tv After Words CSPAN November 14, 2015 10:00pm-11:01pm EST
very astute historian and very quick to dismiss that which, you can call it historical gossip. size talking to this poet and he mentioned there is this banquet, this look came over his face and he said, well actually it was quite common. after each of these shootings there would be these parties, or gatherings for the shooters. i later found out of what should my grandfather was chief, he was present both at this banquet and add another one. and he is the guest at the shooters banquet. >> thank you very much. [applause].
i would like to invite you up to meet rita and we do have copies of the book available for purchase as well. thank you very much. [inaudible] >> interested in american history? watch american history television on c-span three. every weekend, 48 hours of people and events that help document the american story. visit c-span.org/history for more information.
>> and now on afterwards, former congressman patrick kennedy. he discussed living with mental illness and addiction. he is interviewed by congressman jim mcdermott of washington state. >> good morning, good afternoon. i'm. i'm jim mcdermott and i'm here interviewing patrick kennedy. patrick has written a book what you see on the screen, i have to tell you patrick i have a whole shelf of books written by politicians, yours is the only one i have read front to back. so i read it and i thought to myself, he could have written a history of mental health parity question or he could have written his own memoir. he put them them both in the same book, i would like you to tell me why
you chose to write this book? >> thank you jim, it is good to be with you again. i loved serving with you in congress then you have been a huge champion for mental health and the congress for years. it was great to work with you on the passage of the mental health parity and the addiction equity act. as you know no one knows this is the law of the line because when we pass the bill it was attached to the tarp bill and so of course everyone cared again but no one knew the underlying bill 1424 was this mental health guarantee. so insurance companies have exploited the fact that no one knows about this and continue to exercise their discrimination against people who are looking for treatment in the space and who art denied because their illness of the brain instead of other organs of the body. i know another policy book issue as you point out is either going to sit on the shelf if anyone is like enough to have it sold, or
just not get read. so, obviously i wanted it to be a compelling narrative and there has to be certain appeal for people to dig through the book and read through the whole book. so i did not wanted to be a policy book. i knew the real story was the one i did not even want to tell, which is even though i was the champion of mental health parity i was also a consumer of mental health services. i did not want anyone to know about, because i was worried it would ruin my credibility as the champion of mental health. go figure, right? even while? even while i am trying to get mental health coverage and insurance which by the way we had in the federal employee health benefits plan, i was trying to keep quiet the fact that i needed to go into these inpatient settings for my own treatment of addiction and mental illness.
so it was apparent to me that i had to tell my story, and you cannot make up the fact that our lives work out the way they do, out of our control. what ended up happening is it tracked very well, like my own struggles within my political struggle to pass the bill, the irony that my father ended up taking over for paul wellstone added to this incredible aspect of this. i had father, son relationship issues. he was also the generation that did not believe these were real medical issues, he thought of it as moral failings for the most part. because i was a. a member of congress negotiating with him and others to get a
better bill, of course the house bill was much better than the senate bill because it was more inclusive of all brain illnesses, it truly reflected the spirit of parity. i thought what an interesting kind of narrative to educate people about the fact there is a law of the land, but to do it in the context of the common struggle that all of us have with being open of the fact that we are consumers because no one really wants anyone to know that they have a mental illness or addiction. >> tell me about the struggle of not wanting anyone to know? what is that about? we call that stigma. >> i grew up around it. i wrote in the book on my mother had debilitating alcoholism. everyone everyone knew it, it was written about everywhere. for her age, she was well known as betty ford as no being as an alcoholic. , yet we kept it under wraps as
if it was some big secret in our house. people would come and visit, my mom would walk through the house , absolutely debilitated from alcoholism and no one would look at her, no one would talk to her. it was like the people we all walk by in washington, d.c. d.c. and we don't look at, we walk by and it was the same thing except it was my mother. so i got that message, you do not want anyone to talk about these issues. i was like everyone else. i was frozen in place waiting to my mom goes to her room, shut, shut the door so there's no embarrassment. that is how we all felt, the grip of shame, we are outsiders looking at her and thinking, zero my god. john kennedy is drunk. god forbid forbid anyone would say that. she had a physical illness but
we felt shame around it. it was real. i had that same fear that my mom would be exposed even though everyone knew she was suffering as an alcoholic. >> did you think you were sort of invisible up having problems when you are in the congress? you are not admitting it to anybody and it is that a true thing if folks do not see a? >> that is the big issue with these illnesses, is you do not have the insight to your own health. it it is called denial. there's many forms of it. so i thought i was managing what the public knew about my own struggles in the way that i conducted myself. i thought i was keeping it a secret. of course, the big aha moment
was that we are the last ones to know. in other words everyone around us knows, but doesn't say anything. so, that was true for me. i really was convinced, and no one could pick up on the fact that i was sweaty palms, i was perspiring, i was moving around in an agitated way. i totally thought no one knew. >> do you think in looking back on it, use darted seen child to kyle just when you were young, and people understood that patrick had some problem. so you saw these people, do you think there could have been an intervention at that point that could have freed you to be yourself? >> yes, i, i do. i do think for my son and daughters that i want a different mo for them for their medical system when they grow up.
