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>>> HELLO, EVERYONE, AND WELCOME TO "AMANPOUR AND COMPANY."
HERE'S WHAT'S COMING UP.
>> INDICTMENT WAS UNSEALED CHARGING DONALD J. TRUMP WITH CONSPIRING TO DEFRAUD THE UNITED STATES, CONSPIRING TO DISENFRANCHISE VOTERS, AND CONSPIRING AND ATTEMPTING TO OBSTRUCT AN OFFICIAL PROCEEDING.
>> THE UNITED STATES OF AMERICA VERSUS DONALD J. TRUMP.
AGAIN.
WHAT HAPPENS NOW THAT THE FORMER PRESIDENT HAS BEEN INDICTED FOR A THIRD TIME?
THIS ONE, FOR ATTEMPTING TO OVERTURN THE RESULTS OF THE 2020 ELECTION.
WE GET THE LEGAL VIEW WITH THE FORMER FEDERAL PROSECUTOR JESSICA ROTH.
>>> THEN, HOW REPUBLICANS ARE REACTING TO THE NEWS WITH PRESIDENTIAL CANDIDATE JOE WALSH.
>>> AND THE DEMOCRATIC TAKE, WITH CONGRESSMAN JOE NEGUSE, WHO SERVED AS A PROSECUTOR IN THE SECOND IMPEACHMENT TRIAL OF THEN PRESIDENT TRUMP.
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>>> WELCOME TO THE PROGRAM, EVERYONE, I'M CHRISTIANE AMANPOUR IN LONDON.
THE U.S. AND THE WORLD REACT TO PERHAPS THE MOST IMPORTANT INDICTMENT IN AMERICAN HISTORY FOR TRYING TO OVERTHROW THE 2020 ELECTION.
THE SPECIAL COUNSEL, JACK SMITH, LAID FOUR FEDERAL CHARGES AT HIS DOOR, STATING IN A 45-PAGE DOCUMENT THAT THE FORMER PRESIDENT CONSPIRED TO DEFRAUD THE UNITED STATES IN HIS ATTEMPTS TO OVERTURN THAT ELECTION.
WHICH ULTIMATELY LED TO THE JANUARY 6th ATTACKS.
>> THE ATTACK ON OUR NATION'S CAPITOL ON JANUARY 6th, 2021, WAS AN UNPRECEDENTED ASSAULT ON THE SEAT OF AMERICAN DEMOCRACY.
AS DESCRIBED IN THE INDICTMENT, IT WAS FUELED BY LIES, LIES BY THE DEFENDANT TARGETED AT OBSTRUCTING A BEDROCK FUNCTION OF THE U.S. GOVERNMENT, THE NATION'S PROCESS OF COLLECTING, COUNTING, AND CERTIFYING THE RESULTS OF THE PRESIDENTIAL ELECTION.
>> IF CONVICTED ON ALL CHARGES, TRUMP COULD FACE LIVING OUT THE REST OF HIS LIFE BEHIND BARS.
HE CONTINUES TO DENY ANY WRONGDOING.
AND WE'RE GOING TO BE LOOKING AT THIS FROM ALL PERSPECTIVES TONIGHT.
FIRST, ON THE LEGAL SIDE, JOINING ME TO MAKE SENSE OF ALL OF THIS IS JESSICA ROTH, A FORMER PROSECUTORS WITH THE SOUTHERN DISTRICT OF NEW YORK, AND A PROFESSOR NOW AT THE CARDOZO LAW SCHOOL.
WELCOME TO THE PROGRAM.
SO, THIS IS THE THIRD OF THESE INDICTMENTS.
AND YET, IT IS THE MOST SERIOUS, EVERYONE IS SAYING.
WHY SO?
>> I AGREE, THESE ARE THE MOST SERIOUS CHARGES WE HAVE SEEN TO DATE AGAINST THE FORMER PRESIDENT.
THEY ARE SERIOUS, BECAUSE WHAT THEY ALLEGE IS A SCHEME WITH TRUMP AT THE CENTER TO OVERTURN THE RESULTS OF THE 2020 ELECTION.
DEPRIVE THE AMERICAN PEOPLE OF THEIR RIGHT TO HAVE THEIR VOTES LEGITIMATELY COUNTED.
AND TO PREVENT THE PEACEFUL TRANSFER OF POWER.
THOSE ARE ALLEGATIONS THAT GO TO THE HEART OF OUR DEMOCRACY, AND THEY DESCRIBE A SCHEME THAT WAS ONGOING OVER A PERIOD OF MONTHS, SO, WELL BEFORE THE EVENTS OF JANUARY 6th ITSELF, THAT WAS MULTIFACETED.
IT WAS BUILT ON LIES THAT THE FORMER PRESIDENT TOLD AGAIN AND AGAIN ABOUT ELECTION FRAUD, BUT IT WENT WELL BEYOND HIS WORDS.
WHAT THE INDICTMENT DESCRIBES IS AN ORCHESTRATED SCHEME PERPETRATED IN SEVERAL STATES TO HAVE STATE OFFICIALS DELEGITIMIZE THE LEGITIMATE ELECTORS WHO HAD BEEN ELECTED FOR BIDEN BY THE PEOPLE OF THE STATE TO SUBSTITUTE OTHER ELECTORS, FAKE ELECTORS, WHO WOULD VOTE FOR TRUMP, AND THEN SUBMIT THOSE TO THE U.S. CONGRESS, AND THEN, FURTHER THE SCHEME INCLUDED PRESSURING MEMBERS OF THE U.S. CONGRESS TO ACCEPT THOSE FALSE ELECTORS, AND EFFORTS TO PRESSURE VICE PRESIDENT PENCE TO ACCEPT THOSE FALSE ELECTORS, OR AT A MINIMUM, TO DELAY THE CERTIFICATION PROCESS.
SO, IT IS A VAST SCHEME, AND IT GOES TO THE HEART OF OUR DEMOCRACY.
>> AND, YOU KNOW, I HEAR YOU SAYING SCHEME SEVERAL TIMES, AND I'M INTERESTED IN THAT WORD YOU USE, BECAUSE THE ACTUAL INDICTMENT AND THE WORDS OF JACK SMITH USE CONSPIRACY, CONSPIRACY, CONSPIRACY.
AND CONSPIRACY IS -- IS EVEN MORE UNDERWORLDY.
IT SMACKS OF RACKETEERING AND ALL THE REST.
DO YOU MAKE A DISTINCTION BETWEEN SCHEME AND CONSPIRACY?
>> I DON'T, AND THAT'S IMPORTANT TO POINT OUT.
A SCHEME, IN A SENSE, COULD -- IT COULD DESCRIBE THE ACTIONS OF ONE INDIVIDUAL, ALTHOUGH USUALLY IT DOES NOT, WITH SOMETHING THIS COMPLEX.
WHAT IS THE HALLMARK OF A CONSPIRACY, WHICH IS THE NUB OF THREE OUT OF FOUR OF THE CHARGES, IS THAT IT INVOLVES AN AGREEMENT BETWEEN TWO OR MORE PEOPLE TO ACHIEVE A COMMON PURPOSE.
AND SO, THAT IS AT THE HEART OF THIS CASE.
AND WHEN I SAY SCHEME, I COULD BE SUBSTITUTING THE WORD CONSPIRACY.
>> OKAY.
>> THERE ARE SIX CONSPIRATORS NAMED IN THIS INDICTMENT, OR, I SHOULD SAY, WHO ARE DESCRIBED IN THE INDICTMENT, ALTHOUGH THEY ARE NOT NAMED, WHO WERE KEY TO THE PERSON TRAGS OF THE PLAN THAT I'VE ALLUDED TO.
>> SO, YOU'VE OBVIOUSLY NO DOUBT HEARD, BECAUSE EVERYBODY'S BEEN LISTENING TO THE REACTION ON BOTH SIDES, THE TRUMP PEOPLE, THE PEOPLE WHO ARE COMPLETELY ON HIS SIDE, ARE BASICALLY SAYING, THIS IS JUST POLITICAL, THIS IS ALL ABOUT, YOU KNOW, WEAPONIZING THE JUSTICE DEPARTMENT, WEAPONIZING GOVERNMENT, AND LET ME JUST READ WHAT IT SAYS.
THE RESPONSE IS, THESE UN-AMERICAN WITCH HUNTS WILL FAIL AND PRESIDENT TRUMP WILL BE RE-ELECTED TO THE WHITE HOUSE SO HE CAN SAVE OUR COUNTRY FROM THE ABUSE, INCOMPETENCE, AND CORRUPTION THAT IS RUNNING THROUGH THE VEINS OF OUR COUNTRY AT LEVELS NEVER SEEN BEFORE.
FROM A LEGAL PERSPECTIVE, WE JUST SAID, IF HE'S CONVICTED, IT COULD BE 50 YEARS OR SO ON ALL CHARGES, WHICH WOULD BE THE REST OF HIS NATURAL LIFE BEHIND BARS.
WHAT WOULD YOU SAY?
AND I KNOW THIS IS POLITICAL, BUT FROM THE LEGAL PERSPECTIVE TO THAT KIND OF DEFENSE BY THE DEFENDANT?
>> IF ANYONE READS THE INDICTMENT, AND I HOPE THAT PEOPLE WILL, IT IS IMPOSSIBLE TO COME AWAY WITH THE CONCLUSION THAT YOU JUST DESCRIBED, THAT THIS IS POLITICAL AND UNFOUNDED AS A PROSECUTION.
THE INDICTMENT IS DETAILED, IT REFERENCES CON ITEM RAIN USE NOTES BY PEOPLE WHO WERE IN COMMUNICATION WITH THE FORMER PRESIDENT, INCLUDING VICE PRESIDENT PENCE, ABOUT THE PRESSURE THAT THE FORMER PRESIDENT WAS PUTTING ON HIM TO -- TO OBSTRUCT THE CERTIFICATION OF THE LEGITIMATE ELECTORS.
IT RECOUNTS IN DETAIL ALL OF THE ACTIONS TAKEN BY MR. TRUMP AND HIS CO-CONSPIRATORS TO PERPETRATE THE SUBVERSION OF THE ELECTION RESULTS.
