Meet Zach Wahls

0:02

Welcome to the Healthy Brain Toolbox. I'm Dr. Ken Sharlin, neurologist, and host for this show. In each episode, I interview influential people whose work impacts how we live and how we think. My guests are leaders in the health and fitness industry, physicians, scientists. Here, you'll find conversations that break down barriers, expand your horizons, and give you the tools you need to protect your health and nourish your aging brain.

Dr. Ken Sharlin 0:32

Welcome to the Healthy Brain Toolbox podcast. I'm your host, Dr. Ken Sharlin. guest today is a sixth generation Iowan, a dedicated public servant and a champion. For working families, Zach Wahls first captured the world's attention in 2011 as a 19-year-old college student when a video of his powerful testimony before the Iowa House in defense of his two mother's marriage went viral, becoming one of the most watched political clips in history. Since then, Zach has turned that advocacy into action. An Eagle Scout and author of my two moms, he earned his masters in public affairs from Princeton before being elected to the Iowa State Senate in 2018. He rose quickly to serve as a Senate minority leader. Where he has been a vocal advocate for healthcare access, affordable housing, and rural development. Now he's bringing that fight to the national stage as a candidate for the United States Senate. We're here to discuss his journey from a viral advocate to a legislative leader and his vision for the future of healthcare in Iowa and across the nation. Zach, welcome to the Healthy Brain Toolbox.

Zach Wahls 2:00

It's great to be here. It's a very generous introduction and really excited for the conversation today.

Dr. Ken Sharlin 2:06

I've known Zach for many years. It's been a real honor to watch him to we probably first met back in about 2016 or so, so about 10 years when in Princeton, my hometown. And knowing him through his mother's Jackie and Terry, who are dear friends, I'm so honored that time out from his political campaign to join us.

Zach Wahls 2:28

so there's some people who get really particular about the Senator title, and it's never been about the title. I know it's obviously an honorific and reflects people's, trust. And it's funny actually, you mentioned in the intro I was elected in 2018, the same year I finished my master's at Princeton. Fun little fact is that my graduation day from my program was actually the exact same day as the primary election and I had a competitive four-way Democratic primary. And so the joke could, I told a hundred times on the campaign trail that first race was I won't be able to walk, but I am able to run. And folks we're still chuckling at it. On, on the night. We we won the race.

From Viral Moment to Advocacy

Dr. Ken Sharlin 3:04

That's wonderful. I like to do a bit of an origin story. So take us back to 2011. You're a college student. Speaking about your family in that moment, did you see yourself as a future politician or were you simply a son defending his home?

Family Story and 2011 Testimony

Zach Wahls 3:21

Yeah. It's interesting actually that 2011 speech was obviously what kind of catapulted me into the the limelight, so to speak. But for me, the story really starts with my two moms, mentioned Jackie and Terry. My mom by my biological mom, Terry. I grew up on a family farm in northeastern Iowa, up in the Driftless region Clayton County, right along the Mississippi River. And, growing up she always knew that she was a little different. And it wasn't until she was in college at the, at Drake University in Des Moines where she figured out, that she was a lesbian woman and came out to her parents a little after that. And then, I was actually born in 1991. My mom Terry was practicing medicine at the Marshfield Clinic in central Wisconsin. And then met my mom, Jackie a few years after that. I was one of the, the earliest part of the generation of young people born to openly out LGBT parents being a single woman trying to start a family living in central Wisconsin in the late 1980s. Not an easy time or place to do that. But she was able to find great fertility clinic and a sperm bank from Fairfax, Virginia that was willing to work with her. And not everybody was willing to do that at that time. And then we moved back to Iowa when I was eight years old. My mom had gone to medical school at the University of Iowa in Iowa City. And so it was a bit of a homecoming for her. And one of my most vivid memories, Ken, is as I was in the eighth grade. Watching the 2004 Republican National Convention for a Social Studies assignment that year. And we, the assignment was to watch the speeches and then report back the next day in class. And I will never forget what it was like watching, very powerful political figures. Men in our country talk, about. The war that was raging at that time, the war in Afghanistan, the war in Iraq the global War on Terror. And then in the next breath, warn about this radical Supreme court state supreme Court decision from Massachusetts that had, for the first time in our nation's history, recognized marriage equality for same-sex couples like my parents. And the realization that they're talking about my family as that. Eighth grade the 13-year-old student was just, it was a shocking and very frankly, very scary realization. And that I still remember that next day went into class, I'd taken notes. I'm still a very scrupulous note taker here. And I wanted to speak up and to say something, I was afraid, frankly and I was afraid of being judged. I was afraid of somehow making myself, even more of a target. It wasn't a secret that I had gay parents, but leaning into that or defending your family at that age, it was not something that I felt like I was able to do, and that was exactly why as a sophomore at the University of Iowa myself, studying civil and environmental engineering, when that opportunity came around again in 2011. To go speak up and to defend my family from politicians in Des Moines who were trying to use my parents' marriage as this wedge issue, to divide our state, to pit us against each other over something as simple as. Family. I felt like at that time I had the courage, I had the ability to go be that advocate that as a 13-year-old, I didn't see on the television. And so I knew that I had to go. And when I gave that speech, it was a short three minute testimony about what marriage equality had meant to my family. The commitment that my family had made to work through the hard times so we could enjoy the good ones. And as you obviously know Ken, and we can get into later, my family's been through plenty of hard times. And come out on the other side. And when that opportunity presented itself I just thought back to that eighth grade Zach and how disappointed he would be in college, sophomore, Zach, if I didn't go speak up and do the right thing. And I was frankly as shocked as everybody else. I think when the video that went. Went viral. It was not something, frankly, that we were prepared for. My parents both working in medicine, going viral means something very different in your line of work than it did for us. And but thankfully we had support of close family, friends and many others who came forward to help us navigate both the opportunity but also the challenge of that experience. I just got a firsthand lesson that when you do find the courage to speak up, to share your story to be that voice that it inspires a lot of other people to join you and to find that courage themselves. And so as a result, I spent several years doing advocacy work across the state and then ultimately across the country trying to win hearts and minds from people with whom we may have had some disagreements. But I knew that we had a lot in common too. And that's one of the, I think, the kind of the signature, one of the lessons for me of that experience is that when you, even if you look at things differently, if you try to find that common ground, the shared values, you're willing to meet people where they are, treat them with respect, bring some grace and some humility to that conversation. You can go a heck of a lot further than some of the pundits might think because there is still so much more that unites us, than divides us.

