Decarceration Nation (with Josh and Joel)

78 Abdul El-Sayed

Episode Summary

Joshua Hoe interviews Abdul El-Sayed about his new book "Healing Politics"

Episode Notes

Joshua Hoe interviews Abdul El-Sayed about his new book "Healing Politics"

Find full show notes from our website http://decarcerationnation.com/

Episode Transcription

78 Abdul El-Sayed Transcript

1

Joshua Hoe

0:03

Hello and welcome to Episode 78 of the Decarceration Nation podcast the podcast by radically reimagining America's criminal justice system. I'm Josh Hoe, among other things, I'm formerly incarcerated, a freelance writer, criminal justice reform advocate and the author of the book writing your own best story addiction and living hope. We'll get to my interview with Dr. Abdul El Sayed in just a second. But first the news. 

 

I've been super busy despite staying at home. Yesterday I participated in an online meeting concerning the recent court decision and sad legislative response by Michigan's legislature in regards the sex offender registry here in Michigan. This has been a long and ongoing struggle. But unfortunately, in response to the courts to sit recent decision, suggesting that massive changes need to be made. In order to make Michigan's registry constitutional. Their legislature decided essentially Do none of the changes that were recommended, but just kind of change the wording of the registry to try to make it meet the decision. And so we're working on strategy to try to defeat the new legislation. And we had a huge webinar yesterday about that topic. 

 

You know, most of my work has been focused, as you might imagine, as you might imagine, on COVID 19, in prisons and jails. Unfortunately, this has become increasingly critical yesterday, Michigan suffered the loss of its first prisoner due to COVID-19. We've had nearly 200 incarcerated folks test positive to date, the organization I work for safe and just Michigan has been very busy working with state and local officials, all you know, 24 hours a day, basically, to try to encourage the decarceration wherever possible. We are very happy that our governor recently released guidance for the decarceration of jails. And we're really hopeful that Governor Whitmer will be releasing guidance on prison soon as Well, we are also very hopeful that she will use her emergency powers and her commutation powers to help in our prison population as soon as possible. In this environment, I could not have been blessed with a better guest than epidemiologist and political commentator, Dr. Abdul El-Sayed. So let's get to that interview now. 

 

Dr. Abdul El-Sayed is a physician, epidemiologist, public health expert, progressive activist, former gubernatorial candidate and CNN commentator. He is a former professor at Columbia University's Mailman School of Public Health holds a doctorate in public health from the University of Oxford as a Rhodes Scholar has a medical medical degree from Columbia in addition to his degree from the University of Michigan. He's also the author of the new book healing politics which will be which is now available for purchase. I still remember as a former debate coach how impressed I was with him during the people's forum debate many moons ago when he was first running for governor here in Michigan. Welcome to the decarceration nation podcasts Doctor El-Sayed.

 

Dr. El-Sayed

 

Thank you so much for having me really excited to be on.

1

Joshua Hoe

3:04

Yeah, thanks again, I always ask the same first question. And in a sense, you just wrote a whole book about this. So it shouldn't be too tough. How did you get from where you started? Started out to where you are now as a doctor, former gubernatorial candidate and a CNN commentator.

2

Dr. El-Sayed

3:19

I am, you know, my, my childhood was spent between Southeast Michigan and Egypt. I spent a lot of my summers out in Egypt, in middle school in high school and there I'd hang out with my my grandmother, one of the smartest people I've ever met in my life, but she never got to go to school. And she had this great sense of, of moral reasoning. And she would always remind me that I was no different at core than any of my other cousins, who didn't have the opportunities I had growing up in Egypt, of course. And she, she'd say, you know, the difference between you and them is that you have opportunities and you have responsibilities. She lost two of her infants before the age of one of age to whom she gave birth. And those would have been my aunt and uncle. And the crazy thing is that when I would travel between where I grew up in Southeast Michigan, in Oakland County, to Egypt, I'd go 15 hours, and I travel about 10 years difference in life expectancy. But I could drive 25 minutes south on the large freeway, or I 75 and travel the same 10 year life expectancy gap and thinking about and reflecting on what my grandmother taught me. I think my my focus on trying to solve that problem, that deep difference in the experience of health and disease between people is what became my why. And I've spent a lot of my career thinking about how, whether it was going to medical school and then realizing that our healthcare system and its disincentives are a big reason why that that that difference in life expectancy exists rather than a way to solve it and then going into public health and And being a researcher and then, and then getting the opportunity to rebuild a health department taught me a lot about institutions and what they do and how they work and the limits of their potential impact on this problem, and ultimately decided to run for office because I came to appreciate when I was working in the city of Detroit, just how much politics shaped what we could do. It wasn't a limitation of our technical capacity was a limitation of our moral capacity. And I wanted to run on the moral argument that we should build a more just equitable and sustainable society. And that's why I ran for office. And of course, I didn't win. But a lot of my work as an activist and as a commentator, is about trying to make that argument that we need a new politics that we need a new political culture, and that you know, for serious about it, we've got to heal this this epidemic of insecurity that I talked about in my book, and that we need to bring our best forward which I believe is our most most empathic self

