The Joe Walker Podcast - Deaths Of Despair And The Future Of Capitalism — Angus Deaton

Episode Date: January 11, 2021

Sir Angus Deaton is a Nobel Prize-winning economist and coauthor of Deaths of Despair and the Future of Capitalism.Read the full transcript at: josephnoelwalker.com/deatonSee omnystudio.com/listener for privacy information.

You're listening to the Jolly Swagman Podcast. Here's your host, Joe Walker. Swagman and Swaggets, welcome back. Welcome to a new year on the Jolly Swagman Podcast. 2021 is set to be the best year yet for this humble Australian outfit, and I'm very excited by what's in store. Please make sure you subscribe to or follow the podcast, depending on which app you use, to ensure that you never miss a new episode. This year, we're aiming to release episodes every Monday, Australian Eastern Standard

Time. Here's what you can expect. First, I will continue to increase the depth of research and quality of conversations. Second, the mix of topics and guests will continue to be idiosyncratic. I'll avoid the tendency for shows to become slowly captured by their own audience. All people, including me, enjoy the warm, fuzzy feeling of having their pre-existing views validated, of hearing their fave author interviewed about their pet topic. So naturally, there's a strong incentive to just keep feeding an audience more and more of what they want. At risk of veering into a gratuitous elevator pitch, just let me say, not on the Jolly Swagman podcast. Here, we'll do our best to find golden nuggets of truth in a hopelessly complex and complicated world. My views and interests will evolve along the way. I'll seek to challenge myself, my guests, and you, and hopefully we'll have some fun along the way.

Third and finally, we now have transcripts available for new episodes going forward. These transcripts cost money to produce, but I won't be putting them behind any paywall. They'll be freely available on the relevant episode pages on my website, starting with today's episode, which I will now introduce. A catastrophe has been slowly unfolding in American capitalism. The white working class has been denuded, its way of life hollowed out, until now people are dying in their droves. Dying deaths of despair. This episode is essentially about two historic points of inflection. The first historic point of inflection is a change in mortality rates. The 20th century saw such steady improvements in health that by 2000, continuously

increasing life expectancy was the default assumption. Children lived longer than their parents who lived longer than their parents. The mortality rate for whites aged 45 to 54 in the United States was 1,500 per 100,000 people in the year 1900, and by the new millennium it had fallen to 400 per 100,000 people. But then something broke. In contrast to other rich countries where mortality continued to fall, for midlife whites in the United States, mortality stopped falling altogether and began to rise. The cause was stalling progress in heart disease on the one hand, and, more disturbingly on the other, increasing deaths of despair. Deaths of despair refers to deaths by suicide, drug overdose, or alcoholic liver disease. But did the risk of dying deaths of despair increase for all middle-aged whites?

The short answer is no. And this brings us to the second historic point of inflection. The key to understanding which middle-aged whites are dying and which are not is education. For more than a century, suicides were more common among the educated. The hard edge of enlightenment was that it unmoored a person from her family and community. But that is no longer true. Over the past 25 years, deaths of despair have barely risen among middle-aged whites with at least a college degree, whereas among those without a college degree, they have tripled.

For those born in 1980, whites without a BA are four times more likely to commit suicide than those with a BA. Black people with BAs are now more likely to live through midlife than white people without them. What was once called the blue-collar aristocracy in America is now being destroyed. in 2017 for middle-aged whites, 600,000 more people, 600,000 individuals, men and women, would be alive today. The deaths of despair disaster was discovered by my guest and his wife and collaborator. Angus Deaton is an economics professor at Princeton University, and in 2015, he won the Nobel Prize in Economic Sciences. Along with his wife, Anne Case, he is the co-author of a brilliant book which came out last year titled Deaths of Despair and the Future of Capitalism, which builds on the

couple's extraordinarily influential research and whose title I have borrowed for this episode. The subject matter of this episode is distressing. If you are having thoughts of suicide, help is always available. In Australia, you can call Lifeline at 13 1114. In the US, you can call the National Suicide Prevention Lifeline at 1800 2738255. In the UK, you can call Samaritans at 116-123. And wherever you are, you can find additional resources at iasp.info. Without much further ado, here is my conversation with the great Angus Deaton.

Angus Deaton, welcome to the show. Thank you. Pleased to be here. It's a real honor to speak with you, sir. And we're going to cover many topics of great import, but I thought we could begin with your background. And I thought we could start with your family. Tell me about your father, Leslie Harold Deaton. My dad grew up in a mining village in Yorkshire. He was actually born in the year of the last pandemic, the 1918 flu pandemic. And then I guess, you know, his father worked down the mine, though I think in a fairly supervisory role, but he was down the mine.

And he always wanted to get out of there. And I think he was not well educated. He left school, I think, when he was 12 or so. They didn't really have high school for kids in those villages. But he was drafted into the army on his 21st birthday in 1939. And then he got tuberculosis during the war and spent some years in a sanitarium and was eventually invalided out of the army in Scotland where he'd been training. And met my mother there and they settled in Scotland.

And he went to night school to try and make up for his education or lack of it. And he went to what is now the Harriet Watt University. It was night school in those days and took many, many years to eventually get the sort of equivalent of a high school degree and then a university degree and then a degree as a civil engineer.

And he finished up being the water engineer for the Southwest Company. But he was always very determined that I get a better education than he'd had, and he certainly succeeded in pushing me in that direction. And how did he succeed? Well, I mean, he made it clear that for him, you know, education was a big deal. And actually, when I was just a kid and we lived in Edinburgh, we used to take walks on Sundays. My dad was often not there because he was working for a firm of civil engineering.

And he would go off on expeditions. And so I used to love going, walking with him. And we'd often go to the Botanical Gardens in Edinburgh. And next to the Botanical Gardens was the school, Feddes College, which he had found out somewhere was a very, very good school, perhaps the best school in Scotland. And he said his ambition was for me to go there. And he knew he couldn't afford it

because the fees were a very large fraction of his salary. But there was a couple of scholarships every year and he managed to persuade the teachers in my high school in Hawick, which was a pretty amazing thing, to give me special training to take these exams. And so I got a scholarship and went to FedEx. Was that typical for a Scotsman of his generation, who was also uneducated, to be so focused on educating his children? Well, he wasn't a Scotsman. I mean, he grew up in Yorkshire. And so he settled in Scotland once he met my mom. So the Scots were typically, they leastly liked to think of themselves as much more keen on education than the English are. But actually it was my dad and not my... I've always assumed it was

because he really didn't much like this mining village. There was a lot of drinking, a lot of early death. And he was, you know, a smart kid who, I think there was one kid in their school who was allowed to go to high school and he was not it. And I think he always felt that very sharply and wanted to make sure that that didn't happen to me. Angus, I'm a walker, but on mum's side of the family, we're McIntyres. And I've actually still got some family in Edinburgh. Martin McIntyre, who's a Gaelic poet and doctor. But my grandfather, my maternal grandfather, was born in South Uist, which is a very rugged and remote island.