AND IT SHOWS HOW HE WAS TOLD REPEATEDLY BY ADVISERS, INCLUDING THE ATTORNEY GENERAL OF THE UNITED STATES, WHO HE APPOINTED, AND OTHER TOP OFFICIALS AT THE DEPARTMENT OF JUSTICE, AND IN THE WHITE HOUSE COUNSEL'S OFFICE, THAT THE THEORIES THAT WERE BEING PROMOTED AS FOR WHY WHAT HE WAS TRYING TO DO WAS POSSIBLE, THAT THOSE THEORIES WERE COMPLETELY UNFOUNDED.
HE WAS TOLD REPEATEDLY THAT HE HAD LOST THE ELECTION.
AND SO, AGAIN, IF YOU LOOK AT THE EVIDENCE, AT LEAST AS PRESENTED IN THIS INDICTMENT, AND THE GRAND JURY FOUND THE STANDARD OF PROBABLE CAUSE, IT'S IMPOSSIBLE TO COME AWAY WITH A CONCLUSION THAT THIS IS ANYTHING BUT A JUST PROSECUTION FOUNDED IN EVIDENCE.
THAT'S VERY IMPORTANT FOR ACCOUNTABILITY AND THE RULE OF LAW IN THIS COUNTRY.
>> SO, THERE'S BEEN A LOT OF SPECULATION ABOUT WHAT KIND OF DEFENSE HE AND HIS TEAM COULD MOUNT, AND TO CNN, TO KAITLYN COLLINS, THIS IS WHAT HE MAIN LAWYER SAID ABOUT WHAT THEY WOULD COME UP WITH.
>> OUR DEFENSE IS GOING TO BE FOCUSING ON THE FACT THAT WE HAVE AN ADMINISTRATION THAT HAS CRIMINALIZED THE FREE SPEECH AND ADVOCACY OF A PRIOR ADMINISTRATION DURING THE TIME THAT THERE'S A POLITICAL ELECTION GOING ON.
>> SO, FREEDOM OF SPEECH, I MEAN, DOES THAT SOUND REMOTELY POSSIBLE UNDER THE -- THE FRAMEWORK?
>> IF THE PROSECUTION FOCUSED SOLELY ON STATEMENTS THAT MR. TRUMP HAD MADE, LIES HE TOLD IN PUBLIC, THEN IT WOULD BE A VERY DIFFERENT CASE, AND THERE MIGHT WELL BE A FIRST AMENDMENT DEFENSE.
BUT THAT IS NOT THE BASIS FOR THE CHARGES HERE.
THE CHARGES ARE BASED ON CONDUCT THAT MR. TRUMP AND HIS COCONSPIRERS ALLEGEDLY ENGAGED IN TO CREATE THESE FALSE SLATES OF ELECTORS, AND HAVE THEM SUBSTITUTED FOR THE LEGITIMATE ELECTORS, AND ALSO TO EXPLOIT THE VIOLENCE AT THE CAPITOL ON JANUARY 6th TO INCREASE THE PRESSURE ON MEMBERS OF CONGRESS AND THE VICE PRESIDENT TO ACCEPT THE FALSE SLATES OF ELECTORS.
SO, THIS IS A CASE THAT IS VERY MUCH FOCUSED ON CONDUCT, AS OPPOSED TO SOLELY SPEECH.
THE FORMER PRESIDENT'S SPEECH IS A CRITICAL PART OF THE OVERALL CONSPIRACY, BECAUSE BY SAYING THE LIES REPEATEDLY ABOUT ELECTION FRAUD, HE HELPED CREATE THE CONDITIONS IN WHICH PEOPLE IN THE PUBLIC MIGHT HAVE ACCEPTED THE NOTION THAT THERE WOULD BE THESE OTHER SLATES OF ELECTORS WHO HAD VOTED FOR MR. TRUMP.
SO, HIS SPEECH IS PART OF THE EVIDENCE IN THE CASE, BUT HE IS NOT BEING CHARGED FOR HIS STATEMENTS, BUT RATHER, FOR THE CONDUCT.
>> AND TO THE NOTION OF A SPEEDY TRIAL, THERE HAVE MANY WHO HAVE OBJECTED TO THE PACE OF THE APPOINTMENT OF THE SPECIAL COUNSEL, OF JACK SMITH, AND HE HAS SAID HE WANTS A SPEEDY TRIAL.
WELL, THE TRUMP PEOPLE SAY, WELL, WHAT DOES THAT MEAN?
YOU WANT TO THROW A TRIAL OUT, YOU KNOW, IN THE MIDDLE OF MY ELECTION CAMPAIGN, WHERE I'M LEADING THE POLLS, YOU COULD HAVE DONE IT A COUPLE YEARS AGO, WHY NOW?
>> WELL, I DO THINK THAT IT IS GOING TO BE A CHALLENGE TO GET THIS CASE TO TRIAL BEFORE THE ELECTION.
MY SUSPICION IS THAT THE SPECIAL COUNSEL CHARGED ONLY MR. TRUMP IN THIS INDICTMENT, NOT WITHSTANDING IDENTIFYING OTHER CO-CONSPIRATORS, IN ORDER TO MAXIMIZE THE CHANCES THAT THIS COULD BE BROUGHT TO A TRIAL IN THE MOST EXPEDITIOUS FASHION.
MR. TRUMP WILL, I BELIEVE, ARGUE THAT HE NEEDS MORE TIME IN ORDER TO RELITIGATE CERTAIN ISSUES, LIKE WHETHER THERE WAS ELECTION FRAUD.
HIS ATTORNEY ALSO SUGGESTED IN HIS REMARKS YESTERDAY THAT THAT WAS SOMETHING THAT THEY WANTED TO PURSUE.
I SUSPECT THAT THE JUDGE PRESIDING OVER THE CASE MAY WELL SAY, THE QUESTION OF WHETHER THERE WAS ELECTION FRAUD HAS BEEN LITIGATED REPEATEDLY IN THE STATE COURTS, AND IT HAS BEEN FOUND REPEATEDLY BY THOSE COURTS THAT THERE WAS NO FRAUD, SO, THERE'S NO NEED TO ALLOW MR. TRUMP AND HIS LAWYERS IN THIS CASE TO PURSUE THOSE ISSUES AGAIN.
IF THE JUDGE WERE TO TAKE THAT POSITION, THEN DIDN'T SEE A REASON WHY THIS NEEDS TO BE DELAYED ANY LONGER THAN THE TIMEFRAME THAT THE SPECIAL COUNSEL IS LIKELY TO PROPOSE.
THERE WILL BE MANY WITNESSES IN THIS CASE, IT IS A COMPLEX CASE, AND SO, IT WILL TAKE A GOOD DEAL OF TIME TO TRY, BUT I DON'T SEE ANY REASON WHY IT NEEDS TO BE PROLONGED INDEFINITELY, OR CERTAINLY PAST THE ELECTION, TO RELITIGATE ISSUES OF ELECTION FRAUD, NOR, FRANKLY, IS THERE A BASIS FOR SAYING THERE WAS DELAY TO THIS POINT, THAT IT NEEDS TO BE DELAYED FURTHER.
>> JESSICA ROTH, AS YOU KNOW, ALSO THEIR SIDE, THE TRUMP SIDE, SAYS THERE IS NO WAY IN THIS EARTH THAT DONALD TRUMP CAN GET A FAIR TRIAL IN WASHINGTON, D.C.
THEY'VE CALLED IT THE SWAMP FROM THE BEGINNING, THEY SAY THAT, YOU KNOW, OVERWHELMINGLY IT VOTES DEMOCRAT, IT VOTED FOR HILLARY CLINTON, THE JUDGE IN CHARGE WAS APPARENTLY APPOINTED BY PRESIDENT OBAMA, SHE HERSELF HAS SPOKEN OUT FREQUENTLY AGAINST WHAT HAPPENED IN 2020, THE ELECTION.
AND SHE SAID PRESIDENTS ARE NOT KINGS AND PLAINTIFF IS NOT PRESIDENT.
DO YOU THINK THEY WILL HAVE ANY LUCK OR TRACTION, HIS TEAM, IN SAYING THAT THIS IS -- THE DECK IS STACKED AGAINST US?
>> I DON'T THINK THEY WILL.
THE PRESUMPTION IS THAT TRIALS OCCUR IN THE LOCATION, IN THE VENUE AND THE DISTRICT WHERE THE EVENTS IN QUESTION OCCURRED.
AND HERE, THAT IS THE DISTRICT OF COLUMBIA.
IT IS RARE TO TRANSFER A CASE OUT OF A VENUE WHERE THE EVENTS OCCURRED.
THE KEY WILL BE WHETHER OR NOT A JURY CAN BE FOUND OF PEOPLE WHO CAN BE FAIR AND IMPARTIAL TO BOTH SIDES IN TRYING THIS CASE.
AND EVEN IF OTHER CASES OF STRODE THEIR PUBLIC IMPORTANCE, JUDGES HAVE BEEN ABLE TO FIND JURORS WHO MEET THAT STANDARD.
WITH RESPECT TO THE JUDGE, SHE DOES HAVE FAMILIARITY WITH THE EVENTS OF JANUARY 6th, SHE HAS SENTENCED INDIVIDUALS WHO ARE CONVICTED OF CRIMES RELATED TO THE JANUARY 6th RIOT.
SHE HAS USED STERN WORDS IN THOSE SENTENCINGS.
FROM WHAT I HAVE SEEN, I DON'T SEE ANYTHING THAT SUGGESTS A REASON WHY SHE WOULD NEED TO BE RECUSED FROM THIS CASE.
>> JESSICA ROTH, THANK YOU VERY MUCH, INDEED.
>>> NOW, JOINING ME FOR MORE ON THIS, FROM THE DEMOCRAT SIDE, IS CONGRESSMAN JOE NEGUSE.
HE SERVED AS HOUSE MANAGER FOR THE SECOND CONGRESSIONAL IMPEACHMENT OF TRUMP OVER THAT JANUARY 6th ATTACK.
THE CONGRESSMAN IS ALSO AN AUTHOR AN HIS NEW BOOK "COURAGE IN THE PEOPLE'S HOUSE" IS OUT NOW.
CONGRESSMAN, WELCOME TO THE PROGRAM.
I MEAN, I GUESS, YOU KNOW, HAVING BEEN HOUSE MANAGER DURING THE IMPEACHMENT, I GUESS I NEED FIRST YOUR REACTION FROM YOURSELF AND FROM THE PARTY ON THIS VERY, VERY SERIOUS INDICTMENT.
>> WELL, IT'S GOOD TO BE WITH YOU, CHRISTIANE, THANK YOU FOR HAVING ME ON.
IT'S BEEN A SOLEMN 24 HOURS FOR THE COUNTRY.
