The Ezra Klein Show

The Ezra Klein Show

United States

Ezra Klein gives you a chance to get inside the heads of the newsmakers and power players in politics and media. These are extended conversations with policymakers, writers, technologists, and business leaders about what they believe in and why. Look elsewhere for posturing confrontation and quick reactions to the day's news. Subscribe for the anti-soundbite.


Keith Ellison: The Democratic National Committee has become the Democratic Presidential Committee, and that needs to end  

Congressman Keith Ellison is the frontrunner to lead the Democratic National Committee in the Trump era. Ellison has a fascinating backstory: he's the first Muslim elected to the US Congress, and he was the second member of Congress to endorse Bernie Sanders's presidential campaign. 

Now, Sanders has returned the favor, backing Ellison to lead the DNC. But in an unexpected effort to close ranks, Senator Chuck Schumer — who does not exactly come from Sanders's wing of the Democratic Party — has also backed Ellison. 

Which isn't to say Ellison doesn't face a race. Many in the White House are known to be skeptical of Ellison for this job, and have recruited Tom Perez, the popular Labor Secretary (and previous EK Show guest), to challenge Ellison. 

The campaign between the two men is increasingly seen as a new front in the Sanders-Clinton fight  — but that's a bit absurd. Both are extremely progressive, and neither is actually running for president. Which is why, in this conversation, I wanted to draw Ellison out on his vision for the job of DNC Chair, which is not a role that sets the ideological direction for the Democratic Party. What powers does the DNC chair have? How does Ellison want to use them? What is his philosophy of party organizing? How does a party — as opposed to a candidate — build a relationship with voters? What should the national party apparatus be doing in off-years? How much confrontation should there be with Trump? 

We get into the weeds of party-building here, and it's obviously a topic Ellison has thought about a lot — both in his own campaigns, and in his run for DNC Chair. The Democratic Party has some hard choices to make in the coming years, and so it's well worth hearing where Ellison wants to push it. 

Books (so many books!):
-Evicted, by Matthew Desmond
-Give Us Liberty, by Dick Armey
-What a Party, by Terry Mcauliffe
-Strangers in Their Own Land, by Arlie Hocschild
-Hilbilly Elegy, by JD Vance
-Manchild in the Promised Land, by Claude Brown
-The Autobiography of Malcolm X
-The Warmth of Other Suns, by Isabelle Wilkerson
-Who Stole The American Dream, by Hendrick Smith
-Give Us the Ballot, by Ari Berman

Elizabeth Kolbert: We have locked in centuries of climate change  

Elizabeth Kolbert covers climate change for the New Yorker. She's the Pulitzer prize-winning author of The Sixth Extinction. And she recently wrote a paragraph I can't stop thinking about. 

"The problem with global warming—and the reason it continues to resist illustration, even as the streets flood and the forests die and the mussels rot on the shores—is that experience is an inadequate guide to what’s going on. The climate operates on a time delay. When carbon dioxide is added to the atmosphere, it takes decades—in a technical sense, millennia—for the earth to equilibrate. This summer’s fish kill was a product of warming that had become inevitable twenty or thirty years ago, and the warming that’s being locked in today won’t be fully felt until today’s toddlers reach middle age. In effect, we are living in the climate of the past, but already we’ve determined the climate’s future."

Kolbert lives, to an unusual degree, in the planet's future. She travels to the places around the world where the climate of tomorrow is visible today. She has watched glaciers melting, and seen species dying. And she is able to convey both the science and the cost with a rare lucidity. 

Talking with Kolbert left me with an unnerving thought. We look back on past eras in human history and judge them morally failed. We think of the Spanish Inquisition or the Mongol hordes and believe ourselves civilized, rational, moral in a way our ancestors weren't. But if the science is right, and we do unto our descendants what the data says we are doing to them, we will be judged monsters. And it will be all the worse because we knew what we were doing and we knew how to stop, but we decided it was easier to disbelieve the science or ignore the consequences. 

