It's only the second day of 2018, and Matt, Ezra, and Sarah are already talking about alarming statistics--this time, to do with average American life expectancy.
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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
I need to have like, like a weed sweater in the office.
happy new year while them to another, so did the weeds on a box media potass network, I'm at the workplace is doing today by
recline and Sarah Clip where were taken off the new year right so called we got that luxury all last week and you know Montreal is literally colder than was on Mars. How cultures that answer
I mean negative ten to twenty, but that's colder than Mars, which in impotent breathable oxygen labelling, has really how kind of accident does.
Take us from me Matt you, there
to complain about that. That's very few of us are very cold and about the
I called might well organised heed of the studio with some with some hot telematics. We,
Look at what didn't happen and twenty seventeen we have a great white paper.
this leaders are perceiving their constituencies more conservative.
actually are, but before we get to
I actually request for my other podcast the impact which just wrapped up its first season,
And were now looking at producing a second season of that show all about local and state level policy experiment, so interesting, different, good bye.
Great terrible things that are happening at a more
local level. I am looking for.
My ideas of what our episodes should be about some really novel, different things happening across the country, and I think, since
Thus nerves are so tuned in to what is happening by them in the policy space
I want to know your ideas, so we set
form where you could tell us about an interesting policy experiment.
Opening near where you live, that you read about somewhere? I know this isn't the easiest on the podcast, but it will also be an show notes the link to submit your ideas. It is bitterly such impact dash season dash to that is bitterly the ip dot l. Why such impact dash season dash to that spelled out t w, oh, like I said this will be in the weeds Facebook group it'll, be an show notes out without a link for my twitter account. So you
to be able to find it somewhere else if you're having trouble typing it in, but we're going to start with something we touched on a little that last week, but wanted dig into in more detail, which is the decline in life.
Currency. So over the past two years, the life
Secondly, in the United States has gone to out- and this is not normal
in other developed countries and the United States. It has been very typical for the past four so decade that life expectancy,
year after year as we get better technology, as our healthcare
proves, as we learn more about extending our lives, but this
your and last year we saw life expectancy go down,
the last time life expectancy went down, was in the mid nineties nineties during the AIDS epidemic. The last time
went down two years in a row was in the nineteen sixty years before that you have to go back to the nineteen twenties. To find an example.
So it is really really rare to see
What we're seeing in these public health trends
now- and there was a great piece- some says. Oh, what is China
is it sounds a lot but small when you say it out loud life expectancy for an infant born and United States. It has decreased from seventy eight point, eight to your
go to seventy eight point six years, so we're talking about point
years over two years, which its own small, when you say it that way, but there is a great posed from on,
nor at the incidental economist, which is a blog, I read very right regularly and what highly recommend? Where
does the mouth on the and really shows that this is a catastrophe that this is a huge huge, huge change.
So he works it out that you know we're talking about point. One year's lost for every invent. Therefore, million birth
on average in United States each year, we're talking of four
hundred thousand years of life lost over that group of babies who will be born
or who were born in twenty seventeen. That's a huge change
that is more than the amount of years life lost in the Iraq war. It is a massive economic consequences that amazing that particular comparison. You think about how much attention correctly the Iraq WAR not and were like. Looking at
seemed to take a one day store, that's among American, sir
I remember that rapidly under the deaths in the Iraq war, there was a big deal. I then
I mean it is a challenge.
To love it about the causes last week. It is a challenge that is multi faceted bathing. Some of the numbers that jump out when you go through the CDC report is
Even the drug over
says in the past year rose twenty one percent
Some drug overdose is eighty. This among middle aged Americans are not the entire co.
Born you zoom in on middle aged Americans
intentional accidents went up. Ten percent
causes it. It is not just one thing that is happening. It is multiple things, but drug overdoses and operate epidemic are playing a huge
troll here- and I think that your thing as it is something that doesn't get you know
fort comes out from the CDC. There are headlines about it for one day and then we kind of move on, but it's a huge change in it's not good
somewhat unprecedented in Modern America, so want to add a couple more things under list here that there were driving this and- and we should someone here
conceptually about what we mean by driving less, because what makes up the bulk of death rates right, and that is what makes up the sort of income
It'll change such that we are,
losing life expectancy, but but let me bracket that four minutes, so the other two
once you are suicides, we are seeing a huge increase in suicides in this country and Alzheimer's disease.
