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Amanpour
Interview With Former White House National Climate Adviser And Former EPA Administrator Gina McCarthy; Interview With "Fear Is Just A Word" Author And New York Times Investigative Correspondent Azam Ahmed; Interview With The New York Times Reporter Reed Abelson; Interview With KFF Health News Senior Correspondent Jordan Rau; Interview With Banjoist and Singer Nora Brown. Aired 1-2p ET
Aired December 01, 2023 - 13:00:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[13:00:00]
BIANNA GOLODRYGA, CNN INTERNATIONAL ANCHOR: Hello, everyone, and welcome to "Amanpour." Here's what's coming up.
Dreadfully off track, those words of warning from King Charles at COP28. I speak to former climate adviser Gina McCarthy on this year's summit.
And Israel resumes military bombardment of Gaza as a seven-day truce with Hamas ends. We bring you the latest from the region.
Then, a mother takes on a Mexican cartel. "New York Times" reporter Azam Ahmed tells an astonishing tale of revenge in his book, "Fear is Just a
Word."
Plus, the staggering cost of caring for the dying. Two U.S. reporters speak to Hari Sreenivasan about their series, "Dying Broke."
And finally, a banjo prodigy from Brooklyn, Nora Brown, joins me to discuss her musical inspiration.
Welcome to the program, everyone. I'm Bianna Golodryga in New York, sitting in for Christiane Amanpour.
Britain's King Charles took to the stage at the U.N. Climate Summit in Dubai, saying that the world is approaching "dangerous, uncharted
territory" as the climate crisis deepens, with 2023 set to be the warmest year yet. Take a listen.
(BEGIN VIDEO CLIP)
KING CHARLES III, UNITED KINGDOM: I pray with all my heart that COP28 will be another critical turning point towards genuine transformational action
at a time when already as scientists have been warning for so long, we are seeing alarming tipping points being reached.
(END VIDEO CLIP)
GOLODRYGA: And he is not alone. U.N. Secretary-General Antonio Guterres had these words of warning.
(BEGIN VIDEO CLIP)
ANTONIO GUTERRES, U.N. SECRETARY-GENERAL: We cannot save a burning planet via fire holes of fossil fuels.
(END VIDEO CLIP)
GOLODRYGA: As day two of the summit closes, the pledges are coming thick and fast. Over 100 countries making a major new food pledge, vowing to
reduce the impact of agriculture on our planet. More than 110 countries are agreeing to triple renewable energy by 2030. And delegates formally adopted
a loss and damage fund to transfer finances to countries hit hardest by the climate crisis.
Ahead of the conference, I spoke with Former White House National Climate Adviser Gina McCarthy to get her steer on the importance of this year's
COP.
(BEGIN VIDEO CLIP)
GOLODRYGA: Gina McCarthy, welcome to the program. Thank you for joining us. So, this year, COP28, as we know, is in Dubai. The leader of the summit is
Sultan Al Jaber, the UAE oil chief executive. That has some people wondering whether this year's meeting is being greenwashed or if you think
perhaps, it is important to have fossil fuel leaders at the helm of these types of events?
GINA MCCARTHY, FORMER WHITE HOUSE NATIONAL CLIMATE ADVISER AND FORMER EPA ADMINISTRATOR: You know, there's been a lot of news around this -- of late,
and, you know, it's very challenging, obviously, to have the oil and gas companies at the table, but we have to have these discussions. And frankly,
I think the UAE, because of all these challenges, are going to try to work as hard as they can to really move progress forward.
So, I'm hoping, rather than this being a detriment, that it becomes a real spark for action moving forward because lord knows we need some real
impactful outcomes from this COP.
GOLODRYGA: Well, as you know, on the eve of the summit, there were leaked documents from the Center of Climate Reporting leaked to the BBC,
suggesting that the UAE planned to use this summit to make additional oil deals.
Now, we should note the Abu Dhabi National Oil Company, which Sultan Al Jaber leads, did not reply to CNN's request for comment, but the company
previously told CNN that any suggestion that it was using the climate talks to promote itself is incorrect and baseless. What do you make of the timing
of these leaked documents? And do you think they could possibly derail some of what you say is an important aspect of who's attending and where this
summit is taking place?
MCCARTHY: Look, I have no independent. judgment available on this issue other than what I'm reading. And again, I clearly think that the UAE
understands that this COP needs to be about reducing our fossil fuel emissions.
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This COP needs to be about reducing our fossil fuel emissions. This COP needs to take a stand about phasing out fossil fuels. We can no longer
ignore or look at this as just the glamour of clean energy, which of course is essential, but we have to be very clear eyed. And I think now that the
UAE is very obligated to make their position known and that we have to keep pushing not just to ensure that clean energy beats out fossil fuels, but to
do as many suggests, which is to really set some stringent goals so we can triple renewable energy by 2030.
We have to be strong. We have to get investments out there. And frankly, the investments in the developing world right now don't match our
obligations from the developed world. And that has to be addressed as well.
GOLODRYGA: So, given all of that, what would you call a successful summit?
MCCARTHY: We have to address the loss and damage fund, which is what I was referring to. We have to get significant resources on the table to actually
help the developing world move forward. That is the only way that we're going to be legitimately addressing the real challenge of climate change
where it's most extreme.
We have to also look at how we, again, address a phase down, at least if not a phase out, of fossil fuels and begin to address that in a more
specific way.
