Hi, I'm Molly John Fast and this is Fast Politics, where we discussed the top political headlines with some of today's best minds. And this week alone, President Biden has canceled over one hundred and fifty thousand students debt.
We have such a great show for you today.
Rise's Mary pat Hector talks to us about gen Z getting out to vote and organizing. Then we'll talk to doctor Ouch Blackstock about her new book, Legacy of Black Physicians, Reckoning with Racism and Medicine. But first we have legendary campaign manager and the author of the Conspiracy to End America Five Ways My old party is driving our democracy to autocracy, The Lincoln Project's owned Stuart Stephens. Welcome back to Fast Politics.
My buddy, Stuart Stephens.
Nys for asking me to the party. Great to be here.
I was so excited to talk to you because.
Last night I was on the eleventh Hour and I'm sitting in the makeup chair and I'm listening to Lawrence's monologue and I don't know You're in Sweden and you can't get MSNBC in Sweden, so you may not have heard it. But this week's Big Brainworms Fiasco has featured Ezracline last week said that even though he loves Joe Biden, that Democrats should kick Joe Biden to the curb. I
have talked to everyone I know off the ledge. Everyone I know has then come to me and said, talk me off the ledge, and I've said, you can't kick
Joe Biden to the curb. But anyway, one of the brilliant things that Lawrence did last night was he explained just how destructive and how much a broker convention Besides the fact that I think Biden is a great president, besides the fact that I think Biden is going to win maybe by more than a lot of people, besides the fact that, you know, my own personal feelings, the idea of this is so completely insane. And Lawrence did a really great historical analysis of what happens during a
broker convention and just how destructive it is. So talk us through this media mailstorm created by and for media.
Yeah, I'm fescinated by broker conventions. When I was in film school, I actually wrote a screenplay, shockingly, shockingly, this was never produced about the nineteen twenty four Democratic Convention with Al Smith, which went to like thirty six ballots. You can imagine how the market was just dying to hear.
Ah.
Great, finally a film about the thirty six ballots. I don't understand this about Democrats, right, and I say that with great love and affection, because Democrats are the only pro democracy party left in America. Why there's any reluctance to get behind their guy? You know? To me, this is just a variation of a couple of years ago when Biden gave what turned out to be a great State of the Union address and Democrats gave not one, but two alternatives. I took an alternative to their own guy.
I think what's really lost here is the fact that, you know, Biden has an extraordinarily young administration. You know, he has passed the church. Look at the people who are running the country now compared to who Trump picked, you know, compare Secretary of States. You know, he didn't get a guy in the sixties was running Exxon. He got a young, brilliant guy. And I think that's across the board. I really think that Biden is historically great
president domestically and abroad. I find the fact that Democrats are unhappy with him where people are unhappy with him I find that very normal. I mean Americans won't choices, you know. I mean, if he's paid somebody, would you like the choice? No one says well no, or don't.
Would you speak a little bit about that?
Because I feel like there's a lot of historical president for people being a little irritated with their president.
How about that? Another point is in June of nineteen ninety two, Bill Clinton was running third, not second, third, famously on the cover of Time magazine and that X ray photo of why can't we Trust Bill Clinton? And you know, I seem to remember that they played Tales of the Chief, you know, the next year when he was walking into the room. There is something that is very American about wanting choices. There's not a lot of restaurants in Germany or France or Sweden that have like
cheesecake factory long menus. You don't walk into the McDonald as they go, well let's sell hear what we're serving today. We got two things. They're really good. It's all about options and how do they sell cars. They never said, well, you know, are just as good as it was last year. I promise you. You know, there always has to be something new. But I think that the numbers of Biden's
approval are flawed comparing it to historical precedents. So you have, what over fifty percent of the other party believes that Joe Biden is an illegal president. So think about that.
Which is insane.
In a normal world, this would not be happening. And it happened because no body ever stood up to Trump.
Because the Republican Party went along with it. Yeah, I mean, all they had to do was have their com shop put out a statement congratulating the president.
Of the leg That's all they would have to do.
In the history of defending democracy. That's a pretty low bar. No one was asking him to go charge of beach or take a machine gun nest. They just have their commshop congratulate the president like the United States, and you know only a couple of them did. But you know, once you believe that the president is illegal, what in the world can you tell somebody to make them like that president? Okay, look, I know he stole the light offf but how about that Infrastructure Act. Those people are lost,
and I think that they affect those numbers. If I was polling here, I would ever screen that says, do you believe he's legally elect your president. He said no, say thanks very much and just continue the conversation.
And those are the mag of faithfulls, and that crew is not going to be won by anyone.
No.
