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

Trevor, Eugene, and author Tom Mueller examine how corruption, greed, structural failures, and declining public trust in the American healthcare system have shaped patient care — and whether meaningful reform is still within reach.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  The story of dialysis is an amazing case study of good intentions being thwarted by bad incentives, poor oversight and profiteering.

• 0:07Speaker 01

  When I was working at DeVita, the priorities was to get them on dialysis and get the next patient on as soon as possible. It was all about numbers.

• 0:15Speaker 02

  Tom Mueller is the author of How to Make a Killing: An Investigation of the Dialysis Industry.

• 0:22Speaker 03

  In America, patients on dialysis die one to two times faster than in any other developed country.

• 0:33Trevor Noah?

  This is What Now with Trevor Noah.

• 0:38Trevor Noah?

  This episode is presented by Whole Foods Market. Eat well for less.

• 0:44Trevor Noah?

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• 1:19Trevor Noah?

  This segment is brought to you by Google Pixel. You know what's really frustrating? Knowing the exact information you need is somewhere on your phone, but still ending up wasting your time digging through five different apps just to actually find it. Thankfully, Google Pixel 11 is designed with Gemini intelligence, so it can proactively find the information I need right when I need it. Like my flight info on travel days or my calendar when Eugene texts me to hang out. Oh, sorry Eugene, I'm booked. Learn more about what Google Pixel 11 can do at googlestore.com. These AI features are available in select countries and languages for users 18 and over, and make sure to check responses. Yeah, booked

• 2:04Trevor Noah?

  forever, forever.

• 2:07Trevor Noah?

  This episode is brought to you by Verizon.

• 2:11Trevor Noah?

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• 2:56Trevor Noah?

  all-inclusive music festivals, and the chance to meet your favorite stars, plus daily drops, tickets, and pre-sale access all week. So, let's recap. Cash back in your pocket every month with Verizon Dollars, and epic experiences from Verizon Shine every Monday all year round. Now, those are some rewarding rewards. Only from Verizon. Enroll today at Verizon.com.

• 3:26Trevor Noah?

  I've never known you without glasses, now that I realize it.

• 3:28Speaker 05

  You actually have.

• 3:29Trevor Noah?

  When?

• 3:30Speaker 05

  Half of our relationship was without glasses.

• 3:32Trevor Noah?

  What? Take off your glasses?

• 3:35Speaker 05

  Remember this guy?

• 3:37Trevor Noah?

  No, actually, no, you're right. You're right, actually. Yeah, the beard, now it's like a flip.

• 3:41Speaker 05

  Yeah, there was no beard, more hair, no glasses.

• 3:44Trevor Noah?

  It's like I've known every version of you.

• 3:47Speaker 05

  Do you know this guy? Eugene, where are you? I'm here!

• 3:51Trevor Noah?

  Oh, Eugene, you're back!

• 3:53Speaker 03

  I think someone else is in glasses.

• 3:57Trevor Noah?

  And just saying. Welcome to our idiot friendship, Tom, I'm so sorry.

• 4:03Speaker 03

  Thank you very much, Eugene. I feel like I fit right in.

• 4:06Trevor Noah?

  You do, actually. You do. If you want to, you do, man. You do indeed. Actually, you know why I feel like you fit right in is because you've got like one of the the most beautiful weird stories of how you've lived your life, you know. And when I read your books, I can't help but wonder if the way you write and the way you've thought of writing comes from how you've lived your life. Like, just take us through some of this. So, because a lot of people are fans of your books, but I don't think a lot of people know a bit of your life. It's like, where were you born?

• 4:33Speaker 03

  I was born in New York City.

• 4:34Trevor Noah?

  Okay.

• 4:34Speaker 03

  Left six months later, went to London and Paris.

• 4:38Trevor Noah?

  I like how you say that, like, you left. You were like, I'm out.

• 4:40Speaker 03

  I was lefted.

• 4:41Trevor Noah?

  You were like, I'm out, I'm out, parents. I can't do this anymore.

• 4:45Speaker 03

  Yeah, when I say I was born in Columbia Presbyterian, my New Yorker friends say, yeah, but you're not a New Yorker. So I try to make that clear at the outset tonight. And we moved around a lot in the United States, California, upstate New York, Texas. I did my high school in Houston, Texas, which I do not recommend, but was an experience. I learned about football, which is something. And then, yep, we went east for college and then went to England for grad school and have really not lived in the United States since Ronald Reagan was president.

• 5:18Trevor Noah?

  That is wild.

• 5:19Speaker 03

  I spend half my time or more in the United States and I technically live in the United States, but yeah, I've been based in Italy for 30 years or so.

• 5:29Trevor Noah?

  Do you think that some of that has affected how you're able, like, maybe I'm projecting here, but I sometimes feel regardless of nationality, one of the best things you can do is remove yourselves from a situation to be able to see it better. Doesn't matter who you are in the world. Spend time away from your family, come back to them, you'll see them slightly differently than when you're always in it. And I feel like you've done that with America, with the corporations, with the way we see, you know, the way things just work. Is that, do you think that's partially because of just like how you've lived, where you've been?

• 6:00Speaker 03

  I think no question, stepping back and looking at the way in which, for instance, you mentioned the corporations, the way in which in America corporations and money are regarded with a certain religious awe. Whereas in other places, it's, you know, they are welcome and they are sometimes very powerful. But they're not the be all and the end all. And, and again, stepping back into a place where you've been born and raised, you realize, my gosh, you know, things really have changed here. And that amidst the last thirty plus years, things in America have changed at an accelerating pace, an alarming pace, really. But you can see that better if you're outside the bubble for a while and then you pop back in, so.

• 6:42Trevor Noah?

  How did you get into writing? Because I don't know if my research was correct, but were you in banking at some point?

• 6:47Speaker 03

  Yes, I, I did a PhD in history and love history, but realized I was not cut out for academia. So I thought, well, I know languages, Europe nineteen ninety-two is happening, let's try. You know, there were recruiters on, on, on campus checking for people who were interested in recruiting, in banking and consultancies and various others. And I ended up at Goldman Sachs in London doing mergers and acquisitions, which, for two years, which was a remarkably good experience from a business point of view. I met some of the most fantastic people in the world and I came away with this amazement that some of the most fantastic people in the world were swindled into giving their lives away for a modest amount of money.

• 7:32Speaker 03

  I mean, it was big money.

• 7:33Trevor Noah?

  What do you mean by that?

• 7:35Speaker 03

  They were indentured servants to this company. And simply their lifestyles were terrible, their incomes were very good, but terrible, terrible lifestyles. And, and that was well before, you know, the run up to two thousand eight and all the massive crime. I was in a business where it was still, the relationship was important. And, and if you screwed up with a client, you were done. I mean, you were finished. And then later, clients became sock puppets and traders replaced relationship bankers and you got two thousand eight. So, you know, one of my closest collaborators or bosses and collaborators at the bank was on the one NDB indictments. I mean, he was, you know, they had investment banking.

• 8:16Trevor Noah?

  We're talking about like the, this is the two thousand and eight Wall Street crash, financial collapse.

• 8:22Speaker 03

  Yeah, I mean, they were testifying before Congress. They were explaining why you could call a client a sock puppet and you could create financial vehicles.

• 8:32Speaker 05

  Wait, Tom, that's an actual term?

• 8:34Speaker 03

  The actual term, sock puppets, yes.

• 8:36Speaker 05

  Was it used within your circles or just?

• 8:39Speaker 03

  Not within my circles, but you know, my, the folks that I worked with who stayed at the bank, that's what they were talking about. Yeah. And again, trading is very, very different from relationships. Trading is one day at a time, I win, you lose. I mean, there's a zero sum game. So, trading is, at the end of my day, I close out my position and you are my counterparty. You're not my client at all. And that means I can take advantage of you. And that's what happened in the run up to 2008. Goldman was in particular, I mean, involved in all sorts of bad stuff, but they were basically building financial vehicles to fail and then selling them to unsuspecting pension funds and various other, you know, innocent parties as a good investment.

• 9:20Speaker 05

  Yeah.

• 9:20Speaker 03

  And then betting against them. That's insane, man. I still can't believe that that happened. And then I, you know what shocks me even more, is that the ramifications were barely felt. Do you get what I'm saying?

• 9:32Speaker 05

  Yeah, yeah.

• 9:32Speaker 03

  It's one thing to go something wild took place. It's another to go, nothing happened.

• 9:38Speaker 05

  But I think that's why a lot of people have sympathy and sometimes admire people who do white collar crime, right? Because it almost feels like it's a victimless crime. If someone is bleeding on the side of the road and someone has a firearm in their hand, that's a crime. If someone says, I lost millions of dollars, and people go, how much do you still have? Couple of million more. There's no crime here, no farm. You see what I'm saying?

• 9:58Speaker 03

  Yeah. No, I mean, you look at Mike Milken. I mean, he was actually prosecuted and sent to jail for multiple felonies. Comes out, he's the toast of the Nobel Prize community. He's got billions still in his, in his foundation. It's, no, I mean, white collar crime is vastly more, it's the cancer of society. It's vastly more damaging. It causes massive amounts of, of harm. But as you say, it's, it's almost lionized in, in the business school community as something, hey, you know, you really is a risk taker, right? He's a real hard, you You talk about killers in business, you talk about making a killing.

• 10:36Speaker 05

  Yeah, yeah, yeah, yeah.

• 10:36Speaker 03

  That's a good thing. That's supposed to be a positive attribute.

• 10:39Speaker 05

  Different than we do.

• 10:41Speaker 03

  Yeah, and and if you're flying, you know, close to the to the wind in legal terms or beyond, that's it's viewed as an incentive. There's no normative quality to a law. You break the law.

• 10:51Speaker 05

  Yes.

• 10:52Speaker 03

  You're it's wrong.

• 10:53Speaker 05

  Yes.

• 10:53Speaker 03

  What do you they say, what are you talking about? I mean, how much do I have to pay here? What's the settlement? I'll pay it. Put all the checkbook, write it. And while you're at it, individuals don't go to jail anymore. It's corporations, right? So it's the perfect crime. I mean, you you you are lionized as a killer on Wall Street. You are covered by your corporation, so you individually aren't prosecuted at all. And when the time comes to write a check, you can write a check instead of going to jail, and your corporation writes it for you, and you keep your beach house. It's beautiful.

• 11:22Speaker 05

  You're the perfect person to be having this conversation with. In South Africa, we had the State Capture Commission.

• 11:27Speaker 03

  Yeah.

• 11:27Speaker 05

  Where based you, did you read about it?

• 11:29Speaker 03

  I did.

• 11:29Speaker 05

  For those who don't know, it was an inquiry headed by a constitutional judge who's now retired that was based in South Africa to hear about widespread corruption in the government with private actors. So who were involved in having government contracts. That went on for, I think, almost two years, a billion ran later, not a single prosecution. Everyone got away with everything. But when I was having conversations with my friends even, I would always say, why is it that whenever we talk about corruption, we speak about the person whose hand is caught in the cookie jar? So if you and I steal, we make a billion dollars, we still have to go buy Ferraris, Maseratis, Lamborghinis. Who's selling us those cars? We have to go buy mansions. Who's selling us those mansions?

• 12:13Speaker 03

  Absolutely.

• 12:13Speaker 05

  Who's investing our monies? Where are those funds kept?

• 12:16Speaker 03

  Yeah.

• 12:16Speaker 05

  Where are we making the transaction and the withdrawals?

• 12:18Speaker 03

  Yeah.

• 12:18Speaker 05

  And I always think to myself, I would love to meet someone who can make me understand why is it that even when corruption is thwarted, it doesn't go further than when people exchange the same money for goods.

• 12:30Speaker 03

  Those enablers, I mean, there is is one whistleblower in finance who Revealed that a certain bank, Wells Fargo bought it, was laundering money for the Sinaloa cartel. He said, "Those enablers, those bankers had their finger on the trigger every time the Sinaloa cartel fired gun."

• 12:48Trevor Noah?

  Damn.

• 12:48Speaker 03

  And that's true. I mean, we cannot look at enablers, bankers, real estate people, corporate, you know, corporate foundations.

• 12:57Trevor Noah?

  Yeah, yeah, yeah.

• 12:58Speaker 03

  All the other folks that make their lives possible, tax advisors, all these offshore.

• 13:03Trevor Noah?

  Yeah, yeah.

• 13:04Speaker 03

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

• 13:33Trevor Noah?

  Mm-hmm.

• 13:34Speaker 03

  The hitmen and women in this world.

• 13:35Trevor Noah?

  They're the lowest in the food chain.

• 13:36Speaker 03

  Yeah, they're just tools in the hands of these other people. But we admire the lawyers, the white shoe lawyers and the big bankers and so on. We admire them. They get their names written on, you know, New York Public Library, all sorts of very special perks for them.

• 13:50Trevor Noah?

  You know what's amazing? Even when we think about our thinking of it, it's amazing that if you shoot somebody in the street, or if you rob somebody, or if you shoplift one of those, you have committed a crime, you are a criminal. But if you defraud millions of people's pensions, if you get millions of people addicted to opioids, and, you know, now they're having overdoses, et cetera, this is white collar crime. It's amazing that we've given crime a different name, but why? Do you know what I mean?