they are going to have the genetic risk, it runs in our family and we ought to count for that when they do it checkup with their pd at trish and and it needs to include a mental health screening. that in part will say what is your family history. we know it runs in your family, it gallops in your family, we are going to make sure that we put you on this track. what is this track? i don't know but i know enough to know that we have to go to the experts and find out what the resiliency building strategies, coping mechanisms, the social, emotional learning of skills that we can give to our kids and help them navigate around these issues of anxiety that in adolescence you all have. but if you have that predisposition you are much more
prone to go deeper into that stage. the key is to keep people from falling off. everyone knew i stricken too much. i was a mess. they thought i was just being a teenager, right? i don't think we should just assume that teenagers are going to be a mess. i think we should try to keep them from ending it going down that road. >> you saw lots of different kinds of therapists who had all kinds of theories about what was going on with you. some wanted to treat you this way, some that way, how did that all work out in your mind? you went one person and they said this and another said that, how did you work that out in your own head? >> it is interesting because i wrote this because there is a system out there, there is no standards of care, there's no consistency in metrics to determine whether you are well are not based upon a baseline.
that is true and the rest of medicine but not in mental health. i know personally because i experienced it as you point out as a patient. i got all kinds of advice in therapy, i had no clue as this doing me any good or is that to a manny good, is that this medication or that? i hope that in the future we are going to have a standardized, i know there's a certain science and art what you do in therapeutic setting, but there ought to be some expectation that these things work for these populations of people just like we do with cancer. we say this therapy is probably better for you depending on your background, both genetically and typically. we ought to do the same for mental health and addiction. obviously, i did not get that. but it makes me an expert on the
current system and what needs to happen. >> did you 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 turn the corner. a lot of people watching this who have probably had some of the same problems you had, they're sitting there saying, well how did he get out of the rut he was in? because you going down, in spite in spite of everybody's therapeutic attempts. >> i talk about in the book how i had been to treatment five months before i got into the car accident with driving under the influence. the problem is, when i when
entering our christmas break because i figured i have at least two and half weeks where no one will ask where i am. none of the constituents will think, where's he at the town hall meeting, with the holidays. so i checked myself and at mayo clinic in rochester, minnesota. minnesota. i told the administrators there, i am a congressman, i cannot afford for you to send me down the hall to the mental health wing. and they said well congressman that is where you need to go. i said that's going to be too disruptive, if anyone finds out, i'm 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 they detox me, it takes a good week and a half and i kinda went over during the day to the mental health wing to get some counseling but i wasn't really in it.
you know i get some treatment, we know what works and recovery, recovery, it's the medical, the social, the spiritual. so i got the medical side but i do not get the social and spiritual aspects of recovery. so even though on my body side i was clean, my head was not where it needed to be. hence, hence, five months later i was back in that jackpot. so, i would say recognizing the fact that i had not done the full treatment, after the dui i went back to mayo and i went to the mental health section of the hospital, finally. >> it sounds like you are in control of your treatment. should the doctors have been in control and said no, you are not going to the medical unit you are going to the mental health unit. >> i did not have the insight i needed to know what i needed. that is a big issue in this entire debate.
