HH: Pleased to welcome now Nicholas Kristof of the New York Times. Nicholas, welcome back, thanks for spending time with us.
NK: It’s my pleasure.
HH: I want to start with your column today, because it really touched me. We’ll get to the stuff I want to argue a little bit with you about, but let’s talk about your friend from the Sudan who’s trying to build a high school there. I actually had never heard this story before. Tell people about Valentino Deng.
NK: Valentino is just an amazing person. He’s one of the lost boys of Sudan who were orphaned, in effect, by the civil war there. And then Valentino walked all across Sudan with other kids. He saw children being attacked by lions, he had to eat leaves, he almost starved to death, he was shot at. Finally, after unbelievable adventures, he ended up in a refugee camp learning to write letters in the dust with his fingers. And somehow, out of this experience, instead of some kind of a hard-boiled, antagonistic personality, he emerges this just incredibly sweet, cheerful, optimistic person who just treasures absolutely everything, and also is a brilliant student.
HH: Now I have not read the book, What Is The What by Dave Eggers that details that. How did he meet Eggers?
NK: I’m not sure how they met originally. I think that Dave Eggers had some interest in the lost boys, and met a few, and then came across Valentino, and was just blown away by his story, and thought this has to be a book. And so Dave Eggers wrote an account of Valentino’s, you know, entire journey to the U.S., and his difficulties adjusting here, frankly, after finally Valentino got a visa and came here as a refugee in 2001, right after 9/11, moved to Atlanta. But they decided together that they were going to use the profits from the book to try to build a high school in Valentino’s hometown in South Sudan. And there, they are doing it, and Valentino, he’s just doing the impossible in the middle of nowhere in South Sudan. He’s building the first high school it’s ever had, a school serving a vast, vast region. They just got the microscopes, they just arrived at the school, and the science teacher they had hired was blown away, because he had never actually seen a real microscope. He had seen pictures of them, but never actually seen a real microscope.
HH: That anecdote is in the Nicholas Kristof column this morning in the New York Times. I have linked that at Hughhewitt.com, America, as well as the website for Valentino, if you are interested in his project to bring a high school to South Sudan, that is there. He needs to get about $15,000 grand to finish a dorm for girls, as you explained, Nicholas Kristof. The girls have to have a place to go to, or their families won’t let them go to school.
NK: And the good news there is that the readers have come through, and now have come through in helping to build that dorm. And so now they’re aiming to build two dorms.
NK: We just got an e-mail from them.
NK: So yeah, it’s an incredibly inspiring project. And you know, people periodically ask me if it isn’t depressing to run around war zones like South Sudan. Boy, when you see people like Valentino, it isn’t depressing. It’s inspiring.
HH: And that takes me to your column earlier this week. You’re doing your Win-A-Trip-With-Nicholas, Part 4 here, and I want to give that a little publicity as well, so that not just readers of the New York Times know about this. Once a year, you grab some unsuspecting, traveling, stargazing tourist who wants to be, and goes off with the New York Times correspondent. And it doesn’t turn out to be what they think it’s going to be.
NK: Well, it turns out to be a little less glamorous. You know, we may meet a president, but we spend a lot more time in huts listening to people. And I’m a real believer that the way you learn about poverty is you listen to people about their lives, and what they need, and how they can change their lives. And so we do a lot of listening in villages in, it’s been in Africa each time so far, and probably this time again it will be in Africa.
HH: And you have to, it’s only for high school/college kids, right? Or can they be a little bit older than that?
NK: Just for university students. You have to be 18, so one has to be in university. But the student, it’s not a sightseeing trip. I mean, the student will be blogging on the New York Times website, will be reporting with me. Originally, I devised it partly to help draw attention to the issues that I tend to care about – sort of global poverty and all the kinds of international challenges. And I thought that both the contest and the fact that a student would be writing about these issues with fresh eyes would help garner attention to these kinds of causes.
HH: Now Nicholas Kristof, I work with Children International, so I’m going to have to put them off to the side, present company excluded kind of rule. Of the relief agencies that you work with, I’m very high on CI, which ones impress you? I don’t need to slag on anyone on the program, but who do you say they’re very good?
NK: You know, there are a lot of them that I think are great. Among the really big ones, CARE, Save the Children, MercyCorps, Heifer International, all do just fabulous work, I think. And among the U.N. agencies, you tend to, they tend to do very good work, but they tend to be much more bureaucratic.