1

Joshua Hoe

6:00

We'll get a little bit more to the book in just a second. But since you're actually an epidemiologist, it seems appropriate to ask where you think we are with the National Response to Cova 19. Right now,

2

Dr. El-Sayed

6:10

you know, the hard part is that our public health infrastructure is made up of a number of interlocking institutions, local, state, and federal. And we have some of the most incredible people who work in public health in the United States. But it requires high quality leadership at the very top to coordinate the response. since the very beginning, our federal public health infrastructure, which is of course demanded by the President has been slow in appreciating the challenge and has been playing for the backfoot constantly playing to where the challenge is today, which is really just more where it was two weeks ago than where it's going. And in public health there are two real to real outages number one, it's better to prevent than it is to to deal with what you fail to prevent. Number two, you've Got to get ahead of the response. And, you know, we failed to put out the fire when it was very small, you know, a toaster in Taiwan, and now it is burning down the neighborhood. And so we have to respond. And our response has been slowing coming. And it has been, you know, behind where the epidemic is rather than ahead. And so, you know, my hope is that we're all doing what we need to do to take this on. But, you know, we've seen state and local officials have to step up and provide the leadership that the federal government hasn't, which is not how the system is supposed to work.

1

Joshua Hoe

7:34

And how are you said that we should get up on the can on the front foot? How would you get ahead of this thing from where we are right now?

2

Dr. El-Sayed

7:42

You know, we should have started building these access hospitals weeks ago. And the fact that they're just now getting up is a problem. So just want to step back, you know, we're talking a lot about social distancing to flatten the curve, and that's really, really critical. It's what all of us can do about this challenge. But it's not enough to just flatten the curve, we also have to anticipate the curve. And part of the problem is that the number of covered cases has the potential to overwhelm our healthcare system. And if we don't build out the healthcare system to accommodate the influx of coded cases, even as we work to flatten and delay, and reduce that number of cases, there's a potential where it would overwhelm the system and people would go about without the care that they needed. And so, you know, we needed to start a long time back like two weeks ago, building out these, these, these these excess facilities, you know, enacting the defense production act to get necessary personal protective equipment and ventilators and testing kits on board. And so we're, we're playing from behind what what can we do now? Well, we have to catch up. But even beyond that, we need to be thinking a lot more about, about what more can be done on both of these fronts. And, you know, the hard part is that you know, once again, we're behind and so You know, it's not enough to stick just to just to, you know, to be thinking about how to get to where you needed to be two weeks ago, but thinking really outside the box about about what can be done to prevent more disease and suffering. And I think, you know, thinking about what are the alternative spaces to provide health care? What are the alternative ways to identify who may be color coded positive, who's not, you know, one exact one idea there is, instead of just using tests to tell you that people who are already in sick or sick, using AI and machine learning algorithms to identify who's likely to be covered positive, and then testing those folks who are in the middle level of likelihood. But you know, this is this is the kind of public health planning that you want done well before you ever face a pandemic like this, rather than you know, being produced and thought through in the middle of the pandemic when you're already responding.

1

Joshua Hoe

9:53

One of the real problems we've been struggling with in my field is to effectively communicate to people the importance of thinning personal jail populations and getting the folks who are elderly at risk inside prisons commuted or relocated. Do you have any thoughts on Kovac 19? In our prisons and jails?

2

Dr. El-Sayed

10:10

No, it you know that one of the one of the most dire communities in need right now are folks in prisons and jails. And the reason why is because you're all talking about socially, just socially distancing. You can't socially distance when you're artificially incarcerated in a place with a lot of other people. And we all know that we're as vulnerable as the most vulnerable person with whom we come in contact every day. And so, you know, you've got, you've got workers who are coming in and out potentially getting exposed, and then exposing people in the facilities and then, you know, once it's in somebody's in those facilities, the ability then to stop it from, from propagating is very low. And so we really need to think about what it looks like to decarceration you know, at scale right now, to protect people inside of jails and prisons and and it's a community that Don't pay as much attention to as we're battling this, but they're extremely vulnerable. And we all have a responsibility to them. Because, you know, in theory, they're under our government's care. And, and we've got to be advocating right now to protect incarcerated, folks.

1

Joshua Hoe

11:13

You're also a political commentator on CNN, given this unprecedented break in our campaign based on Cova 19. I have to at least ask how you see the 2020 elections playing out.

