Tom Mueller: The Most Dangerous Part of America’s Healthcare System Isn’t What You Think

The story of diialysis is an amazing. case study of good [music] intentions. being thwarted by bad incentives, poor. oversight, and profitering. >> When I was working at Dvita, the. priorities was to get [music] them on. diialysis and get the next patient on as. soon as possible. It was all about. numbers. >> Tom Mueller is the author of How to Make. a Killing, [music]. an investigation of the dialysis. industry. >> In America, patients on [music]. diialysis die one to two times faster. than in any other developed country. >> [music].

>> This is What now with Trevor [music]. Noah. This episode is presented by Whole Foods. Market. Eat well for less. [music]. >> I've never known you without glasses now. that I realize it. [music]. >> You actually have. >> When? >> Half of our relationship was without. glasses. >> What? Take off your glasses. [clears throat]. >> Remember this guy?

>> No. Yeah. No, you're right. You're. right. Actually, yeah. Yeah. The beard. now it's like a flip. >> There it was. Was no beard, more hair, no glasses. >> It's like I've known every version of. you. [laughter]. >> Do you know this guy? >> Eugene, where are you? >> I'm here. >> Oh, Eugene, you're back. >> I think someone else is. >> Where [laughter] is he? >> Welcome. Welcome to Welcome [laughter]. to our idiot friendship, Tom. I'm so. sorry. Thank you very much, Tri Eugene. I feel. like I fit right in.

>> Oh, you do. Actually, you do. If you. want to, you do, man. You do indeed. Um, actually, you know why I feel like you. fit right in is because you you you've. got like one of the the the most. beautiful weird stories of how you've. lived your life, you know, and and when. I read your books, I can't help but. wonder if the way you write and the way. you've thought of writing comes from how. you've lived your life. Like, ju just. just take us through some of this. So, cuz a lot of people are fans of your. books, but I don't think a lot of people. know a bit of your life. is like, "Where. were you born?". >> I was born in New York City. >> Okay. >> Left 6 months later, went to London and.

Paris. >> I like how you say that. Like, you left. You were like, "I'm out. >> I was lefted.". >> You're like, "I'm out. [laughter] I'm. out, parents.". >> That's right. >> I can't do this anymore. >> Yeah. When I say I was born in Columbia. Presbyterian, my New Yorker friends say, "Yeah, but you're not a New Yorker." You. So, I try to make that clear at the. outset. And I. >> And we moved around a lot in the United. States. Um, California, upstate New. York, Texas. Um, I I did my high school. in Houston, Texas, which I do not. recommend, >> but was an experience. I learned about.

football, which is something. >> And uh and then, yep, I went east for. college and then went to England for. grad school and have really not lived in. the United States since Ronald Reagan. was president. >> That is wild. I spend half my time or. more in the United States and I. technically live in the United States, but yeah, I've been based. [clears throat] in Italy for 30 years or. so. Do do you think like some of that. has affected how you're able like maybe. I'm projecting here, but I I sometimes. feel regardless of nationality, one of.

the best things you can do is remove. yourselves from a situation to be able. to see it better. >> Doesn't matter who you are in the world. >> Spend time away from your family, come. back to them. You'll see them slightly. differently than when you're always in. it. And I feel like you've done that. with America, with the corporations, with the way we see, you know, the way. things just work. Is is that do you. think that's partially because of just. like how you've lived, where you've. been? >> I think no question. stepping back and. looking at the way in which for instance. you mentioned corporations the way in.

which in America corporations and money. are regarded with the certain religious. awe whereas in other places it's you. know they are welcome uh and and they. are sometimes very powerful uh but. they're not the be all and the end all. and uh and again stepping back into a. place where you've been born and raised. you realize my gosh you know things. really have changed here and that and. that's in the last the last 30 plus. years things in America have uh changed. at an accelerating pace and an alarming.

pace really. But you can see that better. if you're outside the bubble for a while. and then you pop back in. So. >> how did you get into writing? Because I. I don't know if my research was correct. but were you in banking at some point? >> Yes. [laughter] I um I did a PhD in. history and [clears throat] love history. but realized I was not cut it out for. academia. So I thought well um I know. languages Europe 1992 is happening. let's try you know there were recruiters. on on uh on campus um checking for.

people who are interested in recruit. [snorts] uh in banking and in uh. >> um consultancies and various others and. I ended up at Goldman Sachs in London um. doing mergers and acquisitions which for. two years which was a remarkably good. experience from a business point of view. um I met some of the f most fantastic. people in the world and I came away with. this amazement that some of the most. fantastic people in the world were. swindled into giving giving their lives. away for a modest amount of money. I. mean, it was big money. >> What do you mean by that? >> They um were indentured servants to this.

company. Um and simply their lifestyles. were terrible. Their incomes were. >> very good, but uh terrible, terrible. lifestyles. And uh and that was well. before, you know, the runup to 2008 and. all the massive crime. I was in a. business where was still the. relationship was important. Mhm. >> Um and and if you screwed up with a. client, you were done. I mean, you were. finished. Um and then later clients. became sock puppets and traders replaced.

relationship bankers [clears throat] and. you got 2008. Uh so, you know, one of my. closest collaborator were bosses and. collaborators at the bank was on the. 1NDB indictments. I mean, he was, you. know, the head of investment. [clears throat] bank. >> We're talking about like the this was. the 2008 Wall Street crash financial. collapse. >> Yeah. I mean, they were testifying. before Congress. They were explaining. why um you could call a client a sock. puppet and you could create financial um. vehicles. >> Wait, Tom, that was an actual term. >> The actual term sock puppets. Yes.

>> Was it used within your circles or just. >> not within my circles, but you know, my. the folks that I worked with who stayed. at the bank, that's what they were. talking about. Yeah. And the And again, trading is very very different from. relationships. Trading is. >> one day at a time. I win, you lose. I. mean, there's a it's a zero sum game. So. trading is at the end of my day I close. out my position and you are my. counterparty. You're not my client at. all. >> and that means I can take advantage of. you. Um and that's what happened in the. run-up 2008. Goldman was in particular I.

mean involved in all sorts of bad stuff. but they were basically building. >> uh financial vehicles to fail and then. selling them to unsuspecting pension. funds and various other you know u. innocent parties as a good investment. and then betting against them. >> That's insane man. I still can't believe. that that happened. >> And then I you know what shocks me even. more. >> is that the ramifications were barely. felt. >> Absolutely. >> Do you get what I'm saying? >> Yeah. Yeah. >> It's one thing to go something wild took. place. It's another to go nothing.

happened. >> But I think that's why a lot of people. have sympathy and sometimes admire. people who do white collar crime, right? Cuz almost feels like it's a victimless. crime. If someone is bleeding on the. side of the road and someone has a. firearm in their hand, >> that's a crime. If someone says, "I lost. millions of dollars." And people go, "How much do you still have?" A couple. of million more. Uh, [laughter] there's. no crime here. No farm. You see what I'm. saying? >> Yeah. No, I mean, you look at Mike. Milin. I mean, he was actually. prosecuted and sent to jail for multiple. felonies. Comes out, he's the toast of.

the Nobel Prize community. He's got. billions still in his in his foundation. It's no, I mean, white collar crime is. vastly more it's the cancer of society. It's vastly more damaging. It causes. massive amounts of of harm. But as you. say, um, it's it's almost lionized in in. the business school community as. something, hey, you know, you really is. a risk taker, right? He's a real hard, you know, you talk about killers. [clears throat]. in business, you talk about making a.

killing. That's a good thing. That's. supposed to be a positive. >> See it different than we do. >> Yeah. And and if you're flying, you. know, close to the to the wind in legal. terms or beyond, that's it's viewed as. an incentive. There's no normative. quality to a law. You break the law, you're it's wrong. What are you? They. say, "What are you talking about?" I. mean, how much do I have to pay here? What's the settlement? I'll pay it. Put. all that checkbook, write it. And while. you're at it, individuals don't go to. jail anymore. It's corporations, right? So, it's the perfect crime. I mean, you. you you are lionized as a killer on Wall.

Street. Um, you uh are covered by your. corporation, so you individually aren't. prosecuted at all. And when the time. comes to write a check, you can write a. check instead of going to jail. and your. corporation writes it for you and you. keep your beach house. It's beautiful. >> You're the perfect person to be having. this conversation with. In South Africa, we had the state capture commission. >> Yeah. >> Where bas you did you read about it? I. did. >> For those who don't know, it was. >> an inquiry headed by a constitutional. judge who's now retired that was based.

in South Africa to hear about widespread. corruption in the government with. private actors. So who were involved in. in having government contracts that went. on for I think almost two years a. billion rand later not a single. prosecution everyone got away with. everything. But when I was having. conversations with my friends even I. would always say why is it that whenever. we talk about corruption we speak about. the person whose hand is caught in a. cookie jar. So if you and I steal we. make a billion dollars. We still have to.

go buy Ferraris, Maseratis, Lamborghinis. Who's selling us those. cars? We have to go buy mansions. Who's. selling us those mansions? who's. investing our monies, where are those. funds kept, where are we making the. transaction and the withdrawals? And I. always think to myself, I would love to. meet someone who can make me understand. why is it that even when corruption is. thwarted, it doesn't go further than. when people exchange the same money for. goods. >> Those enablers, I mean, there is as one. whistleblower in finance um who.

revealed that a certain bank um Wells. Fargo bought it was um laundering money. for the Sinal Cartel. He said those. enablers, those bankers had their finger. on the trigger every time the Sinaloa. cartel fired up. And that's true. I mean. we cannot look at enablers, bankers, real estate people, corporate f you know. corporate um foundations, all the other folks and make their lives. possible tax advisors, all these. offshore, >> you know, those are fundamental.

>> figures in the crime syndicate and they. are as responsible for every bullet that. hits as the actual person who pulls a. trigger as I would argue that they're. more responsible. I mean, I would argue. that people who do it just for the. money, um, as opposed to a hired killer, I mean, I don't know what that person's. background is. I don't support hired. killing, but somehow it's even more. sinister when you're making a killing by. doing a killing. I mean, those people. are not making a lot of money, right? >> The hit men and women of this world in.

the food chain. >> Yeah. They're just tools in the hands of. these other people. But we we admire the. lawyers, the white shoe lawyers and the. and the big bankers and so on. We admire. them. and they get their names written. on, you know, New York Public Library. All sorts of very special perks for. them. >> You know what's what's what's amazing? Even when we think about our thinking of. it, it's amazing that if you shoot. somebody in the street or if you rob. somebody or if you shoplift one of. those, you have committed a crime, you. are a criminal. But if you defraud.

millions of people's pensions, if you. get millions of people addicted to. opioids and, you know, now they're. having overdoses, etc., This is white. collar crime. It's amazing that we've. given crime a different name. But why? >> Do you know what I mean? Why is it a No, no, this is a white [clears throat]. collar crime. We've almost we've almost. given it a a respectability that it. doesn't deserve. It's like. >> what kind of color do the people who. define it wear? They wear white collars. They're judges. They're lawyers. They're. the folks who are making these rules, right? I mean, you know, they are the.

people who see this. They see someone. bursting into their house and and shoot. and robbing them or shooting things as a. major threat. They do not see um someone. who is defrauding a pension fund and. having, you know, elderly uh teachers. eat dog food for the rest of their. lives, which is something that happens. >> Yeah. >> Um they don't see that as a problem. These they're not elderly teachers. They. don't see they don't see at the at the. ultimate. >> analysis, they don't see the common good. as a major concern. >> They just don't. It's a dog eat dog. world. It's an Einran world.