HH: And what do you think of the microlending organizations like Kiva? I’ve had Thomas P.M. Barnett on the program talking about www.kiva.org before. What do you think of those?
NK: I’m a great fan of Kiva, and you know, of microlending in general. It’s not a silver bullet, and nothing works perfectly. And lately, Kiva has drawn some criticism, because people say that it’s kind of flashy marketing, and that in effect, one is raising money to support a larger pool of microlent capital as opposed to the specific individual that one is paired with. But you know, I’ve seen, I visited, actually, somebody I lent to through Kiva. I visited the two borrowers I lent to in Afghanistan. I showed up in their shops in Afghanistan and said I’m your banker. And it was pretty amazing.
HH: Were they in Kabul?
NK: Yeah, that was in Kabul.
HH: Okay, and are they prospering?
NK: I’m sorry?
HH: Are they prospering?
NK: Yeah, they had both benefited from, one was a baker who had, he borrowed about $250 dollars, paid back his loan, and he had used it to essentially increase his stockpiles of flour so that he could produce more bread at a time. And then a small electronics shop who had done something similar. So they both became more effective through that. I would just say that it seems that the really most effective thing is maybe not microlending so much as microsavings, and that it’s really important to help people build up, accumulate their own capital and save money, and that there’s a real market failure there in a lot of poor countries in the difficulty of saving money.
HH: You know, next hour I’ve got restaurateurs on, Nicholas Kristof, talking small business. It seems to me that the essence of small business in the third world is the accumulation of capital that allows them to open them up. And I’m not sure that all that money that goes to these massive grants does anything as, you know, if the federal government just were to sort of completely capitalize Kiva so they could recapitalize all these small entrepreneurs, I sometimes wonder if that wouldn’t be a lot better than USAID.
NK: USAID is a real mess. There’s no doubt about that. And I really agree with you about the importance of encourage business development. I spent most of my career in Asia, and that was how Asia prospered, was through business. But I also think that that kind of business development in Asia only happened because they had spent time building up human capital, in education in particular. And so I think that investing in education, in health care, also does have payoffs, and tends to create the groundwork for business growth later on.
HH: Are you a fan of Thomas P.M. Barnett, the Pentagon’s New Map, and the Great Powers books?
NK: Yeah, you know, I’ve skimmed through the books, one in particular, but I don’t have, you know, I don’t have strong feelings.
HH: Well, he’s a big infrastructure fellow in connecting up the gap, and we’ll come back to that. Now let’s move from the love-in to the stuff I’m not going to agree with you on.
HH: And go there with, I’m genuinely fascinated by your column about John Brodniak of two weeks ago.
HH: I started to have my booking producer try and get in touch with you after I read it, because it raises some profound questions. Set this up for people if you would, Nicholas, about who John Brodniak is, how you came to meet him, and what you wrote about him.
NK: Sure. John’s a former saw mill worker in, actually in my home county in Oregon, Yamhill County, Oregon, and he had, or he has a condition, hemangioma, in his brain. And he had, well, he had very limited insurance to begin with through the mill. Then he was, in April, he blacked out and went to the emergency room. He was diagnosed, he ended up losing his job, he was unable to work. He lost his insurance, and then, since then, he’s been in and out of emergency rooms, which have been unable to treat him. I wrote a column about him. He’s now, it looks as if he’s going to get treated by a surgeon in Louisiana who read the column.
HH: That’s what I was going to ask. And so the kind of surgery he needs is neurosurgery, obviously, on his brain to relieve the pressure, et cetera. Do you know which hospital he’s going to have that done at?
NK: It’s a hospital in Louisiana, but I don’t know the details. I basically connected the surgeon to John, and I…so I don’t know the details.
HH: Okay, now the question that immediately occurred to me, there are number that came up after this, do you believe the health care bill that is before the Senate right now, and let’s focus on that one, since it’s the one most likely, would have done anything for John’s situation?
NK: Well, it’s unclear, essentially. I mean, it’s not, it would not automatically have responded. John was able in August to get into a, basically the Oregon version of Medicaid. And so there was a long lag in getting in, but eventually he was able to get in Medicaid. And then one of the problem with Medicaid is that the reimbursement rates are very low, and so doctors were unwilling to see him. And some people have said, and I think it may be right, that if one knows how to navigate the system well enough, that one can find a doctor who is willing to do things. And I think one of his problems was that he wasn’t a master at navigating the system and finding those that could help. But I mean, your point that the health care legislation is not a panacea, you know, I would accept. I do think that it’s a major step forward.