Which is beginning to take to become more widespread, is killing more people. They were thinking for some time that possibly is just a diagnostic increasing. We actually had it for a very long time now. They dont think that actually actually receive a pretty big increasing in in Alzheimer's Disease
and what makes this to me so striking is that it's not have
elsewhere. So Chris anger him at the Washington Post had had a good piece on this and what he
they showed with it,
in the seventies and eighties. You wanted to be an american
in this. If you're the typical american baby born in making seventy nine you could expect to live at seventy. Three
when ninety years wall, the typical baby born in one of the other thirty four we see these are more or less developed countries would live roughly to set a seventy two point, three by twenty fifteen. So before this that's
leaped. The average American born in twenty fifteen can expect
a little less than seventy nine years, while the typical baby born in those thirty four OECD countries has an expected life,
of nearly eighty one years. So
seeing its life expectancy fall behind that of other countries
that life expectancy is dropping further. We are not seeing those kinds of jobs in other countries. We are not seeing a global rash of suicides of unintentional, introduce of drug overdose of all times. Just something is wrong.
Going wrong in an, and also want to note.
It's going wrong in a way that we
most don't anymore hike have the language to talk about. We think so much. We almost come to take these advances so much for granted the religious track.
the country through the economy, growth, has GDP, doing how incomes doing-
We don't make deserve release of this
atta every year big deal because you ve come to just expected to move up like clockwork, but
This is more important than GDP like this is. This is the most fundamental well being and health of the country being
and here are you likely the live view sort of longest and most healthy life and comparative
out of other competitor countries. That is no longer true for America. Wait a name I mean, I think, that's a really sort of a sobering
point that I mean that we had been falling behind previously and now it's getting.
War or sent any it's not just that this is more important than GDP, but, but I think it's important to emphasise because
I've seen a lot of people. Over the past couple of years we looked at at sort of life expectancy decline.
Kind of like debts of despair, narrative and kind of like
My time is the whole phenomenon right, an image.
We're saying that, like the book
Read the great recession was really bad. The recovery from great recession was very weak, but that there was also
who, in Europe and in many ways in large parts of Europe, it was worse than you turning into likely pure economic phenomenon of unemployment.
sluggish recovery, not only our countries like France and ITALY, their poor,
than the United States they have higher unemployment
rates in the United States have more sluggish labour markets. The United States with what they are as they are healthier, and I think it's it's worth you know actually dwelling on
health as a sort of independent thing. Obviously like lots of things in society. The extent
to which you are able to develop effective public health programme,
it depends on the economic risk
does that are available to you. It's like it's real.
Hard for Namibia to have long life expectancy, because it such a poor country, but countries at
The level of economic development of Spain and ITALY and France are clearly capable of pulling off a much greater level of population health than the United States
is achieving, even though we have many more financial resources- and you know
I mean a lot of this is like not mysterious, like everybody knows that I you know like junk food is bad for you. Re knows it is good to have more physical activity in your life. A new, more percent of
broadly familiar with that sort of
long run outlines of Americans poor health, the fact that its getting worse is
really frightening and a lot of ways, but it's not something that
Have they ever seen a real mobilization of round even say like here is a programme that we think is gonna make people
healthier, because I think everybody knows that delivering
care. Services to people who are very sick is important, but the like. That is not the way you engender population level. How put it so? I think
One thing that differentiates us aside from like junk food, those,
things is the lack of it
of course system, and I think that a good example,
reported an episode of the impact by their podcast cast on how policy affects people about me
colonel deaths, which feels like this trend were thing in life expectancy.
on steroids. The rate of
maternal deaths in the United States has steadily increased over the past decade as it has decreased in all of our pure countries. So it's not just. We are
getting better. Slowly like we are getting worse
where women are dying in childbirth. Now
ten years ago, in the United States Army eight times more likely to die
a baby here than you are in the United Kingdom, for example, its is to really staggering to friends and what we
looked in. That episode was that there are ways to to make this better. California has done an excellent job, implementing tool, kit,
let's say: okay, if this is going wrong in childbirth here the exact steps you follow. Two
to make sure that the mother and the baby both are able to survive, and California has a maternal death rate three times less the rest of the United States,
I think one of the big problems with them with this with how we treat opium
that's how we prescribe opium with how we manage mental health.
Is. There is no national body and United States to say man this thing in California. It it really works that one
Women are dying in childbirth and that it is easy.
Implemented doesn't require fancy equipment adjust requires following a check list of step.
to make sure that the best methods are used. What that reporting, that story and maternal deaths even really showed me as the law,
of any sort of coordinating body to say this works and like
This is how we should prescribe opium
here's how we should deal with chronic pains and here's what we ve learned about, what works best, entreating populated diction, of applying those methods that have really worked from maternal deaths in California. They put it
huge disadvantage and a new maternal deaths. There not one of the main drivers, but they are certainly a driver of increasing
That's among you know, prime aged women. Right now and it's
really sad that all heard of this a lot of the solutions are out there and it seems to be a challenge of scaling them up across a very big country that does not have things to coordinate. Those sort of approach
so a couple of things that I think are interesting. So one is that when we have this conversation first, the overall healthcare conversation is country is really come.
nation, but healthcare financing,
as it happens in its policy state, we dont
nearly enough about.
Delivery? We don't talk nearly enough about. Actually what kind of care is their right of wanting to make health care much more effective in this country.
