Today, Explained - Elizabeth Warren needs a poster boy

Episode Date: January 14, 2020

Elizabeth Warren’s best bet to fight the opioid epidemic might be stealing a page from the battle against AIDS. Vox’s Jillian Weinberger explains how for The Impact. (Transcript here.) Learn more about your ad choices. Visit podcastchoices.com/adchoices

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BetMGM.com for terms and conditions. Must be 19 years of age or older to wager. Ontario only. Please play responsibly. If you have any questions or concerns about your gambling or someone close to you, please contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Jillian Weinberger. Hello. Hi, Sean.

Host of The Impact Season 3. Yes, that is me. You're taking over the show and you guys are doing in your new season kind of a new version of what you've done in the past. Is that fair? Yes. This season, we're looking at the big ideas from people running for president in 2020. And a lot of those ideas have been tried before in other places or at other times. So we thought this season we would look at how all of those big ideas have worked or not worked in the past. And we thought, because today is the seventh Democratic debate,

the last debate before the Iowa caucus, today would be a great day to run an episode of this new season of The Impact. Yeah, so in this episode, instead of going to a place where someone's testing out one of these big ideas, we're going to a specific time. We're going back in time to the 1980s. San Francisco? In San Francisco, yes.

Let's go. This is a story told by survivors. There was a lot of rumors about previously healthy young men getting sick. Cleve Jones is one of those survivors. Our story begins in his adopted hometown of San Francisco on an autumn day in 1981. I was just walking down Market Street to Castro and went past the Twin Peaks Tavern, which is a very famous bar here in San Francisco. It was actually believed to be the first gay bar that had plate glass windows so that one could see in from the outside and see who the patrons were. And Bobby was there. Bobby Campbell, a registered nurse who lived in the neighborhood. I'd known Bobby just peripherally, but I certainly knew who he was.

And he took off his shoes and socks and right there in the bar showed me the bottom of his feet, and I saw these small, slightly raised purple spots. Those spots were Kaposi's sarcoma, once a rare skin cancer mostly affecting older men. It would soon become well-known as a condition associated with AIDS, but no one really knew that at the time. They just knew that a bunch of gay men in the Castro had these purple bumps. And Bobby decided to do something about it. He got a Polaroid camera and he took pictures of his spots.

And he made a poster, which he then got placed in the window of the Star Pharmacy that was at 18th and Castro. And that, I believe, was the very first attempt at public education about the disease we now call HIV-AIDS in the entire world. And within minutes of it being taped up there in the window, a small crowd of very anxious men had assembled on the sidewalk to look at these pictures. And with that, Bobby became his community's representative for this new disease. Quite literally, their poster boy. By 1990, nearly a decade after Bobby put up his poster, hundreds of thousands of people had HIV AIDS.

Tens of thousands had died. And that year, Congress finally passed the first nationwide coordinated response to the AIDS crisis. It was called the Ryan White Care Act. In the years since, it's dedicated billions of dollars to the fight against AIDS, and it revolutionized care for patients with this once-deadly disease. When the government takes bold action, we can tackle big problems, like the AIDS epidemic. Recently, Senator Elizabeth Warren has been revisiting the Ryan White Care Act. She's using it as a blueprint to fight a new public health crisis. The opioid epidemic doesn't discriminate. It goes after every single community, urban, suburban, rural, poor, middle class.

Warren's big idea to fight the opioid crisis is called the CARE Act, a deliberate echo of the Ryan White legislation. It's become a major part of her presidential campaign, and it would cost $100 billion over 10 years. Addiction experts agree this is the kind of money we need to fight the opioid crisis, but it's a really expensive idea to help a deeply stigmatized population. How would a President Warren get it through Congress? From the Vox Media Podcast Network, this is The Impact. I'm your host, Jillian Weinberger. The Impact is a podcast about the consequences. When people in power act, or fail to act, what happens to the rest of us?

It's 2020. You may have heard that there are a lot of people running for president in November. But we're staying away from their personal bios, their campaign gaffes, and their debate prep. We're going to talk about what they actually want to do if they're elected. A hundred billion dollars.

Move away from fossil fuel to energy efficiency. Obamacare. Hit this opioid crisis head on. We add a public option. And it's going to be a great wall and it's going to work. These are all big ideas, but they're not new. A lot of them have been tried before, here in this country and around the world. Germany.