I am really hoping that tripling renewables by 2030 is something that we can actually move forward and embrace as a goal. I think in the U.S., we
can clearly see a doubling. And now, with the Inflation Reduction Act, which has been so successful, we have the opportunity to achieve a tripling
in renewable energy capacity by 2030. We're going to push for that.
But the other thing we're trying to make sure we do, frankly, and work that I'm doing with Mike Bloomberg is to make sure that sub-nationals get a
place at the table. Look, he is actually working with Al Jaber to actually make sure that there is a sort of groundbreaking local climate action
summit the first couple of days at the COP.
Because frankly, we know that the federal governments are great, these national ideas are wonderful, the international discussions need to move,
but it's only going to happen if communities start to get engaged, if sub- nationals can get together.
We know the challenges of burning fossil fuels and what it's done to actually impact health across the world, how many people and kids have been
lost. Fundamentally, this is about the health and well-being of every individual in this world and fossil fuels are taking away their ability to
lead healthy lives. We have to go after this every step of the way. And I think sub-nationals can help.
GOLODRYGA: You know, technology has played a huge role over the past decade or so on the issue of grappling with fossil fuels and the amount that are
burned by big emitters, like the United States and China, first and second there.
But are you concerned that companies and countries in turn are relying too heavily on technology like carbon capture in hopes of engineering our way
out of climate change? Is that more of a lazy approach or get out of jail free card? Because some experts that I've talked to are worried that that's
the path that companies and countries are going down.
MCCARTHY: I think we have to really be aware of this. And I am, you know, concerned myself about how much carbon capture sequestration can actually
bring to the table as opposed to resolve the issues that we need to face.
It could easily become a band aid approach. It could easily be big investments in limited benefits. So, I agree that we have to look at all of
these challenges with open our eyes and make sure that we're not giving up the opportunity to really have much longer-term transition to clean energy,
which, frankly, in the end is what we have to look at, not reducing -- just reducing emissions or burying them in the ground, but doing the hard work
that it's going to take to make sure that we have the right balance of technologies so that we have these longer-term solutions.
GOLODRYGA: Gina, there's no doubt that President Biden and this administration have done more in addressing climate change than any of his
predecessors, the Inflation Reduction Act namely. But it is notable that the two -- the world's two largest carbon emitters, the leaders of those
two countries, China and the United States, will not be attending this summit. They met in California just a couple of weeks ago.
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But I'm wondering if you think it's a missed opportunity and what message does it send to not have them in attendance this year?
MCCARTHY: Well, I know that President Biden is, you know, certainly engaged in and many other world issues, most notably the challenge in Israel and
the Gaza. And I know that Secretary Blinken is coming, which is, I think, very good news because of his ability to understand these issues and bring
gravitas to the table.
But I have to say that the agreement between the U.S. and China, to me, set the stage for action. Now, I know a lot of folks may not think that this
was as detailed as it needed to be, and certainly it wasn't, but think about the relationship between China and the U.S. before the announcement
of the agreement that was reached to really focus on methane and forest protection and plastics and other key issues, this was a signal sender.
This was an effort to say that, yes, we've had our disagreements, but we can move forward together.
And if China and the U.S. don't act together and aggressively, we will not win this climate challenge. We all know that.
GOLODRYGA: Yes. Let's give our viewers a sense of the agreement that you talked about that was reached between President Biden and President Xi at
the ASEAN Summit two weeks ago, and that was "to pursue efforts, to triple renewable energy capacity globally by 2030 and to accelerate the
substitution for coal, oil and gas generation."
You hit on something that I'm wondering if concerns you and other experts in this field, and that is the war in Israel and Gaza. And the past year,
before that, a year and a half, we've been covering the war in Ukraine as well.
Is there concern that these geopolitical events are prioritizing attention that maybe could have been directed towards climate change?
MCCARTHY: You know, I don't know how you can minimize -- anybody can minimize the need to have attention focused on this issue, because it's not
just about Israelis and Palestinians, it is much broader than that. And so, I'm hoping. That we can both rub our stomachs and tap our head at the same
time.
Clearly, we have to address climate change. I think, frankly, part of the challenge is to make sure that we recognize that there are challenges
internationally, that politics can be put aside, but need to be managed internally in the climate process, because after all, I think the
developing world is seeing that the developed world has prospered from fossil fuels for far too long and damaged our ability across the world to
actually live healthy lives.
And we now have to recognize that we need to develop investments that are appropriate to actually advance the developing world and provide us an
opportunity for much more stability. I think a clean energy future is the goal to provide stability across the world and a more secure future.
Look, we are seeing terrible challenges across the globe that are impacting communities everywhere, in the Middle East and well beyond. We have to face
the fact that these challenges in countries, many of them are exacerbated by the poverty, by the challenges of energy not being available, by high
energy prices.
These are challenges, food scarcities, many of these challenges are exacerbated directly by climate change and are causing some of the
instability that we're seeing in the world today. So, I don't think we need to dissect the two issues. I think we need to link them.
GOLODRYGA: Well, people around the world in this country, they might not be aware of it, but their lives are impacted by climate change every single
day. We cover it here every month. There's a record-breaking month when it comes to heat waves. Each year is hotter than the previous year. We've
covered flooding, we've covered fires, we've covered heat waves and droughts and hurricanes, you name it.
Are you concerned at all that we have become desensitized to these types of events and view it as our new normal?
MCCARTHY: I don't think so. I think I -- unfortunately, I think in every country, and clearly in the United States, it took a long time for people
to get their arms around climate change, but it's hitting them in the face now.