If we invented a bunch of new antibiotics or effective, we don't really
talk about, had to do that. Instead, he spent a lot of time talking about how to structure insurance and that isn't this a structure. Insurance is not important, it is, but we do
I'm going to miss the point of insurance is what kinds of health can you buy with it
and we ve not been moving, that margin up nearly as fast in the past couple decades, as we had before another thing that I think it is important to think about when you think about these numbers. Is
There is what is going wrong and there is what is going right right there
is getting worse, so suicides drug overdoses and then those what isn't getting better but could
So one thing happening, these numbers is, we are seeing the decreasing cardiovascular
which is a lot of that is coming from improved, acknowledging how to treat our problems levelling off
If we had invented something or had changed over the populations eating or smoking or whatever might be such it, there was less heart disease killing people. These numbers could look very different.
The same is true said about on anything you can imagine and so willing, I think, is
did to do when you, when you think about life expectancies, Tredah, think about like what don't we talk about their rather mean. If we invented perfect driverless cars tomorrow, thou be uninstall,
a boon to life expectancy and in Amerika we has still huge huge, huge gains. It can make an tobacco regulation and and smoking cessation a huge number of people to still die from tobacco. It may not be going up.
we sent a believe. It's going up. I've looked at those number specifically, it's really not seen anything like opiates, our, but nor is it like.
I'm in the way that that cut it still much bigger than most other things and
one of these things where I think we have a kind of we dont focus on
send tracking and think about it. So we don't even really have a language for you know you could imagine
putting together a commission a very smart epidemiologists in public health people and so on, and is trying to ask the question what would be the most cost effective ways to reduce death rates in the United States right. Just like look at everything. Look at everything you can think
what could we do for the least money that would have the biggest impact I mean my guess is it would probably around tobacco and sugar unprinted
pretty sold on the science round, sugar being a huge causes. Some of these problems like diabetes, but whenever it is, I think, I'll, be interesting and its economy
I mean the number of fuck fiscal commissions we have had in this country compared to commissions like this. It's just unbelievable like
Simpson balls now people today of breast out that at a calm the over the week be like yeah all the
is it hawks who made a huge deal out of that in two thousand ten we're gonna wrongly the amount of time
spend on some problems that are not as big a deal as dying early is, is pretty shocking
they all say. Real quick! Is that one thing
talk about Europe or when you talk about Mexico, which has better life expectancy outcomes in Europe,
sit or from some of the other inputs to that
we should have a problem in this country that I think is pretty well documented this one, but is not when we know how to talk about much us fix politically with
loneliness and social fragmentation that leads to unbelief.
We bad healthcare comes for people of loneliness, I've seen arguments it. It is just as bad or were few than obese,
smoking, but with
we optimize culture of aging people get sort of wild off from folks? They end up in homes and I'm nothing. There can be good work.
of that on Monseigneur. Aren't reasons for that when it happens, I'm not here to criticise anyone
but we have a real issue with Lonesomeness.
some other just way. Society structured that some other countries that are cop
will the US either money or lower than
some money don't, but they get a lot of help from that did the breakdown of law, the social fund
work of religion, of unions, of upholding leagues of all of that, that's
comes out in these numbers. We don't really have a
course around it, but it is something we should totally forget here. Maybe that's why I think your proposal to have like cost benefit
thinking of these measures gets really difficult ride, so that lies for you know
more stringent tobacco regulation does not have any kind of financial cost. Right. Like, though,
Cost of that is like it's annoying to smokers and at this point, we're sort of way,
below the horizon on hassling smokers as
something we all agree to
we were to say,
we regulate the use of added sweetener. Swipe people would get very upset at that proposal is that it would be too costly
in a financial sense, it's that I mean, I think I think
pretty clear that, like eating lots of sugar is not good for you. I don't think that's cunt
virtual. I don't even like tobacco science in the eighties, where there's like a large group of people who are like no like jolly ranchers are amazing health food. It just like people.
I being available and its I mean. I think it's important to tackle these kinds of topics, but the word
could that would need to be done, is just I think, sort of different from from low work
of cost benefit? Analysis, worship,
We are some things on public health right I mean like Sera talking about maternal maternal health interventions. That is the question where, like we could spend more resources and like build better programmes and people might be sceptical of the merits of the expenditure, but
we are actually costing it out. You know makes a lot of sense. Why did so? Why are we spending penal
ever trillion dollars, unlike bombing Afghanistan when may be helping pregnant women, give birth safely, would do more to improve american security.