Yeah, I've been there. Yeah, grew up sleeping on hay. And then by virtue of some hard work and scholarships, managed to get himself educated. But it was a struggle, that's for sure. It was even a struggle. I mean, I was very fortunate. I had three cousins who I was very fond of who lived in the Scottish borders when we first went there. And they gave up on trying to find work.

His dad worked on the railway. The railway was closed by Dr. Beecham. He had a second job on a farm. And then when the railway job went, they couldn't keep body and soul together. So they all went to Australia. And they all live in and around Melbourne now. Nice. I read that your father refused to pay for you to renew your fishing license one year

because there wasn't enough money. Were family conversations preoccupied with money when you were growing up? There was certainly a lot of it. It was very tough for them, I think. And there may have been other things that I didn't know about at the time, which meant there was a real shortage of money. But, you know, my father kept a little black book and he wrote down every single thing he spent, you know. And he was very, very careful with money. And I think he thought that, you know,

I didn't inherit enough of that, which is probably true. Do you like Edinburgh? Yeah, very much. And it's been very sad. We would have been there this last summer. And I'm hoping I'm invited. You know that they've restored Adam Smith's final house, Panmure House in Edinburgh.

And I'm giving the Adam Smith lecture there in the spring. But unfortunately, I'll be doing it like this, I'm afraid. Though they promised I can take a rain check on the visit. But yeah, I love Edinburgh. Yeah. Having done a little bit of travel around Europe, I'd have to say it's probably my favorite city in Europe, at least aesthetically.

But what would you say is the most underrated thing about Edinburgh? I don't know. You know, I haven't been there. I haven't lived there for a really long time. Yeah. But, you know, we always used to make fun of Scottish food, and that's not really true anymore. Edinburgh is a good place to eat.

And, of course, the festival meant a lot to me when I was a kid, and it was really before the French started, but when I was at FedEx, we would go in the summer and hear fabulous music. Yeah, my impression of Scottish cuisine was that it was very path dependent and was originally probably poverty food. And there's really no reason to continue eating haggis in today's day and age, but that's my subjective tastes. Angus, as a poor kid who made good, how do you think about the notion of meritocracy? Well, I think meritocracy is great.

It was great for me. But I think, you know, you certainly think it's a good idea that the people who know how to do things do things. You know, you'd like your pilot to have a pilot license rather than be a randomly selected guy on the street sort of idea. Ideally. And I wouldn't be talking to you if you hadn't made your way up

through the competitive business of podcasting or whatever it is. But it's... So, yes. and you know, no one wants to go back to the time when everything went to the, you know, the children of the aristocrats and so on. But it's become clear recently,

and you've read The Deaths of Despair, that, you know, we and quite a few other of today's writers are exploring the much darker sides of meritocracy and, you know, thinking that the meritocracy has something to do with the emergence of disenfranchised populist classes in the U.S. and in Europe, too. I mean, it's probably sharpest in Eastern Europe

where under communism, there was really no way of getting out of those places. And so we all rejoiced when it was opened up and these kids could then go abroad to go to school and so on. But if you send, if Bulgaria sends all its best kids to Harvard or other universities around the U.S., the IMF is now populated with Bulgarians,

including its managing director. But there are lots of Bulgarians, very talented Bulgarians, but all of those people are not in Bulgaria. And there's been huge exodus out of these countries and a huge demographic outpouring too. And I think, you know, that's been a problem that they don't even have their own Maricrats at home. But even in the U.S., you know, you've got this ruling class, the educated elite, that, you know, is not very responsive to the people who didn't go to college. And in many ways looks down on them. Yes.

You know, Hillary Clinton's comment about the deplorables is a sort of almost perfect synthesis of those views. And it was a disaster and it remains a disaster. Yeah, it really struck a nerve, that word. You became an economist almost by accident and with little formal training. How do you think about self-education? Is it more of a blessing? Is it more of a curse? Well, to say that I was self-educated,

I mean, maybe I'm a little bit self-educated instead of economist, but I wasn't self-educated. I mean, you know, I went to a very fancy private school in Edinburgh with wonderful teachers. And I went to Cambridge to study mathematics. And, you know, I got tired of that about the same time they got tired of me. And so I fell into economics. But I do think that there's something to be said for, you know,

I've learned a lot in a long career. And I'm always finding new techniques that I didn't know about or new data sets or new problems. And there is a tendency to remember things that you learn for yourself rather than are drilled into you. But I've always been in places where I had wonderful colleagues who would teach me, who would help me. You know, so when I'd be giving up, beating my head against the wall, trying to read some paper that I didn't understand, I would go and ask someone, and they would often tell me. It's amazing in academia how little people ask other people to help them.

And people love helping people, I think. Do you think that's because nobody wants to expose themselves as a fool? Yes, exactly. Yes. And it's a big problem in teaching in graduate school here that, you know, the kids won't put their hand up and say, I don't understand that. Or a few of them will, and they're worth their weight in gold, but the others all don't want to show their compatriots that they're missing out on this.

A key theme of your career as an economist seems to be the question of measurement and epistemology more broadly. And I don't want to go into all of that, but I thought I might just ask you one question about causality in economics and whether observations made in the absence of and stand on your feet in the morning, didn't come about through RCTs. There's also a lot of even drug knowledge. Like, you know, there's been lots of RCTs using aspirin, but I think the basic RCT on whether aspirin cures a headache is something that I don't believe there's been an RCT on, and we don't need one on because we know it works. And there's a huge amount of things like that that we know work for which there really hasn't been any, you know, very good, or there hasn't been an RCT. So there's certainly plenty of knowledge and plenty of causal knowledge without RCTs.

There's certainly some causal knowledge that's come from RCTs, but it's certainly not the only way of getting there. And often it's not as good as it seems. Do you think RCTs have been fetishized in development economics? Yeah, for sure. I would love to see, well, I'm not totally convinced that they've done much to reduce poverty in the world, which was the aim of them. And is the main problem external validity? That's one problem. There's a lot of problems with even internal validity. And actually, you know, part of the issue is people expect too much of them and they think they reveal the truth. And quite often you can catch people actually saying that.

