How hospice became big business. A new investigation in The New Yorker reveals an industry that at times puts profits before patients.
Claire McCaskill grew up in rural Missouri, surrounded by strong women and an encouraging father. Filled with ambition, McCaskill pursued a career in politics, winning a Missouri house seat and later becoming state auditor. She lost a close race for governor in 2004. But two years later, she became Missouri’s first elected female senator. Along the way, McCaskill faced sexism and harassment in a male-dominated political world. Her Senate career has been marked by tough stands against government waste and military sexual assault. Diane talks with Missouri Senator Claire McCaskill about the dangers of being “ladylike” and the growing power of women in the U.S. Senate.
- Claire McCaskill U.S. senator, Missouri (D)
Read A Featured Excerpt
Excerpted from PLENTY LADYLIKE by Claire McCaskill and Terry Ganey. Copyright © 2015 by Claire McCaskill. Reprinted by permission of Simon & Schuster, Inc, NY.
MS. DIANE REHMThanks for joining us. I'm Diane Rehm. An eighth grade teacher once told Claire McCaskill that she wasn't ladylike enough. She ignored the advice and pursued a career in politics, becoming the first woman elected to the U.S. Senate in Missouri. In a new memoir, she reflects on her Midwest upbringing, facing sexism in politics and belonging to the sisterhood of female senators. The book is titled "Plenty Ladylike" and Senator Claire McCaskill joins me in the studio.
MS. DIANE REHMWe'll welcome your questions and comments on 800-433-8850. You can send us an email to email@example.com. You can follow us on Facebook or send us a tweet. What a pleasure to have you here.
SEN. CLAIRE MCCASKILLIt is terrific to be here. I am an unabashed fan and thrilled to be here in the studio with you. It's a big deal for me.
REHMThank you. I'm delighted to have you here. But sadly, it's a day when more violence is occurring in Ferguson, Missouri. We know that Tyrone Harris, Jr. was shot police as he apparently had been involved in some kind of incident during a peaceful protest there. What do we know about what's going on?
MCCASKILLWell, what we know is we had hundreds of people gather peacefully yesterday in St. Louis and marched and they were quiet and their silence spoke volumes about their desire to seek justice for all in our criminal justice system. And then, it got dark and then there were a series of shootings. There was a shooting near where Michael Brown was shot and then there were rival groups shooting at each other at 2:00, 3:00 in the morning after the police told them to disperse.
MCCASKILLThis was a very small crowd, very late. And no question that there was a criminal element involved and...
REHMHow do we know that?
MCCASKILLWell, we know because, first of all, the gun that was recovered from the young man who was shot was a stolen gun from Cape Girardeau, Missouri, which is a long way from St. Louis. And there are people who were on the scene who said that there was shooting between these two rival groups. This did not begin as a shooting against the police. The police then moved in to try to stop the shooting going on between the two groups.
MCCASKILLAs the people that were there, there were fewer than 100 people there, were running for cover and ducking behind SUVs and then that's when they went -- chased this young man and then he returned fire on the police and then that's when he was shot by the police. So there was gunfire going on and anybody who's shooting guns in a public place at other people are people that, obviously, are more interested in violence and criminal activity than they are peaceful protest.
REHMAnd he is currently in critical condition. We will keep you informed as the hour goes on. Today, apparently, is to be a day of civil disobedience. What does that mean?
MCCASKILLWell, I think there are going to be a variety of ways that various people around the country are going to express, in the tradition of Martin Luther King and other wonderful leaders in our country, that disrupted and did things to draw attention to injustices. And I'm fully supportive of that. I think it's important to remember, Diane, that the Michael Brown shooting was investigated by the Justice Department.
MCCASKILLAnd the Justice Department, in a very clear report, said that the shooting was justified based on the physical evidence that was at the scene and they independently tested all the physical evidence, the FBI did. This was not done by local police or a local prosecutor. But that unleashed, that shooting unleashed, so much frustration that has been pent up because at the same -- the same day that the Justice Department released their report that said the shooting was justified, they also released a report that said the pattern and practices of the Ferguson Police Department were a problem.