a lot of us who are in the throes of our ailment do not have that insight and that is one of the big challenges of getting people treatment who don't recognize they need treatment. >> the stigma i guess is what you are dealing with when you went into mail, was if it comes out, anybody finds out, i'm done. did you ever know anybody that happened to? >> no, it was the fear. i had the specter of scandal looming over me because they always wanted to get the kennedy in a scandal, they wanted to write that story. i was always trying to be careful not to get into a situation of a scandal. >> as i was reading your book i was wondering did you ever hear the story of thomas eagleton and his problems? >> i heard about about it but obviously you witnessed it. >> i live through a politically,
all the sudden heat throughout his vice president candidate on the basis of having electric shock treatment. i was angry at that point because the president jewel candidate would act like that. i've seen what the issue of stigma does to you. it is not surprising, did anybody else realize you made the turn at that point? did you tell anybody? or did you just say put me in the mental illness section, i'm ready. >> i had to surrender after the car accident, everyone knew. i was in trouble. everyone was calling on me to resign. i had really started to hit bottom, at some level politically, the gig was up.
i had to go back to treatment and everybody knew what it was. i cannot hide it anymore. >> sometimes they say an alcoholic treatment that you have to hit bottom, when you understand. >> i don't think that's the case. i think we can raise the bottom for a lot of people. >> so you don't have to go all the way down. >> no, no way. i hit a lot of bottoms and then of course i change the floor. and i hit new lows. >> you find normal right. >> right normal becomes normal. >> that's talk about the idea of both addiction and mental illness. the the concept of comorbidity is in your book, describe for me what you mean when you say i am comorbidity or what comorbidity is all about? >> as you know we have this artificial distinction that you either have an addiction or you have a mental illness.
when in fact, addiction and alcoholism is a form of 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, in essence you need mental health which is a component of treatment for addiction and alcoholism. but the funding streams, you have mental health over here and addiction over here as of the two are separate. that's how the systems were created. as i say in the book, those systems allow a lot of people to fall through the cracks because they are not mental, they don't want to be labeled a mental illness patient and they don't want the label of being in recovery from addiction. it works against the people who need the care for both. to have these dueling systems of care. >> in your own case, do you feel
one was more problematic, was it that you had mental problems and medicating with alcohol and drugs or question my. >> bottom line is, who cares if it was the chicken or the egg. bottom line is the quality of my life was disrupted. it did not matter whether it was from some psychiatric issue or that i was self-medicating or the fact that i might have through my addiction to medication, i ended up having a bigger problem with my mood. the bottom line is that i have problems. >> when did you decide, or what led you to the decision, i am going to make my causing congress getting mental health parity so people can people can
get the treatment. your family had money so you could get way you needed but that wasn't true for most people. you took on a real issue. when did you decide to do that and what sort of got you started in exploring what wasn't there and what was their question marks. >> as i said you can't make this up jim. i could could not imagine that i would be the sponsor of a bill that president kennedy, my uncle uncle spoke about when he signed the original community mental health act in 1963 and i would in some way be connected to this amazing legacy i was born with because of my last name. as i said i grew up thinking i did not want anything to do with this mental health stuff, i was ashamed to have it in my family and i knew we were supposed to keep it quiet. so the notion that i was a big outspoken leader about this, is that's contrary to how i was
program. i do not know how it happened jim. it is a miracle for me. it does mean a lot to me to be a part of this. i love working in the space because i get to meet people who are like me, people who have been through the common struggle. it is is enormously satisfying to connect with other people who feel like they have been marginalized. i feel very proud that i was given this chance to be part of this effort. i cannot give you a specific example. >> one did you put the first bill in congress? you you serve for tenure. >> 16 years total. what happened was i was the
cosponsor of parity in rhode island when i was a state legislator. >> so that far back you are aware of it. >> my colleague in the rhode island legislature was the primary sponsor. furthermore the chapter president of rhode island talk to me about it. so i was already a cosponsor. when when i went to washington i wanted to sign on to all the bills i had signed onto as a state rep. it's basically taken taken your gender to the national level. i cannot believe that i ended up having the distinction of having the first name of the bill. i assumed because this bill required equal cover for mental illness and addiction there would be tons of people and i would wait in line and i might be lucky to be in the top 100.
