Transcripts For CSPAN2 After Words 20151116

Are defined principally because their illness is of the brain as opposed to other parts of the bodies i want to get that message out there but i know that another policy but as you point out is either a going to sit on the shelf if anyone is lucky enough to have it sold. I wanted to be a compelling narrative and there has to be certain appeal for everyone to dig through the book and read the whole book so i didnt want it just to be a policy book. I knew that the real story is the one even i didnt want to tell which is even though i was the champion of mental parody, i was also a consumer of Mental Health services that i didnt want anyone to know about because i was worried that it would ruin my credibility as the champion of Mental Health. So come even while im trying to get Mental Health coverage and intense but either way we had in the federal Employee Health benefits plan, i was trying to keep quiet the fact that i had to give into these go into the settings for my own treatment of addiction and Mental Illness. So it was apparent to me that i had to kind of tell my story and you cant make up the fact that our lives work out the way they do. Out of our control. And what ended up happening is it tracked very well my own struggles to pass the bill and the irony my late father ended up taking over for Paul Wellstone added to this incredible aspect because i had fatherson relationships into these were not real medical issues hes often as moral failings for the most part yet here i was a member of congress negotiating with him and Pete Domenici to get a better feel and of course the house bill was much better than the senate bill because its more inclusive of all to reflect the spirit of parity so i thought what an interesting narrative to educate people about the fact there is a law of the land, the two it in the context of the struggle all of us have been good about the fact we are consumers because no one wants anyone to know they have a Mental Illness or addiction. Host more about the struggle about not wanting anyone to know. Tell me about that. Guest i write in the book about how my mother had really debilitating alcoholism. Everybody knew it. It was written about everywhere. For her age she was wellknown as being well known as being an alcoholic. It was john kennedy who had written about it and yet we kept it under wraps as if it were some big secret in our house so people would come and visit. My mom would walk through the house absolutely debilitated from our call as them and no one would look at her or talk to her. It was like the people we all walk by in washington, d. C. And we dont look at and it was the same thing except it is my mother. So i got that message. You dont want anyone to talk about these issues. I was like everyone else whos been in place wait until my mom goes in her, shut the door so theres no more embarrassment. Thats how we all felt a group of shame. We are outsiders looking at her and thinking. She had a Mental Illness and we felt ashamed around that. It was real. I had that same fear that the same fear that my mom would be exposed even though everybody knew that she was suffering as an alcoholic. Host did you think that you were invisible of having problems when you were in the Congress Backs you are not admitting it to anybody. But did you think that folks didnt see it lacks guest thats the big issue as you know in these illnesses you dont have the insight and its called denial. So i thought i was managing what with the public knew about my own struggles in the way that i conducted myself. I thought i was keeping it secret. The big moment for all of us that have these illnesses is that we are the last ones to know in other words everyone around us knows that those in say anything so that was true for me. I was convinced no one could pick up on the fact. I was perspiring, i was, you know, moving around in an agitated way. I totally thought no one knew and host you started seeing child psychiatrists when you were fairly young and people understood that he had some problem. And you think there could have been an intervention at that point that could have freed you to be yourself . Guest waiting for my son and daughter that i want Something Different for them in the medical system when they grow up because they will have the genetic risk that we ought to account for that when we do a checkup to their physicals need to include a Mental Health screening which in part will say what is your Family History x. Window with modeling runs in your family, but it gallops and your family. We are going to make sure we put you on this track. I know enough to know we could be experts and find out what are the kind of resiliency building strategies, the coping mechanisms, the social and Emotional Learning of skills that we can give to your kids and help them navigate around these issues of anxiety that adolescents all have but if you have that predisposition, you are much more prone to go deeper into that space and so the key is to try to keep people from falling off. Everyone knew i was drinking too much, was a mess, but they thought he was just being a teenager. And i dont think we should just assume that teenagers are going to be a mess. We should try to keep them from ending up going down that road. Host you saw different kinds of therapists that have different theories of what was going on. Some would treat you this way or that way. How did that work out in your mind . He went to one person and one and one said this in another setback. How did you work that out in your own head . Guest i wrote this because theres a