it`s -- this bill blows a hole in that value that we have as a country and that`s why I think it`s so insulting to those of us that are trying to expand on those efforts and make sure we strengthen the Affordable Care Act and build upon the values that we`ve built.
But what Speaker Ryan has said -- and, you know, amazing that he`s willing to go out there and say it, because we certainly didn`t hear that rhetoric last night during the course of that -- two nights ago, during the course of nearly 30 hours together in the room.
HAYES: Congressman Joe Kennedy, I appreciate your time tonight. Thank you very much.
KENNEDY: Thank you.
HAYES: All right, still to come, why did one tiny pharmacy in a small West Virginia town get shipped over 9 million painkillers over just two years? An All In special investigation coming up. You do not want to miss it.
Plus, an amazing television debut in tonights Thing One, Thing Two starting after this break.
(COMMERCIAL BREAK)
HAYES: Thing One tonight, each night this show and others like it bring guests on from various remote locations in cities around the country, live locations or studio setups with cityscapes or other scenes behind them.
You`ve probably seen guests sitting in front of this same pretend bookcase on every cable TV show going back 10 years. Some guests even have cameras set up in their homes, which is really convenient if you want to talk crime any time.
Or if you need a North Korean expert right away, like the BBC did recently.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: what does this mean for the region?
UNIDENTIFIED MALE: My apologies.
North -- sorry.
Um -- North Korea -- South Korea`s policy choices on North Korea have been severely limited--
(END VIDEO CLIP)
HAYES: The door close does it. That video is Thing Two in 60 seconds.
(COMMERCIAL BREAK)
HAYES: Today, a political science professor based in South Korea appeared as a guest on BBC via Skype from his house. Robert E. Kelly was on to talk about the impeachment of a South Korean president which almost everyone involved in that segment would agree is a pretty serious story.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: No. I would argue that this is a triumph of democracy. Scandals happen all the time, the question is how do democracies respond to those scandals.
UNIDENITIFIED MALE: And what will it mean for the wider region? I think one of your children has just walked in. I mean, shifting sands in the region? Do you think relations with the north may change?
UNIDENTIFIED MALE: I would be the surprised if they do. The -- pardon me. My apologies.
UNIDENTIFIED MALE: What does this mean for the region?
UNIDENTIFIED MALE: My apologies.
North -- sorry. North Korea -- South Korea`s policy choices on North Korea have been severely limited in the last six months to a year because of North Korea`s behavior, most recently the use of VX gas in the airport in Malaysia that indicates that North Korea doesn`t follow global norms.
(END VIDEO CLIP)
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
TRUMP: We will stop the drugs from pouring into the country and poisoning our youth and we will expand treatment for those who have become so badly addicted. We will soon begin the construction of a great, great wall along our southern border. We are removing gang members, drug dealers, and criminals that threaten our communities and prey on our very innocent citizens.
(END VIDEO CLIP)
HAYES: The president tells a specific story about the origins of the drug epidemic that`s ravaging this country. It`s a very real crisis. Just look how the number of overdose deaths from opioids shot up from 2000 to 2015. More Americans now die from drug overdoses than they do from car crashes.
But a wall on the southern border isn`t going to solve the problem. To show you why, we travel to a small town in West Virginia that`s at the heart of the epidemic. Our special investigation coming up next.
(COMMERCIAL BREAK)
HAYES: This Monday, we`re airing another edition of All In America: Bernie Sanders in Trump Country. We`re headed to McDowell County, West Virginia way down in the southern part of the state in the heart of coal country. Like many parts of the U.S., a lot of them poor, rural, largely white, West Virginia has been ravaged by a flood of opioids, highly addicted drugs that range from heroin to legal painkillers like Vicodin or OxyContin.
The state has the highest rate of overdose deaths in the entire country by a long shot.
The president of the United States has promised to put an end to the crisis, but when he talks about where it came from, he`s got it all wrong. We went to West Virginia to investigate.
(BEGIN VIDEOTAPE)
HAYES: This is Kermit, West Virginia, population just under 400. And this was the Save-Rite Pharmacy in Kermit, where at least 9 million opioid painkillers were shipped in just two years. 9 million. That`s the equivalent of over 22,000 pills for every person in town.
