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Transcript: The Rachel Maddow Show, 12/20/21

Guests: Bernie Sanders, Pramila Jayapal, Gabriel Bosslet


Interview with Vermont Senator Bernie Sanders, chair of the Senate Budget Committee. Interview with Washington Congresswoman Pramila Jayapal is chair of the Congressional Progressive Caucus.


HEATHER MCGHEE, COLOR OF CHANGE: Don`t worry, he doesn`t have to look that up. He can just have this sort of racialized, you know, classist impressions. But anyway, sorry. I just had a hard time even getting that sentence out (AUDIO GAP) Manchin wants.

But nonetheless, the question is, are we having in a country that can be competitive because families have what they need. And that`s that choice in front of Joe Manchin and we -- all the rest of the Democratic Party has to say about the answer to that question.

CHRIS HAYES, MSNBC HOST: David Plouffe, Heather McGhee, thank you both.

That is "ALL IN" on this Monday night.

THE RACHEL MADDOW SHOW starts right now.

Good evening, Rachel.

RACHEL MADDOW, MSNBC HOST: Good evening, Chris. Thanks, my friend. Much appreciated.

HAYES: You bet.

MADDOW: And thanks to you at home for joining us this hour. Happy to have you here.

Two weeks ago, the CDC said that the omicron variant of COVID accounted for 0.4 percent of all the COVID known to be circulating in this country, 0.4 percent. Then last week, the CDC said it went from 0.4 percent of all COVID to 3 percent.

Now, from last week to this week, omicron has gone from 3 percent of all the COVID in the United States, from 3 percent to 73 percent, 0.4 percent two weeks ago, 3 percent last week, 73 percent this week. So, bye-bye delta?

Omicron is now leaping ahead, becoming the dominant strain in the United States of America in just a lightning flash. In terms of what the new omicron pandemic is going to be like compared to the delta pandemic, compared to the original strain coronavirus pandemic before that, well, what we know about omicron thus far, for sure, is that it is massively contagious. It`s just massively transmissible.

We know that, yes, vaccinations help when it comes to omicron. It helps prevent you from becoming infected and it certainly helps you avoid serious illness, hospitalization and death. Vaccinations do help.

Even if you are already vaccinated, though, we know in the case of omicron, you need a booster now. If you`re not vaccinated yet, my God, now`s the time. I mean, the big question here is we do not yet know exactly what this new variant and its massive transmissibility, the huge case numbers it`s already generating, we don`t know what that means for expected hospitalization numbers and death numbers. So far, for example, New York City, which is a place that`s very highly vaccinated, they are seeing the largest daily case numbers they have ever seen. More new infections in New York City right now than they have ever seen ever before.

But that`s the case numbers. Hospitalization numbers aren`t -- don`t look the same. The hospitalization numbers in New York City are not rising, too, as huge numbers of new infections are reported.

Now, this wave of omicron infections in New York City is sudden. Hospitalizations always come a little bit after the new infections happen so it possible we`ve got a little lag time issue here and the hospital hospitalizations will go up. It`s also possible an overwhelmingly vaccinated population can sustain because they do that good work against this type of variant? We`ll see.

As the new omicron variant overspread the country and again appears to be way more contagious as we are poised to have a huge crush of new infections sweep the country, the problem, even as we don`t know exactly how it`s going to affect hospitalizations, the problem right now is we`re about to get huge numbers of new infections, is that the hospitals in much of the country are already being crushed right now, even before massive new omicron infection numbers start hitting everywhere. Rhode Island emergency room doctors have just put out a statement saying that state`s health system, quote, is currently collapsing. Quote, no one who is practicing medicine alive in this country right now has ever experienced what we are going through right now. Again, that`s emergency room physicians in Rhode Island.

National Guard`s been called out in large number in two additional states today, Indiana and Ohio getting hundreds of guardsmen and guards women to spell staff in hospitals. One hospital told WBUR in Boston today that they have a list of 30 hospitals, 30, to which they refer their own patients who need more serious care, 30 different hospitals in five different states. That community hospital in New Hampshire says, as of today, there is not a single bed available in any of those 30 hospitals in any of those five states.


Not a single place they can send their own station. And that`s in New England, which has some of the best vaccination rates in the country. Even with a minority of people choosing not to get vaccinated, it`s that unvaccinated population that is stuffing the hospital so that nobody else can get in, and that is before this new massively, massively transmissible new variant spikes case numbers all over the country.