very convoluted system out there. Theres the standards of care, theres no consistency in metrics to determine whether you are well or not based upon the baseline. You pointed out as a patient i got all kinds of advice and therapies and i had no clue is testing me any good or is that doing me any good. This medication without medication. I hope just like i talked about with my son and my daughter in the future we are going to have a really standardized and other is a science and art to what you do that there but there ought to be some expectation that the states work for these populations of people just like we did with cancer. We say this therapy is probably better for you depending on your background of genetically. We ought to do the same for Mental Health and addiction. Obviously i didnt get that but it makes me an expert on the Current System and what needs to happen. Host did it take the incident where your car hits the barrier to do it or were you turning a corner and recognizing tell me about how you turned the corner. Theres a lot of people watching this who have probably had some of the same problems youve had and they are sitting there saying how did he get out of the rut that he was in because he kept getting out despite everybody strategic attempts. Guest i talk about and about in the book how i had been to treatment five months before it got into the car accident driving under the influence. The problem is i went during christmas break because i figured ive got at least two and a half weeks no one is good to ask where i am, none of the constituents are going to think where is he at this time on making . Its the holidays. So i checked myself in at the mayo clinic in rochester minnesota and i told the administrators im a congressman. I cant afford for you to send me down the hall. They said thats where you need to go. I said thats going to be too disruptive if anyone finds out im done so i want you to detox me here in the main campus from my opiate addiction from my dependence on oxycontin. They said okay so of course they detoxed me. It takes several, a good week and a half and i kind of went over during the day to the mentalhealth wing to get counseling but i wasnt really in it. Wouldnt you know i get some treatment we know it works and recovery. Its a the medical, social, the spiritual. I got the medical but not the social and spiritual aspects of recovery. So even though on my bodys site i was clean, my head was and where it needs to be in five months later i was back in the jackpot so i would say recognizing the fact i hadnt before treatment because of course after, i went back to me and i got i went to the mentalhealth section finally. Host it sounds like you are in control of your treatment. Should the doctors have been in controlling said no, you are going to the mentalhealth unit lacks guest didnt have the insight that i needed and that is a big issue today because i think a lot of us who are in the fruits of our illness do not have that insight and that is one of the big challenges getting people treatment who dont recognize the need to treatment. Host the stigma is what you are dealing with if it comes out anybody finds out, im done. Did you ever know anybody when it happened . Guest its the fear. I had the specter of scandal always looming over me because thats what they wanted to get. They wanted to write that story so it was always trying to be careful not to get into a situation would create a scandal. Host i was wondering did you ever hear the book of thomas i was back at George Mcgovern and all of a sudden he threw up a Vice President ial candidate on the basis of having had electroshock treatment and i was angry at that point where it seems like its what the stigma does to you so its not surprising. Did anybody else realize youve made the term at that point . Did you tell anybody or did you just say put me in the Mental Illness section a Mental Illness section and im ready . I had to surrender after the car accident and every one knew i was in trouble. Everyone was calling on me to resign. I have started to hit bottom at some level politically and big egg was up. Everybody knew it was and i couldnt hide it anymore. Host sometimes they say in alcoholic treatment that you have to hit the bottom is when you understand. Guest i dont think thats the case i think we can raise the bottom for a lot of people. I hit bottom and of course i changed the floor and hit new lows and thats what we do. Host defined normal. Guest the abnormal becomes normal. Host the concept of comorbidity is thrown around. Describe for me what you mean when you say i comorbidity with comorbidity is about. You have the distinction that you either have an addiction or Mental Illness. Often if you have an addiction or Mental Illness you also have a Mood Disorder because you are not regulating your thoughts and emotions in a healthy way. So you need Mental Health which is a component of treatment for addiction and alcoholism but the funding streams as you have Mental Health over here. It will allow a lot of people to fall through the cracks because they are not mental, they do not want to be labeled as a Mental Illness patient or someone recovering from addiction so it works against the people who need to care for both to have the systems of care. Host in your case do you feel one was more problematic was with that you have mental problems that you were medicating with alcohol and guest the bottom line is who cares if it is the chicken or the egg. If it is the quality of my life was disrupted. And it didnt matter whether it was because of the psychiatric issue or that ive selfmedicating or