How Social Change Happens

Dr. Ken Sharlin 7:55

So much agree. And as you're saying this, one of the things I think about is this general perception about this wonderful democratic process that we have, that despite the fact that it's by the people, for the people that democratic change. Generally tends to be slow and generally tends to be a one step forward, two steps back, three steps forward, one step back, et cetera, is different, political administrations gain power and sometimes undo with the previous administration did, or attempt to and so forth. What I'm saying by that is if we talk to a young person today. just ask them at the gut instinct level, their feeling about gay marriage in general. I have a feeling the younger generation would look at me, us bewildered and say, yeah, what do you mean? That's not different than any other person getting married. And yet. This change really in reality happened in such a short, relatively short period of time. I think I, when Obama was elected president in the first administration and they were debating about Don't ask, don't tell, and I don't know about marriage, and yet here we are in 2026 and it is a totally different situation and all I mean by that is regardless of the subject, rights and Gay marriage or healthcare access, that sometimes the system kind of works. Sometimes things can happen and they don't have to take 50 years.

Zach Wahls 9:31

Yeah. I think that, our founding fathers had tremendous wisdom and foresight and we're celebrating this year, the 250th anniversary of the Declaration of Independence of course, a decade or so later, they would pass the Constitution and the Bill of Rights, and, I think it's a tremendous. I think just opportunity for all of us who call America Home or who look up to American values and ideals just take some time this year in particular to celebrate and to look back at some of those founding documents, those first principles that our founders put forward. They were of course, imperfect men but they had tremendous wisdom, tremendous foresight. The system of government that they laid out in those founding documents certainly looks a lot different today than it did 250 years ago. And I'm sure that there are a lot of things that are true about the modern world that would seem totally alien or, unforeseeable to them at that time. But that's precisely the beauty of what was in our constitution in that bill of Rights. The words that are written in our Declaration of Independence was a forward looking vision. For the progressive realization of human rights of, the universal rights of bans they talked about at that time. The continual work of perfecting our union, which certainly was not perfect then, is not perfect now. But I think that commitment and that willingness to move forward is something that is really important. I do think it is worth, of course saying, the, even though it's, I think to a lot of folks outside of the LGBT advocacy space the progress on marriage equality felt. Almost lightning speed to go from Massachusetts in 2004 to the Supreme Court Obergefell decision in 2015. There was an enormous amount of work that happened before that first Supreme Court decision in 2004, Iowa then was actually the third state in the country to recognize same-sex marriage. And I would also just, toot tide our horn a little bit. We are the first state in the country for it to be a unanimous decision by our state Supreme Court. Which was pretty special for Iowa. And again, the reason the court here in Iowa held that ruling unanimously was because of the words that the founders of this state wrote into our constitution. And so I think that from our perspective there's certainly, an appreciation for, on the one hand, how quickly social progress can happen. But on the other, the fact that it requires, a lot of people working really hard thinking really strategically to make those changes in that progress a reality.

Dr. Ken Sharlin 11:58

That's wonderful.

MS and Disability Shaping Values

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Dr. Ken Sharlin 13:54

You've spoken about your mother Terry's journey with MS. And how your mother, Jackie, who was a union nurse, of your family stability. And I'm wondering how witnessing that intersection of chronic illness and safety net, contract shaped your worldview as a politician.