so, honestly can't begin to describe what it was to allow me to be the sponsor. >> where you on the committee that that would. >> know i was on the armed services committee. then i was on the preparations committee. the appropriations committee i served on the nih subcommittee and the hhs subcommittee, there i learned a lot and advocated a lot in a very direct way for more preparations for national institutes of mental health, alcoholism. so, i was very proactive. in fact whenever we had a mental health or addiction hearing he would let me have the chair. so i could conduct the hearing. so soma so-and-so does this in
so-and-so does that, patrick kennedy does mental health. again jim, i don't how that how that happened. >> do you think they saw that you were on admission that you did not know about? >> like i said with my illness, i did not have the insight. a lot of people knew things about me that i did not know about myself. that is why there's so much business for your folks. >> how do you think your mental problems, emotional illness, how does it affect your ability to operate in the congress? >> first, lets me make the distinction between mental health and mental illness. i. i think a lot of people get this confuse. if you are in a place where brain health is in a severity index where it is debilitating, you have an illness that needs to be treated by our medical system.
so, of course that's were parity comes into place, it covers you, primary care, primary care and secondary levels of care. let me just say this whether you are impatient, in in network or outpatient or outpatient out-of-network, or any pharmacy or er benefits that they provided they have to provide to the person with mental addiction. as you know, most people do not know that is the law of the land. but, there's the other side that is mental health. health. we all need better mental health. so, we need to do better mental health so people fall into mental illness. suffice it to say, i kind of weaved in and out of being more disabling and sometimes less disabling. there is not a clear narrative that i was impaired all of the
time. i think i probably had, as we talked about some level of denial about how much i was impaired or not. >> that's what i was wondering about. how much denial was there that you are not functioning very well when people around you could see that you are not at the level they were sometimes at. >> well, i was blessed because i had really the best staff. i had had a lot of great people apply to work for me. terrific chiefs of staff, executive assistant, i had the longest running staff. as we know, there is high staff turnover in our offices because the pay is very low. i was blessed, i had a core group that stuck with me, i very first hired an executive assistant, for day wanted tell i left congress was there with me.
brilliant. organized, she was like incredible. i had so many good people and thank god i did. i needed them. they really helped me function and perform. >> they help to buy not saying anything? or by covering covering up the things you're doing? >> while they definitely clearly made up. i was killing it as an appropriate her. i was on the appropriations committee, they put me on early in my congressional tenure, david ob was a good friend, i was really, really knocking it out for my constituents back home. i was announcing appropriations everywhere in my district. people measure the effectiveness of congress as to what they're bringing home. on that score, jim i was aces. i also had fantastic constituent
service. they knew the inside and out of everything in rhode island, so she knew to called no matter what the question was. the reputation was whenever you think of kennedy, he gets it done. even though they were like i wonder how patrick is doing today? there at this event with me, i speak with the chamber of congress, their rolling their eyes, whatever. they all wanted to come to my office to make their pitch because they knew i could deliver. i would say there is a lot of people like me in the business world who are high functioning and do not know they have a problem. or know they have a problem but are not fully aware that it may be affecting them in ways that they do not need to have it affected. >> ..
do you think that we separate ordinary citizens into mental illness and do something different for you see it being done differently or is it all one in the same? >> in the past their way to be cared much there peers and there is enormous value in that support. having that recover, there are certain advantages to that. but ultimately is the brain, the bank, the brain. wing of the treatment methodologies.