>> and it's um I win, you lose. That's it. And that's ultimately why the heroes of. of finance, the heroes of the law and so. on are so clubbish and so in agreement. um along with the judges when it comes. to defining the social damage by certain. kinds of crime. And as you said, white. collar crime causes infinitely more. damage and just erosion of trust, erosion of respect, erosion of this. social fabric than any blue collar.

crime. People don't realize how much the. things they're experiencing in the world. every single day are a byproduct of. those crimes. And while we'll never dismiss a murder. or a robbery, those crimes have far less. of a ripple effect out into the world. Do do you know what I mean? So when when. you see your town dilapidated, when you. see your parents sick or a family member. who is dying and can't get treatment, when when you see your your your.

retirement fund disappear, when you. those types of things have such a. widespread effect, >> you know what I mean? They're more. likely to create more of the thing. >> Yes. >> that you don't want to see. And and it's. it's it's so crazy to see this. I I I. actually wonder like how you had this. because your your life is really it. almost feels like a series of trap doors. when I think of your life. You know, you. you're studying history and then you. fall down this trap door and then all of. a sudden you're in London, you fall down. a trap door and then at some point you. were studying music, >> you know, and then it's like you you. fall down another trap door, another.

trap door and then you stumble into this. world that honestly I think everyone. should be grateful for. And for me it. was like, you know, when you're writing. about the corruption in the olive oil. industry, which seems like a such a like. light topic, you know. So, so when I saw. that, I was like, huh, corruption in. olive oil. Well, this is like a a cute. world to be in, you know, but you expose. so many of the layers. And then your. next book, you talk about whistleblowers. >> and and and and the the role they play. in society and how we don't protect them.

enough and what they've done to expose. what we're experiencing. >> And man, I feel like your latest book, I. hate to say it, is more and more. applicable every single day, >> right? you know how to make a killing in. healthcare in America is like. you know you look at all the stories. that popped up the Luigi Manion story. you know you you you look at people you. know going on strike or rioting in. certain parts of the world you look at.

because they're losing their health. benefits you look at people just losing. faith. >> in the societies that they live in in. the system. >> and when I read your book I went this I. you didn't just critique it. You you you. break it down on the on on the like the. most minute levels. And I wanted to know. like why you started with diialysis. because that's that's like the you know. the the the real crux of your book, but. it exposes everything. You you went you.

go into diialysis. Why why that topic? Help me understand. >> Yeah. Well, I as you mentioned, I wrote. a book about whistleblowing and I was. interviewing a bunch of different. whistleblower classes. So there's, you. know, the big pharma whistleblowers and. the uh defense contractor. whistleblowers, the big bank. whistleblowers, all these and there's. this weird outlier. >> um dialysis whistleblowers, the finance. people in dialysis who were. >> who were bringing false claims suits, whistleblower lawsuits against the big. diialysis companies. I'm like, what's. going on here? And they were the. dialysis companies were signing $4.

and500 million uh settlements at a pop. Their stock price was going through the. roof. Uh Warren Buffett owned 40% of one. of them. And I'm like, "Okay, what's. going on here?" My my bank inner banker. was like, "Bing [laughter] bing bing.". The board is all bells are going off. Yeah. What is going on here? And so I. looked into um well, first I started. with the finance people. Then I worked. my way back into nefologists, kidney. doctors who were working for these. companies and then gradually back down. to the blood floor where diialysis is.

actually delivered. >> And that's when I realized this is not a. chapter in a whistleblower book. This is. its own book. Cuz as you said, Trevor, I. mean, it is it is a perfect microcosm. [clears throat] of what can go horribly. wrong when you put profits before. patient care. >> It's also a terrible story of of how a. miracle can be turned into a curse, >> right? Because you look at when this. technology is invented, you know, and I. only learned this from your book. It's. not like I knew this before reading the. book. >> I didn't either. >> You look at this world where it's like. diialysis is this miracle. Yeah.

>> It's like, wow, we've invented this way. to basically, you know, >> Yeah. an external mechanical kidney. What What have we done? >> Yeah. >> And in such a short amount of time, it. goes from miracle to oh no, this is a. curse on people's lives, on their. finances, on their futures, and on their. families. And I was like, when you when you when you stepped into. it, what made it the perfect place to. start? Like what what would people not. understand about diialysis? like they. might be like, "Oh yeah, what what makes.

diialysis so big or or or so unique or. why diialysis versus everything else?". What was it about this spec specific. topic? >> Well, first of all, um as you say, it. was a miracle and it's such a miracle, such a breakthrough, the first. replacement organ uh that it that had. the potential to save millions of lives. Um and it was such a miracle that the US. Congress got involved. I mean, they were. this was 1972, the early '7s, um 1972, the actual law was passed. Congress that. got involved at a time when, and this is. going to take you back, at a time when.

the Republicans, the Democrats, the. insurance companies, the AMA, everybody. had their plan for national health. Yeah. The US was going to have national. health and they viewed dialysis, this. breakthrough um cure which had hit the. news in a way that made it very. difficult for them to ignore. There was. who decides who lives and who dies. There was, you know, Life magazine cover. stories about this. There's um Edward. Newman doing doing um NBC reporting on. it and uh and it's pretty blunt that you.

know the folks who were chosen for the. very few chairs that were available. survived and lived pretty well for. decades and the rest were were dead. I. mean they had no chance at all. They. were condemned to death. So Congress got. involved and they made it the one and. only Medicare for all program in 1972. signed by Richard Nixon. And that is at. a time literally where everyone is. thinking we're going to have national. health. Everybody else, I mean, most. other countries around that same time. adopted national health. >> Australia, which is the [clears throat]. the counterpart that I compare the US to.

a lot in 1972. >> But then Watergate consumed Nixon, the. Vietnam War went ballistic. um you know. uh the OPEC oil embargo, stagflation and. the entire government pivoted from build. a great society to cost cutting. >> and regonomics very soon after. >> and and government government's the. problem not the solution and we've never. looked back. We've never gone back. So. dialysis from a historian's point of. view was a really interesting sort of.

relic of a different era where the. government felt and the people felt the. government had a role in taking care of. human beings. Um that's an important. part of being a citizen is getting. health care. So we once thought. >> Um and then then the dialysis uh the. fascination to me of this treatment. which is done wrong. It's a sort of an. incarceration. I mean you need diialysis. three times a week minimum minimum. minimum three three and a half hours. each treatment. >> Mhm. >> Or you die. >> It's as simple as that.

>> They own you. If if it's a good. organization they are looking out for. you. They're saving your life every. single time. If there it's a bad. organization that's run like Taco Bell, which one of the former CEOs actually. bragged about this is how we're going to. run this company, >> then it they own you. They actually. possess your body. So, it reminded me. one of the lawyers who got in I I have. in order to help a lot of patients who. have contacted me, I've been contacted. by over 3,000 patients and and family. members since this book came out and.

long before. Uh, one of the lawyers who. really got it was a former innocence. project lawyer. So people um in unjustly. incarcerated people on death row, mostly. black and brown. >> And he said, "Oh, I get it." He had just. retired from the Innocence Project. because Illinois had done away with the. death penalty and it was a major success. for him. >> And I and I said, "You got to get. involved with this uh involuntary. discharge from the Dallas of. Facilities." And he said, "I get it. I. get it. You're trying to bring me back. onto death row." Oh,

>> damn. punch in the gut. He suddenly saw. what he meant about this combination of. health care and incarceration. So to. come back to your question, this is ex. let's say one of the most extreme cases. of health care delivery where you need. it and you're going to if you don't get. it, you're going to die. At the same. time, you have to follow the rules that. whatever organization is taking care of. you is laying down or you don't get it. Yeah. And if those and there are good. organizations and there are good. facilities and there are wonderful.

people um. >> and they do a good job about focusing on. the individual and their individual. needs as with all medicine. >> But there are big companies that are. running things on an assembly line. one-sizefits-all basis. And they're. really looking much more at Wall Street. than they are at their individual. patients. I mean they are hedge funds. with an exposure to healthcare. That's. not an overstatement. They are financial. vehicles with exposure to healthcare. How complicit or how complicit is the.

average person who buys stock in. >> Why did you look at me when you said. that? >> That was weird. >> Complicit is ours. Complicit. >> No, it's Tom's world. >> No, no, no. But what you you went. >> How complicit are you? >> The average person. And you [laughter]. looked at me. >> You looked directly at me. >> as if I've bought stock in any of these. complicate a friend of yours who has an. afro. That was really wearing a tan. Ask. you a question and [laughter] look away. from me. Don't be looking at me like. that.

>> Look the other way when you say. >> I have never bought any stock in a. healthy. You look the other way. Don't. Don't do that. >> No, take that back. [laughter]. >> I take it back. [laughter]. >> Do you feel better now? >> People like to wash their hands off of. something that is innately horrible. When people say if there's insider. trading and you give me a tip off and I. put a million dollars in something and I. make a lot of money, but if I put $5.

because my banker said I should and this. company ends up blowing up like it does. and it does the things that you say it. does, how complicit am I? >> Yeah, it's it's an interesting thought. of like how far away do we get the blame. for? because. >> Mhm. >> Yeah. Like do you if I'd expand on on. that, it is it is a difficult question. >> But do you think people know when. they're investing in these companies? Like the average person, do you think. they know what they're investing into? >> No idea. No, I I think they have no clue. what they're investing in. And and the.

all of the signaling, all of the PR um. is about health and wellness and, you. know, thriving united health. just to. take one example. Um but um you know for. me the individual investor you should. probably do your homework because that's. part of your responsibility as a. citizen. >> But the people who are really complicit. to me are people like Warren Buffett. I. mean you own 40% of a company. You have. owned it for a long time. You yourself. have made a killing in this investment.