the fact i might have through my abuse of medications i should say my interactions with medications i ended up having a bigger problem thats how we should focus is getting people into some stability. Host when did you decide what led to the decision. Im going to make my cause in Congress Getting mentalhealth 30s so people can get the treatment that whatever you needed but that isnt true for most people so you took on a real issue so when did you decide to do that and what got you started. Guest i couldnt have imagined i would be the sponsor of a bill that president kennedy spoke about when he signed the original Mental Health act of 1963 and that i would in some way be connected to this amazing legacy that i was born with because of the sins of my last name. As i said i grew up thinking i dont want anything to do with this mentalhealth stuff because i was ashamed to have it all in my family and i knew we were supposed to keep quiet so the notion that i was an outspoken leader about this is contrary about how it was programmed so i dont know how it happened. Its a miracle for me. I had a chance to do this because it does mean a lot to be part of this. People that are like me have entered a struggle and the struggle and its satisfying to connect with other people who feel like theyve been marginalized. Host when did you pick put the first bill in congress . Guest why does the cosponsor. He and rhode island. I was aware of it. Was the primary sponsor. Furthermore i have a the chapter president in rhode island who talked to me about it. So, i was already a cosponsor and when i go to washington, i went to basically signon tool for those i have signed onto as a state rep because its like basically taking your agenda to the national level, but i couldnt leave that i ended up having the distinction of being the first name on the bill. I assumed because the bill required equal coverage for Mental Illness and addiction that there would be tons of people that the police in line and maybe i would be lucky to make the top 100 because theres 435 members of congress. So honestly, i cant begin to describe what it was that allows me to be the sponsor. Host did you know on the committee . Guest i was on the Armed Services committee. And then i was on the appropriations committee. I served on the nih subcommittee and the hhs subcommittee and a fair i learned a lot and have dedicated a lot of. In a very direct way for more appropriations like alcoholism. So, that i was very proactive. In fact, whenever we had a mentalhealth addiction hearing, he would let me have the chair to conduct the hearing because, Jesse Jackson junior does this, roosevelt or a business does the same Patrick Kennedy does mentalhealth. So, again, jim i dont know how that happened to just kind of happened. Host do you think they saw that you are on a mission that you didnt know about . [laughter] guest like co. Like i said i didnt have the insight. A lot of people knew things about me that i didnt even know about myself. Thats either so much business for your folks. Host why do you think that your mental problems and emotional illness and Mental Illness, whatever, how does it affect your ability to operate in the congress . Guest if they make the we make the distinction between Mental Health and Mental Illness. I think a lot of people get this confused. If you are in a place where you are brain health is in a severity index where its debilitating you, you have an illness that needs to be treated by the medical system. And so, of course thats where parity comes into place and covers you. Primary care, secondary care and let me just say this because its important for people to know whether you are impatient or outpatient. They need pharmacy or er benefits if they provide a cancer patient or the cardiovascular. Most people dont thats the law of the land. Then theres the other side just mentalhealth. We all need better Mental Health. And we need to do better Mental Health so less people fall into the mental on this. So, suffice it to say, i kind of believe in and out of it being more disabling and sometimes less disabling so there isnt a clear narrative but i was impaired all the time and i think i probably had as we talked about a level of denial about how i was impaired or not. Host people all around you could see that you were at the level guest well, i was blessed because i had the staff. A lot of people applied to work for me. I have terrific chiefs of staff and a longest running staff as we know the high staff turnover. I was blessed by a group that stuck with me. My very first hired executive assistant. Brilliant, organized. I have so many good people and i needed them to vent and they really helped me function. Host they help you by not saying anything or covering up the things you were doing . Guest they definitely i think made up like i was killing it is an appropriate or on the committee during a debate between the early. David obie, i was announcing appropriations everywhere in my district and people measure effectiveness from a member of congress to what are they bringing on the internet scorched i was basing it and everybody knew it. I also had fantastic constituent service. This woman is inside and out of everything in rhode island and so the reputation was whenever you think a candidate gets it done so even though they were like wow i wonder how patrick is doing today they are at this event with me speaking at the chamber of commerce rolling their eyes were forever, they all wanted to come to my office because they knew i could deliver. So i would say theres a lot of people who are just like be in the Business