• 14:21Speaker 03

  Yeah.

• 14:21Trevor Noah?

  Why is it a, no, no, this is a white collar crime. We've almost, we've almost given it a respectability that it doesn't deserve. It's like-

• 14:27Speaker 03

  What kind of collar do the people who define it wear?

• 14:30Trevor Noah?

  Exactly.

• 14:30Speaker 03

  They wear white collars. They're judges, they're lawyers, they're the folks who are making these rules, right? I mean, you know, they are the people who see this. They see someone bursting into their house and robbing them or shooting things-

• 14:41Trevor Noah?

  Exactly.

• 14:41Speaker 03

  -as a major threat. They do not see someone who is defrauding a pension fund and having, you know, elderly teachers eat dog food for the rest of their lives, which is something that happens.

• 14:52Trevor Noah?

  Yeah.

• 14:52Speaker 03

  They don't see that as a problem. These, they're not elderly teachers. They don't see, they don't see, at the ultimate analysis, they don't see the common good as a major concern.

• 15:02Speaker 03

  They just don't. It's a dog-eat-dog world. It's an Ayn Rand world. And it's I win, you lose. That's it. And that's ultimately why the heroes of finance, the heroes of the law and so on, are so clubbish and so in agreement along with the judges when it comes to defining the social damage by certain kinds of crime. And as you said, white-collar crime causes infinitely more damage. And just erosion of trust, erosion of respect, erosion of this social fabric than any blue-collar crime.

• 15:36Trevor Noah?

  People don't realize how much the things they're experiencing in the world every single day are a byproduct of those crimes. And while we'll never dismiss a murder or a robbery, those crimes have far less of a ripple effect out into the world. Do you know what I mean?

• 15:54Speaker 03

  Hundred percent.

• 15:54Trevor Noah?

  So when you see your town dilapidated, when you see your parents sick or a family member who is dying and can't get treatment, when you see your retirement fund disappear, when you... Those types of things have such a widespread effect. You know what I mean? They're more likely to create more of the thing

• 16:14Speaker 03

  Yes.

• 16:15Trevor Noah?

  that you don't want to see. And it's so crazy to see this. I actually wonder like how you had this... Because your life is really... It almost feels like a series of trapdoors when I think of your life. You know, you're studying history and then you fall down this trapdoor. And then all of a sudden, you're in London, you fall down a trapdoor. And then at some point, you were studying music. You know, and then it's like you fall down another trapdoor, another trapdoor. And then you stumble into this world that honestly, I think everyone should be grateful for. And for me, it was like, you know, when you were writing about the corruption in the olive oil industry, which seems like such a light topic, you know? So when I saw that, I was like, huh, corruption in olive oil? Well, this is like an acute world to be in, you know? But you expose so many of the layers.

• 16:58Trevor Noah?

  And then your next book, you talk about whistleblowers and the role they play in society and how we don't protect them enough and what they've done to expose what we're experiencing. And man, I feel like your latest book, I hate to say it, is more and more applicable every single day.

• 17:18Speaker 03

  Right.

• 17:18Trevor Noah?

  You know? How to Make a Killing in Healthcare in America is like...

• 17:25Trevor Noah?

  You know, you look at all the stories that popped up, the Luigi Mangione story. You know, you, you, you look at people, you know, going on strike or rioting in certain parts of the world. You look at, because they're losing their health benefits. You, you look at people just losing faith in the societies that they live in, in the system. And when I read your book, I went, this guy, you didn't just critique it. You, you, you break it down on the, on, on the, like, the most minute levels. And I wanted to know, like, why you started with dialysis, because that's, that's like the, you know, the, the, the real crux of your book, but it exposes everything. You, you went, you go into dialysis. Why, why that topic? Help me understand.

• 18:08Speaker 03

  Yeah, well, I, as you mentioned, I wrote a book about whistleblowing and I was interviewing a bunch of different whistleblower classes. So there's, you know, the big pharma whistleblowers and the defense contractor whistleblowers, the big bank whistleblowers. And there was this weird outlier, dialysis whistleblowers, the finance people in dialysis who were, who were bringing false claims suits, whistleblower lawsuits against the big dialysis companies. I'm like, what's going on here? And they were, the dialysis companies were signing four hundred and five hundred million dollar settlements at a pop. Their stock price was going through the roof. Warren Buffett owned forty percent of one of them. And I'm like, okay, what's going on here? My, my bank, my inner banker was like, the board is lighting up red.

• 18:52Speaker 03

  Yeah, what is going on here? And so I looked into, well, first I started with the finance people, then I worked my way back into nephrologists, kidney doctors who were working for these companies, and then gradually back down to the blood floor, where dialysis is actually delivered. And that's when I realized, this is not a chapter in a whistleblower book. This is its own book. Cause as you said, Trevor, I mean, it is, it is a perfect microcosm of what can go horribly wrong.

• 19:17Trevor Noah?

  Yeah.

• 19:17Speaker 03

  When you put profits before patient care.

• 19:19Trevor Noah?

  It's also a terrible story of, of how a miracle can be turned into a curse. Right? Because you look at when this technology is invented. You know, and I only learned this from your book. It's not like I knew this before reading the book.

• 19:32Speaker 03

  I didn't either.

• 19:32Trevor Noah?

  You look at this world where it's like dialysis is this miracle.

• 19:35Speaker 03

  Yeah.

• 19:35Trevor Noah?

  It's like, wow, we've invented this way to basically, you know, an external kidney. Yeah, an external mechanical kidney. What, what have we done?

• 19:42Speaker 03

  Yeah.

• 19:43Trevor Noah?

  And in such a short amount of time, it goes from miracle to, oh no, this is a curse on people's lives, on their finances, on their futures, and on their families. And I was like, when you stepped into it, what made it the perfect place to start? Like, what would people not understand about dialysis? Like, they might be like, oh yeah, what makes dialysis so big, or so unique? Or why dialysis versus everything else? What was it about this specific topic?

• 20:11Speaker 03

  Well, first of all, as you say, it was a miracle, and it's such a miracle, such a breakthrough, the first replacement organ that had the potential to save millions of lives. And it was such a miracle that the US Congress got involved. I mean, they were, this is 1972, the early 70s, 1972, the actual law was passed. Congress got involved at a time when, and this is gonna take you back, at a time when the Republicans, the Democrats, the insurance companies, the AMA, everybody had their plan for national health. The US was gonna have national health. And they viewed dialysis as this breakthrough cure, which had hit the news in a way that made it very difficult for them to ignore.

• 20:53Speaker 03

  There was who decides who lives and who dies. There was, you know, Life magazine cover stories about this. There's Edward Newman doing NBC reporting on it. And it's pretty blunt that, you know, the folks who were chosen for the very few chairs that were available survived and lived pretty well for decades, and the rest were dead. I mean, they had no chance at all, they were condemned to death. So Congress got involved, and they made it the one and only Medicare for All program in 1972, signed by Richard Nixon. And that is at a time, literally, where everyone is thinking we're gonna have national health. Everybody else, I mean, most other countries around that same time adopted national health. Australia, which is the counterpart that I compare the US to a lot in 1972.

• 21:38Speaker 03

  But then Watergate consumed Nixon, the Vietnam War went ballistic. You know, the OPEC oil embargo, stagflation, and the entire government pivoted from build a great society to cost cutting and Reaganomics very soon after. And government's the problem, not the solution. Damn. And we've never looked back. We've never gone back. So dialysis from a historian's point of view is a really interesting sort of relic of a different era where the government felt and the people felt the government had a role in taking care of human beings. That's an important part of being a citizen. Yeah. Getting healthcare. So we once thought.

• 22:19Speaker 03

  And then, then the dialysis, the fascination to me of this treatment, which is done wrong, it's a sort of an incarceration. I mean, you need dialysis three times a week, minimum, minimum, minimum three, three and a half hours each treatment, or you die. It's as simple as that. They own you. If, if it's a good organization, they are looking out for you. They're saving your life every single time they. If they're, it's a bad organization that's run like Taco Bell, which one of the former CEOs actually bragged about, this is how we're going to run this company, then it, they own you. They actually possess your body. So it reminded me, one of the lawyers who got in, I, I, in order to help a lot of patients

• 23:00Speaker 03

  who have contacted me, I've been contacted by over 3,000 patients and family members since this book came out and long before. One of the lawyers who really got it was a former Innocence Project lawyer. So people unjustly incarcerated, people on death row, mostly black and brown. And he said, oh, I get it. He had just retired from the Innocence Project because Illinois had done away with the death penalty and it was a major success for him. And I, and I said, you've got to get involved with this involuntary discharge from the dialysis facilities. And he said, I get it, I get it. You're trying to bring me back onto death row. Damn. Punch in the gut. That's exactly what it is. Suddenly saw what he meant about this combination of healthcare and incarceration.

• 23:43Speaker 03

  So to come back to your question, this is, let's say, one of the most extreme cases of healthcare delivery, where you need it and you're going to, if you don't get it, you're going to die. Yeah. At the same time, you have to follow the rules that whatever organization is taking care of you is laying down, or you don't get it. Yeah. And if those, and there are good organizations and there are good facilities and there are wonderful people.

• 24:08Speaker 03

  And they do a good job about focusing on the individual and their individual needs. As with all medicine. But there are big companies that are running things on an assembly line, one size fits all basis. And they're really looking much more at Wall Street than they are at their individual patients. I mean, they are hedge funds with an exposure to healthcare. That's not an overstatement. They are financial vehicles with exposure to healthcare.

• 24:31Speaker 05

  How complicit or how complicit is the average person who buys stock?

• 24:38Trevor Noah?

  Why did you look at me when you said that? That was weird.

• 24:42Speaker 05

  Complicit is ours.

• 24:43Trevor Noah?

  No, no, no.

• 24:44Speaker 05

  Complicit?

• 24:44Trevor Noah?

  No.

• 24:45Speaker 05

  It's Tom's world.

• 24:45Trevor Noah?

  No, no, no. But what you you went.

• 24:48Speaker 03

  How complicit are you?

• 24:49Trevor Noah?

  The average person. And you looked at me.

• 24:51Speaker 03

  You you you we.

• 24:53Trevor Noah?

  You looked directly at me as if I've bought stock in any of these.

• 24:58Speaker 05

  How complicit?

• 24:58Trevor Noah?

  Yeah.

• 24:59Speaker 05

  A friend of yours was an afro.

• 25:00Trevor Noah?

  That was really weird.

• 25:01Speaker 05

  And you're wearing a tan sweater.

• 25:02Trevor Noah?

  Ask your question and look away from me. Don't be looking at me like that.

• 25:05Speaker 03

  Look the other way when you say that.

• 25:06Trevor Noah?

  I have never bought any stock in the healthcare. You look the other way. Don't don't do that.

• 25:10Speaker 03

  No, take that back.

• 25:13Speaker 05

  I take it back.

• 25:16Speaker 05

  Do you feel better now?

• 25:21Speaker 05

  People like to wash their hands off of something that is innately horrible. When people say if there's insider trading and you give me a tip off and I put a million dollars in something and I make a lot of money. But if I put five dollars because my banker said I should and this company ends up blowing up like it does. And it does the thing that you say it does. How complicit am I?

• 25:42Trevor Noah?

  It's it's an interesting thought of like, how far away do we get the blame for? Because. Yeah, like, do you? If I'd expand on on that, it is it is a difficult question.

• 25:55Trevor Noah?

  But do you think people know when they're investing in these companies? Like the average person? Do you think they know what they're investing into?

• 26:02Speaker 03

  No idea. No, I I think they have no clue what they're investing in. And and that all of the signaling, all of the P R is about health and wellness and.

• 26:12Trevor Noah?

  Yeah.

• 26:13Speaker 03

  Thriving, United Health, just to take one example. But. You know, for me, the individual investor, you should probably do your homework because that's part of your responsibility as a citizen. But the people who are really complicit to me are people like Warren Buffett. I mean, you own forty percent of a company, you have owned it for a long time, you yourself have made a killing in this investment, you should be kicking the tires on what's going on, right? I think that's very important. And I think people should be able to call folks on that. Now, he might argue that this is a good investment, and what I'm doing is investing. And that is precisely the argument, that there is zero social, you know, obligation on my part. I am an investor. And that's the sort of the

• 26:56Speaker 03

  Ayn Rand approach, right? Or the, you know, the Reaganomics approach is ultimately, it means that you don't have a social responsibility. And in fact, there's, there's an argument that says, social responsibility in running a company is actually, should be illegal. I mean, your only legal obligation is to shareholder value.

• 27:14Trevor Noah?

  Yeah.

• 27:14Speaker 03

  That's another of those insane things, like corporations are people and money is speech. One of those completely idiotic, insane things.

• 27:23Trevor Noah?

  Corporations are people?

• 27:24Speaker 03

  This is United, Citizens United. Corporations are people as a, as a legal entity.

• 27:29Trevor Noah?

  Yeah.

• 27:29Speaker 03

  And, and their money, and any money, is speech. Those are two things.

• 27:33Trevor Noah?

  Yeah, that's one of the worst decisions America ever made.