They say we know it's true because we did a randomized controlled trial. But randomized controlled trials certainly don't reveal the truth. They give you an estimate, like other statistical procedures, and that estimate has a standard error probability of having arisen entirely by chance. And that's true for all RCTs. There's nothing, you know, they're not constructed in such a way. In fact, in some ways, the ideal experiment is an experiment that a physicist would do in a lab in which you control everything. And in a lot of social scientists, you can't control everything.

And so people rely on a randomized trial. Well, this is sort of weird because a physicist would say, what? You know, I very carefully controlled the air temperature in this room. What do you mean I should set it randomly, right? So random is sort of if you can control, you control. If you can't control, randomize and you'll get the right idea on it. You'll get the right answer on average, maybe. But it's not the gold standard that it seems.

It's actually a fairly weak alternative to what you'd really like to do. And I guess even if you could control everything, it still wouldn't mean that the results are applicable moving into the future because unlike the laws of the universe, the social world isn't stationary. Well, it's not clear that the laws of the universe are stationary either. But yeah, no, and it's often pretty clear that it won't. I mean, I think what's going on right now is very interesting. I mean, I'm not a professional on medical randomized controlled trials,

but the discussions are going on about these different vaccines, whether you should use them sequentially, whether you can mix and match them. And the RCT people have been jumping up and down and saying, different vaccine, whether you should use them sequentially, whether you can mix and match them. And the RCT people have been jumping up and down and saying, I heard someone on the radio this morning saying, you know, the British government is abandoning science, which translated meant there's no randomized controlled trial that supports what they're doing. Right. But the people who are doing it have a very good reanalysis of the data, which certainly makes assumptions. But you always have to make assumptions somewhere,

including in an RCT. And so the idea that anything's not an RCT is not scientific would rule out most of scientific endeavor on the planet but i mean it's clear that there's lots of compromises going on right now which around this vaccine and i think rightly so that compromise any idea this is a pure gold standard that's always the right way to do this so capitalism in my experience is like a one word raw shark test and as john height points out some people hear it as a synonym for liberation others for exploitation and i thought just for the sake of a nice clean conversation we could begin with a definition of capitalism in your eyes i'm not sure definition really helps very much um because then we get back into who used the word first, you know, what did it mean to them, what has it meant historically.

But it's something to do with the largely free market systems that we have in the US and Australia and the UK, in which, you know, production is not controlled by the government, mostly not controlled by the government and there is you know, but I mean the margin which I've been trying to work is the question of you know, variance of capitalism because I don't think

there's really that much option out there right now you know, state driven socialism because I don't think there's really that much option out there right now. You know, state-driven socialism was not a great success. And, you know, it really did undermine people's liberty, and in the end was not very good at producing stuff either. So, you know, the critiques from the right on that, you know, were very much proved to be right. But on the other hand, it's some form of market organization that has hauled a billion people out of poverty around the world.

And it's very hard for me to imagine anything that's very different from what we have now, in a systemic sense, really doing that. That doesn't mean that a lot of it isn't working very well. And I can understand, and I think it's a great danger actually, that there are so many abuses at the edges going on, especially in America, but not just in America, that I can understand, you know, if pharma companies are allowed to poison people for profit. You know, if one of the most respected pharmaceutical companies in America, Johnson & Johnson, you know, is growing opium in Tasmania to feed the epidemic. And if McKinsey,

one of the most respected companies in America, is advising Purdue Pharmaceuticals how to incentivize pharmaceuticals to kill their own pharmacies, to kill their own patients, then you can see if that's capitalism, why most young people don't want to do it. And, you know, that's so I think we anything to do with it. So I think we've got to fix that. Otherwise, we'll lose this great engine that produces stuff and that can keep us healthy and can allow us to enjoy good lives. The Great Escape is the story of that engine and then Deaths of Despair and the Future of Capitalism is kind in rereading The Great Escape, you caused me to go back to the letters between Charles Darwin and his wife and first cousin Emma in 1851, when they're anguishing over the illness of their daughter Annie. And you picked that as sort of an example because Darwin's obviously a famous person, but it serves to illustrate the commonplace

for parents for most of human history, which was there was always the specter of losing one of your children. And perhaps just talk a little bit about that and how we've made such great leaps forward in things like infant mortality yeah well you know i i wanted to back off just a little bit first which is the great escape is not a pollyannish book in that, you know, I never ever claim that progress was smooth, you know, and that real wages and health has improved every day since James Watt invented the steam engine or something of the sort, right? And some of the most awful setbacks have been in the 20th century.

When you think of Mao Zedong and the Great Leap Forward and the 30 million people who died, never mind the Holocaust and all the rest of it. So this is not a smoothly working system. And I mean, I resist a little bit this idea that The Great Escape is an optimistic book and the, you know, Deaths of Despair is saying, well, we got it wrong. And I don't think what's happening now is anything like as bad as, you know, some of those episodes. So with that said, let's go back to Darwin, because I do love that story. And while I don't love the story. I love the humanity of Darwin and how eventually they lost that child, I think. He was always very worried that his wife

was his cousin and that marrying your cousin was a bad idea and might have had something to do with this. But why did we come out of that? I think through human ingenuity, one way or another, at the deepest level, I put a lot of, I think of the Enlightenment as being the hinge around which all this happened at a very deep level, that people just didn't accept their fates and didn't just accept doing what they were told to do by the church or by the state and started thinking out things for themselves. And then when they did that,

you began to get the industrial revolution. You began to get something like capitalism. And, you know, it's not a fail-safe mechanism because, you know, by the time Darwin was there, the Industrial Revolution was really starting. And, you know, for the first half of the 19th century, wages were not rising. Infant mortality was not going down, especially in the cities. But in the

end, it sort of sowed the seeds where we really could come away from this and build on that. And a lot of that was because there were opportunities for people to think up new ways of doing things. And in many cases, they could get rich by figuring out those new things. So they had big incentives. I don't think incentives are the only things that really matter. The Chinese woman who discovered, what's it called, the drug artemisin that goes against malaria

was sort of ordered to go and do that by Chairman Ma she certainly didn't get rich as a result of doing that she was in the Nobel Prize the same year I did so I don't for a minute think you need incentives to do things,

but I think they probably help. And, you know, it's probably true that we want people to invent wonderful new things, whether that make our lives better. And somehow we falter on that in a way that, you know, we should be able to do better. How was Deaths of Despair and the Future of Capitalism born? Anne and I tend to spend our summers in Montana. I used to say we spend every summer in Montana, but we did not this year, though we probably could have done. And, you know, we read and we work and

we go fishing, we go hiking, we cook and all those nice things away from this sort of rather frenetic atmosphere around here. And we were each working on you know, but not totally unrelated things. I'd had a long-term interest in happiness and measures of happiness, and I'd promised to write a paper for a conference about whether happiness and suicide were related or not. So suicide seems to be the ultimate unhappiness. You would have thought that places where there's a lot of suicide are places where people are very unhappy, which turns out not to be true, by and large.