Bridging Urban and Rural Iowa

Zach Wahls 14:14

It's interesting, it's actually a direct extension of the conversation that we were just on because, I think if you look at the kind of sweep of American history, obviously economic security and social progress do not always go hand in hand. But more often than not. I think in just generally speaking, people are more willing to consider new ideas and to embrace social change when they feel that economic security. And I don't think it is a coincidence that when we saw, during the latter half of the 20th century, a more broad based economic prosperity a very strong middle class that we saw, pretty rapid social change during that time the baby boomer generation. And she was diagnosed when I was only eight years old. And watching her battle that disease it certainly influenced my understanding and you think about how these different parts of our identities intersect. Seeing how my parents sometimes were treated differently because they were a same sex couple and other times treated differently because my mom, Terry, was spent several years in an electric tilt recline wheelchair. And the fact that at different times their relationship was not treated the same way or with the same respect or recognition that my own wife now and I enjoy in our relationship. It certainly made a very strong impression on me as a young person. And helping me understand that the experience that my family was going through was not quote unquote normal. Although I think honestly normal is just really a word we used to describe somebody who we don't know very well. There certainly are more normal quote unquote right, families or identities in the world. And as a result in an appreciation that even though someone may have a different. Upbringing than you, or different experience than you, or different family than you. That doesn't make that their experience or their life or their family any less valid or worthy recognition than your own. And during my time in the legislature, I've been serving now as my eighth year. I've always sought to be a champion and a voice and an advocate on behalf of people who may sometimes fall outside what we consider the norm, but who nonetheless deserve the same rights of protection under the law. Recognition from their neighbors, our state lawmakers. As anybody else, and whether that's been as a champion for Iowans who are being preyed upon by predatory investment companies, whether that's been people who need someone to speak up on their behalf because they're facing discrimination on the law or these various circumstances. I've certainly tried to live those values because they were the values that I was raised with.

Dr. Ken Sharlin 16:37

Wonderful. I think of Iowa in the General's. A bellwether state, not just because the caucus is, so early in the presidential election or primaries. But I've spent time in Iowa, I've ridden through across the state on very rural state obviously, but some beautiful urban centers of Des Moines, Iowa City, Cedar Rapids, et cetera.'And you've represented both urban and rural. Swing counties like Cedar County, when I think about. politics. I always think one of the challenges, particularly I think on the democratic side of the ticket has been this ability to bridge these blue collar more urban values of the union, member and the rural values that characterizes so much of middle America. And they're not necessarily different of course, but how getting people to communicate together, communicate and how to help folks realize that we're all on the same journey together. That's probably the bigger challenge. And make sure that people, everyone is being heard. And I'm wondering what you've learned about, because we've already talked about unanimous votes in the United, in the Iowa State. In, in the house and state Senate, Iowa, what have you learned about finding common ground on kitchen table issues like grocery prices or healthcare costs in this very politically divided state?

Immigration and American Hope

Zach Wahls 18:04

Yeah it's a really important question and I'll tell you, I feel really fortunate to have represented the Senate district that I have for these last eight years. When I was first elected in 2018, my senate district included three different counties. Johnson County, which is where I live and where I was raised which as you said is a more kind of progressive. Iowa City's a college town. I live next door in Coralville, which is a more suburban community. But I also had rural parts of Johnson County as well as Cedar County. And a slice of Muscatine County, both of which are much more rural small town areas both counties that voted for Barack Obama in 2012, Donald Trump in 2016, and for Zach Wahls in 2018. The way that I was able to win in those counties. And what I learned representing them is that, when you show up when you're able to build relationships, develop a real understanding of the issues and the challenges that are facing those communities the exact same way that I was able to win hearts and minds as an advocate for my family several years earlier. People are often very willing to meet you where you are as well. And again, even though life in, so the largest community in Cedar County is a town of Tipton. It's the county seat has 3,200 people and one stoplight. Even though life in Tipton is certainly different than it is in Coralville. Many of the challenges that we see in Tipton are not so different from what we see here where I live. We see, as you mentioned earlier, rising cost of living wages that have been, growing much slower than the cost of everyday necessities. We see challenges around childcare. Challenges around the cost of nursing homes, challenges around public education some of these things. And so I, in, again, in, in my experience that what people are really looking for is not, do you have a 10 point plan to fix every single problem in your life, but do you understand the challenges that people are going through. Do you understand the fears that they have about the future? Do you understand the hopes and the dreams that they have for their kids, for their grandkids? And I've always worked really hard to do that, to bring that work with me. What I would tell you is that as I look around at what's happening in Iowa and frankly across our country right now. I think one of the things that is the most concerning is the fact that we have seen just massive consolidation in industry after industry. In our economy, we have seen a growing amount of corporate power that is then on the other side of the equation politically is used to preserve a status quo that increasingly benefits people at the very top of our society to the detriment of the rest of us. And of course there are always going to be differences in wages and salaries based on, the amount of training that a physician or an engineer or an attorney requires. But we see today just this massive amount of income and wealth being concentrated among. The very wealthiest people in our society. And then using that wealth to continue to expand their power, their influence, their their control over the economy, over our politics. I have seen that play out firsthand in the state legislature. We can all obviously see it happening in Washington DC and even though there's certainly no doubt that the smartphones and the laptops that we have today are much fancier and better than they were 20 years ago. I think there are a growing number of Americans who really do not feel as though the life of their kids or their grandkids is going to be better than the one that they had growing up. And so as as a lawmaker as a political leader, I see it as my responsibility to ensure that, people who have those concerns are able to articulate them, to bring them to our political process. So that we can figure out, as you mentioned earlier, through that sometimes slow moving, sometimes frustrating, sometimes three steps forward, two steps back process. How we actually do build a better future for our state and for our country.