Taiwan. 1968. Nogales, Arizona. The fall of 1981. This season, we have the stories of how these big ideas worked or didn't work. How they changed people's lives. We have stories of hard-fought success and epic failure. Stories about the problems we're facing and the candidates' big ideas that could solve them.

Stories of what might happen in the next four years if these big ideas get rolled out, or if people in power fail to take action. Today on the show, how an epidemic begins and ends. What it took to get the federal government to finally act on AIDS. And what that means for Senator Warren's plan to fight the opioid epidemic today. So let's go back now to the Castro in the early 1980s. After Bobby Campbell taped up that poster, he started writing a column about his illness in a local newspaper. And across the country, in Washington, D.C., Tim Westmoreland read that column. I was counsel to the Subcommittee on Health and the Environment.

Tim was one of the few openly gay people working in Congress at that time. And in 1982, he asked Bobby to testify at a congressional hearing. A hearing about the illness that caused those purple spots on Bobby's feet. Researchers had started calling it GRID, Gay-Related Immune Deficiency. As I was setting up the tables and the chairs the day before, Bobby came in and I'd never met him in person. We sat and talked a little bit. And he said to me, I don't know anything about congressional hearings. What should I wear as a witness? And I said, well, what would you ordinarily wear? And he said, well, I can wear a jacket and a tie, or I can wear my nurse's uniform, if you think that would be helpful.

Or I'm a member of the Sisters of Perpetual Indulgence. I can come in a nun's habit. The Sisters of Perpetual Indulgence. It's a drag troupe with a whole lot of glitter and fake eyelashes. They do community service work. It's customary to take a name when you join, and Bobby, a nurse, became Sister Florence Nightmare RN. I saw my whole career pass before my eyes at this point. Oh my god, I've invited this witness and I have no idea what he's going to do. The hearing wasn't recorded, but in the end, Bobby wore a suit and tie. And he was a very good witness. Bobby's testimony didn't get much

attention, but he continued to speak out about what it was like to live with this disease. It was devastating. Bobby talked to CBS News not too long after Tim's hearing. He was skinny, with a thin blonde mustache. He wore a button that said, I will survive. When I came down with this disease, I found this button and it absolutely reflected my position. You know, I may be down, but I'm not out. This was just over a year into President Reagan's first term. Reagan ran on budget cuts. Only an all-encompassing program combining restraint in government spending with economic growth in the private sector will work.

And he made good on that promise when he took office. Tim was worried. We had the idea that there was going to be consequences from this, that there would be public health problems, perhaps a public health disaster. Tim's boss in Congress was afraid that the federal government didn't have what it needed to fight this disease. By that point, it was known as AIDS. He started holding more hearings

with witnesses from the Centers for Disease Control, the National Institutes of Health, and others. At these hearings, they'd ask, Do you have enough support given the budget stresses that the public health service has been under? And the witnesses were saying, as they must, because they're testifying on behalf of the administration, we've got what we need. It's not a problem. We're transferring some money around. In private, though, some of those same witnesses would tell Tim the opposite.

They didn't have what they needed to fight the AIDS epidemic. And Tim saw evidence of that in his own life. So did Cleve Jones, the activist we met at the start. In their own community, the situation was grim. I knew people who were getting sick. I knew people who died. You have to understand that people were dying every day. We were in funerals every day. Tim asked if we knew what a Rolodex was, the old school kind with address cards that flip around. I did. I still have a Rolodex probably someplace over there of people who are in my Rolodex who died and that I couldn't bring myself to throw away their Rolodex cards,

so I moved it over into a second Rolodex just so I wouldn't have to throw them away. In our address books, we had entire pages where every name had been crossed out. And then, in the spring of 1984, Tim got a hold of some information. Evidence that the Reagan administration wasn't being entirely forthcoming about its commitment to fight AIDS. It all started with these anonymous envelopes slipped under Tim's office door.

Plain brown envelopes with Xerox budgets in it. They were copies of budget requests, requests from the health agencies for federal dollars, including... An entire AIDS budget that had been for the public health service, probably 100 pages, but of what we would now call spreadsheets. And Tim realized... That the public health people, the scientists, are actually requesting a dramatic increase in funding

that never makes its way into an official budget. In other words, public health officials, the scientists, the experts, they said they needed millions more to effectively fight the AIDS epidemic. The Reagan administration ignored them. Tim leaked that budget to the press, and it landed in the San Francisco Chronicle just before the Democratic National Convention arrived that summer. Bobby Campbell read the report.