third-party administrators. the problem,problem, most veterans were get the care from their employer-sponsored health care i serve on the board. i think there will be the to kick down the proverbial doors. we have prejudice against these illnesses, but it does not apply as much are returning soldiers, thank god. in this sense, our soldiers can open the door for the rest of america. just like they were freedom fighters, they will be freedom fighters in a new way, opening up the notion
that trauma that happens to a soldier on the battlefield when they see something inexplicable can also happen to aa child that grows up in an inner-city that hears gunfire are sees one. beat the other with a have a parent with an untreated alcoholism addiction or mental illness and have to grow up with that. that is trauma, too. if we understand the trauma can afflict an adult who has coping mechanisms, imagine what it does to a child that has no way to assimilate what has happened to them in their lives. 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 it is shocking to me just how a lot of these
childhood traumas just affect people for their whole lives and debilitate for their whole lives. not only for a soldier looking at the funding. do you think we, again, another funding stream that goes off to the va and for addiction and mental health, in your own mind how you would do it, if you were still in congress? >> a magic wand. well, 1st, i created the kennedy forum .org, shameless promotion.
on the medical, savemedical, save money on education and dropout rates. how are we going to do it? we will employees protocols and take a mortgage out for our house. we will mortgage to get the money up front, build up the system and pay for it from the cost averted because we tip of the new worked to reduce disability. when you think about the reading to our country will be swamped in, already is, ssdi,, ssdi, medicare, medicaid, we have no choices. we have to do things differently, and it is shocking we don't have the congressional budget office general accounting office saying to members of congress, there is a new way for us to finance housing, education, human services, samsung, we can look at treating people and
appropriate the budgets to treat people not in this old-fashioned, hard way but in this new way that we can bring because of the smarter plan and approaches. with all the information, data sharing and ability to integrate various budgets. let's get some smart people and have them laid out for us and let's not get stuck in, well, that is a dollar away from me. well, that will keep people out of the criminal justice system. but it does not affect my budget. the hell it doesn't. it doesn't. it affects all of our budget if you don't spend that money. what is my incentive? we have to give people the incentive to be part of the solution.
how much have you -- >> host: how much have you looked at the interface between the mental health system in the criminal justice system? for about nine months in seattle i was the jail psychiatrist and ran the second-largest mental hospital in the state of washington every night. i would have just a little bit less than the main mental hospital in the jail. >> guest: that's right. >> host: no treatment or anything and then turned up back in the street. how much have you looked at the funding for what we do with jails? >> guest: 1st, we have over the institutionalized. i am all for people living as independently as they can , but when we walk around the streets of washington dc we see people and full psychosis, and our inclination is to walk past them and ignore them.
they would never do it if it were cancer or they were dying of a heart attack. i am always trying to make the economic argument because it can be made so persuasively,persuasively, but we ought to just address this. if this were cancer we need to make the economic argument? of course you can by diverting people with 80, 90 pes in the jails by diverting people with 80, 90 percent recidivism rates in the jails, the guard time, probation time, jail time, you had all of 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 the community. it is a fraction of the cost. and those models are now being built. the national association of county executives. >> where is the best example you know of? >> there is a great example in miami-dade, this terrific
judge command he said, i am going to float the bond to pay for more housing and case management. i'm going to do it because you want to float the bond for another forensic unit within the jail and another jail. and i think i can get that money and put in something else and you won't need the jail. but he managed to convince the county board, and there is this great county commissioner in miami-dade and others who bought on to this. now we have a model. you. you know, that is the kind of stuff that we need to look at. we don't have to reinvent the wheel. and there are other models out there. if it works in this county why can't it work in your county? so if you are a politician,
you want someone to come to you and say, here issay, here is the answer, vote on it. saves money, reduces. okay. we have got it already. here is the homework. it is all complete. and that is what we ought to be doing. >> when you look at one of the interesting things about a lot of mental health stuff is comeau we know what to do >> that's exactly right. >> but we don't move ahead and do it. why with a model like dade county isn't that more frequent around the country? what do you think it is politically that gets in the way of that? >> lack of political leadership at the end of the day it is all of political we will. we need people to want to do these things. we need people to want in our education system to make sure we treat the child and recognize that they come