MCCASKILLAnd in our state, we are beginning to look carefully at a lot of things that were impacting the marginalization of African-Americans within the criminal justice system, like municipal court reform, like the fact that there were judges that were in the municipal court system in Ferguson that were relegating African-Americans to a cycle of poverty over de minimus ordinance violations that we are looking at recruiting more police officers that are African-American, that we are looking at recruiting more National Guard members.
MCCASKILLWe're opening a National Guard Armory in the Ferguson area to recruit more African-American National Guard members. So we really, I believe, are making some progress, but there is a awful lot of work to do 'cause there is institutional bias that we have to address.
REHMSo we've been talking about Ferguson, but a story in the New York Times over the weekend pointed out that St. Louis is one of the most segregated cities in the country. What was your reaction to learning that?
MCCASKILLWell, it wasn't shocking to me. I grew up, you know, my first political offices that I ran for were in Kansas City and I was surprised when I came to St. Louis by the lines of demarcation even in politics between North St. Louis and South St. Louis and that people in St. Louis were used to thinking of the political system in the terms of North St. Louis and South St. Louis, which is shorthand for the black citizens of St. Louis and the white citizens of St. Louis city.
MCCASKILLNow, having said that, I know that we have a problem in low income housing in this country that a lot of it is segregated. And this isn't just something that's going on in St. Louis. This is going on in many urban and nearby suburban areas of metropolitan areas.
REHMBut to be called one of the most segregated cities in the country, must hit you hard.
MCCASKILLOf course, of course. And, you know, I believe that what we have to do is we have to use the tools we have. And there are tools we have to try to make sure that we're putting low income housing in places that will bring a mix of integration, not just continuing to load up low income housing in communities that are socioeconomically stressed…
REHMBut now is that going to affect the population that's already there, that may be resistant to that introduction of low income housing?
MCCASKILLWell, I mean, there's -- I think most people in St. Louis welcome black neighbors. I think -- and in fairness, I think one of the things that we've got to do is we've got to address this because the underlying education system is also impacted. We're trying to redo the housing in Canfield, which is the area where Michael Brown was shot. One of the problems we have is we've got the mechanisms in place to redo that housing, but the school district is not accredited.
MCCASKILLWell, why should we expect young African-American families to move to an area where their children would have to go to an unaccredited school district
MCCASKILLSo this is complicated stuff and it's not as simple as just a housing issue, or just a education issue or just a policing issue. A lot of this goes to, frankly, making sure that young African-American families have the resources for their children to get even early childhood education, to be ready for school, to look more carefully if what we've done to marginalize urban school districts. This is hard, hard stuff.
REHMYou know, Senator, it sounds as though the changes that you're talking about make all kinds of sense, but it also sounds as though it could take generations to make.
MCCASKILLI think that any politician who tries to say that this is something that we can fix with a piece of legislation or that we can fix with a series of quote/unquote "programs" is being disingenuous and, frankly, being terribly unfair. This is going to take time and it's going to take a lot of people focused on it for longer than the incredible media headlines that occurred around not just the Michael Brown shooting, but the Eric Garner death and the other deaths that have occurred around the country.
REHMIt's going to take lots of money as well.
MCCASKILLIt's going to take resources. It's going to take resources.
REHMAnd where are they going to come from?
MCCASKILLWell, I think one of the things that we have to do is we have to give these young people hope and we have to make sure that they see themselves as someone who's going to college, not someone who is dropping out. Part of that is making college easily attainable. I think that is a program that the next president of the United States needs to worry about.
REHMHillary Clinton has talked about that.
MCCASKILLI think that's her focus this week. I hope all of the candidates talk about it. We can't expect these young people to navigate their way through a complicated system of grants and sometimes scholarships, but usually grants, and find a way to get through school many times shouldering debt that makes it impossible for them to economically get to the place they need to be to have their choice of housing and whatever neighborhood and whatever schools they want their kids to go to.
REHMClaire McCaskill is Democratic senator from Missouri. In 2006, she became the first woman from Missouri to be elected a U.S. senator. She was reelected in 2012. Her new book is titled, "Plenty Ladylike: A Memoir." Short break. We'll be right back.