2

Dr. El-Sayed

11:26

You know, you're seeing this artificial bump in, in approval for Donald Trump. And I think that's driven mostly by what is a pretty well documented bump that that in the middle of a crisis any leader gets, but if you also compare his bump relative to the bump that most governors are getting, it's far smaller, which suggests to me that, it, it's not going to last. The other challenge, though, is that, you know, we need to be able to provide a credible alternative and that means, you know, showing leadership right now and so it really is incumbent on folks running for president on the left, to provide that and to be out there leading on this issue, to be offering suggestions for a way forward to be providing resources and in providing leadership and so, you know, he's got his sort of his three ring circus have of his of his press conferences that he does every day. And that's giving him you know, wall to wall coverage for two hours every single day. It's not like folks got anything else to do. So, you know, he's getting as he likes to point to very high ratings. The response though, has to be clear. And then, you know, on the other side of it, we can't forget the fact that this didn't have to happen. pandemics are preventable, and this happened on his watch because of his failed leadership. And so I think on the left that that has to be pointed out to every single day that you know, this this man called it a hoax. He called it just like the flu. He wanted to shut down on response before Easter, all of these things put people's lives at risk. And he oversaw what has been, you know, up until now a failure from the federal government to respond. And I think we've got to continue to call that out. And so, you know, the the last question I'll say is just how do we vote in November? And that's an open question. We don't know how long these social distancing protocols are going to be in place. And so we've got to facilitate vote by mail everywhere. And that's going to be really, really important, I think, as well.

1

Joshua Hoe

13:31

And just to follow up on that real quickly, you know, I think there's a long standing tradition that, you know, generally when there's a national emergency, you try to keep as a campaign or whatever you try to keep politics out of. You try as a as a competitor, you don't really traditionally challenge commander in chief during an emergency. Do you have any suggestions for how someone might navigate that at the same time they're trying to provide a response from the left

2

Dr. El-Sayed

14:00

I mean, I'll be honest with you. It's something that I've tried to walk very carefully as somebody who's a public health doctor and doesn't want to interfere at all with the trust that people have for public officials, to whom they need to listen right now. And also somebody who is trying to be honest about the etiology of this pandemic, how it happened, why it happened, and whose leadership failed. And walking that that that that tightrope is not easy. I do think that there is a way that on the left, we need to be talking about what we need to do in contrast to what had been done before, to make sure something like this never happens again, and at the same time to talk about what the public officials in charge need to be doing that they're not doing. And I think by doing that, right, you're not necessarily working against those public officials capacity to respond. But what you are doing is leading that response, by advocating for what needs to be done in the Both in contrast to what was done that, that allowed for this failure, and what needs to be done to save lives imminently.

1

Joshua Hoe

15:07

So let's get to the book “Healing Politics.” As I read it, it seems to be broken up into kind of four parts in my head. The first part is about your personal journey, I learned all kinds of things, for instance, that you and your wife met during an event that I personally helped organize, called festa fall when you're both that students the University of Michigan, but one thing I know one after you, man.

But one thing I noticed after I was reading is you seem to be wrestling with in the book almost negotiating with yourself between markers of privilege and identity. At one point later in the book is summarized This is having both privilege and constraints. And another point in the book you talked about two boys double consciousness, well incarcerated and formerly incarcerated people are pretty aware of having to live live this negotiation to what kind of have you concluded from your journey writing the book in terms of kind of public Religion identity, I

2

Dr. El-Sayed

16:01

think it's something that you you constantly should be wrestling with inside. But I also think that the importance for action is it overrides the the sort of cognitive dissonance of asking, what should I be doing right now, and you know, all of us have a certain number of actions that are within our grasp right now. And, you know, and the kind of service that we can provide in the world. And I think sometimes we have to appreciate both the level to which our services is possible, considering our privilege, and also the level to which it's been constrained, but always to act at the level that we can to make the world a better place. And that's, that's what I've I've tried to do is that, you know, on the one hand, you've got to, it's frustrating. You know, when I speak again, as somebody with tremendous amount of privilege and you know, the privileges, I don't have ar, ar, ar AR themselves, you know, limited. But on the one hand, you know you you need to do something about articulating why the world is an unfair place, but on the other acting within the bounds that you can to make it a more fair place not just for you, but for for everyone. And I think that there is there is a there is a way that oppression or injustice can convince you that nothing is possible. And that's I think when the perpetrators of injustice when, when they they they make you think that you don't have a voice and that you can't do something. And it's true that that those folks are taking away the full capacity that you may have to do something. But it's not true that they've taken at all and I think our job is to constantly push up against the bounds and expand the bounds of what's possible within the limited capacity that each and every one have us has. And, you know, I've tried to use the abundant privileges that I've been given always to try and address the set of injustice as I saw, you know, in the contrast between where I grew up and where my cousin's grew up or where I grew up in, you know, neighborhoods just 20 minutes away in the city of Detroit and I hope that that can be an example of of how we think about leveraging what we have to make the world a more just place but you know, I fully appreciate that for so many people the the the system has taken away so many privileges and rights, that it's easy to feel like you know, I've got nothing left to give but even a small thing that to you may seem insignificant can be the most of all and you know, I think about random people who've reached out to me and said you know, I don't know if you remember who I was, but you helped edit my essay to help me get into college and, and thank you for that or you help tutor me in English when I just arrived United States, thank you for that. Now I'm working as a pharmacist. So there's little things sometimes you, you know, you forget that you did for somebody can make all the difference. And there's always somebody out there who can use your help. And part of the part of the work is identifying who those people are. And then giving of yourself and I think, you know, it goes around comes around and, and I found that, that you know, those little those little pieces of service, however small they may seem, can mean a lot. And sometimes, you know, you'll find folks who, you know, lift a hand for you that you never saw coming.