Kolbert and I talk about the consequences, but also about what would be necessary to stabilize the climate and back off the mass extinction event that is currently underway. We discuss geoengineering, political will, the environmental cost of meat, and what individuals can and can't do. We talk about Trump's cabinet, about whether technological innovation will save us, and if pricing carbon is enough. We talk about whether hope remains a realistic emotion when it comes to our environmental future.

-Edward Abbe’s “Desert Solitaire”
-Rachel Carson’s “Silent Spring”
-David G. Haskell’s “The Forest Unseen”
-Bill McKibben’s “The End of Nature”

Sarah Kliff and Ezra Interview Obama About Obamacare  

Two weeks before he leaves office, President Obama sits down for a lengthy conversation about the lessons of the Affordable Care Act and the law's uncertain future.

You Ask, Ezra Answers  

At long last, here’s the Ask Ezra Anything episode. You sent in great questions, and I answered as many as I could. 

To keep me honest — and to make sure I didn’t just talk to myself for two hours — I invited friend-of-the-show Grant Gordon back to the program to help out. We covered a lot of ground. Topics included:

- Immortality 
- The best concerts I’ve been to
- Why I think culture is the biggest impediment to a universal basic income
- Three lessons this podcast has taught me
- Three lessons the 2016 election taught me
- Three lessons running Vox has taught me
- Why my interview questions are so annoyingly long and rambling
- How explanatory reporting differs from other kinds of reporting
- The best advice I’ve been given about interviewing
- My favorite books
- Why the idea that this reality is a computer simulation reflects a failure of imagination

And much, much more. Thanks to everyone who sent in questions, and apologies for all the ones we didn’t get to. This was a lot of fun. We’ll definitely do it again soon. 

Evelyn Farkas explains the crisis in Syria and the threat of Russia  

From 2012 to 2015, Evelyn Farkas served as Deputy Assistant Secretary of Defense for Russia, Ukraine, and Eurasia, where she was responsible for policy toward Russia, the Black Sea, the Balkans, and Caucasus regions and conventional arms control.

Farkas is now a senior fellow at the Atlantic Council, and I asked her on the show to explain two of the issues that worry me most right now: the horror that has befallen Syria, and the risky belligerence that has overtaken Russia. 

If this sounds like a tough episode to you, give it a chance. This conversation doesn’t presuppose deep — or really any — knowledge of either conflict. Farkas is clear, thoughtful, and insightful, and at a moment when Syria is destabilizing Europe and Russia is destabilizing the United States, it’s more than worth taking the time to dig into both.

Along the way, we talk about Farkas’s time in Bosnia, her frustrations with President Obama’s hands-off approach to the Syria conflict, why she’s sick of “slippery slope” arguments in foreign policy, the ways in which the lessons of Yugoslavia and Bosnia collided with the lessons Iraq and Afghanistan, and what to make of Russia’s hack of the US election.

Also, a number of you have asked me to start putting book recommendations in the show notes, so here they are:

-David Rhode’s "Endgame: The Betrayal and Fall of Srebrenica, Europe's Worst Massacre Since World War II” 
-Peter Pomerantsev’s "Nothing Is True and Everything Is Possible: The Surreal Heart of the New Russia” 

In the days since our interview, I picked up “ Nothing is True,” and Farkas is right: it’s amazing. 

Tim Wu's interesting, unusual, fascinating life  

Columbia law professor Tim Wu makes me feel boring and underaccomplished. He’s been a Supreme Court clerk, a Silicon Valley startup employee, a bestselling author, and a star academic. He coined the term "network neutrality," wrote the superb book The Master Switch, and was dubbed "Genius Wu" by Richard Posner — a man many consider to be our smartest living judge. And this is to say nothing of Wu's award-winning side-gig as a — yes — travel writer.

Anyway, screw that guy. 