Again, 70 percent -- 70 plus percent of the COVID in America now is already omicron. So those huge case numbers are coming, huge numbers of new daily infections from a hugely transmissible new variant. That`s coming. We`re going to have a report from the front lines in just a few minutes.

But I will just say before we do that, just as a personal plea from me, if you have been putting off being vaccinated for whatever reason, don`t agonize about it, don`t let anybody make you feel bad about that and get you defensive about it, just make a fresh decision now. Take a fresh look at the issue now, looking at what`s going on now. No matter why you have put it off in the past, no judgment, now is the time to actually go do it, because we really cannot afford you having to go to the hospital right now.

If you`re unvaccinated, you have a much higher chance of getting this newly transmissible variant we had never seen before, before a couple of weeks ago. And it`s the unvaccinated people who it`s going to make sick and we really just cannot afford for you to have to go to the hospital. I mean, looking around the country, depending where you live, there`s a very good chance there`s no room for you in the hospital if you need to go.

And if you can somehow get a bed because you got COVID and you got sick from it because you weren`t vaccinated, if you are able to get yourself into a bed, you`re going to be filling a bed that somebody else really needs.

So, even if you didn`t feel like you could do it before, even if you`ve been holding off for whatever reason, look at it fresh live now. Now would be the time. Even if it wasn`t okay for you before, it`s okay for you to do it now. Honestly. Your country needs you.

And if you are vaccinated but you haven`t been boosted yet, and you`re available for your booster, make your appointment for your booster. Now`s the time. And I know from anecdotal experience in the part of the country where I live, right now signing up for booster right now it`s sometimes hard to find an appointment. The on reason I`m saying that is not so you will be discouraged from getting one, but because if you know you need a booster, you should try to make it now because you may need to make it in advance in order to get into a vaccination site. So, time to do it. This is it.

All right. We`re going to -- like I said, we`re going to have more on that talking with a frontline physician in just a couple of minutes tonight.

There`s also, I need to tell you some breaking news we`re keeping an eye on tonight. The January 6th investigation has sent a request, not a subpoena, a voluntary request to a member of Congress from whom they are now seeking testimony and documents about his involvement in the January 6th plot.

It`s Republican Congressman Scott Perry of Pennsylvania, who does appear to have been involved in the efforts to try to use the powers of the U.S. Justice Department to falsify the election results. The January 6th investigators wrote to Congressman Perry tonight very politely. They`re saying that they don`t take it lightly that they`re requesting testimony from a serving member of Congress but there is an implicit threat that would appear to be there if he does not choose to comply with their voluntary request, they could potentially serve him with a subpoena.

So, we shall see. That`s a big new step for the January 6 investigation. We knew they were looking at some members of Congress in terms of their alleged involvement in the plot. Here is the first one who is actually getting targeted communications from the investigation asking him to come in.

"The New York Times" is reporting that the January 6th investigation is considering making criminal referrals for prosecution along a couple of different lines. This isn`t just contempt of Congress, people refusing subpoenas or whatever. This is crimes related to January 6th.

Quote, according to people briefed on their effort, investigators are looking into whether a range of crimes were committed, including two in particular. Number one, whether there was wire fraud by Republicans who raised millions off assertions that the election was stolen, despite knowing the claims were not true and, two, the question of whether Mr. Trump and allies obstructed Congress by stopping the certification of electoral votes.

Again, that`s new reporting tonight in "New York Times" about the January 6th investigation, turning toward potential e referrals for criminal prosecution. We sort of saw this come coming.

Multiple Trump world figures have already said they invoke or plan to invoke their Fifth Amendment rights against self incrimination. You don`t do that, unless you think there is going to be prosecution associated with that investigation.


So, like I said, this is a train we could sort of see coming but too toot, toot, here it comes into the station. Again, both of those stories about the January 6 breaking late tonight. We`re going to keep eyes on both of those over the course of the hour.

But we`re going to start tonight with live interviews with the top progressives in the House and Senate. Congresswoman Pramila Jayapal heads up the Progressive Caucus in the House, Vermont Senator Bernie Sanders, both of them are our guests right off the top here tonight, as Democrats in Congress and the Biden White House appear to have had their proverbial tires slashed over the weekend by West Senator Joe Manchin.

Republicans are, of course, unified in their opposition to the Build Back Better bill. That`s the bill that includes most of President Biden`s economic agenda, almost everything he wants to do, for example, on the issue of climate as well.