the biggest public health winds are in. This kind of Em
You told yes, I think, on the show about the Like Cleveland Clinic, like public health, to stop here that they ve created there
and it's the Ivan, you can see why you can see. Why would work cried till? It really restrict people's freedom to like make poor health choices, but also why people at this time,
measure. But I think that also skirts around, like
the big issue and the life expectancy report is opiates. It is a drug overdose is ends so part of some of the stats from that so
the number of drug overdoses arose. Twenty one
saddened. Just between two years, between twenty fifteen and
when he sixteen, the number of Americans dying from drug overdoses rose twenty one percent and from fifty two thousand people in twenty fifteen to sixty three thousand people in twenty six
That is a mass I mean for one year for a number of change. Twenty one percent is just a Norma
it's hard to think of other things that change that we talk about the
the economy- you don't
because other statistics that change that much in one year declines in teen births, for example, they declined like four percent,
between two years, we're like that's a massive public health change
I dont know we have like the solution to scale
there. This is something you know. I've been also rather show. The impact have been reporting. Is that one of the things that striving that they may is
massive amount of chronic pain in the United States, and we, the ring
hope you always became you look so pervasive in the United States is that there was a real problem that wasn't getting addressed very well and all this
thing, comes along that drug companies promise a safe and effective and
for a while seem really gotta treating chronic pain? It turns out those promises about safe and effective way,
wrong and that these drugs were not so
then at very high risks of addiction.
I don't know you know when I think of like maternal deaths. That's a really big problem, but it seems like one where we actually have some thoughts about
How to make that work better, and there are some things your mom Lopez has been reporting on some great work there
doing in Vermont to reduce opiate addiction. But it's
It's a hard problem and it is a big problem and it is just a
is not normal to see in public health statistics. One thing changing that much in just the same
of one year and I dont know I dont know what, like the cost, effective
solution is to obey them. If someone
who is listening to tell us if it doesn't seem like it exists yet, and that seems to be really what's driving the decrease in life expectancy this year.
Yeah, I think that's right. I mean I will say because of that. That's part of why say that, and you hear an unexplained segment of some thought,
the head, that we should be doing more in opiates, but
but it's also. I say that it might be that some of the gains to be made don't come their first right. We have to do like everything we can
you're the opium crisis. But I think we can look at these numbers and all
think about the things have begun going wrong. When life expectancies life expectancy right, if you can make other things, go right, that would be great too.
one other disappoint or make on this, because I do think it since it's something important to call out in the data America's really big country,
so we say things like american life expectancy is going down her and, like that's true, so you seen these
big changes in life expects you, but they have not been. They ve not been equally share, and I mean they were there: much bigger fur, richer Americans and for poor Americans. Yet there is actually a great land said article. Then I wonder if quoth many pulled out, the life expectancy of the wealthiest Americans now exceeds that of the poorest by ten to fifteen years. That's unbelievable gap right. So, if your porn,
Merrick, I mean you have life expectancy in very poor countries.
of your rich in America you some of the best life expectancy in the world like this is a kind of
quality. That is our
the most damaging of the inequalities we have, but again, one that I don't think we talk about that much. We certainly don't have like a big plan
tat to redress
But it's here it's it's like present and like we're. Are you know that
the line from willing
gifts, and thus I find I was at the future- is here just unevenly distributed the capacity
here too, it is also just unevenly distributed. A lot of people. America live in places where we
the newly as much to solve the infant and maternal mortality problems where two is much worse for sanitation is worse, I mean
it's really really awful? I know that
too many things in the weeds end with this is awful
the Junta them, but
I do want to use that is as a transition to turn next topic here, which is
I've been reading a lot of the two thousand seventeen retrospectively
and they all have this quality of totally correctly and understandably, of being about what happened right. The test
spill or the travel ban or the resistance? Or you know what ever you pick the things it up in a politics here or that were kept from happening in politics, one. The things I think we have trouble talking about is counterfactual is what didn't happen, but there's a lot of opportunity cost in the trumpet ministries you of this very
in discipline, chaotic, poorly managed, unfocused
ministration that also is now
doing a good job. I think adapting to changing circumstances is not doing a good job like looking to see like what. What what could it spend its time on and so part of the cost here. Is it
prince between the Trump administration and applause
administration? That was.
Using the last year to poor countries
because hardest problems and solve them? So I thought I
ask it pose a question to you on. I've got my own answer for two, but what should have happened and twice
Do you like? What is the? What is the cost we incurred from not doing acts because
ass. We have of not solving problems of letting them festering get worse or not taking opportunities to make it
you bet it s, a real costs, it will pay in the future and that I think we furnace
for reasons do a pretty bad job talking about in Delhi political coverage, I mean they're, so many
riding in parliament is right. There's an infinite space of jobs you could tackle, but to discipline myself a little and ever thought making
John President was a good idea, but I was thinking like what think unexpected good things like might happen here and tromp
stay developer by profession. He obviously has a regulatory mindset. The republican Party enjoys business friendly, deregulatory
policies, and I read in some of trumps books stuff about how it
stream difficult to get permission to do urban bit in construction projects, which is something Donald Trump, actually knows. A lot
I mean we ease often cared
Her dislike he's
moron. He doesn't know anything about public policy like this, a real policy issue. That he's
very well informed about historically up that I care about a lot and that I think, particularly with the economy, strengthening its like more important than ever, to make it possible for people to build homes and have places to live in places where
fish will economic opportunity. There was some scratchings of momentum in this direction. At the end of the Obama administration, they put out a report on how we need
more housing, permitting Hillary Clinton camp
in programme was a billion pages long, but there was like two pages on. We need to make it easier for people to build housing.
