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Political Trends In Medicine: How Does Election Season Affect Our Health?


We're going to talk politics again. But also - health. Dr. Sally Satel is a practicing psychiatrist who studies political trends in medicine. She's a lecturer at Yale and a resident scholar at the American Enterprise Institute. And she joins us in our studios. Thanks so much for being with us.

SALLY SATEL: Oh, thanks for having me.

SIMON: I recognize we're asking you to do this at a distance. But how do you think this election season might be affecting some people?

SATEL: What I sense is a kind of bewildered demoralization. And remember, it's on a backdrop of low trust in government and a sense that very few politicians in Washington really represent the interests of many people.

And as a result, so many people are casting their vote, if they're voting at all, for who is marginally tolerable. I think, also, that the current situation has enhanced a sense of how estranged a lot of Americans feel from other Americans - a lack of understanding, really, of how other people in this country live if you're not on the coasts.

And that's manifest really in the question, you know, how could they possibly vote for him? In some cases, how could they possibly vote for her?

SIMON: Do you still see patients?

SATEL: Yes, I do.

SIMON: And without violating that important confidence, do they kvetch about this election or what's going on?

SATEL: Actually, they don't. They kvetch about not having access or how hard it was, sometimes, to get help for their problem, which is, in my case, heroin. I work with - in a methadone clinic.

SIMON: Well, and we want to talk to you about this because both candidates talk about it as an example of what could be better in this country. Yet I don't know if I've heard anything that really advances the argument past that stage.

SATEL: You know, during the primary season, there was a fair amount of discussion about opiates. I think the more town-hall meetings you do, the more this comes up. It's - obviously, it's a national problem. But it's felt acutely at the local level.

SIMON: If you could give advice - and I guess they're listening now - what would it be? What can the government do?

SATEL: Well, it's very difficult because, you know, one of the approaches is, understandably, to cut down on that prescription of narcotic painkillers. There is also - obviously, many doctors, frankly, don't know how to treat pain very well. And it's very difficult. And training in pain management isn't so good. They may deprive people who really need these pain medications.

SIMON: I was going to point that out. Of course.

SATEL: And then they - know what they'll turn to. They might actually turn to conceivably illicit drugs. So what I would suggest is several things - more Narcan, make Buprenorphine, which is a substitution for opiates, and Methadone, which is old-style, more available, along with behavioral therapy. This is not just something we can treat with medications.

SIMON: You've had a couple of transplants and have written about this kidney transplant.


SIMON: Let me get you to talk about some of the politics of transplants.

SATEL: Yes. I had two transplants. I actually had one last July. And I am enormously grateful. I'm speechless of gratitude to the two women who did this for me. So I got two living transplants. But there are 101,000 people on the list. Last year, about 17,000 people got transplants.

Twelve people die every day because there aren't enough kidneys. And we have tried everything. In 1984, the National Organ Transplant Act developed our current system of organ procurement. And part of the law establishing that system prohibited any payment for an organ.

So if I needed one, I couldn't pay you. I could go to jail for five years and/or pay $50,000. Altruism, then, became the sole legitimate motivation for giving a kidney. And it is a partial - I say a partial failure.

SIMON: So you would be in favor of letting...

SATEL: I am not in favor of a traditional free market. But I am in favor of an idea that's been around for a number of years, which is to reward people who are willing to give a kidney and save the life of a stranger.

We have to at least experiment with a system that would - should be government-run, government-regulated and that would offer people the opportunity to get, let's say, a tax credit, a contribution to their 401K, tuition voucher waivers. That would, then, avoid the issue of having a situation where only the wealthy could participate.

SIMON: Dr. Sally Satel, thanks very much for being with us.

SATEL: Thank you so much for having me. Transcript provided by NPR, Copyright NPR.