REHMAnd if you've just joined us, Claire McCaskill, Democratic Senator from Missouri is with me. Her brand new memoir is titled, "Plenty Ladylike." In our first segment, Senator, we were talking about what's happening in Ferguson, the aftermath of the Michael Brown shooting, the shooting of young man, Tyrone Harris, Jr., who may have been involved in some other activities. We were also talking about the racial segregation that does exist in St. Louis. And in one measure of that entire region's segregation, a Brown University study said that 70 percent of white people and 70 percent of black people would have to move in order to achieve some racial balance. How is that ever going to happen?
MCCASKILLWell, I don't think it will. But I do think that what we have to do is make sure that people have choices where they live. And that's the problem that we face now is that so much of the low-income housing that is reachable and affordable by many are all placed in one location. So they don't have a choice where they can go to live. And I think we can achieve some progress just by making sure that we're not clustering. And that's one of the things the Times article talked about is the clustering of low-income housing just in areas that are predominantly African-American.
REHMAnd another factor that was talked about were the vouchers. A single mom, Crystal Wade, with two young children, was a Section 8 voucher from St. Louis Housing Authority. She desperately wants to get out of a very dangerous neighborhood and she can't find any landlords who are willing to accept that voucher.
MCCASKILLYeah. It's a huge problem. And I see it and, you know, it is one that, as I say, we've got a lot, a lot of work to do in St. Louis. But we have a lot of work to do all over the country on this issue. Because while we've made a lot of progress, I think one of the things that too many people did was, when Barack Obama got elected president, they said, "Well, okay. We're done. We've figured out how to get past racial politics. We've figured out how to truly make sure that an African-American has every opportunity that any other American has." And I think what the last year has shown us is we're not done.
REHMClearly not done. I wonder also about your reactions to the Republican debates that took place last week: first, the minor -- so-called minor league candidates, and then the one with Donald Trump on the stage. And since you speak a great deal in your book, "Plenty Ladylike," about your own career and passing through these pockets of discrimination, how you reacted to what he had to say and then the reactions of others on the stage as well.
MCCASKILLI think what was most startling to me -- I mean, I see Donald Trump as somebody who's just bluff and bluster, who will do anything to get attention, who takes narcissism to a level that I don't think we've ever seen. And we've seen narcissism among presidential candidates and politicians. But this is a different breed of narcissism where it's just him, all about him. And anybody who doesn't say wonderful things about him is attacked. But what -- so put him aside. But the fact that Megyn Kelly asked the question about his long history of derogatory comments about women and then him making the flippant comment about Rosie O'Donnell -- the fact that not one other candidate spoke out at that moment, that was stunning to me.
MCCASKILLThat was an opening I think a Mack Truck could have driven through. If I'd been a candidate on that stage, which I will never be -- but I think if there were Democratic candidates on that stage, one of them would have spoken up and said, "Wait a minute. Wait a minute. It is not appropriate to use that terminology for women in public discourse. End of discussion." And the fact that none of them spoke up and the fact that all of they are tip-toeing around Donald Trump, because they're afraid that if they say anything, maybe his supporters won't support them.
REHMWhat did you think of the debate, quote, "as a whole."
MCCASKILLI didn't think there was near enough substance. I didn't hear how we are going to address the crisis we have in this country of people working hard, playing by the rules, and getting further and further behind. It's a crisis. It is making people cynical. It's making people distrustful. It's making people blame the government -- and sometimes the government is to blame -- but many times this is about an economic system that's gone a little off the rails with a new economy that is a service-based economy and not a manufacturing-based economy and the fact that labor has gotten cheaper with an international global marketplace.
MCCASKILLThese are all complicated public-policy issues and we deserve presidential candidates that are addressing that. Because those are the issues that affect most Americans right now.
REHMFascinating to me, an article in Sunday's New York Times about the fact that you have to be born in a certain economic system in order to rise up. And if you are not born with parents who hold good jobs, with people who are willing to help you through school, you're not going to rise. So that the idea of anyone can make it is no longer quite true here in America.
