tv Beth Macy Steven Thrasher CSPAN August 25, 2023 6:47pm-7:36pm EDT
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heritage foundation. the panel and everyone on the book, thank youou bob. [applause] ♪ this year a book tv marks 25 years of shining a spotlight on pleading nonfiction authors and their books. from author talks, interviews, and festivals. book tv has provided viewers with a front row seats on glittery discussions on history. politics and so much more. you can watch a book tv every sunday on cspan2 or online at booktv.org. book tv, 25 years of television for serious readers. ♪ healthy democracy does not just look like this. it looks like this it.
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americans can see democracy at work in. citizens are truly. our republic thrives. get informed straight from the source on c-span. unfiltered, unbiased, word for word. from the nation's capitol to wherever you are. you get the opinion that matters the most is your own. this is what democracy looks like. c-span, powered by cable. >> thank you for coming out to this panel about a very important subject health and inequality and health justice. we have here to fantastic authors with books i think every american needs to read.h first off we have a virginia-based journalist, her previous book was dope stick dealers, doctors and the drug company that addicted a mare she was executive producer and cowriter on hulu's peabody award-winning dope stick theories. before that she spent many are supporting for the roanoke times
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giin virginia. she occasionally contributes to essays to the "new york times." she is here with her book raising lazarus, hope, justice and the hope of the overdose crisis. next to her we have steven thrasher. he will be the inaugurall chair northwestern school the first journalism professorship in the world. to focus on lgbtq research. he is also the faculty of northwestern institute of sexual and gender minority health and well-being. he has written about the hiv, covid-19, for the "new york times," the guardian, the atlantic, as well as numerous scholarly journals. he is here with his book the viralth underclass. the human toll with inequality and disease collide. i think we are going to have a great discussion. i want to start this off framing with this quote that raising lazarus with martin luther king
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jr. all the forms of inequality justice to health is in the shocking and inhuman it offers. i think that is so important to keep in mind as we continue with this discussion. i want to start with you beth, with raising lazarus. this is in many way a follow-up to dope stick which i can only imagine was a very difficult book to report on. i cannot imagine the sorrow and the pain you would have to share with people in them. so if you could just explain why your reporting on the opioid crisis again? and i would love you to share that story of that title. it is such an important vital part of the book. >> thank you. thanks everybody for coming. i already cannot stop talking to steven. this is a great pick whoever picked this. why write a second book about
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the opioid crisis? i was so bereft by the time i finished dope stick my main person have been followingg a young woman who'd struggled with addiction for five plus years. had been murdered after being abandoned by every system that was meant to help her. the last image of the book for those of you who haven't read it is her mother saying goodbye to her battered body at the funeral home. bereft because of the loss but also bereft because of the poor response of our nation to the opioid crisis. i wasit not ever going to write about again. my husband said you should write a book. and then i started going out and talking to people and learning about really innovative things that surprised me. particularly we have people doing cutting-edge harm
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reduction and low barrier care in rural states, and rural communities have not passed medicaid expansion. holy cow, if they can do it why aren't they the model for our nation going forward? we still have 87% treatment gap in america for oh, you d opioid abuse disorder. that means only 13% of folks were able to access treatment. that is largely because of the stigma and an action. i thought the opioid money about to be coming down, the litigation settlement money, why don't i write this book? it is more hopeful. certainly the bits of hope or arenot to the scale we wish it were. this will help teach communities how to best spend that money. which is in the ways the evidence support. and also in the way humanity
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supports which leads to the title. some people think the title is a reference to narcan the overdose reversal drug. narcan is part of it. but he started reporting on these two women who were married. they started at the time they call that nations only clear biracial faith-based harm reduction group. they started passing out needles on the slide before it was legal in north carolina they were poised when needle exchange was legalized in north carolina to become a full-fledged organization. they do amazing work they did cutting-edge work. people call upon michelle, the minister when she is trying to get christian groups to check their blind spot about harm reduction which is this idea of going to people where they are even in chaotic views treating them with non- judge mental
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care, love, being okay if they are still using but you're still a person if you are still using. people go to needle exchanges or five days were likely to injure treatment. i'm about to land this a plane sorry this is a long answer. [laughter] the first time i meet michelle she's been in this community that's been hijacked said what i think they should overdose we should let them die and take their organs. [laughter] really? so she stands up and tells the story of lazarus. jesus was four days late getting to lazarus threat he was dead when he got there. jesus performs the miracle bringing lazarus back from the dead. but it is up to the disciples to roll the stone, to remove the barrier i have a chapter called stone rollers.