I saw some very interesting numbers, I thought the other day out of Pennsylvania and New Hampshire, where Biden's approval was thirty eight and he was winning by nine points. And I think that that's where we're going to start to see a lot of that. I actually think that there is a very good chance that this could be like nineteen eighty in reverse for the incumbent, you know, a tight race to the middle of October and then
the bottom really falls out, you know. I think there's an element to Donald Trump being on trial and four different jurisdictions that is sort of like a guy walking around with a paper bag full of water. I don't think it's going to leak, but if it goes, it's going to go the conventional wisdom of Biden. It's going to come down to four hundred thousand people in a couple of states, and usually the conventional wisdom is right.
But if I was placing a bed on it, I would bet that Biden is going to win by a substantially larger margin. Media lest I.
Happen to agree with you.
And one of the things that I continue to be not even struck by, but shocked by is the level of unforced errors that this Republican party keeps making. And I want to talk to you about Alabama, and if so. Yesterday, the biggest hospital in Alabama, a state that has really had trouble attracting medical talent. I think that's the understatement of the year, right, But they have had some problems, you know, attracting guynecologists for obvious reasons.
Now they shut down IVF in this.
Biggest hospital in Alabama because they're worried about being prosecuted because embryos are people in the state of Alabama. I'm sorry, but like a Pennsylvania suburban voter who lives on the mainline and wants lower taxes is about to find out that she can't do IVF, listen.
I think that it is just a pattern that there are two ways to look at what was going to happen when Republicans went down this Trump path. Either they were going to modulate themselves and decide that they were not that crazy, and it's necessarily just all about campaigning, or it was going to get crazier craze here, and we've obviously seen it's the latter extremist movements go that way.
They get in a cycle of purity tests. It happens, happened with the Khmerre rouge, happens with the right card. It just you have to prove that you can be more extreme. That becomes the test. I think that there is a deep misogyny at the heart of this, you know. I thought one of the most extraordinary numbers that come out of the Iowa Caucus was the fact that in the last Des Moines Register poll Mancelter, according to her, sixty eight percent of the Republican Party in Iowa was mail.
That's self collecting. It's really important for the Biden campaign to focus on the future and what is it going to mean. So nobody would have believed that you would have someone who was raped and had to go out of state and was prosecuted and they went after the doctor, but that happened. Nobody would have believed what just happened at Alabama, and it's just going to get worse. I mean,
the difficulty with the unimaginable. Is it's difficult to manage that is just going to get worse and worse and worse, and there's no moderating force. Nothing inside to Republican Party is going to stand up and say this is too far. But the thing about it, they had this moment Trump inside of a riot of people who came into your workplace and tried to kill you, and you still didn't vote to convict him. Once you're not going tovict somebody that like got people who try to kill you. What
do you even think? Well, okay, I think that this is too far. It's really extraordinary. I don't think it's at all where the country is. Look I'm a seventh generation Mississippi and I don't think this is where Mississippi is at all. I think it's a great miscalculation. You know, when Trump tried to frighten suburban voters at the end of the left contane by saying, and he's doing it again, you know that someone non white or a different religion
might move in next door. I think most suburban voters I know would go out of their way to show their kids that they're welcoming to this family. It's somewhere the country is hating people. I mean that happens some, but it's not the majority of the country.
You talked about polling.
A lot of the Biden panic of the last few weeks has been almost exclusively based on polling, right, I mean, there's no other theory of the case. Right, there's no other piece of information like New York three last week, Democrats way overperformed the polls, Like, there's not some piece of information that I'm missing here, right.
No, it's a tentativeness about the Democratic Party that I sawn just sort of fascinating. You know. I wrote a piece for the Bullwork right before the twenty EELESSU where I said, you know, my dear dear new Democratic friends walk with swagger. There's more of you than them. You're right, they're wrong, And I think there ought to be a righteous prosecution about this, and I think they ought to go about it with the attitude we are right, and Joe Biden is right, and Joe Biden is doing great things.
Embrace that. And I think that there's a case that if Joe Biden was running against pick your favorite governor or Republican camp in Georgia or whatever, I think you beat that person because there's really no policy in the Republican Party. Now, then think about it, and this was really clear in twenty two. What is it you're getting when we vote Republican and Hunter Biden's laptop investigations. I mean, there's no policy at all.
So let's talk for a minute about Patrick McHenry.
I want you to hit on this because I don't think Democrats are spending nearly enough time talking about this. Patrick McHenry was the Speaker pro tem for about five minutes. He's resigning. He's not running again. He's one of the few Republicans who knows what they're doing. Still there, he tells CBS this morning. We went through five choices and Mike Johnson's the fifth choice. He has not been around
leadership decisions. He's had a really tough process. We've thrown him into the deepest end of the pool with the heaviest weights around him. We're trying to teach him how to learn how to swim. It's been a really rough couple of months.