MCCASKILLAnyone can make it, but they have to be extraordinary and tenacious and outside of average or norm. And we want it to be the norm in American that anyone can make it. That's what the foundation of our country is all about. And that's why I think many of us are worried. And the debate the other evening did nothing to reassure me that the Republican field understands the challenges we face.
REHMNow tell us about your own parents and your own upbringing.
MCCASKILLWell, I was -- my parents were not politically powerful. They worked in campaigns. I stuffed a lot of envelopes with my mother at the kitchen table. She would kind of fool us and say that whoever sealed the most envelopes with the cut-up sponges would not have to do the dishes that night. And we figured out later...
REHMShe was a homemaker?
MCCASKILLShe was a homemaker. She did never -- until my father got ill, later in life, my mother never got a paycheck outside the home. She was busy outside the home.
MCCASKILLShe was very active.
MCCASKILLAnd she worked very hard. And I always use her as an example. I hate it when women who work outside the home somehow diminish the work that women do that have made a choice to stay home. Many women don't have that choice. But my mom did. Although I'm not sure she was ever, honestly, Diane, comfortable that -- with the fact that she was not out in the world in a career. And I think she passed that on to us, that we needed to be independent before we were hooked up with anyone else. That we needed to figure out a way to make our own way in the world before we were married.
MCCASKILLShe wouldn't let us have a Barbie Queen of the Prom game because it was a stupid game, because to win the game you got a date, a dress, and went to a dance. And she said, "This is not how you win anything." And this was all -- and she was embarrassing to us because she was very outspoken, very opinionated. And it was very embarrassing, growing up with my mother. And she was not only the one...
REHMGive me an example of how.
MCCASKILLShe would, you know, first of all, she was -- sang the loudest in church, which was embarrassing to all of us. But we'd, you know, pull up at a gas station and my mother would -- this was back in the days where there was no self serve and there would always be someone that would pump the gas. And mom would get out of the car and strike up a conversation and begin to tell the person pumping the gas about, you know, my sister's violin lessons, or that I'd gotten an "A" on my spelling test, and then start asking them questions about their family. And by the time we'd pull out of the gas station, my mother, you know, would -- had attracted another group of friends to her circle. And looking back on it, I am in awe of the role-modeling she was doing for me at that moment.
REHMWhat about your dad?
MCCASKILLMy dad gave me permission to not be popular with boys. I was, you know, I didn't have a lot of dates in college. And I was even marginalized somewhat in high school in terms of nicknames I had.
MCCASKILLWell, I was, you know, they called me motor-mouth McCaskill and I was opinionated and outspoken. And my dad kept telling me it's okay. Men will eventually catch on, honey. Don't worry. The right men will catch on. Just be patient. And in college, when most of my dates were fix-up dates that my girlfriends would fix me up with and I didn't have anybody I really dated. He kept calling me and reassuring me. You know, "Don't get discouraged about that. Be yourself. Be yourself."
MCCASKILLSo to have a man, who was the most important man in my life, telling me that I was perfectly ladylike and perfectly wonderful, even though I was being bossy and opinionated and therefore not attracting a lot of men to my orbit, that got me through, I think, sometimes where I might have tried to dumb-down.
REHMNow you write a lot in this book about being treated unfairly on the basis of your gender. Give us some examples in the workplace.
MCCASKILLWell, there are so many. I -- when I was -- beginning when I was an intern in Missouri legislature and even an intern here in Washington in the mid-70s, I was spoken to in a way that was very inappropriate. And I was uncomfortable a lot of the time. And I took steps to avoid situations which, you know, is not really good. Because that meant I wasn't in situations -- the vast majority of the legislators were men -- but I went out of my way to be sure I was not in situations where I was alone with some of the legislators that said things. I mean, I got trapped in an elevator one time with a couple of legislators saying, you know, "Do you party?" And, "Why don't you come to our office for a drink?"