1

Joshua Hoe

19:32

I thought one part of the book guy that demonstrated that pretty well, I thought was the part where you talked about the person who in essence voted for the first time only because you were running for governor, which I thought was a pretty powerful part of the book. One of the real goals of the movement to change. Our criminal punishment system here in America is to have more formerly incarcerated folks run for office where that's possible. So you ran for governor as we've talked about, You got a lot of attention, a lot of support. And also I do endorse some pretty tough and often racist attacks. I remember a particular competitor of yours in particular, leveraging some attacks that were very upsetting even to me. In the book, you've talked about being afraid to run just based on the effect that your name would have. So after having gone through all that, what did you learn that you could kind of pass on to some of the folks that might be listening about negotiating these complexities of running in electoral politics?

2

Dr. El-Sayed

20:34

First, please do we need your voice folks who are affected by the experiences that you've had uniquely need your voice, so I hope that you'll run and I hope that when you do, you'll find me out and let me have the opportunity to support. The other part of it though is, is sometimes sometimes we believe what they say about us and, you know, for me as a Muslim American Everybody told me there is no way you can run. You're too young to Brown, you're too Muslim. And I couldn't believe that. And in my worst moments I did. But at the same time, part of me just said, You know what, but that's exactly why. Because that shouldn't be a an argument that's leveled against anybody that you're to X, Y, or Z. Because all of us have something to offer. In particular, folks who've had an experience with a deeply broken system, you have something deep to offer. And in some respects, for me, the reason I wanted to run is because I do have expected experiences with a different broken system, which is the healthcare system. And I felt like the contribution I might be able to make was to help fix that, despite what people have said about whether or not I could run based fundamentally on what I look like and how I pray like and, and so for folks who've had experiences with the criminal punishment system, I just think it's so important for you to to get out there to share your voice and your experiences. Because if you can translate that for folks who've never experienced it, you can make one A whole lot better for folks who are experiencing now. And so there's a real responsibility there. And so part of it is just having the courage to step beyond what people tell you as possible, and to imagine a different possible, and then to go and make it possible. And you may not win, you know, I didn't win. Maybe they were all right. But I do hope I made it. I don't know he did pretty well.

1

Joshua Hoe

22:21

I think he did pretty well, I was I was pretty impressed with your campaign. In the second part of the book, you make the case, for the core of America's current problems being related to a series of insecurities. Do you want to explain your kind of encapsulate your argument about America being an insecurity epidemic?

2

Dr. El Sayed

22:40

So right now, you know, we have so many systems that have been been been been torn apart and sold for parts to the highest bidder. Corporations have stuck their hands in every part of our society, to the exclusion largely of poor And oppressed folks and also to the exclusion of folks, you know, in the very middle, because they take and they take and they take. And so, you know, whether it's the health system or the criminal punishment system, or it's the housing system, or it's the economy itself, or it's our political system, people feel locked out. And that's left us extremely insecure about whether or not we'll have the basic means of a dignified life. And, and because of that, I think it's really shaped our politics folks, you know, are worried about what more the system is going to take from them. And in this moment, I think we have a responsibility to recognize what's happening, and to do the work of solving it. And to decide that rather than fear what people will take from us, which opens us up to exploitation by demagogues who tell us that you know, this other person is going to take our job or this other person is going to take our opportunity that we Coming together a band together in build the kind of society that frees us of that kind of exploitation and susceptibility and insecurity from those corporations that have been so focused on their bottom lines, rather than all our well being.

1

Joshua Hoe

24:15

Yeah, I think, you know, one of the things that I appreciated was at different points, you kind of made reference to this, you know, we kind of have this I think we're all taught when we're young, that one of the parts of a capitalist system that's really great, it's it creates competition. But what seems to have happened is that in a lot of areas, all of the different companies have essentially colluded to stop competing. And this ends up meaning that, you know, they basically get to operate in kind of Monopoly systems. It's kind of like every city or town has its own cable company. Is that correct? Am I reading that correctly?