Dr. Ken Sharlin 21:36

Off script on my planned questions, but I am a second generation American. My grandfather joined his father who had come ahead of him by a few years to establish a footprint in Trenton, New Jersey where he owned a baby carriage business he started and was spending money home to the family. And then when they saved enough money, brought his wife and the rest of the children by ship through Ellis Island to make a better life for themselves. And eventually my grandfather took over that business. It was around the time of the depression, somehow morphed it into a retail lighting business, and then turned it into a national lighting company called Sharlin Light Corporation. And it was a very moving experience for me to visit Ellis Island and to energy of the people that came through those doors, traveling thousands and thousands of miles with all they had in a suitcase and with hope to make a better life for themselves. I think that's so important. I don't know that. I don't know what the immigrant story is today. I'm not trying to focus on any one group at all, but just to make the broader generalization is. Are we still the land of hope and opportunity? coming to our country to make a better life for themselves and for society as a whole.

Housing as Health Policy

Zach Wahls 23:12

Yeah, I can hear it in your voice, Ken. And I feel I feel certainly the same way. Virtually every family in this country, unless you're from a Native American background, has an immigration story of some kind. My family, I'm the sixth generation Iowan, my great-great-great grandfather. He came to this country, and did not speak a word of English. Fled a or torn and politically turbulent Germany at that time, settled in northeast Iowa in which was at that point there were a lot of people in that county who did not speak a word of English. There were multiple German newspapers and, but he had the same way that you just articulated about your family come to this country seeking a better life, more opportunity. At tremendous personal cost. His first wife died during the voyage to America. And they faced enormous challenges, both getting to this country and then building their own life, their own future in this country. And again, I think that is something that speaks to so many people. And it, this was in the 18, late 18 hundreds. And whether it was in the 18 hundreds, 17 hundreds to 19 hundreds, or even today. America for so many people around the world has been that shining beacon the shining city on a hill that President Reagan invoked from John Winthrop many years earlier. And I think even though we are in a really hard time right now, and there are a lot of people who are concerned as they should be about things that we see happening in our state, in our country i'm 100% convinced that there is nothing that is wrong with this country, that cannot be fixed by what is right with this country. And even though we are facing enormous challenges, I just talked about the concentration the economic forces in this country. We also see, on the algorithms that some of these tech companies control, I think that there is really this. They have this benefit essentially from us, being glued to our screens and scrolling, and they're optimizing for attention and frankly, divisive arguments and polemics that get made in those news feeds. Even though we have all of these challenges, I know that we can work through them. I know that our best days can be ahead of us. It does not mean that it will be easy or that it will not. Come without tremendous struggle or hardship along the way. But in the same way that your ancestors just like mine fought to make that better life for their kids and their grandkids. I know without any doubt in my body that the people who are rising to that work again today will be able to be successful if we have the right people and the right conviction among all of us.

Dr. Ken Sharlin 25:32

Since this is the Healthy Brain Toolbox podcast, let's talk healthcare. Maybe a little anecdote. You led a significant effort to protect residents mobile home parks, from predatory private equity firms, and wondering how that struggle for housing security relates to the overall health and mental wellbeing of Iowans.