• 27:35Speaker 03

  It's preposterous. I mean, if you think about it, what is that? That's crazy. It's crazy talk. But we've been fed it so many times, you know, with our papulum, that we ultimately say, oh, well, it must be true. I guess those really smart people are saying it. It's, it's, not only is it insane, it's also hugely damaging. Because of course, then, the corporations with their speech are going to go in and buy politicians. And that's what our, I mean, the US campaign system, campaign finance system, is illegal in most countries.

• 28:02Trevor Noah?

  Yeah.

• 28:02Speaker 03

  I don't know how it is in South Africa.

• 28:03Trevor Noah?

  No, no, no.

• 28:03Speaker 03

  But a big company can't come and give you a million bucks.

• 28:06Trevor Noah?

  So ours is, you can in South Africa. They, they make these big donations. But I was shocked, when I first came to the US, I was shocked at how many things are legal here. And just full on bribery where we're from and in other parts of the world. It's just like, it's just bribery. They would just go, this is bribery.

• 28:23Speaker 03

  Yeah.

• 28:23Trevor Noah?

  Half the stories that make the headlines in South Africa, politician got a private jet flight to this place and was put up in a hotel for a weekend and went out for, and then spent this much and got, and then you come here and they're like, no, no, no, that's, that's lobbying. What are you talking about? That's not, that's not bribery.

• 28:38Speaker 03

  Speech, free speech, first amendment.

• 28:41Trevor Noah?

  Yeah, they're expressing themselves. This poor company needs to speak. Are you going to silence the company? Oh, poor company.

• 28:48Speaker 05

  We, we're going through that actually right now where officials from our version of the DMV went to France.

• 28:55Trevor Noah?

  Oh, yeah.

• 28:55Speaker 05

  To solicit, you know, to hang out and be on private jets, expensive dinners, expensive gifts with a company that will print driver's licenses.

• 29:04Trevor Noah?

  They have the exclusive contract essentially for, and it's, it's massive amounts of money, but it's exactly what you're saying. And when you, you know, when we talk about complicit, I lo-, I love that you use that word because when we talk about somebody like Warren Buffett, I go, I will not call Warren Buffett good or bad or whatever, but it is interesting. It is interesting that we would never accept that excuse. Let's say from another person, if they, if it turned out they funded the Sinaloa cartel, you know, if they owned forty percent of it. Like imagine if you said to somebody, I own forty percent of the Sinaloa cartel. They'd go, you're a criminal. And you're like, no, no, no, no, no. I just invest in the Mexican drug cartels. I, I don't engage in it.

• 29:45Speaker 05

  Hmm.

• 29:45Trevor Noah?

  They're a good investment.

• 29:46Speaker 05

  Yeah.

• 29:47Trevor Noah?

  They are.

• 29:47Speaker 05

  Great investment.

• 29:48Speaker 03

  Rapidly growing, good market share. Yeah, all of them. The return on assets is awesome.

• 29:52Trevor Noah?

  It's a great, uh, uh, but I, look, do I condone everything? Of course I don't. Uh, but I'm not, I'm not there for the murder. I'm just there for the investment. There, there is a level of asking yourself like, you know, like who, if everyone gets to say that they are not responsible, then who is responsible?

• 30:08Speaker 05

  Yeah, I think it's also how things are phrased, you know, an inquiry, an inquisition, a, you know, white collar crime, corruption, bribery.

• 30:16Trevor Noah?

  Yeah.

• 30:17Speaker 05

  It's theft. All of it is just theft. And I was asking you before we started that, what is it that makes

• 30:25Speaker 05

  people steal?

• 30:28Speaker 05

  I know what would motivate someone to tell the truth and blow the whistle. I can kind of figure it out. You get tired of how things are. You go, I have to make a change. I have to be the change that I want to see. But in your research, what makes someone go, here's a million dollars that's supposed to go to public good and I'm just gonna buy a nice car and a nice house.

• 30:47Speaker 03

  Well, first of all, um, steal from necessity. I'm hungry and I gotta eat. My family has to eat. I get that. Um, I'm not condoning it, but I get it. Um, and a lot of that is caused by the white collar crime we were talking about earlier. Right. Um, but second of all, if you ultimately, um, if you and your peers are uh, an aggressive corporate culture and you talk about how you really gotta push things, you really gotta go for the, go for the throat, you know, all these sort of sports slash killing analogies of war. I mean, corporations as war fighting machines. That's kind of, you know, penetrate and, and, and uh, take uh, you know, enemy territory, this sort of thing.

• 31:28Speaker 03

  Then you're going to naturally push hard and you're going to do things which are potentially illegal, but maybe, you know, there's this sort of nudge, nudge, wink, wink. We, the compliance department says we're doing everything just right. We have a gold plated compliance department.

• 31:42Speaker 05

  Plausible deniability.

• 31:43Speaker 03

  Go on, go on. Off camera, you can do, you know. But then there's this, there's this worship of money and the way in which people keep score in their lives. I mean, it's hard to figure out when you're doing the right thing. If you're saying, am I doing the right thing today? By uh, I don't know, by writing a book, by doing a comedy show, by talking. It's hard at the end of the day or the end of a year to say, I've done something really important. It's easy to count money. And if you're in that culture where you say, like, look at that, I got five million bucks. That's very tangible. And now it's five point two and on this, and the stock market is growing, growing. The wealthy people that I know, the ones that have a hundred million, they only talk about the people who have two hundred and three hundred million. The ones who have three hundred million, they talk about the billionaires.

• 32:28Speaker 03

  The ones who have a billion, they talk about the two billion. It's never enough. It's like the shark that can never get full. And that's where I think that's the ultimate problem. It becomes, especially when the society worships these people and, and condones all of their actions. It becomes this sort of endless, endless hunt for more, for more money at the end of the day. And it's a status thing and it's a, but how can you possibly live? How can you possibly use even a million dollars, let alone a billion dollars? I mean, how can you, it's just, it's just a score, it's a counter for the quality of your life. Because the quality of your life, I don't know. I mean, again, working in banking for a brief time, I saw some amazing people, incredibly smart people,

• 33:11Speaker 03

  doing incredibly dumb things with their life, throwing away their time in order to have a metric ton of money. They didn't have cars, they didn't travel, they didn't live, but they felt successful. And for me, after two years, I was like, you were losers, you guys. I mean, I'm sorry. And now they think I'm sure that I'm a loser because I have any money.

• 33:33Trevor Noah?

  Don't go anywhere because we got more what now after this.

• 33:38Trevor Noah?

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• 34:23Trevor Noah?

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• 35:08Trevor Noah?

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• 35:12Trevor Noah?

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• 35:57Trevor Noah?

  Ooh, then suddenly you're talking about the cut, the fit, the weight, the way it falls on your body. Then you're like, no, no, no, you don't understand. Look at the sleeve. And that's what I've really enjoyed about Quince. One of my favorite things is their Pima Cotton Lux Touch t-shirts. And it's become one of those pieces I keep reaching for. The cotton has this really smooth, premium feel to it. The fit is great and it just lays really nicely. And I think that's what you sometimes take for granted with simple clothes. When they're done really well, they become the foundation of an entire outfit. You can throw on a jacket, a sweater, whatever you want, but everything works because you started with the right thing. That's what I like about Quince. It feels premium without feeling like you're trying too hard.

• 36:42Trevor Noah?

  It's effortless. So, find your next fall favorites at Quince. Download the Quince app for app exclusive offers or go to quince.com. Get free shipping on your order and 365 day returns. Now available in Canada and the UK too. Hello over there. Oh, and if Quince asks you where you heard about them? Let them know it was What Now with Trevor Noah. It's the best way to support the show.

• 37:18Trevor Noah?

  We had a, we had an episode of the podcast with Rucka Bregman. Right. And some people might not know his name, but he was the guy who rose to a little bit of infamy by, um, he went to Davos. And at Davos, he, he basically said to everyone in the room, he's like, hey, hey, why is everyone here trying to solve the problems of the world? As if you are not causing the problems of the world. And he said to everyone in that room, just pay your taxes. Everyone here is avoiding, you flew in on private jets and you're like, what should we do? He's like, pay your taxes. And then they were like, who invited this guy? Don't invite him back again. But one of the things he talks about, and that's what he's working on now, is he said, we've created a society, a society where the smartest, brightest minds

• 37:59Trevor Noah?

  go into fields where they're just trying to extract from society. There was, there was a time when the most brilliant scientist tried to work on the science that would change the world in the most positive way. Invent a light bulb, create an airplane, find a new type of health solution. You know what I mean? And then now that person goes like, go to a company that can make as much money as possible, as quickly as possible. Mathematicians were trying to solve going to space or, you know, trying to figure out the circumference of the globe, whatever. And then they were just like, go to this company, make as much money as possible, get the trading. But, but what you said, I think is key, it's the reverence.

• 38:36Trevor Noah?

  You turn on the news and they go, Larry Ellison, now the richest man in, but why, like, if society, like, and, and I mean that on like a, a media level. Not, not the people on the ground, because I think the people are oftentimes sort of not victim to it, but you, you, you're experiencing it. If the news tells you that this is good and important, and the media tells you it's good and important, then you think it's good and important.

• 39:01Speaker 03

  And not by accident, half the media is owned by those very people. And if you look at the oligarchs that are, that are owning, you know, the big news outlets, they're legion and, and trying to tell Jeff Bezos that he really shouldn't be a monopsony and all, you know, goods sold in the United States. You will not last very long, right? There is a lot of self-editing. So I think that's, no, that's absolutely right. This reverence, a sense that they are gods. And it builds into this sense, too, that there is an Uber mensch society. And then there are underlings. And those underlings, if they're, you know, homeless, well, they're not human, really. It's not my problem. I mean, that's a sense that I get. It's horrible to say, but there are people who, the haves and the have nots have always existed

• 39:45Speaker 03

  since ancient Greece, since Rome, since whenever. But this is a sort of an institutionalized

• 39:53Speaker 03

  form of of superior being, judged by your, you know, net worth. And then everybody else is really expendable.

• 40:00Trevor Noah?

  To talk about expendable, you you you can look at one of the examples you give in the book. And you go through multiple, um, multiple hospitals and healthcare systems.

• 40:13Trevor Noah?

  I I was reading about the dialysis and and and how each system doles it out. And to what you're saying, in some of these stories, it it it sounded less like healthcare and more like a fast food drive through chain. It felt like they're trying to get people on and off a machine as quickly as possible, use as few nurses as possible, make as much time work as possible, look after the patient for the least possible. And I went, I mean, I guess this is great if you're trying to get fries out quickly. But these are human beings, you know what I mean? It it it feels like the business model isn't, it's not about healthcare, it's about health profits.

• 40:55Speaker 03

  Hundred percent. It's fast food medicine and it's a model that wasn't invented by dialysis. It was invented in the sixties by um, by people who actually um, ran Kentucky Fried Chicken franchises and and Wendy's.

• 41:08Trevor Noah?

  Literally.

• 41:09Speaker 03

  Literally, who then started buying up, um, you know, started privatizing hospital systems and putting together. So they literally were the people with this branding experience and this mass fat, you know, and in theory, I mean, you know, Atul Gawande wrote the the Cheesecake Factory article in the New Yorker, which got a lot of attention. I don't I don't like it, but he's a smart guy, he's a doctor and he. The idea of focusing in on a specific medical procedure, making it as efficient as possible and delivering it and as low cost away as possible, that's a potentially a useful idea. The important thing here is that it not become turning patients into widgets on an

• 41:53Speaker 03

  assembly line, which is precisely what the fast food model or the Cheesecake Factory does. You're not tailoring your care to the individual needs of your patient. You are looking, and once again, this is a finance version view. The person who brought this into dialysis or popularized it, Kent Theory, he was a former CEO and the founder of DeVita, one of the two big companies. He made his bones at Bain Capital. That's a private equity firm. He was a finance guy, the kind of guys that I worked with. And he basically, and he said, speaking to a business school audience, he said, you know, if I were running Taco Bell with, I forget the exact numbers, 23,000 outlets and I would be doing all the same things as I'm doing. No.

• 42:36Speaker 03

  It's not about the patients, is what he said. And some doctors hate it when I say this. This is a quote, right, from his speech. This is an actual quote. Actual quote. Yeah, I can show you the video. It's quite striking. But again, it fits in a business situation in which you are Wall Street facing and you're talking about return on assets. If you have 2,000 dialysis clinics around the country and your main focus is shareholder value. And I'm getting paid in stock as a CEO, so my shareholder value is pretty important to me too, right? It's a conflict of interest on a massive scale. Anyway, if that's your aim, you want to run as many patients through every single one of those facilities as you can, because your asset base, your buildings, your machines and so on, the more units you shoot through them.

• 43:21Speaker 03

  And it is just like Taco Bell, except people are not burritos, right? Every single person who goes into that facility needs, should have a treatment that is tailored to their individual problems, their individual biology, their individual size and everything.

• 43:38Speaker 03

  And if you're running it as a fast food, you know, assembly in my model, you're not gonna do that.

• 43:43Trevor Noah?

  One size fits all.

• 43:45Speaker 03

  One size fits all, and you're gonna penalize the people who slow things down. They say, oh, actually, you know, Tom here, he should be getting five hours. No way, no way. And they're violently pushed back. And the doctors, some of the doctors I've talked with who work in these facilities are not best pleased. And some of them, some of the workers are also suffering from serious moral harm because they realize this is like soldiers forced to commit, you know.