MCCASKILLAnd, you know, I wasn't even, you know, I wasn't 21 at the time or -- I think it was before my 21st birthday. And it was, you know, made me very, very uncomfortable. And then, when I came back as a legislator, I was constantly -- I was single and I was in my 20s -- and I was constantly being teased, inappropriate jokes. I went up to speak to the speaker of the House on the dais, asking him for his assistance getting my first bill out of committee. And he turned to me and he said, "Well, Claire, did you bring your knee pads?"
MCCASKILLAnd he thought it was funny. And of course, I laughed. But I obviously never forgot it. And those kinds of things went on all the time. I'm not sure I handled it right. Because I had a tendency to ignore it and laugh about it and work harder, and just keep working harder and keep working harder and figuring out ways. And that's where the strategy stuff comes in.
REHMExactly. And the strength comes in, because once it happens, somehow you know you have to prepare yourself, because it's going to happen again.
MCCASKILLIt's going to happen again. And particularly back then -- this was in the '80s -- and, but I figured out ways to strategize. And that's what really this book is about. I want women to realize that being hyper-strategic is something they should embrace. And it should be part of being feminine and being a lady, is to be hyper-strategic so that you can accomplish your goals in spite of some of the nonsense you put up with.
REHMAnd you're listening to "The Diane Rehm Show." We have an email from John in Baltimore who wants to ask, "Have you visited Ferguson, Mo.?
MCCASKILLOh, many times. I've been to dozens and dozens of meetings, church meetings, other kinds of meetings, with everybody from the mayor to many in the clergy community to many of those who've been very active in the protest movement -- a group of very dynamic, young African-American professionals that I have tried to work with as we've tried to find ways forward. So, of course, I was in Ferguson very soon after the Michael Brown shooting, have been there many times since.
REHMAnd another Tweet from Iris. "What about the realtors? When are they going to be held accountable for their hand in the racial divisions because of redlining practices?"
MCCASKILLI think there are institutional biases that we have to look at up and down the board. There are -- it's not just realtors. It can also be banking institutions. It can be insurance companies. It can be credit companies. It can be employers. So we've got to continue to look at all of these institutional areas to see if we can't work harder to removed all these barriers that are (word?) .
REHMNow, it's interesting to me -- with everything that's been going on not only in Ferguson, but St. Louis and elsewhere in Missouri -- how much of your focus considering all that, is spent on your own state, you as a U.S. Senator, and how much is spent on the wider country?
MCCASKILLBoth. And that's one of the challenges of my job. I have -- I've got legislation I've introduced, I'm very proud of, because it's endorsed by the Police Officers Tactical Association and the NAACP. And that's the kind of effort we have to find. It can't be...
REHMWhat would it do?
MCCASKILLIt would reform the federal programs that equip local police departments. It would make sure that we are prioritizing those departments that need the kinds of equipment they're getting. It would make sure that training was occurring for the proper use of this equipment, not just how you use it but when you use it. Making sure that these programs are in sync with each other. When I had the hearing on this, the three federal programs that do this, the people who ran the programs were there. They had never met one another...
MCCASKILL...until that hearing. That says a lot...
MCCASKILL...about these three programs.
MCCASKILLSo we are -- it's -- I think it -- and it prohibits certain kinds of equipment from ever being passed on to police departments: like bayonets, like some of the heavy-wrapped vehicles that are not meant to be driven on streets. Not that we would ever prohibit armored vehicles. Police officers need armored vehicles, not only to protect themselves but to protect citizens.
REHMBut what about tanks?
MCCASKILLThat's -- and tanks, obviously, would not be something that would be part of the equipment that could be passed on to local police departments. So this bill, I think, represents progress. And the most important progress, as I say, is that we've got to get out of this us-versus-them narrative that has been burned in place and -- with the help of the media, I might add -- been burned in place.
REHMClaire McCaskill, the U.S. Senator from Missouri. Her new memoir is titled, "Plenty Ladylike." Short break here. Your calls when we come back. Stay with us.