HH: But since the argument was implicit in the column, that because of the John Brodniaks of the world, we ought to support health care reform, I failed to make any connection whatsoever between this law and Mr. Brodniak’s situation. In fact, Nicholas Kristof, I thought to myself when I read about this, we’re going to make, it’s going to be worse for John Brodniak after this law passes, because they’re going to cut a half trillion dollars out of Medicare, the reimbursement schedules are going to go down, we’re going to adversely affect the number of specialists available, especially anesthesiologists who he’s going to need when he has that surgery. And it is not a solution to support things which make you feel good, not you personally, but generally make someone feel good, if in fact they’re not addressing the problem. Is it possible that I’m right that this law, which I’ve spent a lot of time going over, would make it worse for Brodniak rather than better? And if I’m right, then I ought to oppose the law on his behalf?
NK: I don’t think so. I don’t think so at all. I mean, one of the problems is that you have so many people who in addition to being uninsured are underinsured, and that was essentially Brodniak’s problem. And in general, it seems that the direction that we’re moving to with these exchanges is going to be that people will have much better insurance packages, and you won’t have people chained to their jobs so that when they lose their job, then they’re just left with nothing, as John was for this period from April until August when he got into Medicaid. Likewise, in John’s case, then his wife had to leave her job to look after him, and then she lost insurance for herself and for their two kids, or for her two kids. So that would be addressed in the new legislation. But I mean, the other issue that people don’t want to take doctors under existing Medicaid reimbursements, that’s a legitimate one, and it raises the real problem that this is not a, this is not a panacea, and that issue has to be addressed as well.
HH: Yeah, I’ve had literally hundreds of doctors call this program. Dr. Hal Scherz, a pediatric urologist in Atlanta, started an organization called www.docs4patientcare.org, and all they do is they try and get Congress to understand this bill will destroy American medicine, because it will drive out doctors from specialized medicine, it will cause doctors to go into concierge practices. I mean, especially the anesthesiologists who are screwed the most under Medicare/Medicaid reimbursement of all the specialties, Nicholas. They’re just not going to be there.
NK: Yeah, except that really our weakness in America is not the shortage of specialists. It’s the opposite. It’s a shortage of general practitioners. And that seems to be one reason why American health care data is relatively poor, that we have few general practitioners, and you have this drive when one goes through medical school then to become a specialist. And I mean, while there are indeed plenty of doctors who oppose reform, there are also, after all, an awful lot of doctors and public health specialists who are fully behind reform, and think it will improve the situation.
HH: Well, I’ll come back to that in a second, but John Brodniak, he needs specialists, doesn’t he? He needs neurosurgeons and anesthesiologists. He doesn’t need GP’s.
NK: Yeah, he does. Now I don’t know whether, if he’d had better routine care whether this is something that would have been addressed earlier. I just don’t know enough about hemangiomas. But in general, that is one problem in the health care system, that people who don’t have adequate health care don’t get enough routine care, and so as a result, things don’t get caught early. It’s why I think people who are uninsured have a 40% higher death rate than people who are insured, why things like cervical cancer tend not to be caught. In his case, I don’t know whether that is something that one might catch or not.
HH: All right, there is an Investor’s Business Daily poll of doctors that revealed that 45% of those polled said that if some version of Obamacare passed, they would either retire, or quit the practice of medicine and go into something else. Do you believe them, Nicholas Kristof, because I genuinely believe, after doing a lot of this for an entire year, that it’s got to be at least three to one among medical professionals against this bill, because it fails to address the underlying problems in American medicine, and will make it worse.
NK: No, I really don’t believe that, and you know, remember that the AMA was ferociously against Medicare in 1965, well, in the early 60s in the run up to passage in 1965, and you know, was predicting all kinds of dreadful consequences. And there is obviously real concern about the changes that have occurred in medicine, and the declining prospects of earning a great income if one is a doctor today compared to fifteen years ago. But I don’t think that we’re going to face some kind of a cataclysm in medicine. And you know, that has not been the experience in other countries. Switzerland has adopted a kind of reform that is very similar to what we’re talking about here, and it was very controversial when it was initially passed in the 1990s. These days, everybody in Switzerland thinks it was the best thing to do.