People came from all over the region to get drugs in Kermit.
CHALRES SPARKS, MAYOR, KERMIT, WEST VIRGINIA: A lot of traffic from different states where people are getting and getting their prescription filled because they heard that this was an easy place to get it filled so this is where they came to.
HAYES: Those drugs didn`t come over the border from Mexico, they were manufactured by American firms, prescribed by American doctors and sent to pharmacies by American drug wholesalers or distributors, some of the nation`s biggest companies.
ERIC EYRE, CHARLESTON GAZETTE-MAIL: You have those rogue doctors prescribing incredible numbers of opioids. You have the pharmacies dispensing large numbers of OxyContin and Hydrocodone and then you have the drug wholesalers which are shipping from the manufacturers to the pharmacies.
HAYES: Tommy Priest has lived in Kermit his whole life. He served on the town council for 17 years. He`s now chief of the volunteer fire department.
TOMY PRIEST, KERMIT RESIDENT: It was a great life growing up here in a small town. Everybody knowed everybody.
HAYES: But prescription painkillers transformed Kermit.
PRIEST: My generation, we growed up, we looked back and the kids wasn`t out playing no more. They wasn`t doing nothing. I guess they was afraid to come out.
SPARKS: There was some robberies. There were some people that were robbed, and what have you, but it was just not a safe place to be at the time when this was going on.
HAYES: At the fire department, Tommy Priest found himself responding to more and more overdoses. Many times he and his men would arrive too late.
PRIEST: It`s a terrible feeling when you go in and you know you can`t revive somebody and help them. It is, it`s a bad feeling.
HAYES: Priest knows that feeling intimately. In 2005, his younger brother got a prescription for several large doses of OxyContin.
PRIEST: They fill it no questions asked, you know, they fill it for him. And two days later we get a phone call. My brother`s laying in a trailer down here in Wayne County dead, he OD`ed on the OxyContin. And I never heard of anybody giving like four 80 milligram OxyContins per day. That`s just -- that`s something else that`s unheard of. And it`s really a big loss to lose my brother. Me and him was close.
HAYES: No state has lost more of its people to drug overdoses than West Virginia. Law enforcement has cracked down on pharmacies around the state, including the one in Kermit that received nine million pills in two years, its owner was fined and sent to prison.
But in West Virginia, until recently, the distributors that supplied those pharmacies with millions of painkillers have largely escaped consequences.
EYRE: Every drug they distribute to is to a licensed pharmacy and every prescription that the pharmacy fills is from a licensed doctor. So they say hold on a minute, we`re just the middleman.
HAYES: According to an investigation by the Charleston Gazette-Mail, drug wholesalers shipped 780 million Oxycodone and Hydrocodone pills to West Virginia between 2007 and 2012.
During that period, over 1,700 West Virginians fatally overdosed on the same two drugs. Under West Virginia law, distributors are legally required to report pharmacy orders that seem suspicious.
EYRE: The quantities of the opioids were increasing dramatically that were shipped from the wholesalers to the pharmacies. That should have sent signals to the distributors.
HAYES: West Virginia sued the distributors for failing to raise red flags about the number of painkillers flowing into the state.
During the previous 12 years, the state received just two suspicious order reports. In the years since the lawsuit was filed, that number shot up to more than 7,200.
The state just settled with two of the biggest distributors, which agreed to pay a combined $36 million, neither admitted to any wrongdoing.
Now the town of Kermit is following the state`s example, suing five drug distributors for damages.
SPARKS: If we don`t get anything out of this suit, monetary, maybe we can get the fire started and keep it going where it grows bigger and we can get over people involved in it, other towns.
HAYES: That fire appears to be spreading. Late last year, the county next door sued three of the drug wholesalers. McDowell County was shipped more than 12 million painkillers over a six-year period.
It has the highest rate of fatal drug overdoses in the nation. In the county seat of Welch, 80 miles from Kermit, mayor Reba Hoeniger just filed her own lawsuit against the drug wholesalers.
REBA HOENIGER (ph), MAYOR OF WELCH: I`m here to file this.
HAYES: She wants to hold the wholesalers accountable for their role in the opioid epidemic that has devastated West Virginia.