REHMAnd it's time to open the phones for U.S. Senator Claire McCaskill. She has a new memoir out. It's titled, "Plenty Ladylike" and, of course, as you can well imagine, we're talking about many things, including a day of civil disobedience, which is going to be carried on not only in Ferguson, but I gather in St. Louis as well. Let's open the phones now to North St. Louis, Missouri. Marty, you're on the air.
MARTYYes. One of the things is that in this society, here in this country, is the systematic racism that's here. And one of the things about St. Louis is it has a stigma where this is one of the most prejudiced states in the Union. And what I call the Claudine Theory is that over the years, the systematic racists have destroyed the black family, kicked the father out, last hired, first hired, all that plays a part in it.
MARTYAnd like she was saying, if you think you can just throw money at this situation or a bunch of programs, it's going to take a long time because you pile people on top of each other with the projects, you started a subculture and that's what we're dealing with kind of now. And we got to get a lot of the older black Americans back involved in the marching and everything now because we got to keep the younger -- show the younger kids what this is really about because I went to a think they had at the Chavez Center and a lot of black kids didn't want to listen to the older black Americans.
MARTYLike, we had our day, but it's time for the older black Americans to step up and show these kids what this is really all about and...
REHMAll right, sir. I'm glad you called.
MCCASKILLI couldn't agree with him more and -- but I will say this. I want to remind everyone that Barack Obama came within a few thousand votes of winning Missouri. It was the closest election in the country and many of us believe he won Missouri if we'd counted some of the provisional ballots that had been case. But since he'd won the presidency, we didn't, obviously, go back and try to count those. So I do think there's a lot of people in Missouri that are not racist and that are not -- don't have that filter of bias that the caller referenced.
MCCASKILLBut too many people do and we've got to continue to work on that and he's exactly right. The best antidote for some of these young people who see their life in very limited terms that involve -- crime is one, doing some real reform of the criminal justice system and, two, more mentoring with more African-American men.
REHMHere's an email from Susan who says, you are one of my personal heroes. Please talk about your position on the NRA. I believe it has a stranglehold on our government, which is very destructive. What can be done?
MCCASKILLWell, eventually, I hope, that the voters of this country shake their elected officials into some kind of sensical position as it relates to background checks and gun show loopholes. We've got to crawl before we walk.
MCCASKILLI don't think that these common sense reform measures threaten anyone's ability to own a gun, and use a gun for hunting, but, you know, there is a price we're paying in this country for refusing just to do the bare common sense minimum of making sure that guns stay out of the hands of people who should not have them. And we can do this. This is not something that is hard to do. And that doesn't mean that any deer hunter in my state. My dad was a big hunter. And we had cream of mushroom soup in the cabinet because my mom had to put it on all the critters he shot.
MCCASKILLSo that we could eat them. And so, I grew up in a household that, my dad had bird dogs and he loved to hunt. So, this isn't about getting guns out of the hands of people who want to enjoy hunting in this country. This is about weapons that slaughter innocent people in the hands of people who shouldn't have them. And hopefully, eventually, it's a little bit like campaign finance reform. Those two issues, I think, are ones that average citizens have the power. They just got to muscle up.
REHMAnd on that very point, an email from Claire. Can you tell me how many hours a week you and your Senate colleagues fundraise? Is there truly a way to change this sad aspect of our political system?
MCCASKILLI believe that we're going to have to have a Constitutional amendment to change Citizens United. I think that's possible. I think most Americans would support that. This idea that -- and by the way, we could make it transparent now. If -- we've tried to pass legislation making all this money going into these big super PACS, making it all transparent. But the Republicans have blocked it time and time again. I don't spend as much time fundraising as I probably should.
MCCASKILLBut I'll tell you, there is some hope here. And that is with the internet, we now have a way to go broad and not deep. We have a way to reach millions of people for 10, 15, 20 dollar contributions.
REHMBut that isn't what major candidates are going for.
MCCASKILLWell, not presidential now, because they're all shopping for billionaires so they can have a super PAC, especially in this cast of thousands in the Republican primary. So, we've got to clean that up. This notion that all you gotta do is find a billionaire and you too can get elected President. That's not the way our democracy is supposed to operate.
REHMHave you already lent your public support to Hillary Clinton?