California has had some baby steps in the state legislature to this it would have been right,
nice to see a New Republic administration led by a real estate developer. President
say you know we're going to tackle this on a federal level. We're going to have hide, you don't make sure it's grants are aligned to making sure there's housing supply, we're gonna when we tweak the tax code. Do something about this.
You know, did it's not primarily a federal issue, but you know determined people can can make progress on whenever they want, and I think it's recognised by economists that sort of housing scarcity
is a huge problem in the country. It seems like one that trump some kind of
Idealized version of Trump like really could have taken
on without becoming like a radically different person or someone who has a whole different world view, but he would he would you still need to be like good it being president. You know like talk to people find out. What's gonna think of things and Eric,
he just he isn't. So I guess I mean you could use to different baselines or this right like if we elected a Democrat verses, if we elected a non Trump Republican,
we like in the universe I trump Republican, literally yeah, I'm just saying I don't even think Republicanism cut. I I think I thank you.
take us how you gonna take the point. Is it need new rules for the we could have done twenty seventeen differently s, wife? We had done what would be the x you wish we had done so I think one thing: actually, you would have seen from either Clinton.
We're like another version of Trump is something
drug prices so trumped came in
again like similar to this housing is ample you're talking about it. You
Things are very or unorthodox republican candidate about how Medicare
should have the power to make deals and that the drug prices are too high and farmers getting rich, and it is not something you typically here from Republicans, but
It is something that poles very well. When you look at what people are frustrated with and how
here you know more than their premiums. More than access to doctors is the price of drugs that its very very expensive divide
pharmaceuticals in the United States in there
These early gestures during the campaign during a speech am Trump gave in jail
where twenty seventeen, just before he took office where he said things
made. It seem like this is an issue. He was
stood in just
something very unorthodox on and I think actually a Clinton administration. I would have expected you knew there, the affordable,
have to be there to stay, and they will move on to some kind of fight about prices and drug prices are really the place where you politically probably want to start that fight, and they
Thank you. There were some meetings with Pharma. This was backed off on some points. You do SEC. Former secretary price didn't really seem to have much interest in taking on this issue.
You the add new nominee for each of had Alex's air comes from Pfizer's. I don't know you know what
going to do on this, but I think that's one space where
You could have seen a really interesting healthcare policy.
discussion. You know we ve talked a little bit about different ways to reward
Farmer that my door country, better you know, maybe with prizes, are reform of our patent system and that somewhere, where trumpet took these
real steps and could of you know if you have
like more disciplined, more organised white House,
would follow through on the things that the president promised may be would have seen some action and those they
matter. You know. I've talked about this on
before- and you like see this in my reporting- is that the problem with their healthcare system is the prices. It's not. You know that people are going to the doctor too much that this,
inordinately more each time that they do so. I think that's a missed opportunity of twenty seventeen
so all I'll go for one that I think both republican and a democratic administration might have done, which is take the opium.
Crisis seriously in and really try to orient the federal government to doing something about it. So cerebral- I am weeds fans- will note that sir and I talked about this last week, we not sliding the up your problem
that and who knows I'm mad, they care about the opium. Is don't we neither have mentioned that bring it up, it wasn't on their list of things you could, if they just don't care, but I care
Talk about it, you don't get the waves in Canada
Let's do call they can.
The Euro is coming up with a quarter.
anyway, so at last week the weeds apparently did an amazing opiate Chris under his later on us, but soap,
we sixteen votaries. Here we have data. Sixty three thousand people die from drug overdose, is two thirds and given the way report, probably more than that of those desperate, appeared belated, and I think it's just briefly. If hastened to put this in these
spectres, that's more Americans and died from HIV and AIDS in the worst year of the plague, its
Americans die annually for motor accidents or from gun violence. In fact, if you look at the entire drug overdose death rate, sixty thousand
twice as many as die from gun, violence, her or traffic accidents? If current trends continue opiates could kill? Six hundred and fifty thousand
and people in the country over the next decade, which you know this obviously Donna
Current events will continue could get better. It can also get worse so that kind
number, I mean that is an emergency level number I
I also think this pretty good reasonably that opium aids are, and so the wreckage and in open ravaged communities is so deep that it has a lot of effect beyond just deathrays.
Which I think is always important to say I beseech every one of those people as a family.
many of them have jobs, many them or parents of children. Many of them support elderly parents themselves.