Secretary of Health and Human Services Margaret Heckler called AIDS the number one priority of Reagan's health administration. But many of us feel that in Washington it's still business as usual while we are dying. Bobby spoke in a march in San Francisco just before the convention began, in July 1984. We who have AIDS have a disease that is poorly understood, often fatal, expensive, inadequately testable, and so far incurable. On that stage, in front of a huge crowd, Bobby looked even thinner than he had on the news two years earlier.

Beside him stood his boyfriend. Gay love in 84! People today don't appreciate how much people disliked gay men and drug users at that time. Wait a minute, are you going to tell me you're a fag? I mean, if you're going to tell me you're a fag, I don't think I can handle it. Yes, you're a total fag. Doesn't this cafeteria have a no fags allowed rule? I'm not a fag.

I mean, if the AIDS epidemic had first appeared among members of the American Legion, the way Legionnaires did, or people of Norwegian descent, I think the Reagan administration would have done something out of the ordinary. What might have been an extraordinary response if it had appeared in another group was just not common because we don't care. We don't care about the people who are getting sick. In the lead up to the 1984 election, the Republican Party remained silent on AIDS. And we didn't set a weather vane on top of the Golden Gate Bridge before we started talking about the American family.

The Democrats, though, adopted a gay rights platform, including a promise for spending on AIDS prevention and research. But Bobby Campbell's health started to deteriorate soon after his speech. A lot of people have given me support for being brave. I don't feel brave so much as maybe a show-off, I guess. Despite widespread homophobia and the stigma against AIDS, Bobby went public with his disease when very few would. He explained why on a local radio show. I just thought that the more I talked about it,

the better it would be for me, the better it would be for me and the better it would be for other people in my community. Take care of yourselves, brothers and sisters. You're the only one you've got. AIDS activists lost their poster boy on August 15, 1984. Bobby Campbell was 32 years old. A few months later, Ronald Reagan defeated Democrat Walter Mondale in a landslide. Seems we did this four years ago.

Let me just say, well, you know, good habits are hard to break. Reagan did not mention AIDS in his re-election campaign. In fact, by December 1984, he'd never publicly discussed AIDS at all. The disease continued to spread far beyond the

gay community, and thousands of miles from San Francisco, the day after Christmas that same year, a mother had to give her 13-year-old son some terrible news. I just said, Ryan, you know, you've been really sick. And he said, yes. I said, they say you have AIDS. He said, am I going to die? And I said, we're all going to die someday. We just don't know when. After the break, how a Midwestern middle schooler transformed the government's response to the AIDS crisis, and what that can tell us about fighting the opioid epidemic today.

Support for Today Explained comes from Ramp. Thank you. finance teams' unprecedented control and insight into company spend. With Ramp, you're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join Ramp. You can go to ramp.com slash explained, ramp.com slash explained, Welcome back. By December of 1984, more than 5,500 people in the United States had died of AIDS. It had already devastated the gay community. Now it was reaching those who thought the disease had nothing to do with them.

I mean, I remember seeing people on TV wasted away. Gay man. Jeannie White Gender didn't know many gay men who were out at the time. She lived in a mid-sized city in the Midwest, Kokomo, Indiana. A very industrial city. Almost everybody it seemed worked for GM or Chrysler. Jeannie's son Ryan was born there in 1971. He had severe hemophilia, and soon after he was born, the doctors told Jeanne.

They had this new drug that they wanted to use on Ryan. It was called Factor VIII, which contains a clotting agent found in blood. And they said that we feel like this new drug is going to enable hemophiliacs to live almost a normal life. So I was really excited about it because there was always serious bleeding problems with hemophiliacs before then. We thought it was a miracle drug. The drug was made with blood from thousands of different donors. And at that time, donors weren't screened for disease.

Ryan used Factor VIII at least twice a week for more than a decade. And then, the year he turned 13. Ryan was very sick and I had him to the doctor a lot. One day he got off the school bus. He come in the house and he said, mom, you got to do something. He said, I can't even get off the school bus without being tired. And then just a few days later, he got pneumonia. So they did a biopsy. They took two inches out of his lung. The results came back that he had pneumocystis, which meant he had AIDS. Ryan got infected by all the donated blood used to make Factor VIII, his hemophilia medicine. I really kind of didn't want to believe it at first. You think you're going to wake up and

it's not going to be the way it is. And then you figure out it is the way it is, you know, and you have to deal with it. He was only supposed to live three to six months. Jeannie's mom switched to the night shift at the GM plant so Ryan could be with his grandmother during the day when Jeannie was at work. It was hard to go back to work because you don't know how long your child has. And you want that time special with him. But at the same time, I needed my insurance. And that was the arrangement for the first few months of 1985. And as those weeks slipped by...