Healthcare Consolidation and Medicaid Cuts

Zach Wahls 25:52

Yeah, absolutely. I think, been a growing conversation around social determinants of health and the impacts that your personal situation has on your health and your wellbeing. Housing is certainly one of those income of course, and another one and many other factors. My mom terry is well known for her work around the use of diet and nutrition some other lifestyle factors on influencing health outcomes. And so I certainly have think probably more intimate in understanding than many lawmakers do about how important all of those are. When I was a freshman legislator, this was in 2019. We saw this surge in out-of-state investment companies coming into Iowa, purchasing manufactured housing communities, trailer parks, and then increasing the monthly lot rent that those residents pay to live in those communities by, increases that I thought were just frankly shocking. You're talking 50%, 60%, 70% increases in some cases from one month to the next. If my mortgage went up 70% from June to July. My wife and I would be in a really serious challenge and that's certainly true for Iowans across our state when they felt, saw these increases in their their housing costs. It was a very powerful experience for me to see. We did have the ability to get legislation through the Senate where I serve that would've extended some basic protections under the law to my constituents and to, to our neighbors across the state who were as I certainly saw the victims of these predatory companies. Unfortunately, when that bill was sent over to the House of Representatives,'cause it has to pass through both chambers that was where we ran into a lobbyist who was able to get one state representative as a favor to him to kill that bipartisan legislation that I passed through the Senate. 48 to zero. It was unanimously passed. And then state representative killed that bill and I was actually in the room. I was in the meeting, and I watched this happen with my own eyes. It was a very powerful learning experience of how kind of politics works. It certainly didn't work for my constituents. Incidentally, Ken, the woman who killed that bill in 2019 was a state representative named Ashley Henson. Today, she's now a congresswoman representing Northeast Iowa, and in all likelihood, she will be my Republican opponent for the general election this November. So when we talk about the connection between how these powerful forces economically in our country have actually been able to benefit and corrupt our political process through a campaign finance system that is so driven by money both in the lobbying side and on the campaign side. I got a very powerful education in that just as a freshman lawmaker. And that is one of the reasons why throughout my career, I've really championed a campaign finance reform that would try to significantly reduce the massive influence that currently exists in our process for the wealthiest and the most well connected because it is ultimately. Those of us who have to live with those consequences who really do pay the price, we see it play out in health. We see it play out in educational outcomes. We see it play out in our ability to build an economically secure livelihood for ourselves, for our families, for our kids. And it has to change because when we think about the challenges that we are facing as a country, so many of them come back to, like I said earlier, this increased concentration that we have seen. The fact that we have some of these big companies doing. Better than ever. More, people who have made, the amounts of money that accrue at the very top of our economy are almost hard to fathom. And look, I'll be really clear, like I've been a small business owner. I believe that free enterprise and competition and markets can lead to really good things for consumers. So I don't begrudge people for trying to start a business or anything like that but when you look at how much influence these massive corporations have on our political process and how entrenched these interests are. I think that there is a very deep connection between the what has happened in our economy and the corruption of our politics by our current campaign finance system. That's why that has become a real focal point of our campaign. And I'll tell you Ken, too, we've been to 66 of Iowa's, 99 counties. We've held over 250 campaign events. Actually, just yesterday morning, we turned in our nominating petitions to get onto the ballot in June for the Democratic primary. By law, we're supposed to, we need to collect 3,500 from across the state. We collected over 10,000. I was particularly proud that of the 10,000, 15% of those petitions were signed by registered Republicans and independent voters. And that is because our message about what is happening in the economy, what has happened to our politics is really resonating with the broad coalition across the political spectrum of Iowans who, we may not agree on every single issue. We may have different views about things like reproductive rights or immigration or public education, but we can agree that what has happened in our economy is unacceptable. What is happening in our politics is unacceptable, and we have to elect leaders who have the courage to fight that corruption head on and really push for real change in the Congress and the US Senate.

COMMERCIAL BREAK 30:28

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Local Innovation and Federal Missteps

Dr. Ken Sharlin 32:30

So if we frame,'cause I know you have healthcare as a human right. I'm curious how this plays into it. Is the economy of healthcare sort of the problem and how it's driven by power, from your perception, from by powerful organizations. How does this, impact things that are close to your heart? Rural hospital closures, maternal healthcare crisis issues. What's going on here? Is it money and powerful corporations or what other factors are playing a role?