MCCASKILLI have. I have a long time ago.
REHMAnd if Vice President Joe Biden gets into it?
MCCASKILLI can't presume to advise the Vice President what to do. Joe is a dear friend and all of us, you know, think the world of him. He's our friend, we served with him in the Senate. I don't see where he pulls support away from Hillary Clinton, because their views are almost identical on so many subjects. I'm not really even sure I could name a place where they differ. And so, I think, I feel protective of him.
REHMSuppose he did get into the race. Would that change your position?
MCCASKILLOh no. No, I believe Hillary Clinton is a fighter. She has demonstrated that to the American people. I think she is strong and she represents stability. I think she has an amazing resume of qualifications to be President of the United States. And I believe she will win the nomination. And it's okay if she has to fight for it. She wants to fight for it. She wants to prove to the American people that she is a fighter and she will be a champion for them. So I don't mind that she would have competition, but I still believe she'll win.
REHMNumber of people across this country no longer believe she's trustworthy.
MCCASKILLWell, I think that is a frankly a subset of a reality that everybody is attacking Hillary. Everybody is attacking Hillary. But I've looked at recent polls. She is beating every Republican in the field. She is beating Donald Trump by double digits. I don't believe that all of this incoming negativity that she's going to be putting up with over the next 18 months, in the long run, is going to change peoples' fundamental belief about her strength, her stability, and her ability to lead us in a very complicated and dangerous world.
REHMAll right. Let's go to Long Island, New York. Anthony, you're on the air. Go right ahead.
ANTHONYHello, Senator McCaskill, I'm from New York, but when you ran, first ran, I did send a small contribution to contribute to your campaign. But I want to bring up something. This repeal of a medical device tax and give you the facts on that. I don't know your position. I hope you do not vote for the repeal. Here's the facts. American manufactures produce like a hip prosthesis. It costs 250 dollars. That's the cost. No profit. Then it goes into many, many, many middlemen who are taking this and adding the price. It sold to the average hospital and average price in New York, in America.
ANTHONYFor 7,000 dollars. That same device goes to Europe, by the same American manufacturer, and it's sold to the patient in Europe for 1150 to 1350 dollars. It's a rip off. They're claiming job losses. The job losses are those middle men that shouldn't even be there.
MCCASKILLWell, I think we've got to look at not just what's going on with medical devices, but also with pharmaceuticals. In a hearing a few weeks ago, we, I heard from a pharmaceutical company where a drug had been 44 dollars a vial that another pharmaceutical company had bought them. And it had gone to 254 dollars a vial. Then another pharmaceutical company bought them and it went to 2500 dollars a vial. Same drug, just a new label. And this is a drug that's used in a hospital setting and they tried to tell me after the hearing.
MCCASKILLWell, you know, the cost of the procedure hasn't changed. Well, that's nonsense. We're all paying for this. We're paying for it in various ways, but we are paying for it. The consuming public. So, I certainly get the point you're making, and I think all of us need to stay focused on why are these costs going so high? Especially to America and not to the rest of the world. A lot of it goes back to the failure under the Bush administration for Congress to allow us to negotiate for volume discount on the drugs that are being used within the Medicare system.
REHMAll right. To York, Pennsylvania. James, you're on the air.
JAMESGood morning. Thank you for taking my call.
JAMESSenator, I think you're being a little disingenuous. You yourself raised funds in your last campaign during exactly what you're criticizing others of doing. How do you explain that?
MCCASKILLWell, I will tell you that I am not going to decide that I cannot raise money the way it's legally allowed to raise right now. Because then all the people that want to keep it that way get elected. And somebody who wants to change it is relegated to the sidelines. I want to stay in office to fight to make these changes. I am more than happy to give up PAC money. I am more than happy to make sure that any money going to super PACs is fully disclosed. I am more than happy to limit campaign contributions. I'm working right now, in Missouri, to try to change the laws there.
MCCASKILLWhere they have unlimited contributions and unlimited gifts from lobbyists. The only state in the union that is operating with reckless abandon in terms of ethics in campaign finance. So...