You should be kicking the tires on. what's going on, right? I think that's. very important and I think people should. be able to call folks on that. Um now he. he might argue that this is a good. investment and what I'm doing is. investing and that is precisely the. argument that there's zero social you. know uh obligation on my part I am an. investor and that's a sort of the a rand. approach right or the you know the. regonomics approach is. ultimately it means that you don't have. a social responsibility and in fact. there's there's an argument that says.

social responsibility in running a. company is actually should be illegal I. Your only legal obligation is to. shareholder value. >> That's another of those insane things. like corporations are people and money. is speech. One of those complete idiotic. insane things. >> Corporations are people. >> Keep this is United Citizens United. Corporations are people as a as a legal. entity. And and their money and any. money is speech. Those are two things. >> Yeah. That's one of the worst decisions. America ever made.

>> It's preposterous. I mean, if you think. about it, what is that's that's crazy. It's crazy talk. But we've been fed it. so many times, you know, with our pablum. that we ultimately say, "Oh, well, it. must be true. I guess those really smart. people are saying it." It's it's not. only is it insane, it's also hugely. damaging because of course then the. corporations with their speech are going. to go in and buy politicians. That's. what our I mean the US campaign system, campaign finance system is illegal in. most countries. Yeah. >> I don't know how it is in South Africa, but a big company can't come and give.

you a million bucks. So ours is you can. in South Africa they they make these big. donations but I was shocked when I first. came to the US. >> I was shocked at how many things are. legal here. >> and just full-on bribery where we're. from and in other parts of the world. it's just like it's just bribery just go. this is bribery. >> half the stories that make the headlines. in South Africa politician got a private. jet flight to this place and was put up. in a hotel for a weekend and went out. for and then spent this much and got and. then you come here and they're like no. no no that's That's lobbying. What are.

you talking about? That's not. >> That's not bribery. >> Speech. Free speech. First amendment. >> Yeah, they're expressing themselves. This poor company needs to speak. >> Are you going to silence the company? >> Oh, poor company. >> We We're going through that actually. right now where officials from our. version of the DMV. >> went to France. >> Oh, yeah. >> To solicit, you know, to hang out and be. on private jets, expensive dinners, expensive gifts with a company that will. print driver's licenses. they have the. exclusive contract essentially for and.

it's it's massive amounts of money but. it's exactly what you're saying and when. you you know when we talk about. complicit I I love that you use that. word because. >> when we talk about somebody like Warren. Buffett I go I will not call Warren. Buffett good or bad or whatever but it. is interesting it is interesting that we. would never accept that excuse. >> let's say from another person if they if. it turned out they funded the Sinaloa. cartel you know if they owned 40% of. Like imagine if you said to somebody, "I.

own 40% of the Sinaloa cartel." They'd. go, "You're a criminal." And you're. like, "No, no, no, no. I just invest in. the Mexican drug cartels. >> I I don't engage in it.". >> They're good in a great investment. >> Rapidly growing, good market share, all. of them. The return on assets is. awesome. >> It's a great But I look, do I condone. everything? Of course I don't. But I'm. not I'm not there for the murder. I'm. just there for the investment. There is. a level of asking yourself like you know. like who if everyone gets to say that. they are not responsible then who is.

responsible. >> Yeah. I think it's also how things are. phrased you know an inquiry an. inquisition a you know white collar. crime corruption bribery it's theft all. of it is just theft and I was asking you. before we started that. >> what is it that makes. people steal? I know what would motivate someone to. tell the truth and blow the whistle. I. can kind of figure it out. You get tired. of how things are. You go, I have to.

make a change. I have to be the change. that I want to see. But in your. research, what makes someone go, here's. a million dollars that's supposed to go. to public good and I'm just going to buy. a nice car and a nice house. >> Well, first of all, um, steal from the. necessity. I'm hungry. I I got to eat. My family has to eat. I get that. Um, I'm not condoning it, but I get it. Um. and and a lot of that is caused by the. white collar crime we were talking about. earlier, right? Um but second of all, if. you ultimately um if you and your peers.

are uh an aggressive corporate culture. and you talk about how you really got to. push things, you really got to go for. the go for the throat, you know, all. these sort of sports/killing. analogies of war. I mean go corporations. as warf fighting machines that's kind of. you know penetrate and and and uh take. you know enemy territory this sort of. thing then you're going to naturally. push hard and you're going to do things. which are potentially illegal but maybe. you know there's this sort of nudge.

nudge wink wink we the compliance. department says we're doing everything. just right and we had a goldplated. compliance department. >> plausible. go on off camera you can do you know but. then there is this there's this worship. of money and the way in which people. keep score in their lives. I mean it's. hard to figure out what when you're. doing the right thing. If you're saying. am I doing the right thing today by uh I. don't know by writing a book by doing a. comedy show by talking. >> it's hard at the end of the day or the.

end of a year to say I've done something. really important. It's easy to count. money. And if you're in that culture. where you say, "Look, look at that. I. got 5 million bucks. That's very. tangible." And now it's [clears throat]. 5.2. And on the and the stock market is. growing, growing. >> The wealthy people that I know, the ones. that have 100 million, they only talk. about the people who have 200 and 300. million. The ones who have 300 million, they talk about the billionaires. The. ones who have a billion, they talk about. the two billion. It's never enough. It's. like the shark that can never get full. And that's where I think that's the.

ultimate problem. It becomes, especially. when the society worships these people. [snorts] and and condones all of their. actions, it becomes this sort of um. endless endless hunt for more uh for. more money at the end of the day. And it. and it's a status thing and it's a but. how can you possibly live? How can you. possibly use even a million dollars, let. alone a billion dollars? I mean, how can. you? It's just it's just a score. It's a. counter for the quality of your life. because the quality of your life, I.

don't know. I mean, again, working in. banking for a brief time. I saw some. amazing people, incredibly smart people. doing incredibly dumb things with their. life, throwing away their time in order. to have a metric ton of money. They. didn't have cars, they didn't travel, they didn't live. Um, but they felt. successful. >> And for me, after two years, I was like, "But you were losers, you guys." I mean, I'm sorry. And now they think I'm sure. that I'm a loser because [laughter] I. don't have any money. Don't go anywhere cuz [music] we got. more what now after this.

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some people might not know his name, but. he was the guy who rose to a little bit. of infamy by um he went to Davos. >> Mhm. And at Davos, he he basically said. to everyone in the room, he's like, "Hey, hey, why is everyone here trying. to solve the problems of the world as if. you are not causing the problems of the. world?" And he said to everyone in that. room, "Just pay your taxes. Everyone. here's avoiding you flew in on private. jets." And you're like, "What should we. do?" He's like, "Pay your taxes." And. then they were like, "Who invited this. guy? Don't invite him back again." But. one of the things he talks about and.

that's what he's working on now is he. said. >> we've created a society a society where. the smartest brightest minds. go into fields where they're just trying. to extract from society. There was there. was a time when the most brilliant. scientist tried to work on the science. that would change the world in the most. positive way. Invent a light bulb, create an aeroplane, find a new type of. health solution. You know what I mean? Yeah. [clears throat].

>> Mathematicians were trying to solve, you know, trying to figure out the. circumference of the globe, whatever. And then they were just like, go to this. company, make as much money as possible, get the trading. [clears throat]. >> But but what you said, I think, is key. It's the reverence. >> You turn on the news and they go, Larry. Ellison, now the richest man in But why? like if society like and and I mean that. on like a a media level, not not the. people on the ground cuz I think the. people are often times sort of not. victim to it but you you you're.

experiencing it. >> If the news tells you that this is good. and important and the media tells you. it's good and important, then you think. it's good and important. >> and not by accident. Half the media is. owned by those very people. If you look. at the oligarchs that are that are. owning, you know, the big news outlets, they're Legion and uh and trying to tell. Jeff Bezos that he really shouldn't be. uh a monopsiny in all, you know, good. sold in the United States, you will not. last very long, right? There is a lot of.

self-editing. So, I think that's no. that's absolutely right. um this. reverence, this sense that they are. gods. And it builds into this sense too. that there is an uber mench society and. then there are underlings and those. underlings if they're, you know, homeless, well, they're not human. really. It's not my problem. I mean, that's the sense that I get. It's. horrible to say, >> but um there are people who the halves. and the have nots have always existed. since ancient Greece, since Rome, since. whenever. This is a sort of an. institutionalized.

um form of of superior being. [clears throat] judged by your you know. net worth and then everybody else is. really expendable. >> To talk about expendable you you you you. can look at one of the examples you give. in the book and and you go through. multiple um multiple hospitals and. health care systems. I I I I was reading about the diialysis. and and and. how each system doss it out. And to what. you're saying in some of these stories,

man, it it it sounded less like. healthcare and more like a fast food. drive-thru chain. It felt like they're. trying to get people on and off a. machine as quickly as possible, use as. few nurses as possible, make as much. time work as possible, look after the. patient for the least possible. And I. went, I mean, I guess this is great if. you're trying to get fries out quickly, >> but these are human beings, you know. what I mean? It it it feels like the. business model isn't it's not about.

health care, it's about health profits, >> 100%. It's fast food medicine and it's a. model that wasn't invented by diialysis. It was invented in the 60s by um by. people who actually um ran Kentucky. Fried Chicken franchises and and Wendy's. >> literally. >> literally who then started buying up. >> um you know started privatizing hospital. systems and putting together. So they. literally were the people with this. branding experience and this mass f you.

know and in theory I mean you know um. Atul Gowande wrote the the Cheesecake. Factory um article in the New Yorker. which got a lot of attention. I I don't. like it but he's a smart guy. He's a. doctor and he the idea of focusing in on. a specific u medical procedure making it. as efficient as possible and delivering. it in as low cost away as possible. That's a potentially a useful idea. The. important thing here is that it not. become um turning patients into widgets.

on an assembly line, which is precisely. what the fast food model uh or the. Cheesecake Factory does. Um you you're. not tailoring your care to the. individual needs of your patient. You. are looking and once again this is a. finance person's view. the person person. who brought this into diialysis or po. popularized it Kent theory he was a. former CEO and the founder of Dvita one. of the two big companies. >> he made his bones at Bane Capital that's. a private equity firm he was a he was a. finance guy the kind of guys that I.

worked with um and he basically and he. said speaking to a business school. audience um he said uh you know if I. were running Taco Bell with I forget the. exact numbers 23,000 outlets and I would. be doing all the same things as I'm. doing. >> no it's not about the patient. is what he said. And some doctors hate. it when I say this. These are quotes, right, from his speech. This. >> is an actual quote. >> Actual quote. Yeah, I can show you the. video. It's quite striking. >> But again, it fits in a business. situation in which you are Wall Street.

facing and you're talking about return. on assets. If you have a 2,000. diialysis clinics around the country and. your main focus is shareholder value and. I'm getting paid in stock as a CEO, so. my shareholder value is pretty important. to me too, right? It's a conflict of. interest on a massive scale. Anyway, if. that's your aim, you want to run as many. patients through every single one of. those facilities as you can because your. asset base, your buildings, your. machines, and so on, the more units you. shoot through them. Yeah. And it is just.