Wu's new book is The Attention Merchants, and it's a history of how the advertising business has shaped the information we consume, the products we crave, and the way we think. We talk about that book, but we also talk about Wu's approach to life. He explains why his great strength is his ability to ignore inconsistency, how Larry Lessig shaped his career and his marriage, why working in Silicon Valley left him skeptical of markets, and Marshall McLuhan and Timothy Leary’s advertising jingle for acid (really).

We also go deep into antitrust law, the inner workings of the Supreme Court, whether Google and Facebook are monopolies, and what a world without advertising in media might look like. 

So this conversation covers a lot of ground. Enjoy!

Ta-Nehisi Coates: "There’s not gonna be a happy ending to this story"  

Ta-Nehisi Coates is an author at the Atlantic. His book, Between the World and Me, won the National Book Award, and was spoofed on SNL. He's writing the (awesome) Black Panther series for Marvel. He's a certified MacArthur Genius. And he just released a blockbuster story based on hours of interviews with President Obama about the role race played in Obama's upbringing, his presidency, and the 2016 campaign.

Coates is also one of my favorite people to talk to, and I think this conversation shows why.

The first half of our conversation is political: it's about Coates's conversations with Obama, his impressions of the president, his perspective on American politics, the way his atheism informs his worldview, why he thinks a tragic outlook is important for finding the truth but — at least for nonwhite politicians — a hindrance for winning political power. 

The second half is much more personal: it's about his frustrations as a writer, his discomfort with the way "Between the World and Me" was adopted by white audiences, how he learns, his surprising advice for young writers, his belief that personal stability enables professional wildness, his past as a blogger, his desire to return to school, his favorite books. 

I loved this interview. I think you will, too.

Stripe CEO Patrick Collison on management, rationalism, and the enlightenment  

Patrick Collison is the 28-year-old CEO of Stripe, the online payments company that was just valued at $9 billion.

Haven't heard of Stripe? You've probably used it. Last year, 40 percent of people who bought something online used Stripe's payment systems. The company has become an integral part of the internet's financial plumbing. And Collison has become one of Silicon Valley's leading lights — he made the cover of Forbes last year, where one venture capitalist described him as "the LeBron James of entrepreneurs."

Collison is also one of the few people I've met who is a genuine polymath. He seems to know everything about everything, and his recall — particularly his ability to live-footnote his own comments — is something to behold. We talk about how he and his brother conceived of, and launched, Stripe, and then we go much deeper. Among the topics we discussed:
-Why there was a market opportunity for Stripe in a world that had PayPal
-Why people are often wrong when they look at a market and think an incumbent has dominated it
-What he thinks is untrue about the stereotypes of how Silicon Valley handles regulation
-How we might be able to tell whether a buildup of regulations are preventing new companies from emerging
-Why jobs like home healthcare and childcare are becoming tension points in our national immigration discussion
-The difference in the way politicians and tech leaders approach problem-solving
-How he tries to shape culture within his company to help it become, in his words, more like itself
-What he admires about CEOs like Jeff Bezos and Jim Simons
-The culture of "rationalist” bloggers, and why he reads them
-How we underestimate the importance of the Enlightenment period


Award-winning chef José Andrés on cooking, creativity, and learning from the best  

José Andrés isn't just a chef. He's a force. All that talk of how DC is now a hot dining scene? Andrés deserves more than a bit of the credit. He's popularized Spanish tapas through Jaleo, brought El Bulli-style molecular gastronomy to America through MiniBar, and racked up some Michelin stars and James Beard awards along the way.

Andrés has hosted television shows, taught courses on the science of cooking at Harvard, extended his restaurant empire to Las Vegas and South Beach, set up a nonprofit in Haiti, and launched a fast-casual chain focused on vegetables. He's been named "Man of the Year" by GQ and one of the world's 100 most influential people by Time. 