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I think they're not ignoring it. And instead, I think they're recognizing that it poses a significant threat to communities all across the United
States and frankly, all across the world. We can see the damages.
The challenge that I try to focus on is how do we make sure that the resolution to climate change, if you can call it that or the action plan on
climate, has to be one that is optimistic, not sacrificial.
GOLODRYGA: Gina McCarthy, if there were ever a time for optimism it's now. So, we'll take whatever we can get. Thank you so much for joining us today.
We appreciate it.
MCCARTHY: It was great to be with you. Thanks for having me.
(END VIDEO CLIP)
GOLODRYGA: Well, also in Dubai at COP28, King Abdullah of Jordan, who highlighted how climate and humanitarian challenges are linked. Here's what
he said.
(BEGIN VIDEO CLIP)
KING ABDULLAH II, JORDAN: We cannot talk about climate change in isolation from the humanitarian tragedies unfolding around us.
The massive destruction of war makes the environmental threats of water scarcity and food insecurity even more severe.
(END VIDEO CLIP)
GOLODRYGA: Well, fighting has now resumed between Israel and Hamas after a weeklong truce. Let's get the latest from Correspondent Oren Liebermann in
Tel Aviv.
Oren, the truce has expired, the fighting has begun. I know there's some talk behind the scenes among the Qataris about renewing a truce. What's the
likelihood that that could happen and what would that entail?
OREN LIEBERMANN, CNN CORRESPONDENT: Those efforts are ongoing, despite the fact that the war and all the fighting have restarted since about 7:00 this
morning here, local time. The question, of course, how likely is that to come to fruition?
It's worth remembering that the truce itself came about because of weeks of negotiations, difficult negotiations at times during the war. So, it at
least is theoretically possible to get back to a point of truce. And a senior State Department official expressed some level of optimism that they
could get there, perhaps even in the next day or two.
But challenges, of course, remain. Qatari officials said the resumption of hostilities has made that even harder. And then, of course, there's the
conditions and the requirements for a truce to be carried out. Israel's requirement is still per the original agreement, which is Hamas must
release 10 women and children for a 24-hour pause in the fighting. Israel believes there are at least enough women and children for one truce or two
more days of a pause.
Hamas says there aren't, in fact, enough women and children to release for a pause. Instead, they wish to focus on expanding the truce agreement and
lengthening the pause in the fighting itself to elderly men being released and then men and women of fighting and reservist age in Israel. They say
Israel rejected any attempt to have those conversations.
So, you can see how difficult the negotiations are. But the efforts are still ongoing, even as we see incredibly intense fighting pick up once
again Gaza.
GOLODRYGA: Talk about the fighting that we've seen pick up, where they left off. Obviously, geographically, they've gone to Southern Gaza, but in terms
of tactics, Israel has been warned and Israeli officials have publicly said and acknowledged that their approach to this war now has to change and
become more surgical. Are they doing that? Are we seeing that in the first 24 hours?
LIEBERMANN: It's hard to get that sense right now. We're 13 hours and some minutes into here. And all we see now is the results of heavy Israeli
bombardment in Khan Younis in Southern Gaza and Rafah, which is near the main border crossing between Israel -- I'm sorry, between Gaza and Egypt.
Worth noting, there are trucks lined up outside of that border crossing that have not gone through, according to an eyewitness that we have spoken
to who is at that crossing. And that's another critical problem for Gaza.
But in terms of those Israeli strikes, they occur in Southern Gaza, which is where Israel told Palestinians in the north to evacuate to. They have
tried to drop leaflets saying to evacuate certain areas that are war zones and even tried to drop a QR code that leads you to a map of Gaza with
certain parcels that they may then be able to use to see where operations will be and where to move from.
The challenge, of course, is you need internet connectivity for that, and that is not something that's been guaranteed over the course of this war.
So, challenges remain, you're absolutely right. Secretary of State Anthony Blinken was here basically demanding that Israel have concrete plans in
place to protect civilians as we move into the next phase of this war.
Health authorities in Hamas controlled Gaza say that more than 100 Palestinians have already been killed in the resumption of fighting. And as
we look at what's happening, certainly seems likely that that number may rise.
GOLODRYGA: And, Oren, we've gotten more information from the IDF about at least three Israeli hostages now confirmed dead in Gaza. Can you tell us
more about that?
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LIEBERMANN: I don't have the names right in front of me at this moment, but this is part of the IDF's operations there. They confirmed that three more
Israelis were killed in Gaza, post October 7th, post the terror attack. Sometimes it has taken a tremendous amount of time to be able to confirm
this.
For many of the loved ones and their families, they were missing or considered kidnapped without any definitive information. So, this is at
least an answer on that, and certainly hints at the horror of that day, as the families learn more, and as Israel tries to figure out more on exactly
how many hostages are left, and where negotiations might try to go.
GOLODRYGA: Yes. Some of that information coming from the hostages that have already been released and no doubt traumatize young children and elderly
among them. Oren Liebermann, thank you.
Well, we turn now to Mexico, where this week saw the worst day of violence against journalists in a decade. Five were shot and wounded, four of them
in the Guerrero State, the scene of many deadly turf battles.
Former New York Times Bureau Chief for Mexico, Azam Ahmed, has seen violence like this up close, as well as a desperate fight against it. His
new book, "Fear is Just a Word," tells the story of a mother seeking revenge for the death of her daughter murdered by one of the most violent
cartels in the world. And Azam Ahmed joins me now from Mexico City.