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it's up to the disciples of the dirt treatment messy work of unbinding lazarus. but only by getting close to these folks on the ground can you experience the miracle of raising lazarus. that is for the title came from. click select that phrase the stinky messy work involved in them. >> it is. quick steven, lissette with the viral underclass which is not afraid phrase you coined your soap used to great effect in the book. i love the framing that you put on the book. we follow the virus any virus really we follow the faultlines of our culture which is the through line which are explored in the book the izinterrelationship what is the genesis of this book? fix first of all i'm really honored to be here. [inaudible] the first was originally used by
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was using it to describe how and why people are criminalized for transmitting hiv or coding other people's hiv. there are many points and one of them is understanding the stigma. but keeps people from getting the help a neighbor for the people who don't know it's illegal to expose hiv transmitted someone else on about half of the states and other countries around the world. it's when people are housed and this disease what we want is to come forward and get the care they need prayer to know they are not going to be judged. they are certainly not going to prison for his darted writing pg on a case of a young man and sts garrested for criminal exposure to hiv andac transmitting hiv to people is facing life in prison. he got sentenced to 30 years in
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prison because of our reporting abuzz feet a lot of activists work we got it out about 25 years early. he still spent most of the 20s and present through a wake-up call to be to understand even the peoplee think doing things that might lead to exposure to someone else no oneto try to gie anyone else covid partner was trying to have anyone hiv or aids. but when you tell people he find out your positive for the reste, of your life you can be prosecuted and you can see somebody go to prison for 30 years becomes the stone that keep people from getting tested in the first place the work of hiv prevention people got much harder after beginning of that. viral underclass of started dating, shot you should talk cha people living with hiv are a little living under a different set of laws but i heard it being used in a cell a different way. begin the base of my phd dissertation. i really understood as ate way o understand systemic racism because overwhelmed the people
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are prominently lacking or of af the world this happens. i started to use this as a way to thinkan of the viral undercls as an analytic to understand how and why similar groups of people become exposed to different social conditions. in different kinds of viruses but hiv, you look at where people get hiv work progresses to aid you also find people who werere dying of addiction for defining criminalized policing you're finding police killings you see it on maps the covenant teens are happening in 2020 is all the same maps going in. might move and the book i still build off of the work around race for think oneys of the ways our books h introspect is that this is not onlys a matter of race.bu race is a big part of it. this is affecting for white people. this is affecting people who are lgbtq. people who are disabledth and another way our books intersect introspectare people who have bn incarcerated. but i wanted to add quickly with
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hope. exhibit really, really good work awareness of the criminalization of hiv. only two states have gotten rid of the laws entirely pay what people areou cynical about the o party system. i tell them they seduced two states have gotten rid of hiv laws are illinois, where i live. blue a top to bottom in texas. hope this happened under your government. christ great. i think the first area i like to drill into you both alluded to in your discussions just then. it is a stigma. both reporting about in this book. stigma is grading a sense of other. these problems use issues or for other groups. din this country it most of us have a pretty good awareness of how we treat people arts others when it comes to things like racial divisions or sexual
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orientation part or gender identity. but what you both explore is the treatment of other when it comes to drug use. or homelessness. or incarceration. or sixpack work. or even people having some these decisions are, stigma hepatitis, hiv. so i think it put so well by somebody and raising lazarus the britta don't remember who but treating human beings as objects instead. these marginalized people. i would love for both of you to drill in a little bit more how stigma prevents us from reaching solutions in the public health crises? quickset is such a great question. do you want me too go first? let's go ahead. quick so much of the stigmatization comes from this place of people fall for the gaps and die.