I've known Andrés for a couple of years, and I've never met a better storyteller, or seen anyone who thinks harder about the component parts of creativity.  We talk about that, as well as:

-What Andrés learned from his father
-Why the most important job when making paella is tending the fire
-Why cooking at home is important but not essential
-What he makes of Americans eating out of the house more than ever before
-Why we need to be pragmatic about sourcing food
-How he applies what he learned in the Spanish navy to his restaurants
-What he learned from Ferran Adrià, the founder of molecular gastronomy
-How he takes ideas from other disciplines and applies them in his kitchens
-How important hiring is to him and why immigration policy is so crucial to the American restaurant business
-Why his fast-casual restaurants called Beefsteak are nearly meatless
-How he's managed to run an empire while remaining focused on the creative side
-What he thinks we might lose by eating synthetic food or soylent
-The one dish he thinks people should learn to cook

Do you eat? Do you think? Then listen to this. 

Heather McGhee returns to talk Trump, race, and empathy  

There are few episodes of this show that people loved as much as my conversation with Heather McGhee, president of the think tank Demos. Our first discussion focused on race, class, populism, and the sometimes toxic ways the three interact. It's a topic I wanted to revisit in the aftermath of Trump's election, and so I asked Heather back to the show. After this conversation, I'm very, very glad I did. Among other things, we discussed:
-The three factors that explain the election results -Why race is a more complex force in politics than either liberals or conservatives assume-The dangers of Democrats convincing themselves that populism and racial justice are either/or-Her experience talking with a white man who realized he was prejudiced, and asked her help in changing-Why Clinton lost states Obama won-Why Clinton didn't outperform Obama among nonwhite voters-Why the core of modern racism is seeing some races as made of individuals and others as collectives-Whether the very language around race and racism makes empathy more difficult-How Democrats should think about cooperating — and not cooperating — with Trump
And, as always, much more. Heather is brilliant on these topics, and this is worth listening to.
Also, a lot of you have asked for an episode where I answer your questions, and we're going to make it happen. So send your questions for me to

Ron Brownstein: Clinton didn’t lose because of the white working class  

Why did Hillary Clinton lose the election? Why did Donald Trump win it? And why was the polling so completely wrong?

No one digs deeper into the demographics, polls, and trends of modern American politics than the Atlantic's Ron Brownstein. Though he didn't predict Trump's win, his pre-election writing explained exactly how it could — and eventually did — happen. And it's a more complicated story than you've heard.

In the week since the election, much has been made of Trump's strength among white working class voters — and properly so, as they were core to his victory. But the white working class wasn't the primary cause of Clinton's loss. Her real problem were groups that didn't turn out for her in the numbers her campaign expected — college-educated whites, African-Americans, and millennials. And that suggests a very different future for the Democrats. 

In this conversation, Brownstein goes through the math of the election in detail. We also talk about:

-What Clinton’s campaign assumed, wrongly, about winning the middle of the country.
-The two quotes that Brownstein thinks explain the entire election
-How much James Comey influenced the election’s outcome
-Why Trump was able to win the support of voters who thought him unqualified
-What might have happened if Democrats had chosen Bernie Sanders as their nominee.
-Whether the next Democratic nominee should be focused on winning back working-class whites or energizing the Obama coalition
-The worrying signs the Republican Party will see if it compares Trump's win to Reagan's wins
-Why Brownstein sees Trump as a political independent candidate who happened to run under the Republican banner (and why Ezra disagrees)
-What will be hard and easy for a Trump administration to do while working with a Republican Congress.

And much more. There's a lot of confusion about this election. Brownstein is here to clear it up. 

David Frum on the 2016 election, and the long decline of the GOP  

We’re bringing the Ezra Klein Show to you a little early this week because, well, there's an election coming in a few days. And we wanted to talk about it. 

The 2016 election is the product of profound failures on the part of different institutions in American life: the Republican Party, the media, the financial system. And few have tracked those failures as clearly, or closely, as David Frum.