World who are functioning and do not know they have a problem or they do have a problem and are not fully aware that it may be affecting them in ways they dont need to have it affect them like host as long as they can get by without having to confront the public situation than they can keep going and thats basically the running under the surface in a way. I was when people read what they say here is a guy with four and a half years of it guest february 22. Host i sat next to a guy on the ways and Means Committee that had to dwis and he wound up going into god we acted reelected. A lot of people will look at you and say i havent got the family and resources and i dont have access. So they dismiss that they could do what youve done. What do you say to them . Guest the honest assessment is that we dont have in place for everybody else would i have in place. And even while it was in perfect, i am here talking and im alive. And in spite of the illness, it is a very deadly and fatal illness and we know that from the suicide rate and overdose rates. The country is epidemic and we still refuse to address them so this is rampant. And part of the reason is because we dont have the system in place to catch people comes around people, give them the support services and integrate their families into their care, give them the support of employment and make sure they dont end up back in jail because the lack of stable housing. These are things we all need to iron out. Now i was blessed. I have a lot of people there to catch me. And im absolutely grateful that ive had the opportunity. But i dont think it needs to be unique to me. I think that we can put in place a system of care that knows what to do with with abuse illnesses and actually gets funded to do these things because the price of not doing it is enormous human loss and suffering, and its also lots of economic wherewithal in this country in a dramatic way so i just think that its time we figure out how we are going to address this epidemic and host my inexperience i was in as a psychiatrist so i see people coming in with posttraumatic stress disorder before it was in the dsm and you were on the Armed Services committee. Do you think that we separate sort of ordinary citizens in Mental Illness and then we do Something Different for you see it being done differently for soldiers and marines and whatever or is it all one in the same . Guest so in co. So in the past the military culture liked the va and wanted to be cared for him on their peers and theres enormous value in that supports so, having a firefighter recover with another firefighter and a marine recover with a fellow marine theres certain advantages to that. But ultimately, its we know what the onus is ari and we know that methodologies needed to apply whether it is the va paying for them or the selfinsured company. So, the problem is as you know most veterans will get their care from their employersponsored culture because most of the folks that fought for us are in the guard and reserve. So, thats not what most people understand. They think the va covers anybody that served the country, and why i think that ready is going to get implemented is i serve on the part of board of the iraq war veterans of america because i think they will be the one to take down the proverbial door just like they take down iraq and afghanistan. We have a prejudice against these elements is but it doesnt apply as much to the returning soldiers. But in the sense they can open the door for the rest of america and just like they were Freedom Fighters they will be in a new way and that is they will open up the notion that when they see something inexplicable in a city that hears gunfire or sees another parent beat another parent where they have one parent with an untreated alcoholism or addiction or Mental Illness and they have to grow up with that that is trauma and if we understand it can afflict an adult but as coping mechanisms, imagine what it does to a child that has no way to assimilate whats happened to them in their lives and so they are permanently scarred. I go to a lot of Adult Children of alcoholics meetings as well as 12 Step Programs for my addiction and alcoholism and its shocking to me how many of these just affect people for their whole lives and debilitate so we need to get a handle on trauma not only for the soldiers but for the rest of america. Again we have another funding streak that goes off over here to the va and we have another one thing to Mental Health. In your own mind to you have how you would do if he were still in congress clicks guest i have co i have a magic wand. I know how. Well, first i created the kennedy for him. Org, shameless promotion host i was going to bring it up. Guest i kind of analyzed with the policy should look like. Clearly it is all about the dollar. How do we reorder my and spending to get more for our money. That should appeal to the republican friends. So, whether they vote for it because it saves dollars on the physical health site or saves dollars from our criminal Justice System because all of the Police Officers are so busy doing what should really be the purview of the Health Care System in the social Service System rather than the domain of the criminal Justice System all because we ignored its cheaper to provide system up front than to wait in a way to allow people to be hospitalized or rescinded in the jail in the criminal Justice System so these are not complex problems created they are difficult to implement because we dont have the financial incentives to implement them. Thats. Thats why a social innovation bonds where its kind of like here