THE CHARGES THAT THE GRAND JURY ULTIMATELY ISSUED AND THE INDICTMENT ARE VERY SERIOUS.
SERIOUS CRIMES.
THE FACTS THAT ARE IN THE INDICTMENT, AS STATED BY THE SPECIAL COUNSEL, GO TO THE HEART OF OUR FORM OF GOVERNMENT HERE IN THE UNITED STATES OF AMERICA, AS A CONSTITUTIONAL REPUBLIC.
AND THE BEDROCK PRINCIPLE OF THE PEACEFUL TRANSFER OF POWER, WHICH YOU KNOW WAS AT THE CENTER OF THE IMPEACHMENT TRIAL TWO YEARS AGO IN THE UNITED STATES SENATE.
SO, LOOK, I THINK IT'S IMPORTANT FOR THE CRIMINAL JUSTICE PROCESS TO PLAY OUT WITHOUT ANY KIND OF POLITICAL INTERFERENCE BY ANY PARTIES.
THE FORMER PRESIDENT IS ENTITLED TO PRESUMPTION OF INNOCENCE UNDER OUR LAWS.
HE'S ENTITLED TO DUE PROCESS OF LAW, AND A FAIR TRIAL.
SO, I THINK THAT WE NEED TO LET THE INDICTMENT SPEAK FOR ITSELF, AND I ENCOURAGE FOLKS TO READ THE INDICTMENT AND THE VARIOUS FACTS THAT ARE ALLEGED THEREIN, AND I'LL CERTAINLY BE FOLLOWING THE CASE, AS IT PROCEEDS.
>> YOU MENTIONED, YOU KNOW, TWO YEARS AGO, AND THE -- THAT IMPEACHMENT TRIAL OVER WHICH YOU PRESIDED IN THE HOUSE, AND BEFORE SENDING IT ONTO THE SENATE, WHICH YOU JUST MENTIONED, YOU DELIVERED AN IMPASSIONED SPEECH AND WE'RE JUST GOING TO PLAY A LITTLE BIT OF THAT.
>> WE HUMBLY, HUMBLY ASK YOU TO CONVICT PRESIDENT TRUMP FOR THE CRIME FOR WHICH HE IS OVERWHELMINGLY GUILTY OF.
BECAUSE IF YOU DON'T, IF WE PRETEND THIS DIDN'T HAPPEN, OR WORSE, IF WE LET IT GO UNANSWERED, WHO IS TO SAY IT WON'T HAPPEN AGAIN?
>> SO, OF COURSE, AS WE KNOW, HE WAS NOT CONVICTED BY THE SENATE.
NOW, HE'S BASICALLY CONTENDING WITH THE FEDERAL JUSTICE SYSTEM.
IS THIS ACCOUNTABILITY FOR YOU?
>> WELL, I'D SAY A COUPLE OF THINGS.
FIRST AND FOREMOST, IT'S IMPORTANT TO REMEMBER THAT ALTHOUGH HE WASN'T CONVICTED DURING THE IMPEACHMENT TRIAL AND, OF COURSE, YOU JUST PLAYED THE CLOSING SPEECHES OF THAT TRIAL, IT WAS THE MOST BIPARTISAN VOTE FOR CONVICTION IN THE HISTORY OF THE UNITED STATES, AS FAR AS IMPEACHMENT GO.
57 SENATORS, INCLUDING SEVEN REPUBLICANS WHO CHOSE COUNTRY OVER PARTY, AND VOTED TO CONVICT.
NOW, AS YOU ALSO KNOW, AND I UNDERSTAND THAT THERE ARE MANY WHO -- OR SOME, RATHER WHO ARE CRITICIZING THE GRAND JUROR THE SPECIAL COUNSEL AND THEIR COLLECTIVE ACTIONS IN THIS INSTANCE, WHAT I WOULD SAY -- OR, RATHER, POINT FOLKS TO, IS THE STATEMENTS MADE BY THE REPUBLICAN MINORITY LEADER OF THE UNITED STATES SENATE, MITCH McCONNELL, WHO JUST MOMENTS AFTER I DELIVERED THAT SPEECH AND THE VERDICT WAS ULTIMATELY RENDERED, SAID IN A FLOOR SPEECH THAT HE BELIEVED THAT PRESIDENT TRUMP WAS PRACTICALLY AND MORALLY RESPONSIBLE FOR PROVOKING THE EVENTS OF THAT DAY, AND, OF COURSE, STATED THE -- THE UNDERSTANDING HERE IN THE UNITED STATES THAT HAS LONG GOVERNED OUR CONSTITUTIONAL SYSTEM, WHICH IS THAT FORMER PRESIDENTS ARE NOT INSULATED OR IMMUNE FROM LEGAL LIABILITY FROM THE CRIMINAL JUSTICE SYSTEM OR FROM CIVIL LIABILITY.
AGAIN, THOSE ARE THE WORDS OF FORMER REPUBLICAN -- OR, RATHER, CURRENT REPUBLICAN SENATE MINORITY LEADER MITCH McCONNELL.
SO, FROM MY PERSPECTIVE, THE DECISIONS MADE BY THE SPECIAL COUNSEL ARE DECISIONS THAT HE AND THE GRAND JURY WILL, OF COURSE, DEFEND DURING THE COURSE OF THIS PARTICULAR CASE, AND I'M NOT GOING TO OPINE ABOUT, YOU KNOW, THE NATURE OF THE CHARGES THAT HE HAS ALLEGED.
BEYOND SIMPLY SAYING THAT THEY ARE VERY SERIOUS, AND, AGAIN, THEY GO TO THE HEART OF OUR DEMOCRACY.
>> AND WE WILL BE DIGGING FURTHER INTO THIS FROM THE REPUBLICAN SIDE WITH OUR NEXT GUEST, BUT FIRST, WE MENTIONED THAT YOU ARE THE AUTHOR OF A NEW BOOK.
PREPARING FOR THAT SECOND IMPEACHMENT, YOU DOVE INTO HISTORY, AND YOU REALIZED THAT THERE ARE SO MANY IMPORTANT CONGRESSPEOPLE WHO AMERICANS KNOW NOTHING ABOUT.
AND YOU WROTE "COURAGE IN THE PEOPLE'S HOUSE."
WHY DO YOU THINK, AND WHO DO YOU MOST WANT TO PROFILE AND TALK ABOUT RIGHT NOW?
WHY DO YOU THINK THERE'S THIS LACK OF KNOWLEDGE?
>> OH, I THINK THERE ARE A NUMBER OF DIFFERENT REASONS.
AND YOU ARTICULATED WELL THE KIND OF -- THE REASONING, THE IMPETUS FOR WHY I DECIDED TO WRITE THIS BOOK.
IT CAN BE EASY IN THIS CURRENT POLITICAL ENVIRONMENT TO DEVELOP KIND OF A SKEPTICISM, A CYNICISM ABOUT OUR ABILITY TO SOLVE BIG PROBLEMS AND ADDRESS BIG CHALLENGES.
THE POLITICAL ENVIRONMENT THAT WE FIND OURSELVES IN, AND THAT'S, OF COURSE, SEEN, YOU KNOW, ON FULL DISPLAY OFTEN IN THE HOUSE OF REPRESENTATIVES, WHERE I SERVE, REFERRED TO AS THE PEOPLE'S HOUSE.
AND I THINK IT'S BEST TO FIGHT BACK AGAINST THAT TEMPTATION, AND IT'S TO LOOK AT ORDINARY AMERICANS THAT DID EXTRAORDINARY THINGS IN SERVICE OF THEIR COUNTRY, THEIR CONSTITUENTS, AND THE CONSTITUTION.
SO, I DETAIL PROFILES OF NINE PARTICULAR MEMBERS OF CONGRESS, MEN AND WOMEN OF BOTH POLITICAL PARTIES, FROM ALL WALKS OF LIFE, WHO OVER THE LAST CENTURY, YOU KNOW, IN MY VIEW, SERVED COURAGEOUSLY HERE IN THE UNITED STATES, IN THE PEOPLE'S HOUSE.
IN TERMS OF WHY WE MIGHT NOT NECESSARILY HAVE THAT KNOWLEDGE, OR PERHAPS FOLKS DON'T KNOW MUCH ABOUT THESE INDIVIDUALS, I THINK THERE'S A BIT OF A HISTOICAL BIAS, AS FAR AS SCHOLARSHIP GOES, FOR THE PRESIDENCY, THE SUPREME COURT, THE UNITED STATES SENATE, OF COURSE, AND, YOU KNOW, THE LARGER THAN LIFE CHARACTERS AND INDIVIDUALS THAT HAVE SERVED IN THOSE VARIOUS UNITS OF OUR GOVERNMENT.
AND VERY LITTLE ATTENTION PAID TO THE PEOPLE'S HOUSE, WHICH, AS JAMES MADISON AND OTHER FRAMERS OF OUR CONSTITUTION OFTEN SAID, IS THE BRANCH OF GOVERNMENT CLOSEST TO THE PEOPLE.
>> YEAH.
>> SO, I THOUGHT THAT THIS WOULD BE A VALUE IN PERHAPS GIVING READERS, AMERICANS, FOLKS ACROSS THE WORLD, A SENSE OF HOPE AND OPTIMISM ABOUT ALL THAT I THINK -- >> AND MANY OF THE STORIES ARE INCREDIBLE.
YOU FOCUS ON BLACK CONGRESSPEOPLE, FOR INSTANCE, JOSEPH RAINEY, HE WAS BORN ENSLAVED, THE FIRST BLACK MAN TO SERVE IN THE HOUSE.
THAT WAS AROUND 1870.
YOU ARE THE FIRST BLACK CONGRESSMAN TO REPRESENT COLORADO.
BUT REPRESENTATIVE BARBARA JORDAN ALSO IS THE TOPIC OF YOUR LAST CHAPTER, VERY PROMINENT BLACK FEMALE IN CONGRESS, AND SHE HAD WHAT MANY SAY IS ONE OF THE GREAT SPEECHES OF THE HISTORY OF THE CONGRESS, DURING THE IMPEACHMENT INTO RICHARD NIXON IN 1974.
LET'S JUST LISTEN TO WHAT SHE SAID.
>> AND HYPERBOLE WOULD NOT BE FICTIONAL, AND WOULD NOT OVERSTATE THE SOLEMNNESS THAT I FEEL RIGHT NOW.
MY FAITH IN THE CONSTITUTION IS WHOLE, IT IS COMPLETE, IT IS TOTAL.