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that is a tension between treating people like a terminal any moral failure and treating them like the human beings they are with a treatable medical condition. they really are people with a treatable medical condition. just like you would take insulin if you had diabetes, which i have. at that, it goes back to the harrison narcotics. of 1940. it goes back to the nixon's war on drugs. i take brief digression to talk about nixon his early years when he actually treatment funded as well as as he had incarcerate for drug use funded and he appointed the first the nation's first drug czar this super crusty psychiatrist named jerome, who reported directly to him and designed a program on demand methadone clinics. but then, you know you see it start to become a way police
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people in order to get votes and you know the southern strategy that he employed is which is well documented that is harsher against poor people particularly people of color. when i think of stigma i think of the story in my book that got me the most i was following a ryan white hiv who whose job to tell who to test and treat people for hiv in charleston, west virginia. the state that has the most concerning hiv outbreak in the nation and state. the just criminalized needs based syringe exchange. the one thing that we know works to prevent the spread of these infectious diseases. and so i'm following around this ryan white worker named parker. and she's looking for three people. but but they're mostly unhoused and she can't find them. and then the needs are just screaming out of there, like
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like coming out a right and left and at one point, we're looking a person we're at a homeless encampment. we run into this man in a wheelchair he's dopesick. he's crying he's picked maggots out of the abscesses his feet earlier in the day and he won't go to the hospital even though he's going to die of this bacterial infection because. he went there last week. you was treated like --. 18 hours. he's not going to go. not going to go. she's begging him to go. so she sits at his feet and it was like watching jesus. she sits on the dirty ground. she opens her first aid kit, she puts gloves on, she sits on the dirty ground, she put the gloves and put the packet after packet of antibiotic ointment on. he is one thing, he is crying he needs to get drugs to get well. and at that moment a police officer comes up and puts an eviction notice upon the homeless encampment. and i thought all the stores just came together in that
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moment. the sex worker who also lives in the homeless encampment comes up and says to brooks, honey, that antibiotic ointment ain't going to cut it. i was a nurse for 17 years. an lpn and then i got married. and she went like this. it was incredible. and she walked away and brooks said she should be the person treating him. if something had not got wrong for her parade this is what we had to remember it's a stigma. the sky in a wheelchair had a family he had kids. i think stigma is at the base of those many things. all of the layers of discrimination in that one moment.
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and just how poorly people and our own health care system which by the way participated in a starting the opioid a crisis. and they need to participate in putting an end to it. >> it david? >> the statistic i think about the most that i write about in the book and have for years as and gayevery two black men are projected to become hiv positive in our lifetime. theree' is no reason to happen. it can take five, seven, 10 years for it to start having bad health effects 10 -- 15 until they die. the better part of a million die around the globe. a big part of it is economics but it stigma. the disease is made to feel so shameful. the ways people are treated in healthcare settings they don't
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get the help they need. and i was thinking while you're talking as well if people do not have a safe place to sleep it doesn't matter whether or not you get them these drugs. it's relatively easy to deal could you catch day, they go on with their life are pretty much normal thereafter. stigma is a huge a barrier getting the care they need. i was think the thing nice about your state earlier but what abbott w is doing with transit children withe the trans children lgbtq people are being criminalized, and this estate in florida and arkansas is creating these pathways of the state to let viruses the trans people cannot get medically supervised care that they need for hormones in a safe setting people who are dealing with addiction of a health matter cannot g get stere syringes the state is opening up their veins in their bodies to hiv into hepatitis and other because they are going to get the care they need somewhere.