is the target. We are going to save money from the jail system. We are going to save money on medical and education and the dropout rate. How are we going to do with . This protocol come of this and, this and this and we will take a mortgage out and get the money up front, built up the system and pay for it from the cost digger did because we did what he knew would we knew would work to reduce disability. That when you think about the red ink that our country is to be swamped and already is and medicare and medicaid, we have no choice in this we have to do things differently and its shocking to me we dont have the Congressional Budget Office and the General Accounting Office saying to the members of congress and the president there is a new way for us to finance housing, education, human services. We can look at treating people in the appropriate the budget to treat people not in this oldfashioned hard silo way but in this new way that we can bring because of the smarter planet approaches that use ebusiness use. Why cant the government use some of those approaches . Especially with all the information data sharing and ability to integrate various budgets. So lets get some smart people and have them lay it out for us and lets not forget the stock in that a dollar away from the dollar away from me. Providing that housing dollar is going to keep people out of the criminal Justice System. But it doesnt affect my budget. The but hell it doesnt. It affects all of our budget if you dont spend that money so whats my incentive . We have to give people the incentive to be part of the solution. Host how much have you looked at the sort of interface between the Mental Health system and the criminal Justice System . For about nine months as the i was the chief psychiatrist and i ran the secondlargest Mental Hospital in washington every night. I would have a little bit less than the Mental Hospital in the jail but with no treatment, no anything and then turned back out to the street. How much have you looked at the funding for what he we do not jail . Guest first, we over the institutionalized. Im for People Living as independently as they can. That is the goal area that we have cut a psychiatric patient care that we see when we walk around the streets of washington, d. C. People are in full sentences and are due to our inclination is to walk past and ignore them. We never do it if it is cancer or dying of heart attacks a heart attack so whats come to the fundamental notion. It can be made so persuasively that we ought to just address this if it were cancer would we need to make the economic arguments . Tell of course you can make the argument by diverting people with 80, 90 recidivism rates in the jail who eat up the police time, the car time im at the probation time and jail time. You add all those costs and compared to what it would take for us to pay for a case manager and Supportive Housing and a fountain house to allow people to be part of a community. I think it is a fraction of the cost into the models are now being built. The county executive host what is the best example you know of . Guest is an example in miamidade. Hes angry to float a bond to pay for more housing and case management. Im going to do it because you want to float a bond for another forensics unit within the jail in another jail. And i think i can do it, get that money and put it in Something Else and you wont need the jail and he managed to convince the county board, and there is a great county commissioner in miamidade and others got onto this. Now we have a model and thats the kind of stuff we need to look at. And if it works in this county by kit at work in your county so if you are a politician coming you want, you want someone to come to you and say heres the answer, vote on it. It saves money and reduces homelessness. Dont worry about it. Weve done it already. Its all complete. Thats what we ought to be doing. Host one of the interesting things is we know what to do but we dont move ahead and do it. Why would a model like data county isnt that more frequent around the country . What do you think it is politically . Guest at the end of the dates of political will. We need people to want to do who want to do the same. We need people to want in the Education System to make sure we treat a child and recognize they come from a traumatic background they will never see the literacy. We need social Emotional Learning. We need to be in on this stuff. So my point is we can solve these problems if we have the political will. There is no shortage of solutions. What is missing is the political will. Host and if it is mostly do we get back to stigma where is the problem there is more weakness if they dont pull ahead of their bootstraps . Guest there is a lot of that and a lot of recognition that there is no constituency. They dont vote or the perception is they dont vote. By the way the rest of us are quote unquote anonymous which is also killing us because we have no perception of power. Imagine the constituency of up to 23 million americans who are in longterm recovery that no one knows about. You have a fraction of those people to be politically active. You could literally change the president ial election were Congressional Election if that constituency was recognized. Theres no reason that hell cant wag the dog. Weve seen it with these other interest groups. That is a big problem. Host when i was reading the book i was thinking to myself people are going to listen to us and they are going to think about this and think about people in their own family and they are going to wonder what can i do. And im not like Patrick