Yeah, being Speaker of the House is turning out like the third person in ol Kaeda. You know, you just really she just really don't want to be that person. There's gonna be a drone over your head pretty quickly. It's really amazing. I mean, I think you know, if you're applying for a job, you would not put it on your resume if you have been speaker at this point. It's because they're not a governing party. So you know, normally you can unify elements of your party to disagree
with you based upon certain fundamental principles. You can get up there and say, look, we don't agree on this or that, but here are some big issues we agree on. And there really aren't those big issues in the Republican Party except they would like to be in power. And you take some sad example of humanity like Lindsey Graham. Yeah, he goes to Ukraine and swears that he'll support Ukraine forever,
and here he votes against Ukraine funding. If you joined the party that was defined by Ronald Reagan standing in front of the Berlin Wall and saying, mister gorvig trofth tear down this wall and you end is now the pro Putin Party, it is the most disconcerting, strange sensation.
And you know, I don't.
Think we talk enough about the simple pack pattern here. We know the Russians wanted Donald Trump to win, we know he helped him win. What did they get? Turns out they got a lot and they may very well get a victory over Ukraine because of that. It's the most successful covert operation in history. That has to be And I think these next ten days or so are
going to have generational effects. I think in five years, if you're gonna be able to get a car in Paris and drive to Warsaw without crossing some really nasty borders, I think that's going to be decided probably in the next ten days.
Wow, I've not heard someone explain the war in Ukraine like that. Save a tiny bit more on that, will you.
Well, I we know what Putin wants. He wants to reconquer tote the Soviet Union. We know what the Soviet Union was, we know how he operates. He will have a small incursion there NATO to fight, So then it'll be a question is NATO really going to fight over ten square miles? And that'll be an interesting question. And Russia now is on a war footing, unlike any European country has been since Germany re armed and the thirties
and there has been a reluctance to admit it. People don't graft the fact the United States military budget it's larger than the next non countries combined. I mean, that is just such a staggering number. And those are some awfully big countries. We are living in a Pax Americana and is that going to continue? And we've sort of become like third generation rich kids. We've sort of forgotten what it was like to earn this and this is this is what kills me about these Republicans. There air
the greatest generator. They were handed this legacy one a great unimaginable cost. And now, well, just think that there are a lot of data Americans buried across Europe and if they could come back to life and vote whether or not they were going to support Ukraine? Does anybody think that they would vote for Putin? And those are the people that earned the freedom. And we have a European democracy that is engaged in the largest land war since World War Two, and the Republican Party doesn't want
to support it. It's a leadership because of Donald Trump, a guy who was elected with Putin's hill. I mean, if you can't see our history's going to write that it's just unromaginable. Hopefully it's still going to pass. I accept what everyone says. It seems to know a lot about the House, and if you put it up for vote,
it will pass. I have to ask yourself, how many innocent Ukrainian men women in Shortern, how many brave Ukrainian fighters have to die for a guy from Shreef Ports who's an accidental speaker's concerce.
Yeah, Stuart Stevens please come back.
Well, thanks for asking me. I love the show.
Did you know?
Rick Wilson and I are bringing together some friends for a general election kickoff party at City Winery in New York on March sixth. We're going to be chatting right after Super Tuesday about what's going on, and it is going to probably be the one fun night for the next eighty days. If you're in the New York area, please come by and join us. You can go to City Winery's website and grab a ticket.
Mary pat Hector is the CEO of Rise.
Welcome to Fast Politics, Mary Pat.
Thank you so much, Molly. I'm super excited to be here.
I really think that elections are won by young activists who get out there and organize. And so when I heard you speak a couple months ago, I thought, we got to get Mary Pat on this podcast so she can talk about all of the organized thing she's doing.
So Mary Pat tell us about Rise Sure Well.
Rise is a youth and student center organization that focuses on building student political power. Young voters are some of the more difficult voters to touch and reach, but we've been able to prove that when you organize three hundred and sixty five days a year on these college campuses and but some trusted messengers, that you can truly be
successful in mobilizing these voters. And this year, in twenty twenty four, literally forty one million gen z years between the ages of eighteen and twenty seven will vote for the first time for the first time in our country's history. Nearly forty nine percent of the countries are electric under
the age of forty five years old. Young voters have extreme, extreme power, but it's all about organizations and individuals who really value them and prioritize reaching out to them to exercise their political agency and utilize the power that they have. And that's what we do at RISE.
So explain us how you started Rise and where you started Rise and where Rise is now and where Rise is going.
