Volcanoes are erupting in The Philippines, but on-fire Australia received some welcome rain. The Iran war cries have been called off and The Donald’s military powers are about to be hamstrung by the Senate. Meanwhile, his impeachment trial is starting, and we’re all on Twitter for a front-row seat.
S5. EPISODE 10
Revisiting The Feminine Mystique
Featuring Rachel Shteir
How have gender politics shaped the role of women in our society? How far are we from equality, or are we there? And how has history informed our modern conversations on women’s rights? In her latest book, “Betty Friedan: Magnificent Disrupter,” renowned essayist, writer, and critic Rachel Shteir presents a compelling biography of the woman behind the 1963 bestseller “The Feminine Mystique,” which first popularized the idea of women’s fulfillment outside the identities of wife, mother, and homemaker.
Prefer to read? Check out the Audio Transcript
Zachary Karabell (ZK): What could go right? I’m Zachary Karabell, the founder of The Progress Network, and joined as always by my co-host, Emma Varvaloucas, the executive director of The Progress Network. The spirit of all this has been and will continue to be that there’s a lot going on in the world that is positive, that is constructive, that we don’t pay as much attention to, given that there is a lot going on in the world that is negative and destructive that we do pay a lot of attention to. So what do people do about it in a way that is constructive rather than wallowing in the nadir and destructive loops? And that is why we have these conversations. And today we’re gonna talk about something that remains deeply unresolved in spite of assiduous efforts of a lot of people to resolve, which is gender politics and the role of women in society. And historically, what the beginning is of our contemporary movements toward more gender inequality.
Emma Varvaloucas (EV): Today we’re gonna be talking to Rachel Shteir, who’s an award-winning essayist, critic, and writer. She’s the head of the Dramaturgy and Dramatic Criticism program at the Theatre School at DePaul University. We are gonna be talking about her latest book, which is called Betty Friedan: Magnificent Disrupter. It’s a biography of the woman who wrote The Feminine Mystique, if that means anything to you. It was a 1963 bestseller that gave middle class women a language for their unspoken dissatisfaction and oppression. The book struck a major chord and Friedan, who was a writer and an activist, went on to found the National Organization of Women, which advocated for women’s rights as human rights in the United States and elsewhere. And she sparked what’s now known as the second wave of feminism. And for those keeping track, we are now in the fourth wave and some people think post-feminism. So that’s what we’re gonna be talking about today.
ZK: Cool. I’m looking forward to it. Let’s do it.
So good to have you with us this morning, Rachel. And for those who don’t know, which would be everybody except Rachel or me, I was actually one of the people that you interviewed for your Betty Friedan book ’cause I had my own kind of odd encounters with Betty Friedan when I was, I guess, 10 to 12 years old, 9 to 13 in the ’70s in The Hamptons via my mother and her community. So it’s a real pleasure to talk to you today. I think one thing that I’m struck by is kind of how recent her life was and how distant her life feels, I don’t know, in the sense of there’s so much of what she wrote about and so much of The Feminine Mystique that has kind of entered our cultural DNA permanently, but her footfall and imprint seems oddly dissipated. I mean, maybe that’s true of a lot of people. I don’t know, does that resonate with you, Rachel, when you were writing about this and talking about it?
Rachel Shteir (RS): Absolutely, yes. First of all, thanks for having me. I’m so thrilled. Her ideas about what feminism was dated much earlier. They were issues of equality and representation, pay equality, representation in politics, childcare, reproductive rights. Those were her issues, including her idea that the mainstream feminist movement had gone too far. That it was too radical, which was a constant cry of hers beginning in the late ’60s and then on through the rest of her life. And I think that accounts actually in part for why she seems distant, because she rejected a lot of that radical feminism, which has become the dominant narrative of feminism. Second wave of feminism is the idea of the sexual revolution, and of course sexual identity politics as part of that.
When I think about Betty, what I think about is that we haven’t really achieved the very basic rights that she was interested in. We have made enormous strides on identity issues, right? That kind of representation. But in terms of childcare, reproductive rights, equal pay, representation in government, and that sort of thing, women have not really, they haven’t done it.
EV: So Zachary and I had someone on the podcast, Richard Reeves, that talks about the striking sort of pull ahead of women and girls as far as education in terms of way more women and girls are now high school valedictorians, way more women and girls go into college. And if you take that argument generously, as Zachary and I did at the time, I was saying like, well maybe this is where we’re finally gonna start to see the representation you’re talking about as far as representation in government and Fortune 500 companies and stuff like this, like really high points of society where I think it takes the longest to change.
Tying into that, what I was gonna ask you is, is that why you went back to her as far as a biography? Because she, you know, dissipating in public consciousness, it’s to the point where, I was born in 1990, when Zachary was like, let’s talk about Betty Friedan on the podcast. I was like, who’s Betty Friedan? [laughs] You know, like, oh. And then I realized she wrote The Feminine Mystique, and I was like, oh, okay, I can put her into the slot now. But even you writing the book, she would probably be canceled nowadays. So yeah. Why did you go back to her particularly in this time?
RS: Yeah. 10 years ago, which was the 50th anniversary of The Feminine Mystique, I wrote an article for the Chronicle of Higher Education Review, which is a newspaper for scholars, but it covers university beat or whatever. But they have this review which is sort of more literary. And so I wrote about the 50th anniversary of The Feminine Mystique, and then I wrote about some other books that were coming out that had just come out at the time. One was Hanna Rosin’s The End of Men, another one was Naomi Wolf’s book about her rediscovery in her 50s.