Azam, congratulations on both a beautiful and heartbreaking story, a mother in search of her daughter and ultimately once she finds out that her
daughter has been killed in search for those killers and bringing justice to her daughter. Tell us about Miriam and her daughter, Karen.
AZAM AHMED, AUTHOR, "FEAR IS JUST A WORD" AND NEW YORK TIMES INVESTIGATIVE CORRESPONDENT: Thank you for having me. Miriam Rodriguez was a merchant in
the local market in the town of San Fernando, which is about 70 miles from the Texas border. She sold cowboy boots, mother of three children, and then
her town became an inferno when two warring cartels made it sort of the center of their fight. And her daughter was kidnapped.
And like any parent, she did whatever she could to try and rescue her. She paid ransoms, multiple. She went to the police. She went to prosecutors,
asked anyone to help her -- anyone for help. And no one really came to her aid. And so, she sort of almost broke with love and just started to go
after the individuals responsible herself.
She sort of became a one woman "Law and Order:" episode almost. She began to figure out who these people were, track them down, and eventually, get
them -- get many of them arrested with an extraordinary amount of sort of resilience and perseverance.
GOLODRYGA: Yes. Karen was kidnapped and killed in 2014. It is stunning, though, one of the takeaways in Miriam's quest to seek justice for her
daughter is that she did it on her own, as you just laid out there. All of the authorities weren't there to do the job for her.
I would imagine that this speaks not only for Miriam's case, but for countless other family members who are looking and seeking for their loved
ones?
AHMED: Absolutely. There's a hundred thousand people disappearing in Mexico. And disappeared, it literally means one day they just vanished and
families have no idea what happened to them.
Oftentimes, organized crime and sometimes government forces will take people and they won't -- you know, it's a -- it's sort of part of the dark
war continuum. If you disappear someone, there's no crime, there's no body. And so, it became a prominent feature of the war on drugs here in Mexico.
And, essentially, Miriam's case was a -- for me, an iconic case. There are so many others like her. In fact, she began to represent other people who
had children who had been disappeared. And her agenda was essentially find out what's happening, pressure the government to do something, because, I
in the way I describe it in the book is Mexico is a truant state. You know, they're absent. You can't go to government officials and ask them for help
in a situation like this, which is why it's gotten so -- it's become such a widespread problem. And the idea that you can lose the most precious thing
in your life in an instant and have no recourse sort of is what drives this narrative.
GOLODRYGA: The Mexican military, no doubt, has resources. In this "fight against drugs, war against the cartels," really it began in earnest in
2006. And yet, administration after administration after administration has failed at doing just that. Why is that? And what in your reporting have you
been able to reveal in answering some of these tough questions?
AHMED: That's absolutely right. I mean, the government opted for a militarized approach because they didn't have a functional law enforcement
approach. And I think one of the things that I tried to do in the book is trace back when that began, how that evolved, how we got to where we are
today in Mexico, where essentially, you've got a nation where the rule of law is rather broken.
And in some ways, it began shortly after the Mexican Revolution, when they were creating a new Mexican state. And law enforcement almost was a wing of
government corruption. Over the years, there was never an effort to build a functional independent Police. There was never an effort to build a
functional and independent judiciary.
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So, you flash forward today and there's an inversion where organized crime has become far more powerful and you just don't have the capacity to
structure a law enforcement or police body that can confront this. And so, the answer has been meeting violence with violence. Sending out highly
trained marines and soldiers to combat the cartels.
But in the end, it's just sort of the same reckless cycle of violence. And none of the actual originating factors of this violence are being
corrected. They're just being amplified.
GOLODRYGA: And corruption has played a huge role in this as well. Tell us about the Zetas cartel. brutal, brutal cartel that you described. Behead
people, dissolve bodies in acids, even made people fight to the death just for their amusement. A sick mindset here. This is ultimately the cartel
that killed Karen. Tell us more about them.
AHMED: Exactly. So, the Zetas were a wing of a much older cartel that began around the 1930s. Ironically smuggling alcohol into the United States
during Prohibition. Over time, that cartel switched from smuggling contraband across the U.S. border to smuggling cocaine, and it became a
hugely profitable business.
As that cartel evolved and as the war on drugs started to begin, the leader of the cartel, who, sometime in the late '90s, decided he needed an armed
wing. Essentially, as politics and power were changing in Mexico, he kind of had this epiphany that violence was going to be the new currency of
power, this sort of dark pioneering vision for the future.
So, he hired a bunch of former -- actually active Mexican special forces soldiers. And those -- that group became the Zetas. And they were sort of
his armed wing. They battled other cartels. And eventually, they came to take a very prominent role in this cartel.
And where the book sort of -- I think, what the book is trying to do is essentially explain how this cartel and the genesis of this cartel explains
in some ways the genesis of, you know, the failure of the state in Mexico.
So, the Zetas and the Gulf Cartel, who are partners, eventually break. And that war is what Miriam Rodriguez and her family are trapped in the middle
of. Because it takes place in this state right on the border with the United States, Tamaulipas. And basically, engulfs the entire state. And
then later, much of the nation in violence, as these two, these two cartels fight it out, and the Mexican government responds to their violence by
militarizing their strategy. And essentially sending in soldiers to fight the Zetas, who themselves were former soldiers.
GOLODRYGA: It's sort of a David and Goliath type of mission that Miriam is on. And she succeeds, quite impressively. I want to read an extract from
the book here before we get to what she was determined to spend the rest of her life doing and fighting for. She said, well, it's been a month and they
are not going to bring her back to me, Miriam said.