And I was working on that. And Anne, who suffers from quite severe lower back pain of the kind that we describe in the book, was working on pain. And so when we had these suicide numbers and we discovered that there'd been a big upsurge in suicide in middle-aged, among middle-aged white Americans, you know, which is not something we were looking for and knew. And so we're going to have a slide in the deck on that and then I thought well it would be quite good to see is this a big thing or is it

a small thing you know that's what we're all trained in e-learning to check you know here's this thing is it interesting but is it important so we drew a graph which showed total deaths of the same people to see whether suicide was big or small relative to that and that was when we discovered that total deaths were going up in this age group

for white non-Hispanics in middle age and going up quite fast for those without a BA, for instance. So that was the beginning of this. And I think, well, then we looked and said, well, you know, it can't just be suicides. The suicides are not big enough to produce this. So the question was, you know, what else is going on? That's when we discovered opioids, we discovered rising alcoholic liver disease. Actually, in a sense, we made a mistake because we looked for the things that were the rising fastest, which is

where you would start. And so we got these three things, which later, I think Anne in an interview, someone like this one, had called deaths of despair and that sort of caught. But actually, probably the biggest factor going on is the fact that cardiovascular disease, heart disease and stroke, which has been falling quite rapidly in nearly all countries, all rich countries, including Australia, has driven the rapid decline in mortality in the last quarter of the 20th century. It seems to have stopped doing that and is beginning to turn around at different rates in different countries.

But there's so many people who die of cardiovascular disease that even if that slows down and wasn't actually turning around, that's enough to make the total go the wrong way. So at the same time that deaths of despair are increasing, heart disease isn't, like the progress there isn't providing the same fall in mortality rates that it used to. That's right. And that's true to varying degrees in different countries. Some countries are less affected by this than others. There's been pretty much a slowdown everywhere. But in the US,

I think it's pretty unique in having slowed down and beginning to go up. And it's not because you might think, well, we've done so well on this that we've hit the floor. We can't do better than this. And that's not true because other countries have much lower rates of cardiovascular disease than we do. One of the ways your work is commonly misconstrued is that people think that poverty is the source of the deaths of despair, but it's really not.

It has to do with this lack of a four-year college degree. Is that problem unique to the United States? I don't know, and I suspect not, but it's the data don't exist in most other countries. So we've been trying to persuade the British Statistical Office to, and let me back up, U.S. the death certificate for the last 30 years has had education on it. So we download the 40 odd million death certificates and we can look at educational status on each one. And that's how we find these things out. It would be lovely to know what their income was or how much money they had or what occupation they were in,

but we don't know any of that. And to be fair, we don't know their poverty status. But you'd be stretching it quite a lot, especially because for most of the period we worked on, it's not true anymore, African-American mortality was doing just fine. And the poverty rates among African-Americans are much higher than those among whites. So we never really thought of this as really being a story of poverty.

Do you know anything about deaths of despair in Australia? Well, I know you had a drug epidemic, which I think has largely been brought under control. And if Anne were here, she could answer that question much better than I can, because she's been looking at these international data. But I don't want to say something that may not be true. But it's certainly true that when we looked at deaths of despair across countries, it was the English-speaking countries where you see some trace of it in one, two, or three of those categories. And Australia was certainly included in that. Angus, can you just give our listeners a sense of the scale of the problem in the United States? How many deaths are we talking well if you add um suicides and alcoholic liver disease

and um opioids or drug overdoses together um you get it's running at about 160 000 deaths a year so we just got the data for 2019, which was, I think, 164,000. And the two years before that were both 158,000. So there's 340,000 people died of COVID in 20 hours so far. So relative to that, it's about half of that. It's also true that we can hope at least that COVID goes away. It's less obvious that this will go away. I should say that the 160,000 or whatever is too many because that includes all suicides, all drug deaths, and so on. So maybe if you go back to the 90s or something,

they were probably running about 60,000 a year. So there's about 90,000 to 100,000 deaths from this that didn't used to happen and are not happening. And if you go to a country like Germany, there's basically none of these there at all. Suicides, which are rising pretty rapidly in the United States, are falling in pretty much every country in the world. And so the U.S. has got suicide rates that are up near the former countries, the former Soviet Union, which were always the terrible places for suicide.

So, you know, America has really joined a pretty bad club there. Why did Emil Durkheim believe that it was more educated people who killed themselves? I think because if you... Remember, he was writing at a time when there weren't all that many people who were educated. And that's one thing. But it's also this feeling that, you know, to get educated, you move out of the social structure, which is a source of support.

And then you move into another one. And, you know, when I think about it, I think about when I was at Cambridge. And, you know, I had to call my parents every so often and you know like all college students there were times when I was really troubled and I didn't think the academics were doing very well or girls or something right. Well you can never talk about girls for your parents but you could at least talk with about the work in principle. But my parents had no idea what world I was in.

And it was just impossible to talk about the things that meant anything to me. And for them to have any sort of understanding of what that was about. Now, that wouldn't have been true, I guess, if my parents had been educated at the same level. It might have been easier. But I think there is this sense that I think in Durkheim State, many educated people came from places where there was none, and

they didn't, you know, the enlightenment comes with a cost. You break away from religion, you break away from the state, but boy, you're out there on your own now. And those people are not really there to help you. So that would be the broader idea. Why are African Americans much less likely to kill themselves

than are white Americans? Yeah, well, that's a question that's plagued us since the very beginning. So one thing is they are doing it now. Well, no, no, no, okay, sorry. Let me, I leapt ahead to something that was actually not your question. We don't know.

It was true for Durkheim even. He said that Negroes do not kill themselves. And, you know, I don't think there's any super convincing story there. But Durkheim and others sort of thought there was some sense or you know they're capable they're attuned to suffering would be one way of putting it so those rates have always been

low relative to those for whites and also women are much less likely to kill themselves than men too, that's always been true but when I leapt ahead at the beginning it it turned out that there was very little in the way of opioid deaths among african-americans until 2013 and then it happened there too so now you see this happening everywhere yeah right so now people are mixing fentanyl with heroin and crack. Right, right.