Frum is Canadian by birth — a perspective, he says, that helps him see American politics as the product of institutions, rather than just personalities. Since moving to the US in the 80s and finding himself inspired by Ronald Reagan, he's chronicled and commentated on conservatism in America. His book, Dead Right, is one of the key documents for understanding the Republican Party of the 1990s. He then did a stint as speechwriter in George W. Bush's White House, where he wrote the famous "Axis of Evil" line in Bush's 2002 State of the Union. More recently, he's written for the Atlantic, where he's been unsparing — and largely proven right — in his assessment of the Republican Party's institutional collapse.

This conversation is an exploration of what has happened to the Republican Party — what it was, what it's become, and why. We talk about:

-Why journalists need to account for governing institutions before turning to cultural explanations
-How he thinks diversity and inequality are linked
-How Ronald Reagan and Donald Trump differ
-What he learned about inequality while working for the Wall Street Journal editorial page
-The best-titled speech Newt Gingrich probably ever gave
-His critique of the 1994 Republican Revolution and Newt Gingrich’s consolidation of the Speaker’s power
-How Fox News and conservative talk radio echo chamber have harmed the Republican Party
-The apocalyptic attitude conservatives rely on while campaigning 
-Why Trump was so successful running against the Bush family legacy
-The role white nationalism plays in Trump's rise (This is an argument I found particularly valuable)
-How Canada avoided the nationalist backlash that plagues the US
-His best and worst-case scenarios for a Hillary Clinton presidency

Enjoy! And then go vote.

Deborah Tannen on gendered speech, Hillary Clinton, Donald Trump, and you  

To understand the 2012 election, you had to ask a political scientist. To understand the 2016 election, you need to call a linguist.

At least, I did. Deborah Tannen is a Georgetown University linguist who's done pioneering work in how men and women's communication styles differ. Her book You Just Don't Understand: Women and Men in Conversation, was on the New York Times best seller list for nearly four years, including eight months as number one. But I got to know her earlier this year, as part of a reporting project to understand Hillary Clinton's leadership style, and the ways in which it's lost — and even a liability — on the campaign trail.

Tannen's work has helped me understand not just Clinton and Trump's communication styles, but my own — her analysis of how men and women communication at home, and in the workplace, is useful no matter who you are. This episode, more than any other I've done, is full of practical insight into situations we all face daily. Among our topics:

-How she became a linguist
-Why everyone in her doctoral program was recording the conversations at dinner parties
-The ways in which linguistics can solve the same problems as psychology
-How cultural attitudes about interruptions and silence lead to miscommunication and frustration (I found this one *very* relevant)
-The debate over African-American Vernacular English, and the crucial research that both powered it, and has been forgotten about it 
-The components of what she calls “conversational style” and how they vary depending on who you are
-How gender roles can create conflict within relationships, even just in end-of-the-day check-ins with your partner
-Why women are perceived to speak more than men, even when they're speaking less
-How gendered forms of communication have changed perceptions of Hillary Clinton
-Why she tries to never use the word "sexism" when discussing evaluations of Clinton and other female politicians
-How expectations of good leadership are caught up in gendered ideas of what leaders look and sound like

And so, so much more. Enjoy!

Joseph Stiglitz on broken markets, bad trade deals, and basic incomes  

This week’s guest is a Nobel Prize winner. We like to sprinkle those in every so often. 

Joseph Stiglitz revolutionized how economists understood market failures (hence that prize), served as chief economist at The World Bank, led the Council of Economic Advisers under Bill Clinton, has written more great books and articles than I can count, and now leads The Roosevelt Institute. He's a pretty smart guy. 