from the dramatic background. >> mostly the problem really is they just have more weakness? >> there is a lot of that in and a lot of recognition that there is no constituency here. >> they don't vote. >> or the perception is they don't vote. the rest of us are anonymous which is also killing us because we have no perception of aa power. imagine the constituency of up to 23 million americans and long-term recovery that
no one knows about. we've got a fraction of those people to be politically active and you can literally change the presidential election, change congressional action. if that constituency was recognized, like the nra constituency is recognized, there's know reason why the tale can wag the dog. that is a big problem. >> when i was readingi was reading your book i was thinking to myself, people are going to listen to us and think about this think about people and their own family and wonder, what can i do? and i'm not like patrick kennedy. i don't have access, but what do you say to an ordinary citizen about what they can do to help this process, how you teach them how to plug-in changing as
they make. they may have the desire, but they think, well, he is different than me. i could never do what he is doing. >> so, my uncle, bobby kennedy who you know was such a powerful and passionate advocate for social justice said each time a person stands up or asked to improve a lot of others they sent forth a tiny ripple of hope command coming from 1 milliona million centers of energy and bearing, those ripples could create a current that could knock down the mightiest walls of oppression and resistance, meaning all we need to do in our lives is the next right thing, try to make the world little bit better from the small things we do every day that make life easier for someone else. all we have to worry about is how we make a difference. i have a kennedy name and these other things going for me which means i have
opportunities to do it on a bigger scale, but i'm doing what i can do command we need everyone to because all of us collectively can have aa bigger impact than if all of us act independently. the nominee is terrific, mental health america is terrific. we started this now campaign.org which is trying to get some political action and the 2016 campaign you know, hearing from republican candidates what they will do, it is the number one issue in new hampshire, number one issue, the epidemic of opiate overdoses. all the candidates need are more articulated, well-developed positions command we are looking to push them for that, but if we'll show up with a town hall meetings meetings and aren't asking questions and writing letters to the editor and guess what, we won't be part of the dialogue.
everyone can be part of this and help the local chapters and the campaign is an effort to try to develop -- >> national alliance for the mentally ill. >> host: people can look it up online or whatever and find it. there was a particular poignant incident. i was amazed at how you decided from all of the stuff that went on in your life what you decided to put in the book. one of them that struck me was when you and your brother decided you were going to make an intervention with your father. >> guest: that's right. abcawun iright. >> host: i am sure there are hundreds of people watching this who would like to know what is the best way or what have you learned that could help me make that intervention with my brother for my wife or my uncle or my father or whatever?
what would you say to them about, somebody in your family has got a problem. >> guest: 1st of all, whenall, when someone in the family is suffering, the whole family is suffering. i often get people at these meetings, the hearings i do about parity and implementation telling me about crisis in the family and what i will give my love for and suffering. first of all, what are you doing yourself for your on mental health? because we get so wrapped up in our loved one that we are not very helpful to them if we aren't healthy ourselves, and there is an osmosis family, it's a family is 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 are into it more
and know how to intervene and be helpful without looking like you are judgmental. all of that is important to get the person in recovery who is in need.need. they can't feel like they are getting patronizing and preachy talk. so they have to be more in tune to where they are emotionally because they are scarred, hurt, and the instinct is to lash out at the loved one who is suffering. it is your fault. instead of saying, i need help, you need help, let's all get help. >> host: do you think it would have been possible if somebody in the situation had been able to say to your family, let's all get together? or was it so much to keep it a secret? >> guest: that was an impossibility for our generation, butgeneration, but i don't think it is one
for my children's generation but, yeah. ibut, yeah. i mean,, think about all of the suffering. parents and my cousin, the brutal murder of both my uncle. you know, in the future that would not be ignored. listen, you are about to suffer. you are suffering. here are the ways you begin to cope, instead of trying to stuff it and think that it will be all all right because we all no it is never going to be all right. >> host: it always comes out. >> guest: it always comes out somehow. >> host: you have put together an organization. talk about that. >> guest: just as convoluted as our mental health delivery system, our neuroscience system is also convoluted. we have a dozen nih institutes all studying the brain. theyou have the national