Sure. So Rise was actually founded by Maxwell Lubin in California in twenty seventeen as an organizing that really advocated for students' access to college and college affordability. Max realized that in order to influence issues that young people care about, it's really about building youth political power student political power to really influence policies that directly impact young people around
those issues like college affordability. You know, students basic needs and issues that they were fighting were in California, and they ended up expanding the organization to Michigan and Wisconsin and they were able to see higher education policies passed and they were organizing in those particular states, and then we ended up expanding to places like Georgia and now
we're in eight states collectively doing the work. And I actually began my organizing journey with the organization back in twenty eighteen when I was a student organizer at Welma College, organizing around college affordability at HBCUs and you know, student debt relief and food access and leading hunger strikes on my college campus, and I remained involved in the organization
upon graduation. I became the Georgia State Organizing Director, where we led the organization's largest FOTEM campaign in twenty twenty one, in twenty twenty and twenty twenty two, and I ended up continuing to work within the organization. I became the CEO eight months ago. We're coming up on my one year anniversary as the CEO of the organization, but I've been immenisely proud to see the organization grow since I've been working with RISE since twenty eighteen two.
Wow explained to us a little bit about the sort of theory of the case, how it works. I have a college kid, so I know a little bit about how hard it is to get them to vote.
I think oftentimes when young people think about voting, they immediately just think about the candidates. What we're seeing with gen z ors specifically, is that they're not really moved by the two party system, right. They're not impressed with
either of these candidates. I mean they feel like, you know, they're forced to choose between the candidates, and with us as an organization, we're not mobilizing student voters around candidates we're mobilizing student voters around the things that they care about. We're mobilizing them around things like student debt relief. We're organizing around issues that they care about like college affordability. And some of our partner organizations that are also successful
in this wh're disorganizing around climate change. They do this organizing around, you know, reproductive justice. And we also know that the issues that we talk to students about in Georgia might kind of differ around the issues that we
talk to student on the ground in Wisconsin. So we really adjust, but we center the issues that young people care about, and beyond sending the issues that they care about, we also center the fact that we are trusted messengers on the campuses where we're mobilizing because they see us on their campus three hundred and sixty five days a year. Oftentimes, what happens is civic organizations and campaigns show up two to three months before an election and they're like, we
want your vote. Well, the truth is gen zers are not as trusting, right, Like they're like, I don't know you. You showed up two months before this election and you're only just like here to pretty much ask for my vote and you haven't shown me that you value me as a person or that you really align with me
on my values. So gen Zers value individuals that they see in community with them through sixty five, which is also why we stress the importance of organizing three sixty five, especially with such a difficult And I am a gen Z voter voter myself, so I understand this a difficult base. Right It's very hard to gain the trust of gen Z voters.
And it's not exclusive to gen Z. I mean, young people have always been hard to get to turn out.
Absolutely. What I will say is I would love to give them credit. Young voters have been showing up for the past two cycles like never before, especially in moments and times when we really needed them. But right now in twenty twenty four, there is so much going on, so many issues and problems that young people internally are not happy about. They're not happy about a lot of things that they felt were promised that didn't necessarily happen, a lot of issues going around.
In the world.
Young people are just be us censoring the issues, is what we're noticing are what's most resonating with them right now. I'm hopeful that with this opportunity and the power that they have in twenty twenty four, they will show up.
Let's talk about a student debt really, because that is something where the Biden administration did try to cancel student debt. The Supreme Court, in its inherent conservativeness, kicked it out. Now Biden is going program by program trying to forgive debt. Yesterday was a huge victory with that. Are people hearing about that and are you able to transmit that to them? And is it making any kind of inroads there?
We are in the need to you know, educate voters on you know, the things that are happening on the ground. I think, you know, people are here. You know, Biden approves one point two million in luve forgiveness and they they're like, oh, well, you know, I still have by loans.
But the reason being is because of course, like you mentioned, the Supreme Court issues around reproductive justice that have been rolled back in this administration are not due to Biden's you know doing or the fact that we weren't able to get student debt forgiveness is not his faut I think oftentimes, and that's the reason why it's important to have trust The messages on the ground to like debunk a lot of disinformation that you see on things like
TikTok and Instagram, and you know, have these things come from people that people trust on these campuses are amongst the group of individuals because you know, the work that Biden is doing is not trickering down to those at the margin or those that need to hear it the most. And then beyond Biden proposing student debt relief in it being striggened down by the Supreme Court and even what he did recently, a lot of people don't know that.
Right now, the US Department of Education has really introduced a plan for debt relief for borrowers who are experiencing hardship, which is a lot like almost you know, providing in the debt relief because many borrowers have not been able to literally over half of the US borrows have not been able to make payments on their student loans since October, when you know we began repayment and so through negotiated role making, which is happening right now, Secretary of Education
in Cardonia and his team have pretty much taken the next steps to say, hey, we want to provide debt
relief to student loans borrowers experiencing hardships. And what that means is basically, if that is passed and the conversation will actually take place today, if the Department of Education, through this process of negotiated role making, it's provided the opportunity to prov buy debt relief for borrows experience hardship, more borrowers will be I think a lot of people who feel that in Biden's recent student debt relief moves just didn't impact people because it was for people with
balances under twenty thousand dollars. Typically, Americans who really need this debt relief are they're in student loan debt way more than twenty to forty thousand dollars worth of student loan. That also individuals who have been making consecutive payments for ten years, you know, the people who are really feeling this debt and it's directly impacting their ability to buy
homes to take care of their families. And they're individuals that have not been able to make ten year consecutive payments.