REHMAnd considering your positions there, why not support Bernie Sanders?
MCCASKILLWell, I think Hillary Clinton has already said she's for a Constitutional amendment as it relates to campaign finance. I don't think Bernie Sanders and Hillary Clinton differ one bit in terms of trying to clean up what has become a very corrupted system, particularly at the Presidential level. This is unprecedented. I think there was -- a week ago, they discovered that there had been 270 million dollars raised by the super PACs, compared to 78 million directly by the candidates for President.
MCCASKILLAnd of that 278 million raised, almost half of it came from like 60 people. So, think about the consequences of that. And I am not out looking for billionaires. I am raising money under limits in the federal system, to try to stay in office. But I am more than happy to give it up. I wish my Republican colleagues felt the same way.
REHMInteresting that Bernie Sanders was shouted down in a fundraising campaign. Or simply a campaign appearance he made in Seattle, by those who objected to his statement that all lives matter, not just black lives matter. How do you react to that?
MCCASKILLWell, I think Bernie getting heckled is part of being a Presidential candidate. I've witnessed when Barack Obama was a candidate, I've witnessed him being heckled. I've witnessed him being heckled as President. I've witnessed many candidates being heckled. I've been heckled many times. I think you've got to figure out a way, when you are heckled, to persevere and not allow the heckling to move you from a position of trying to get your message across. But it's, I think, I understand that people are trying to be heard. And when you're trying to be heard, sometimes it means you work in unconventional ways and this is America. You have a right to do that.
MCCASKILLAnd you're listening to The Diane Rehm Show. Let's go now to Greensboro, North Carolina. Roy, you're on the air.
ROYHello, Diane. Senator McCaskill, it's actually a privilege and honor to speak to both of you. So, my call has to deal with something that the Senator mentioned earlier, kind of in passing. About the general cynicism in the youth, I guess, in the country. I'm 26-years-old. I feel like I've, you know, done what America tells you to do. You know, I served the country. I was a combat medic and I'm in school now. But I don't come from a rich family. And it's always like an uphill struggle, getting anywhere, and it doesn't really feel like there's ever going to be somewhere where I can actually -- like, there's no -- it doesn't seem like there's anything that I'm going to be able to get to.
ROYLike, I'm never going to be able to build wealth at this rate. And it just feels like an uphill battle. And the government system just seems kind of flawed. Like, you look at all the politicians out there and they're absolutely ridiculous. You can't take people seriously. And I wonder if you have anything to add to that.
MCCASKILLMy heart hurts, listening to you.
REHMI should say.
MCCASKILLMy heart hurts. I worked my way through school as a waitress. And my parents, you know, my parents had both gone to college. But we didn't have a lot of money. And my husband's first job out of school was in a steel mill and he has created thousands of jobs and we are blessed by wealth that he has created through his work. And so I have lived, and my husband has lived the American dream. And I want that for you, particularly someone who says take me, I volunteer. And we've got to do better.
MCCASKILLAnd it is not about platitudes. It's about focusing on a system where we have a widening inequality. And I think we can do better. And I want people to be hopeful and optimistic. I think we can make education more attainable. I think we can figure out ways to make sure people do better than their parents did. But it's obviously, the cynicism has taken root, and with it, a total abandonment of the idea that government has any value to anyone. And that makes me very sad. I love my job. This book is about overcoming things and being strategic.
MCCASKILLAnd even being non-traditional in terms of some of my strategy. The way I promoted Todd Akin in a primary to get him nominated, because I want young women to realize they can figure out a way forward and upward, even when it appears that the system is kind of stacked against them. And so, I hope that for you, too.
REHMNot just young women.
MCCASKILLNo. Young men also.
REHMYoung men, as well. Claire McCaskill, US Senator from Missouri. Her new memoir is titled, "Plenty Ladylike." And indeed, you are plenty ladylike. Lovely to have you with me.
MCCASKILLThank you, Diane. I hope when people read it, they'll realize that I've been so candid, it's pretty obvious I'm never running for President.
REHMAnd thanks for listening, all. I'm Diane Rehm.
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