HOENIGER (ph): I would love to see the drug companies take responsibility for the number of drugs that they send into our city and our county.
(END VIDEOTAPE)
HAYES: I`m joined by Dr. Ana Lembke, chief of addiction medicine at Stanford University, author of Drug Dealer MD: How Doctors Were Duped, Patients got Hooked and Why it`s So Hard to Stop.
Doctor, if you look at any of the data that chart we showed about opioid overdoses, there`s just something crazy that happened about, I don`t know, 10, eight years ago in this country in terms of opioid consumption. What happened?
ANA LEMBKE, STANFORD UNIVERSITY: What happened? Well, it really began in about 1980. Prior to 1980, doctors were very reluctant to prescribe opioids for pain because they were concerned about patients getting addicted. But in 1980, there was a huge shift in medicine -- 1980 -- and doctors started prescribing opioids for minor pain conditions and chronic pain conditions. And a major driver behind this was the pharmaceutical industry.
But in order to really understand how this happened it`s necessary to realize that the pharmaceutical industry used a Trojan horse-like approach to infiltrate what I call big medicine. Basically the pharmaceutical industry behind the scenes launched a covert operation in essence to influence academia, to influence the FDA, the federation of state medical boards, the joint commission, these are watchdog organizations that are supposed to keep as eye on how doctors practice.
And the pharmaceutical industry ended up perpetrating one of the greatest myths in modern medical history which is if a patient is prescribed an opioid for a pain condition they won`t get addicted. And now we know that`s not true.
HAYES: So you have got big pharma. You`ve got the distributors who are the wholesalers in this story, who are the ones who are the targets of the lawsuit. You have doctors doing prescribing, huge amounts of pain pills flowing into the American populace. I guess my question for you is in places that have seen a lot of economic devastation, how much is this a story about the specific nature of opioids, how much is it a story about essentially economic desperation leading to addiction?
LEMBKE: It`s a great question.
Karl Marx said that religion is the opium of the masses. And I think today we`ve reached a new era when essentially opium has become the religion of the masses, which is to say we have so wrenched our social fabric, we have communities that are devastated by unemployment, devastated by multigenerational trauma and these are communities in which people are particularly vulnerable to becoming addicted and when you add to that poor access to quality health care. And you have got doctors who are prescribing opioids simply because it`s all they have at their disposal to target pain, they don`t have access to other resources, you have a perfect setup for addiction.
HAYES: So, one of the things that is so horrifying about those numbers on overdoses is you have addiction is one thing and then you have people dying from addiction. And there`s one story that people tell that the kind of restraints on pain pills that we started to see reform that lowered the prescriptions, started monitoring it, that people then moved to things like heroin and even more dangerously Fentanyl which is synthetic and that that moved from prescription pills to things in the black market is part of what`s driving the overdose epidemic.
LEMBKE: Certainly it`s true that many individuals begin with pain pills and then transition to heroin, but it`s not clear that this transition is because they can no longer get the opioids they need from the doctor.
What`s more likely happening is that in the general populace people are exposed to opioids through a doctor`s prescription or a friend`s prescription or a family member`s prescription and hence get a taste for opioids and then quickly transition to heroin because it`s cheaper.
In other words, the crackdown on excessive opioid prescribing is not driving the increase in heroin use, it`s simply that we have now created a nation of people who are addicted to opioids.
HAYES: How do we solve it?
LEMBKE: Well, one of the ways we have found to be most effective looking at communities around the country is when many different stakeholders within the community come together. For example, volunteer firefighters, the criminal justice system, the school system, the medical community, when all of those different factors and people from different stakeholders come together and try to rebuild their community from the inside, including getting affordable and immediate access for patients who have become addicted, then we see better results.
HAYES: All right, Dr. Ana Lembke, thank you for joining me.
LEMBKE: You`re welcome.
HAYES: As I mentioned, we`ll be airing our All In America special with Senator Bernie Sanders this coming Monday at 8:00 p.m. Plus, don`t forget, in just 11 days my new book A Colony in a Nation comes out. You can pre- order it now. Make sure to check out our Facebook page for details on the book tour, because spots are filling up at all those events. And I hope to see you out there.
That is All In for this evening. The Rachel Maddow show starts right now. Good evening, Rachel.
END
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. END