With the unified opposition from Republicans, Democrats need all 50 Democratic senators to vote for that, bill if it will pass this weekend, after strong everybody along for a better part of the year, supposedly a negotiating toward something he would vote, yes and something he had agreed he could support in principle. Senator Joe Manchin went on Fox News this weekend and said none of these negotiations and made any difference to him, and he`s a "no" no matter what.

The White House put out an unusual blistering statement, in response, calling his reversal inexplicable, basically saying that senator Manchin had not exit in good faith, and he had not been honest. The Progressive Caucus made the same, point both in print, a statement from, them in their leader, Congresswoman Jayapal, saying publicly today that she spoke with Senator Manchin this morning. She did take his call, but she also did not mince words in describing her view of what he has done.

She said quote, that lack of integrity is stunning. That lack of integrity is stunning, in a town where people say the only thing you have is your word. is reporting tonight that Senator Manchin and President Biden have spoken personally since the Fox News thing and this isn`t over. They are still talking, something could still happen.

Leading progressive Senator Bernie Sanders saying today that he wants a vote on the bill, before the Senate and he wants is soon because at the very least, Senator Manchin should have to stand and account for what he`s saying. Where does this stand now? Where are there possibilities remaining, if any? And how will the progressives both in the Senate in the U.S. House, chart a path forward toward getting at least some of this done?

Joining us now live is Vermont Senator Bernie Sanders, who, of course, is chair of the Senate Budget Committee.

Senator, it`s a real pleasure to have you with us tonight. Thanks for making time to be here.

SEN. BERNIE SANDERS (I-VT): My pleasure.

MADDOW: Let me just start by asking you the big picture. If this is -- if this is done, or do you believe there`s any chance of passing what this bill contains? Either in a single bill or in pieces?

SANDERS: I think, nothing is done until it`s done. And I think our job right now is to lay out to the people of west Virginia, what is at stake here, the people of America what is at stake here.

West Virginia is a beautiful state. It`s a great state, but it is a state that economically is suffering in a really bad ways. And the people of West Virginia have got to understand, that if we can lower the outrageous cost of prescription drugs, we`ve got to pass this legislation. If we`re going to have the kind of home health care that we need in West Virginia, Vermont, in America, we have to pass the bill.

If we are going to expand Medicare, West Virginia, Vermont they are all this for a lot of people walking around without teeth in their mouths. They need hearing aids. That`s in this bill. We`ve got to pass this bill.

And everybody in America, must understand that the scientists are telling us we have very little time, in order to transform our energy system, if we are going to prevent future absolute disasters, in terms of climate change. And that is in this legislation.

This is enormously important bill. And the American people have to stand up and demand that every member of the Democratic caucus, and it`s pretty pathetic I have to say, that this one Republican has the guts to stand up to the Trump company, in the insurance companies. Or the fossil fuel industry. But it least all of us have got to work together.

The last point that I would make on this Rachel, is in the caucuses, everybody knows, there`s a wide diversity of opinion. But what is troubling to me. Is that you have two senators, who are not just prepared to fight for their ideas. But they have said, you know what, it`s my way or the highway. If you don`t do what I want, Mr. President, or members of the Democratic Caucus, I`m walking away. That is an arrogance that I think is unacceptable.

Any member of the Democratic Caucus can do that, as you well know. I happen to believe the current health care system is dysfunctional. I believe in a Medicare for all system. And I could walk away, if that Medicare for all is not in this bill, I`m out of here.

But I don`t do that, because not everybody in the caucus agrees with me. So, what bothers me is that we have people like Mr. Manchin, turning their backs on the working families of this country, allowing the big money interest once again to prevail and basically saying, if I don`t get everything I want, I`m not going forward. That is not acceptable to me.

MADDOW: Senator Sanders, a lot of Democratic senators, and new Democratic members of the House have tried to negotiate with Senator Manchin in good faith, including talking with him away from the cameras, having private conversations, having multiple sort of tiered conversations with him to try and get him to say yes, tried to pull him into the coalition.

You and a lot of grassroots activists we have talked to on the show have tried another approach, tried to push him on the outside with direct action, with editorials in his hometown paper. We`re talking to West Virginians and supporting their own activism around this sort of thing.

Neither of those two approaches appeared to work on him. He has complained sort of bitterly on the last one.

Strategically, what do you think is left to try?

SANDERS: Look, I just think that we have got to bring this bill to the floor. I think frankly, we look like fools to the American people one month after month, quote/unquote, negotiations are ongoing. And finally you either have to fish or cut the bait.