Big Pharma, PBMs, and Who You Serve

Zach Wahls 33:02

Healthcare is a perfect illustration. Frankly, I think some of the broader trends in the economy. Consolidation being one of those. There's obviously been a massive amount of consolidation in the healthcare space over the last 50 years. You've seen huge amounts of private equity money move into the space, consolidate practices, clinics, hospital systems you've seen that happen as well on the payer side with, fewer and fewer massive insurance carriers. Increasingly having disproportionate influence as you mentioned earlier. Closures to rural healthcare systems. So the Medicaid cuts that were passed last year the big beautiful bill which was it really was a big bill, there's no doubt about it. It touched on a lot of different things. One of the single largest things that it did was it cut$800 billion, it's billion with a b from our health, our Medicaid system. This is the public health insurance option for low income Americans. And one of the things that has been starting to happen as a result of that budget is that the providers in rural places, whether it's, in a rural setting, in, in some cases in urban settings too that provide these services, critical access hospitals, federally qualified health centers have seen Medicaid funding start to dwindle as a source of their revenue stream before Medicaid's directed payments. System kicked in. This is several years ago. About 60% of Iowa's rural hospitals and clinics were operating at a structural deficit. They were operating in the red with a very uncertain, political or financial future. And when that directed payment system came online that was a real lifeline. Actually, we've toured now multiple rural hospitals and the phrase that keeps being used as salvation, the Medicaid's program was our salvation. And with these cuts that my Republican opponent Ashley Henson voted for we've already started to see more of those hospitals go into the red. We've seen hospital systems clinics announced closures and I think that there are a lot of biome who, even if you were not on Medicaid, and so I think this is a really important point, even if your health insurance is not through Medicaid. Your providers those systems depend on Medicaid as a major source of revenue to keep the doors open. And so even if your health insurance is not what's being cut. The system that you rely on, the provider that you rely on their operations are now in jeopardy. And that was a policy choice. That was a part of this bill in order to pay for the extension. Like I said earlier, of massive tax cuts for that overwhelmingly benefit the wealthiest Americans in our society. And, so I'm not someone who again, thinks that we should have, socialist, communist country or anything like that. However, I do think it is reasonable to expect the people. Who have benefited the most from America's prosperity and opportunity to pay their fair share and that we can use those resources to ensure that no person who lives in this country is unable to get the healthcare access that they need. And so from my perspective. There are a multitude of issues facing our healthcare system. And as many people have pointed out it's often not really a healthcare system. It's a sickness management, sickness system, right? But I think certainly, those are some of the big biggest challenges that we've seen is increased consolidation defunding of these really essential services. Don't get me started on prescription drugs, but I guess we can talk about those too. But there's so many different places where we see, these trends playing out. In healthcare that are real concern?

Dr. Ken Sharlin 36:16

For you, Zach? Are there some examples, community health centers, physician led initiatives that you know, as really shining examples that you would say scale should you be elected?

Zach Wahls 36:28

Yeah, it's a great question. I think the answer is that there is certainly lots of innovation that is happening is exactly you just said. Often physician led, provider led services. I'll give you one really concrete example here in my own community. The junior high school that I went to had the opportunity to see a woman who was a part of my church growing up, Dr. ODing. I was able to help actually start a clinic in that school to get kids who are on Medicaid. Iowa has the Hawkeye program chip was able to get those kids services in a school setting so they didn't have to make a separate appointment at the doctor's office. Their parents might not be able to get'em there. They're able to get regular checkups, support that they needed in that kind of setting. We've certainly seen more and more places where that innovation is happening. And this is one of the things that I've learned, Ken, in my time in government is that, most of the best ideas do not start at the State House. They start with people who are in the field people who are innovating, who have the flexibility the resources to try new things. Not every single one of them is going to succeed, but that's the nature of science and innovation, right? Is that you have plenty of things that don't go the right way before you do find something that really works. And at its best what government is able to do is help make that innovation possible to support that innovation when it occurs in the private sector and help bring it to scale across the state, across the country. And I think the fact that we've seen less and less of that is a priority is certainly a cause for some real concern. I'll just give you one, one really concrete example. So the Doge Elon Musk got certainly a lot of attention last year when that initiative got going. And when we were in southwest Iowa, this was late last year. We were visiting a community that had been devastated by flooding just a year earlier. There had been some ongoing challenges over the previous several years. One of the ways that they've been building back from that was through a grant program called Building Resilient Infrastructure in our communities, or BRIC, BRIC. And weeks before that meeting they had submitted a grant proposal as a part of that program had been told that they had been selected to receive. That funding and then the funding was put on indefinite hold because apparently Doge had flagged this program for further study because it had the word resilient in the title, even though resilient referred to the infrastructure, not to some kind of quote unquote DEI concept or other problem and I just thought that was such a perfect illustration of how decisions that are made in DC can sometimes have very negative consequences that affect people far beyond what those policy makers realize.

Dr. Ken Sharlin 38:50

Let's touch on, you said pharmaceutical companies or pharmaceutical. Don't get me started. In the US Senate, you'd be up against massive pharmaceutical and insurance lobbies and wondering how you plan to position yourself as an advocate for the patient without being buried in that establishment interest that you've already.