• 44:09Trevor Noah?

  Yeah, yeah, yeah. That's the perfect analogy.

• 44:11Speaker 03

  It is, yeah. They're literally, they know what's wrong and they are not able to fulfill their Hippocratic oath to their patients and take care of their patients because the structure they're working in doesn't permit it.

• 44:23Trevor Noah?

  Yeah, I think that's the perfect analogy because we take for granted how much an overlord and a system can then oppress even the people within it. And then what happens is in a society, we start fighting amongst ourselves.

• 44:36Speaker 03

  Yes.

• 44:36Trevor Noah?

  Yeah. As if there's not one central thing that we should be looking at. So you have leaders and governments who send soldiers to do things that are despicable. Those soldiers return home to their countries. They get spat on in the streets.

• 44:47Speaker 03

  Right.

• 44:47Trevor Noah?

  Yes. The defense company doesn't get spat on.

• 44:49Speaker 03

  Yeah.

• 44:49Trevor Noah?

  The people who lied about weapons of mass destruction, they don't get spat on.

• 44:53Speaker 03

  No, no.

• 44:53Trevor Noah?

  Do you know what I mean? And the same thing happens here. People go, my doctor is trash, my this is.

• 44:57Speaker 03

  Yeah.

• 44:58Trevor Noah?

  But it's when you delve into it that you go like, oh, man, my doctor's victimized by the same system.

• 45:03Speaker 03

  The doctor is called a provider now or even a vendor. I mean, you know.

• 45:06Trevor Noah?

  Yeah, yeah.

• 45:07Speaker 03

  He or she is a cog in a wheel. And, and again, certain things, maybe, maybe burritos should be made that way. I'm game for that. But healthcare, there are other things. I mean, you know, are we good with private prison systems? Are we good with private warfighting? Are we good with? You know, there are certain things that should not be primarily profit facing.

• 45:29Trevor Noah?

  Yeah.

• 45:30Speaker 03

  And healthcare is one of them. But there are a lot of others and we just, in America, we've lost that discourse.

• 45:35Trevor Noah?

  When you look at other countries, what did you find? Because I, I think. There's a perspective that you bring in this book and in your work that I think is really important. Because oftentimes people will go, well, I mean, show me a better way to do it. And you're like, oh, yeah, I can. And you actually go to other countries.

• 45:50Speaker 03

  Yeah.

• 45:50Trevor Noah?

  And you show a better, but, but talk us through some of that because like Australia, Japan, like a wealth of other wealthy countries. Show that this is not the normal way that it needs to be.

• 46:01Speaker 03

  No, precisely. I mean, we've gotten so caught up in American exceptionalism that we lose sight of the fact that there are a lot of places where, where things in general and healthcare in particular are done a lot better. And the example, and the most brutal example is how long do patients on dialysis survive in the US versus other countries?

• 46:20Trevor Noah?

  What are the stats?

• 46:21Speaker 03

  They die two to three times faster than any other developed world and many lesser developed countries as well. I mean, you know, we're talking twenty percent to twenty-two percent per year death rate, whereas mortality in, in Europe is anywhere twelve to fifteen percent. And more on the twelve side, Japan's six percent. I mean, we're talking the most, and that's, and that's just how soon do you die? Quality of life is another big issue. But I mean, the, the, the central premise that everything has to be for profit is, is preposterous because every other country in the world does it better, does it cheaper? I mean, the basic promise of the Reaganomics era and ever since is

• 47:06Speaker 03

  we will do it better because government's the problem and we will do it cheaper because we are so efficient. Now, in, in America, we do it worse and we do it vastly more expensively at the same time. So something's rotten in the state of Denmark, not Denmark. You know what I mean?

• 47:22Trevor Noah?

  Yeah, I know exactly what you're talking about.

• 47:23Speaker 03

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

• 47:55Speaker 03

  You know, absorption. You're talking about middleman and the cost to healthcare. This is a classic example. You have these two twin towers that are soaking up a lot of the billions and billions. We're talking roughly.

• 48:09Trevor Noah?

  I wouldn't do twin towers in the hands like that. It might be, it looks like the wrong thing.

• 48:13Speaker 03

  Yeah.

• 48:13Trevor Noah?

  Yeah, you went twin towers and you used hands and I was like, whoa, whoa, whoa, Tom, Tom, Tom. Wrong hands.

• 48:19Speaker 03

  Let's find.

• 48:20Trevor Noah?

  Different analogy, different analogy. Let's go with something.

• 48:22Speaker 03

  Too large.

• 48:23Trevor Noah?

  Yeah, too large. You know what?

• 48:24Speaker 03

  Sinkholes.

• 48:25Trevor Noah?

  Sinkholes, that's better. Two sinkholes.

• 48:28Speaker 03

  And all the money goes into the sinkholes.

• 48:30Trevor Noah?

  That's way better.

• 48:30Speaker 03

  Looks nothing like the nine eleven.

• 48:32Trevor Noah?

  Towers and then your hands did this. And yo, man, we from another country, Tom, don't be doing that to us. Yeah. Yeah.

• 48:39Speaker 03

  Look at the calendar, man, look at the calendar. What was yesterday? Yeah.

• 48:44Speaker 03

  No, no, you're absolutely right. These are the twin sinkholes of money absorption. And the money goes into the sinkhole and not so much comes out.

• 48:52Trevor Noah?

  Yeah.

• 48:52Speaker 03

  And this is, again, this is not unique to dialysis. It's particularly, in my view, obscene in dialysis. But it happens, you know, what is United Healthcare's model? It's to take as much money as they can and give as little as they can away.

• 49:05Trevor Noah?

  Yeah.

• 49:05Speaker 03

  That's it. And the rest goes into the sinkhole.

• 49:08Trevor Noah?

  I feel like it's the Rosetta Stone of healthcare. That's what you've shown us with the dialysis model is you've gone, let me show you this example. Show it to you so clearly that you can then understand every different language of what's going wrong in American healthcare and how to actually look at it. You know what I mean? And when you, when you look at these other countries, what would you say is the biggest thing? Like, just on one level that they're doing differently. I mean, I can understand the government is paying and it, you know, it's a different. But what would you say is like something that they're practically doing differently than in the US?

• 49:40Speaker 03

  Well, they're following universally accepted medical guidelines, which have to do with how long, how gently you treat, at what, what values you treat. Do you do it at home or not? I mean, if you look at Australia, the majority of, of, they push patients to home dialysis.

• 49:56Trevor Noah?

  Wow.

• 49:57Speaker 03

  And ever since the 1960s, ever since this miracle cure was invented, the people who are not trying to make money off of it said, home dialysis. Is the way to go. You get to control your destiny. You get a feeling of, I mean, any chronic disease, a sense of agency is critical to getting well or to feeling better, right? And being a passive recipient of care, lie down, put your arm out, I'm gonna take your blood. I've heard this, I've heard patients tell me this from, you know, in, in dialysis facilities. You need to have control of your destiny and doing that at home is the way to do it. Also, again, you can tailor your care to, and it's doable. So Australia pushes people home. But just a, that is another of the fundamental, widely, universally accepted laws of dialysis is being broken in the United States.

• 50:42Speaker 03

  It's being broken because it's, you know, there are companies that make a lot more money doing it elsewhere. But it's also being broken because CMS, well, the Health, Health and Human Services, doesn't enforce best practices on their, you know, I, I beat up in my book, I beat up a lot on corporations. I think they deserve it. But I didn't give sufficient time to the silent partner in the crime. And that is the CMS, that is the National Health Administration in America. That is simply in bed with or complicit with or toothless to do anything about major corporate wrongdoing.

• 51:21Trevor Noah?

  What is, what is CMS?

• 51:23Speaker 03

  It's the Center for Medicare and Medicaid Services.

• 51:26Trevor Noah?

  Okay, got it. Yeah, yeah.

• 51:27Speaker 03

  Administer Medicare and Medicaid funds. And they know what good dialysis is. They know what the metrics are. They're just not counting them. So they don't count treatment time.

• 51:37Trevor Noah?

  Yeah.

• 51:38Speaker 03

  They don't penalize people who don't treat longer and then, and they don't count UFR, ultra filtration rate, which is the speed with which you remove liquid from someone's blood and their body, which are critical to survival.

• 51:51Trevor Noah?

  Yeah.

• 51:52Speaker 03

  They don't count those things. Like, what are you counting exactly? They don't count septicaemia, which is, you know, one of the major causes of death. What, if you're not counting that shit, what are you counting? I mean, you know, it's putting the ladder up against the wrong wall.

• 52:05Trevor Noah?

  Yeah, but the question is, who's telling them what to count and how to count?

• 52:09Speaker 03

  I guarantee you, the answer is the revolving door. I mean, I, in my book, I, I, I cite several examples of people from the White House who have gone to the board of, of the big pharma companies.

• 52:22Trevor Noah?

  Yeah, man, same thing.

• 52:23Speaker 03

  Dialysis companies and vice versa.

• 52:25Trevor Noah?

  Yeah.

• 52:25Speaker 03

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

• 52:57Trevor Noah?

  You know why? That they've done a great job of tricking us, you know?

• 53:01Speaker 03

  Yeah.

• 53:01Trevor Noah?

  It's, it's one of the greatest scams that has ever been pulled on people collectively. What they did was governments were providing a good. It doesn't mean that they were perfect, but the good was being provided by the governments. In this case, it's the nineteen seventies when Medicare says they're going to cover dialysis.

• 53:18Speaker 03

  Yeah.

• 53:18Trevor Noah?

  This is revolutionary. You have this problem with your kidneys, they're going to come in, the machine will be there, the government is going to help you out.

• 53:25Speaker 03

  Yeah.

• 53:25Trevor Noah?

  And because you can amortize the cost across a population.

• 53:28Speaker 03

  It becomes cheaper.

• 53:29Trevor Noah?

  It will work, it will work.

• 53:30Speaker 03

  Yeah.

• 53:31Trevor Noah?

  And then very quickly, companies who see a gap go, wait, wait, wait. If the government's paying for it, we can get that money. And then they go, if we can get that money, how do we get more of that money? And then they become part of the cycle. It's so crazy how you see this in every country, whether it's the UK, whether it's South Africa, whether it's the United States, wherever you're having these issues.

• 53:51Speaker 03

  Hmm.

• 53:52Trevor Noah?

  The people who work in government work with the companies to make the government look inept.

• 53:58Speaker 03

  Yeah.

• 53:59Trevor Noah?

  The people on the ground then go, the government is terrible. We should give this to the private companies. The private companies then take the work.

• 54:06Speaker 03

  Yep.

• 54:06Trevor Noah?

  And then they provide a professional ineptness that not only doesn't do the job as well, but it extracts more wealth. So it's like before the government was going to be maybe not great.

• 54:18Speaker 03

  Yeah.

• 54:19Trevor Noah?

  But they weren't going to be as expensive. And now you're getting a shit thing for an expensive price.

• 54:24Speaker 03

  Yeah.

• 54:24Trevor Noah?

  But you then hate the government. You go, the government doesn't do anything. It's like, yeah. And the companies that made that happen are the reason you keep coming. It's it's such a it's such a pernicious cycle.

• 54:33Speaker 03

  Con job and exactly. And and the government does become people. People in America, oh, big government is really bad. I mean, you look at the the Pentagon, trillion dollar. And that is a bunch of sock puppets. I mean, they have Lockheed Martin up their butt with their hands going like this.

• 54:47Trevor Noah?

  Right.

• 54:47Speaker 03

  You know, I mean, and you see the revolving door between the generals who go on to Lockheed's board and I'm just speaking Lockheed, even Raytheon, you name it, they got it. The whole outsourcing government contracting thing is such a scam.

• 54:59Trevor Noah?

  It's a greater scam.

• 55:00Speaker 03

  Corporatizes. And at the same time is able, as you say, to to to push the blame onto onto government, big government, which never gets it right. And talk about socialism. I mean, you look at warfighting in America, a trillion dollars a year to the to the Pentagon.

• 55:14Trevor Noah?

  Trillion dollars.

• 55:15Speaker 03

  Trillion, yeah, that's socialism, right? Oh, no, no, it can't be because it's America. Sorry, my my bad.

• 55:20Trevor Noah?

  Yeah. And because it's war.

• 55:22Speaker 03

  No, it's war.

• 55:22Trevor Noah?

  Because it's war. It's like, it's amazing how war. Yeah, war is always the thing where people are like, the government shouldn't be smaller there. You're like, why why shouldn't the government be smaller there?

• 55:31Speaker 03

  We cut everything else, but 10% raise for the Pentagon.

• 55:34Trevor Noah?

  Smaller government. And he's like, except for war, oh, war, I mean, no, that's.

• 55:37Speaker 03

  And how successful have our wars been recently at producing security and national defense? Not so much, actually, you know, if you think about it.

• 55:46Trevor Noah?

  More importantly.

• 55:47Speaker 03

  But I don't want to think about it. Sorry.

• 55:48Trevor Noah?

  Yeah. More importantly, this is the question I often ask people as I go. You are so comfortable accepting the premise that America's job is to go out and fight wars. Why? To protect Americans.

• 56:02Speaker 03

  Far from Americans.

• 56:03Trevor Noah?