And I think, either we bring the bill to the floor, Mr. Manchin chooses to vote against it, he will have to tell the people of West Virginia and this country why he is supporting all of the powerful special interests in this country, the drug companies, the insurance companies, the fossil fuel industry, the very wealthy who do not want to pay anything more in federal taxes. He`s got to explain that.

But you have to bring that bill to the floor. And if it goes down, we can decide what the next step is. But we cannot keep just talking and talking. We`ve got to do something, bring that bill to the floor.

And by the way, it has to be a strong bill. A clear bill that makes it clear to the American people, we are substantially reducing the cost of prescription drugs, that we are expanding Medicare, that we are building the affordable housing and home health care and the child care that the American people want.

We`ve got to do a better job in getting the word out as to what`s in this bill and what it will mean among other things, by the way. The $300 per month for working parents that they`re getting for their kids, that`s going to end if this bill is not passed, despite the fact we`ve reduced childhood poverty through that by almost 40 percent.

MADDOW: What you are seeing there, particularly at the end, really echoed by the statement that was put up at the White House in response to Senator Manchin`s pronouncement. We will continue to press him to see if he will reverse his position yet again to honor his prior commitments and be true to his word.

But in the meantime, Senator Manchin will have to explain to those families paying $1,000 for insulin why they need to keep paying that instead of $35 for that vital medicine. He`ll have to explain to nearly 2 million women who would get the affordable day care they need to return to work, why he opposes a plan to get them the help they need. Maybe Senator Manchin will explain to the million of children have been lifted out of poverty in part due to the child tax credit, why he wants to end the program that is helping achieve this milestone. Maybe he can explain to those millions of children, we cannot.

The -- covering this from the outside it has felt from a chronicle death foretold, because it has felt like Senator Manchin has been sort of feeding the prospect that this would pass and that he could get to yes just enough to keep the attention on himself, frankly, and I don`t need to speak derogatory in personal terms. But it has felt like he has enjoyed all the intentions. He`s enjoyed being asked every day. He`s enjoyed all of that -- you know, sort of tea leave reading about his feeling.

I don`t know how you plan to get around that. But I also don`t know how putting him on the line and making him vote for it, I am sure he`s going to vote no if it comes to the floor in January. I don`t know how that will move him either.

SANDERS: Well, it`s -- you know, this is not only Mr. Manchin, it`s not only these policies which are so important to working families. It is about the Democratic Party trying to restore faith with the American people that they actually stand for something.

What has been really painful through this whole process to my mind, Rachel, is not only the dragging on of the so-called negotiations. It is that the American people don`t know where we are at.


Do we have the guts to take on the drug companies who are spending over $300 million in lobbying right now? Is that the Democratic Party? Do they have the guts to take on the private insurance company who do not want us to expand Medicare and dental, hearing and eye glasses? Do we have the courage to do what the scientists are telling us has to be done and transform our energy system away from fossil fuel?

So the issue is not just Mr. Manchin. I mean, it would be really sad and someone worked really hard on this, if we were not successful. But it would be even sadder if the American people said, these people stand for nothing. Not only can`t they get anything done, they don`t believe in anything. They don`t have the guts to take on the powerful special interests.

And I would prefer for us to say, look, we tried. That we had all the Republican bought off by the big money interests. We have two Democrats who couldn`t stand with us. Give us more Democrats and in the first week of the new Congress, we will pass this.

That is better to me than just to be negotiating forever and standing for nothing.

MADDOW: Vermont Senator Bernie Sanders, the chairman of the Senate Budget Committee -- sir, thank you for your time tonight. It has been too long since you have been here with us. I really appreciate you making time for us tonight.

SANDERS: Thank you very much.

MADDOW: All right. Let`s bring in to the conversation now, one of the central players in the effort to craft this Build Back Better deal. Washington Congresswoman Pramila Jayapal is chair of the Congressional Progressive Caucus. In that role, she has led progressives in the House in their many negotiations with, among other people, Senator Manchin, and the White House.

I should tell you, Congresswoman Jayapal and Senator Manchin also spoke directly by phone this morning. The senator called her and she took his call.

Congresswoman Pramila Jayapal, official optimist of THE RACHEL MADDOW SHOW, thank you -- thank you for joining us. I`m going to say, a hard day to be the perpetual optimist.