2

Dr. El-Sayed

24:49

That's right. That's right. And so you know, a lot of folks think that the biggest danger to the free market is government regulation, actually the biggest danger to the free market. government regulation. It is oligopoly and monopoly. And what a lot of these major corporations have done is that they have so limited their competition that they've in effect, become oligopolies, and monopolies and then use the system against us to say that when the government tries to regulate in favor of them of the existence of a real market, where the little guy has a chance, that somehow they're operating against the free market, and it's a perverse approach to to the system that hurts all of us, as consumers and as people who work in the system.

1

Joshua Hoe

25:33

The third part of the book seems to be a model for a different kind of politics based on what is an act of empathy. Can you summarize what you mean by healing politics?

2

Dr. El-Sayed

25:44

And right now, you know, we are so focused on this us versus them, approach to politics, pointing fingers and telling people that they're just wrong. And I think I think the folks in power benefit from that. And so if we want to change Politics honestly, then we'll deal with it in the form of empathy, we'll step back and ask why does this person think the way they do? And how can I get them to see the world from my perspective by seeing it from their perspective, and focus on winning the future rather than winning the argument. And I think if we were able to do that, if we were able to bring that to our politics, it would be a fundamentally different experience. And we'd have fundamentally different opportunities to actually make things better. And that's the that's the kind of empathy politics that that I hope that we can engage with.

1

Joshua Hoe

26:33

In the criminal justice reform world, we kind of believe in second and third chances pretty inherently so that makes a lot of sense to me. You say that empathy politics seems to understand and heal insecurity rather than ignore and inflame it. But at the same time, right now, we seem to exist in a communication environment kind of characterized by, for lack of a better term trolls on the right and the canceled culture on the left. Do you have thoughts on how we might never navigate those extremes towards this healthier politics.

2

Dr. El-Sayed

27:04

And you know, the hard part about social media in particular is that it plays to our worst instincts, not our best instincts, it plays to our first instincts, which are usually our worst instincts. Right? You know, it's that why I oughta feeling that you get when you read something that you don't like on on social media on Twitter. And so I think that, you know, part of it is that we've got to bring back a sense of asking, Why did you say that rather than what did you say? And why do I how do I feel about it? Now? What did you feel that made you think that you should write that you should say that, and I know I'm guilty of it, too. It's frustrating people say terrible mean things, but if we want to solve it, I think it really starts with us asking, so why is this happening and how do I fix it? What do I do about it? And I think if we can get there, the world becomes a far easier place to manage. And I've found that you know, in my my work specifically, you know, in politics, if you sit down with somebody and they say some They really mean and you just say, you know, you really hurt my feelings. And I wish you didn't say that it's a very different response than when you hit them back. And I found that hitting folks back doesn't really get anyone anywhere, it just gives them a bigger incentive to hit you back. And, and that doesn't solve the problem. And so I do think that there's a vulnerability that we have to we have to bring to it. But also at the same time, an opportunity to, to empower one another, and to engage one another, and to inspire one another, and to believe that we can all be different and better. And it's like you talked about, right? It's that if you want real reform, you have to believe in second chances. And so why not give folks second chances?

1

Joshua Hoe

28:40

I do recommend, there's a part where you kind of give a five point, I think four or five points. Plan and the last one is Be kind, which is when I really appreciate that I I don't know. Is that part of your faith journey or did that just just generally, I agree that that's a great way to approach on social media,

2

Dr. El-Sayed

29:01

okay, I think it's, you know, it's something that we should just be doing, because it's the right thing to do. But it's also the more effective thing to do, right? I've always found that if you beat somebody in an argument, it's not like they believe you afterwards. Right? Maybe that other people believe you, right? But they don't usually believe you afterwards, because they're more hurt by the fact that there was this conflict, rather than empowered by the way you treated them. And I just think it's a central insight of, of you named the sort of historical tradition that if you're kind to people, you're generally going to get, you're going to get there faster. There's a thing about Abraham Lincoln, and his approach when he was mad. I mean, the social media didn't exist in that time. But he would get letters from really angry constituents or angry people that he'd worked with in the government. he'd write the letter out, responding to them, and then he he'd throw it in the trash is because he knew his first instinct wasn't his best instinct. And, and I think, you know, you think about what he was able to accomplish because of his unfailing kindness to people. It just, you know, it, it there is this sort of notion right now that, that that being kind means being weak. And I actually think, you know, in my own experience, it takes a lot more to be kind than it does to hit back. There's a strength in that. And if we brought more of that strength, maybe we'd be a better a better country.