  That's what you say, right? We are willing to spend trillions of dollars to go out into the world to protect America. Why wouldn't you spend trillions inside the country to protect America? If Americans are dying from kidneys dialysis machines that are too expensive, healthcare that's not being provided, you know, food on a basic level.

• 56:25Trevor Noah?

  That's a war that you could be fighting in your country without bombing anybody.

• 56:28Speaker 03

  And that's exactly the reason in the nineteen seventies, a number of people, this is during the, you know, the Cold War, the coldest part of the Cold War and the fight against Russia and everything else. And yet, at the same time, bipartisan congressional figures, Republicans and Democrats are saying, we're spending billions, back when a billion was a big number, billions to build these rockets, and we can't even take care of our own citizens.

• 56:51Trevor Noah?

  Yeah.

• 56:52Speaker 03

  And they were pushing for a dialysis in that, in that way. And the other thing about war is, of course, and, and the trillion dollar Pentagon is that, you know, as, as one former general told me, when you get to be a big hammer, everything starts to look like a nail.

• 57:03Trevor Noah?

  Yeah.

• 57:04Speaker 03

  I mean, you gotta go out there and I built all this cool stuff.

• 57:07Trevor Noah?

  You've got to find a reason to use it.

• 57:08Speaker 03

  Highly trained in doing this stuff, gotta find a way to use it.

• 57:11Speaker 05

  And we have to get rid of it, because we have to make more.

• 57:13Trevor Noah?

  Ah, you're not wrong.

• 57:14Speaker 03

  That's right.

• 57:15Trevor Noah?

  You're not wrong.

• 57:16Speaker 03

  That's right, there's this new stuff coming on.

• 57:18Speaker 05

  And some of it gets lost in these smaller third world countries.

• 57:22Trevor Noah?

  Oh, don't even get me started on that.

• 57:24Speaker 05

  It, it, it's almost like what you guys are explaining to me, it's almost like a shepherd that is not tending to the flock, but is out there hunting for wolves.

• 57:33Speaker 03

  That's a perfect analogy, actually.

• 57:34Speaker 05

  Yeah.

• 57:35Speaker 03

  That's the perfect analogy.

• 57:36Speaker 05

  Yeah.

• 57:37Speaker 03

  The wolves are taking over in the, in the shepherd's room, like wolves are cooking dinner.

• 57:43Speaker 05

  Having lamb chops.

• 57:45Speaker 03

  Shepherd, you know, you can sit this one out, we'll take care of it.

• 57:48Trevor Noah?

  You wanna, you wanna do something about that wolf? Whoa, whoa, whoa, wolves have their rights too, you know? These poor, you, do you know how the wolf feels about the sheep? You're the shepherd, though. Ah, yeah, yeah, yeah, but I mean, you know, come on. You know, that's, that's, you know, when you, when you, when you think of it, like,

• 58:06Speaker 03

  yikes.

• 58:07Trevor Noah?

  Man, it's scary because you see this moving into everything.

• 58:10Speaker 05

  Yeah.

• 58:11Trevor Noah?

  People wonder why things are getting shittier and shittier in everything.

• 58:16Speaker 05

  Yeah.

• 58:17Trevor Noah?

  And when I looked at this dialysis story, I couldn't help but think of the analogy of, it's almost like what, what these healthcare companies did. Would be the equivalent of car companies realizing the value of a seat belt.

• 58:32Speaker 05

  Yeah.

• 58:32Trevor Noah?

  And then going, we're gonna charge you every time you need to put it on.

• 58:36Speaker 05

  Yeah.

• 58:36Trevor Noah?

  And now you have to gamble with your life and go, do I?

• 58:41Trevor Noah?

  Can I afford it? Can I not afford it? But you shouldn't, this shouldn't be a choice. We know that you need the seat belt, put it on. And I was like, ah, but, but can I? And they're like, oh, do you wanna, do you wanna play with your life? And they know, because to your point, it's, it's a duopoly. It's what, two companies? Is it still two companies?

• 58:54Speaker 03

  The two major companies own and control eighty percent of the market.

• 58:57Trevor Noah?

  Yeah, but I mean, that's a duopoly. That's like, you, you control everything. No one can push you around. And then, what, and because it's your life, that's the craziest thing.

• 59:05Speaker 05

  I think corporations realize one thing. The minute a society, we said, there are no holy cows or sacred cows, they thought to themselves, we will leave no sacred spaces.

• 59:14Speaker 03

  Yeah.

• 59:14Speaker 05

  They've moved into organized sport.

• 59:16Trevor Noah?

  Yep, you're not wrong.

• 59:17Speaker 05

  Yeah, you're buying the, the soccer jersey.

• 59:20Trevor Noah?

  Yeah.

• 59:20Speaker 05

  Coming to the matches.

• 59:21Trevor Noah?

  Yeah.

• 59:21Speaker 05

  They're paying your hero, they're controlling their life.

• 59:24Speaker 03

  Yeah.

• 59:24Speaker 05

  Religion, they've made the miserable.

• 59:26Trevor Noah?

  Yeah.

• 59:26Speaker 05

  So they've made us all complicit. And I, I worry a lot. Whenever I watch big organized sports, I'm like, the fact that people who love that sport assume that ninety percent of it is natural talent always amazes me. It's like when people have that debate, thinking before steroids were illegal in sport, how great was sport? And I'm like, no, no, before corporations were involved in sports, how fair was sport?

• 59:51Speaker 03

  Right, exactly. And the money aspect, again, you see sports betting now, and to me, that is another thing where it's like the stock market versus the real economy.

• 59:59Speaker 05

  Who are we?

• 1:00:00Speaker 03

  When you're putting a bet on something, you debase it inherently. And your focus, again, turns from the activity on the field to

• 1:00:07Speaker 05

  Outcome.

• 1:00:07Speaker 03

  Outcome. And you can have derivatives that are bets on bets, and that, and this is all. Yeah, stock market stuff. This is the way in which you think, if you're not really engaging with the real world, and not only is it not helpful to what's going on in the field, or what you're eating, or what your healthcare, it's diametrically opposed. If you focus all your energies on making it into a money-making operation and betting on it, you're actually taking the energy away and the resources and the, and the intelligent people and all the things who should be saying, how do we make a better dialysis machine?

• 1:00:37Trevor Noah?

  There hasn't been a better dialysis freaking machine in forty years.

• 1:00:41Speaker 05

  No way, Tom.

• 1:00:42Trevor Noah?

  Oh, no. Absolutely. There have been tiny little adjustments, but there's been no phase shift, major breakthrough. Why is that? Because there's no freaking money in it. These two corporations, big corporations, before them, there were others, have locked in the market, they have their cash cow, and they're milking it relentlessly. They're not interested in a new milking machine.

• 1:01:02Speaker 05

  Yeah.

• 1:01:02Trevor Noah?

  They're not interested in the cow.

• 1:01:03Speaker 05

  Yeah. You know what I've realized as well with, I don't know how it is in this country, but in South Africa, when you get life cover now,

• 1:01:09Trevor Noah?

  Yeah.

• 1:01:10Speaker 05

  you're not obligated to take an HIV test. Well, before, you were obligated to take an HIV test if they're going to insure you for a certain amount of money. So you'd have to test or they have to know

• 1:01:18Trevor Noah?

  Yeah.

• 1:01:19Speaker 05

  what your lifespan is, what your CD4 cell count is. But right now, they're like, no, just bring it and then we'll see when we get there. So I'm like, was HIV always that dangerous to the body and your longevity? Or they found a way to not profit from you having HIV anymore? Do you know what I'm saying?

• 1:01:35Trevor Noah?

  I wonder which one it'll be, though.

• 1:01:36Speaker 05

  Because remember that before, there was no home testing.

• 1:01:39Trevor Noah?

  Yeah, yeah, yeah.

• 1:01:39Speaker 05

  So they would have to send you to a facility.

• 1:01:41Trevor Noah?

  Yeah.

• 1:01:42Speaker 05

  Then you'd get tested.

• 1:01:43Trevor Noah?

  I wonder which one it is, because my brain goes, which one is it? Have they found a way to de-risk it? Or have they found a loophole on the other side? I'm saying I don't know which one it is. It's just interesting when I hear that. I go like, huh, I wonder what changed. Do you know what I'm saying?

• 1:01:55Speaker 05

  Yeah, yeah.

• 1:01:56Trevor Noah?

  Like, what switches in a system that changes something? How do we look at it differently? I even think of, man, that, can I tell you, there are parts of your book where I was just like, I have to just meet this person. Because, no, there's books and there's thinkers that you encounter in life where you go, who is this person and how are they so magical in the way they approach things?

• 1:02:16Speaker 05

  Or crazy.

• 1:02:17Trevor Noah?

  No, but crazy in a good way.

• 1:02:19Speaker 05

  Or takes naps.

• 1:02:20Trevor Noah?

  Yeah.

• 1:02:21Speaker 05

  At noon.

• 1:02:23Trevor Noah?

  He's a noon napper.

• 1:02:25Speaker 05

  He's a noon napper.

• 1:02:28Trevor Noah?

  But like, there's, there's a part of the book where, man, I was, I was so impressed and like, just like taken by how you stitched together even civil rights in, in American healthcare. And the way we think about how it's doled out to not dole out because you see, again, I, I didn't know, and I would have never known how you can trace dialysis and Medicare and who gets treatment and who doesn't get treatment back to segregation and desegregation in the United States. No, literally, I mean, talk a little bit about that because it's, it's, that blew my mind. I was just like, oh, man, we, we, we really have to think holistically. And sometimes I don't think our brains are big enough.

• 1:03:03Speaker 03

  No, I, yeah, it, one of the most shocking things in my research for this book was the way in which dialysis impact, um, impacts disproportionately black and brown communities.

• 1:03:17Speaker 03

  If you're black in America, you're 13% of the population, but you're 35% of the end-stage renal disease or kidney failure population. You're four times more likely to get dialysis than if you're white. And, and it's this death by zip code redlining, you know, that, that I've gradually begun to see. I mean, dialysis is a perfect map for it, but there are many other diseases that, you know, the incidence of, of hypertension, diabetes, um, and, and obesity, the way in which these communities, historically, the wrong side of the tracks, and I mean, I literally, I'm working in, um, I'm working in South Chicago, um, where there's a disparity in life, uh, in, in longevity

• 1:04:00Speaker 03

  in between North and South Chicago of 30.1 years.

• 1:04:05Trevor Noah?

  In the same.

• 1:04:05Speaker 03

  Thirty years in the same city, 30 years, if you're in North Chicago, the wealthy areas, you live 30 years longer, 30.1 years longer than in South.

• 1:04:13Trevor Noah?

  That's insane.

• 1:04:14Speaker 03

  It is insane. It is utterly, utterly unacceptable and it's been going on. I mean, as one, um, Magellan Hanford, one of my great, um, dialysis nurses, who was formerly an LAPD officer, as he said, it's got Jim Crow written all over.

• 1:04:31Trevor Noah?

  Yeah.

• 1:04:32Speaker 03

  This is absolutely, if you look at the maps of the impact of, of dialysis on communities, and that's kind of what I'm doing now, this book, I couldn't walk away from the book. I was usually with, with, with books, um, you know, I, I write it, I care about it. But six months before it comes out, I'm thinking, what's next? I don't have any next, this is next. So I've gotten together with folks at the New School, the Institute for Race, Power, and Political Economy, and we're doing some research on these areas in Chicago, South Chicago, and East LA, Boyle Heights, where the impact of dialysis is disproportionate.

• 1:05:15Speaker 03

  Try to understand, not just on individuals, what bad dialysis does, but what does it do to a community? How do they start to see dialysis as sort of a part of their life's arc? You'll end up in the chair. Grand did, my uncle did, my kids are coming with me now to my treatments, they'll probably end up, I mean, it's just nightmarish. And especially when there are solutions that are in hand, that are, and, you know, again, every other country does it better, but there are very straightforward solutions to prevent this from happening in the first place. So, but come back to your question, I mean, it is absolutely, dialysis in America is absolutely perfect. Radiograph, CT scan of what's wrong with racialized structural racism in America.

• 1:06:00Speaker 03

  It is, it is the poster child of what can go wrong. And it is, for me, it's been quite a, I mean, a kind of a rediscovery of what America is. I'm going to places I haven't spent a lot of time in.

• 1:06:10Speaker 05

  I can imagine.

• 1:06:11Speaker 03

  And, and I understand what the wrong side of the tracks means now. I mean, in Chicago, you literally walk underneath the tracks and you're in a different world. Everyone's a different color.

• 1:06:23Speaker 05

  Yeah.

• 1:06:24Speaker 03

  I mean, literally, in the space of, it's the most segregated city in the, in the country, but many, many, many areas are like that. And it's, yeah, I'm rediscovering my homeland in a way that is deeply, deeply disturbing.

• 1:06:36Speaker 05

  We had an episode where we spoke to

• 1:06:40Speaker 05

  One of, one of the most interesting people we've spoken to in South Africa, Dan, and we spoke about the remnants of apartheid.

• 1:06:46Speaker 03

  Yeah.

• 1:06:47Speaker 05

  And what, what, what people who say it's been thirty years, it's time to move on now. And I said, what the genius of that system was, was to ensure that the longevity or the quality of life of a black person for generations will not be the same as the life quality of a white person.