He started gaining weight. He didn't look sick no more. He said, call the school, okay, Mom? Ryan was eager to go back. So Jeannie called the principal. He said the school board's going to vote in July whether to allow Ryan in school next year or not. And the school board voted on the 15th of July

not to let Ryan back in school. All of a sudden, overnight, it became chaos. I mean, every media in the country was calling, showing up at our doorstep, wanting to talk to this little boy that wants to go to school with AIDS. Ryan White says he gets very lonely. The 13-year-old was banned from school after it was found he was suffering from AIDS.

And now his school have said they never want him back in class. I think it's better for him to stay home. I ain't got nothing against Ryan or anything. I just don't want AIDS in our school. State health officials said it would be safe for Ryan to go back to school, that AIDS couldn't be spread through casual contact. But the local school board refused to admit him. The White family sued, and the legal battle continued for months.

Ryan finally won the right to go back to school the following year, and he got a lot of publicity for his fight. He first captured people's hearts four years ago when his battle with AIDS and his fight to remain in school became front-page news. How do you think about the future, or do you think ahead? Well, I think ahead.

You know, I plan my future. I plan to go to college and so forth, but we really just live one day at a time. This brave little boy was the not-gay poster boy we needed. Back in San Francisco, Cleve Jones was still organizing and lobbying. He saw all the media coverage of Ryan White and realized... This boy could be acknowledged publicly in the way that Bobby Campbell

could never be acknowledged publicly because this boy wasn't gay. I hope that doesn't come across as detracting from or diminishing in any way the bravery, the courage of Ryan and of his family. I don't want to do that, but I think, you know, we need to understand that that's the reality. We needed a poster boy. Ryan's doctors underestimated him. He made it through middle school and into high school. And as the 80s wore on, more and more people were getting diagnosed. By the summer of 1989, 100,000 people in the United States had the disease. Public hospitals in urban areas were being overwhelmed by the number of people who were coming in to be treated for AIDS.

That's Tim Westmoreland again. Hospital emergency rooms were completely blocked because there were so many people. So that was bad enough, but it also meant that anybody who was not an AIDS-related illness, somebody who was in a car crash, showed up at an emergency room and they couldn't get in. In the late 1980s, most patients with AIDS had a grim prognosis. And they had a lot of needs. Prescriptions, counseling, end-of-life planning. A lot of those needs could be met outside the emergency room.

So Tim helped write a new piece of legislation to do that. It was a funding bill to help regions hit hardest by the virus, with money for prevention, testing, treatment, counseling, and outpatient care. It was a safety net program for people with HIV, a way for the federal government to help cities and states cope with the epidemic. There was just hearings going on in 1990 when Ryan became very sick. And, of course, Elton John was always by our side. And he was there the last week and a half of Ryan's life at the hospital and everything. And he was taking filtering phone calls from people from all around the world. And Elton come and told me that he

said, this is a call that I think you should take. It's Senator Kennedy. So I got on the phone. It was Senator Kennedy. He said, we're having these hearings in D.C. here, and nobody has brought so much attention to this disease. He said, for the first time, we have people caring about AIDS now. There on the phone with Jeannie, Senator Ted Kennedy described this new legislation, the bill that Tim helped write. But back in Washington, Tim heard that they faced a serious obstacle to pass it, Senator Dan Coats.

And he was from Indiana. Mr. Kennedy and his staff suggested naming the legislation for Ryan White, who was from Indiana, and making him quite literally a poster child for this legislation, even though it was not only for kids or only for hemophiliacs. So when Senator Kennedy was on the phone with Jeannie, he said, with your permission, we would like to name it the Ryan White Care Act. And at the time, I said that would be nice,

not ever really realizing how enormous that bill would eventually become. But then I lost my son. And a few weeks after Ryan passed away, Senator Kennedy called me again. He asked me if I would come to D.C. and talk to senators. I said, no. I said, Ryan, did that not me? He said that we really need your voice. Ryan's death is so fresh on everybody's minds. We have a chance to make a difference for people with AIDS now. So Jeannie flew to Washington. She talked to senators all over Capitol Hill. And in the end, that Indiana senator, Dan Coats, voted in favor of the legislation.