I know this in my heart, as a mother. She said that Karen was never coming home, at least not in the way Miriam had once hoped, because Karen, her
youngest, was dead. There was no self-pity in her voice, no tears or currents of pain spread across her face. She stood for a moment, choosing
her words. For the rest of my life, with the time that I have, I'm going to find the people who did this to my daughter, Miriam said. And I'm going to
make them pay.
And make them pay she did. At least five of her targets got arrested, six more died at the hands of Mexican Marines, until she ultimately succumbed
to these cartels and was killed on Mexico's Mother's Day, right, in 2017.
AHMED: Yes. No, it was -- it's an extraordinary tale because, again, there are so many people, you can lose count of the number of people who have
suffered tragedy in Mexico. And many of them have to go on living in this sort of hollow state, missing their children, missing their husbands. And
Miriam sort of became entrepreneurial in her grief.
She found a way to channel that pain into rage and purpose. And she did something extraordinary. And it was one of the reasons that I thought her
story could be a stand in for so many other stories and a vehicle to describe what's happening in Mexico.
I mean, the lengths she went to were incredible. She wore disguises, she dyed her hair. She would stake out homes where she believed the cartel
members were living for days on end without leaving the abandoned house from which she was operating. She would go into these open desert areas and
begin searching for remains.
One of the tragic elements of the disappeared is that people are so desperate to find their loved ones, they just dig holes in deserts and in
mountains hoping they might strike or get lucky. You know, sometimes they have evidence that says maybe someone's there, but other times it's just
it's all they can do.
And I think for her, as she said, you know, with the life that I have left, you know, she, in many ways, was upholding the most -- you know, the most
sacred pact in the world between a mother and it's -- and her child, and that was essentially what drove this entire quest.
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And there are elements of this which are, you know, straight out of a Hollywood movie. It is action-packed and like thrilling. And you see her
succeed and you see these people tremble before her. You see these inept and corrupt and in different state officials tremble before. But
ultimately, it's also, you know, a tale of kind of the -- I guess the inescapable cycles of violence and corruption that many Mexicans, millions
live in.
GOLODRYGA: And, Azam Ahmed, thank you so much for telling us this story that we know as in the intro noted that so many Mexican journalists there
also are trying to investigate and sadly putting their lives on the line as well. Thank you for your reporting. Thank you for bringing this really
heartbreaking but really powerful story. We appreciate it.
AHMED: Thank you so much for your time. It's great to be here.
GOLODRYGA: Well, turning now to the end-of-life care in the United States, an emotional time for so many families and also a time for many who are
forced into financial ruin.
Reporters Reed Abelson from "The New York Times" and Jordan Rau from KFF Health News talked to dozens of families and experts about the tremendous
toll of taking care of dying loved ones in a country with no coherent elderly care system. Their "New York Times" series is called "Dying Broke,"
and here they are talking to Hari Sreenivasan.
(BEGIN VIDEO TAPE)
HARI SREENIVASAN, CNN INTERNATIONAL CORRESPONDENT: Bianna, thanks. Reed Abelson of "The New York Times" and Jordan Rau of KFF Health News, thank
you both for joining us.
When you were starting out to do this series, "Dying Broke," what were you setting out to find?
REED ABELSON, REPORTER, THE NEW YORK TIMES: I think we wanted to learn what people's experience is and trying to be able both to find, but also very
importantly to afford care when they get older.
SREENIVASAN: Jordan, what are the kind of assumptions that we all have about how our elder care is going to go that, well, your series really
challenges?
JORDAN RAU, SENIOR CORRESPONDENT, KFF HEALTH NEWS: Well, one of the big ones is that so many people think that Medicare covers long-term care, and
it doesn't. So, long-term care is, you know, if you need a personal aid to help you because you have dementia or if you need help going to the
bathroom or whatever, and it's totally separate.
And that's really why we wanted to focus on this area because there's a huge gap, and private insurance doesn't cover it and people think that it
might, and Medicare doesn't cover it and they are surprised and their children are surprised when they get to this stage that they're on their
own financially.
SREENIVASAN: Reed, you know, Jordan just touched on a subject, which is really just kind of the definition of -- and our understanding of what
long-term care means, because it's easy to kind of fall into a trap saying, well, no, no, that's not going to be something that I need in the future. I
don't need, you know, fully assisted living, et cetera, et cetera. Nobody plans for that.
ABELSON: Well, some people do plan for it because they save money for their retirement and they assume that when they get older, they may need a little
bit of help. But I think people have no idea of the staggering costs of an assisted living facility or even a home aid. And so, they really -- you
know, the vast majority of people simply can't save enough for these costs, and I think that's what the series really underscores.
SREENIVASAN: What are some examples? What kind of costs are we talking about?
ABELSON: Well, I mean, a nursing home or assisted living facility, I mean, we're talking about tens of thousands a year. A home aid. It depends on how
much help you need. But, you know, again, that can be tens of thousands. Nursing homes are easily over 100,000, you know, a high-end assisted living
facility is -- it can start being that much.
And, you know, if you're talking about several years, if you're talking about living there for more than a year or two, you find that you wipe out
your savings. And most people actually find that they're caught in the middle, that they don't qualify for Medicaid, which is the state federal
program for the poor, but they really can't afford care on their own.
And so, many people will actually go without care. And I think the series looked at various examples of that.