REP. PRAMILA JAYAPAL (D-WA): It is really true. But I`m not giving up the role. But you know I always tell you the truth.

And I think the truth needed to be told here, Rachel, which was that Senator Manchin did make a commitment to the president on the framework that the president, you know, unveiled to us the day before he went to COP and that framework, Rachel, would never have happened had the Progressive Caucus in the House not stood up and refuse to pass the infrastructure bill until we got that framework and then until we got the legislative text.

But I do believe that Senator Manchin has -- has said many things. And, look, he`s a nice man. I`ve had good conversations with him. But I had to be clear that your word is everything around here. You can`t enter into negotiations if you are not going to be an honest negotiator, and if you are not going to keep your word to the president of the United States.

The president told me that Senator Manchin committed to that framework, and if there were things that weren`t matching that framework, then you wouldn`t go on Fox News the Sunday before Christmas and make a case that the Build Back Better Act is done and that it`s reshaping the country in a way that is untruthful, frankly, but is reshaping the country in a way that`s not beneficial for the American people.

Rachel, we are in the midst of COVID. I think you`re sitting in New York somewhere where omicron is hitting hard.

And the Build Back Better is about making sure we have elder care, so that when people are suffering from COVID, they can be taken care of at home. It`s about making sure we reduce the premiums for people to be able to get health care coverage in a country where I agree with Senator Sanders, we are the writers of the Medicare for All bill. We should have a different system. But at least we should bring down the costs of being able to get health care for people.

The Build Back Better Act is about making sure we pay $35 for insulin instead of hundreds and hundreds of dollars or driving across the Canadian border. It is about making sure that we give people the ability to have child care in a time when we`ve had a she-session. Women have been pushed out of the economy and they`re waiting. So, these are real people.

And the child tax credit, which is now not going to go out in January or February or probably March is -- means that millions of Americans are now going to be pushed back into poverty at a time when the virus is back on the surge.

So, yes, it is a tremendous frustration because we all thought we were negotiating in good faith.

And the optimist in chief of THE RACHEL MADDOW SHOW says that the things that we are working on are hard. They are. If they were done -- if they were easy, they would be done. They`re not.

They`re hard and we can`t give up and we won`t give up and that`s why we will pursue a two-track strategy now to both push for the Build Back Better legislation to pass the Senate and we are also calling on the president to take some significant executive actions that will make people`s lives better today and that will also put pressure on continuing to get legislation through instead of doing it through executive action.


So, we`ll have a two-track process here. We`re not giving up but it`s a hard day. I`ll be honest.

MADDOW: What is it that you think the president could do by executive action, what pieces of this or what goals do you think that he could get to by executive action before any legislation could pass?

JAYAPAL: Well, you know, we`d love to see -- I mean, we`re looking into all of that. We`re going to -- we just had an executive board meeting of the progressive caucus in the House, and I think that there are some things that he could certainly do around health care. I think that, you know, we should look at what we can do on insulin, on EpiPens and making sure that people can get the prescription drugs they need and not cave in to big pharma and those big interests that have been lobbying for months and are gleeful and supporting Senator Manchin as he -- as he does what he does. And so, that`s one area.

But I also think we want the president to look at things that are going to reduce costs for Americans. At a minimum, he should continue the moratorium on student debt because people can`t afford to pay that right now. But we also want him to look at canceling student debt, at least $50,000 in student debt so that people who are struggling right now with the surge of omicron can continue to lower their costs, because that`s what Build Back Better would have done. It would have lowered costs.

And if we`re not passing Build Back Better, then we better look at other ways that we can lower costs.

And, finally, Rachel, I think the president has to consider taking serious action on fossil fuels and on climate because if we`re not passing Build Back Better any time soon, then we still need to address the fact that the world is looking to us for our leadership on climate and we need to -- we need to be taking that action.

All of that said, Rachel, I don`t want anyone to think that we are giving up on passing Build Back Better. We -- we have to continue to push that forward and we have to make sure that we are getting the kind of assistance to people that we promised and that will be transformational.

MADDOW: Washington Congresswoman Pramila Jayapal, chair of the Congressional Progressive Caucus and a person who`s never had a non- constructive word to say about an intransigent problem, that is a testimony -- a testament to your -- your overall approach as a public service -- as a public servant, Congresswoman Jayapal.

It`s part of the reason I like talking to you about this stuff so much. You are always talking about the way ahead.

Thank you for your time tonight. I know this is a really, really, really tough time. Thank you for being here.