He became sort of the linchpin vote for passage of Ryan White. I asked him what he thought about naming the bill for Ryan. Tim told me he admired him, how brave he was. He said that Jeanne was a strong advocate for all patients with AIDS, not just for children or hemophiliacs. And? I sort of thought that it was, okay, if that's what the Senate needs, then that's what we'll do. My chairman, Mr. Waxman, was actually surprised and I think disappointed that I had agreed to this. It didn't change the policies or the dollars or anything. And Henry said to me, you know, I know a lot of people who've been sick and died, and we're not naming it after them. Congressman Henry Waxman said as much on the floor of the House when the

CARE Act finally passed in August of 1990. This bill now has been given the Senate title of the Ryan White CARE Act. Ryan White gave this epidemic a face in the mass media of the nation, someone that we could all recognize, admire for his courage, and mourn, and I would take this opportunity to do so. But I also want to take a few moments now to acknowledge that there are also thousands and thousands of other Americans, our friends, loved ones, and fellow citizens, who have died and who deserve our recognition, our admiration for their courage, and our mourning. In closing the consideration of this legislation, I would like to add just a few names of people who have died of AIDS,

some friends of mine and some friends of friends. Mr. Speaker, let us acknowledge Sheldon Andelson, Mel Boozer. Some of them were friends of his, some of them were former witnesses, some of them were actually friends of mine that I'd asked him to add in. Andrew Ebert, Tito Kasner, Zach Kaufman, our colleague Stuart McKinney. President George H.W. Bush signed the bill into law on August 18, 1990. And federal money started to move. The following spring, more than $200 million went to cities and states for AIDS treatment, education, and prevention. And that number continued to grow year after year.

By 2019, it was more than $2.2 billion. The CARE Act funding was of incredible importance for all of the social services that were necessary at a time when so many people were getting so sick and dying. These federal dollars were lifesavers, and it would be difficult to overstate the importance of that funding. Cleve Jones found out that he was HIV positive in 1985. When I talked to him last September, he told me, I certainly never imagined I would live to be 40, let alone I'm going to be 65 next month. Thanks in part to the Ryan White Care Act, AIDS prevention and treatment has changed dramatically since Cleve's diagnosis.

In 1995, just that one year, nearly 50,000 people in the United States died of AIDS. In 2017, that number dropped to just under 6,000. It's a remarkable success story. And now Senator Elizabeth Warren wants to do the same thing for the opioid crisis. She's running for president with a bill modeled on Ryan White. Her CARE Act would dramatically expand access to addiction treatment and overdose prevention. It would send billions of dollars to agencies like the NIH and the CDC

for addiction research and training. But will it take a poster boy to get it passed? The answer may depend on the poster boy. In the 1980s, the Reagan administration decided that it could ignore Bobby Campbell without political consequences. They were right. And the result was tragic. If you want an example of the consequences of homophobia, look at millions of dead heterosexual men and

women and their children all across this planet. But elected officials realized they couldn't ignore a poster boy like Ryan White. And after all those years fighting for federal legislation on AIDS, Tim Westmoreland thinks a face like Ryan's might help pass legislation like Elizabeth Warren's. What I need to add, lest you think I've come away not learning a lesson, is that it was a stroke of genius to name the legislation after Ryan White. Poster children actually do convince people to do the right thing sometimes. We'd really love to hear from you, so please send comments and questions to impact at vox.com, or you can tweet us at hashtag impact podcast. If you enjoyed this episode, could you take a moment and leave us a review on Apple Podcasts?

It really helps other listeners find the show. The Impact's editor is Amy Drozdowska. Our producer is Bert Pinkerton. This episode was mixed and scored by Jared Paul with help from Paul Mounsey. Thank you. Keith Humphries, Cliff Morrison, Noam Hassenfeld, Hermann Lopez, Irene Noguchi, and Dr. Owen Albin. Liz Nelson is Vox's editorial director for podcasts, and thank you to Lauren Katz, Zach Kahn, and Marika Ball-Damburg for all their help with marketing and engagement. I'm Jillian Weinberger, and the field reporting for this episode

got a little emotional, including my first encounter with Tim Westmoreland's miniature dachshund puppy. Oh my god! Hello! Hi, sweetie! Talk to you next week.