In Coming Apart, Charles Murray's book, he lays the problems of less educated whites at the feet of their own lack of industriousness and self, I guess, their own pride. And indeed, to the extent that it has a theme, that's probably also the main theme of J.D. Vance's book, Hillbilly Elegy. Yeah. The problems have an internal source. Do you have much sympathy with that view? A little.

Not much, but some. I mean, Charles Murray is a serious scholar with a very conservative take on these things I mean his book about the whites is very similar to the book he wrote about the blacks in the 1960s sort of idea

and I think the thing that impressed us and actually it was the person who suggested this four days after the deaths of despair paper was published, the first paper was President Obama who said, you know, what you're writing about here happened to the black community in the 60s and 70s. You ought to go back and draw that parallel, which was certainly a very good suggestion. And, you know, when Murray and indeed Daniel Patrick Moynihan wrote about the problems of the Negro family, then it reads like this is what's happening again now.

And, you know, Wilson at Harvard, you know, had basically taken on Charles Murray then and basically said the problem is not within the community itself. It's the fact that jobs have gone away. And what happened was the talented, educated blacks moved out. You were left with dysfunctional pathologies in the center cities. And, you know, a lot of that reads like what's happening now. Now, for us, there's, let me tell you the bit I do agree with and the bit that we have trouble with. The bit we

have trouble with is there's been a fall for more than 50 years. I mean, with the business cycle, but it fluctuates with the business cycle, but the trend is very much down in the employment to population ratio. So, for men, without a BA. And for women it rose like everywhere

in the world until about 2000, but since 2000 it's been going down too. So, why are those people not in the labor force? Well, a lot of them lost their jobs. And, you know, so every time there's a recession, you see a big decline in this ratio, and then it picks up. And then you get another recession, it goes down again, but it never gets back to where it was last time. So there's a ratcheting down of this. And Charles Murray attributes this to lack of industry, lack of industriousness, and that people would rather stay home and play video games than they would, you know, actually go to work.

The trouble with that explanation is that if that's happening, wages should be rising, not falling, you know, sort of econ 101. And sure, there's lots of other things that could be going on and offsetting that, but it's a pretty obvious story. And, you know, you have a pretty good mechanism for why that's the case, that there are less and less jobs

for less educated workers in good firms, that there used to be there. There used to be jobs for drivers and elevator operators, mailroom jobs and transport and, you know, food services and cleaning and security, and food services, and cleaning, and security, all of that, they're all gone. They've all been outsourced to labor supply companies. You can go work for those companies if they're not in Malaysia or somewhere, but they're

not really very good jobs. And so we really do see this as the economy has just turned against those people. The bit where I think Charles Murray is right is the social bit is very hard. And, you know, one big technical innovation here was the contraceptive pill, which the sociologists argue took bargaining power away from young unmarried women who could refuse to have sex unless the guy who promised to marry them.

And with the pill, the responsibility just switched to the woman. And the man said, well, you know, if you're worried about that, go take a pill. And so there was this feeling that things got very much worse for less educated women and both white and black and there became a sort of disintegration in the family which is not happened did not happen among people with the BA degree and you get these so called fragile families that turn this due to my colleagues here in McLennan, in which these cohabitations are serial. They don't last for very long.

They often produce kids, and you get people in their 50s who don't know their kids. You know, it's a mess. And so that social destruction, which has come about partly through the contraceptive pill, but also through changes in social mores, you know, that it used to be, you know got much easier. And so these men got all that additional freedom, but it came back and bit them, you know, 30, 40 years later. And so to summarize, the most elegant critique of Charles Murray's view is that falling wages would suggest that this is more a problem of labor demand than labor supply. Oh, you know, if quantity is going down and price is going down, it's got to be demand.

Makes sense. So what are some of the reasons why deaths of despair have been increasing? Well, I think it's this, I mean, we come back to our discussion about causality here, that there's not a single cause. And, you know, it's like, if you want to trace out these causal things, a lot of it's contingent, it depends what else is happening at the same time and the environment in which it's happening. You know, because the globalization and automation has been hard for less educated workers everywhere in the rich world. It's not just an American problem.

So why is it worse here? And one of the reasons we think is because of the incredible cost of health care here. And we write a lot about that in the book. And the fact that it's done through employment instead of paid for through general taxes. And when it's done through employment, the fact that, you know, the cleaner's health insurance costs about the same as the CEO's health insurance means that the burden of health care and wages is intolerable at the bottom and is not really a significant thing at the top.

So we think that has been destroyed a lot more jobs than needed to be destroyed, even though it's happening everywhere. The other thing which people on the left say, and it may well be true, is most countries have a much more elaborate welfare system, a much more complete welfare system than we do here. So European countries typically have a value-added tax that generates a lot of revenue and that's used to support a welfare state, you know, which provides unemployment benefits and so on. So that's one story.

You've also got this crazy, another strike against health care. You know, other countries don't allow doctors to prescribe heroin. It's huge. I mean, it's not called heroin. It's called OxyContin or something. But, you know, that just doesn't happen in Britain. It doesn't happen in continental Europe. You know, these drugs are used in hospitals. Like if you have a hip replaced, you know,

they might slip you a couple of those for a few days while you're recovering in hospital. But you don't get to take home 100 pills. Your dentist doesn't give them to you when you have a toothache, for instance, all of which happened here. And then once the docs had discovered what they were doing and pulled back, it had ignited a secondary explosion

of illegal drugs after that. And we're still dealing with that. So those are some of the things that are different here. I think the marriage things are a bit different too. The people, European countries seem to have given up. They don't expect everybody to be married anymore. And it doesn't seem to have the same negative consequences that it has here. There's a pretty clear line from unemployment and falling wages to family breakdown, and that is that if men don't have good jobs, then they're not marriageable. Could you draw a line then also rippling further outwards to the breakdown in community that's

been documented by people like Bob Putnam? Is that related to the declining wages, or is that something that's been documented by people like Bob Putnam. Is that related to the declining wages or is that something that's been happening largely separately? No, I think it is related. And Bob Putnam and I talk about this quite a lot. Remember Bob Putnam's guy who was bowling alone was in a union hall, right? Those union halls don't exist anymore because there are hardly any unions left in the private sector. And those unions were, you know, they helped keep people's wages up. They helped keep even their non-membership wages up.