1

Joshua Hoe

30:20

The last part of the book identifies a lot of ideas for policy solutions. One of the positions that you're most identified with is Medicare for All. here in Michigan several years ago, we lost a battle which put work requirements in the Medicaid expansion, something that impacted a large number of formerly incarcerated folks. In kind of the micro and the macro, how do we change the politics on healthcare?

 

I know that's a tough one.

2

Dr. El-Sayed

30:46

I think, look what we're seeing the consequences of our failure to build a more just equitable, sustainable health care system right now. It's showing up in so many ways, the fact that 10% of people don't have health care in the middle of a pandemic 50% And the people on top of them have their healthcare behind a paywall, because their deductibles are so great, right? That's not a helpful thing when you want people to to be safe and healthy in the middle of the pandemic, right that in the fact that our health hospitals are facing bankruptcy at the same time, as they're facing kovat because they've been forced to cancel their most lucrative cases, which are elective procedures, that in the fact that there's really no incentive to prevent disease in a system that pays people when people get sick, that in the fact that you know, just in time business techniques that tell you that you should, you shouldn't, you shouldn't stockpile your preventive gear isn't great advice in the middle of a pandemic. So I just think history is, is endorsing Medicare for all and this moment is telling us that we should have acted sooner. Now the question is whether or not we're willing to act in the future. It's going to be a different world coming out of this pandemic. I mean, this is the the greatest collective trauma that I think the country has seen since World War Two. All of us are experiencing it, and even if you're not You know, fighting for your life on on a bed, you may know somebody who is and and even if you don't know somebody who is you're now sitting in your house worried about when this will all clear up. So, you know, this is a moment for us to say, look, we could do it better, and we never want to be here again.

1

Joshua Hoe

32:16

So some people seem to be suggesting that, you know, if this was a call for Medicare for all, it won't happen in time to solve the problem. What do you think about that?

2

Dr. El-Sayed

32:28

That's true, it won't happen until it's time to solve this problem. But we'll be done with this someday. And when we all we get, we get to make a decision about whether or not we're going to solve the next one. And my hope is that we

1

Joshua Hoe

32:39

do. And it's a little weird, but in a time when we just spent, you know, I think was $3 trillion in like five seconds. Seeing PIP some people seem to worry that Medicare for all cost too much, is that fair?

2

Dr. El-Sayed

32:51

And you know, what it costs too much is the system that we're in right now, which which puts healthcare behind a paywall for people so that they can actually access it. You know, what costing means, to me is what it costs to the average individual who's looking at their budget at the end of the month. And asking, Can I afford this? You know, the trillions of dollars that we talked about in terms of state and federal budgets was what usually mean that much to people. And we know, right, based on the preponderance of the evidence that actually Medicare for all would cost the system less, but more importantly, it would cost individuals in the system less, because it would be a more effective, more efficient system that asks corporations to pay their fair share. And that takes the the added cost of health care that you don't usually factor into your health insurance costs, the deductibles and the CO pays away. It just to me seems, seems obvious. But you know, this is a nice talking point and people will keep pushing it. Who who will oppose this because there's a lot of money to be made on the health insurance system, right. The CEO Blue Cross Blue Shield of Michigan, made 19 million bucks last year that guy doesn't want to give that up. Right? I would need that if I were him. But maybe if I knew that it was coming at the cost of people getting health care when they needed it. Maybe I think differently. And that's just what we're asking.

1

Joshua Hoe

34:02

Yeah, I thought this is one of the really contributions that Andrew Yang made to the presidential campaign was this notion that our standards of economic health, our statistics for economic health, really don't describe economic health very well. I think there's probably a pretty good example of that when we talk about it costing too much or something like that. Others seem to be concerned that everyone works in the insurer who works in the insurance industry or around insurance would be displaced by Medicare for all, is there a solution here?

2

Dr. El-Sayed

34:31

two things. Number one, you know, that that we do have to make sure that there's a just transition for people into other jobs that that will exist, but think about this right 10% of of everyone will all of a sudden have access to healthcare they never had before. That's 10% more demand for for all of the healthcare that's offered. We need more doctors and more nurses and more staff. So there'll be jobs made. And then you know, it's not like health insurance is going away, it's just going to change. So most of the loss is like the CEO, now goes from earning $19 million a year to earning $150,000 a year. And, and I'm okay with that. Right. And other folks in the in the health system, my hope is that we can transition them from being in jobs that deny people health care when they're sick to being in jobs that provide it. And so, yes, that transition is real, and we shouldn't pretend like it's not, but in the long term, right, it's a transition that's morally right for us and provides real opportunities on the back end. It's not like those jobs just go away. It's just they transition into something else.

1

Joshua Hoe

35:37

Finally, some folks worry that co pays kind of prevent a moral hazard. They prevent people from overusing health services. I find this to be a pretty troubling argument. But I do hear people make it their thoughts on this.