• 1:07:03Speaker 03

  Yeah.

• 1:07:03Speaker 05

  And I said, here's a typical example. Malnutrition within the black community is such a, you might have groceries in your cupboard, but are they keeping you healthy?

• 1:07:13Speaker 03

  Yeah.

• 1:07:13Speaker 05

  That is the question. And what I did one day with a friend of mine is we drove to two schools. We drove to a very private school, wealthy, black and white children. Then we went to a township school with only black children and we took a photo. Right? That we just said, you take this photo, take this photo. And we compared the photos at the end of the day and we saw the sizes of the kids.

• 1:07:35Speaker 03

  Yeah. That's heartbreaking.

• 1:07:37Speaker 05

  And they were not even forty minutes apart from each other.

• 1:07:40Speaker 03

  Right.

• 1:07:40Speaker 05

  What they ate, what they did, you even see it when they do, they've even stopped doing it now in South Africa. Where they do inter schools.

• 1:07:46Speaker 03

  Oh.

• 1:07:47Speaker 05

  They never mix now schools that are doing well with schools that are not doing so well.

• 1:07:51Speaker 03

  Damn.

• 1:07:52Speaker 05

  And doing sport because it becomes so glaringly obvious that there's size differences, that there's nutrition differences, and also there's concentration differences. I mean, the queues that will come up, I was, when I was growing up, they took us into this rugby clinic at one of the biggest stadiums. It was um a program by the rugby club. The one thing that happened when all the township buses landed at the stadium or arrived at the stadium is all the township kids went to go queue for food.

• 1:08:20Speaker 03

  That's the first thing they did.

• 1:08:21Speaker 05

  First thing we, we did, not they. I was part of the, the kids that were in the bus from the township school. This was one of the first things that we did. It was, we left where we were and the first thing we were like, we're gonna eat something because clearly it's not gonna be where we come from. And I'm thinking to myself.

• 1:08:36Speaker 03

  Hunger and malnutrition as a government, as a, as a government agenda or as a weapon, yeah.

• 1:08:41Speaker 05

  Of oppression and no, no one ever talks about that. And I always think whenever big companies expand and whenever corruption is going to take place, you can always. See by how much hope they give to people about how many of them they'll employ.

• 1:08:54Trevor Noah?

  Yeah.

• 1:08:55Speaker 03

  Yeah, that's right.

• 1:08:55Trevor Noah?

  They love that.

• 1:08:56Speaker 03

  Yeah.

• 1:08:56Trevor Noah?

  Bringing, bringing this many jobs, bringing, oh, they love that.

• 1:08:59Speaker 03

  The mining companies.

• 1:09:00Trevor Noah?

  Yeah, yeah, they love that.

• 1:09:01Speaker 03

  Yeah, they're great.

• 1:09:02Trevor Noah?

  Oh, no, they love that.

• 1:09:03Speaker 05

  Yes, yes, in South Africa now, they're trying to clamp down on illegal mining, but they've discovered that the billions of rands in illegal gold lands in the mainstream.

• 1:09:13Trevor Noah?

  Yeah, because, because the gold needs to be sold into a market that is formalized. So at the end of the day, it, it, it all comes back.

• 1:09:19Speaker 03

  To the enabler.

• 1:09:19Trevor Noah?

  Yeah, it all, it all, it all comes back in a loop. And that's, that's why, and I'm glad you really give them the credit they deserve.

• 1:09:27Speaker 05

  Yeah.

• 1:09:27Trevor Noah?

  That's why whistleblowers are so important.

• 1:09:29Speaker 05

  Yeah.

• 1:09:29Trevor Noah?

  Like you, I mean, I know you've got a whole book on it, but without these people, you just don't know.

• 1:09:36Speaker 03

  No, exactly.

• 1:09:37Trevor Noah?

  You lit, you literally just don't know. Without a whistleblower in FIFA, without a whistleblower in the banking system, without a whistleblower in the healthcare industry, without a whistleblower in the defense contractors, without a whistleblower, you just wouldn't know.

• 1:09:50Speaker 03

  And it's fascinating to see the, um, the organizational reaction to a whistleblower.

• 1:09:54Trevor Noah?

  Hell, yeah.

• 1:09:55Speaker 03

  Like this immune response, the T cells go out there. I mean, the people lose their minds. They're so angry and so frightened. Because at the end of the day, what you said is exactly right, that those whistleblowers really do have the kryptonite.

• 1:10:08Trevor Noah?

  Yeah.

• 1:10:08Speaker 03

  The question is whether they'll be able to give the kryptonite to someone who can use it before they are rubbed out, literally or figuratively.

• 1:10:14Trevor Noah?

  Yeah, yeah.

• 1:10:15Speaker 03

  And, uh, but it is a really interesting thing to see this sort of organizational, people just, it's perfectly sane, professional people go completely off the rocker. Um, when a whistleblower stands up in their, in their, in their.

• 1:10:28Speaker 05

  But there's some, you, you are making me realize there's so much power in words and phrasing. You started with a, with white collar crime and now you even speaking about whistleblowers. When it's corporate, it's whistleblowing.

• 1:10:38Trevor Noah?

  Yeah.

• 1:10:39Speaker 05

  When it's violent crimes, it's a.

• 1:10:41Trevor Noah?

  Witness.

• 1:10:42Speaker 05

  It's, no, no, besides, it's not a witness, it's a, it's an informant.

• 1:10:45Trevor Noah?

  Oh, yeah, yeah, yeah.

• 1:10:46Speaker 05

  Information.

• 1:10:47Trevor Noah?

  That's interesting.

• 1:10:48Speaker 05

  That could ultimately lead to something.

• 1:10:49Trevor Noah?

  Yeah.

• 1:10:50Speaker 05

  But when I'm telling the truth about how many people are losing lives and how much money, what are you doing? Why are you blowing that? Who still blows a whistle? Like, information is timeless. But whistleblowing also makes, makes it feel like you shouldn't be doing it in the first.

• 1:11:01Trevor Noah?

  That's right. It has an annoying connotation to it.

• 1:11:03Speaker 05

  Yes, where do you find a whistle?

• 1:11:05Trevor Noah?

  Yeah, that's right.

• 1:11:06Speaker 03

  Whistleblower, you're a snitch.

• 1:11:07Speaker 05

  Yes, it's got a snitchy vibe.

• 1:11:09Trevor Noah?

  Yeah.

• 1:11:09Speaker 05

  Whistleblower. And why are you blowing it? Why is everyone keeping their whistles quiet? And, and there's always, in whistleblowing, there's never plurality.

• 1:11:17Speaker 03

  No, no, no, that's right. The individual.

• 1:11:20Speaker 05

  Assange will stand on his own. Yes, it's always this shunned person who will generate as much noise as possible.

• 1:11:26Trevor Noah?

  Edward Snowden.

• 1:11:27Speaker 05

  Snowden, yes, but if you get rid of them, you almost feel like you've gotten rid of the problem, right?

• 1:11:31Speaker 03

  Exactly. And that's exactly it. If you can't deal with a message, kill a messenger. I mean, that is literally the way in which you. The reason why this is scorched earth approach to whistleblowing is literally they can't deal with a message. Quite often, you know, a corporate informer will say that there's a trillion dollars in fraud here. They've been dumping arsenic into the water or the Bhopal or whatever. And so you can't actually say, well, actually not so much or not too many people were died. They you go after the messenger, you totally destroy their credibility. You destroy them financially, you destroy their how their home life, you destabilize them psychologically. And all of a sudden, there's kind of a quirk or a disgruntled person that you can dismiss them. So that's the way you can't, when you can't actually face the facts and say, actually, no.

• 1:12:14Speaker 03

  He's wrong on this and this and this point, and we can prove it. Cause you can't, because the person is right, the whistleblower is right. You just destroy their credibility and it goes away. It's a disgruntled employee, you know, someone who's deeply or just psychologically not stable.

• 1:12:29Trevor Noah?

  Yeah, but what they don't realize is they can only kill the messengers for so long. And then at some point, as we saw with Luigi Mangione, society turns around and goes, all right. I guess I'm also going to make my own rules. I'm not saying Luigi did or didn't do it disclaimer. I'm just saying like we saw in that trial in that case.

• 1:12:47Speaker 03

  Yeah.

• 1:12:48Trevor Noah?

  Someone said, you know what? I I don't agree with this and I realize that I cannot beat you in the game because you have created the rules.

• 1:12:57Speaker 03

  Precisely.

• 1:12:57Trevor Noah?

  So I will then play my game by a different sets of rules.

• 1:13:01Speaker 03

  Precisely.

• 1:13:02Trevor Noah?

  And you know, one of the reasons I think it's so important. We we have these conversations where I try and talk to as many great authors as possible. Particularly people who have done like all the real research. I always say this to Eugene. One of the things that that I hate the most is how people will say something they'll go like, I'm going to do my own research. And I'm like, no, you're not. You're not going to do your own research. You are going to go read an article that either affirms what you think. Yeah, you're gonna go read someone's, you're not gonna go do the research. And yes, you can argue on a like a semantic level. Yeah, on a semantic level, you can be like, but that is research. No, no, no, no, no. Commutative effort. Yeah, I like to read the the work of people who have done the work. Do you get what I'm saying?

• 1:13:42Trevor Noah?

  And that is how we should acquire knowledge in life. I don't think every one of us should go and test the principles of Newton to actually apply them in our lives. Yeah. We can apply. Exactly. Commutative process, exactly. You know what I mean? But but you know, but when I, when I, when I look at that situation, where the United Healthcare CEO is shot. And then even that that story, that was like a weird one. You know, the the gunman in Manhattan went into that tower. Oh, yeah, yeah, yeah. And then shot, and then they said like, they said they they were there to shoot the NFL person. But then they shot a a person who was in, um, I think they were a CEO or they they headed up a division that was specifically tasked with. Housing. Oh.

• 1:14:23Trevor Noah?

  But I know the thing, and everyone was like, oh, wait, wait, wait. This is weird. You're saying they went there to shoot someone in the NFL. Yes. But they shot somebody who a lot of people don't like. Yes. Did they shoot anyone else? Not really.

• 1:14:35Trevor Noah?

  And you're sure they were going for that? Coincidence. Yeah, and you're like, wait, and and what I found most interesting is just after the Luigi Mangione story. What I found most interesting, and I'm not naive about this, is how the news and how these healthcare CEOs and all CEOs and came out on TV and they're like. I, why would people be celebrating this? Why, why? Then I was like, wait, wait. I'm not condoning any of this. Yeah. But you're shocked. You you really don't know why people are cheering for this? You're really gonna act like you don't know why people are cheering for this?

• 1:15:10Trevor Noah?

  But the reason I think we need to keep having these conversations, I'll talk to an author who's written a book ten years ago, twenty years ago, like Robert Putnam we had, I was like. Because. The thing about the book is it expands, it dives deep, it gives you concrete understandings of what the situation is. It's not glamorous, it's not glossy, it's not quick, it's not snappy, it doesn't catch you really quickly. But when you're done reading it, you really, really, really understand. And I wonder if it's a little frustrating for you, you go into this process, you write this whole book, you do this whole thing. You see a moment like Luigi Mangione. Everyone was in on, like, everyone's like, healthcare, let me tell you what's wrong with them, and let me tell.

• 1:15:51Trevor Noah?

  And then Sheen was selling T-shirts of Luigi Mangione's face, and then there's like a movie, Emma Stone's gonna be doing a movie about Luigi Mangione. And then it just trickles out, and then you just see new headlines, healthcare, United Healthcare buying this, United Healthcare announcing that, cutting these jobs, expanding on this, merging with that, and you go, huh. It's like, people enjoy the flash of the moment, but not what the moment actually meant. Like, how do you keep yourself going despite, I'm assuming you might be, but maybe I'm wrong.

• 1:16:23Speaker 03

  No, no, it's deeply frustrating, and to see something with a lot of PR potential, an opportunity, a crisis gone wasted, because you haven't changed the structure. You haven't basically asked the fundamental question. Number one, are you really serious that you don't understand the outrage and the anger and the sense of powerlessness? And number two, are we really going to make sure that something called United Healthcare is primarily focused on health and not primarily focused on their, you know, share price? We haven't done anything about that. We haven't gone upstream and said, is capitalism indeed the best way to organize our society, or better, is profit motive the only way we should be focusing on

• 1:17:07Speaker 03

  our healthcare industry? Is it really an industry? You know, these are bigger questions that never get raised. And I had my own sort of Luigi Mangione moment. I was corresponding with, since my book came out, I had countless contacts from people in the industry. And one of them was a young nephrologist, Dr. Andrea Buah. Who was very, is and was very, very frustrated about the misuse of dialysis by certain nephrologists that he named. And he sent me a lot of data. He showed me, he has a website, as a matter of fact, kidneykiller.com, which alleges

• 1:17:51Speaker 03

  the use of certain drugs to knock out people's kidneys so they will be on dialysis sooner, all sorts of stuff like that. And he wrote, we corresponded for three months until January of this year, and then three days after his last email, which were data-filled, really thoughtful. He gets in a car, he drives from Miami to Terre Haute, Indiana, and he attempts to, allegedly, attempts to murder one of the nephrologists. Wow. That he had mentioned in his emails, and was mentioned in other lawsuits. Now, of course, when I heard this, I was horrified, and I went through those emails a million times, saying, what, could I have seen this coming? Could I have missed?