AND I AM NOT GOING TO SIT HERE AND BE AN IDLE SPECTATOR TO THE SUBVERSION, THE DESTRUCTION, OF THE CONSTITUTION.
>> SO, THAT WAS 50 YEARS AGO.
ABOUT.
SHE -- IT COULD HAVE BEEN SAID TODAY, GIVEN THE CIRCUMSTANCES.
WHAT DO YOU DRAW FROM THAT SPEECH ABOUT, YOU KNOW, AS YOU SIT IN CONGRESS TODAY?
>> YEAH, WELL, LISTENING TO HER WORDS AND THANK YOU FOR PLAYING THAT CLIP, CHRISTIANE, I MEAN, HER SPEECH INSPIRED SO MANY, AND HER WORDS RING TRUE TODAY.
I CAME ACROSS THAT SPEECH DURING THE PREPARATIONS FOR THE FIRST IMPEACHMENT PROCEEDINGS OF THE FORMER PRESIDENT.
IN 2019, DURING THE JUDICIARY COMMITTEE'S INVESTIGATION, AND HER SPEECH WAS CONSIDERED A NORTH STAR OF SORTS, IN TERMS OF HOW TO ARTICULATE WEIGHTY AND COMPLEX CONSTITUTIONAL SUBJECTS.
IN THIS CASE, THE CONSTITUTIONAL STANDARD FOR IMPEACHMENT.
I THINK THAT, YOU KNOW, HER, AS I SAID, HER WORDS, HER -- THE PASSION WITH WHICH SHE SAYS THOSE WORDS, HER FAITH IN THE CONSTITUTION BEING WHOLE AND COMPLETE, I CERTAINLY SHARE HER SENTIMENTS TODAY.
UNITED STATES HAS BEEN TESTED MANY TIMES DURING THE COURSE OF THE LAST TWO CENTURIES.
BUT ON EACH OCCASION, WE HAVE ULTIMATELY RISEN TO THE OCCASION.
AND THAT FIDELITY TO OUR CONSTITUTIONAL PRINCIPLES IS SOMETHING THAT I THINK WE NEED TO HOLD DEAR TO AND, OF COURSE, FOLLOWING BARBARA JORDAN'S EXAMPLE.
AND THE EXAMINE PMS OF MANY OTHERS.
>> IT'S REALLY FASCINATING LOOK BACK AT HISTORY.
I WANT TO ASK YOU A TODAY POLITICAL QUESTION, AND THAT IS THE BLACK VOTE HAS SYSTEMATICALLY HELPED DEMOCRATS, CERTAINLY PROPELLED THEM TO THE PRESIDENCY, AND WE KNOW THAT IT WAS SOUTH CAROLINA THAT, YOU KNOW, REALLY CHANGED THE TRAJECTORY OF CANDIDATE BIDEN'S ELECTION LAST TIME AROUND.
NOW, DEMOCRATS APPARENTLY WORRY THAT THE BLACK VOTE WON'T TURN OUT FOR HIM IN 2024.
DO YOU SHARE THAT WORRY?
AND WHAT NEEDS TO BE DONE BY THE PRESIDENT BETWEEN NOW AND ELECTION DAY?
>> I'M CONFIDENT THAT AFRICAN AMERICAN VOTERS, AS WELL AS, YOU KNOW, VOTERS OF ALL RACES HERE IN THE UNITED STATES, WILL ULTIMATELY SUPPORT PRESIDENT BIDEN AND VICE PRESIDENT HARRIS'S RE-ELECTION, AND THAT'S BECAUSE OF THE WORK WE HAVE DONE OVER THE COURSE OF THE LAST THREE YEARS TO DELIVER FOR THE AMERICAN PEOPLE.
AS YOU KNOW, THIS IS REFLECTED IN THE EMPIRICAL DATA THAT CONTINUES TO COME OUT ON A WEEKLY BASIS, IN TERMS OF THE ECONOMIC GROWTH OUR COUNTRY IS SEEING.
THE LOWEST UNEMPLOYMENT RATE FOR BLACK AMERICANS, HISPANIC AMERICANS.
AGAIN, AMERICANS OF ALL RACES, AND ALL CREEDS.
INCREDIBLE JOB GROWTH, THE WORK THAT WE'RE DOING TO LOWER COSTS, TO INVEST IN OUR INFRASTRUCTURE.
WE'VE GOT A GREAT STORY TO TELL, IN TERMS OF THE WORK THAT WE HAVE DONE TO IMPROVE THE LIVES OF EVERYDAY AMERICANS, AND SO, I CERTAINLY LOOK FORWARD TO TALKING ABOUT THAT WORK OVER THE COURSE OF THE NEXT YEAR AND A HALF, INTO THE NEXT PRESIDENTIAL ELECTION AND I SUSPECT THAT THE AMERICAN PEOPLE WILL AGREE.
>> CONGRESSMAN NEGUSE, THANK YOU >>> NOW, LET US SEE HOW THE REPUBLICAN PARTY'S RESPONDING TO THE INDICTMENT AGAINST DONALD TRUMP.
HIS RIVALS FOR THE PRESIDENTIAL NOMINATION ARE SPLIT ON THESE CHARGES.
SOME, LIKE THE FLORIDA GOVERNOR RON DeSANTIS, ACCUSING THE SPECIAL PROSECUTOR OF, QUOTE, THE WEAPONIZATION OF THE FEDERAL GOVERNMENT.
HE CLAIMS, QUOTE, WASHINGTON, D.C. IS A SWAMP, AND IT'S UNFAIR TO HAVE TO STAND TRIAL BEFORE A JURY THAT IS REFLECTIVE OF THE SWAMP MENTALITY.
BUT TRUMP'S VICE PRESIDENT MIKE PENCE REFUSES TO BACK HIS FORMER BOSS, SAYING, THE INDICTMENT SERVES AS AN IMPORTANT REMINDER, ANYONE WHO PUTS HIMSELF OVER THE CONSTITUTION SHOULD NEVER BE PRESIDENT OF THE UNITED STATES.
SO, WHAT WILL TRUMP'S LEGAL JEOPARDY MEAN FOR THE REPUBLICAN PARTY AND HIS OWN PRESIDENTIAL AMBITIONS?
LET'S GET THE DETAILS WITH THE FORMER GOP CONGRESSMAN JOE WALSH, WHO VOTED FOR TRUMP IN 2016, GREW DISILLUSIONED WITH HIM IN OFFICE, BROKE WITH HIM, AND EVEN RAN AGAINST HIM FOR THE REPUBLICAN NOMINATION IN 2020.
JOE WALSH, WELCOME TO THE PROGRAM, WHERE YOU ARE IN WASHINGTON.
I'LL GET TO THE WHOLE SWAMP AND FAIR OR UNFAIR IN A MOMENT, BUT FIRST, YOU KNOW, OBVIOUSLY, YOU ARE NOT A TRUMPER.
WHY DO YOU MAKE OF THIS INCREDIBLY SERIOUS INDICTMENT, AND WHAT IT SAYS ABOUT YOUR PARTY, FRANKLY?
>> CHRISTIANE, GOOD TO BE WITH YOU.
IT SAYS THAT MY FORMER POLITICAL PARTY IS A CULT.
I'M NOT THE ONLY ONE WHO HAS SAID THAT.
BUT IT SAYS THAT MY FORMER POLITICAL PARTY, THE VOTERS IN THAT PARTY, CHRISTIANE, ARE COMPLETELY RADICALIZED.
I -- I CAN'T EMPHASIZE THIS ENOUGH, BECAUSE I SPEAK TO REPUBLICAN VOTERS EVERY DAY, BECAUSE, AS YOU RIGHTLY RECOGNIZED, I COME FROM THE BASE, AND TO THEM, HE CAN DO NO WRONG.
I MEAN, HE CAN DO NO WRONG.
THEY CROSSED THAT BRIDGE AWHILE AGO.
THEY CONSIDER HIM TO BE A VICTIM, SO, EVERY NEW CHARGE AND EVERY NEW INDICTMENT ONLY STRENGTHENS HIM.
THIS WILL LOCK UP THE NOMINATION FOR HIM.
>> YOU SAID, AND YOU TWEETED TODAY, PERSONALLY, THIS IS A GOOD DAY, THIS IS A HAPPY DAY, THIS IS A DAY TO CELEBRATE JUSTICE.
SO, CLEARLY, YOU'RE HAPPY, YOU BELIEVE WHAT YOU TWEETED.
DO YOU THINK JUSTICE WILL BE DONE AS YOU THINK IT SHOULD BE?
>> I DON'T KNOW.
LOOK, THIS IS REALLY, REALLY SERIOUS, AND I THINK WE'VE BECOME SO NUMBED TO HOW BAD TRUMP IS.
2 1/2 YEARS AGO, YOU KNOW, HE TRIED TO END OUR DEMOCRACY.
THE FIRST SITTING PRESIDENT IN AMERICAN HISTORY WHO LOST AN ELECTION AND TRIED TO HALT THE PEACEFUL TRANSFER OF POWER.
THAT'S OFF THE CHARTS SERIOUS.
I THINK HE BELONGS IN JAIL.
HE DESERVES HIS DAY IN COURT, BUT MY GOD, THANK GOD HE WAS INDICTED.
IT'S NOT A TRAGIC DAY.
IT SHOWS THAT THIS COUNTRY CAN HOLD EVEN EX-PRESIDENTS ACCOUNTABLE FOR WHAT THEY DO.
>> CONGRESSMAN JOE WALSH, YOU TWEETED, MAYBE IT WASN'T TODAY, BUT IT'S BEEN IN THE PAST OVER THIS TRAUMA, USING AN EXPLETIVE, CALLING HIM A TRAITOR, AND THAT HE HAD COMMITTED TREASON.
HOW DO YOU -- I MEAN, HOW A TRAITOR?
>> OH, I -- OH, BOY, CHRISTIANE, I SO BELIEVE THIS.
HE -- AGAIN, HE TRIED TO END OUR DEMOCRACY.
HE REFUSED TO ACCEPT THE WILL OF THE PEOPLE.
HE REFUSED TO ACCEPT AN ELECTION LOSS.
YOU KNOW THAT ELECTIONS ARE THE HEARTBEAT OF A DEMOCRACY.
80% OF MY FORMER POLITICAL PARTY DOES NOT BELIEVE JOE BIDEN WON FAIR AND SQUARE.