HH: Now there are two questions here. The first is whether you’re right about what doctors feel, and the second comes to the bigger one. So I just want to ask the first one first. Have you spent a lot of time with doctors who are not academics or AMA doctors, but actually as much time, say, out talking to them as you have with the John Brodniaks, because I really believe you would find that they are adamant about this, and they are ready, I spent so much time with doctors on this program just calling in, and they’re so earnest, and they’re so hard-working, Nicholas. I just think that a lot of the proponents of what is called health care reform have not done their homework here. Have you?
NK: Well, I mean, no, I can’t say I’ve talked to doctors systematically, but I mean, I certainly have talked to a number of them. I talked to one in Grant’s Pass, an OB/Gyn who was telling me about a young woman who came to her who had been uninsured, and had not had a pap smear in I don’t know how many years, seven or eight years, and as a result, came to her with advanced cervical cancer, and was dead three months later, and in the view of that doctor, this was very much a consequence of this woman not being insured, of not having some kind of broader insurance program. And that doctor, I mean, who was, you know, she had a tough time telling that story, she was obviously very much in favor of health reform package as proposed right now. So I don’t know, I mean, clearly, there are people, doctors on both sides of this. I haven’t seen a poll. I’m a little suspicious of an Investor’s Daily Poll, how scientifically that was calculated. So I wouldn’t want to hazard a guess about how doctors overall come in on this.
HH: Okay, what would you think about in the current bill in the Senate, there is an individual mandate backed up by fines and an implicit threat of additional sanction. What would John Brodniak do, unemployed, his wife is unemployed, they’re on Oregon Medicaid, with an individual mandate? How would he ever pay that?
NK: You know, I just don’t know enough about John’s situation. There are clearly going to be some people who are not going to be insured, even under the reform. But it does seem as if the number would drop very significantly. So you might have, in any given year, you might, you know, have whatever, perhaps up to ten million people who are not going to have some kind of an insurance, even with this effort at universal care. But that is a big improvement over, say, 45 million under the present situation. So you know, if…I certainly agree with you that this is not a panacea. There will still be people who will be unable to afford a mandate, and will fall through the cracks. But I think it is pretty meaningful if one can dramatically reduce the kind of despair, the kind of problems, and I think the existing system we have really is truly dysfunctional.
HH: Well, that could be very true, and I agree with you on that. I spent a lot of time with, for example, Irwin Redlener of the Children’s Health Fund.
HH: And Irwin is a frequent guest on this program about this. And so I know about the problems. But if it doesn’t fix it, that’s my big question, if you’re convinced that this law not only doesn’t fix the problems, but makes it worse, aren’t you morally obliged as you were suggesting in your column, not to pass by the people who will be hurt by this, and to oppose the bill dramatically?
NK: Yeah, but I do think that the bill does improve things. I mean, we essentially have two main problems. One is access, and the other is health care costs rising. And you know, neither the House nor the Senate bills will resolve the problem of access, but I think that most people think that they will improve access, that there will be fewer people at any given moment who will be unable to afford care, whether preventative or major problems, and likewise on the problem of costs. I think it’s clear the Senate bill does more than the House bill, and there’s disagreement about how much they will do, but I think it is clear that by and large, they will take steps to reduce the growth in health care spending.
HH: Let me push you a little on that a little bit.
HH: Have you read Richard Foster’s report, the chief Actuary from the Department of Health and Human Services which came out on December 10th?
NK: No, I have not.
HH: It made quite a stir on Friday of last week, and so it came out after, in all fairness, it came out after your Brodniak column, but it is the government’s own Actuary. He says far from controlling spending, we will be spending more of GDP upon health care after the Senate bill passes than if we were to do nothing at all. Is that relevant to your analysis, Nicholas Kristof?
NK: Sure, I mean, it is. I mean, there have been lots of analysis of what, you know, where health care spending is going to go. I mean, I think the general sense is that we’re on an upward track, and you know, right now, we’re up at maybe 16% of GNP or something on health care?
HH: 16-17%, yeah.
NK: And so the question is, can that be arrested. And there’s certainly divergence among health care economists, but I think that there is a pretty good sense among most health care economists who’ve looked at it that the Senate bill, more than the House bill, and the House bill to some degree, but the Senate bill in particular, does begin to take some steps that will tend to reduce the proportion of GNP that we will be spending on health care.
