America’s patchwork for payment of medical expenses has ostensibly left the poorest and sickest among us vulnerable in ways unlike virtually any other advanced nation in the world.  To call the whole system a mess is an understatement.  That’s why it continues to get so much bandwidth in our political debate.  And while the Affordable Care Act has brought more coverage to millions of Americans, it hasn’t pieced together this fractured system into a coherent whole.  So the debate goes on.  Will it be Medicare for All?  A public option cobbled on to the existing private market?  Or will we leave insufficient enough alone? No one knows.  But until we agree on whether health economics is to be underpinned by the goal of making certain that a rich child and a poor child have the same access to medical care, we will continue struggling with the vagaries of our current system.  Preeminent Princeton economist, Uwe Reinhardt in his final book, ‘Priced Out’, completed just before he died recently challenged us to take into account the economic and ethical costs of American health care.  His life partner, Tsung Mei-Cheng, a researcher at Princeton University, helps explain his thinking, and hers, about this crucial subject.  If you want a primer on how we got here and ways out of this morass, this is your podcast.

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Sure there are blogs, podcasts and citizen journalists, and even public television and radio.  But, the vast majority of citizens get their information from a dwindling number of outlets that aren’t under the control of six major corporations in this country.  While the role of the media in our society is to investigate, inform and provide a crucial check on political power, are some of those obligations shaded in service to an increase in profits and the need to ‘entertain’ so as to attract more listeners, viewers and readers?  Studies show that the time spent covering public policy issues is being diminished in the media while the horse race and ‘show’ part of the process is accentuated.  One must ask whether a Donald Trump presidency ever would have been possible without an attendant desire for ratings, because he was good for business, and a simultaneous dumbing down of the our public discourse in the news media and lack of focus on civic education in our schools.  Mickey Huff, our guest, along with Nolan Higdon explore all these issues in the book, ‘The United States of Distraction’.  It’s a very important read and a compelling listen, as he lays out how we got here and, in the book and on the podcast, some ways we may reclaim an informed civic culture–before it’s too late.

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: Renowned psychiatrist, Dr. Arthur Kleinman, learned a lot about caregiving when his wife, Joan, suffered early-onset Alzheimer’s Disease.  It made him re-assess much about his own professional approach to patients and that of the medical community, in general.  In his book, ‘The Soul of Care’, he looks at why care is so central to our lives–and how it’s at risk in today’s world.  He says that the political atmosphere and medical business necessities and metrics work against it.  He offers candor and wisdom, having taught at Harvard for over 40 years, in this conversation and challenges our notions about healthcare today.  It was astonishing to hear him remind us that at any given time in this country over 50 million Americans are performing the long, hard, unglamorous work of caregiving.  And, yet, he also suggests that its richness in meaning is vastly undervalued.  We have an engaging conversation about the role of doctors and other allied medical professionals in providing care in our country.  It’s  all about health care reform, with a strong side of humanity, on this podcast.

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You can work very hard in America, yet still be broke.  And you can be white in America and still be poor. As our guest points out in her searing memoir, ‘Heartland’, ‘poor whiteness is a peculiar offense in that society imbues whiteness with power-not by just making it the racial norm next to which the rest are ‘others’ but by using it as a shorthand for economic stability’.  She has seen it in generations of her family members in the Midwest as they work their with their hands and on their farms never thinking about the systemic forces pushing against them.  ‘They speak a form of poetry, made up of things and actions’.  But do those voices and the importance of those actions resonate in the power centers in America?  I use Sarah Smarsh‘s words in this description of the podcast because they are so beautifully crafted and say so much.  You must hear the message she has for America in trying to understand flyover country.  One more nugget: ‘People on welfare were presumed ‘lazy’ and for us there was no more hurtful word.’  She explains her prose and her thoughts on being broke in the rich country on earth.

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 Given the cost and what’s at stake in choosing a college, perhaps, we are asking the wrong questions when we set about the process. Oh, there are a slew of books, rankings and resources which announce themselves as being definitive guides to making that choice.  But, are they? Using the ‘jobs to be done’ concept developed by Harvard University icon, Clayton Christensen, Bob Moesta(our guest) and Michael Horn, apply the concept to ‘Choosing College’, the title of their new book. Instead of focusing on what job a student wants after college, their focus is getting you to do the hard work of determining what ‘job’ a student is hiring a school to do.  By adopting the ‘Jobs to Be Done’ theory, students can better understand what motivates them. The book presents five different Jobs for which students hire a school. Once you’ve thought about these five Jobs, you can better approach which schools might meet your individual needs. This may be one the one book and one podcast you need before signing a letter of commitment to __________U.