THAT'S ALL BECAUSE DONALD TRUMP LIED ABOUT THAT ELECTION.
HE ATTACKED OUR COUNTRY.
THAT'S AN ATTACK ON OUR DEMOCRACY.
IF THAT'S NOT THE ACT OF A TRAITOR, I DON'T KNOW WHAT IS.
IT IS FORMALLY TREASON, NO.
BUT INFORMALLY, IT'S A TRAITOR ROUSE ACT, WHAT HE DID.
>> SO, I WANT TO ASK, GIVEN WHAT YOU'RE SAYING, AND GIVEN THE VERY SERIOUS WORDING AND NATURE OF THE CHARGES IN THAT 45-PAGE INDICTMENT, WHEN SOMEBODY LIKE RON DeSANTIS, THE SITTING GOVERNOR OF FLORIDA, TALKS ABOUT, YOU KNOW, THIS WEAPONIZATION OF THE FEDERAL GOVERNMENT IS THE REASON FOR THE POLITICIZATION OF THE RULE OF LAW, THE DIVISIONS IN THIS COUNTRY.
TIM SCOTT SAYING, WHAT WE SEE TODAY, TWO DIFFERENT TRACKS OF JUSTICE.
ONE FOR POLITICAL OPPONENTS, ANOTHER FOR THE SON OF THE CURRENT PRESIDENT.
YOU KNOW, IT'S NOT JUST PEOPLE WHO, AS YOU CALL, ARE CULT FOLLOWERS OF DONALD TRUMP, IT IS THE ESTABLISHED LEADERS WHO ARE RUNNING FOR THE HIGHEST OFFICE IN THE LAND, WHO ALSO BELIEVE THIS STUFF.
IN FACT, PENCE, HIS VICE PRESIDENT, IS THE -- AND OBVIOUS LY CHRIS CHRISTIE, ARE THE ONLY ONES THAT HAVE REALLY COME DOWN REALLY HARD, AND ASA HUTCHINSON, TOO.
>> WELL, BECAUSE THE REALITY ON THE GROUND IS, THIS IS TRUMP'S PARTY.
I MAKE NO BONES ABOUT IT.
THERE'S NO ROOM IN THIS PARTY FOR ME OR LIZ CHENEY OR ADAM KINZINGER.
THERE'S NO ROOM IN THIS PARTY FOR ANYONE WHO PUBLICLY OPPOSES TRUMP IN THE NOMINATION FIGHT, TO BECOME THE NOMINEE NEXT YEAR, THERE'S ONLY ONE LANE, THAT'S THE TRUMPY LANE.
AND TRUMP IS IN THAT LANE, RON DeSANTIS IS TRYING TO BE IN THAT LANE.
THERE'S NO OTHER LANE.
SO, IF YOU -- IF YOU CAME OUT AGAINST DONALD TRUMP ON THIS INDICTMENT, YOU HAVE NO SHOT AT THE NOMINATION, AND YOU'RE DONE AS A REPUBLICAN.
I LIKE WHAT CHRIS CHRISTIE IS SAYING, BUT CHRIS CHRISTIE KNOWS HE HAS ZERO CONSTITUENCY IN THIS PARTY.
THE ONLY ONES WHO KIND OF DO ARE DeSANTIS, SCOTT, HALEY, REALLY, AND CHRISTIANE, THEY'RE NOT TRYING TO BEAT TRUMP, WHICH IS WHY THEY'RE EMBRACING HIM.
THEY'RE HOPING THAT A HEART ATTACK OR THE JUSTICE SYSTEM, SOMETHING WILL TAKE TRUMP OUT, AND THEY CAN BE THE LAST MAN OR WOMAN STANDING THERE.
>> OH, GOSH.
YOU KNOW, A LOT OF PEOPLE, OBVIOUSLY, WANT TO KNOW, HE -- IT LOOKS LUKE HE'S CLEARLY, BARRING WHAT YOU JUST SAID, GOING TO GET THE NOMINATION.
>> YES.
>> BUT WILL HE BE PRESIDENT, WILL HE GET ANOTHER TERM?
MANY PEOPLE AROUND THE WORLD WANT TO KNOW THAT, AND IT'S CAUSE OF GREAT CONCERN FOR MANY OF THE REASONS YOU OUTLINED.
SO, I WANT TO KNOW FROM YOU, THE FIRST FEW INDICTMENTS, THE FIRST TWO, SEEM TO GIVE A SPIKE IN HIS POPULARITY, IN HIS POLLS, AND IN HIS FUND-RAISING.
IT'S SAID THAT THIS ONE IS NOT HAVING A SIMILAR AFFECT TODAY YET.
DO YOU THINK THAT IT WILL OR DO YOU THINK THAT CULT OR NO CULT, THIS SERIOUSNESS WILL BE REFLECTED AMONGST THE REPUBLICAN VOTERS?
>> CHRISTIANE, I HAVE A CONTRARIAN VIEW HERE.
I THINK THIS SERIOUS INDICTMENT WILL BOOST HIM EVEN MORE AMONG REPUBLICAN VOTERS, BECAUSE IT FITS THEIR NARRATIVE OF TRUMP AS THE VICTIM OF THE DEEP STATE GOING AFTER HIM.
THIS FITS THAT NARRATIVE PERFECTLY.
I THINK THE INDICTMENT IN AUGUST DOWN IN GEORGIA THAT'S COMING WILL STRENGTHEN HIM EVEN MORE.
AND I REALLY -- LOOK.
I THINK THE NOMINATION IS HIS, AND I -- I THINK THE WORLD NEEDS TO UNDERSTAND THAT ONE OF OUR TWO MAJOR POLITICAL PARTIES IS FULLY RADICALIZED.
THAT'S WHY THE REST OF THE WORLD HAS A REAL DIFFICULT TIME UNDERSTANDING THIS, BUT THE OTHER WARNING IS, DONALD TRUMP HAS A REAL GOOD CHANCE OF BEING ELECTED AGAIN.
AND THE -- THE COUNTRY, AND THE WORLD, NEEDS TO WRAP THEIR ARMS AROUND THAT.
>> WELL, I CAN ASSURE YOU, FROM ALL THE CONVERSATIONS WE HAVE ON THIS PROGRAM, THAT POSSIBILITY, THAT WORRY, IS VERY FOREMOST IN THE MINDS OF MANY PEOPLE AROUND THE WORLD.
DO YOU THINK THAT -- YOU KNOW, YOU SAID THAT HIS VOTERS, HIS CULT FOLLOWERS, SEE HIM AS A VICTIM, AND SEE HIM EMBODYING, I GUESS, WHAT THEY THINK IS THEIR OWN VICTIMHOOD, SO, WHEN PEOPLE TALK ABOUT THE SWAMP IN WASHINGTON, AND IT'S UNABLE, YOU KNOW, THE DEEP STATE, TO GET A FAIR TRIAL, ET CETERA.
DO YOU THINK THAT'S GOING TO BE A WINNING -- ANOTHER WINNING POLITICAL MESSAGE?
>> SADLY, I DO.
AND WHAT REALLY CONCERNS ME, CHRISTIANE, IS I'VE HEARD FROM INDEPENDENTS AND REPUBLICANS LAST NIGHT AND TODAY WHO ARE NOT DONALD TRUMP HARD CORE SUPPORTERS, AND EVEN THEY'RE TELLING ME THAT, JOE, THIS REALLY SEEMS LIKE THE JUSTICE DEPARTMENT IS PILING ON.
IT SEEMS LIKE THE JUSTICE DEPARTMENT IS TRYING TO PUT THEIR THUMBS ON THE RESULTS OF THE 2024 ELECTION.
MY WORRY IS THAT TRUMP WILL BE ABLE TO USE THAT, THAT THE JUSTICE DEPARTMENT IS INTERFERING IN THIS UPCOMING ELECTION TO HIS ADVANTAGE.
>> OKAY.
>> AND I THINK THAT WILL REALLY RESONATE WITH PEOPLE.
>> WELL, CERTAINLY, THE, YOU KNOW, THE ORGAN OF CHOICE BEING FOX NEWS AND NEWSMAX AND THE OTHERS -- >> YES.
>> ARE SAYING THAT.
HERE'S WHAT THEY JUST SAID AFTER THE INDICTMENT.
LET'S LISTEN.
>> ARE WE NOW LIVING IN AMERICA WHERE EQUAL JUSTICE IS DEAD?
THE EQUAL APPLICATION OF OUR LAWS IS A THING OF THE PAST?
THAT WE'RE -- THE SHREDDING OF OUR CONSTITUTION?
WE'RE WITNESSING THIS IN REAL-TIME, IN FRONT OF OUR OWN EYES?
>> THIS IS ONLY THE BEGINNING OF POLITICIANS PUTTING OTHER POLITICIANS AND THEIR FAMILIES IN PRISON.
SAD WE HAD TO GO DOWN THIS ROAD, BUT THIS IS WHERE WE ARE, AND NOW WE HAVE TO FINISH IT.
>> SO, I GUESS THE QUESTION TO YOU, AND WE ASK, YOU KNOW, THE LEGAL EXPERT, FORMER PROSECUTOR JESSICA ROTH, WHAT WAS THE ALTERNATIVE?
YOU KNOW, YOU SAY, THESE PEOPLE HAVE SAID, YOU KNOW, IT LOOKS LIKE PILING ON.
WHAT IS THE ALTERNATIVE?
>> CHRISTIANE, THAT'S SUCH A GREAT, SMART QUESTION.
THERE WAS NO ALTERNATIVE.
NOBODY'S ABOVE THE LAW, HE COMMITTED CRIMES, HE TRIED TO END OUR DEMOCRACY.
BUT YOU KNOW, THE -- THE MAGIC OF TRUMP IS, AND I HAD ADVISERS DURING HIS PRESIDENCY TELL ME THIS, HE -- EVERY DAY, HE SAYS AND DOES SO MANY BAD THINGS THAT YOU BECOME NUMBED TO IT ALL.
AND I THINK THAT'S WHERE WE ARE NOW.
THERE ARE GOING TO BE FOUR INDICTMENTS, AND A LOT OF AMERICANS ARE JUST GOING TO ROLL THEIR EYES AT THE WHOLE THING AND SAY, THIS IS CRAZY, DOESN'T FEEL RIGHT, DOESN'T FEEL FAIR.
BUT THERE WAS NO ALTERNATIVE.