So you see a lot of this community breakdown. See a lot of kids left as orphans. You see a lot of on parents left a single parents.
so you of these terrible knock on effects for the rest of other people's lives. Bizarre
it is a lot of emotional paints. What does I really want to link? This is really bad. It's really big. It is. I think it is
oh big, that it's hard to keep stock of the numbers because it
Not so much in the past couple of years now says right
We don't have a silver bullet on opiates, but there is a lot we could be trying to do so. President tromp after lot of foot dragging on this did declare public health emergency, but he did so without using it to appropriate any new funds or really before
anything do as a strategy. He had an opium commission.
but he's not really done anything with recommendations. One of the members who said I'm am Trump has been all talking no follow through
and come wage. Alright, the duchess
That's so flat rate.
We should have had, but that I forgot that until you just mentioned it, like my stomach, just turned remember when chaired cushioned has got us all
the press is still like. This stuff is really bad anyway. So point is you could do things
no there, you can go check this out. There's a great box article on from her mom Lopez, Alma Vermont, has been doing. They had a very successful protein opiates,
imagine a race to the top spell programme where you were funding, states and cities to try a lot of interventions. You were doing the job studying them and then you were putting funding to scale up the most effective models.
Another thing that is important here- and this is another thing that her mom Lopez's reporting is taught me on this. But a huge thing that we need to do is just a cold.
shift of understanding chemical addiction is something like opiates, as not just a moral fail
that's not really moral feeling at all. It's a chemical addiction. These things are built to make it almost impossible to stop using them. That is so
that a president using the bully pulpit could do or could at least work to do to try to get Americans to think about things like opiate addiction differently ought to say this is a hard problem,
cause. It is a hard problem and as such as one easy solution, it actually makes the need for the government to focus on it in a creative, serious, sustained, like all hands on deck way more central. I think I heard that in prison and see would have done
John CASE presidency would have done that. Even acquits Christie presidency would have done that, like you can imagine allotted from president's takings.
These are real serious thing, but that has not happened here for many years.
Matt points out, even if Trump conceptually cares about, he doesn't care about
really anything enough to focus on it? And so, instead, we ve burnt,
this time, trying to take health insurance away from people burnt. All this money giving corporations tax cuts.
so that is one way in which I think we d, like a real plausible other twenty seventeen, because of had we really working
progress on this and instead, like we didn't and we'll pay the cost of that going forward
appealing. So I urge you want a question like how much of this is Trump specific rights because, like we should take the american public healthcare system and just absolutely got it right, just like rip out tons of money so that nobody can get health cover.
Like that was not an eccentric, Donald Trump idea, and it was not like inattention rhetoric.
Every single member of the Republican Party and the whole conservative movement. The absence
We believed a critical top political crisis in Amerika was that too many people have access to Medicaid and that, like we need to fight like hell to make sure that people can't get that healthcare read like that was not just like it. Damas Trump thing, that's
so close to the heart of conservative ideology in America is that, like the government should not be helping people need that, like. I think that
to be like scene. I wonder I like I'm not used like Trump flipping on it
blow to defend the conservative movement on healthcare cohort knows, but I think there are a lot of repair.
in governors have taken the opiate crises in their states. For seriously, I think there are public candidates would have taken this more seriously. Is there a very, very serious cross problem? Words like, on the one with one hand, you're trying to take medicate away from people and I'm either maybe you're trying to address is definitely, and it would be interesting to see somebody else try to solve it, but I do not. I do not think it is hard
Imagine another presidency taking this more seriously and being more focused on it and making it more of a priority. I dont think it is, I dont think Opie Lloyd Politics.
simply one and the same is a bomb care or even broader healthcare. Paul that's only way go deaf, which congressional Republican has lagged an interesting bill on opiates, but Chris Christine junk.
So did take it to me like we watched them. Like Christie, ran the presence, Opiates Commission and actually like ran away
the commission- and I think, if like they, took the recommendations by Susie that would have been good, I'm I'm I'm
studied enough on members of Congress on opiates to be able to tell you much about them. It tells me away
Can I do
An interesting paper came closer recently by David, Brutal
and Christopher Skull Run and it seems to be an updating of the work.
Paper that I'd seen from them for five years ago, but it is actually changed somewhat. What what their findings are?
It's called them they'd. The current idols bias in perceptions
look opinion among political elites.