They provided a lot of safety and work condition inspections in factories that, you know, the feds should do but don't have the manpower to do. And they were the center of social life in many times. So, you know, when the power plant goes away and generous motors, as they like to call it, you know, closes its plant, these people are not just deprived of jobs, they're deprived of a social life, they're deprived of a lot of stuff that goes together with that. So I think the decline in unions

is a big part of this story, both directly and indirectly. I also think the unions used to give people a political voice that's not really there anymore. I think this is true in most rich countries too. It used to be, I think you probably have more of it left in Australia than we do, but, you know, in Britain in 1945,

seven members of the Labour cabinet had started work on the coal face. And so these were workers, and they were representing workers and they were not professional politicians, which politicians on the left today are. So I think there's been a real loss of representation among working people, the ability to participate in society. Something like 98% of the U.S. Congress has a BA, and so two-thirds of the population do not. And that's just a terrible source of misrepresentation. And I think that's been very bad for people too.

But Putin also talks about religion and many younger, less educated Americans are drifting away from churches too. Churches have been very much more important here than in most church countries and part of the reason they're drifting away from churches is because the churches have become very right-wing. Not African American churches but a lot of the evangelical churches are seen as being very right wing. And so people, young people are repelled by that. As I think Bob Putnam showed in his book, American Grace, we have this very odd thing in America, which I first thought was really odd,

which is that people choose their religion based on their politics and not the other way around. That is a strangely American thing. And so to the erosion of work and the degradation of community life, we then add at least the perception of a loss of racial privilege. Talk a little bit about that. And this was something that was obviously discussed in the book, but at the same time, it's something that's very difficult to quantify. And it's not really our research area. I mean, we're quoting other people who've written very movingly on this. And it's not that people enjoyed the privilege. I mean, we're quoting other people who've written very movingly on this.

And it's not that people enjoyed the privilege. I mean, I think they had the privilege without particularly knowing it was there. But they're not enjoying the withdrawal of that privilege, which in many cases is all they had. Have you read Ali Hochschild's book, Strangers in Their Own Land? Yes, very much so. No, that's sort of what I'm quoting from here. And she reviewed our book in the New York Times, too, so you can look at the full closure on that feedback loop. But yeah, she talks about people jumping in line and, you know, people who are pursuing their version of the American dream and they can't do it anymore because these jobs will be given up to people who, you know, they don't think really deserve it.

Led by, I think she calls Obama the cutter in line and chief or something of the sort. But that's right. And, you know, the elite universities that have diversified and are taking large percentages of minority kids of one sort or another, there's a lot of resentment on behalf of the people who could have gone to Princeton or Harvard in the old days, but can't anymore. And so fundamentally and ultimately, people feel like they don't really matter to anybody else, whether in their own family or their community or society at large. And that is something that underpins deaths of despair, with Durkheim's conception of suicide, which is that it occurs in the context of a social network that's failed to provide meaning and structure to the individual. Absolutely. I agree with that. And that is not a bad summary of the thesis of the book. I mean, you know, it's one of these interesting things when you think about causal structure.

If you were to ask me what's the proximate cause of someone killing themselves, it may be that, you know, they're an alcoholic or they're addicted to drugs. And that seems like the only way out of that. You know, so it's a pretty bad place to be there. People really do despair because they think they'll never escape from that. Or what would have tipped me over the edge is, you know, if I was 50 years old

and I'd had three sets of kids and I didn't know any of them anymore and I was on my own living in a small apartment somewhere I'd feel my life had been a failure and it wouldn't be very clear to me what was worth living for at that point now of course at that point you're a long way away from you know the labor markets that have not done very well. But, you know, this happens at many levels and it didn't always happen the same way. It's just sort of how the causal structure is wired up in a particular society at a particular time. Though, as you said very nicely, I think there are still these

underlying forces that seem to be there for a long time, like Durkheim. I remember in the book you quote the example of two ladies who were in i think kentucky one her husband blows his brains out with a gun because he's carrying this enormous guilt from his son turning to drugs and the second has cancer and has had lifelong alcoholism along with most of his friends and pours alcohol down his feeding tube directly into his stomach and dies from alcohol poisoning. to drugs and then alcoholism, but then you can start to sort of dig a little deeper and ask, what are the ultimate causes, which I think is sort of the great contribution of this book and the work you've done with Anne. I think just to complete that, the big tell in some ways that we haven't probably emphasized enough is these are not happening among people

who have a BA. We can get addicted just as well as anyone else can get addicted, right? We could become alcoholics, we could become heroin addicts, but we don't. And this education has been a really protective thing for people somehow. And so it's not the labor market's not doing this badly for everybody, it's doing it just for some. In the book, you write that before 1970, there was growth and no increase in inequality. Afterward, there was lower growth and growing inequality. Are those trends interrelated? Yes, but I'm not quite sure in which ways. I mean, there's much slower growth after 1972. Yeah.

So the increase in inequality becomes much more difficult because, you know, we don't mind inequality. You know, there's Hirschman's favorite story of the tunnel, which is, you know, there's two lines of cars stuck in the tunnel, and you're not allowed to change lanes, and they've been stuck for an hour and a half, and then one lane starts moving. And so there's huge amount of inequality, and the lane that's stuck is very pleased because they think, okay, we'll be out of here soon too.

And then, but as time goes on that pleasure turns to suspicion and eventually to outright rage as they see these people doing well when they're not doing well at all so I think the lack of growth has made this much worse than it would otherwise

be I think most of us most people can see other people doing much better than them if they're doing okay, their life is going okay. But if their lives are not going okay, then that's likely to produce a lot of trouble. That doesn't tell you why all this happened. I mean, why growth slowed down. and there's as many stories of that as there are macro companies yeah and maybe maybe even more maybe so your concern is primarily with rent seeking and if the process that generates inequality

is an unfair process if people are sort of pulling the ladders up behind them, that's a problem. But you've got no truck with sort of the makers as opposed to the takers. problem of rent-seeking in America. Perhaps the relationship between stagnation and rent-seeking is that while there were low-hanging fruit to be picked, making a success in life was primarily a task of exploiting nature rather than other people. But in a world where the overall size of the pie isn't growing as quickly as it used to be, or sometimes isn't growing at all, people's mindset is liable to shift to zero-sum and negative-sum thinking, which fosters rent-seeking. What do you make of that story? Yeah, I'm not sure about the low-hanging fruit.