A New Generation in Washington

Zach Wahls 39:12

Yeah, absolutely. Again another good story in contrast here. My Republican opponent, Ashley Henson, has accepted millions of dollars over her career from insurance, pharmaceutical companies, and executives. And I made a promise very early in this campaign that we were not going to accept or solicit money from Corporate pacs, which are the vehicle that are often used to funnel those contributions because I think that my constituents deserve to know that they have. A senator who's working for them not just for their campaign donors. One of the things that has really come to my attention serving in the state Senate and again representing small town and rural Iowa, is the profound impact that pharmacy benefit managers or PBMs have had on especially a lot of rural, independent small town pharmacies. If you look at a map of the state of Iowa and you just put a little dot where a community has lost a pharmacy, small town pharmacy, independent pharmacy. Over the last 5 to 10 years, the entire state of Iowa lights up. Because this has been, and this is again, this is being driven by consolidation of PBMs, which have been able to become massively profitable businesses. Not everybody knows this. PBMs have been so lucrative that one of them actually purchased CVS, the pharmacy company. So now, CVS itself is owned by a PBM company. When you talk about where pressures are coming on pharmacists, this coming from PBMs. I was really proud to vote in a bipartisan way. A few years ago in support of PBM reform in our state. But we need national action as well. So it fundamentally comes down to this question of who do you see yourself? Who do you work for? Who is your most important constituency? And for me, that is always going to be like you said. Patients the folks who count on being able to get the medication that they need from a nearby pharmacy, rather than having to drive 35, 45, 55 minutes into town to get access to lifesaving medication. And then working in a practical way to try to find ways to find the balance between limiting costs for patients. Insulin is one that gets talked about pretty regularly. Something that is lifesaving medication for quarter million Iowans but is often very expensive. And so there's been, and I've heard from people, whether they're my age or older who have had to face the challenges of accessing. Those medications at an affordable price. And so from my perspective, again, it's fundamentally comes down to who are you working for? When you mentioned my time at Princeton. It was funny. It wasn't even a class that I was taking. One of my best friends from my program was taking the class and he just would not stop talking about how great his professor was for reasons that became evident later. One of the things Devin told me that, he learned in that class that made a big impression on me was that there are a lot of people in government legislators people in the executive branch who essentially think it is their job to represent the government to the people. Rather than representing the people to the government, and it is such a succinct idea, but it is so powerful. And that was exactly why in 2019 when these big companies came in, started buying mobile home communities and trailer parks. I took it upon myself. I wasn't getting deluged with emails, but I knew this was happening. And so I just took it upon myself to go canvas these communities. To go knock on doors in these communities that were acquired by this one company, to hear directly from my people about what was happening and what it was gonna mean to them and to their families. I met a woman named Candy. A widow who lives in my district, in Gulf View Mobile Home Park. Widow who's one of the last things that her late husband did was purchase her home, her trailer so she could live a comfortable and economically secure retirement. I met Don. Quadruple paraplegic who one of the last things that his parents did was help him purchase this home to accommodate, what he needed with his disability. And just hearing from them and sitting with them and understanding the pain, their fear and what it felt to be preyed on by this company through no fault of their own had come in and was proposing these massive rent increases is fundamentally being able to represent those stories. To understand that it is my job as an elected official to represent those stories, my constituents to our government, to the Iowa Senate, to the US Senate, hopefully. That's what I've always seen as my number one responsibility.

Fixing Politics and AI Risks

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Dr. Ken Sharlin 44:51

So you're running for the seat. You're young and handsome and articulate, and I'm just seeing you as the new generation politician. And the question is, what is the new generation perspective that you believe is missing from the current Washington milieu as we approach, whether it's the healthcare crisis or other major hot button issues.

Closing and How to Support

Zach Wahls 45:18

Yeah, it's a great question, Ken. I think when I talk to other people. So I was born in 1991, grew up essentially after the end of the Cold War in the very beginning of the Global War on Terror. And I talked about that a little bit at the beginning of the show. Watching our country sucked into the Middle East during that war I was in high school and then going into college when the global financial crisis hit the Great Recession. I was still becoming politically aware, but started to see a number of these scandals break in Washington, DC around the Jack Abramov scandal and the lobbying scandals, the corruption that was evident then. And then of course watched the rise of Donald Trump in 2016 which happened while I was at Princeton, which was a very, it was an interesting time to be getting a degree in public policy during the 2016 campaign and the first Trump administration. And, in setting aside the disagreements that I have with Donald Trump on policy, there certainly are many of those. But watching the way that he campaigned about basically challenging the establishment of Washington DC that from his perspective had been failing a lot of ordinary Americans. When watching that resonate with so many people it certainly was informative to me because Iowa is a state that had voted for Bill Clinton twice in the nineties, voted for Barack Obama twice in the two thousands, and then has now voted for Donald Trump in three consecutive presidential elections. There was clearly feeling that he was speaking to that was held by, not necessarily a majority of Americans, but certainly by many people, including people who had previously been voting for Democratic candidates for office. And I think it was, it is really important for Democrats to be clear-eyed about what his appeal was to a significant part of people who had previously been supporting Democratic candidates. And that was his perceived willingness to challenge the status quo and shake up the establishment. Now again, I don't agree with Donald Trump on many issues. But I think it has certainly made a mark. I think on people who are the millennial generation who have watched, frankly, a lot of the failures of the kinda traditional establishment. Whether that was the war in Iraq, whether that was the Great Recession. We look at what's happened since then with the COVID pandemic and some of the ongoing challenges that we are dealing with now around social media and increasingly around artificial intelligence. I think it is very clear today, probably more than in the past that these entrenched interests really are responsible for a lot of the challenges that are facing our state, facing our country. And there's just a necessity, a basic requirement that you have to be willing to challenge that status quo. That's what I've tried to do in the state Senate to do it in a way that can find common ground because you can't do anything alone. That's the number one rule of politics is you can't do anything alone. It is democracy truly is the ultimate team sport. We have to be able to bring people together in order to make change happen. So I think from my perspective it's that worldview. It is the belief that even though, we may have profound disagreements on issues that I think are really important. There are other places where we do have agreement and where we can actually work together to move things forward. And I'll also just tell you too as someone who grew up, I think the term is digital native. Increasingly, a lot of these challenges are posed to us by these large tech companies, social media companies. And so being I think, more fluent in how those technologies are utilized in many cases to divide, to distract our attention our energy is something that I think and sets us apart in terms of how we view the problems that are facing our country.