HE HAD TO BE HELD ACCOUNTABLE, AND NOW, IT'S UP TO THE REST OF THE COUNTRY TO MAKE SURE THAT GUY ISN'T IN THE WHITE HOUSE AGAIN.
>> OKAY.
>> IT'S A POLITICAL SOLUTION NOW.
>> OKAY, SO, NOW, THE NEXT POLITICAL, I GUESS, PERFORMANCE IS GOING TO BE THE FIRST OF THE PRESIDENTIAL DEBATES, RIGHT?
THE NOMINAING DEBATES, AND WE'LL SEE WHO GETS ONTO THE STAGE.
BUT DO YOU THINK ABSENT, I GUESS, MAYBE PENCE, MAYBE A COUPLE OF THE OTHERS, IF THEY GET THE, YOU KNOW, THE -- WHATEVER IT IS, THE NUMBER OF PERCENTAGES THEY CAN GET ONTO THE STAGE, DO YOU THINK THEY WILL USE THAT PLATFORM TO DO WHAT YOU'RE SAYING, YOU KNOW, TO HOLD HIM ACCOUNTABLE IN PUBLIC?
>> NO.
NO.
AND I DON'T THINK TRUMP WILL BE THERE, BUT TO DO THAT, CHRISTIANE, IN TODAY'S REPUBLICAN PARTY, IS A CAREER KILLER.
SO, I AGAIN, I EXPECT CHRIS CHRISTIE, WHO WILL BE ON STAGE, TO DO THAT.
BUT HE -- HE'S DOING SOMETHING DIFFERENT HERE.
HE KNOWS HE CAN'T WIN.
PENCE, SCOTT, HALEY, AND DeSANTIS, STILL BELIEVE THEY CAN, SO THEY WILL EMBRACE TRUMP AND GO AFTER THE DEEP STATE.
>> ALL RIGHT.
GOSH.
THANK YOU SO MUCH, CONGRESSMAN, FOR JOINING US.
THANK YOU, JOE WALSH.
>>> HEALTH CARE IN AMERICA IS NOT YET A BIG ELECTION ISSUE, DESPITE PATIENTS FACING MANY HARDSHIPS.
DR. CHAVI EVE KARKOWSKY IS A MATERNAL FETAL PHYSICIAN AND JOINS MICHEL MARTIN TO DISCUSS HOW RED TAPE COMPLICATES ACCESS TO CARE, AND ALSO ENDANGERS LIVES.
>> DOCTOR, THANK YOU SO MUCH FOR JOINING US.
>> THANK YOU FOR HAVING ME.
>> YOU WROTE A PIECE FOR "THE NEW YORK TIMES" ABOUT THE ADMINISTRATIVE BURDEN THAT AMERICANS EXPERIENCE IN THE U.S. HEALTH CARE SYSTEM.
NOW, THAT'S KIND OF A FORMAL WAY OF TALKING ABOUT WHAT WE'RE TALKING ABOUT, BUT WE'RE TALKING ABOUT PAPERWORK, RIGHT?
IS THAT WHAT WE'RE TALKING ABOUT HERE?
>> I THINK WE ARE TALKING ABOUT PAPERWORK, BUT EVERYTHING IN MEDICINE IS ALSO BORING AND ALSO HEARTBREAK, RIGHT?
SO, WE'RE TALKING ABOUT PAPERWORK, BUT WE'RE ALSO TALKING ABOUT HUMAN SUFFERING.
>> YOU OPEN THE PIECE WITH A SCENARIO THAT JUST IS TERRIFYING AND HEARTBREAKING, AND ENCOURAGING IN SOME WAYS.
SO, AS BRIEFLY AS YOU CAN, JUST TELL US HOW YOU OPEN THE PIECE FOR PEOPLE WHO HAVEN'T HAD A CHANCE TO READ IT.
>> SURE.
I STARTED THE PIECE WITH A STORY FROM SEVERAL YEARS AGO, I'M A HIGH-RISK OBJECTIONS TRIGS.
I WAS WORKING A SHIFT IN THE HOSPITAL AND I WAS CALLED TO OUR TRIAGE UNIT, OUR SMALL EMERGENCY ROOM THAT WE HAVE FOR PREGNANT PATIENTS.
AND THERE, I FOUND A PATIENT WHO WAS ABOUT 28 WEEKS PREGNANT, SHE HAD A VERY HIGH FEVER AND SHE WASN'T BREATHING WELL.
AND THE STORY THAT SHE TOLD ME WITH THAT, SHE HAD STARTED TO HAVE SYMPTOMS OF A URINARY TRACT INFECTION, WHICH IS COMMON, BUT VERY COMMON IN PREGNANCY.
SHE HAD GONE TO HER DOCTOR AND GOTTEN A PRESCRIPTION, BUT WHEN SHE WENT TO THE PHARMACY, THEY WOULDN'T FILL IT.
AND SHE WASN'T REALLY CLEAR ON WHY, IF THERE WAS TROUBLE WITH PAYMENT OR HER IDENTIFICATION, BUT SHE JUST DIDN'T GET HER MEDICINE.
SHE STARTED TO GET SICKER, BACK PAIN, STARTED TO CONTRACT, AND SHE EVENTUALLY CALLED 911 WHEN SHE BECAME SHORT OF BREATH.
WHEN SHE CAME TO SEE US, WE VERY QUICKLY WERE CONCERNED ABOUT A KIDNEY INFECTION, WHICH IS SOMETHING THAT HAPPENS IF YOU HAVE AN UNTREATED UTI, AND CAN LEAD TO PRETERM LABOR, OR EVENLESS PROTOIR DISTRESS, IF IT'S REALLY UNCONTROLLED.
>> SO, THEN, WHAT HAPPENS IS, PEOPLE RUSH IN, THEY FOCUS ALL THEIR ATTENTION, YOU KNOW, YEARS OF TRAINING AND EXPERTISE AND DEDICATION, TO SAVING THIS PATIENT'S LIFE, BUT YOU JUX POSE THAT, HOW MUCH WOULD THAT ANTIBIOTIC WOULD HAVE COST?
>> THE ONE WE TEND TO USE AND THE ONE I BELIEVE SHE WAS GIVEN IS A REALLY OLD, GENERIC MEDICATION, I THINK $12 TO $20 FOR A FIVE TO SEVEN-DAY COURSE.
WE'RE TALKING ABOUT SOMETHING THAT'S VERY CHEAP FOR WHAT IT IS.
>> $12 ANTIBIOTIC, IF SHE GOTTEN IT ON TIME, WHEN IT WAS PRESCRIBED TO HER, SHE DIDN'T, NOT TO PUT A DOLLAR PRICE ON THIS, BUT HOW MUCH DO YOU THINK ALL THAT MEDICAL INTERVENTION COST TO SAVE HER LIFE WHEN SHE DIDN'T GET THAT ANTI-BEE YOTIC?
>> I HESITATE, BECAUSE I CAN'T FACT CHECK ANY OF THIS, BUT BALLPARK, A DAY IN THE HOSPITAL IS $2,000, $3,000.
BUT ICU-LEVEL CARE, WHICH WE PROVIDE FOR SOMEBODY WHO IS EXPERIENCED PRETERM LABOR AN NEEDS THAT HIGHER LEVEL OF CARE, IT'S OFTEN $5,000 A DAY, RIGHT?
SO, IT'S VERY COST EFFECTIVE TO PREVENT THAT KIND OF ADMISSION.
EVEN AT THE SAME TIME, I'M REALLY, REALLY PROUD OF MY TEAM THAT DOES ASSEMBLE SO QUICKLY FOR A PATIENT WHO IS SICK AND BRINGS SO MUCH EXPERTISE AND SO MUCH PASSION AND SO MUCH DEVOTION, YOU KNOW, I'VE GOT A TEAM THAT'S ANESTHESIOLOGISTS AND THE NICU TEAM, WE ARE READY, BUT YOU'RE RIGHT, WE'RE VERY EXPENSIVE.
>> YOU'VE ALSO WRITTEN A BOOK CALLED "HIGH RISK: A DOCTOR'S NOTES ON PREGNANCY, BIRTH, AND THE UNEXPECTED."
AND YOU ALSO WROTE AN OP-ED IN 2021 FOR "THE ATLANTIC."
VACCINE USERS HAVE COMPASSION FATIGUE.
THE REASON WE CALLED YOU TODAY, FOR THE OP-ED YOU WROTE FOR "THE TIMES."
BUT TAKING THOSE ALL TOGETHER, DO YOU THINK THERE'S A THROUGH LINE THERE?
>> IT'S REALLY INTERESTING, ONE OF THE CHAPTERS IN MY BOOK, MY BOOK THAT CAME OUT ONE WEEK BEFORE THE PANDEMIC, WHICH WOULD NOT RECOMMEND AS A MARKETING TECHNIQUE, JUST IN GENERAL, MY LONGEST CHAPTER IS ABOUT SYSTEMS.
AND SYSTEMS ALWAYS SOUND LIKE SUCH A BORING TOPIC, RIGHT?
PAPERWORK AND RULES AND WORK FLOWS AND ALGORITHMS.
BUT I THINK, WHAT I'M HOPING I'VE SHOWN IN THAT CHAPTER, IS THAT IT'S ALSO PEOPLE'S LIVES.
AND PEOPLE'S TIME.
AND PEOPLE GETTING SICK OR PEOPLE GETTING WHAT THEY NEED, BECAUSE OF THOSE RULES AND ALGORITHMS AND ADMINISTRATIVE BURDENS.
AND THIS HAS BEEN SOMETHING THAT AS I BECOME MORE EXPERIENCED IN MEDICINE, AS I BECOME SOMEBODY WHO MANAGES MORE AND MORE OF MY COLLEAGUES, I'M STARTING TO SEE THE BIGGER PICTURE.
AND I'M TRYING TO PUT THAT TOGETHER IN MY WRITING TO SHOW ALL OF US, TO SHOW ALL OF YOU SO WE CAN HAVE THESE CONVERSATIONS.
SO, SOMETHING I TALKED ABOUT IN MY BOOK AND YOU CAN SEE MY EVOLVING UNDERSTANDING OF THE SYSTEM THAT I WORK IN, THAT I SOMETIMES SAY I SWIM IN LIKE A FISH IN THE OCEAN, AND TRYING TO BRING THAT TO EVERYBODY, BECAUSE I ACTUALLY THINK IT HAS A BIGGER AFFECT ON YOUR CARE, ON THE CARE THAT I GIVE AND THE CARE THAT YOU RECEIVE, THAN ANYBODY REALLY KNOWS, AND I THINK IT DESERVES SOME ATTENTION.