institute of neurological disorder, national institute of mental health, childhood human -- it is the brain. and yet we silo the diagnoses for the clinical trials even though if we have the dimension alzheimer's folks throwing with the parkinson's folks, parkinson's has dementia as a symptom command we understand the mechanisms that affect the intellectual stability folks that have higher dementia we can begin to make -- have a better pattern to understand what is going to work in these illnesses because they are heterogeneous illnesses, not just one illness. it's kind of the spectrum. spectrum. so when you are understanding panic or an eating disorder or bipolar or schizophrenia, you are understanding the patient that is kind of a multitude of these illnesses impacting them that will understand better if we organize the
science into a more open science principal which basically means let's figure out with our new knowledge capability, big data, high computing, how we get more people involved in this research so that we can get better understandings as to how to treat the most important organ in our body, our brains. >> host: you look at it as being all brain and chemistry. >> guest: i do, in the sense that i think that it is imperative we move this out of the psychology aspect. i am all about supportive living as key for sobriety. supporting my fellows in recovery,recovery, connecting with them on a daily basis, all-important my recovery. but we need to get the medical piece down because we failed on the medical piece.
if we get the medical piece, my belief is that we can then really get the rest of the pieces in place,place, but we are not even getting the 1st thing right. we are dismissing people from getting even detox coverage, missing the early screening, missing elementary things in our medical system. i am for fixing those. while we are doing all of these of things, but the big issues, and the president of the united states has an obligation to require insurance companies to disclose how they make medical utilization review decisions, how they make these medical necessity determinations to deny this care, medical care, and it is against the law, and the law now requires that we find out, are you treating the person with the mental illness or addiction the
same as we would treat the diabetic, cardiovascular disease patient, the cancer patient? the only way to no is if we see the algorithm of how they make these medical necessity determinations, who this for primary, secondary, tertiary levels of care. do they provide that? did they not provided for a person with an eating disorder, what have you? we just need the data. insurance company's tell us that it is proprietary. guess who is the biggest payer for their bottom line? the taxpayer. these consumers who are paying and getting nothing for what they are paying for. it is an outrage that we are letting insurance companies walk away leaving suicide and overdoses rampant in the country, and they are to be held accountable just as much as the federal government for not covering a lot of these things.
the only way is to know, to demand get this data from them. the reason he has not done it is because the insurance companies come as you know well, brought the aca into existence. so no one in the white house wants to pressure any of the major executives, anthem, aetna, cigna, humana, kaiser wants to pressure them. yet, they are all going to be windfall. the money that they will make on the share risk which we are all going through these models, who is the primary beneficiary? the insurance company.
it is notnot going to be the use to -- not going to be the consumer. we are not returning dollars and more services. we need better public advocacy for the space. play a significant role. i think he would be appalled at the fact that we are not holding these insurance companies accountable after giving them a market. you cannot make this up. they are self referring to all these businesses that they supposedly cover. 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, jim. they love it when no one knows about this stuff. no one is pressuring the president to do this. but you know, i am hoping --
>> your view is that the mental patient, the patient with any kind of emotional, mental illness is at the bottom of the list of people that are concerned? they will repeal their denial of care. they are feeling so shamed by their care. those national alliance for mentally ill people pressuring the political process to stay, this is an issue that you have got to respond to. i think that i would agree with you that not very much happens if there is some pressure from the outside. >> for frederick douglas, power concedes nothing without demand. never has, and never will. >> host: this has been a wonderful hour with you, patrick. i hope that people will take
the time to read your book. it does, as you said you wanted to do, puts a compelling narrative in while you are explaining policy. policy can be dull. if that is that is all this book was about no one would read it. but the 2nd you are willing and open to put yourself into it turned it into a fantastic book. >> here is a look at some authors recently featured on book tv afterwords. then burning key, former chair of the federal reserve explainedexplain the actions he took to try to stabilize the us economy.