SREENIVASAN: Jordan, one of the stats that leapt out to me when we're talking about costs here is that almost half of upper middle-class couples
with lifetime earnings of more than $4.75 million will also end up on Medicaid. Tell me about how it is that this system is structured where you
have to exhaust what might be your life savings to qualify?
RAU: The system is set up, and it varies from state to state, but the -- most Medicaid programs require you to only have $2,000 or $3,000 before you
can get coverage and they also require you to exhaust most of your assets, and they're very, very complicated rules in each state about, you know,
what happens if the spouse is there and how do they get their money?
[13:35:00]
Reed and I interviewed people that were trying to figure out how to do this and basically impoverish themselves so that they could get the care, and
they had to hire private lawyers for the help. So, you've got a system for the poor that costs money to access it.
SREENIVASAN: How much, for example, does Alzheimer's or having cancer at an old age complicate the cost of care? Because I have to imagine that a
facility that needs to keep its door locked to make sure that people aren't wandering out if they have, you know, dementia is going to be more
expensive.
ABELSON: A place like that is going to be more expensive, but it's also going to be harder to find. That's one of the things that struck me is that
even people who really wanted to place their loved one in a facility because that's where it was safer sometimes really had very few options,
particularly under Medicaid.
RAU: You know, a lot of these people have substantial medical needs and there's an additional financial cost to that and there is also a huge
logistical cost. I mean, if you have to go to get chemo somewhere because you have cancer, that's a whole extra thing. The transportation is a huge
issue.
And so, you know, having, you know, both of these areas in the American healthcare system filled with sort of pitfalls and trenches that you could
slip into and then, you know, having to deal with the double issues at once, make it even more perilous for people and more financially brutal.
SREENIVASAN: Give me an idea of how many families are facing these stresses right now, what are the actual numbers?
RAU: It depends on how you define it. I mean, we look what we were curious about for our data part of it, was we took a very conservative definition
of who needed long-term care and found that about 8 million people needed it who are older and about 3 million of those were not getting anything,
but that doesn't count a whole bunch of things. That's really like at the point that you would qualify for being an assisted living or nursing home
or such. It's everybody.
I mean, everybody who has a relative, and one of the reasons that this series resonated so much is that, I mean, everybody, either themselves has
gone through this, is expecting to go through it has it right now or has friends to know it through. And what we tried to do for those people was to
connect the dots, because it's such a disparate system.
But no one is -- and of course, you know, all of us are in danger as well. So, it's as universal problem as you can get in health care, I think.
SREENIVASAN: Let's talk a little bit about what's happening to all of the people around the individual that needs the long-term care. I mean, you
spoke to so many different people who are in really different levels of mental, emotional, financial stress.
ABELSON: I think what was striking is how much people sacrificed for their loved ones. You know, I talked to Phelan Lewis (ph), who was you know, in
England, had a promising career. She had to give it all up to move home to take care of her mother, who had had a stroke. She incurred debt. She
really worried about being able, at some point, to move, -- you know, to get her own life in order.
I think people sacrifice all the time. It's fascinating. I think Jordan and I found families who, you know, moved an older relative into their own home
and really sort of changed their life to be able to accommodate that person.
Yes, there's a tremendous both financial cost, you know, that the -- you know, deciding not to work, for example, or cutting back on work, incurring
debt. But there's a real emotional cost too, and many of these families had children that they were also juggling along with older relatives. So, it's
a very tough situation.
SREENIVASAN: One of the folks in your story, I want to get to is Gay Glenn and her mother, Betty Mae. They live in a nursing home in Kansas until she
died in October. Tell me a little bit about their story.
RAU: Yes. I mean, Gay is a really tremendous person. She lived in -- she's about 60. She lived in Chicago. And when her mother needed care, she moved
back to her home in Kansas.
And the mother was in -- Betty Mae, before she passed, she was in a nursing home and got private pay and Gay had to manage all of that. And at the same
time, she was living to have very modest -- two modest rental places. She was living in one of those, and she has to pay rent to her mother under
Medicaid rules, because you -- otherwise they would have had to sell it.
So, she, you know, went into her own financial troubles, you know, just to take care of her mother. And then, you know, at the same time, they had to
sell the mother's house, because the way Medicaid works is after you die, while you're allowed to keep a residence, you eventually have to repay
Medicaid with your estate's assets.
[13:40:00]
So, it was, you know, both financially and emotionally to have to be doing all these things at once, being there for your mother in the nursing home,
you know, taking care of yourself financially. These are all the things that Gay had to work through for multiple years.
SREENIVASAN: You know, one of the stories that you really dug deep on was the challenge to find labor to be able to -- even if you can afford a home
health aid to do this, what's happening with the agencies? What's that marketplace like?
ABELSON: So, there has always been a chronic shortage, but it's gotten much worse as the job market in general has become stronger. And quite frankly,
you know, these are low paying, very hard jobs. So, it's very hard to fill. There's no question that the gap, there's already a gap. So, people
struggle to find workers, and you struggle to find workers even under public programs like Medicaid.
Similarly, though, it seems in the private market and the public markets, the situation is only going to get worse. There's a lot of talk about how
to, you know, build a workforce where people are available to help older Americans. But so far, it just looks very scary.
SREENIVASAN: What are the costs that we are not planning for? What surprised you as like, you know, a consistent theme that came up in your
reporting that you wish more people knew about and thought about in terms of planning for their retirement or even long-term care?