>> YOUR PIECE IS TITLED "THE OVERLOOKED REASON OUR HEALTH CARE SYSTEM CRUSHES PATIENTS."
I HAVE TO TELL YOU THAT -- BEFORE OUR CONVERSATION TODAY, YOU KNOW, I MENTIONED TO A COUPLE PEOPLE I WAS GOING TO TALK TO YOU.
TO A PERSON, EVERYBODY HAD A STORY.
EVERYBODY HAD A STORY.
HOW IS THIS OVERLOOKED?
>> I HAVE TO TELL YOU THAT I THINK THIS IS SORT OF THE CURRICULUM THAT I LEARNED IN MED SCHOOL, RIGHT?
IMMEDIATELY AFTER LEARNING ALL THE ANATOMY, YOU START WORKING WITH PATIENTS, AND THE FIRST THING YOU START TO LEARN IS THAT NOTHING THAT YOU NEED TO DO IS HELPFUL IN ANY WAY UNTIL YOU CAN GET IT TO THE PATIENT.
RIGHT?
AND GETTING IT TO THE PATIENT IS ITS OWN DISCIPLINE.
ITS OWN SORT OF ACADEMIC PURSUIT.
IT'S A COMPLICATED EXPIANOER AGAINST.
AND I THINK FOR PATIENTS, THEY'RE LEARNING THAT, AS WELL.
SOMETIMES OVER YEARS OF A CHRONIC ILLNESS, AND SOMETIMES VERY, VERY QUICKLY, AS THEY GET VERY ABRUPTLY SICK.
>> HOW DID IT START, THAT FILLING OUT FORMS BECAME SUCH FUNDAMENTAL TO AMERICAN HEALTH CARE?
>> I DON'T HAVE A HISTORICAL VIEW FOR YOU, WHAT I CAN SAY IS THIS.
THE AMERICAN HEALTH CARE SYSTEM, AND WHEN I TALK ABOUT THAT, I DON'T JUST MEAN ME OR A HOSPITAL, OR EVEN A CLINIC.
I MEAN ALL OF IT.
YOUR INSURANCE PROVIDER, THEIR CLAIMS ADJUSTERS, EVERY SINGLE ONE OF US IS ADJACENT TO HOW HEALTH CARE GETS PROVIDED, PAID FOR, APPROVED, DISAPPROVED, ALL SORTS OF THINGS.
IT'S A MASSIVE BEAST OF AN INDUSTRY, RIGHT?
MOST OF WHICH IS THERE TO HELP YOU, BUT LIKE ANY LARGE SYSTEM, I THINK HAS TO EVOLVE.
I SOMETIMES COMPARE IT TO THE MILITARY, EXCEPT UNLIKE THE MILITARY, YOU ARE ALL GOING TO END UP IN IT AT SOME POINT.
AND THERE'S GOING TO BE A LACK OF TRANSPARENCY AND ORIENTATION TO THE PROCESSES WHICH ARE GOING TO GOVERN YOUR LIFE, OFTEN WHEN YOU ARE AT YOUR MOST STRESSED OR FEELING YOUR LEAST WELL AND ABLE TO HANDLE THEM.
SO, I THINK THERE ARE THINGS THAT ARE PARTICULAR ABOUT THE AMERICAN SORT OF MEDICAL SYSTEM THAT WE CAN TALK ABOUT, THAT MAKE IT PARTICULARLY DIFFICULT, EVEN AS SOME OF THOSE THINGS ARE THINGS WE ARE VERY PROUD OF.
>> WOULD YOU SAY MORE, YOU KNOW, TELL US A COUPLE OF OTHER STORIES?
>> I MENTIONED IN THE PIECE THAT I WAS IN CLINIC, I HAVE A CLINIC WHERE I OVERSEE OUR HIGH-RISK FELLOWS ON A WEDNESDAY, AND I HAD A PATIENT WHO HAD NOT BEEN ABLE TO PICK UP HER GLUCOSE FINGER STICK, TESTING STRIPS, AND SHE HAD BEEN THREE, FOUR WEEKS WITHOUT THEM, WHICH FOR PREGNANCY IS AN I TERNTY, RIGHT?
EVERY WEEK COUNTS, EVERYTHING I DO IS TIME SENSITIVE.
AND SHE HAD TAKEN OFF THE MORNING OFF OF WORK, SHE IS AN HOURLY WORKER, THAT'S NOT WORK SHE'S GOING TO GET BACK, SO THAT SHE COULD FERRY BETWEEN, YOU KNOW, HER INSURANCE OFFICE AND THE MEDICAID OFFICE AND THE PHARMACY, AND SHE FINALLY GOT THE TEST STRIPS.
AND I HELPED HER.
I WENT WITH HER TO THE MEDICAID OFFICE, BECAUSE IT'S RIGHT ACROSS THE STREET.
I WENT WITH HER TO THE PHARMACY AND WE CLEARED IT ALL UP.
AND SHE GOT HER TEST STRIPS FOR $5, $10 COPAY, BUT IT COST HER ALL OF THE MORNING, WHATEVER CHILDCARE SHE HAD TO GET FOR OTHER CHILDREN, RIGHT?
ON THE OTHER HAND, I WAS HAPPY TO DO IT, BECAUSE IT WAS MUCH CHEAPER THAN ADMITTING HER FOR A DIABETIC COMA.
SO, I KNOW THAT ESPECIALLY IF YOU WORK WITH AN UNDERSERVED POPULATION, I WORK IN AN AREA THAT SERVES SOME OF THE POOREST ZIP COLDS IN ZIP CODES IN THE ENTIRE UNITED STATES.
LIFE IS VERY HARD ALREADY FOR THESE PEOPLE.
THESE BARRIERS BECOME INSURMOUNTABLE, BUT A LOT OF TIMES OUT'S THIS ADMINISTRATIVE WORK.
>> A LOT OF PEOPLE ARE GOING TO SAY, WELL, YOU KNOW THIS IS FOLKS THAT ARE UNINSURED OR, WELL, MAYBE PEOPLE WHO -- ENGLISH ISN'T THEIR FIRST LANGUAGE, OR PEOPLE WHO DON'T REALLY NAVIGATE SYSTEMS -- YOU CITE IN YOUR PIECE A HARVARD MEDICAL SCHOOL STUDY THAT FOUND THAT A QUARTER OF INSURED ADULTS REPORTED THAT THEIR CARE WAS DELAYED OR MISSED ENTIRELY BECAUSE OF ADMINISTRATIVE TASKS.
>> YEAH.
I WORK IN NEW YORK STATE, AND NEW YORK STATE, AND I FEEL VERY BLESSED BY THIS, EVERY SINGLE PREGNANT PATIENT IS INSURED.
DONE.
ELIGIBLE FOR MEDICAID.
I FEEL VERY, VERY LUCKY IN THIS SETTING.
I NEVER HAVE TO WORRY IN THAT WAY.
POSTPARTUM COVERAGE COULD BE BETTER, BUT ONCE THEY'RE PREGNANT, AND BECAUSE I EXCLUSIVELY TAKE CARE OF PREGNANT PATIENTS, THAT'S ALL OF MY PATIENT POPULATION, AND I STILL SEE THIS TREMENDOUS BURDEN.
IT'S NOT JUST ABOUT BEING UNINSURED.
I THINK ANYBODY WHO HAS INSURANCE HANDLES THIS.
HOW MANY PHONE CALLS DID YOU HAVE TO MAKE TO GET TO A SPECIALIST?
HOW MANY FORMS DID YOU HAVE TO FILL OUT TO GET YOUR RIGHT MEDICATION?
HOW MANY TIMES DID YOU PRESS THE WRONG NUMBER ON A PHONE TREE AND YOU SPENT ANOTHER HOUR WAITING FOR SOMEBODY WHO REALLY KNEW WHAT THE RIGHT ANSWER WAS AND COULD PROVIDE YOU THAT EXPERTISE?
>> HAS THE MEDICAL ESTABLISHMENT ITSELF PLAYED A ROLE IN THIS, TO BE FAIR?
>> I GUESS I FEEL LIKE I WORK WITH SOME OF THE MOST DEVOTED PEOPLE, RIGHT?
WHAT I WOULD SAY IS THIS, I SPEND A LOT OF MY TIME OVERCOMING ADMINISTRATIVE BURDEN FOR PATIENTS.
AND THAT IN ITSELF IS BOTH VERY BEAUTIFUL AND EXTREMELY DUMB.
IT'S A DUMB USE OF, LET'S SAY, MY TIME.
I AM SOMEBODY WHO IF I COULD SEE FIVE MORE PATIENTS THAT DAY, IT'S PROBABLY A BETTER USE OF MY PARTICULAR 20 YEARS OF TRAINING TIME.
BUT I WORK IN A SYSTEM THAT I CAN BE SMART AND GIVE YOU THE RIGHT INSULIN, GIVE YOU THE RIGHT ANTIBIOTIC, BUT IF IT DOES NOT GET TO YOU, YOU WILL END UP SICKER.
I'M GOING TO TAKE THAT 10, 15, 30 MINUTES, TALK TO YOUR PHARMACY, TALK TO YOUR INSURANCE OFFICE.
THE CHOICE I OFTEN HAVE IS NOT, DO YOU WANT TO BE EFFICIENT FOR THE, YOU KNOW, FOR THE MEDICAL SYSTEM AT LARGE, THAT'S NOT THE CHOICE IN FRONT OF ME.
THE CHOICE IN FRONT OF ME IS, ARE WE GETTING THIS PATIENT WHAT SHE NEEDS OR NOT?
AND I HAVE ALWAYS GOTTEN THE PATIENT WHAT SHE NEEDS.
BUT I WILL TELL YOU, TO BE ANGRY AT PROVIDERS OR DOCTORS, I THINK, IS THE WRONG THING.
I AM DOING SOMETHING THAT'S SUB OPTIMAL, BECAUSE THE SYSTEM I AM IN IS SUB OPTIMAL, AND THE CHOICES I HAVE ARE BAD.
>> AND I'M ASKING YOU, HAVE NOT MEDICAL PROFESSIONALS BEEN OBSTRUCTIONISTS IN FIGURING OUT HOW TO PROVIDE AFFORDABLE CARE AND ACCESS ACROSS THE BOARD?
IS THAT NOT THE CASE?
>> I DON'T KNOW IF THAT'S THE CASE.