Kennedy, i dont have to name the name or the access to people around the world. But what do you say to an ordinary citizen about what they can do to help this process . How do you teach them how to change it if they have the desire that they think well, hes different than me. I could never do what hes doing . Guest so my uncle Bobby Kennedy was such a powerful advocate for social justice and set each time a person stands up or acts to improve the lives of others is in for a tiny ripple of hope and coming from the centers of energy those ripples can create a current that can knock down the mightiest walls of oppression and resistance meaning all we need to do in our lives is to do the next right thing and make the world better through the things we do each day to make life easier for someone else. All we have to worry about is our job is to help me in our own lives make a difference. Now i have the kennedy name in all these other things going for me. That means ive got opportunities to do it in a bigger scale. But im doing what i can do and we need everybody to do what they can do because all of us collectively could have a bigger impact than if all of us act independently. So until hope america is terrific. We started this now campaign. Org to get some Political Action in the campaign so hearing from republican candidates and what they are going to do is the number one issue in New Hampshire. The number one issue in New Hampshire is the epidemic of opiate overdoses so all the candidates need are more articulate it well developed positions and we are looking to push for that but if we dont show up at town Hall Meetings and we are asking questions or writing letters to the editors, then guess what we are nothing to be part of the dialogue so everyone can be part of this and they can help their local chapters and campaign is an effort to get host and that is the National Alliance for the mentally ill people can look it up online or wherever and find it. There was a particular incident. I was amazed at how you decided what from all the stuff that went on in your life which you decided to put in the book and one of them that struck me is when you and your proper decided you were going to make an intervention with your offer. Im sure there are hundreds of people watching this public to know whats the best way or what could help me make that intervention with my wife or uncle or father or whatever. What would you say to them about somebody in your family has a problem. I want you to talk about that. Guest when someone is suffering the whole family suffers. So, i often get people at these hearings that i do around the country about. He implementation to tell me about the crisis. Like what am i going to do with my loved one is suffering and i said first of all what are you doing yourself for your own Mental Health because we get so wrapped up in our loved ones that we are not very helpful to them if we are not healthy ourselves and there is an osmosis if the family gets to be healthier mentally it has a Ripple Effect on the other family members and then of course you act in a way that is less reactive to them. You just know how to intervene in the book helpful without looking like you are judgment. That is in an effort to get the person recovery in need of it. The catholic they are getting a lot of pitch revising talk. So, they have to be more in tune with your emotionally because they are scarred and hurt and the instinct is to lash out at the loved one who is suffering. Its your fault. Instead of saying the same time i need help from you need help, that kind of notion. Host do you think it would have been possible if somebody in the situation had been able to say to your family lets all get together . And go and see someone or was that so much to keep it secret . Guest that was an impossibility for our generation. But i dont think that its one for my childrens generation and maybe my generation ultimately. But yes, you think about all that was suffered, by my appearance, my cousins come in, the brutal murder of both my uncle. You know, any future, that would not be ignored. You are about to suffer coming you are suffering from heres the ways you begin to cope with that instead of trying to think that its going to be alright because we all right because we all know its never going to be all right. It always comes up somehow. Host you have put together an Organization Called the one mind. Talk about that a little bit. Guest just as convoluted as the Mental Health Delivery System is coming our science system is also convoluted. We have a dozen institutes all studying the brain, disorders of the National Institutes of health. Its the brain. And did we sign with the diagnosis for the Clinical Trials even though if we had the dementia alzheimers folks in with the parkinsons folks in the parkinsons has dementia as one of them and we understand the mechanisms that affect the intellectual development of disability folks that have a higher rate, we could begin to make a better pattern to understand whats going to work because they are heterogeneous on this is not just one. They are kind of a spectrum so when you are understanding panic or eating disorder or bipolar, you know, or schizophrenia, you are understanding the patient that has kind of the multitude of these illnesses impacting them that will put them into more science principles to figure out with all of our new knowledge capabilities big data, high computing, how do we get more people involved in this research so that we can get a better understanding how to treat his most important organ in our body, the brain. Host you look at it