ABELSON: I think personally what surprised me is how little planning and how little discussion public -- when I say public discussion, I mean,
discussion among families before something happened.
There's a tendency just not to talk about it, for parents not to talk about their finances with their children, not to talk about their wishes with
their children. It's almost as if we just hope if we don't talk about it, it won't happen.
RAU: Yes. I mean, the other problem with this, in particular, of long-term care is there's a limit to how much planning you can do. I mean, you can't
plan to not have dementia. You can't plan when that hit. You can't plan if you fall and suddenly you can't take care of yourself.
You can't plan when your spouse dies. And so, that's one of the big problems is you've got this thing that is so unpredictable happens to, you
know, everyone in -- you know, or everyone's at risk, and it's the area of the health care system that has the fewest institutional guardrails.
SREENIVASAN: So, Reed, does it make a difference if we start planning in our 40s and our 50s? You know, somebody's going to watch this and say,
well, if I spend everything, I'm going to have to exhaust it all anyway before I qualify for Medicaid.
ABELSON: Well, I do think saving does help, although I think Jordan is perfectly right in saying that you can't save your way out of basically
what can be a catastrophic event. I mean, if you have -- you know, if you need 24/7 care for 10 years, it's really unlikely -- even five years, it's
so unlikely you're going to have been able to save enough.
But I think it's important at least to start looking at your options and to start thinking about it. Again, one of the things both actually, in terms
of the readers' comments and in general in the reporting, I was struck by how resilient people are. People can be very creative in finding solutions.
And so, it's important to start thinking about that early and start talking about that early.
SREENIVASAN: So, Jordan, if we lack the kind of institutional guardrails, is there any kind of role for state government and a federal government to
play? And have we taken those steps? Have we tried to take those steps?
RAU: Well, we've tried. One of the -- and failed on a national level. We have failed on that. There was a provision, that was a voluntary insurance
provision in the Affordable Care Act, and it was repealed even before taking effect because it was unworkable.
So, on the federal level, there's very little movement except for a tiny bit of tinkering around Medicaid. There are some places, the State of
Washington has instituted a mandatory long-term care insurance program. So, that's an example where workers can get it, you know, if you're fully paid
in about $36,000 to pay for long-term care. So, that is something. But, you know, if the average, you know, assisted living facilities, $60,000, you
know, you can do the math and see that you -- that even that's not going to go for as long. So, there are little efforts like that.
[13:45:00]
?Our State of California is changing its law so that it's a little bit easier to have more assets and get on Medicaid. There's some of that, but
it's all very piecemeal. And overall, I think we were struck by the fact that there's so little political movement on this and it's been the case
for so many years that it's almost people -- it's not almost, it is, people just take it for granted. This is the way it is. It's not like a lot of
these other battles over, say, prescription drugs where there's an active discussion on Capitol Hill.
SREENIVASAN: If this is the kind of state of play in the United States, are there other countries that we can look at as models that we might be able
to learn from?
RAU: We looked at a lot of countries. We looked at five in particular in this series, and I mean, the big problem is that there's not -- there's no
momentum for a mandatory social insurance program in the United States.
So, you rule out the Netherlands. You rule out, you know, a lot of your northern countries. There are some programs in other countries that do do
interesting things. I mean, Japan, I was really struck by. They have case workers who are assigned to each -- to everyone. And they get -- you know,
they have about a caseload of about 40 people, but just to have a navigator who helps out is something that is in a systemic change.
But, again, one of the things that I was struck in the reporting was how many problems there are in the foreign countries, too. They're grappling
with this as well. They have the same aging infrastructure problem. And their long-term care programs are not as radically different in places like
Canada and England as you would think that they would be, right? Those are places that they have, you know, centralized public medical systems, but
that's not the case with long-term care.
So, I mean, the United States, you know, we have this great chart in this series that shows where the United States is, in terms of spending, on
long-term care, and we are way down there for wealthy countries, but everyone has got the problem.
SREENIVASAN: What happens to the caregivers in this process? Let's say if you are caring for your own family member, when there's an inevitable end
to this, whether they see this as almost a sense of relief.
RAU: We actually -- well, there was people that I talked to and I assume that we did too, who've said that, who said, you know, there's a part of me
that just wants this to over, and not just for themselves, but also for, you know, their parents.
I mean, if you're in, you know, incredible pain or you're just so deep into dementia, you don't know where you are, that's a painful way to live and to
see someone that you love live that way.
And for the caregivers, there's -- you know, there's a financial issue, the sacrifices that they have to make in terms of their own career and earning
power, which then, of course, becomes a future problem for their own financial solvency when they reach their stage. And then it exacerbates the
family stresses. And it's everything. So, it's just a, a very, very, very difficult thing to be a caregiver.
SREENIVASAN: Reed, President Biden, recently signed an executive order that was supposed to help the pay and working conditions of home health care
aides and workers, is that going to make a difference?
ABELSON: I think it's going to make a difference if it actually translates into something, right? I mean, for example, there's a proposal in Medicaid
to make sure that more of the money that goes to the agencies actually flows to the individuals providing work, but that's a proposed rule. It
hasn't happened yet.
And, you know, while intentions are really important, it's very important to make sure that actually it translates into actual laws or new
regulations. And so far, that's been disappointing. Congress hasn't been willing to really take this on. I think the fundamental issue is that all
of this cost's money. And the Republicans aren't interested in spending that money. And, you know, the Democrats have a long list of priorities.