Markets, Stiglitz argues, are man-made, and we need to make them a lot better. We often treat markets as natural phenomena, but they have rules, their rules create some winners and some losers, and, crucially, those rules can be changed. How to change those rules, and which rules to change, is where Stiglitz's recent work has focused — work that is known to have caught the eye of Hillary Clinton — and we talk about it at length, as well as:

-Why he became an economist
-The nature of the work that won him the Nobel prize
-His basic explanation of “information asymmetry,” the term for which he’s probably most famous
-His time as the chair of the Council of Economic Advisors
-The unintended consequences that can come from rewriting economic rules, even when it's being done with good intentions
-Why we can’t use NAFTA to try to understand the Trans-Pacific Partnership
-What a good trade deal would look like in this day and age
-The difference between Obama’s and Hillary Clinton’s economic priorities
-Who he’d like to see working at the Treasury Department and on the National Economic Council in the future
-What he thinks about a Universal Basic Income-What he learned from the economic failings of Venezuela and Greece

The arguments you hear in this podcast are very likely to be things a Clinton administration will be thinking about as it tries to craft a post-Obama economic agenda. So there's a lot worth mulling over here. 

Let's talk about Hillary Clinton's policy ideas, with Jonathan Cohn  

The overwhelming focus of this election has been Donald Trump — the things he does, says, tweets. But the next president is likely to be Hillary Clinton. And we've put a lot less effort into understanding her lengthy, detailed agenda for the country.

So I sat down with one of my favorite journalists, The Huffington Post’s Jonathan Cohn, who has been doing that work, to talk through what Clinton's platform actually says, and what it all adds up to. We also discussed:

-How the stereotype of her has gone from "radical liberal feminist" to "sell-out conservative Democrat," and what both miss
-How childcare, work-life balance issues, and parental leave define Clinton's platform
-How racial dynamics have changed since Clinton’s emergence as a national public figure in the 90s
-The people who surround Clinton and shape her policy platforms
-Jon’s evaluation of how Obamacare’s doing and what about it still needs work
-The way geography’s complicating the way Obamacare works by creating so many healthcare marketplaces
-Why Obamacare's specific struggles have made it so hard for Republicans to promote their own healthcare plans

All this and more. I hope you enjoy!

Francis Fukuyama on whether America's democracy is decaying  

Francis Fukuyama is a political scientist, a public intellectual, and progenitor of the famed "End of History" thesis. But his recent work is his most important yet. Over two volumes, he's been studying how societies become safe, pluralistic liberal democracies — and then how those advanced democracies descend, and decay, into chaos.

Sound familiar?

This is a scary conversation that comes at just the right time. We discussed:

-How American became a “vetocracy”
-Why the representative democracy we have has calcified
-Why the internet may be overwhelming our ability for government agencies to deal efficiently with public comment
-What he thinks is stoking Trump supporters in the way we talk about diversity and pluralism
-Why conversations about class are important
-What he thinks about different models of government around the world, especially Denmark’s
-How we overcompensate for what we’ve learned through past wars
-How polarization is disrupting the way the public views government agencies like the Fed and NOAA
-What he's learned from Samuel Huntington, from the Iraq War, and from the Black Lives Matter movement
-What an agenda to reverse America's political decay would look like


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Tyler Cowen interviews Ezra Klein about politics, media, and more  

A number of you have asked that we turn the tables and have someone interview me for the show. So when Tyler Cowen — economist at George Mason University, blogger at Marginal Revolution, and generalized genius — invited me on his podcast Conversations with Tyler, I said yes, and asked if we could post the discussion here, too. 

Tyler — whose podcast you should listen to — asks some of the hardest, strangest, most provocative questions of anyone I know, and so this was a lot of fun. Among the topics we discussed:

-What we do now that we will reflect on as kind of crazy or unethical in the next few decades
-How my video team at Vox has taught me to think about visual stories
-The value of making content that’s made to be re-discovered
-Why identity as a driver of virality is important to the current online media landscape
-The ethics of eating meat, and why I think those attitudes will change fast in the coming decades
-My thoughts on how CEOs work and how the job of being a CEO has become its own profession
-What I think I’m good at in leading Vox, and how I try to support my team in fostering the things they do
-The importance of to-do lists
-My biggest talent-spotting tip
-Why the government doing clunky, difficult things is sometimes good
-How you shouldn’t probably trust my taste in culture, like sports or music
-The role of shame in the media

All this and so much more on this week’s episode. I hope you all enjoy.