I DON'T KNOW WHO MEDICAL PROFESSIONALS ARE.
IS THAT ME AND MY DOCTORS?
I DON'T KNOW, WE'RE PRETTY -- WE'RE PRETTY IN THE TRENCHES KIND OF FOLKS.
IF MEDICAL PROFESSIONALS ARE CEOs OF INSURANCE COMPANIES OR GIANT MEDICAL SYSTEMS, THEY HAVE A DIFFERENT AGENDA.
I'M EXTREMELY CLINICAL, I'M BOTH VERY FOCUSED ON THE PATIENT IN FRONT OF ME, BUT AS I HAVE BECOME MORE SENIOR, MORE AWARE OF THE WAY THE SYSTEM AFFECTS THEM ALL.
>> IN THE REAL WORLD, DO YOU THINK THAT POLICYMAKERS THINK ABOUT THE TIME COSTS FOR BOTH PATIENTS AND PROVIDERS, PHYSICIANS, IN THEIR RULE-MAKING?
>> I THINK THAT'S IT.
I THINK WE DO NOT COUNT TIME COSTS.
AND TIME COST IS A REALLY, REALLY INTERESTING SUBJECT, BECAUSE TIME COST IS VALUABLE, ONLY IF YOU VALUE SOMEONE'S TIME, RIGHT?
SO, A LOT OF THESE PATHS ARE DONE BY PEOPLE WHO THE INSURANCE COMPANY DOESN'T PAY THEIR SALARY, SO, TWO HOURS SPENT ON THE PHONE ISN'T ON THEIR BOTTOM LINE.
I WOULD ARGUE THAT MANY TASKS ARE DONE BY WOMEN AND ARE PART OF THE UNPAID WORK THAT MANY WOMEN DO TO SUSTAIN THEIR HOUSEHOLDS.
AND WE TEND TO NOT VALUE A LOT OF THAT HISTORICALLY.
BUT IT IS COSTLY.
IT DOES TAKE TIME.
AND IT SHOULD BE COUNTED.
WHEN IT'S NOT COUNTED, WE DON'T ULTIMATELY VALUE IT, BECAUSE WE DON'T EVEN UNDERSTAND WHAT WE'RE PAYING.
>> HOW WOULD YOU FIX THIS?
HOW WOULD YOU FIX THIS?
>> YOU KNOW, IT'S VERY INTERESTING, BECAUSE I ASKED THIS QUESTION TO SOME OF THE PEOPLE I SPOKE TO FOR THE ARTICLE, AND THEY REALLY SAID THAT THEY DIDN'T HAVE A LOT OF GREAT IDEAS.
IT'S VERY, VERY HARD TO ESTIMATE TIME COST.
IT'S VERY, VERY HARD TO KNOW HOW MUCH TIME PEOPLE ARE SPENDING.
BUT I'LL SAY THIS.
I SEE HOW WE FIXED OTHER THINGS.
SO, THE WAY THAT WE PAY ATTENTION TO MATERNAL MORTALITY AND MORBIDITY.
WE DON'T DELIVER BABIES BEFORE 39 WEEKS WITHOUT A VERY GOOD REASON.
THE WAY WE DO THAT IS, WE PAY ATTENTION.
WE PUBLISH METRICS, WE GRADE PEOPLE.
WE SORT OF SHINE LIGHT ON THE SUBJECT AND WE ALSO MAKE THAT KNOWLEDGE PUBLIC.
WE TELL PEOPLE, THIS CLINIC HAS AN A-PLUS.
THIS CLINIC HAS A B-MINUS, WHERE WOULD YOU RATHER GO?
AND I GUESS I WONDER IF THERE'S ANY ROOM FOR CALCULATING TIME COSTS AND REQUIRING A METRIC THAT REFLECTS THAT KIND OF TIME.
MAYBE SOMETHING THAT WE WOULD DO ACROSS THE COUNTRY SO THAT PEOPLE WOULD KNOW, THIS PLACE IS A PLACE THAT VALUES MY TIME.
THIS PLACE DOESN'T.
AND IT WOULD ALLOW, I THINK, FOR MORE KNOWLEDGE FOR PATIENTS TO PURSUE THINGS THAT ARE IN THEIR BEST INTEREST, PERHAPS.
>> WELL, YOU KNOW, I MEAN, THE IRS DOES THAT.
I MEAN, THE IRS WILL DESCRIBE HOW LONG THEY ESTIMATE IT WILL TAKE TO FILL OUT ONE FORM OR ANOTHER IN TAX COMPLIANCE.
IN OTHER SPHERES, THIS IS PART OF PUBLIC CONVERSATION, BUT IT DOESN'T SEEM TO BE WHEN IT COMES TO THIS, AND I'M JUST WONDERING IF YOU HAVE A THEORY ABOUT THAT.
>> I DO THINK THERE'S SOMETHING HERE THAT WE HAVEN'T DISCUSSED, WHICH IS COST.
AND THE UNITED STATES PAYS MORE OVERALL PER PERSON, YOU KNOW, AS A PERCENTAGE OF GDP, THAN ANYWHERE ELSE.
AND THERE ARE WAYS IN WHICH WE GET LESS FOR IT.
THERE'S OUR MATERNAL MORTALITY IS AWFUL, OUR MATERNAL MORTALITY FOR WOMEN OF COLOR IS TRULY SHAMEFUL.
AND WE SPEND MORE MONEY THAN ANYONE ELSE.
AND SOME OF THIS, I THINK, IS FROM THE COMPLEXITY OF THE SYSTEM WE'RE IN.
DON'T HAVE A SINGLE PAYER.
WE DON'T EVEN HAVE A SINGLE PAYER PER REGION.
WE HAVE A CAPITALIST MARKETPLACE, RIGHT?
MOSTLY.
COMBINED WITH PUBLIC INSURANCE, WHICH IS A VERY LARGE PLAYER.
AND SO, I THINK IT'S JUST A VERY STRANGE AND COMPLEX SCENARIO AND ONE THAT'S VERY, VERY HARD TO DRIVE, ONE THAT'S VERY HARD TO DRIVE CHANGE IN, BECAUSE IT'S REALLY COMPLICATED.
THERE'S A FAIR AMOUNT OF GOVERNMENT INTERFERENCE, BUT THERE'S ALSO A FAIR AMOUNT OF JUST MARKET FORCES, AND BECAUSE OF THIS UNIQUE MIX THAT WE HAVE, WE HAVE SOME WONDERFUL THINGS.
I AM REALLY PROUD OF MY TEAM THAT CAN PROVIDE AMAZING CARE IN UNDER AN HOUR FOR A SICK PATIENT, BUT WE ALSO HAVE THESE COSTS, WHICH IS THAT EVERYBODY'S GOT SIX DIFFERENT FORMS, BECAUSE THEY HAVE SIX DIFFERENT INSURANCE COMPANIES AND SEVEN DIFFERENT PHARMACIES AND NOBODY'S COME TO AN AGREEMENT OR STANDARDIZATION.
BUT THE COST, I THINK, IS REAL, AND A REAL DRIVER.
AND I DON'T THINK IT'S WRONG TO WANT TO BRING THAT COST DOWN.
WE ALL PAY FOR THAT.
WE PAY FOR PREMIUMS, WE PAY IN THE FEDERAL BUDGET.
BRINGING THE COST DOWN IS SOMETHING THAT I THINK WE'RE GOING TO HAVE TO DO.
IT'S JUST THAT SOMETIMES COMPANIES MAKE THE DECISION TO BRING THE COST DOWN BY MAKING THE ADMINISTRATIVE BURDEN HIGHER, AND THAT ONLY WORKS IF YOU DON'T COUNT THE ADMINISTRATIVE BURDEN AS A COST.
>> I'VE HEARD -- I THINK THERE MAY BE DATA TO BACK THIS UP, THAT THERE ARE DOCTORS WHO HAVE LEFT THE FIELD BECAUSE OF THE PAPERWORK BURDEN.
HAVE YOU EXPERIENCED THAT?
HAS ANYBODY, FRIENDS, PEOPLE YOU WENT TO MED SCHOOL WITH, DO YOU THINK THAT MIGHT BE TRUE?
>> THIS IS VERY PERSONAL TO ME, BECAUSE I FEEL LIKE I AM JUST SEEING SUCH PROFOUND BURNOUT IN THE MEDICAL PROFESSION RIGHT NOW.
WHICH IS HARD.
MOST OF US LOVE THE WORK WE DO, WE LOVE OUR PATIENTS, WE SPENT A LONG TIME BECOMING GOOD AT THIS WORK AND THIS WORK IS VERY, VERY HARD.
BUT IT IS ALSO TRUE THAT MANY OF US SPEND HOURS AND HOURS AND HOURS ON ADMINISTRATIVE BURDEN.
YOU KNOW, THESE ARE TASKS THAT DON'T BRING IN REVENUE.
THEY'RE NOT BILLABLE, FOR THE MOST PART.
BECAUSE OF THAT, THEY MAY NOT BE SUPPORTED.
AND I DO THINK IT ALL ADDS UP.
IT ALL ADDS UP, AND ADDS TO DISSATISFACTION ON TOP OF SORT OF POST-PANDEMIC DIFFICULTIES, FATIGUE, AND MALAISE.
I THINK THERE'S A TRUE BURDEN HERE THAT IS CONTRIBUTING TO CLINICIAN BURNOUT.
AND I THINK IT'S GOING TO HAVE TO BE ADDRESSED.
>> DOCTOR, THANK YOU SO MUCH FOR TALKING WITH US.
>> THANK YOU SO MUCH.
>> AND THAT WAS AND IS AN IMPORTANT CONVERSATION, THE HARD WORK, THE DEDICATION, OF OUR MEDICAL PROFESSIONALS ALL OVER THE WORLD.
>>> FINALLY, THOUGH, GOOD NEWS ON THE MEDICAL FRONT.
THANKS TO ARTIFICIAL INTELLIGENCE, NO LESS.
A NEW STUDY SHOWS THAT IT IMPROVES BREAST CANCER DETECTION BY 20%.
THAT WOULD ALSO MEAN A SIGNIFICANT REDUCTION IN WORKLOAD FOR RADIOLOGISTS.
EXPERTS ARE SAYING IT OFFERS HUGE PROMISE IN THE FIGHT AGAINST BREAST CANCER.
HOPEFULLY THAT IS JUST THE BEGINNING.
>>> AND THAT IS IT FOR OUR PROGRAM TONIGHT.
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