I mean, it's not as if we were in an agricultural society where there were bananas lying around on trees or something. You know, there was a lot of other stuff going on. But the story is not very different from the one that Mansour Olsen told a long time ago. You know, that rent-seeking would bring down modern civilization because basically it was much more profitable to go out there and you know get some congressman or senator to pass a little tweak which made you

incredibly rich and those tweaks not only make you incredibly rich they slow down growth so part of rent seeking is it actually slows down growth too because all these people are spending their time. I think in The Great Escape, I tell the story of a manufacturer I met in India on an airplane who was flying to Jaipur. And he made some widget of some sort. I forget what it was, but it wasn't a very significant thing.

But he ranted on our two-hour flight from Delhi to Jaipur about how the ministers in Rajasthan were so corrupt. So he had to spend his whole time lobbying them, talking to them. And then as he got off the plane and headed off to breakfast, he said, but the rewards are so large when they do what you want them to do, sort of idea. So he was making some totally useless little widget, which he was protecting from the competition of widgets, all other widgets in the world, by bribing or persuading. Probably wasn't bribing or persuading. Probably wasn't bribing. And you know the enormous amount

of lobbying that goes on in Washington didn't used to be there. So that's happened since about 1972. So I think you could tell an Olson type story in which you know everything was sort of hunky-dory when people were all making stuff. And then they discovered that taking stuff from other people was much more profitable, and that slowed down the rate of growth of making stuff. So I think that story is pretty much consistent. Right. There's another story we could tell altogether,

which is that maybe there are now too many elites or too many people aspiring to be elites. And when that happens, because, you know, certain positions have inelastic supply, like there can only be one president, only so many senators or congressmen and women. And when there are more and more elites than there are elite positions available in society,

intra-elite competition begins to increase, which might be then related to things like rent-seeking. It's the sort of story of Africa, in some sense, that you have all those. You educate all these people to get government jobs, but it's really nothing from doing except start civil wars and so on. I think you could tell that story. But, I mean, the trouble with these big stories is that there's lots of variants of them. I mean, I just started reading this book by Joe Henrich, who's an economist, come psychologist, come something else, right?

Which says we all got rich because we stopped marrying our cousin. Well, maybe. But the trouble with it really does get hard i i think of um these economic histories of why the west west got rich and so on this you know it's like listening to symphonies or something you know they're wonderful signs and stories and talented writing but in the end it's hard to settle them yeah joe joe actually sort of inspired my thinking on the connection between slowing economic growth and rent seeking. He came on the podcast recently. Well, Mansour Elson, unfortunately, is long dead, but he probably was the first to really

push that. And it was just this free rider problem that somehow, you know, the small interest groups could always take over because they had such focused interests. And that would bring down civilization. Yeah. I also think there's a lot to be said for the argument that, you know, repair after the war kept us going for quite a long time. And now it got much harder. Thank you. What's happened to deaths of despair in Australia?

Anne just brought me some words. Nice to meet you. The Australians were able to put a lid on their drug overdose problem, which they were quite concerned about, but it seems like it began to rise again recently. I don't have... I actually in two minutes could tell you the exact...

What about cardiovascular disease? I can tell you... It flatlined as well. Flatlined, she says as well. All the English-speaking countries. Similar story, but not as extreme. Okay, you get a freebie in there. Yeah, that's right.

Angus, you and Anne have a fascinating take on the financial crisis and subsequent Great Recession in the book. And I'll paraphrase and, of course, correct me if I'm paraphrasing inaccurately, but you argue that the real impact of the Great Recession wasn't to inflict joblessness and misery, although it certainly inflicted those a great deal, but to pull back the curtain on American capitalism and expose it as a charade for upward redistribution because the ordinary American worker copped the full downside of the Great Recession, whereas the bankers were bailed out.

And if that is true, can we at least partly blame Obama for the rise of Trump? Yeah, I think so. But I mean, the question, yeah, I think that's right. But it's hard to blame Obamaama and say what could he have done otherwise sort of idea i mean if you listen to ben bernanke talk about you know how much he hated having to not punish these guys um you know it wasn't like they did this voluntarily because they didn't know what they were doing if ob Obama had wanted to make a better decision, could he have looked to history or was there really very little to help him?

I don't know. I think that's very hard. But I mean, you know, remember also there was, remember the TARP, the, what was it called? Trouble Asset Relief Program or something. And, you know, the Congress was being asked to pass this huge sum of money in those days, not so huge anymore. And they balked. And they talked about moral hazard and the people on the right said, we don't want to

bail out these guys. We don't believe in this and all the rest of it. And, you know, they took a vote and it was clearly going to go down. And then the stock market went down by some enormous number. And I remember looking at my television and they had the vote totals on one screen and the stock market on the other. And these guys all changed their minds. So I think it's sort of post, but it's really hard. I mean, there's questions which are beyond my expertise as to whether the repairs of Dodd-Frank and so on were done in an

appropriate way to stop this happening but I don't think that's what makes people angry I think what makes people angry is that these guys did this to us and got away with it and now the the Purdue family, the Sackler family, is doing exactly the same thing. And they took 12 billion or whatever it is out of their company, and then the company's gonna be left on the hook, and they've been convicted of criminal charges,

but no one's going to jail, no one's being punished for that. And I think that makes people very angry too. And that's why we wrote the story of the Opio Wars and so on, which was another example of money corrupting power. So it's not a new thing. I mean, people would always have used government to advance their private interest. Can I read you what I thought was the key paragraph of the book?

Sure. I'll make a note of it so that I remember it too. So I always kind of like to find the guts of the argument. And this was by no means the most eloquent paragraph because you and Anna, brilliant writers, but I thought this was kind of the most important paragraph. So this is on page 229. The exorbitant price of health insurance has caused firms to shed workers. This is not a natural disaster, but rather one based on rent-seeking, politically protected profiteering, and weak enforcement of antitrust in the healthcare sector.

Anti-competitive and rent-seeking behaviour is not confined to healthcare. Mergers of firms can give employers power to set wages and working conditions in local markets. Large corporations can potentially use market power to raise prices. Such anti-competitive behaviour hurts consumers who face higher prices and workers who get hurt twice over through lower wages and higher prices when they spend those wages. Competition, one of the hallmarks of American capitalism, has faded while arguably flourishing elsewhere. Not only in the healthcare industry, but also in business more generally, anti-competitive behavioritive behavior wherever it exists is an agent of upward redistribution great like that paragraph and it seems to me the main message of the book if i had to condense it would be we must end rent seeking welleking. Well, that's, I think, exactly right, or rein it in somehow. But it's very hard to see how you do that in America.

So what are some ideas for reining in rent-seeking? Well, I've talked to various members of Congress who agree with the analysis. They say you have to control campaign finance, but I don't know. The members of Congress think that because they spend 80% of their waking hours on the telephone trying to raise money. There's a really terrific book by oh gosh, I'm getting old. Jonathan Tepper and Denise Hearn?