Dr. Ken Sharlin 48:37

As our listeners look to build their own healthy brain toolbox, and as we wrap up our interview today, what's the one policy change, the federal level that you believe would most improve the neurological and mental health of the American people?

Zach Wahls 48:55

That's a great question. I'm gonna give it two answers because I think that they do have to work in a two step solution. Basically what I what I always talk about when we're on the campaign trails that we just desperately need to overturn the Citizens United decision. And some of your listeners who are into politics or more legally minded, may know that was the decision by our Supreme Court 16 years ago. That essentially ushered in the modern age of American politics with these massive super pacs the spending of hundreds of millions and billions of dollars in some cases on senate and presidential campaigns. Increasingly in congressional level, US house campaigns as well. I think that has really been to our detriment as a society and certainly is a kinda our political health and culture. And frankly, I would say probably to all of our mental health too. You look at the impact of all of that. The media advertising, the toxicity of our politics and how that contributes, I think to a sense of dread or fear or hostility that many of us feel in our political lives. And that all I think really does stem back to that decision by the Supreme Court. That kind of ushered this age in. So we need to overturn the Citizens United decision. We need to rebuild trust in our legislative members. I'm a strong supporter of common sense term limits ending the ability of members of Congress to own or trade stock while they're in office. By the way, again, these are supported by vast majorities of Democrats, independents, and Republicans all over our country. And I think that if we're able to get that big money out of politics get these to a place where they are not stoking, division stoking misrepresentation of other sides in our politics. I think that is gonna significantly improve everybody's health because our mental health certainly when it comes to our politics and it would I think also go a long ways towards beginning the process of curbing the influence that these economic giants have in our society. We need to bring back more competition not less in industry, after industry. We need to make sure that we are actually encouraging innovation, encouraging competition in so many different places, healthcare and others. And then I think as we look to the future. There's been some, these are very early studies but I think some very cautionary early studies on the effects of large language models, the use of generative chat ai interfaces on human development on our cognitive abilities. And look I'm someone who use AI pretty regularly is a partner and trying to think through issues or summarize issues and learn. We also need to be very intentional about how we use these technologies, both in our personal lives and from a policy perspective. What the impacts are on our young people in particular on our educational system, you on our healthcare system and so many other places. I think it is totally possible that these artificial intelligence models are gonna wind up contributing in very positive ways to our future to our lives. I think it is also quite possible that they lead to very catastrophic consequences that are very hard to predict until it is potentially too late. And as we think about the future, I think those two things do really go hand in hand.

Dr. Ken Sharlin 51:50

Wonderful. Thank you for spending better part of an hour. This has been a wonderful interview with US Senate candidate from the state of Iowa. Zach Zach Wahls, wish you the very best on the campaign trail and a successful ride to the United States Senate. To be part of your life journey and witness that.

Zach Wahls 52:11

Ken, I really appreciate it and I would, I just certainly say to anyone listening who wants to learn more do not hesitate. You can just Google Zach Wahls that'll get you to the right place. You can also just go to our website zachwahls.com. That's Z-A-C-H-W-A-H-L-S. Even though I'm running in the state of Iowa, this is obviously an election that will have profound consequences for our entire country. And so even if you don't live in the state of Iowa, but you're interested in supporting the campaign, we would welcome your help. Whether that's financially through. Volunteering or just helping to spread the word by sharing more information about us. Every single piece of support that we receive goes a long ways. Thanks, Ken.

COMMERCIAL BREAK 52:46

Hi everyone. Dr. Ken Sharlin here with the Healthy Brain Toolbox. I'd love to hear from you. If you have general questions about brain health, neurology, or the science of keeping your brain sharp. Send them to questions@healthybraintoolbox.com. I'll be reading your questions on the upcoming episodes. Please remember, these need to be general questions, can't answer personal medical questions, or provide individual medical advice. So if you've ever wondered about brain health strategies, lifestyle tips, new research, or the future of neuroscience, send those questions in. I look forward to hearing from you and who knows? You might even hear your question featured on the show. Thank you for tuning into the Healthy Brain Toolbox podcast. I hope today's conversation gave you new insights to protect and nourish your brain. Be sure to subscribe, leave a review and share this episode with anyone looking to take control of their health. Until next time, stay sharp and keep learning.