like Taco Bell, except people are not. burritos, right? >> Every single person who goes into that. facility needs should have a a treatment. that is tailored to their individual. problems, their individual biology, their individual size, and everything. And if you're running it as a fast food, you know, assembly line model, you're. not going to do that. >> One fits all. >> One size fits all. And you're going to. penalize the people who slow things. down, who say, "Oh, actually, you know, Tom here, he should be getting five. hours." No way. No way. And they're.

violently pushed back. And the doctors, some of the doctors I've talked with who. work in these facilities are not best. pleased. Uh and some of them some of the. workers um are also suffering from. serious moral harm because they realize. it's like soldiers forced to commit you. know um. >> yeah yeah yeah that's the perfect. analogy actually they're literally they. they know what's wrong and they are not. able to fulfill their hypocratic oath to. their patients and take care of their. patients cuz the structure they're.

working in doesn't permit it. Yeah, I. think that's the perfect analogy because. we take for granted how much an overlord. and a system can then oppress even the. people within it. And then what happens. is in a society, we start fighting. amongst ourselves. >> as if there's not one central thing that. we should be looking at. So you have. leaders and governments who send. soldiers to do things that are. despicable. Those soldiers return home. to their countries. They get spat on in. the streets. The defense company doesn't. get spat on. The people who lied about. weapons of mass destruction, they don't.

get spat on. Do you know what I mean? And the same thing happens here. People. go, "My doctor is trash. My this is. >> But it's when you delve into it, you go. like, "Oh man, my doctor's victimized by. the same system. >> My doctor is called a provider now." Or. even a vendor. I mean, you know, >> he or she is a is a cog in a wheel. And. and again, certain things maybe maybe. burritos should be made that way. I'm. game for that. Um but healthcare and. there are other things. I mean, you. know, are we good with private prison. systems? Are we good with private war.

fighting? Are we good with, you know, there are certain things that should not. be primarily profit facing? >> Yeah. >> And healthcare is one of them. >> But there are a lot of others and we. just in America, we've lost that. discourse. >> When you look at other countries, what. did you find? Because I I think there's. a perspective that you bring in this. book and in your work that I think is. really important because often times. people will go, "Well, I mean, show me a. better way to do and you're like, "Oh, yeah, I can." And you actually go to. other countries [laughter]. and you show a better but but talk us.

through some of that because like. Australia, Japan, like a a wealth of. other wealthy countries. >> show that this is not the normal way. that it needs to be. >> No, precisely. I mean, we've gotten so. caught up in American exceptionalism. that we lose sight of the fact that. there are a lot of places where where. things in general and healthcare in. particular are done a lot better. And. the example and the most brutal example. is how long do patients on diialysis. survive in the US versus other. countries. >> What are the stats? >> They die two to three times faster than.

any other developed world and many. lesser developed countries as well. I. mean, you know, we're talking tw% to 22%. per year death rate, whereas mortality. in in Europe is anywhere 12 to 15%. Um, and more on the 12 side. Japan 6%. I. mean, we're talking the most and that's. and that's just how soon do you die? Quality of life is another big issue. But I mean the the the central premise.

that everything has to be for profit um. is is preposterous because every other. country in the world does it better does. it cheaper. I mean the basic prem. promise of the regonomics era and ever. since is we will do it better because. government's the problem and we will do. it cheaper because we are so efficient. Now in in America we do it worse and we. do it vastly more expensively at the. same time. So something's rotten in the. state of Denmark and not Denmark. [laughter]. You know what I'm talking about.

>> Yeah, I know exactly. And. [clears throat] you have so in most. countries you have you have the Fisk, you have the Treasury that collects. taxpayer dollars and you have I don't. know patients um in hospitals where. patients go and and the money goes from. the treasury boop boop to the hospitals. pays the doctors, pays the staff and. gets and pays for the treatments. In. America, you have the treasury and you. have the hospitals and in the or the. diialysis facilities in this case in the. middle you have these twin towers or. [clears throat] of of massive corporate.

you know absorption. Um you talk about. um middleman and the cost to healthcare. This is a classic example. You have. these two twin towers that are that are. soaking up a lot of the billions and. billions. We're talking roughly. >> I wouldn't do twin towers in the hands. like that. It might be the It looks like. the wrong thing. You were using towels. and you used hands and I was like. palm wrong hands. Different analogy. Different analogy. Let's go with.

something. >> Two large. >> Yeah. Two large. You know what? Two. sinkholes. Sink holes. That's better. Two sink holes. >> Sucking everything in. That's way. better. Looks nothing to your hands did. this. And yo man, we we from another. country, Tom. Don't be doing that to us. Yeah. [laughter] Yeah. We. >> Look at the calendar man. Look at the. calendar. What was yesterday? Yeah. No, no, no. That you're absolutely right. These are the twin sink holes of of of. money absorption and the money goes into. the sinkhole and not so much comes out.

And this is again this is not unique to. dialysis. It's particularly. >> for in my view obscene in diialysis, but. it happens. You know what what is United. Healthc Care's model? It's to take as. much money as they can and give as. little as they can away. That's it. And. the rest goes into the sinkhole. >> I feel like it's the Rosetta Stone of. healthcare. And that's what you've. you've shown us with the diialysis model. is you've gone let me show you this. example, show it to you so clearly that. you can then understand every different. language of what's going wrong in.

American healthcare and how to actually. look at it. You know what I mean? And. and when you when you look at these. other countries, >> what would you say is the biggest thing. like just on on one level that they're. doing differently? I mean I can. understand the government is paying and. you know it's a different but what would. you say is like something that they're. they're practically doing differently. than in the US? Well, they're following. universally accepted medical guidelines. which have to do with how long, how. gently you treat, uh, at what what. values you treat. Do you do it at home. or not? I mean, if you look at.

Australia, the majority of of they push. patients to home diialysis. Wow. >> And ever since the 1960s, ever since. this miracle cure was invented, the. people who are not trying to make money. off of it said home diialysis is the way. to go. You get to control your destiny. you get a feeling of I mean in any. chronic disease a sense of agency is. critical to getting well or to feeling. better right and being a passive. recipient of care lie down put your arm. out I'm going to take your blood I've. heard this I've heard patients tell me. this from you know in in dialsis.

facilities you need to have control of. your destiny and doing that at home is. the way to do it also again you can. tailor your care to and it's doable so. Australia pushes people home um but just. a fa that is another of the fundamental, widely, universally accepted laws of. diialysis is being broken in the United. States. It's being broken because it's, you know, there are companies that make. a lot more money doing it elsewhere, but. it's also being broken because CMS, well, the health um health and human.

services doesn't enforce best practices. on their, you know, I I I beat up in my. book, I beat up a lot on corporations. I. think they deserve it. But I didn't give. sufficient time to the silent partner in. the crime and that is the CMS. That is. the National Health Administration in. America that is simply in bed with or. complicit with or toothless to do. anything about major corporate u. wrongdoing in.

>> what is what is CMS? >> Uh it's the Center for Medicare and. Medicaid Services. So it's the ones that. administer Medicare and Medicaid funds. >> and they know what good diialysis is. They know what the metrics are. They're. just not counting them. So they don't. count treatment time. They don't. penalize people who don't treat longer. than and they don't count um UFR ultra. ultrailtration rate which is the speed. with which you remove liquid from. someone's blood and their body um which. are critical to survival. >> Yeah.

>> They don't count those things like that. What are you counting exactly? They. don't count uh septasemia which is you. know one of the major causes of death. What if you're not counting that. What are you counting? I mean you know. it's putting the ladder up against the. wrong wall. >> Yeah. But the question is who's telling. them what to count and how to count? >> I guarantee you the answer is the. revolving door. I mean I in my book I I. I I cite several examples of people from. the White House who have gone to the. board of of the big pharma big.

>> same thingis companies and vice versa. people from you know from the from from. um the boardrooms of the big healthcare. companies that go straight into. government and are making these policies. and I cite examples of ways in which the. policies got softer when these people. arrived. I wonder why that is. And. again, it's the notion that, you know, a. corporation is going to do it better. because we've been penetrated and taken. over by this mentality to this point. where we don't even recognize that there. is common good anymore. It's just let's.

grab as much as you can before you know. while it's your turn to eat. >> You know why the they've done a great. job of tricking us. You know, it's it's. one of the greatest scams that has ever. been pulled on people collectively. What. they did was governments were providing. a good. It doesn't mean that they were. perfect, but the good was being provided. by the governments. In this case, it's. the 1970s when Medicare says they're. going to cover diialysis. This is. revolutionary. You have this problem. with your kidneys, they're going to come.

in, the machine will be there, the. government is going to help you out, and. because you can amatize the cost across. a population, it will work. It will. work. >> And then very quickly, companies who see. a gap go, "Wait, wait, wait. if the. government's paying for it, we can get. that money. And then they go, if we can. get that money, how do we get more of. that money? And then they become part of. the cycle. It's so crazy how you see. this in every country, whether it's the. UK, whether it's South Africa, whether. it's the United States, wherever you're. having these issues.

>> The people who work in government work. with the companies to make the. government look inept. >> Yeah. >> The people on the ground then go, "The. government is terrible. We should give. this to the private companies. The. private companies then take the work and. then they provide a professional. ineptness. that not only doesn't do the job as. well, but it extracts more wealth. So. it's like before the government was. going to be maybe not great. >> Yeah. >> But they weren't going to be as. expensive and now you're getting a.

thing for an expensive price. >> Yeah. >> But you then hate the government. You go. the government doesn't do anything. It's. like Yeah. And the companies that made. that happen are the reason you keep it's. it's such it's such a penicious cycle. >> conjob and exactly and and the. government does become people in America. oh big government that's really bad. I. mean you look at the the Pentagon. trillion dollar and that is a bunch of. sock puppets. I mean, they have Loheed. Martin up their butt with their hands. going like this, right? You [laughter]. know, I mean, and you see the revolving. door between the generals who go on to.

Loheed's board and I'm just picking. Loheed even Rathon, you name it, they've. got it. >> The whole outsourcing government. contracting thing is such a scam. It. corporatizes and at the same time is. able, as you say, to to to push the. blame onto onto government, big. government, which never gets it right. And talk about socialism. I mean, you. look at war fighting in America, a. trillion dollars a year to the to the. Pentagon. >> Trillion dollars a year. >> Trillion. That's That's socialism, right? Oh, no, no, it can't be cuz it's. America. Sorry, my my bad. >> Yeah. And cuz it's war.