So, who knows whether at some point there will be real appetite to spend money and actually make some real changes.
SREENIVASAN: Reed Abelson of "The New York Times" and Jordan Rau, KFF Health News, thank you both. The series called "Dying Broke." You can find
it in "The New York Times."
ABELSON: Thank you very much.
RAU: Thank you.
(END VIDEO TAPE)
GOLODRYGA: And finally, there's a special joy in hearing old-time music played by a brilliant young musician. That's why 18-year-old banjo virtuoso
Nora Brown is so extraordinary.
Since she first picked up a ukulele at age six, Brown immersed herself in folk music, recording three full length albums before starting college.
Here's a clip of Nora playing the traditional tune "Hop High" on a historic gourd banjo.
(BEGIN VIDEO CLIP)
(MUSIC PLAYING)
(END VIDEO CLIP)
GOLODRYGA: Her latest EP is called "Lady of the Lake." And Nora Brown joins me now from Yale University in New Haven, Connecticut. Nora, it is
good to see you.
[13:50:00]
So, in addition to being a star musician, you have enough time to attend Ivy League University. We could have a whole other segment to talk about
time management next time. But let's talk about your passion for music, because we typically start these conversations by saying or asking, what
drew you to an instrument?
What drew you to a genre? And that's a difficult question for you to answer because you started playing the ukulele at the age of six. So, I won't ask
what drew you to it. But what are some of your earliest memories playing the instrument?
NORA BROWN, BANJOIST AND SINGER: Yes, sure. Well, I think I remember like the first lesson I ever took. I was learning from a Brooklyn musician and a
historian, really like important person in the Brooklyn old-time scene. His name was Shlomo Pestcoe.
I remember going to his house and like I think I had practiced "You Are My Sunshine" to kind of show I had been working on the ukulele a little bit
before the lesson. I remember like messing up and was like, oh, my gosh, being upset about that.
But yes, I don't know. I have a lot of fond memories of -- that's like I guess my earliest one. But yes, fond memories of taking lessons with
Shlomo. And yes, we'd learn lots of old-time songs and just playing and singing them on the ukulele. And, you know, once I'd pick one up, he would,
like, play fiddle with me or play banjo and it was always, like, the best thing to be able to, you know, engage in music that way, which is, you
know, so important to this tradition.
GOLODRYGA: Well, we're watching -- we're looking at ages of you --
BROWN: So, I'm glad he got me started on that early on.
GOLODRYGA: We're looking at a video of you as a little girl playing the banjo. But it was your time with Shlomo which sadly came to an end when he
passed away. But at that time, you transitioned from the ukulele to moving on to the instrument of the banjo. And playing old-time music, which is
fascinating that someone your age would be interested in this particular genre. Explain to our viewers what old-time music is.
BROWN: Sure, yes Well, old-time music is traditional American music. Placing it in context, it's kind of music before bluegrass that kind of
informed those genres of bluegrass and old country music and folk music.
But you know, it ranges from fiddle tunes, where you're just hearing, you know, fiddle play instrumental tunes. But also, lots of songs. And there's
a great ballad tradition as well, an a cappella ballad. It's kind of -- you know, the borders are kind of blurry on what belongs in what tradition. But
yes, I'd say old-time music is the music that's, you know, passed down through many generations. It's that type of traditional music.
It's very old, coming from, you know, different places. You know, the banjo is an African instrument, so we're getting a lot of West African influences
there through that instrument, but also, you know, there's lots of these broadside ballads coming from like England and Ireland influencing lots of
lyrics and, you know, it's a whole thing to research, I guess.
GOLODRYGA: Yes. And --
BROWN: Lots of different sides to it.
GOLODRYGA: And I love the role your family and your parents, particularly your father, plays in your career and your life thus far. I know he played
with you. He actually is a huge supporter of yours, and that is really critical given how young you were when you started down this career path. I
would imagine you owe a lot to your parents.
BROWN: Yes, yes, that's true. I definitely do. It's very important to -- you know, well, this is obvious, but to have people around you who are
encouraging you and supporting you especially with music like this, I have a lot to thank my family for, especially my dad for --
GOLODRYGA: Yes.
BROWN: -- you know -- yes. He --
GOLODRYGA: Well, I know --
BROWN: On all different points, logistically as well as musically.
GOLODRYGA: Yes. Well, I know you have something to play for us as well. Love to hear it.
BROWN: Yes, sure. I'll play some "Jenny Put the Kettle On." This is a Virgil Anderson tune.
(MUSIC PLAYING)
[13:55:00]
GOLODRYGA: Nora Brown, amazing. Thank you so much and best of luck with your bright future ahead of you. We appreciate the time.
BROWN: Thank you. Thank you.
GOLODRYGA: And just a note, tonight, we've taken you around the world discussing astonishing and important stories, brought you some incredible
music as well. Well, we want to tell you that none of this would be possible without our equally astounding executive editor, Annabel, who
after more than a decade on the program is breaking our hearts and moving on to greener pastures, even though we have tried, we have tried to keep
her selfishly with us.
This show has gone from strength to strength to more strength under her leadership and winning three Emmys along the way.
So, the entire Amanpour team wanted to surprise her at the end of her final program with us to wish her the best of luck in the future and tell her how
much we are going to miss her. This isn't goodbye, Annabel. You always have a home with us at CNN, with Amanpour. We are cheering you on along the way.
Thank you for everything.
And thank you so much for watching. That is it for this hour. Goodbye from New York.
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[14:00:00]
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