JAYAPAL: Thank you, Rachel. I appreciate that so much.

MADDOW: All right. We`ve got much more ahead here tonight. Do stay with us.



MADDOW: The state with the most COVID cases per capita right now is -- any guesses? -- Rhode Island.

Over the last two weeks cases are up 53 percent in Rhode Island. And hospitalizations are up 61 percent in Rhode Island. You can see how steep those slopes are on the right side of each of these graphs. That is new cases on the left-hand side on the red, and hospitalizations on the right.

Emergency room doctors in Rhode Island are now warning that the state health care system is, quote, currently collapsing. The Rhode Island chapter of the American College of Emergency Physician says, quote, any added strain right now will lead to collapse of the state health care system. We, a collective group of emergency physicians, are terrified for the future of health care in the state.

Quote, imagine patients dying while waiting to be seen by a doctor who is 50 feet away. And because of lack of staff and capacity, the doctors simply unable to treat that patients. This is a true tragedy that is currently unfolding for citizens of Rhode Island. This is a true tragedy.

And while it is by the number worst right now in Rhode Island, it is not just happening there. Hospital CEOs and even business CEOs in Minnesota, Indiana, Ohio, have been sounding alarm bells about hospitals failing now in those states. Mostly because of unvaccinated people contracting COVID and then flooding the hospitals.

Leaders of six health care systems in the Cleveland area, signed on to a full page ad on the Sunday edition of "The Cleveland Plain Dealer". This is with the ad looked. Like see the big box, there is one word in bold letters in the middle, "Help".

It says at the bottom quote: We now have more COVID-19 patients in her hospitals than ever before. We have overwhelming majority are unvaccinated. This is preventable. We need you to care is much as we do. That was "The Cleveland Plain Dealer" and hospital CEOs begging the population, in Ohio, to please get vaccinated, so you will please stay out of the hospital, because the hospital cannot take you.

Ohio and Indiana, in particular are both getting big new National Guard deployments right now. Thirteen hospitals in Indiana are getting National Guard personnel to help them with their latest patient surge. In Ohio, more than 1,000 members of the National Guard started to pour into hospitals statewide. Hospitalization there, just about matching their previous record.

All three of those states that I just mentioned, as far as we know, the delta variant, of COVID, is still the dominant strain they don`t seem to have had a big new omicron driven surge there yet. If you want to look down the tunnel and what might be coming, for parts of that country, have a look at New York. For the past few days, New York has each day, broken its record for daily new COVID cases. Cases are rising beyond sharply in New York City, the surge shows no sign of letting up anytime soon. It`s a very right side of your screen, the most recent dates. You see how that number is spiking. That`s new daily infections.

Thus far, though, hospitalization in New York City, have not followed along. On the right there, that is daily average hospitalizations in New York. And you see how hospitalizations basically followed along with case numbers, in the earlier peaks, that is not happening yet in terms of this omicron driven surge of new cases in New York.

I mean, we are not sure if that trend will hold steady. The New York City health commissioner just told my colleague on MSNBC, he expects the hospitalization rate in New York City to rise eventually. They`re preparing for that but we will see.

What we do know is that omicron now counts for 92 percent of the new COVID cases in New York in New Jersey. That`s based on CDC data for the past week. Last week, the CDC reported that delta was the dominant strain, now the CDC says omicron is not only dominant there, and accounts for more than 73 percent of new COVID cases nationwide. Last week that figure was 3 percent, this week it is 73 percent.

So, omicron is spreading like wildfire. We don`t yet know what this means for hospitalizations. But already, in many parts of the country, there is no room in hospitals for anyone else, in fact, the people who work in those hospitals are begging for relief.

How do these two trends come together? You have a frontline report on that coming up.

Hold that thought. Stay with us.


MADDOW: Right now in Indiana, the sort of head-snapping cognitive dissonance is very real. Hospitals are on their knees right now in Indiana, grappling with a flood of mostly unvaccinated COVID-19 patients. Simultaneously, the Republican-dominated legislature decided that now is the right time to advance new legislation to have prevent employers to require their employees get vaccinated.

The mismatch between that reality and that proposal, inspired one frontline ICU doctor in Indiana, to go to the state capital, to plead with lawmakers to please not do this. Watch this. Watch what he said.