HH: All right, I strongly, we’ll leave it at that, but I would recommend the Richard Foster study, because I think the chief Actuary, dull as it might be…
HH: …is the guy to go to. I want to switch to the last subject today, Nicholas…
HH: …which is the religious war column that you wrote on November 26th. I have interviewed repeatedly Christopher Hitchens, I have interviewed Robert Wright, I have interviewed Michael Shermer of Skeptic Magazine. I try to talk to all of the new atheists. I think we’re at the end of the decade of the new atheists. And I wonder, in your column, which was about the religious wars, that’s what it’s titled, when I came away from the end of it, and you…I was wondering, do you believe in sort of the classic Christian God? I think you’re a PK, aren’t you? Aren’t you a preacher’s kid?
NK: No, I’m not.
HH: Oh, I thought you were, okay.
HH: Do you believe in sort of the classic understanding of God that most Christians walking around in America hold?
NK: More or less. I mean, I think I have in mind a, more of a, a somewhat less personal, more ambiguous kind of force than perhaps many people, but…
HH: Well, are you a Christian? I mean, do you believe that Jesus Christ is in fact Lord, all that, basic theology?
NK: Yeah, I mean, I would categorize, I would call myself a Christian.
HH: Because at the end of your column when you write, “I’m hoping that the latest crop of books marks an armistice in the religious wars. I move away from both religious intolerance and the religious intolerance. That would be a sign that perhaps we, along with God, are evolving toward a higher moral order.” And I thought to myself, that struck me as a finger in the eye, that God does not evolve.
NK: Oh, but that was very much a play on the…
HH: On Robert Wright, yeah.
NK: On Robert Wright, and on his…I mean, some readers interpreted it the way you did, and I had not meant it that way. I meant it in terms of, and earlier in the column I talked about the, that this is really our perceptions of God that have evolved. And we, you know, we have enough troubles trying to figure out what God we do or not believe in. So to talk about evolution of God is rather indeed pretentious, as you say. But what is clear is that our perceptions of God have evolved, the God that we have in our head has changed over the millennia and over the centuries to a, indeed, kindler, gentler entity. And that is the kind of evolution that I was talking about.
HH: Okay, then let me, I’m glad to hear that, because that takes away most of my last couple of questions, but I do want to go to this. The L.A. Times Festival of Books just invited me again, and I always joke on air, I call it the Los Angeles Times Festival of non-religious books, because they never invite sort of mainstream Christian authors, whether it’s a Rick Warren or a…
HH: …you know, all the guys, Max Lucado, the people who sell millions and tens of millions of books. And in your column, you cite the normal people – Karen Armstrong, you’ve got Nicholas Wade’s new book, the Faith Instinct. But when it comes to talking about a Christian book, you bring up the Left Behind novels, and it just kind of sank, Nicholas. There’s so much good, solid Evangelical, mainstream, Catholic writing…
HH: And I wonder, why doesn’t the Beltway-Manhattan media elite talk about something, for example, like George Weigel’s Faith, Reason and the War Against Jihadism, or Rick Warren, or Dinesh D’Souza? Why don’t they?
NK: Well, I mean, I think there is a real problem with how few Evangelicals there are in the news media, for example. I mean, I think that we tend to be behind the curve in awareness of Evangelical books, for example. Right now, I’m actually reading the Hole In The Gospels by the head of World Vision, Rich Stearns.
HH: Oh, sure.
NK: And I mean, it tries to address the notion that Evangelical Christians should be concerned not only with moral principles, but with truly making a difference, creating a more just world. And I hugely admire that kind of a spirit.
HH: What about people like N.T. Wright, though, perhaps the most influential Christian theologian at work in the world today? Do you think he gets his due from sort of the media elites?
NK: I would say that in general, the media elites tend to, you know, that we tend to be much, we don’t have our finger on the pulse of religion especially to the degree as it has become more Evangelical, and less kind of mainstream denominations than…I think we’ve, you know, we’ve missed the boat to some degree there. And I, you know, I think that’s a…at one point, I remember I wrote a column noting that in the New York Times, I didn’t know of a single white Evangelical in the newsroom. Now since, after that, after I wrote that, some came up to me and said there are some. But they’re clearly a huge minority. And nationwide, potentially, about one-third of Americans are Evangelicals. And there is, I think, it’s something that media, it is hugely underrepresented in the media, and as a result, we probably don’t do a very good job in covering.
HH: I hope…well, we’ll conclude on common ground. Nicholas Kristof, thank you for that time. I hope you get Simply Christian, and Surprised by Hope, or one of those books for Christmas, and you end up writing about it. I appreciate your time. Good luck on your next trip, and good luck in helping get that high school built in the Sudan.
HH: Thank you.
NK: My pleasure. Take care.
End of interview.