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: Over the past few decades, the job of college professor has been completed transformed.  And, according to Herb Childress, for the worse.  He’s the author of ‘The Adjunct Underclass’ and questions whether we can really value higher education when we treat educators like desperate day laborers.  In order to underpin the notion of academic freedom and to encourage the life of the mind, we all imagine professors who are free to study, research and think, not to be harried because they have no security and must amass many classes, often at different schools, to cobble together a meager living at $3,500(or so)a class.  In 1975, only thirty percent of faculty held temporary or part-time positions.  By 2011, as universities faced both a decrease in public support and skyrocketing administrative costs, that number topped fifty percent.  Now, some surveys indicate that as many as seventy percent of American professors are working course to course, with few benefits, little to no security, and very low pay.  Now, that’s a trend we must discuss, particularly in light of the escalating costs of higher education.  It begs the question, then where is the money going?  Listen to this podcast and find out.

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 At one time in the not too distant past, the drinking age in America was 18 with the logic being that if young men, at the time, could be conscripted to fight at that age in the jungles of Vietnam, they should be able to drink at home.  Then, in 1984, Congress raised the age to 21 as a way to combat drunk-driving fatalities. States were coerced into doing so in order not to jeopardize receiving highway funds. Yes, drunk driving deaths did go down, but was the raising of the drinking age the reason?  Our guest, Scott Johnston, author of ‘Campusland’, makes a strong case that other factors were more important and that kids on campus, his main focus, kept on drinking no matter the law. And that this prohibition changed the campus culture for the worse. We have a great exchange about the issue and learn some stunning facts.  Did you know that of 190 countries, on 12 have drinking ages as high as ours? Or that 100 college presidents have signed on to a letter encouraging the lowering of the drinking age? Or that a former President of Yale University used to welcome students with an open bar? Johnston thinks Republicans should lead this charge. He explains why.  Good luck convincing ‘Martini Mitch’.

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 Phil Mudd, who you see often as an analyst on CNN, was the former
deputy director of the CIA Counterterrorism Center so he has firsthand
knowledge of the vast changes in strategy and tactics that took place
at     the CIA in the wake of the 9-11 attacks on our nation.  He
understands how and why the CIA morphed into an operational agency
instead of an intelligence gatherer for others to act on.  He knows what
The Program meant  in terms of covert ops, enhanced interrogation
techniques and extraordinary renditions.  Yet in his book, ‘Black Site’
he gives a forthright analysis of our intelligence efforts in the War on
Terror.  He places us back at the moment that America’s leaders decided
that they would not allow another attack on this nation and the lengths
they went to in insuring that result.  And then after de-briefs with
many members of the CIA he looks back at the steps of the process and,
in hindsight, after much criticism, what we have learned.  What happened
internally in the decade after the attacks has so rarely been discussed
or written about, until now.  Finally, we discuss whether he thinks
such steps could ever be taken again.

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In the podcast realm, true crime is by far the most listened to genre.
Our focus on it is simply because it’s part of such a growing, and
disturbing, trend in our society.  Following on to our most recent post
about the FBI profiles of active shooters in America, we turn our
attention to the case of Israel Keyes, one of the most meticulous serial
killers of the 21st century.  In Maureen Callahan’s riveting account of
this case in her book, ‘American Predator’, one of the most
inexplicable elements was how little was known about this killer’s
family life and upbringing.  And, in reality, until we begin as a
society to take greater interest in the well documented troubles of boys
in our culture, how can we get to the root of the mass killings
epidemic?  Ms. Callahan sees the nexus clearly between these two killer
types and helps us to understand her thinking in a compelling article
she wrote with the headline ‘angry young men continue to be America’s
greatest threat’.  It’s not something we as a society can continue to
simply tolerate.  As concerned citizens at a town meeting with the
Governor of Ohio, following the Dayton shooting said in unison ‘do
something’.  Well, first we need to admit to the enormity of the
alienation, understand it better and develop a range of strategies that
can prevent it or mitigate its lethality.  But act, we must.  And soon. 
This conversation is a good start, as are previous podcasts still
available to you on this site with Warren Farrell and Dr. Leonard Sax.

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 The nation is trying to reckon with the deadly concoction of troubled
young men, possessing tools of war and espousing, in many cases, hatred
toward  fellow Americans because of their color, sexual orientation,
religion or other characteristics.  The body count from this anti-social
behavior continues to rise and prayers and condolences are becoming an
insubstantial response to mass shootings unseen anywhere else in the
world.  We turn to Katherine Schweit, who when she was with the FBI,
authored the Active Shooter Study to get a better handle on who we are
talking about and what we can do to make these rampages less likely and
lethal going forward.  There is no one answer but we must begin to
discuss what public policy initiatives might halt this growing trend
toward violent extremism–is it guns, more mental health services, or
pre-emptive action toward those who evidence such tendencies.

And
this all must be done within the limits of the Constitution and in a
race against the inevitable tragedy next awaiting the nation.  You may
be surprised at the role that we, the ordinary bystander, happening upon
such a circumstance in a place considered a soft target can and have
had in many cases.

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