And so the Americans at the margins who you know, really need this relief have not been able to get They don't understand that the President can only do what he can do under the circumstances of the Supreme Court, but we are hopeful that President Cardonia's requests through the negotiated rolemaking process, will be able to support and provide immediate relief for most Americans.
To me about the importance of historically black colleges and universities, I know that the Vice president has been coming and speaking there. I've seen videos of people being very excited to see her. We don't see a ton of reporting about that. I'm just curious if you could talk about is the vice president connecting with young people?
Well, one I did attend a historically black college university in Atlanta, Georgia called Spelman College, and the Vice president herself also did attend an HBCU and Washington, d C. Called Coward University. I do believe that the Vice president has been working to kind of be in front of the young people. But I think the real point is not about the vice president or the vice president necessarily
just continue to be around young people. Because it's February of twenty twenty four, so anything that they decided to do on many college campuses at this point with a little perform. I think it should be about them focusing on you know, in which they can do whatever they can do to complete or focus on achieving some of the promises that they made in twenty twenty in twenty
twenty four, and being very strategic about just messaging. Again, Like even with the debt relief, the administration, despite what took place with the Supreme Court, has been very very adamant we're doing all that we can amongst our base to just educate them on what has been done, because a lot has been done, but the administration has had
a very difficult problem with distanging. The previous administration was very strategic in marketing and like made sure, you know, their base always knew what it was that they were doing, how they did it in any time they made a move the world to do about it, and I've seen the current administration kind of should have been taking the
same approach. It it has to. Really the work is relying on the backs of people on the ground, like us at Rise, just making sure that voters are educated on you know, things that have been taking place or things that had not been taken in place, and providing voters with ac information and not disinformation. That they're finding on Twitter and well x and TikTok right and ensuring that, you know, they're also provided the needed resources that they need to show up and vote in twenty twenty four.
So you can give money to Rise, and what will Rise do with the money?
Absolutely? Rise in a student organizing organization. We organize student organizers three hundred and sixty five days a year, We register voters three hundred and sixty five days a year,
We build our base. So the idea is that our student organizers are supporting students now and like making plans to vote leading up to some of our primaries and leading up to the twenty twenty four election, that they are reaching out to those voters three to five times leading up into their upcoming elections, making sure that they, you know, are making a voter plan, making sure that they have a ride to the polls if they don't, you know, providing them with resources to get to the
polls on election day. Any student organizers in twenty twenty most of our organizing was virtual. But what we saw in twenty twenty two was that a lot of young people were not adequately trained or prepared to do a lot of field organizing our work. So our organization also spends a good time and training people to be the trusted messengers that we need on our college campuses but also directly in our communities. So we're training them on
how to be deep canvassers. We're training them on how to adequately look up proper information to combat disinformation happening among this very sensitive group. And what I mean by sensitive is it's very easy for young people to be provided with disinformation based off of BAI and you know,
social media. So ensuring that they're able to train to effectively look up information, search information, and just fatcheck as well as consecutively being on these college campuses and in these communities, knocking on these doors and doing the work that we need them to do to fill our program at RISE, but also for some of the work that some of our harder organizations they're doing across the state.
Because what we for sure is that while young people are moved by the issues, you know, all of them you know that we train, may not be passionate about student debt or you know, college affordability. Some of them may be passionate about reproductive rights. And so connecting them with organizations that they are, you know, passionate about work, you know, working with leading up into the twenty twenty four election and supporting mobilizing student voters in that capacity.
So beyond doing our own build program, really just focusing on training the next generation of civic leaders going into twenty twenty four and even beyond this, you know that is also initiative that we do three hundred and sixty
five days a year. But here in twenty twenty four, our focus is like a registering fifty thousand student voters and our eight core city mobilizing over two hundred and fifty students through supporting them and making a voter plan going into the twenty twenty four election, and knocking on over three hundred thousand doors of young people between the ages of eighteen and twenty nine and touching over a million year loaders this year.
And what states are you in right now and what states do you want to expand to?
Yeah, so right now we are in all of the states that we were looking to expand to in twenty twenty four. We have officially been able to do what the exception was working on California right now, but we are in Arizona. We are in Georgia, Michigan, Pennsylvania, North Carolina, Nevada, in Wisconsin, and we're working on expanding fully into California.
So great. Thank you so much, Mary pat for joining us.
Thank you so much for having us on and allowing me to talk a little bit more about our organization and the importance of lebalizing the youth book this year.
Doctor Ouch Blackstock is a physician and author of Legacy, a Black Physician Reckons with Racism and Medicine. Welcome to Fast Politics, doctor Blackstock.