only a study of a huge group of over three thousand seven hundred elected officials and
their surveying. What it is elected officials think their constituents think about issues and
comparing it to actual survey evidence, and they show that people are less conservative. Then elected officials think that they are and that Democrats perceived
Public to be a little bit more conservative, then surveys indicate that it is and Republicans perceived the public to be way more conservative, then
the survey showed that it is that they go through a bunch of certain statistical task to try to see. What's going on, look at their demographics of the elected officials. They don't see much
on the air it looks like state
with unified were publicly control have like even more misperception, independently of just the fact that they elected officials are
begins, and they also show the politicians who have been in close elections recently are low,
bit better informed about their constituents views, but not a lot better and so what they attributed to it in their current version. That research is that
bring the years that this study was undertaken, which is so mean of the Obama presidency. Conservatives were much more mobilized to engage in the public sphere
that Democrats and Republicans both voted. Obviously Democrats voted enough numbers for Obama to win twice but
Publicans were much more likely to call members of Congress to stage demonstrations. Did you know? Do things
to make their voices heard, and so they fight
some reason to believe that that is what sort of driven that sort did? Dr during the historical period that
conservatives were much more engagement, active in politics and they lead part
a general, but particularly where public and politicians to believe that the public had very, very conservative. Opinions are arranged
issues. Yet I was interested to read this paper in the context of a recent
he's dead, I'm Jacob Hacker Unpopular,
wrote for volumes about why one of the things we ve seen develop in Congress, the Sierra? So this is a study of state legislators. This is a piece about Congress. Is that
Republicans are much more willing to work
on very unpopular bills to you know, put their next on the line for bills that are pulling twenty five. Thirty percent, both with healthcare. That again, with tax reform-
and they were raising the question and kind of an alarm in, and you wrote a low, but about this afterwards about. It is really alarming to see report
It like it is alarming to see republicans pursuing such unpopular bells as it suggests the will of the people becomes marginalized and politics that they're just isn't. You usually
You would think the Republicans would not or any legislator would not want to pursue unpopular bills. Out of fear of losing
action- and you know that could say something about the strength of polarisation that they are willing to go after these popular bells, because they believe that people are going to stick with the party that they ve chosen.
And the actual legislation that they propose is going to become less consequential over time, and I thought this research added an interesting wrinkle
that theory of, if part of
is driving. The pursuit of unpopular bills is hearing from constituents vocal concerned.
twins who, like this balance,
think they ve them eat. You know you talked a lot of political scientists about the role of lobbying,
The role of donors is driving forward a lot of this unpopular legislation, but it feels it was possible to me that
of what is going on is that it is easy
to write off a pull, the tells you that your health care
was unpopular when you hear from like a bunch of vocal constituents are saying, like you,
after appeal and like you have to get this across the
this line ends. It speaks to the type of legislation that has been passed and might help unpack a little bit of you know this question of wire republicans willing to go. You know to the mat really hard for bills that people don't
I think bunch interesting questions raised by this. So you no one there is. I would a little bit
The anguish, the case of Republicans
rebuild their sure everybody Haines from Republicans over,
Estimating the gentle conservatism of of the country has, I think, one possible explanation of that. Is it
begins notice, bills unpopular, but given that almost all of them are in relative,
safe seats, there more afraid of losing a primary challenge, then losing a joke.
Election challenges we even if they had a proper view of like the general electorate. They would still
for the piper thing or they really believe in it. Maybe you can set a good analysed, but but I think I will
living in a wolf, both those questions being really important, but but potentially dropping the same. Something that I do think is interesting about this is, I think it
This is a study that TIM be, has an unused
collision with the idea that the media is very biased towards liberals, because.
One thing you might imagine in a country with EC where the ways
learn about politics. Overwhelmingly are incredibly biased towards liberalism. Is that politicians would have like an overly liberal view,
like what is going on and like what people actually believe in what they see out there and they don't
that's not what you see an end. I think that the way the media structured, where you have the committee
that might have it somewhere like a soft, culturally liberal bias. But like tries pretty hard report on things and in some ways, is very actually open to trying to report out the
way, everybody hates liberals and conservatives are angry and see get along without any of very hard right. Media Rio, Fox NEWS and set up the whole list of things to come after that
do wonder if, like that, being the poles people experience there being like
now these state legislators- maybe they re like than Europe
to the Washington Post and then
news is like what represents the right. If that doesn't have
a role and pulling people, although before the right and the same for Democrats readily be seen. The same study Democrats did in overestimate the conserved
some of the of the electorate by ass much, but they did you buy a bit and again Fox NEWS is very hard core conservative out, leaden and channel and to the extent
That conservatism is represented to people by its most extreme aspects where
liberalism, is represented to people. Vice institutions
I ve been trying to be liberal there in trying to not be that liberal. That might be some part of ice.
Yeah. I mean I just want to say that fundamental
in this it of the research. I think this is a pretty optimistic study compared to
other things that I've seen coming out of political science, that you know there was
famous like America's, and
Gorky now paper that circulate on the internet that wish
we to show that you know politicians only respond to what which people think there's these somewhat elaborate.