DR. GABRIEL BOSSLET, PULMONOLOGIST: Our hospitals are bursting. Part of the pandemic, the state of Indiana had 1,400 maximum ICU beds. We surged up when the viruses coming, in order to deal with what we are going to be facing. Today, there are 1,884 people in ICU beds in Indiana, almost 40 percent above our usual maximum. On Christmas Eve, if this continues, we will have more COVID-19 patients in ICU beds, or in hospital beds in the state of Indiana, than any point in this pandemic.

We are tired. We have been able to scale up ICU beds in ventilators. But we have not been able to scale up people. There are no more of me. There are no more nurses.

Today, we opened an ICU that`s been shuttered for a decade in order to care for nine more ICU patients at the hospital in which I work. It means I won`t be home for Christmas, which is fine. I can deal with that. This is what I signed up for.

When I didn`t sign up for is making people die needlessly. How do I know the people are dying needlessly? Because vaccines work. How do I know vaccines work? I`ll tell you how I know vaccines work.

This weekend, I rounded in the ICU. This is an ICU that normally holds 22 patients. We had 35. We can handle that.

Of those 35 patients, 15 have had COVID-19. One of those people were vaccinated, with a single vaccination, back in February. None of them are fully vaccinated. I can count on one hand, of the hundreds of COVID 19 patients that I have cared for in ICUs, the number of that been vaccinated.

So why should you get vaccinated? You should get vaccinated because you all know people, who despite their efforts at vaccinating protecting themselves, cannot be protected. They are people who have had transplants. They are people who have autoimmune diseases. They are people like my wife who has cancer.

These people can take the vaccine, but their immune system may not protect them. So, what do they need? They need the rest of us to step, up and protect them as well.

I`m tired. And if I seem frustrated, I am, because we have been doing this for almost two years, and we cannot do it much longer. I just want this to end. I submitted to the committee, a letter from -- that has been signed by over 460 Hoosier physicians, was because we almost unanimously reject the language in this bill regarding vaccines.

Why? Because the message this bill sends is that vaccines are not important.

Vaccines are important. They are the only way to end this.


MADDOW: Joining us now is Dr. Gabriel Bosslet. He specializes in pulmonologist in critical care medicine at Indiana University Hospital System.

Dr. Bosslet, thank you so much for taking time to talk about this tonight. I know that public advocacy as a doctor is not necessarily part of what you signed up for in this -- in this role. I appreciate you talking to the state legislator and being willing to talk to us about it tonight.

BOSSLET: Yeah, thanks for having me.

MADDOW: First, let`s just ask you, since that testimony, if the prospects of that legislation have pivoted it all, have changed at all? Have you had any feedback about that very strong statement that you gave them?

BOSSLET: I`ve gotten a lot of feedback.


I don`t know that it`s going to have much of an effect on Indiana state house. It`s Republican supermajority. They seem pretty set on setting this piece legislation to the Senate. I don`t know whether will be that well or whether it will become law. But the fact that it`s even being debated is frustrating.

MADDOW: When you talked about your level of exhaustion and the fact that there is no way to scale up the humans that make our health system work, you can`t make more of you, you can`t make more nurses. You also talked about how so many people involved in the health system, particularly nurses have burnt out, have washed out of the profession because it`s been too hard for these two years.

Given that, I have to ask you how -- what your mindset is. How you are thinking about all this news about the omicron variant and how transmissible it is. It does seem to be supplanting delta around the country. It does seem to be more aggressively contagious, essentially more transmissible. That implies we are going to get a lot more case numbers and maybe unvaccinated people that won`t transfer to more hospitals. But for unvaccinated people it seems like most likely will.

BOSSLET: Yes. I mean, I`ll be honest. We have been through so many rollercoasters of emotions during this thing. As I think back to last March or April, the original strings bearing down on us, you know, everyone left the hospital. We started with really low rates of people in the hospital.

So if I`m honest, I am more scared now than I was when we had no idea what was going to happen when the original virus happened because we are starting now with hospitalization rates that are literally higher than we have ever been in the state. We have never had 14,000 patients in hospital beds in the state. We normally range around 10,000. And that is where we are today.

So, if omicron comes through and even if it is less severe than the delta strain, just a sheer number of people that are going to be infected could very easily overwhelm us very, very quickly, because we have no slack in the system.

MADDOW: What is and I don`t -- I don`t -- I apologize in advance to ask you to go to a dark place, but when you say we can be overwhelmed, overrun, what -- what do you mean? What does that mean in practical terms?