>> It's war. >> It's because it's war. It's like It's. amazing how war Yeah. War is always the. thing where people are like, "The. government shouldn't be smaller there.". >> You're like, "Why why shouldn't the. government be smaller there? >> We cut everything else but 10% raise for. smaller government." And he's like, "Except for war." Oh, war. I mean, >> and how successful have our wars been. recently at producing security, a. national defense? >> Not so much, actually. You know, if you. think about it more important, >> but I don't want to think about it. Sorry. I want. >> more importantly, this is the question I. often ask people as I go.

>> You are so comfortable accepting the. premise that America's job is to go out. and fight wars. Why? To protect. Americans. That's what you say, right? We are willing to spend trillions of. dollars to go out into the world to. protect America. Why wouldn't you spend. trillions inside the country to protect. America? If Americans are dying from. kidneys, diialysis machines that are too. expensive, health care that's not being. provided, you know, food on a basic.

level, that's a war that you could be. fighting in your country without bombing. anybody. And that's exactly the the. reason in the 1970s a number of people, this is during the, you know, the the. Cold War, the coldest part of the Cold. War and the fight against Russia and. everything else. And yet at the same. time, um, bipartisan congressional. figures, Republicans and Democrats, are. saying we're spending billions back when. a billion was a big number, billions to. build these rockets, and we can't even. take care of our own citizens. And they.

were pushing for diialysis in that in. that way. And the other thing about war. is of course and and the trillion dollar. Pentagon is that you know as as one. former general told me when you get to. be a big hammer everything starts. looking like a nail right I mean we got. to go out there and I built all this. cool stuffed highly trained in doing. this stuff we got to find a way to use. it. >> and we have to get rid of it. >> cuz we have to make more inventory. that's right that's [snorts] right. there's this new stuff coming on. >> and some of it gets lost in these. smaller third world countries don't even.

get me started on It it it's almost like. what you guys are explaining to me. It's. almost like a shepherd. >> that is not tending to the flock, but is. out there hunting for wolves. >> That's a perfect analogy, actually. >> Good. >> Yeah, >> that's the perfect analogy. >> Yeah, the wolves are taking over in the. in the shepherd's room. Like wolves are. cooking dinner and [laughter]. >> having lamb. Okay, you can shepherd, you. know, you can set this one out. We'll. take care of you. You want to you want. to do something about that wolf? Whoa, whoa, [laughter] whoa. Wolves have their. rights, too, you know. These poor you do.

do you know how the wolf feels about the. sheep? [laughter] You're the shepherd. though. Oh yeah. Yeah. Yeah. But I mean. come [snorts] on. >> You know that's that's you you know when. when you when you think of it like. >> Yikes, >> man. It's scary because you see this. moving into everything. >> Yeah. >> People wonder why things are getting. shittier and shittier in everything. >> Yeah. And when I looked at this diialysis. story, I couldn't help but think of the.

analogy of it's almost what what these. healthcare companies did. >> would be the equivalent of car companies. realizing the value of a seat belt. >> Yeah. >> And then going, we're going to charge. you every time you need to put it on. >> And now you have to gamble with your. life and go, >> do I. can I afford it? Can I not afford it? But you shouldn't. This shouldn't be a. choice. >> We know that you need the seat belt. put. it on and I was like but but can I can. they're like oh do you want to do you. want to play with your life and they. know because to your point it's it's a.

duopoly it's what two companies is it. still two companies. >> the two major companies own and control. 80% of the market. >> yeah but I mean that's a duopoly that's. like you you control everything no one. can push you around and then what and. because it's your life that's the. craziest thing. >> I think corporations realize one thing. the minute as society we said there are. no holy cows or sacred cows they thought. to themselves we will leave no sacred. spaces. >> they've moved into organized sport. >> Yeah, you're not wrong. >> Yeah, you're buying the the soccer. jersey. You're coming to the matches.

>> They're paying your hero. They're. controlling their life. >> Religion, they've [clears throat] made. them miserable. So, they've made us all. complicit. And I I worry a lot when I. whenever I watch big organized sports. >> I'm like, >> the fact that people who love that sport. assume that 90% of it is natural talent. always amazes me. It's like when people. have that debate thinking before. steroids were illegal in sport, how. great was sport? >> And I'm like, no, no. Before. corporations were involved in sport, how. fair was sport, >> right? Exactly. And the money aspect,

again, you see sports betting now. And. to me, that is another thing where it's. like the stock market versus the real. economy. I mean, when you're putting a. bet on something, you debase it. inherently. And your focus again turns. from the activity on the field to. >> outcome. >> outcome. And you can have derivatives. that are bets on bets. And that this is. all stock market stuff. This is a way in. which you think if you're not really. engaging with the real world. And not. only is it not helpful to what's going. on in the field or what you're eating or. what your healthcare, it's diametrically.

opposed. If you focus all your energies. on making it into a money-making. operation and betting on it, you're. actually taking the energy away and the. resources and the and the intelligent. people and all the things who should be. saying, "How do we make a better. dialysis machine?" There hasn't been a. better diialysis freaking machine in the. in 40 years because Tom Oh, no. Absolutely. There have been tiny little. adjustments there, but there's no been. no phase shift major breakthrough. Why. is that? Because there's no freaking. money in it. These two corporation, big.

corporations before them there were. others have have locked in the market. They have their cash cow and they're. milking it relentlessly. They're not. interested in a new milking machine. >> They're not interested in the cow. >> Yeah. You know what I've realized as. well with I don't know how it is in this. country but in South Africa when you get. life cover now you're not obligated to. take an HIV test. >> where else before you were obligated to. take an HIV test if they're going to. ensure you for a certain amount of. money. >> So you'd have to [clears throat] test or. they have to know what your lifespan is. what your CD4 cell count is. But right.

now they're like no just bring it and. then we'll we'll see when we get there. So, I'm like, was HIV always that. dangerous to the body and your. longevity? Or they found a way to not. profit from you having HIV anymore? Do. you know what I'm saying? >> I wonder which one it'll be, though. >> Because remember that before there was. no home testing? >> Yeah. Yeah. Yeah. >> So, they would have to send you to a. facility. Then you get. >> But I'm saying I wonder which one it is. cuz my brain goes, which one is it? Have. they found a way to derisk it or have. they found a loophole on the other side? I'm saying I don't know which one it is. It's just interesting when I hear that.

I go like, "Huh, I wonder what changed.". Do you know what I'm saying? >> Yeah. Yeah. >> Like like like what switches in a system. that changes something? How do we look. at it differently? I I even think of man. that can I tell you there were parts of. your book where I was just like I have. to just meet this person cuz no there's. there's books and there's thinkers that. you encounter in life where you go who. is this person and how are they so. magical in in the way they approach. things? >> Absolutely. >> Or crazy. >> because [laughter] nobody crazy in a. good way. >> Takes naps. >> Yeah. We at noon. [laughter].

>> He's a noon napper. >> He's a noonapper. But like there's there's a part of the. book where man I was I was so impressed. and like just like taken by. >> how you stitched together even civil. rights in in American healthcare and the. way we think about how it's doled out to. not doled out because you see again I I. didn't know and I would have never known. >> how you can trace diialysis and Medicare. and who gets treatment and who doesn't. get treatment.

>> back to segregation and desegregation in. the United States. No, literally. I mean. talk a little bit about that because. it's it's that blew my mind. I was just. like ah man we've we we really have to. think holistically and sometimes I don't. think our brains are big enough. >> No I yeah it one of the most shocking. things in my research for this book was. the way in which dialysis impact. um impacts disproportionately black and. brown communities. Um, if you're black. in America, you're 13% of the. population, but you're 35% of the um,

endstage renal disease or kidney failure. population. You're four times more. likely to get diialysis than if you're. white. >> And and it's this death by zip code. redlinining, you know, that that I've. gradually begun to see. I mean, diialysis is a perfect map for it, but. there are many other uh, diseases. the, you know, the incidents of of. hypertension, diabetes, um, and and. obesity. The way in which these. communities historically the wrong side. of the tracks, and I mean that literally.

I'm working in, um, I'm working in South. Chicago, um, where there's a disparity. in life uh, in in longevity in between. north and south Chicago. >> in the same. >> 30 years in the same city. 30 years. If. you're in North Chicago, the wealthy. areas, you live 30 years longer. 30.1. years longer than in South Chicago. >> Insane. >> It is insane. It is utterly utterly. unacceptable. And it has been going on. I mean, as one um Mel Hunford, one of my.

great um diialysis nurses who was. formerly an LAPD officer, as he said, it's got Jim Crow written all over it. Yeah. This is absolutely if you look at. the maps of the impact of of dialysis on. communities and that's kind of what I'm. doing now this book I couldn't walk away. from the book is usually with it with. with books um you know I I write it I. care about it but six months before it. comes out I'm thinking what what's next. I don't have any next this is next um so.

I've gotten together with um folks at. the um at the new school the Institute. for Race Power and Political Economy. and we're doing some research on on. these areas in in Chicago, South. Chicago, and East LA, um, Boil Heights, where the impact of diialysis is. disproportionate. Try to understand not. just on on individuals what bad. diialysis does, but what does it do to a. community? How do they start to see.

diialysis is sort of a part of their. life's arc? Like, you'll end up in the. chair. grand did, my uncle did, my kids. are coming with me now to my treatments. They'll probably end up I mean it's just. nightmarish and especially when there. are solutions that are in hand that are. and you know again every other country. does it better but there are very. straightforward solutions to prevent. this from happening in the first place. So come back to your question. I mean. the it is absolutely dialysis in America. is absolutely perfect.

um radiograph CT scan of what's wrong. with racialized structural racism in. America. It is it is the poster child of. what can go wrong. Um and it is for me. it's been quite a I mean a kind of a. rediscovery of what America is. I'm. going to places I haven't spent a lot of. time in. >> I can imagine. And uh and I understand. what the wrong side of the tracks means. now. I mean, in Chicago, you literally. walk underneath the tracks and you're in. a different world.

Everyone's a different color. Yeah. I. mean, you literally in the space of it's. the most segregated city in the in the. country, but many many many areas are. like that. And uh. >> it's an Yeah. I'm rediscovering my. homeland in a way that uh is deeply. deeply disturbing. We had an episode. where we spoke to. one of one of the most interesting. people we've spoken to in South Afghan. and we spoke about the remnants of. apartate and what [clears throat] what. what people who say it's been 30 years. it's time to move on now. >> and I said what the genius of that.

system was was to ensure that the. longevity or the quality of life of a. black person for generations will not be. the same as the life quality of a white. person. Yeah. >> Malnutrition within the black community. [sighs and gasps] is such a. healthy question. And what I did one day. with a friend of mine is we drove to two. schools. We drove to. >> a very private school, wealthy, black.

and white children. Then we went to a. township school with only black children. >> and we took a photo, [snorts]. >> right, that we just said, "You take this. photo, take this photo." And we compared. the photos at the end of the day and we. saw the sizes of the kids. >> Yeah. >> That's heartbreing. >> And they were not even 40 minutes apart. from each other, >> right? >> What they ate, what they did. You even. see it when they do, they've even. stopped doing it now in South Africa. >> where they do inter schools. >> Oh, >> they never mix now schools that are. doing well with schools that are not. doing so well.