Pearson theories about, like totally broken responsiveness of government
a lot of just sort of journalistic commentary to the effective, like Republicans, are going ahead with what
donors want, you know, never mind the public in their identifying in this way,
Sir. I frame this is like a problem for representative government, but this
it really innocent explanation of why Republican Party elected officials might behave in a more hard right manner than public opinion polls suggest
and their explanation is that conservative issue activists did a good job of networking with each other and with citizens
and with inducing citizens to participate in the political process in a more in a thicker away than merely voting and that they gained like disposal
can it sway over elected officials by being more
engage should be more active, Frederick, not by don't.
machines that, by like bribes, not by weird trickery, not by fake news, but by like making phone calls and
Basically, things view would valorize if the people doing it we're doing it in support of a cause that you believed in
and where there's also, I think, if you look at twenty seventeen good race,
to believe that that has flipped right that
a lot of conservatives will very alarmed by the existence of Barack Obama. Are more alike
from scattered covered and liberals are engaged in this huge marches, and things like that. So, if, if
really really really what's going on here is just sort of about
an engagement in point. I am not sure there is like any problem for Denmark
I mean who knows, I scarcely less of an age limit it S. One was the data for this, its elected when he ten and twenty fourteen right
to twenty twelve and twenty underwent twenty told. Yes, I really curious to know like what the twenty cent
nineteen, because I ve seen this year of like, I think, a lot of people getting engaged in Poland.
You weren't before
I'm curious like if you'd, see a shift in opinion.
Follow that I would like, if there is a lack of some sort,
interested in like what it looks like in the era of trumpets. If there's like a bit of flip flopping between presidencies,
people get more engaged when they oppose whoever's in the white line. I especially want to see after an election rights, Illigant Virginia a bunch of republican delegates, just lost there
Seeds, there's a bunch of newly elected Democrats whose went a long time Democrats who, like thought they could never get
majority, and then they suddenly did. Liberals are amp up brightly.
do the newly elected Democratic Virginia, who sort of benefited from an anti trump wave.
Do they now miss perceive their constituents as being incredibly progressive,
Like I don't know, I mean that that would be a fascinating, follow research, because right now you have like really interesting research, but it's about a very particular point in time and like now,
in a totally different dynamic. If the issue
Is that if elected officials,
miss perceived the public as more conservative than it really is
time. No matter what happens like that's pretty disturbing, if they miss perceive it.
because Republicans word like doing well in the mid like that's. I think not that disturbing.
The things here that I do think is interesting as a way of possibly thinking about this is theirs is.
long standing and like very well validated view in political science and and public opinion. Research that Americans are operation
liberal and symbolically conservative. So
idea? There is sort of the don't you dare let the government
get its hands on my Medicare kind of thing where people have philosophically per
conservative opinions in America, why you see consistently I'm higher
numbers Americans, consuls, conservatives, liberals and pulling its basically been that way for as long as you ve been pulling it, and on the other hand, there are operational more liberal, they like government programmes like Medicare. They like Social security, that like public education, they like roads being good and so they vote. The democratic party has just been a more popular party than the republican party.
And I wondered a little bit if
you were having any kind of movement from a cent
of philosophical conservatism bid is in expressing itself because legislators,
much more aligned in their ideology and their party affiliation and their philosophy. The most people are so the somewhat correct idea that the country is concerned.
And some people that are really conservative gets moved when I die
that's more about policy than it should be. So they begin to miss, perceive what people's policy
Indians are because of this stronger than it should be signal of conservatism. I want
Careful because, like I'm not, I didn't understand some of the methodology paper well enough in the time I d read it till. I know they didn't rule that out, but I thought those
fishing and it looked him. You like it was rolled out just says zoom out of it, though, what is it struck me about this papers? How big some of the gaps are for
control. I know you have the paper in front of you mad, but I think was a twenty percentage point gap among republican legislators in what they
leaved about certain measures on how conservative their voters were on EM
certain gone yet Van Orton tracks and saw weapons ban, and the actual lagoons
talking like five percent percentage points are good
twenty percentage point gap that
that's really really big
I think the magnitude of this was also something that jumped out of me,
Similarly, when you looked at gun control measures, he hurried striking that this really shows up and on a number of cultural issues where they mean PETE
systematically underestimate the level of support for same sex. Marriage for background checks for guns.
foresaw weapons bands and for legal abortion and all
which I think are issues where I think people see
perceive a preference intensity gap.
And are then misleading it may I on guns. I think it is very clear right that, like
the issue. Is that almost everyone who has constructed their political identity, a wound, gun activism,
conservative- and that is leading legislators to wildly underrate how much just like regular people support, could control measures
I think it's an interesting question of. I don't know what, like political fury ass like whether it's a feature
or bug of the system, that the very intense preferences of gun rights activists tend to trump, they like widely held but sort of superficial view that gun ownership should be restricted along.
because nothing is that doesn't like a law against gun control, be
She voters are forming,
clubs around this. Like people, don't like don't wanna, do it where's gun owners do
but it's interesting that the politicians it's a good. Looking at that,
as you can see what's happening here, but the politicians themselves don't seem to see at that
legislators are not self consciously saying to themselves. I am taking an unpopular stance on background checks because of preference intensity
patients there talking themselves into the idea that their position is popular when it is, you know it is pop
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Transcript generated on 2021-09-12.