• 1:18:35Speaker 03

  They were the absolute picture of data-driven, thoughtful, measured. Right, yeah. But at the very end of one of the last ones, he said, "I just can't see a way to make this stop. I can't find a way to make change." And, you know, it's a horrifying thing to be in the middle of it, but I think that sense, as you said, Trevor, a pointlessness, a sense of hopelessness and of powerlessness to stop, and just the obscenity of a situation, the Luigi Manzoni situation, where you have one person who apparently, allegedly murdered another. Luigi murdered Brian Thompson.

• 1:19:13Speaker 03

  But you have Brian Thompson, who has been making a very successful career on, in part, denying care to people who claim, whose doctors claim they need it. Now, I don't know about you, but until we can talk about that second group of people making an enormous, making a killing, as they say, on denying care as a form of taking people's lives, if we can't say it out loud. Yeah. We're not going to get anywhere. Yeah. We're not going to ever get anywhere. And if we can't say it out loud that making money doing that makes it worse. We're really not gonna get anywhere. And money may not be the root of all evil, love of money,

• 1:19:57Speaker 03

  but it's a pretty good proxy until you find it. And we really need to get off the money drug somehow. Find a way to reorganize our view of how life should be led so that money isn't the number one thing. And those folks can't come on and say, oh, I'm shocked, shocked. I can never condone violent acts against. But yes, well, you have two people. And how many, again, how many people has the major healthcare CEO accounted for in his long career?

• 1:20:26Trevor Noah?

  Yeah, but it's that old line, right? If you owe the bank a thousand dollars, it's your problem. If you owe the bank a billion dollars, it's the bank's problem. If you do something on a big enough scale.

• 1:20:38Speaker 03

  I was thinking Voltaire, the, you know, Murder to the Sound of Trumpets by the Thousands is called, is good. One murder is unacceptable.

• 1:20:46Trevor Noah?

  Yeah, there's a weird thing that happens in society where if you get the scale great enough, it's somehow not seen as the same issue multiplied when, when in fact it is.

• 1:20:56Speaker 03

  What is it, Stalin's, one murder is a tragedy, a million is a statistic?

• 1:21:00Trevor Noah?

  Yes, exactly. But that's, that's exactly what it is. And, and, and to your point, accountability is also doled out differently. Right? Because if Luigi Mangione.

• 1:21:09Speaker 03

  Yeah, there it is.

• 1:21:10Trevor Noah?

  If Luigi Mangione is found guilty, he's gone, gone for gone for gone. Like life, death, what, like gone, gone, right? Not if, when healthcare CEOs and their companies are found guilty. There's no life sentence.

• 1:21:24Speaker 03

  Right, you check.

• 1:21:24Trevor Noah?

  There's no death sentence. There's barely even a financial sentence, right? The last I checked, the Sackler family, who are responsible for more deaths in the US than most criminal organizations.

• 1:21:38Speaker 03

  Than all criminal organizations.

• 1:21:40Trevor Noah?

  They're still out there. Think about how many families have lost a father, a mother, a brother, a sister, a child because of opioids that they were told were there to help them. Those people became addicted, died from pain, whatever, you name it.

• 1:21:57Trevor Noah?

  Sackler family, they didn't even lose all their wealth. Like, just, just think of this for a moment. Even if you said to me, okay, they're at zero. We took away everything. I know they're not in jail, but they had zero. I'd go, it's still not fair, but, but they didn't even take all their wealth. The people could still fly away in a helicopter. The, like, my brain, do you know what I mean? It's like, wait, wait, wait. Then are we living in a just society? And, and that's the thing that I think people at these levels either don't understand or either act like they don't understand. If a justice system is not just, then people stop believing in the system. Yeah.

• 1:22:30Speaker 03

  Yeah. And we're seeing that more and more. I mean, the violent acts are because the, the safety valve is clogged.

• 1:22:36Trevor Noah?

  Yeah.

• 1:22:36Speaker 03

  And we're blowing.

• 1:22:37Trevor Noah?

  You're like, why would you, why would you not see this? Do you not see that this is gonna blow back on you?

• 1:22:44Trevor Noah?

  We're gonna continue this conversation right after this short break.

• 1:22:50Trevor Noah?

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• 1:23:35Trevor Noah?

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• 1:24:20Trevor Noah?

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• 1:25:03Trevor Noah?

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• 1:26:03Speaker 05

  I think what's going on in the world, you're absolutely making so much sense. What's going on in the world is what usually happens in the classic mafia movies. You know, no one, first part for me is no one ever talks about the marketers. People talk about the great CEO that came from this company that did this to this thing. But if you think about it before, when people trusted the government more, they would buy government bonds. Yeah. And the government would be accountable to the people that bought the bonds because the government would have to pay the bonds back. The same people that make the legislation, which is the guardrails that are supposed to keep people safe. Now go into private business, they get rid of the guardrails, but they still keep the government bonds uh system by saying you're selling people shares. But the marketers have realized, just like in that scene in The Godfather, where he walks around the square and he bites an apple and then later on,

• 1:26:48Speaker 05

  the nun would come and complain and don't call you on it, we'll take care of it. Everyone is wetting their beak.

• 1:26:54Speaker 03

  Yeah, yeah, yeah.

• 1:26:54Speaker 05

  If you are betting online, if you are buying shares, if you're watching the stock price go up, if once in a while, the thing that astonishes me more in this country is when you watch television, these ads about, you know, you owe this much money if you call this and then this was up. And then they always give the stat of how many people haven't versus the how many people should. And all of a sudden, I look at the drug companies different and go, but if they care so much, they're here buying ads, but they are, they're advertising the product, are they, do they really want you, which lawyers must you call to do this thing?

• 1:27:22Speaker 03

  Yeah, it's all, it all becomes.

• 1:27:25Speaker 05

  Yes, everyone's beak is wet. Everyone is eating a little bit here and there with online betting, with buying shares, with working there, knowing someone who is in it.

• 1:27:34Speaker 03

  And no one's looking after the little guy, us, right? And no one is looking at, the Consumer Financial Protection Bureau is constantly the target of attacks, has been dismantled. No one is out there saying, yeah, but what about, you know, Sally out there, what about Bob? I mean, what about, you know, there's no one after them. And that's the thing that, I mean, that's kind of what I saw in dialysis, but I see it everywhere. It's a sense of the most vulnerable people are taking it in the neck. And everyone's sort of, well, you know, they're sort of vulnerable, it's maybe it's their fault, who knows?

• 1:28:07Speaker 05

  And blame the victim, yeah. Yeah, medical aid companies do that all the time in our country. They'll co-opt you into going and using their app that monitors how many times you go to the gym, how much healthier you are. But I'm like, since when are we being lectured about living our lives when your job is to improve our quality of life? So now you're forced at me with the responsibility of not getting sick while I pay you to keep me from getting sick.

• 1:28:28Speaker 03

  And they give you my data too, yeah.

• 1:28:29Speaker 05

  But that's why I was even saying that I think as society, especially if you have a platform and a megaphone, we must be very careful not to use our privilege as a way to lecture people who are hopeless.

• 1:28:38Speaker 03

  Right. Yeah, that's, that's right, yeah. Yeah, the lecturing part is very, is tricky too, and you helicopter into these situations. I am, I'm working in Boyle Heights in Los Angeles and it's in an area that's ninety-five percent Hispanic and.

• 1:28:56Speaker 03

  You know, I could just sort of helicopter in and say, hey, guys, how's how's this working for you? And by the way, there's a way to fix this. So I, you know, I hook up with local organizations that Homeboys Industries is the most. If you haven't been, you gotta go. Okay. The coolest place I have maybe ever been, but certainly the most impressive. It's a gang rehabilitation organization that was started in the eighties by Father Gregory Boyle. No, no relation to the to the neighborhood. And but now they have this view of Boyle Heights that is all inclusive and it's in, you know, Boyle Heights centric. Every business has to be in Boyle Heights. They have urban gardening. They have all kinds of other things.

• 1:29:38Speaker 03

  They have art, but they are actually taking the people who are most at risk. So when I arrived, I mean, the people that everyone else fails to do and won't even take a chance at because their statistics might be skewed. When I arrived, I couldn't get anyone on the phone, but I wanted to talk with Father Gregory Boyle. And I wanted to talk with, you know, the head of of research and so on. So I just arrived and sat down and they have a wonderful homegirl cafe. I sat down and and I said, I'd love to talk with Father Boyle and Michael Ron and the other people. They, oh, well, he's very busy today. And I said, that's okay. I'll stay as long as is necessary. And they said, well, you know, he may be busy all day. I said, oh, that's okay.

• 1:30:20Speaker 03

  I'll stay today and I'm coming back tomorrow and I come back the next day. And I went and sat down and I really meant to go on my computer. I was perfectly happy and I wasn't, you know, and I really needed to meet these people. And about five minutes later, someone and I went back. Remember, this is gang rehabilitation. These are some the people with like tattoos or their faces and stuff. They read you in a heartbeat. Yep. They can see, they know their territory, they know who you are. And and 20 minutes later, a couple of guys came and sat down and had lunch. And and one of them looked, oh, that's the kidney guy. Yeah. And so by by the by the third hour, I had already met with the people I needed to meet with. And we are, we are off and running.

• 1:31:00Speaker 03

  But that feeling of of entering this space where hope is in the air, they have been in a terrible place and they're still facing incredible difficulties. But there is a sense of. Let's not let the state or the government, the federal government or let's do this in a community is that's I think part of the system that we need to employ to get back on our feet as a country, but that place is amazing and that's and that's a sort of street level, person to person information that you really need to make a difference and to understand what dialysis or anything else is doing in a community is find the people who know that community grew up there, who are really plugged in. Yeah.

• 1:31:42Trevor Noah?

  You know what I realize, reading your book and then meeting you is you you're that person from the movies. No, you know, those movies we used to watch, they don't really make them anymore. But remember, you'd watch these movies, you'd watch these movies where they'd be like some random person, they'd be in like a suit that doesn't really fit too well, and they've got their briefcase. Yes. And then they go to like an office and they'll be like, excuse me, I would like to meet the and they're like, I'm sorry, he has no appointments. So it's like, okay, I'll just sit here. And then it's like, and then like two hours later, like, hey, he's not, he's not coming back. It's like, it's fine. I'll just sit here. And I remember watching those movies and I'd go, there's no one like this. Yep. Now I've met one. You have a like a, it's a dogged and insatiable

• 1:32:23Trevor Noah?

  attitude towards like finding the truth, the people, the the story, it's like, is it, is it, is it conscience that's pushing you? Is it like, what is what's motivating you beyond? Don't get me wrong. I mean, it is, it is a noble cause, but beyond that, like, what, what is, what is making you sit down for that long? What's making you go talk where people don't want to talk? What's making you investigate unbeatable, quote unquote, corporations?

• 1:32:50Speaker 03

  Yeah, it's a really good question. And I, you know, part of it is a sense of unfairness. I do have this sort of sense that, you know, bullies are one of the worst species and hypocrites are also one of the worst. So you have a bully hypocrite, who's feeding you a line, that's the worst of the worst. And I run into that a lot in corporate America. So also, just a sense that, you know, we can do better. We have to do better. We must do better. And that it can start with, it needs to start with information, good information. So what is really going on in the dialysis industry? But it can, it can. I think in a, in a, in a pretty short space of time, you can turn something around by taking the small community view and building outwards,

• 1:33:34Speaker 03

  rather than trying to fix it with a blanket, everything needs to change. And besides which, there is no blanket anymore. So you know, might as well do it in your own backyard because no one's going to be looking out for it.

• 1:33:44Trevor Noah?

  Yeah, but you've also done something that's pretty amazing because people would write books, people do, you, you, you know, it's, it's, it's so many stages. First of all, you hope someone will help you make the book. You hope somebody will publish it and put it out there. You then hope that people will read it. You hope that it'll connect.

• 1:34:02Speaker 03

  Yeah.

• 1:34:03Trevor Noah?

  But the hardest step, after all of those hard steps is you hope it'll make a difference.

• 1:34:08Speaker 03

  Yeah, that's.

• 1:34:09Trevor Noah?

  And, and there's something that happened with your book that is, again, it's like a Hollywood movie that you, you hope would be written.

• 1:34:17Trevor Noah?

  There's a moment where the FDA, the head of the FDA goes, I, I want to use your book to go after these two sinkhole companies that are, you know, scamming Americans for their healthcare, scamming the government essentially for all of the money that it's trying to provide to help people. And I think your book, if I remember correctly, got cited 21 times. And there was a lawsuit. What, what's the latest on that is like, is, is this still moving forward? Are these companies still being held accountable? Because your book actually made a change on a level that people didn't think a change could be made.

• 1:34:50Speaker 03

  Well, it is work in progress. Nothing has been fixed yet, but I will say that Marty McCary, who before he became FDA head, had read my book. When he became FDA head, he asked me for a memo. How do you fix dialysis?

• 1:35:03Trevor Noah?

  Yeah, wow.