>> in doing sport because it becomes so. glaringly obvious that there's size. differences, that there's nutrition. differences, and also there's. concentration differences. I mean the. cues that will come up. I was when I was. growing up, they took us into this rugby. clinic at one of the biggest stadiums. It was um a program by the rugby club. The one thing that happened when all the. township buses landed at the stadium or. arrived at the stadium is all the. township kids went to go queue for food. >> That's the first [clears throat] thing. they did. >> First thing we we did, not they I was.

part of the the kids that were in the. bus from the township school. >> That's was one of the first things that. we did. was we left where we were and. the first thing we were like we're going. to eat something because clearly it's. not going to be where we come from. And. I'm thinking to myself, >> hunger and malnutrition as a government. as a as a government agenda as a weapon. Yeah. >> Of oppression. And no, no one ever talks. about that. And I always think whenever. big companies expand and whenever. corruption is going to take place, you. can always see by how much hope they. give to people about how many of them.

they'll employ. >> Yeah. >> Yeah. That's right. >> They love that. >> Yeah. bringing bringing this many jobs. bringing Oh, they love that. >> Love the mining companies to do that. >> They love this. Yeah. Aren't they. [laughter] great? >> Oh, no. They love that. >> Yes. Yes. In South Africa now they're. trying to clamp down on illegal mining, but they've discovered that the billions. of rands in illegal gold lands in the. mainstream. >> Yeah. Because because the gold needs to. be sold into a market that is. formalized. So, at the end of the day, it it it all comes back. >> back to the enablers. >> Yeah. It it all it all comes back in a.

loop. And that's that's why and I I'm. glad you really they deserve. >> that's why whistleblowers are so. important. >> Like you I mean I know you've got a. whole book on it, but. >> without these people you just don't. know. >> No. Exactly. >> You you literally just don't know. Without a whistleblower in FIFA, without. a whistleblower in the banking system, without a whistleblower in the. healthcare industry, without a. whistleblower in the defense. contractors, without a whistleblower, you just wouldn't know. And it's. fascinating to see the the.

organizational reaction to a. whistleblower. It's like this immune. response. The tea cells go out there. They start I mean people lose their. minds. They're so angry and so. frightened because at the end of the. day, what you said is exactly right that. those whistleblowers really do have the. kryptonite. >> Yeah. >> The question is whether they'll be able. to give the kryptonite to someone and. can use it before they are rubbed out. literally or figuratively. But it is a really interesting sort of. organizational people just perfectly. sane professional people.

when a whistleblower stands up in their. in their in their. >> but the you are making me realize. there's so much power in words and. phrasing. You started with a with white. collar crime and now you even speaking. about whistleblowers. When it's. corporate it's whistleblowing. >> Yeah. >> When it's violent crimes it's a. >> witness. It's no besides it's not a. witness. It's a it's an informant. >> The person is bringing information. >> That's interesting. That could. ultimately lead to something. But when. I'm telling the truth about how many.

people are losing lives AND HOW MUCH. MONEY, WHAT ARE YOU DOING? WHY ARE YOU. BLOWING? [laughter] Who still blows a. whistle? But information is timeless. >> But whistleblowing also makes makes it. feel like you shouldn't be doing it in. the first place. >> It has an annoying connotation to it if. you find a whistle. You have to have it. [laughter]. Whistleblower. You're a snitch. It's got. a snitchy sort of whistleblower. Why are. you blowing it? Why is everyone keeping. their whistles quiet? And there's and. there's always in whistleblowing there's. never plurality. >> No, no, no. That's right. The individual. >> will stand. Yes. It's always this.

shunned person who will generate as much. noise as possible. >> Edward Snowden. Yes. But if you get rid. of them, you almost feel like you've. gotten rid of the problem. Yeah. >> Right. >> Exactly. And that's exactly it. If you. can't deal with a message, kill a. messenger. I mean that is literally the. way in which you the reason why there's. a scorched earth approach to. whistleblowing is literally they can't. deal with the message quite often you. know corporate informer will say there's. a trillion dollars in fraud here or. they've been dumping arsenic into the. water or the bopal or whatever and so. you can't actually say well actually not.

so much or not too many people were died. they you go after the messenger you. totally destroy their credibility you. destroy them financially you destroy. their h their home life you destabilize. them psychologically and all of a sudden. there's kind of a quirk or a disgruntled. person, you can dismiss them. So that's. the way uh you can't when you can't. actually face the facts and say actually. no, he's wrong on this and this and this. point and we can prove it because you. can't because the person is right, the. whistleblower is right, you just destroy. their credibility and it goes away and.

say, you know, a disgruntled employee, you know, someone who's deeply or or. just psychologically not stable. >> Yeah. But what what they don't realize. is they can only kill the messengers for. so long and then at some point as we saw. with Luigi Manion, society turns around. and goes, >> "All right, I guess I'm also going to. make my own rules." I'm not saying Luigi. did or didn't do it. Disclaimer. I'm. just saying like we saw in that trial. and that case. >> Yeah. >> Someone said, you know what, I I don't.

agree with this and I realize that I. cannot beat you in the game because you. have created the rules. >> precisely. So I will then play my game. by a different set of rules. >> Precisely. >> And you know, one of the reasons I think. it's so important, >> we have these conversations, I try and. talk to as many great authors as. possible, particularly people who who. have done like all the real research. I. always say this to Eugene. One of the. things that that I hate the most is how. people will say something, they'll go. like, I'm going to do my own research. And I'm like, no, you're not. [laughter]. >> You're not going to do your own.

research. You are going to go read an. article that either affirms what you. think someone's research. >> Yeah. You're going to go read someone's. You're not going to go do the research. And yes, you can argue on a semantic. level. Yeah. On a semantic level, you. can be like, "But that is re." No, no, no, no, no. Effort. >> Yeah. I like to read the the work of. people who have done the work. Do you. get what I'm saying? And that is how we. should acquire knowledge in life. I. don't think every one of us should go. and test the principles of Newton to. actually apply them in our lives. We can. apply those same accumulative process.

Exactly. >> You know what I mean? But but [laughter]. you know, but when I when I when I look. at that situation where the United. Healthcare CEO shot and then even that. that story that was like a weird one, you know, the the the gunman in. Manhattan went into that tower. >> Oh yes. and then shot and then they said. like they said they they were there to. shoot the NFL person, >> but then they shot uh a person who was. in um I think they were a CEO or or they. they headed up a division that was. specifically tasked with housing.

>> Oh, >> but I think and everyone was like, "Oh, wait, wait, wait. This is weird. You're. saying they went there to shoot someone. in the NFL?" Yes. >> But they shot somebody who a lot of. people don't like. Yes. Did they shoot. anyone else? Not really. >> And you sure they were going for that? >> Coincidence? >> Yeah. And you're like, "Wait.". >> And and what I found most interesting is. just after the Luigi Manion story, >> what I found most interesting, and I'm. not naive about this, is how the news. and how these healthcare CEOs and all. CEOs and came out on TV and they're.

like, I why would people be celebrating. this? Why? Why? Then I was like, wait, wait. >> I'm not condoning any of this, >> but you're shocked. >> You You really don't know why people are. cheering for this? You're really going. to act like you don't know why people. are cheering for this. >> Exactly. >> But the reason I think we need to keep. having these conversations, I'll talk to. an author who's written a book 10 years. ago, 20 years ago, like Robert Putnham. we had. I was like, >> because the thing about the book is it. expands.

It dives deep. It gives you concrete. understandings of what the situation is. >> It's not glamorous. >> It's not glossy. It's not quick. It's. not snappy. It doesn't catch you really. quickly, but what it what when you're. done reading it, you really really. really understand. >> And I I I I wonder if like it's a little. frustrating for you. You go into this. process, you write this whole book, you. do this whole thing. You see a moment. like Luigi Manion. Everyone was in on. like everyone's like healthcare let me. tell you what's wrong with them and let. me tell and then Shien was selling.

t-shirts of Luigi Manion's face and then. there's like a movie Emma Stone's going. to be doing a movie about Luigi and then. it just trickles out and then and then. you just see new headlines healthare. United Healthcare buying this United. Healthcare announcing that cutting these. jobs expanding on this merging with that. and you go huh. it's like people enjoy the flash of the. moment but not what the moment actually. meant like how how do you keep yourself. going desp I'm assuming you might be but. but I maybe I'm wrong.

>> No, no, it's deeply frustrating and and. to see something with a sort of a lot of. PR um potential um an an opportunity a. crisis gone wasted um because you. haven't changed the structure. You you. haven't basically asked the fundamental. question. >> Number one, are you really serious that. you don't understand the outrage and the. anger and the sense of of of. powerlessness. >> and and number two, are we really going. to make sure that something called. United Healthcare is primarily focused.

on health and not primarily focused on. their you know share price? We haven't. done anything about that. We haven't. gone upstream and said is capitalism. indeed the best way to organize our. society or better is profit motive the. only way we should be focusing on our. healthcare industry is it is really an. industry you know these are bigger. questions that never get raised and I I. had my own sort of Luigi mania moment I. was corresponding with I since my book. came out I have had con countless um.

contacts from people in the industry and. one of them was a young nefologist. ologist uh Dr. Andrea Buoua who um was. very is and was very very frustrated. about the um about the misuse of. diialysis by certain nefologists. [clears throat]. that he named um and um he sent me a lot. of data. He he showed me um he has a. website as a matter of fact um. kidney.com. >> um which alleges the use of certain.

drugs to knock out um people's kidneys. so they will be on diialysis sooner all. sorts of stuff like that and he he wrote. we corresponded um for 3 months um until. January of this year and then 3 days. after his last email which were. datafilled really thoughtful he gets in. a car he drives from Miami to Terode. Indiana he jumps. allegedly attempts to murder one of the. nefologists. >> Wow. >> That he had mentioned in his emails. Um.

and were and was mentioned in other. lawsuits. Now I of course when I heard. this I was horrified. Um and I went. through those emails a million times. saying what could I have seen this. coming? Could I miss? They were the. absolute picture of datadriven. thoughtful measured. But at the very end of one of the last. ones, he said, "I just can't see a way. to make this stop. I can't find a way to. make change." And you know, it's a. horrifying thing to uh to to to be in.

the middle of it. But I think that that. sense as you said Trevor of pointless of. sense of hopelessness and of. powerlessness to stop um and just the. just the obscenity of a situation of the. Luigi Mjon situation where you have one. person who apparently allegedly murdered. another. Luigi murdered Brian Thompson, but you have Brian Thompson who has been. making a very successful career on in. part denying care um to people who claim.

their whose doctors claim they need it. Now, I don't know about you, but until. we can talk about that second group of. people making an enormous am making a. killing as they say in the on denying. care as a form of taking people's lives. If we can't say it out loud, >> yeah, >> we're not going to get anywhere. >> Yeah, >> we're not going to ever get anywhere. And if we can't say it out loud that. making money doing that makes it worse,

>> we're really not going to get anywhere. And money may not be the root of all. evil or love of money, but it's a pretty. good proxy until you find it. And we. really need to get off the money drug. somehow. find a way to to reorganize our. view of how life should be led so that. money isn't the number one thing and. those folks can't come on and say I'm. shocked shocked I can never condone. violent acts against but yes you have. two people and how many again how many. people has the major healthcare.