Thank you so much for having me.
Talk to us about your book.
It's called Legacy, and why you decided to write this book.
Yeah, so excited to talk about legacy. So the full title is Legacy of Black Physician Reckons with Racism in Medicine. And the title actually has a double meaning. One it's about the legacy of racism in medicine. And then the other meaning is I am a second generation black woman physician. My twin sister and I were the first black mother daughter legacy from Harvard Medical School.
Cool.
Yeah, so your mother was a doctor too. Yeah, My mother's a doctor. Born and raised in Brooklyn, New York, in very different settings than I did. Grew up in poverty, first person in her family go to college, then went I showed to Brooklyn College, then went to medical school at Harvard, and came back to her central Brooklyn neighborhood to practice for many, many years. And that was the influence that both my twin sister, Oni, who's also a physician,
and I had growing up. I thought that most physicians were black women, and I didn't recognize until I was older that we only.
Represent about three percent of all physicians.
This is a topic that I try to talk about as much as humanly possible, despite the fact that these are.
Not my will houses.
It seems to me one of the most upsetting things in American life right now is how incredibly racist our medical system is. And so I was hoping you could talk a little bit for people who are not quite as read in, if you could just sort of paint the scene and explain a little bit, like, you know, what the statistics are and how crushing and deeply troubling they are.
Yeah.
No, absolutely, And that's actually why I wrote the book.
I wrote the book because I really wanted to explain for readers why in twenty twenty four you know, we're seeing you know, even myself, as a black woman with a Harvard undergrad and medical school degree, I fill five times more likely to die of pregnancy related complications than my white peers. In the US, the birthing complication rate for black people is three to four times that higher
than for other people. And these are just high rates overall compared to other high incomnations, even for white people in the country, but especially bad for black people and people of color. And we see that with infant mortality, we see that with life expectancy. So we are seeing all of this. Despite advances in innovation, technology, and research, we're seeing actual worsening of health outcomes along the racial lines.
I was hoping you could talk a little bit about life expectancy because that is one of the most shocking revelations.
Yeah, I mean, it is so shocking because life expectancy essentially is that metric that tells you how healthy a country is. We are not doing well. This country is not doing well overall. And we actually saw when the pandemic started, the life expectancy drop and it dropped for even other hunt income nations, but it hasn't bounced back for the US. Like it has for those other countries, and actually it continues to drop, and it drops for
all racial demographic groups. You know, we have some of the highest overdose rates, the highest suicide rates, highest rates of product disease. We have the lowest professional health professional to provider ratio, Like we don't have enough health professionals the care of the patients. There's a shortage of primary care physicians in this country. Nurses are burning out. So I would say, like our healthcare system is absolutely in crisis,
and the pandemic revealed that. But I think also what we're seeing is this is a result of a nation where so many people are still uninsured and underinsured. There's huge income inequality, and like we're seeing this in these numbers, like these very dismal numbers for the US.
So we had a guy called John Burns Murdoch on this podcast he writes for the Ft and he was talking about how in America at every age, you're more likely to die than you are in Europe.
But as a black person you're even more likely to die.
It's even worse.
And we saw these, you know, they call it age adjusted mortality ratios, Like we saw this like during the pandemic. We saw that black people were dying in the pandemic much much younger ages than white people were, Like, we were dying at rates like that white people tend to twenty years older than us. We're dying at No, it wasn't because of like the fact that our rates is black.
It was because there are many different factors all related to living under and with interpersonal and systemic racism that essentially ages our bodies. Like there is something called weathering, which Arleen and Gerontomous, the public health researcher, she coined that term, which essentially says that you know, under any sort of stress, whether it's poverty, racism, your body kind of wears down and wears down much much earlier you're
was susceptible to developing different diseases. And so that is what we saw literally happened in the pandemic, and that's why you know, we're feel like we're definitely talking more about these issues now than we were before. But black and brown people were still dying before. It's just worse now.
There's a problem with outside stressors, but there's also the problem with racist doctors, right, and not just racist doctors, but also like a system that is innately racist.
Yeah, and that's what I write about in the books. So it's like it comes from all different angles. It comes from like, you know, the everyday stresses that you go through life, but it also comes from the fact that our communities have been deprived of resources because of discredatory housing policies like redlining. But then it's what happens when we interface with healthcare professionals in a healthcare setting.
And what I'm going to say is that, you know, I think that no doctor or health professionals would say, you know, I treat my patients differently, But the fact is is that we're seeing that they are more likely not to live in two black patients. You know, Serena Williams talks about her experience with a blood clot that even the greatest athlete of all time has to deal with health professionals not listening to her. If that happens to her, you know what happens to the average black patients.