• 1:35:04Speaker 03

  Give it to me. Uh, and he said he's, he's, he's, uh, spread it around in, uh, to, to Dr. Oz and to, and to RFK and others, um, at the highest levels. Who knows what's going to come of that, but at least they asked. There has been a recent lawsuit, came out in May, um, alleging antitrust violations of all kinds. They did cite my book 21 times and cited people. I cited another 15, um, and they'd simply lay out, um, in my view, um, they're all allegations.

• 1:35:34Speaker 03

  Until proven, but in my view, a pretty good case for why you have two huge corporations that control eighty percent of the market. That's harming patients, that's harming workers, and that's harming taxpayers. I think they made a pretty good point. So, yeah, I mean, Robert Wood Johnson Foundation is funding some of the work that I'm doing. There is forward motion on this. And there is a sense, I think, I've received thousands of emails from people inside the industry, whether the patients or families or whatever, and I would say it's bipartisan. There is a sense of enough is enough. Some of them are Trumpists, some of them are, some of them are voted for Kamala Harris, some of them, who knows, they didn't vote.

• 1:36:12Trevor Noah?

  Yeah, it doesn't matter.

• 1:36:12Speaker 03

  It's health. It is a fundamental thing that goes beyond politics.

• 1:36:16Trevor Noah?

  Your kidneys don't vote, bro.

• 1:36:19Trevor Noah?

  They don't.

• 1:36:21Speaker 03

  They do not. And those babies, I've never had such a warm and fuzzy feeling for my kidneys. You don't think about your kidneys, right? They are the, they are the, they are the conductor of the whole orchestra of your body without those kidneys, you know? People don't talk about renal fortitude, they talk about guts and brains and heart, but they don't talk about kidney power. They should, they should.

• 1:36:42Trevor Noah?

  Yeah, it's one part of you. You know, the analogy I used, there was someone I was having this discussion with, like, after reading your book, and they said, I don't know, I think, you know, the market, this and the, and I don't think you should get, the government shouldn't get involved in what's happening here. And I think private companies. And I was trying to figure this out, because I was like, wait, okay, how would I, how would I explain this? And I was struck, and then, and then it struck me. I went, I would never deny that there are many private companies that have done an amazing job providing us with products that we love and use. We're using a bunch of them now, right?

• 1:37:16Trevor Noah?

  But there are certain aspects of life where you have to ask yourself, who should be in charge of this?

• 1:37:24Trevor Noah?

  And the reason you need to ask yourself is because of the ramifications on the other side.

• 1:37:29Speaker 03

  Yeah.

• 1:37:30Trevor Noah?

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

• 1:37:58Speaker 03

  Yeah, common good.

• 1:37:59Trevor Noah?

  Yeah, we've made it seem like it's this foreign entity. No, no, no, it's our collective force that's acting. It's your friend. It's almost like having one friend where you go, they go to the bar. Hey, what do you guys want for drinks? Yeah, that's government.

• 1:38:09Speaker 03

  Yeah.

• 1:38:10Trevor Noah?

  You go get us drinks and then you hold them accountable. Be like, yo, where's my drink? That's what it's supposed to be. But now we've made it seem like your friend at the bar goes to the bar. And then all of a sudden you're like, that bar guy, man, let me tell you about Barry.

• 1:38:21Speaker 03

  Took my money.

• 1:38:22Trevor Noah?

  Yeah, it's like, no, no, this is.

• 1:38:24Speaker 03

  Took my money.

• 1:38:24Trevor Noah?

  Yeah, it's like, took my money. Yeah, yeah, but was supposed to take your money to buy you the drink that you wanted them to buy.

• 1:38:29Speaker 03

  Yeah.

• 1:38:30Trevor Noah?

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

• 1:39:01Speaker 03

  Hmm.

• 1:39:02Trevor Noah?

  And now I say to you, oh, no, no, no, no, no. Please, I'm not saying you shouldn't breathe. I'm just saying you should pay me to breathe.

• 1:39:08Speaker 03

  Hmm.

• 1:39:09Trevor Noah?

  Would you accept that? And would you live in that society? Right now, even someone would be like, that's a crazy, that's a, that's a ridiculous analogy. Is it though?

• 1:39:19Speaker 03

  AI, what's happening with AI right now? It's sucking the oxygen out of.

• 1:39:22Trevor Noah?

  If somebody, if somebody has a machine.

• 1:39:25Speaker 03

  Yeah.

• 1:39:25Trevor Noah?

  That decides whether you live or die and you have to pay them in order, like a crazy amount of money to stay alive. And then your government doesn't really cover you the way they should because that same company has convinced them to not, and that. How is it any different?

• 1:39:40Speaker 05

  I think you said the key word, they're convinced. I think we've had, we, we have a lot of whistleblowers. We have a lot of researchers, but I think the fight back from these corporations and these companies and these institutions is how much they invest in marketing.

• 1:39:54Trevor Noah?

  Yeah, they do.

• 1:39:54Speaker 05

  And the language that they put out there.

• 1:39:56Trevor Noah?

  You're not wrong.

• 1:39:57Speaker 05

  For example, I, I, I think even body organs are not given priority based on what the, the language, the common colloquial language is for that, for that organ. For example, a kidney. As essential as it is, marketing and language has made it seem like you can do without it.

• 1:40:12Trevor Noah?

  Yeah.

• 1:40:13Speaker 05

  And also, marketing has also made it feel like it's something that someone will give begrudgingly if you need to. You have to be fine with it.

• 1:40:20Trevor Noah?

  Get a kidney transplant.

• 1:40:22Speaker 05

  Get a kidney.

• 1:40:23Trevor Noah?

  Oh, man.

• 1:40:24Speaker 05

  The, the doctor is not called the kidneyologist.

• 1:40:27Trevor Noah?

  Yeah, yeah.

• 1:40:27Speaker 05

  Anastrologist.

• 1:40:28Trevor Noah?

  That's interesting.

• 1:40:29Speaker 05

  There's also this shroud of mystery that's put around things. And sometimes if it's not mysterious, it's trivialized. So you don't take it as seriously as it should be. You know, the biggest example for me is Department of Defense versus Department of War.

• 1:40:43Trevor Noah?

  Yeah.

• 1:40:43Speaker 05

  And I say to people, whenever they talk to me about self-defense, I'm like, why don't you maybe go to a self-offense class?

• 1:40:50Trevor Noah?

  Yes.

• 1:40:51Speaker 05

  Because that will help you more.

• 1:40:52Trevor Noah?

  Hmm.

• 1:40:52Speaker 05

  Because self-defense means we're blocking, right?

• 1:40:54Trevor Noah?

  Yeah.

• 1:40:55Speaker 05

  Or we're getting away from the thing. So it's the language that people use, but I think the fight back right now after people like you have done the job that they've done is for marketers to reinvent how people see a subject or how people even speak about a body organ for it to become as, as prolific as it should be in people's lives. And people go, when you talk about kidneys, I know what you're talking about.

• 1:41:17Trevor Noah?

  Yeah, but it's like, it's basically on us in these forums, essentially. That's what I feel like.

• 1:41:21Speaker 05

  Absolutely.

• 1:41:21Trevor Noah?

  Because there's no money in that, if we're honest, there's no money in that marketing.

• 1:41:25Speaker 05

  Yes.

• 1:41:25Trevor Noah?

  You know what I mean? You're not gonna make money from that part of it.

• 1:41:27Speaker 05

  Yeah.

• 1:41:28Trevor Noah?

  But, ah, the, man, the one thing I really love and I appreciate about your work, and that's why I really appreciate your time, not you.

• 1:41:34Speaker 05

  Oh.

• 1:41:34Trevor Noah?

  Not you. I do love your work, but not right now. One, one thing I appreciate about your work, Tom, is like, is it, it reminds us that we are the ones who are supposed to make it matter. You know, we are the ones who are supposed to give it a voice. We are the ones who are supposed to speak out about it. And we don't know who will read the books. That's the ironic thing. You didn't know when you wrote that book that the head of, that the person would become the head of the FDA.

• 1:42:02Speaker 05

  Right.

• 1:42:02Speaker 03

  Wow.

• 1:42:03Trevor Noah?

  Do you get what I'm saying? Yes. That's like such a crazy. They they were not in that position. They read your book. They go into that position. Put a message in a bottle. No, and to your point, Eugene, it's like we take for granted what those messages, you know, where those messages land up. Mm hmm. Like where those bottles wash up on shore, where they, you know?

• 1:42:19Speaker 03

  Yeah, it's just that there's an urgency to this that gets me, keeps me awake at night because every time, you know, um. I I took a lot of people's, the patients' stories and convinced them to tell me their stories despite the fact that they were putting themselves at risk. I mean, there's a real risk of retaliation.

• 1:42:36Trevor Noah?

  Yeah.

• 1:42:37Speaker 03

  And and a couple of them use the same kind of language. They said, okay, I'll tell you my story.

• 1:42:42Trevor Noah?

  Hmm.

• 1:42:42Speaker 03

  But when I'm gone, you have to promise that this won't happen to somebody else.

• 1:42:47Trevor Noah?

  Wow.

• 1:42:48Speaker 03

  And I, you know, you don't, it's not the kind of promise you'd make lightly, and it's not one I take lightly. Every day since we've been talking here, people are in harm's way. This needs to stop like yesterday. So that's kind of what, uh, at the, at the same time, there are positive movements and positive. Positive symptoms and a very clear game plan for what needs to happen. It's it's hard, but very clear. Ten point plan. Um, there's an urgency here that just, uh, I can't let go of.

• 1:43:16Trevor Noah?

  Does it make you interact with the healthcare industry on a personal level differently?

• 1:43:20Speaker 03

  It does. Yeah, it does. And and, uh, yeah, with, um. With my brother, who is, who is, uh, undergoing some real, real health challenges right now, I, uh, I see. I see a lot of what I've reported on in a way that hits home, um, hits home very hard. So, yeah, I mean, it's, we're all in this and it's all up to all of us. That's the other thing that I think you brought up, but I think is really important for people to remember. It's on you. It's on us. There is no, you know.

• 1:43:52Trevor Noah?

  Yeah.

• 1:43:52Speaker 03

  The knight in shining armor is going to arrive. The cavalry is not coming.

• 1:43:55Trevor Noah?

  You are, you are it. Yeah.

• 1:43:57Speaker 03

  Yeah. And and but we can. I mean, we definitely can. And I've seen, you know, these small groups and and larger groups, people's lobby in in Chicago and homeboys in. L A and a bunch of others who are just saying, okay, let's just do this, you know, let's just do this right here among us. And then we see how it goes. And and I think that's kind of, that's kind of my model until I see a better one.

• 1:44:20Trevor Noah?

  Hey man, I'll tell you now, you've put forward one of the best models. I hope as many people as possible read your book because one of them might become the next head of the FDA, one of them might become the next something of something. And yeah, wherever we can help, let us know, man. It's really worthwhile. Thank you for taking the time.

• 1:44:37Speaker 03

  Thank you very, very much, Trevor and Eugene. It's been a pleasure.

• 1:44:41Trevor Noah?

  This is really great, man. Thank you so much.

• 1:44:43Speaker 05

  Tom.

• 1:44:43Trevor Noah?

  For real, man.

• 1:44:46Speaker 03

  Thanks.

• 1:44:47Trevor Noah?

  We've got to stay in touch.

• 1:44:48Speaker 05

  Sorry about your brother.

• 1:44:49Speaker 03

  Yeah, yeah, it's tough.

• 1:44:51Speaker 05

  Yeah.

• 1:44:53Speaker 03

  It happens, but you don't think it's gonna happen.

• 1:44:55Trevor Noah?

  Yeah, no.

• 1:44:56Speaker 03

  Until it happens.

• 1:44:56Trevor Noah?

  But can I, but can I tell you, it's, um, you know, my mom is more prophetic in the family, but

• 1:45:04Trevor Noah?

  she would say something to the effect of

• 1:45:08Trevor Noah?

  we don't know what wars life is preparing us to fight.

• 1:45:12Speaker 05

  Right.

• 1:45:13Trevor Noah?

  We just experienced the battles. You know, and I, I almost feel like, you know, in a, in a, in a weird way, it's, it's almost come around where you go like, damn. You, it's, it's, it's put you in the front seat to fight the thing that you're already fighting in an even more energizing way.

• 1:45:32Speaker 03

  Yeah, that's true. Yeah.

• 1:45:33Speaker 05

  You already had perspective, you needed urgency.

• 1:45:35Speaker 03

  Yeah, that's right. That's exactly right.

• 1:45:37Trevor Noah?

  That's a, that's a more eloquent way to say it. Thank you.

• 1:45:42Trevor Noah?

  This episode is presented by Whole Foods Market. Whole Foods Market is the place to get everything you need for Thanksgiving with great prices on turkey, quality organic produce, grab and go sides and everyday low prices from 365 brand. You can prep for the holiday with big savings. Shop everything you need for Thanksgiving now at Whole Foods Market.

• 1:46:06Trevor Noah?

  What Now with Trevor Noah is produced by Day Zero Productions in partnership with Sirius XM. The show is executive produced by Trevor Noah, Sanaz Yamin and Jess Hackel. Rebecca Chain is our producer. Our development researcher is Marcia Robiu. Music, mixing and mastering by Hannes Brown. Random other stuff by Ryan Parduth. Thank you so much for listening. Join me next week for another episode of What Now.

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