>> um CEO um accounted for in his long. career. >> yeah but it's it's that old line right. um if you owe the bank $1,000 it's your. problem. If you owe the bank a billion. dollars, it's the bank's problem. If you. do something on a big enough scale, >> I was thinking of Voltater, the you. know, murder to the sound of trumpets. thou by the thousands is called is good. One murder is not unacceptable. >> Yeah. There's a there's a weird thing. that happens in society where if you get. the scale great enough, >> it's somehow not seen as the same issue.

multiplied when when in fact. >> it is. Stalin of one murder is a. tragedy. A million is a statistic. >> Yes. Exactly. But that's that's exactly. what it is. And and and to your point, accountability is also doled out. differently, right? Because if Luigi, >> there it is. >> Yeah. If Luigi Manion is found guilty, he's gone gone for gone for gone. Like. life, death, what? Like gone gone, right? >> Not if when healthcare CEOs and their. companies are found guilty,

>> there's no life sentence, right? >> There's no death sentence. >> There's barely even a financial. sentence, right? The last I checked, the. Sackler family, who are responsible for. more deaths in the US than most criminal. organizations. >> than all criminal organizations. >> They're still out there. Think about how. many families have lost a father, a. mother, a brother, a sister, a child. because of opioids that they were told. were there to help them. Those people.

became addicted, died from pain, whatever, you name it. M. >> Sackler family, they didn't even lose. all their wealth. Like just just think. of this for a moment. Even if you said. to me, "Okay, they're at zero. We took. away everything. I know they're not in. jail, but they at zero." I'd go, "It's. still not fair." But. >> but they didn't even take all their. wealth. The people could still fly away. in a helicopter. The like my brain, do. you know what I mean? It's like wait, then are we living in a just society? And and that's the thing that I think. people at these levels either don't.

understand or either act like they don't. understand. If a justice system is not just, then. people stop believing in the system. >> Yeah. >> Yeah. And we're seeing that more and. more. I mean, the violent acts are. because the the safety valve is clogged. and we're blowing. >> You're like, why would you why would you. not see this? Do you not see that this. is going to blow back on you? >> We're going to continue this. conversation right after this short. break. [music].

>> [music]. >> I think what's going on in the world, you're absolutely making so much sense. What's going on in the world is what. usually happens in the classic mafia. movies. >> You know, no one first part for me is no. one ever talks about the marketers. People talk about the great CEO that. came from this company that did this to. this thing. But if you think about it, before when people trusted a government. more, they would buy government bonds. Yeah. >> And the government would be accountable. to the people that bought the bonds. because the government would have to pay. the bonds back. The same people that.

make the legislation, which is the. guardrails that are supposed to keep. people safe, now go into private. business. They get rid of the. guardrails, but they still keep the. government bonds uh system by saying. you're selling people shares. But the. marketers have realized just like in. that scene in the Godfather where he. walks around the square and he bites an. apple and then later on the nana would. come and complain. will take care of it. Everyone is. wetting their beak. Yeah, >> if you are betting online, if you are. buying shares, if you are watching the. stock price go up, if once in a while.

the thing that astonishes me more in. this country is when you watch. television these ads about you know you. owe this much money if you call this and. then this was up and then they always. give the stat of how many people haven't. versus the how many people should and. all of a sudden I look at the drug. companies different and go but if they. care so much they're here buying ads but. they are they advertising the product. are they do they really want you which. lawyers must you call to do this thing? >> Yeah. Yeah. It's all it all becomes. >> because everyone's beak is wet. Everyone. is eating a little bit here and there.

with online betting with buying shares. with working there knowing someone who. is in it. >> And no one's looking after the little. guy, us, right? And no one is looking at. the Consumer Financial Protection Bureau. is con constantly the target of attacks. It's been dis dismantled. No one is out. there saying, "Yeah, but what what. about, you know, Sally out there? What. about Bob? I mean, what about, you know, there's no one after them. And that's. the thing that I mean, that's kind of. what I saw in in dialysis, but I see it. everywhere is the sense of the most. vulnerable people are taking it in the.

neck and everyone's sort of, oh, well, you know, they're sort of vulnerable. It's maybe it's their fault. Who knows? Blame the victim. Yeah. >> Yeah. Medical aid companies do that all. the time in our countries. They'll. co-opt you into going and using their. app that monitors how many times you go. to the gym, how much healthier you are. But I'm like, since when are we being. lectured about living our lives when. your job is to improve our quality of. life? So now you forced me with the. responsibility of not getting sick while. I pay you to keep me from getting sick. [laughter]. >> My data too. Yeah.

>> But that's why I was even saying that I. think as society, especially if you have. a platform and a megaphone, we must be. very careful not to use our privilege as. a way to lecture people who are. hopeless. >> Right. >> Yeah. That's that's right. Yeah. >> Yeah. Yeah, the lecturing part is very. is tricky too when you helicopter into. these situations. >> I u I'm working in in Boille Heights in. Los Angeles and and it's in an area. that's 95% Hispanic and uh. >> you know I can't just sort of helicopter. in and say hey guys how's how's the.

working for you and and by the way. there's a way to fix this. >> Um so I you know I hook up with local. organizations that Homeboys Industries. is the most if you haven't been you got. to go. >> Okay. the coolest place I have maybe. ever been, but it's certainly the most. impressive. It's a gang rehabilitation. organization. It was started in the 80s. by um Father Gregory Bole, no no. relation to the to the neighborhood. And. um but now they have this view of Boil. Heights that is all-inclusive and it's.

in, you know, Boil Heightscentric. Every. business has to be in Boil Heights. They. have urban gardening. They have all. kinds of other things. they have art, but they are actually taking the people. who are most at risk. So, when I. arrived, I mean, the people that. everyone else fails. >> to do and won't even take a chance at. because they're statistics might be. skewed. >> When I arrived, um I couldn't get anyone. on the phone, but I wanted to talk with. Father Gregory Bole and I wanted to talk. with um you know, the head of of of.

research and so on. So, I just arrived. and sat down and they have a wonderful. homegirl cafe. I sat down and and I. said, "I'd love to talk with Father Bole. and and Michael Lauron and and the other. people." They, "Oh, well, he's very busy. today." And I said, "That's okay. I'll. stay as long as is necessary." And they. said, "Oh, well, you know, he may be. busy all day." Oh, that's okay. I'll. stay today and I'm coming back tomorrow. and I come back the next day. And I went. and sat down and and I really. [clears throat] meant a guy in my. computer. I was perfectly happy and I. wasn't, you know, and I really needed to.

meet these people. And about 5 minutes. later, someone went back. Remember, this. is gang rehabilitation. These are some. the people with like tattoos or their. faces and stuff. They read you in a. heartbeat. They can see they know their. territory. They know who you are. And. and 20 minutes later, a couple guys came. and sat down and had lunch and and one. of them left. Oh, that's a kidney guy. Yeah. And so by by the by the third hour. I had already met with the people I. needed to meet with and we are we are.

off and running. But that feeling of of. entering this space where hope is in the. air. They have been in a terrible place. and they're still facing incredible. difficulties. But there is a sense of. let's not let the state or the. government the federal government or. let's do this in a community is that's I. think part of the system that we need to. employ to get back on our feet as as a. country. But uh but that place is. amazing and that's and that's a sort of. street level uh persontoperson um.

information that you really need to make. a difference and to understand what. diialysis or anything else is doing in a. community is find the people who know. that community grew up there who are. really plugged in. Yeah. You know what I. realized reading your book and then. meeting you is you you're that person. from the movies. You know, you know those movies we used. to watch? They don't really make them. anymore, [laughter]. >> but remember you'd watch my problem. >> You'd watch these movies where there'd. be like some random person, they'd be. like a a suit that doesn't really fit.

too well and they've got their briefcase. and then they go to like an office and. they'll be like, "Excuse me, I would. like to meet the" and they're like, "I'm. sorry. He has no appointment." It's. like, "Okay, I'll just sit here." And. then it's like and then like 2 hours. later like, "Hey, he's not he's not. coming back." It's like, "It's fine. I'll just sit here." And I I remember. watching the those movies [laughter] and. I go, "There's no one like this.". >> Yep. Now I've met one. You You have a. like a It's a dogged and insatiable. attitude towards like finding the truth, the people, the the the story. It's.

>> like is it is it is it conscience that's. pushing you? Is it like what is what's. motivating you beyond? Don't get me. wrong, I mean it is it is a noble cause, but beyond that, like what what is what. is making you sit down for that long? What's making you go talk where people. don't want to talk? what what's making. you investigate unbeatable quote unquote. corporations? >> Yeah, it's a really good question and um. I you know part of it is a sense of. unfairness. I do have this sort of sense. that you know bullies are one of the. worst species and hypocrites are also.

one of the worst. So you have a bully. hypocrite [laughter]. >> a line that's the worst of the worst and. I run into that a lot in corporate. America. So um also just a sense that. you know we can do better we have to do. better we must do better and that it can. start with it needs to start with. information good information. So what is. really going on in the diialysis. industry but it can it can I think in in. a in a pretty short space of time you. can turn something around by taking the.

small community view and building. outwards rather than trying to fix it. with a blanket. everything needs to. change and uh. >> and besides which there is no blanket. anymore so you know might as well do it. in your own backyard cuz no one's going. to be looking out for it. >> Yeah. But you've also done something. that's pretty amazing cuz people would. write books. People do you you you know. it's it's it's so many stages. First of. all, you hope someone will help you make. the book. >> You hope somebody will publish it and. put it out there. You then hope that. people will read it. You hope that it'll.

connect. >> Yeah. But the hardest step after all of. those hard steps is you hope it'll make. a difference. >> Yeah. That's. >> and and [snorts] there's something that. happened with your book that is again. it's like a Hollywood movie that you you. hope would be written. There's a moment where the FDA, the head. of the FDA goes, I I want to use your. book to go after these two sinkhole. companies that are, you know, scamming. Americans for their health care, scamming the government essentially for.

all of the money that is trying to. provide to help people. >> And I think your book, if I remember. correctly, it got cited 21 times. >> and there was a lawsuit. What's the. latest on that? Is like, is is this. still moving forward? Are these. companies still being held accountable? because your book actually made a change. on a level that people didn't think a. change could be made. >> Well, it it is work in progress. Nothing. has been fixed yet. But I will say that. Marty McCary, who before he became FDA. head, had read my book, when he became.