2

Dr. El-Sayed

35:50

And what the evidence suggests is that people aren't very good at knowing what health care matters and what doesn't. And you know, that's why you go to a doctor, it's not like you just go to a doctor to heal you after you've diagnosed yourself, you go to the doctor because you need a diagnosis and the treatment. And so what happens with CO pays is that people just use less healthcare. And the bigger the steeper the cost of quote unquote cost sharing. What we find is that the consequences are bigger. So folks with big deductibles, for example, women with with serious deductibles are more likely to have more serious breast cancer and later diagnoses than than women without big deductibles. And that's because people know that they're going to have to pay for their health care. And even when they need it, they still put it off. That's a dangerous thing. That's a bad thing. Like I'd rather people make the mistake of using more health care and getting the treatment that they need when they need it, then making the mistake of using too little health care and not getting the treatment that they need when they need it.

1

Joshua Hoe

36:44

So a lot of one of your big issues during the campaign and also as mentioned in the book is kind of access to water and water quality. A lot of formerly incarcerated folks in Detroit and Flint have had to deal with the problems of access to water and water quality and a lot of people in prison have to deal with water quality issues. So what's your take here?

2

Dr. El-Sayed

37:04

It's good news that in the face of this pandemic, that there's finally a focus on stopping water shutoffs and turning water back on but like, you have to ask what kind of high income society has to turn water back on. Right? Like, where have we fallen, where that's a good thing where we're celebrating people finally getting their water back. And the point that you make about about folks in, in institutional settings, right, where we, as a society, are responsible for their well being and we can't get them something as safe, as simple as water. We've got a lot of work to do. And the crazy thing, the irony of it is that in Michigan, it's not like we don't have water, right? We have more more fresh water than any other state. Frankly, almost any other country in the world. It's about the choices we make about how we pay for its purification. And I talk about this a little bit in the book, but it to me, it's just not right. For us to say that. You know, if you can't pay you Don't get especially when you watch Nestle get 400 get as much water as they want for $400 a year. In Michigan, we're telling people that they have to pay $400 a month, or they get the water shut off. It makes no sense.

1

Joshua Hoe

38:11

So there's a ton of other things in the Bible. I can't. This is a very, very dense book. There's a lot of great stuff in here that I'm not covering. So I would really encourage everyone to read it. But I have a few more questions. This is the decarceration nation podcast. I've been asking people all my guests this year, what their best idea for decarceration is so what changes to our system of incarceration Would you like to see implemented?

2

Dr. El-Sayed

38:38

I talked about this a little bit in the book. And there are so many things that need to be done from everywhere from policing to to sentencing to the way we we incarcerate itself, to how we think about about parole. But one thing that to me is really important. is focusing on investing in mental health. Because in so many ways, we've seen a deinstitutionalization of mental health, which was itself a good thing, but we didn't build out the outpatient facilities to support people with chronic mental illness. And so too many of them find themselves in the criminal punishment system, being punished for nothing but not having their mental illnesses treated. And so, I think we need to start really investing in, in support and protection for people with mental illness, as a society. And, and I think that would do a lot to be able to, to get folks the treatment that they need, rather than, than allowing them to fall into a system which itself is, is broken so many other ways but, but also has become, you know, in some ways a receptacle in our, in our, in our society for our failure to be able to care for people with mental illness.

1

Joshua Hoe

40:00

I'm not I don't remember this being a big part of the book, but I remember it being a big part of your campaign Do you want to talk a little bit about kind of digital equity?

2

Dr. El-Sayed

40:09

Um, you know, one of the one of the programs that we, we fought for we talked about was called my fi, which was about making sure that everybody had access to Wi Fi, which, you know, if you think about it, like the internet is the highway of the 21st century, and right now, we're asking people to, you know, to have paved roads and be happy with it. And so being able to provide folks in rural communities in particular, but also urban communities where, where internet is available to be hard, but it's too expensive access to reliable quality Wi Fi because, you know, how do you learn in the 21st century when you don't have the internet in your home? How do you learn when or how do you conduct business when you can't take a payment online and, and we've got to fix that. And it's got to be a real priority that we have as a society, considering that it is no 2020 And they're still people who don't have reliable internet access.

1

Joshua Hoe

41:04

So you're around, I think 35 years old, you're a medical doctor with two doctorates. You've run for governor, you have a kid and you're on television. Are people ever worried about you working too hard?