as being all brains and chemistry. Host i do in the sense that i think its imperative that we move this out of mike psychology aspect. Supportive living is key for my sobriety and supporting my fellows and recovery, connecting with them on a dalia basis important to recovery but i think that we need to get medical peace because we failed on the medical peace. If we get the medical peace, my belief is that we can then really get the rest of the pieces in place. We are but we are not even getting the first thing right. We are dismissing people from getting even detox coverage. We are missing the early screening. We are missing these elementary things in our medical system. So i am for fixing those and then while we are doing all these other things, but the big issue is we have an obligation to require Insurance Companies to disclose how they make medical utilization review decisions and how they make these medical necessity determinations to deny this care thats against the law and the law now requires that we find out are you treating the person with a Mental Illness or addiction the same as we would treat diabetic and other cardiovascular disease patient, the cancer patient . The only way to know is if we see the algorithm of how they make these determinations in who goes from primary care and do they provide us with a cardiovascular disease to the now provided for the person with an eating disorder but have you. We just need the data. Guest Companies Tell Us its proprietary. Guess who is the biggest year for the bottom line. The taxpayer and these consumers who are paying and getting nothing for what they are paying for. Its an outrage that we are letting Insurance Companies walk away leaving suicides and overdoses rampant in the country and they are to be held accountable. This refusal to disclose the information as to no longer tolerate it burwell exercise authority under the Affordable Care act to get this data and you know the president of the United States hasnt done it and and the reason is because that reason is because the Insurance Companies as you know well brought them into existence so no one in the white house wants to pressure any of the other major executives, and some, sigma, kaiser wants to pressure them and they will all have windfall. The money they are of the money they are going to make on the shared risk, who is the primary beneficiary . The insurance company. Its not going to be the consumer because we didnt invest in the public option. We are not returning the dollars into more services. We need better public advocacy in the space and i it played a significant role in his election and was a believer in healthcare for all. I think that he would be appalled at the fact that we are not holding the Insurance Companies accountable after giving them a market that you cant make this up. They are self dealing to all these businesses that they supposedly cover so they are referring to companies they are on the board of making profits here and there and the public is being left out and no one knows this stuff and they love when no one knows about this stuff and no one is pressuring the president to do this. I am hoping host your view is that the mental patient with any kind of emotional Mental Illnesses at the bottom of the list of people that are concerned. Guest they are not going to appeal the denial of care. They are lucky if they want to get care because they feel so ashamed. Insurance Companies Love it because they dont have to pay out for those folks. Host but the answer is those National Alliance for mentally ill people pressuring the political process tuesday to say this is an issue youve got to respond to. You cant i think i would agree that not very much happens if there isnt some pressure from the outside. Guest Frederick Douglass says power concedes nothing without demand. Never has and it never will. Host this has been a wonderful hour with you. I hope that people will take the time to read your book. It does as you said you wanted to do which put a compelling narrative in while you are explaining policy. Thats all this book was about was about policy and nobody would read it but the fact that you put yourself into it its fantastic. Guest thank you. Host my pleasure. That was after words, booktv Signature Program which offers of the latest nonfiction books are interviewed. Watch past programs online at booktv. Org all persons having business before the Supreme Court of the United States give their attention. Tonight, our country faces a grave change or. We are faced by the epidemic that i met at tonight the industry will be shut down. Therefore i am taking two actions tonight. First, directing the secretary of commerce to take positions of the steel mills and to keep them operating. In 1952, the United States was involved in a military conflict with north korea and at home in dispute between the Steel Industry and its unions have come to a head. It was a hot war and the needed steel for munitions, tanks, jeeps, all those things that you needed in the Second World War as well so if the Steel Industry went on an industrywide strike that was great to be a problem because it was basic to things and army and the things an army and a navy need at airports need to fight a war. To avoid a disruption crucial to the military, president harry truman seized control and as a result a pending strike was called off and fuel production continued. However the Companies Led by the Youngstown Company in ohio disagree with the action and took the loss at all the way to the spin court. We will examine how the court ruled in the case and the impact on president ial powers