No, I was thinking of the professor at Harvard who actually ran for president. Oh. And it's called, anyway, it's about rent-seeking and it's about how you basically can't run for Congress unless you have strong vested interests in your... Right. Right. I can look it up for you later, but I'm sure you can find it too. But so there is that aspect of it, which is you really have very little chance of even getting on the ballot somewhere unless there are pretty strong interests behind you. And that, you know, didn't used to be... When I grew up in Britain, you could, you know didn't used to be when I grew up

in Britain you could you know you had to make a deposit of 150 pounds or something to run for parliament but poor people did and poor people often won without any backing at all and so that has

I find it very hard and I don't see a way around this and But I find it very hard and I don't see a way around this. And I really worry because I think in the end, the people on the far left who want to see capitalism dismantled somehow may succeed because young people are so disillusioned with the way it's been. Has the political left been sufficiently empathetic towards the people dying deaths of despair, given that whites aren't perceived as a historically marginalized group? No, they just call them deplorables, right? I mean, I think it's

extraordinary. I mean, right now, I saw something this morning, there was a petition for Joe Biden to forgive all student debt on his first day in office. Right. Well, that's just outrageous. I mean, there's, you know, I'm sure there's a student debt problem. I don't doubt that for a minute. And they say it's a matter of racial justice. Well, maybe it is.

But, you know, the people who benefited from this enormous student debt are the universities and colleges that are charging enormous sums of money, which they didn't used to do, and who are getting rich on the back of these people. This is just a simple demand for the two-thirds of the population who do not have a college degree to bail out the one-third who do. What's more is to make a promise know, promise that it'll be done forever after in the future so that colleges can wind up their tuition rates even further and people can borrow knowing that it'll be forgiven. So that's just a, you know, this

is happening on both the left and the right. And, you know, that's an example of where they're trying very hard on the right, on the left, the left to you know take their student constituents and you know the minority constituents who would love to see their debts written off but you know this is like politics in india now where you know people get elected on promising to forgive the farmers all their debts in his book the twilight of the elites, Christopher Hayes argues that the iron law of meritocracy is that equality of opportunity ultimately overwhelms equality of, sorry, inequality of outcomes ultimately overwhelm equality of opportunity because eventually the elite are able to entrench their positions and guarantee better outcomes for their children. It seems like

society's always going to be locked in that sort of dance because it's just sheer human self-interest. Are there any points in history that we can look to as like touchstones for generations who did it better? I just did want to say that's a great book, and I think it was written maybe five years too early or something, so all the other books. 2012 it was published. 2012, yeah.

And, you know, a lot of other people have been writing about those things, but he got a lot of it right very early on. Yeah, no, it's terrific. Yes, but, you know, if you look, there's some hope, because if you look what happened at the end of the 19th century, right, where there was this huge level of inequality in America. And, you know, Woodrow Wilson, who is now a favor because he was a racist and he really was a racist,

but he campaigned against inequality his whole life. And he was appalled with what went on in Princeton, which was a rich man's club and not a serious university. He tried to make it into a university, lost the battle and had to retreat and become president of the United States, having failed at being president of Princeton sort of idea. But, you know, there was a whole bunch of constitutional amendments that were passed around that time, all of which were pro-equality. One was the vote for women. One was prohibition, which was seen as, alcohol was seen as an oppressive thing,

so it was a pro-equality thing. The establishment of the Federal Reserve, the income tax. So, and then, you know, you did have a long decline in inequality after that. So I don't think it has to go on until it bursts. It's clear big events can help. Maybe this pandemic will help. I mean, one of the things that I think is quite remarkable right now is that, you know, Mises has made about 100 billion extra dollars because of the pandemic. And this is a time when hundreds of thousands of people are dying and other people have lost their jobs and their lives have been disrupted. And if you

add in Musk and Bill Gates and all the rest of it, there's about a trillion dollars there of extra wealth that's come about because of the pandemic. Now, do we think that people will think that's okay? I don't know. Especially if you get Republicans back in power who suddenly worry about the deficit and decide that they have to abandon social security programs in order to repair the deficit while the top of the income distribution has made a trillion dollars in private property. So I think big events like wars or things like that or the thing being seen to be out of control have historically led to you know retrenchment and change so it's possible yeah that was the certainly the thesis of walter

chardell's book the great leveler that inequality is reduced by anyone or any combination of the four horsemen plague war state collapse and revolution. But I sense that you think that book's a little too pessimistic. Well, I mean, I think there are episodes where those things didn't happen. I also think it's a bit optimistic about pandemics. I mean, this pandemic is generating enormous inequality within countries. Maybe not in Australia, where you handle it a lot better than most people, but here there's no doubt about it.

Is the death of despair catastrophe in the United States something that is uniquely American or is it a harbinger for other countries in the West? We don't know the answer to that, but it's a really big question. We wrote a piece in Foreign Affairs asking exactly that question. And you can tell it both ways, which is, you know, health offense, both good and bad, have often begun in America and then spread to other countries. And you see it in, you know, where I grew up in Scotland,

there's now an enormous drug epidemic. And there have been alcohol problems in Britain more generally. You see some in Canada, though that could be just because we're right next to them. And, you know, you had your own problems in Australia. So you tend to see some sorts of deaths of despair in almost all rich English-speaking countries. But then you don't have the crazy health care system we have. You don't generally allow opioids to be pumped out from the medical system to everybody on the planet. You know, you have a much better social safety net. So those things make it less likely.

But I think the threat is really there. And even, you know, apparently, I don't know what happened in the end, but Purdue Pharmaceutical, when they agreed to be sort of wrapped up, there and even you know apparently i don't know what happened in the end but purdue pharmaceutical when they agreed to be sort of wrapped up and the family kept a hold of their international subsidiary omni pharma i think it's called something only i think that's what it's called which you know is doing all around the world what it did here, which is telling bloodhours that people should not be in pain and that, you know, they have the answer. Angus Deaton, thank you for joining me

and thank you for all of your important work. Thank you. It's been a pleasure talking to you. Thank you so much for listening. You will find the transcript for this episode on my website, josephnoelwalker.com. If you're enjoying the show, I would hugely appreciate a rating and a review on iTunes. I know everybody asks, but it does help people find us and it does help us reach the hard-to-reach guests. The audio engineer for the Jolly Swagman podcast is Lawrence Moorfield. Our very thirsty video editor is al

i'm joe walker until next time thank you for listening ciao