2

Dr. El-Sayed

41:17

You know, one thing that that I've, I always try and reflect on. And it's a real sort of subtext of my faith, is the fact that you only have a certain amount of time here. And, you know, I'm 35, which, assuming we, you know, we play the actuarial tables, I'm relatively young, but, you know, as Calvin has reminded us, you never really know when it's your time. And so my hope is that I can spend as much of my time on here making the world more just equitable place for folks and, and, you know, fulfill the responsibilities that come with the level of privilege that I had, and I have, and so you know, I work hard because I think it's a responsibility I have to my time here and the people who don't have that The privileges that I have and the people who could benefit from from, from from from the work I might do. And so, you know, you put your time in, but it also doesn't mean that you don't take some time and enjoy. You know, the beauty in life, like I got a two year old and I love my time with her and some of the most special meaningful time that I spend every day. And so I think there's a balance, but you know, at some point I want to sprint through whenever my end is and know that I've done whatever I could in the circumstances that I had to solve, or to be a part of the solution to problems that I think need solving.

1

Joshua Hoe

42:34

And I think that's probably why I actually asked that question is to ask you, if you have a vision for what's next what what are the next challenges you're planning to take on

2

Dr. El-Sayed

42:44

right now. It's, it's about really trying to, to frame what it is that we need to do coming out of this debacle, to be to do my best to move information about what people can do to keep themselves And what policy should look like in the middle of it? And then, you know, we'll look, we'll look once we're out of here, look at what opportunities exist and where I can be helpful to try and making those matter for folks and we'll see.

1

Joshua Hoe

43:13

Okay, always asked the same last question. What did I miss? What questions should I have asked but did not I'm guessing given the size of the book. I missed a lot. But that's my question.

2

Dr. El-Sayed

43:23

I think you I think this was a great and very comprehensive interview, I really appreciate you giving me the space and the time. I want to thank you for your work and your activism. It's so meaningful, and I'm grateful that I get to to share a state with you. So I hope that we get to get to work work together in the future and and I really, really appreciate you having me on the pot.

1

Joshua Hoe

43:42

Thanks so much for doing this. Do you want to tell everyone all of the information about how to get the book

2

Dr. El-Sayed

43:48

so the best way to do it is to go to healing politics book calm and if you're in Michigan, we've got a list of local local booksellers who really could use your help. are selling the book and so I hope that you'll check it out. Healing politics book calm.

1

Joshua Hoe

44:04

Great, and thanks again and thanks so much for being my guest on the decarceration nation podcast.

 

Dr. El-Sayed

 

It was my privilege. I really appreciate you.

1

Joshua Hoe

44:15

And now my take, Look, I know the news media has anointed him America's governor. But during a time of national crisis, we're even our national Attorney General, a man who famously once wrote a paper defending mass incarceration is himself letting people out of prison. Yesterday, Governor Andrew Cuomo rolled back New York's bail reform law, ensuring that more and more and more people are sent to jail at a time when most of us see decarceration as a national public health imperative. Under the cover of darkness Governor Cuomo threatened the legislature was shutting down the government including the health department if they did not agree to rollback bill In the middle of this crisis, and as a result, the bill passed with less than four minutes of debate. his so called reforms included allowing judges to detain people pre trial for misdemeanor dangerousness based only on the discretion of the judges, something that's never been true in New York, not since 1974. Added multiple categories of new crimes to the list of crimes that people can be detained pre trial for. He made it so prosecutors can literally recall people have been released since January. For new court hearings and possible pre trial detention. He allowed for a new category of folks to be detained pretrial people who committed multiple misdemeanor offenses. As Piper Kerman recently noted in her Washington Post article, the public safety risk created by increasing incarceration probably is larger than the risk of misdemeanor recidivism. In addition, he took this opportunity to narrow discovery reform Discovery, your form in New York basically brought new york back into alignment with what the rest of the country has been doing for a long time. But now, New York will go back to it's a much shorter window for people accused of crimes to have access to the evidence that will be deployed against them. This does nothing but help plea bargain, increased plea bargaining leverage and works against due process ensuring more plea bargains, and even more incarceration, which seems to be the moral of his story for some reason. Look, I get it. He seems personable. He's a Democrat. He actually holds a good press conference and seems thoughtful, but he is a ruthlessly Machiavellian political schemer, and this week he made New York a more dangerous place. As I've explained here for several weeks in a row. One of the biggest dangers to our communities is the churn of people entering and exiting our jails, America. Governor just ensured that that churn increases at a time when almost every other public official in the country is rapidly decarceration people. This is pure politics taking the place of smart policy. I say say no to Andrew Cuomo. 

 

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Special thanks to Andrew Stein who does the editing and post production production for me to Robert Alvarez, who helps with the website indicate summers who is helping with our Instagram and Facebook pages. Make sure and add us on Twitter, Instagram and Facebook and share our posts across your network help grow the decarceration nation. Also thanks to my employer safe and just Michigan for helping to support decarceration Nation podcast. Thanks so much for listening to the decarceration nation podcast. See you next time.