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not only is that a physical matter but stigma becomes a barrier that makes people feel ashamed to gete the healthcare they need. one of the stories that touch me the most is the first person my outer circle to die of covid was a really amazing activist who was known as it transit latin x mother she's the mother of the transit latin x community. she herself up and living with hiv for decades. she had been a sex worker. she did amazing volunteer work she would be in the street and give them sterile syringes. she would give them food and condoms and anything they needed and met people where theyy wer. and she was the first person i knew who contracted covid and died. when she had covid in the very, very early days in march 2020, she did notal want to go to the hospital because a of all the bd experiences she had had in the
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hospital herself. i will not go into any depth here. i wrote about inexperience i had when i needed text to kill her sonogram i was in my phd work as a little bitha older for student but not that old paris made to feel very unwelcome because of my age the receptionist joked about not thinking i could be a referral from a student health center. m that really made me understand the ways a trans a person is going for healthcare particularly around something sensitive like sexual reproductive health or cancer if they're met with that kind of response youti don't look like r what i was expecting that's a big reason why they might not want to go to get care that's lyone of the reasons there so mh more likely to get sick. quick someone to ask about intention here. we have a healthcare system in our country that is capitalistic and profit driven. what interest me too explore a little bit, to what extent do
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you think the people making decisions in a public health system and or healthcare companies or hospitals, have some sense of malignant intention to intentionally marginalize these groups? is this just a byproduct of the structure of our system because it is profit driven? go ahead. >> before dope stick came out i was asked to talk to the nonprofit hospitals within my region. the largest employer and the whole half of the state, five hospitals, medical school blah blah blah. struggle not to be cared for at their own hospital. and i said i'd note not all of you took a free trip courtesy of purdue pharma to arizona and florida to become paid speakers from the country. but you all participated in the
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system. you should participate in correcting it. i think a lot of it at that point, that was 2017. two years later they totally change the way they do medicine. medication assisted treatment offering it in the ev. before the thought that was treating a drug addiction with another drug. it was not their job. so they can change. the world did not end when they change. one guy with o a lot of power decided he could change the rules.s. he had incredible and that's what i see over and over in this book. one person sometimes it's a mother or sister of somebody has died of overdose. sometimes is just somebody like doctoras burton who i asked him what happened and he said well we read your book.se and then we looked into the research but how could we not be doing this? and now he becomes an evangelist
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for other hospitals. wanting to do this evidence-based practice. but it is like 5% of hospitals do it but is not that heavy a lift.e and i don't know if it's because of the capitalistic system as much as the creation of the overdose crisis to begin with. which begins with purdue pharma introducing a very addictive drug in 1996 and basically buying off all of the politicians and lobbyists. the fda the guy who stamps an approval on oxycontin goes to work forng purdue tripling his government salary. three years later nobody is regulating the system. we've got to get rid of the revolving doors one thing. you see that happen later when the dea basically gets me kept from going after suspicious pill
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mill doctors and suspicious orders because of a lot of the lobbyist basically wrote that used to work for the company. you almost could not make this up. i think it is both. the healthcare providers who want to give back to doing no harm. i quote a guy at this addiction medicine doctor i met. i'm doing this because it was a big cross is very religious and runs a homeless shelter out of the basement of his office but the answer comes back to a quote from 19206, francis peabody at harvard said for the secret of caring for the patient is to care for the patient. and i think when we let capitalism rule we have to give back to caring for the patient. >> i will directly blame capitalism. [laughter] the point of capitalism is to extract a profit and values the healthcare system is not about healthcare. the point of these companies is
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to drive profit presents her primary motivation. many of these sicknesses are opportunities to do so.ct there's a phrase i've heard activists use. it was one it was the name a aids organization that fought aids successfully fought government reaction very successfully the 1980s and 1990s. perhaps their most important contribution is they force the fda and the government to change how trials were done that is where billions of us have now been able to get vaccines for covid in a process that used to take 10 years could take as little as one year now. they have a phrase they used by 1996 with the aids medication came out, science and won the debate about what to do about aids for the figured out how to do it they figured out how to save lives. capitalism won the war capitalism is reason more people died of aids after the invention of the medication.
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capitalism racial capitalism is the reason why there is a higher rate of aids among african americans in 2015 than there ever was among white americans before the was medication 20 years earlier. these are the kind of results the capitalist system creates. the people you are writing about and raising lazarus is doing work on the back of the truck but they are interested ine. ca. i think there's a point between our books i know we are writing about people have a different ethic of care and ethics ofan care. and i hope the covid-19 would inform. and it has. many more peoples of different senseses of ethics of care. i certainly know 70 people worked in offices prior to covid 19 pandemic that once they were home truly enjoyed doing things like getting groceries for their neighbors being a mutual aid network and things like that for those of the models we need to look at with more care for people. the person housing people in