But also all that to say is that even myself, I was educated and trained in the Western biomedical model, and this is a model that has you know, messaging foundations that are deeply rooted in the history of this country, and that is a history of slavery, a history that has really dehumanized black people and black bodies. So a lot of these myths get perpetuated in our medical education,
like you know, for example, kidney function. I was taught that black people have different kidney function like normal values than non black people. Most medical students and physicians were taught this based on a myth that black people had more muscle mass and that correlated with kidney function. Do you know what that has done? That has actually led to deferred care, specialty care for black people.
To get kidneys or to go on kidney transplant lits.
And it's not true. It's based on racis lies.
Yeah.
Yeah, And that's the problem is is that that influences how health professionals, whether they intended or not, and mostly don't intend to okaying like most of roth, I want to keep my patients well. But the fact is is that if you've been trained in these institutions like I have been. You know, I'm not excluding myself.
And you're talking about Harvard here, We're not talking about like Podunk.
You know, you went to Heart right, I did, And I talk in the book I talk in a legacy about all these educational gaps, you know, I mean yet I had a great, a great education, but there are all these things I had to unlearn and relearn as a practicing physician, and pieces of history that I never ever ever learned about that totally I should have learned about that should have impacted how I cared for patients.
So interesting, We covered this really great documentary about these fathers and daughters who had the mothers had died black women, and the fathers had been left to raise these children. They had died because of racism and medicine. Right, they hadn't gone treated, they hadn't gone you know, they died of things that were absolutely preventable. This is much more of a story than it has covered us.
Oh absolutely.
And I think the other piece of it, like you know, like for example, lets people know about they call it casually Tiskidi Ciplet study, but it's actually it actually the US Public Health Service Study on the Untreated Negro Male with Zippilid. Like this was a study that was the still uitated, developed orchestrated by our government from nineteen thirty two to nineteen seventy two.
You know, and men living in rural Alabama.
And the only reason that it was actually stopped in nineteen seventy two was because of black ethicaneologists found out
about it and reported to the so Sociated Press. But all I to say is that, like that, it's one of unfortunately many many instances of medical racism, of ways that black communities have been exploited and experimented on, so that, you know, when the pandemic hit, you know, a few years ago, first people were saying, oh, black people had medical mistrusts, and I'm like, wait, wait, wait a minute,
that's not don't put it on the individual. Our institutions have proven themselves untrustworthy towards our communities and really have to earn and engender our trusts.
So because of this history, and that's you know, that's only one story of many many stories.
Yeah, So how do you undo something this big?
I know, I know it, and it seems so overwhelming to people.
And actually, the final chapter of my book, which is sort of like it's like a memoir, but it's also call to action. The final chapter is truly a call to action of different groups of medical schools to rethink and hold themselves accountable. For how they're training our future physicians and to make sure they are training them to care for diverse patient population that we have in this country and to do so equitably.
For hospital systems.
To think about how they're reinforcing racism, one by using these metrics that are deeply rooted in myths about racist myths about black people, like kidney function. But also look at how are their discrepancies between how people are prescribing or health professionals are prescribing opioids or pain medications like those things. Those are structured processes that they can keep track of to see our patients being treated differently. I also say for policy makers, help is not just about
what happens in healthcare. We need to think about help and all policies. So again, we are one of the only high income countries that do not have universal health care. That is a major major issue. We don't have paid sick and family leave. That's another major issue. People come to work sick people. During the pandemic, we knew that low income service workers were coming to work sick and they were more likely to be exposed to the virus. So we need to think more holistically about what health
looks like. And also we know that black communities, because of federal policies like red lighting, like the GI Bill, have left our community so deprived of resources, of wealth and what it looks like. It's for policy makers to make an investment in the pipeline of black health professionals and physicians, but also restore black communities to know the dignity that they need.
For people to be healthy.
People need jobs, they need quality education, you know, they need just like anyone else needs, so that they're not dying these premature lives.
It's very unfair.
Do you think that this is also a problem that can be solved by having more black doctors.
I don't think it's just black doctors. I mean, you know, I talk about in the book How They Were report put a flex and report in nineteen ten that was commissioned by American Medical Association that lets the closure of five out of seven of those medical schools and leaving behind leg Howard and Henry which would have trade between twenty five and thirty five thousand black positions. So yes, that has had a detrimental impact on the health of
our communities. Absolutely, But the other piece of it is that the way that we live in this country as Black Americans is very stressful. Like it's not that being black makes you sick, it's like living as a Black American makes you sick. Having to deal with interpersonal racism, having to deal with the fact that you go to a bank, you're less likely to be approved for a mortgage.
Yeah.
Yeah, Like like all of that, all of that adds up and causes like this, where a tear on the body that makes us thick, or even the lack of access to healthy foods, the fact that many of our communities are in food deserts because grocery stores don't want to come there. So there are all of these reasons that we need to look at, both not just interpersonally, but systemically. Like that's my call to actually think about these issues systemically if we want to improve the health of black people.
