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Jonathan Metzl on how white identity permeates policymaking outside of Washington

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I am Jonathan Kaye. Part and welcome to Cape Up Healthcare in Tennessee guns in Missouri tax tax cuts in Kansas professor. Jonathan Metal at Vanderbilt University focuses on those three areas in his book dying of Whiteness. How the politics six of racial resentment is killing? America's heartland using compelling data and focus groups metal shows how white people are willing to die rather than be connected a two or finance policies. They believe are giving resources to people bayview as undeserving find out more about this important book right now. Jonathan Mental. Thank you very much for being on the PODCAST. Hey It's great to be here. Okay I've been raving about your book for months now and it is really an important book. The name of the book is dying of Whiteness. How the politics of racial resentment is killing? America's heartland it land. And you start off the book by telling the story of Trevor Talk About Trevor sure will basically the the the impetus for the book came from a series of focus groups that Some colleagues of mine and I were doing in kind of rural Tennessee. Where we were talking to medically ill poor White and black Americans about the affordable care act and we just found some very dramatic stories which I recount in the book but I think probably one of the most powerful stories was is one of a man named Trevor who called Trevor in in the book. who was suffering from liver failure and a bunch of other chronic conditions. And he really would have benefited from this was in the year. Twenty eleven at the time. What the what? The affordable care act potentially was offering which was increased access to physicians financial help. Because he was under you know in the facing medical bankruptcy and this was in a focus group and I basically asked You know what you're feeling about the affordable care act. And he told me I realized that I realized that something like the affordable care act might be beneficial for me but I have to tell you. There's no way I'm supporting or signing up for a program that is he put it. Benefits benefits Mexicans and Welfare Queens. That was a quote I heard a lot and basically the the idea was that even if this program might benefit me. I'm not going to support a program. Graham that might also benefit by his estimation kind of undeserving immigrants minorities and the reason that was important was because again. It was a refrain that I heard quite right often that I'm you know we don't we don't want to be part of a program that might not just benefit us but other people and in this case you know. Here's a guy who's he's on. Death's doorstep literally literally on death's doorstep and so part of the jumping off point of the book is how powerful is this idea about kind of what it means to be white in America and this idea that basically weekly to be to be white means to have to block the advance of other groups and in in a way that the call of whiteness because of stories like this where people literally literally traded their lives at rather than sign up for social programs support programs that they felt like might go to benefit other people who were undeserving to the pointed ended the focus groups when you were talking to either all white groups are all black groups who had a colleague who you worked with an African American man who he taught out to all black groups and you talk to the all white groups for obvious reasons but talk about that will we just wanted people to feel comfortable. Obviously Racist Racist Right Marker powerful marker in the south where we're doing are doing our research and so we really wanted to get people's honest opinions About I mean. Obviously I'm a race scholar. So is my colleague Derek Derrick Griffith and so part of the issue as we just we wanted to get the real stuff the real the real responses and so I think part of part of the issue was that but also you know because races such important dividing line in places like Tennessee where we were doing the research we really wanted to see. We really wanted to compare. We asked every Group the same questions and the focus groups were pretty interesting about the first fifteen or twenty minutes of the groups. Were just general questions you know. How do you define health? What do you do to to to to maintain your health and it's interesting that Race really wasn't a factor in those early questions so everybody would joke around and say stuff like you know. I try to keep my weight down around but then I walked by. McDonald's mcrib is on sale for ninety nine cents and everybody would kind of laugh and everybody you know I would. We would all laugh. I mean I personally loved the mcrib awesome. Now go on. I mean I did said Skip Vida But anyway you know so for the first twenty minutes or so when we would ask general questions about health there really were no race race dividers right. And we're also socioeconomic class but we can talk about that later but then about twenty minutes into each group we would ask this question and so who benefits from healthcare reform and. It's important to note that we were doing these interviews in two thousand eleven two thousand twelve. This was a time when Tennessee was really debating. I'm should they should. We expand Medicaid should we create To basically except the affordable care act rejected. That was something very much on people's minds and what we found was when we asked this question who who benefits from healthcare reform the almost to a person the African American men would say things like everybody. Does you know we are society benefit. If more people are insured. Sure not just black people. That's what they would say But really everybody and so this idea that we get from the African American focus groups was was. You know. It's kind of the attitude you want people to have if you're going to create a national healthcare system which is if we get the most people in the system. It benefits the most people when we would ask the groups of particularly lower income white Americans against we got a a range of opinions but one that seemed to dominate was. As I mentioned this idea that basically I don't want to be part of a system where the benefits that could be going to me are going to as they put it undeserving. Immigrants Minorities which tapped into a lot of these things about you know building a wall and keeping people Out and so really. I think that the profound racial difference we found in these groups was really that one group really had a very a very broad idea about Menendez's Monette work at risk. All the things you would want people to have when you're creating health insurance and for for the White Americans we spoke to an you know. Of course I'm a white American myself myself In these groups people people would basically it was the sense of kind of limited resources and privileges are being taken away from me and and and that was important both because it it spoke to an ideology which was just countered to the idea of creating a national health care system it was important because it tapped into historical tensions ends about other times to democratize health. Care you know Johnson and Truman administrations. you know desegregation things like that but it was also important because the ideology the of blocking the affordable care act was one that we didn't just here in the groups that was how the entire state voted. We elected politicians who decided not to expand Medicaid not to create competitive insurance marketplaces. And so in a way that ideology we felt a from a political standpoint was was quite dominant in terms of how the state ultimately voted and decided what to do Well on that larger point of you know the the white focus groups looking at the idea the of their resources going to quote unquote undeserving. People but you also make a point of in here. It's on page one. Seven where you're talking about. President trump and his hammering away at the at the affordable care act that obamacare and you're right trump essentially asked lower income white people to choose less coverage and more suffering over a system that linked them to Mexicans Welfare Queens and to healthier longer lives and it was that that were that verb linked them. The idea of being connected to these people was a was a bridge too far right. I mean it's it was one of the more powerful points and something I couldn't advantage before doing these focus groups but basically the idea I mean think about it. If you're an you know I'm I'm not. I hope people see this. I'm not trying to totally really slam. All the people I interviewed. I feel like there were remarkable stories of bravery just about what it means to stay alive in a part of the country where there's no social safety net. But but I will say that at this idea came came up again and again. which was this kind of particular form of white identity as what I'm holding onto? It's kind of keeping me alive. But what if I smoke three packs of cigarettes a day and I as people that tell me I I live a healthy diet. Things like that and I'm in a network where my good health is dependent on a healthy African American person or Latino person who maybe jogs every day and doesn't smoke you know in a way there's a sense of dependence ends up being in a in a broader social network where my actions are related to other people's actions who it frightens me to be dependent on and so there was. There's all this underlying tension about about what it meant to be in really in a a a healthcare system is a web people are connected and and you're dependent on a certain certain number of people being healthy one got if one person cost ten dollars for just a checkup and one person cost ten thousand dollars because they need a kidney transplant. Supplant it balances out right so in a way your actions are connected to the actions of other people and I think that that anxiety there's an underlying anxiety about what does it mean to be dependent dependent on people who who At least my formulation of Whiteness tells me I'm superior to

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