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their basement. they are doing that work. theou people i have interviewed about monkeypox this summer. they work all summer to inform people about monkeypox, fight the government to try to get vaccines. actually distributing the vaccines. stopping there parties and activities and turning them into places to get people vaccinated. they're the ones doing a new kind of work this interested in people's whole health. and i will say something else i thought about will reading your book how covid-19 put into effect at a very, very different response from that world government and companies and hiv did and monkeypox did. the work around anything that involves the society. we could have an ethics of care that did so with much less a judgment about those activities become not only benefit people and individual level would but would create a much better
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public health come overall for society. >> grates it. i like to invite anyone from the audience who like to ask a question of our panelists to come up and step up while we are doing that, i want to talk a little bit about hope here. a little bit towards a solution. one thing that comes across in both of your books is the idea that the people that need the most care are the ones t with te least access to care. he seems very assorted and you both point to individuals i don't do say fighting back against the system but finding ways to help in the ways they can. are those solutions scalable? is there a way to take those models define and make them work on a large scale? >> i think they have to be. we w cannot lose hope. i also write about a bureaucrat who comes along in the same community where they said let them die in take their organs
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figures out a way to offer post overdose response teams and. recovery specialists. every person who now overdoses gets a. , a person in recovery to come out and help them make those first hard steps into care. he has to battle there it's a political problem more than anything else. he asked about judges that do not want to allow drug court even though he has money for it. the rowdy angels the people are needle exchanges into the. recovery work, they actually reachll out. this one community find one good cop. one of my advice at the end of the book of something gives me hope if you could turnn a one good cop into doing things differently so it's diverting people to care from jail and into care you can then show how
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that worked. i think that is something that is scalable. >> oh say very briefly what i think has been scalable in the past three years are things that people who do work around drug use for decades is now understood by millions and billions of people much more. i think we are going to seat ripples andde that for decades. they heaved unionization effort at starbucks and amazon places like that is a direct result of the pandemic. they feel unsafe and that workplaces and coming together. i think young people understanding for much more collective responses doing with social. and everyone feeling like they are at individual failure and figure out the problem individually. >> great. what's go to the audience.
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situations created these tracks for olderer adults. >> i can jump into that. the huge part of my book. i have an entire chapter which is a former village voice editor. it was completely stupid reason. heated tooth infection and up in the icu and new york state where he lived at the time. they're puttingrs people covid into nursing homes. they were covering from the tooth infection he got covid and diapered one in every 10 people nursing homes died of covid. one in every 12 and congregate care settings also include younger people who are disabled one and 12 of them died as well but i've got many letters to people who are elderly one of things i hope in my book was to give people a chance to not only mourn the people they had lost but for people who had covid you feel like they had been forgotten. this was very much an assault on
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the elderly. he goes into my critique on capitalism. they don't care about the elderly. in crude terms economist talk about the elderly as a drain they are costing money in the economy rather than contributing to it. they elderly are also affected y hiv increases in fdi we assume elderly people do not have sex. there is no consideration given to healthcare, pleasure in that. very much the elderly are how i write about the underclass. and it has borne the brunt. think itre was the attorney general here in texas he talkedn about kant grandparents give up their lives a few years for the good of the economy? it's been disheartening.
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a framework is helpful because the elderly in a way are disabled. it's usually thought of as how productive are you to the economy? and so growingpo old at a certan point means your body is not able to do certain things. it's really, really disheartening to see across the political spectrum a lot of mainstream media a reversion at this point of talking about covid as its only harming the people who have other problems we do not need to be so concerned because they're hard enough to survival we have more than 10,000 people a month dying overwhelmingly. >> soon after that? [inaudible] i live locally howow all of the
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hospitals seem to be on like religious organizations. how that affects people's care and limits their care. and also think that means they're tax-exempt as well. did you cover that in your book? along with capitalism and the religious aspect of what hospital ownership. >> i did not get into that as much. not from a structural level but i explained the title and they use of how mostly individuals at this point, individual people with personal ethics, many of them based on their religious beliefs are really the ones leading us out of this. and are doing the mutual aid. i'd tell the story at the end
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there is a catholic nun activist in her 80s. she is having reach out to me too start a gofundme because she cannot pay her light bill for her addiction education center. the light bill is paid for 200 years. here's an 88-year-old counselor working 12 hours a day and asking for money. most of the nonprofit hospitals are not paying taxes did participate in the system that ultimately led to 7 million americans being addicted. step up.hey should >> religion cuts both ways. is there religion that can attribute to homophobia entrance phobia. at individual level particular with catholic so many people a involved. assuming phenomenal things.
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i turned and right before it came out i came after the dobbs decision. there is a real link and the way we see religion and tax a status and speeches very dangerous the way corporations have so far been able to say we do not want to pay for abortions that violates consumer things are happening with career stuff already. that is a really dangerous vething. the mets there is a massive investigative story all these hospitals are nonprofit. they're using aggressive bill collecting techniques. four people are so sweet it work for free. they're not even aware there's getting that for free they have the same bill collectors of for-profit hospital.