FDA head, he asked me for a memo. How do. you fix diialysis? Wow. >> Give it to me. >> Uh and he said he's ex he's he's spread. it around in uh to to Dr. Oz and to and. to RFK and others um at the highest. levels. Who knows what's going to come. of that, but at least they asked. >> There has been a recent lawsuit came out. in May um alleging antitrust violations. of all kinds. They did cite my book 21. times and cited people. I cited another. 15 um and they simply lay out um in my.

view um they're all allegations until. proven, but in my view a pretty good. case for why you have two huge. corporations that control 80% of the. market. that's harming patients, that's. harming workers, and that's harming. taxpayers. I think they made a pretty. good point. So, yeah, I mean, Robert. Wood Johnson Foundation is funding some. of the work that I'm doing. There is. forward mo motion on this. And there is. a sense, I think, I've received. thousands of emails from people inside.

um the industry, whether the patients or. families or whatever. And I would say. it's bipartisan. There is a sense of. enough is enough. Some of them are. Trumpists. Some of them are some of them. are voted for Camela Harris. Some of. them are who knows they didn't vote. They It's health. It is a fundamental. thing that goes beyond politics. >> Your kidneys don't vote, bro. [laughter]. >> They don't. >> They do not. They just And those babies. [laughter] I've never had such a warm. and fuzzy feeling for my kidneys. You. don't think about your kidneys, right?

They are the They are the They are the. conductor of the whole orchestra of your. body. without those kidneys. You know, people don't talk about renal fortitude, they talk about guts and brains and. heart, but they don't talk about kidney. power. They should they should renal one. part of you. You know, the analogy I. used, there was someone I was I was. having this discussion with like after. reading your book and they said, "I. don't know. I think you know the market. this and the and I I don't think you. should get the government shouldn't get. involved in what's happening here and I. think private companies and and I was. trying to figure this out because I was. like, wait, okay, how would I how would.

I explain this?" And I struck and then. and then it struck me. I went, I would never deny that there are many. private companies that have done an. amazing job providing us with products. that we love and use. We're using a. bunch of them now, right? But there are certain aspects of life. where you have to ask yourself who. should be in charge of this. >> Yeah. >> And the reason you need to ask yourself. is because of the ramifications. on the other side.

>> Yeah. >> Right. Mhm. >> If a private company's in charge of. making these microphones and then they. don't make them, I guess we'll talk. without microphones. You know what I. mean? It's inconvenient, >> but we'll have to find another way. >> Mhm. >> If a private company is in charge of. your health, which is your life, what. are the ramifications on the other side. if they screw you over? And someone will. go, "Oh, but who says government?" You. know, then again, I come back to this. Remember what a government is supposed. to be? >> Is the collective force of the people. >> Yeah. Common good. >> Yeah. We've made it seem like it's this.

foreign entity. No, no, no. It's our. collective force that's acting. It's. your friend. It's almost like having one. friend where you go, they go to the bar. Hey, what do you guys want for drinks? Yeah, that's government. >> You go get us drinks. And then you hold. them accountable. Be like, yo, where's. my drink? That's what it's supposed to. be. But now we've made it seem like your. friend at the bar goes to the bar and. then all of a sudden you're like, that. bar guy, man, let me tell you about. Barry took my money. >> Yeah. It's like, no, no, this is took my. money. Yeah. It's like, took my money. Yeah. Yeah. was supposed to take your. money to buy you the drink that you. wanted them to buy.

>> And when you think about like health. care and these types of industries, I. keep I keep thinking, and this was the. analogy I used with this person. I said, "So, you think it's fine?" They're like, "Yeah, well, they made money. They found. a way to make money on these things." I. said, "Okay, what if I found a way to. make a technology that could suck the. oxygen out of the air? What if I found a way to do that. >> and you lived next door to me? If I sucked the oxygen out of the air, you know, there's no law that like stops.

this right now, right? >> And now I say to you, "Oh, no, no, no, no, no. Please, I'm not saying you. shouldn't breathe. I'm just saying you. should pay me to breathe.". >> Would you accept that? And would you. live in that society right now? Even. someone would be like, "That's a crazy. that's a that's a ridiculous analogy.". Is it though? >> AI. What's happening with AI right now? It's sucking the oxygen out of. >> if somebody if somebody has a machine. >> Yeah. >> that decides whether you live or die and. you have to pay them and in order like a.

crazy amount of money to stay alive and. then your government doesn't really. cover you the way they should because. that same company has convinced them to. not and how is it any different? >> I think you said the key word there. convinced. I think we've had we we have. a lot of whistleblowers. We have a lot. of researchers. But I think the fight. back from these corporations and these. companies and these institutions is how. much they invest in marketing. They do. and the language that they put out. there. >> For example, I I I think even body.

organs are not giving priority based on. what the the language the common. colloquial language is for that for that. organ. For example, a kidney. >> as essential as it is, marketing and. language has made it seem like you can. do without it. And also marketing has also made it feel. like it's something that someone will. give begrudgingly if you need to, but. [laughter] you still be fine with it. Get a trans. the doctor's not called the. kidneyologist. That's interesting. There's also this.

shroud of mystery that's put around. things and sometimes if it's not. mysterious, it's trivialized. So you. don't take it as seriously as it should. be. You know, the biggest example for me. is Department of Defense versus. Department of War. >> And I say to people whenever they talk. to me about self-defense, I'm like, >> "Why don't you maybe go to a self. offense class?". >> Yes. >> Because that will help you more. >> because self-defense means we're. blocking, right? Or we're getting away. from the thing. So, it's the language. that people use. But I think the fight.

back right now after people like you. have done the job that they've done is. for marketers to reinvent how people see. a subject or how people even speak about. a body organ for it to become as as. prolific as it should be in people's. lives. And people go. >> when you talk about kidneys I know what. you're talking about. I mean all of them. basically on us in these forums. essentially. That's what I feel like. Absolutely. >> Because there's no money in that if. we're honest. There's no money in that. marketing. You know what I mean? You're. not going to make money from that part. of it. But the man the one thing I.

really love and I appreciate about your. work and that's why I really appreciate. your time not you not you I do love your. work but not right now one thing I. appreciate about your work Tom is like. >> is it it reminds us. >> that we are the ones who are supposed to. make it matter you know we are the ones. who are supposed to give it a voice we. are the ones who supposed to speak out. about it and we don't know who will read. the books that's the ironic thing you. didn't know when you wrote that book. that the head of that the person would.

become the head of the FDA, >> right? >> Wow. >> Do you get what I'm saying? >> Yes. >> That's like such a crazy They they were. not in that position. They read your. book. They go into that position. You. >> put a message in a bottle. >> No. And to your point, Eugene, it's like. we take for granted what those messages, you know, where those messages land up. >> Like where those bottles wash up on. shore, where they, you know. >> Yeah. It's just that there's an urgency. to this that gets me keeps me awake at. night because every time, you know, um I. I took a lot of people's patients.

stories um and convinced them to tell me. their stories despite the fact that they. were putting themselves at risk. I mean, there's a real risk of retaliation and. >> and and a couple of them used the same. kind of language. They said, "Okay, I'll. tell you my story, >> but when I'm gone, you have to promise. that this won't happen to somebody. else.". >> Wow. And I you know you don't it's not. the kind of promise you make lightly and. it's not one I take lightly. >> Every day since we've been talking here. people are in harm's way. >> This needs to stop like yesterday. So.

that's kind of what uh at the at the. same time that there are positive. movements and positive. >> positive symptoms and a very clear game. plan for what needs to happen. It's hard. but very clear 10-point plan. Um there's. an urgency here that just uh I can't let. go of. Does it make you interact with. the healthcare industry on a personal. level differently? >> It does. >> Yeah, it does. And and uh yeah, with um. with my brother who's who is uh. undergoing some real real health.

challenges right now, I uh I see I see a. lot of what I've reported on in a way. that hits home um hits home very hard. So yeah, I mean it's we're all in this. and it's all up to all of us. That's the. other thing that I think you brought up, but that I think is really important for. people to remember. It's on you. It's on. us. >> There is no, you know, the knight in. shining armor is going to arrive. The. cavalry is not coming. >> You are you are it. >> Yeah. >> Yeah. And and but we can. I mean, we.

definitely can. And and I've seen, you. know, these small groups and and larger. groups, People's Lobby in in Chicago and. Homeboys in LA and a bunch of others. >> who are just saying, "Okay, let's just. do this, you know, let's just do this. right here among us.". >> And then we see how it goes. And and I. think that's kind of that's kind of my. model until I see a better one. >> Hey, man, I'll tell you now, you you've. put forward one of the best models. I. hope as many people as possible read. your book because one of them might. become the next head of the FDA. one of. them might become the next something of.

something. And uh yeah, wherever we can. help, let us know, man. It's it's it's. really worth worthwhile. Thank you for. taking the time. >> Thank you very very much, Trevor and. Eugene. It's been a pleasure. >> This is really great, man. Thank you so. much, >> Tom. >> For real, man. >> Thanks. >> We've got to stay in touch. >> Sorry about your brother. >> Yeah. Yeah. It's tough. It's tough. >> about your brother. >> It happens, but you don't think it's. going to happen. >> Yeah. [laughter] No, until it happens. But can I but can I tell [snorts] you. it's um you know my mom is more.

prophetic in the family but. >> she would say something to the effect of. we don't know what wars life is. preparing us to fight. >> right. >> we just experience the battles. >> you know and I I almost feel like in a. in a in a in a weird way it's it's. almost come around where you go like. damn you're the you it's it's it's put. you in the front seat. to fight the thing that you were already. fighting in an even more.

>> energizing way. >> Yeah, it's true. Yeah, >> you already had perspective. You needed. urgency. >> Yeah, that's right. That's exactly. right. >> That's a that's a that's a more eloquent. way to say it. Thank you. >> This episode is presented by Whole Foods. Market. Whole Foods [music] Market is. the place to get everything you need for. Thanksgiving. With great prices on. turkey, quality organic produce, grab-and-go sides, and everyday low. prices from 365 brand, [music] you can. prep for the holiday with big savings. Shop everything you need for. Thanksgiving now at Whole Foods Market.

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