BOSSLET: I don`t know. Rachel, I don`t know what that would imply. I mean, you know, I -- it makes my heart race to think what that could imply. I mean, it could look like people dying because we don`t have enough places to put them, and then just suffocating alone. It means, you know, putting people in ambulance space, which is happening in one of the hospitals here in conference rooms, which is what`s happening here.

People don`t seem to understand what`s going on in hospitals in states like Indiana. And it is absolutely dire. So, I don`t really want to think about what the worst-case scenario is because honestly, if we come to that will haunt my dreams for years.

MADDOW: If you could wave a magic wand and have the Indiana state legislature open it`s hard, open its mind, think about these things differently, move forward with an understanding of kind of dire circumstances that you are talking about in the grave threat that is just around the corner, if you could get the state government to do all the right things right now, what would they do?

BOSSLET: The -- I mean, the realist in me wants to just do nothing, right? From my perspective, if they just did nothing, than any businesses that want to have a mandate and enforce it the way that the business wanted to could have that.

That is not what they are doing. They are trying to force businesses to basically -- they are micromanaging businesses, which is insane. So, the realist in me would want them to do nothing.

The idealist in me would want them to say, look, we are going to support the mandates on places of business. And we are going to support mandates on even smaller places and businesses in the federal mandate, right? The idealist me would make them under -- would hope that they understand how important this is. That literally the policies that they put forth will save lives, literally.


And not only that, but will save the economy, because we don`t come really racing back until the pandemic is over, right?

Look, I`m not going to restaurants now. I`m not going to restaurants until this peak is gone, regardless of whether they are open. So, you know, I just want them to listen to public health officials and not make public health decisions based upon, I don`t know, political aspirations? I don`t know what it is.

MADDOW: Dr. Gabriel Bosslet is a pulmonologist and critical care physician at Indiana University`s Hospital System. Sir, thank you for talking to us about this tonight and come back in coming days. I know that Indiana is in -- as you said -- sort of dire straits right now. But it`s very warm what`s coming around the corner. We`d love to have you back, sir.

BOSSLET: Thank you so much.

MADDOW: All right. We`ll be right back. Stay with us.


MADDOW: One last thing for you tonight. For a few weeks now, we have been hearing warnings from the U.S. government including the intelligence agencies that Russia appears to plot to invade Ukraine again, like they did in 2014. Well, now, today, the U.S. government is taking that threat more seriously -- seriously enough that the State Department has updated its travel advisory for U.S. citizens.

It`s explicitly warning American citizens now to not travel. Do not travel to Ukraine, quote, due to increased threats from Russia.

So that threat of Russia potentially invading Ukraine looms in the background. But there is also something bizarre to know about going on between the U.S. and Russia that involves a member of Congress. I don`t know if this is received a lot of attention widely but it is worth watching from here on out.

Earlier this month, a Democratic congressman from Arizona named Ruben Gallego led a congressional trip to Ukraine. Congressman Gallego who`s a U.S. marine, said the U.S. should provide Ukraine with better weapons so the Ukrainians can better defend themselves against Russian troops.

It turns out not everybody in Russia appreciated those comments from the congressman, including one member of the Russian Duma, their sort of pretend parliament, who went on state-sponsored Russian TV to declare that as punishment for those comments about Ukraine, Congressman Ruben Gallego should be, A, placed under surveillance, and B, kidnapped. He should be kidnapped.

I think it`s fair to say that Congressman Gallego was less than face from that threat from the Russian parliamentarian. He tweeted in response: F around and find out with an American flag emoji.

It is sort of hard to know if that was the sort of thing that was designed to have a nice domestic shelf life on Russian state-run TV, or if this is an actual thing to worry about from the sky in the Russian parliament. But since that initial threat from violence from that Russian politician towards a sitting U.S. congressman, things have escalated for the worse.

That same Russian politician has now gone back on Russian TV to say that Congressman Ruben Gallego deserves to be convicted in a Russian court of what crime I don`t know. But he says once that verdict is handed down, Congressman Gallego` sentence should be carried out by the same guy who, quote, iced-axed Leon Trotsky to death. So, he should be axe-murdered.

And again, maybe this is just domestic audience nonsense from Russian politicians but at a certain point, no matter what`s the point of all of this is for them, it sort of has to be taken seriously, right? These are not repeated violent threats against a sitting member of Congress from a country that is poised to invade one of our allies.

Watch this space.


MADDOW: All right. That is going to do us for tonight. We will see you again tomorrow when the days start getting longer in the night start getting shorter, right? We`re here.


Good evening, Lawrence.