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[inaudible] >> you got, thank you. what's on the reproductive rights front i was thinking thie serna panel the other night. the hyde amendment basically made abortion illegal for four people. this wonderful axis for a few years before it came in very similar legal thing is happening now a trans care. florida they made it if you have medicare you cannothe get tran scare other states are going to do things like that. that's putting us on a very similar path of the hyde amendment led to overtime abortion not being legal in many places. >> think you both for your books i look forward to reading them. you talked about your cut you talked with who is doing work trying to address these issues. didho either of your talk with other people and the government her trying to make change and do
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things s differently to solve se these issues? >> yes separate edges of the white house a few weeks ago for a recovery a summit i met with e drug czar. i know he knows what the researches he has authored some of it. and again we come back to politics. i am hopeful that this administration knows ways to make sure get evidence-based care. i kept asking everyone at the beginning of the book what's the magic wand what's the federal fixed? it is no federal fix is won by state or community's there's one may not allow exchange all another mightes have 17. a lot of states have made it illegal. we have 13 states that have not passed the medicaid expansion. so where you live in the country
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determines your ability to get healthcare or not. that is really concerning. i think the administration is aware of it but they are struggling to figure how to bring into being. >> they do not interview many government officials. i am more interviewing people in the underclass are more critiquing how things play out in the government across party lines but the biggest one being 400,000 people died of covid after trauma.ru six and 50000 and counting have died under biden. trump didn't have the vaccine. he was a cartoon on fluid with depend of the bright administration likes look at the stats at lots of good people gone to the ministration. but we'll people don't have homes was only so much we can do. the u.s. is more incarcerated people than anywhere else in the world that's a major driving
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while of these paper chiclet respiratory illnesses. i'm writing more about going to their own administration if you like i don't hear from them again. >> that's a good point. [inaudible] the question is why don't we hear from good people? they will be very loud in public. the new scholarship and w activm and critiquing. they critique the government response they get brought in to keep doing that work. and that i don't hear from them for they stop tweeting, stop publishing and vetted to the administration.
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there are a handful of exceptions for doctor dimitri is a very, very out gay leather sex positive person did hiv work in new york city. he is still a big president of the world. a lot of people their ideas are so bright hope that is what drives administration. i feel like that's where the ideas go to diet. >> one last question here? what if what i got my mail. in my mail was a political ad from the political party's impact that said all of these pieces of misinformation about puberty blockers, about trans youth, what the treatment is worked trans youth in our country. i am just curious what can i do?
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what can people do to combat or reverse that information it's coming out coming into all the homes in austin might have gotten that pamphlet. what can i do to make sure my neighbors and my friends aren't believing that? >> i think as a gender person it's out on us to explain what's wrong about it to anyone who will listen to its. people take quote unquote puberty blockers are all kinds of medications that affirm gender for all kinds of reasons. acrossde the lives of all gender spectrums. many of them have been used by people for a long time. it is important to share that as a gay person i find it really important to explain to other gay people when it comes up in our community. the ways we talked about his gay people in the 70s, 80s, 90s and told us something to
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get over. you should go through conversion therapy we would never accept as conversion therapy no space goods being asked for for trans people. i think it's important to talk about that within themu communi. >> i just think we have a real epidemic of misinformation. a lot of that you can trace back to particularly in rural areas you can trace a lot of back to the fact the jobs went away but the government did nothing for the people that were left behind. capitalism ruled that one too. things like the opioid crisis come into being. we are ill-equipped to deal with that. i am thinking a lot now about the media's role. specifically the declining media's role in not covering fact-based journalism. i worked a newspaper for 25 years. we won numerous national awards but had 125 employees in the news or when i got there now is
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eight reporters. i think it is really important that we talk about revolutionizing nonprofit journalism supporting the journalism that slept out there. this kind of sector getting in your mailbox and got to counter that with factual information. thank you. what's one very quick fact people say we don't know what will happen with trans people. this is not true there's 40 years of research for this decade from decades of research. jon stewart better than any national level journalist at the attorney general ofno arkansas o say no, no, no. this is how it works. there's decades of research educator self on the research that is widely available. until your neighbors. >> on tosa echo what beth said support local journalism please subscribe to texas monthly where i work thank you. thanks so much. to bethng and to steven for
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