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The best conversation I’ve had about the election, with Molly Ball  

This election season has left pretty much everything I thought I knew about politics in doubt. Both parties nominated unpopular candidates, even when they had popular alternatives. One party's nominee isn't really running any ads, and has barely bothered to build a field operation. The same party's nominee says things on a regular basis that would've been — or would've been thought to be — disqualifying in any other year. 

So it's been weird.

One of the best chroniclers of that weirdness has been the Atlantic's Molly Ball. In the latest edition of the magazine, she has a fantastic piece looking at whether Trump's candidacy is proving that most of what's done by campaigns — the ads, the microtargeting, the message-crafting, etc — is just a waste of money. We talk about that, as well as:

-Whether there's actually a floor in American politics — if even Trump is remaining competitive, does that mean basically anyone can get 45 percent of the vote?
-How Hillary Clinton’s experience within the political system has come hurt her in some ways
-Whether we've been fooling ourselves by thinking elections are about policy rather than identity 
-The difference between Pat Buchanan in the 90s and Trump now
-Why some voters are rooting for Trump even if they’re not always screwed by the economy in the way you might think 
-How current demographic trends are bearing out the anxieties of older white men
-What might come after Trump for the GOP, and whether a candidate like him could be replicated in other races
-Why high-information voters, especially educated Republican women, are often still undecided
-What the liberalism of millennials coupled with the unpopularity of the major parties means for the future of politics in the US
-Why Hillary Clinton has so much trouble ginning up enthusiasm among her base
-What Molly's learned about human nature after doing a ton of reporting on this presidential campaign cycle

This really is the best conversation I’ve had with anyone about the election yet. Enjoy!

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HHS Secretary Sylvia Matthews Burwell on running Obamacare, Medicare, and Medicaid  

This week, I've turned over the mic to The Weeds' Sarah Kliff. She went to Capitol Hill to interview HHS Secretary Sylvia Burwell about all things healthcare. They talked about how to pay doctors to provide better care, the current state of the Obamacare marketplaces, and what she's learned about management running the federal government's largest agency. I hope you enjoy this, and I'll be back next week!

Dr. Leana Wen on why the opposite of poverty is health  

There are a couple of ideas that drive how I see policy and politics. One of them is that most of what drives health outcomes has nothing to do with what happens in doctor's offices. Another is that we overestimate the importance of the president national politics and underestimate the important of city officials and local politics.

Dr. Leana Wen — and this episode — stands at the intersection of those two ideas.

Wen is the Baltimore City Health Commissioner — a job she got when she was only 31, after a stint as an ER doctor, and a background as a Rhodes Scholar and medical activist. Her work in Baltimore coincided with the aftermath of Freddy Gray's killing, a brutal opioid epidemic, and a renewed focus on urban health disparities (there are counties in Baltimore that have higher infant mortality than the West Bank).

In this conversation, we talk about all that and more. Here's some of the more:

-Why her family moved to Utah after leaving China after the Tiananmen Square protests
-Whether America's culture of sharing problems and working through pain is actually healthy
-How she learned to deal with a serious speech impediment (and how I did)
-What it was like growing up in Compton in the early 90s
-How Bill Clinton’s autobiography changed her life
-What motivated her to become a doctor
-How she squares her idea of herself as an activist with being a government official
-The unexpected process by which you get a job like Baltimore City Health Commissioner
-How the medical community’s understanding of pain has changed, and how that led to the opioid crisis
-The misunderstandings of outdated ideas that have made the opioid crisis so much worse
-Why she prescribed a drug to treat heroin overdoses to everyone — yes, everyone — in Baltimore
-Her thoughts on the paradox of Baltimore’s great health institutions and its huge health disparities
-What disturbs her about the patterns that lead up to infant mortality

I particularly want to call out Wen's discussion of the opioid crisis, and what needs to be done about it. It's one of the clearest and most impassioned tours through that epidemic I've heard, and it's worth listening to this conversation just for that.

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