But it does seem like government could absolutely, I mean certainly not fix this, but work to fix it.
Oh my gosh, Molly. Absolutely.
And in my call to action, I have a special section for policymakers, and I are elected, I said, this is your responsibility. You have to invest with private institutions like academic medical centers in the pipeline of black health professionals.
You have to also think about what does community look like in.
Terms of programs for increased home ownership among black people, because we know that's one way that people generate well b through home ownership, or looking at training community health workers who are actually late health professionals that are from the communities, but who educate the communities about different prevented measures or give vaccines. They use them in sub Saharan African country, so well they can use them here, but that skill is not valued. And I think also we
need to look at what's happening locally and hyperlocally. There are a lot of really great community led efforts that address health, like doulahs and birthing centers and organizations that are trying to increase the canopy, so the amount of
green space and trees in our neighborhood. Because the climate crisis is actually impacting Black communities more so because of the legacy of redlining, we have left trees and so our neighborhoods are actually a few degrees higher than others neighborhoods, and that leads to exacerbation of asthma attack that leads to pre term births like it has health consequences. So those are all areas that policymakers can get involved in at a local level.
I think this is such an important point.
This seems like the kind of thing where if government were at all interested. Obviously there certainly have been some inroads, but if we had a federal government that was committed to fixing this, they could get us there.
Oh absolutely.
You know, it happens in some parts of the country more than others. I'm worried about the obviously the Southeast because actually that's where the largest percentage of black people live in the Southeast. So what states are those? So I'm worried about Florida. I worried about Louisiana. I worried about Alabama, Mississippi. Oh, those last three that I name have like the very worst health outcomes, right, and we know that because of you know, the road decision. We
know that those places that are maternity deserts. Health professionals have left areas that we're getting Titled ten funding, you know that had been cut, not cut, but had been compromised. People left their jobs. Title ten providers left their jobs.
They were counseling around STIs they were providing contraception, they were doing cancer screenings, and so we actually are making those areas actually thicker because they're going to have fewer and fewer health professionals to work with patients.
Yeah. Can you just two seconds on Medicare expansion.
Oh my gosh, yes, yeah, medic Medicaid expansion.
Yeh, Medicaid expansion.
Sorry, yes, So that is so important, and we've actually seen over the last few years in those states where Medicaid was expanded, people do better in the pandemic people. That's that things actually did better because they had health insurance. But there are those still, I don't know they're nine or ten of those states that still refuse to expand.
Red states with Republican governors that refuse to expand.
Yes, who refuse to expand Medicaid And listen, well, we have so much data that shows and people are insured, they actually then end up spending less. We spend less on healthcare because they don't.
Have to go to the emergency room for check ops.
Yeah exactly, And they're getting preventive care. They're getting prevented care, right, They're getting the care that they need. When we see illness and disease in our communities. That is an end result, that's a downtreaming outcome of upstream factors.
We don't want to.
See people with diabetes. We don't want them to get hypertension. We want to get them before they get there. Kind of system we have in its country, it's for profit system that's very decentralized, where many people are uninsured or underinsured. People are getting a big care that they need, and there are not the incentives to keep them healthy.
And also it means that more hospitals are able to stay open right in rural areas too.
It has a larger effect.
Oh absolutely, because they've seen so many closing of hospitals in rural areas because we have a for profit system and they say we're not making enough money, so we're going to close. But what about the people that live there.
It's so important and so deeply relevant to every person in this country.
And I really appreciate having you.
Thank you, thank you so much for having Molly.
And I want people to realize that we can do so much better as a country for everyone because we're not I would say we're on life support right now.
They're no more fo Jesse Cannon by junk Fast. I knew it was coming, but I kind of can't believe the shape it's coming in, with these bills coming out of Oklahoma and the Supreme Court decision in Alabama.
So we all said this would happen. I take no pleasure in being right here. First, Alabama has ruled that embryos are people, and that embryos, if you damage an embryo, it's like damaging a person. As this is happening now,
all of these IVF clinics in Alabama are closing. In Oklahoma, we're seeing that Republicans they have a House Bill three two one six which will ban IUDs and the morning after pill if those are both forms of contraceptive and it would mean that Republicans are now coming after birth control.
We said during the healcyon Days of SB eight, when Texas overturned Roe v. Wade a year before Roby Wade was actually functionally overturned, that Republicans would never stop at abortion, that they would keep going and they would come for contraception IUDs, the Morning after pill, which is by the way, just another birth control pill. And now we are seeing that, in fact, they are absolutely doing that so that infuriating, fucked up, just terrifying anti science xelotry.
That is our moment of fuck Ray.
That's it for this episode of Fast Politics. Tune in every Monday, Wednesday, and Friday to hear the best minds in politics makes sense of all this chaos. If you enjoyed what you've heard, please send it to a friend and keep the conversation going. And again, thanks for listening.