And so, my experience, I had never read The Feminine Mystique 10 years ago. And so I was reading The Feminine Mystique, and I was just blown away by it. The writing is very kind of no holds barred, argumentative, punchy. And it makes for a great read. It also is irritating and in some places dated and so on. But overall, the idea is women should have autonomy, and that was amazing. And then I was reading these other books and I felt that they either borrowed from Betty’s argument without crediting her ’cause they didn’t mention her or they argued with her in ways that I felt were kind of derivative or whatever.
And so, I wrote this piece, which was a defense of The Feminine Mystique and a lot of people really liked the piece. And not long after that, I was asked to write this book. So it was a commission. It’s not like I was thinking for many years, wow, I would really love to write the biography of Betty Friedan. But once I had written this piece and once I got into it, it was very exciting. I mean, obviously, it’s different from my first three books, wildly different. But it does share one thing, which is that in all the cases, the women are kind of going against some public norms even though the norms are very different in the different cases that I’ve written about. But I always thought of that as a thread. So that’s the basic story.
EV: We’ll be right back after this break.
Welcome back to What Could Go Right?
ZK: It’s funny, I have a question for Emma in this, which is, given that you were aware of The Feminine Mystique as a pivotal text or central text, I suppose, when you’re reading and thinking about what Rachel has illuminated of Betty Friedan’s life, does a lot of it feel like, oh of course, meaning, so much of what she pointed out in your growing up has been just accepted as a given? Or does a lot of it also feel strangely other?
EV: Both. I would say both. I mean, I grew up with a— my mom raised me from the age of 12, and she was an entrepreneur. So the idea that the point in my life was to get married and not go to college and be a housewife feels so alien to me that it’s hard to imagine the world that Friedan occupied not too long ago as we’ve spoken about on another episode of the podcast, right? This wasn’t too long ago in history that she had to point this out. I think it is a given, I think, for most people my age these days, and I think even more so for Gen Z and Gen Alpha, if you’re a woman, that it’s taken for granted that you’re going to go and do something with your life other than have a family. And I don’t mean that in a derogatory way towards having a family. At the same time, there is like this weird backlash that you see with the traditional wives on TikTok and things of that nature. Rachel, I’m wondering if you could pick up on that thread as well, the backlash [laughs] that we’re seeing these days to those ideas.
RS: [laughs] Yeah, no, I agree, Emma. I agree with what you’re saying. I think, obviously, on the one hand, there has been, for younger women, the idea that you don’t have to get married, right? So that’s an advance. There are different ways that you can live. But then I also think that there is this incredible persistence of these conventional, whatever you wanna call them, 1950s ideas. I don’t follow TikTok so much [laughs], so I don’t know if I can comment on that. But I think there’s other, you know, like reality television, The Real Housewives and so on. The Feminine Mystique and the problem that has no name, which is what Betty called this idea that women were supposed to get married and sit around in the suburbs, the book is about that, but again, to me, it’s about women having autonomy.
Audio Clip: Feminine Mystique, it defines women solely in terms of her sexual relation to men as men’s sex object, as wife, mother, homemaker, and never in human terms as an individual person, as a human being herself.
ZK: It’s interesting, there was also one way one could look at this, and I was struck by this reading your book, that what Friedan had talked about as a particular constraint and straitjacket for American, maybe a little bit Western, women, although we could have a whole side conversation about whether Simone Weil and Germaine Greer, who were coming out of a different European context, whether it was really the same framework or different. But you also had multiple strains in the ’50s where you had The Man in the Gray Flannel Suit, you have the male version of it,-
ZK: -like that there was a framework that men were supposed to be. And then you had the racial aspects. There was a framework that different classes of races were supposed to be. So in many ways, her book comes at this time where all of those frameworks are getting exploded.
ZK: And even if her lens was gender, each of them were being blown apart.
RS: Yes, exactly. I mean, I definitely see The Feminine Mystique as being part of that same social critique world as The Man in the Gray Flannel Suit. Betty wanted women to live up to their potential, and she didn’t see that happening. And it really upset her. And it came from a deep personal place too. She was right in there just being herself all the time, and there was no filter. And she wanted other women to do that too. She didn’t want women to be constrained by these ideas about gender. And I think that The Man in the Gray Flannel Suit was accepted as a critique. But when Betty wrote The Feminine Mystique, the idea that there just should be a space to talk about women and how there were these gender roles and how they were guided by Freud and universities and so on, there wasn’t a space for that.
And so this persona that Betty developed in my thinking comes directly out of the fact that no one wanted to give her a space to talk about this. It was not considered to even be worthy of a conversation really. And I mean, I often think about her as screaming because no one was listening to what she was saying. And I guess I feel like women— this is, Emma, to your question, yeah, there have been some advances. I feel like women still are struggling to have that space just to talk about how to escape these constraints, whatever the constraints are in the media. I mean, for example, the media. Okay, there’s a lot of talk about differently shaped bodies or whatever in fashion magazines. Okay. There’s a lot of talk about that, but then you rarely see that.
EV: I don’t know if I entirely agree with that, to be honest. And I have to say especially ’cause I live in Greece now and Greece is like 50 years behind kind of everything when it comes to comparing the US with Greece and in particular with things like this that are cultural, like women’s rights and where the conversation is around women. And what I see in Greece I think is like what probably was similar to what you saw in the United States in maybe the ’80s or the ’90s. But in the US, I feel like my social media feed is constantly filled with all different kinds of people that look different kinds of ways and are different ways. I am wondering what constraints you still see operating on women these days that are not tied in with Me Too and sexual politics ’cause that and maternal leave seem to be the two biggies for me. But I feel like Friedan would not agree with that.
RS: We don’t have pay equity. We don’t have reproductive rights in the States. We don’t have childcare. There’s huge ageism, especially around women, another of Betty’s campaigns. I mean, I would say just those four for starters. I mean, we don’t have representation in government. Betty thought that there would be a female president in 1976. We haven’t really done that well there. I also would say Betty was really interested in unifying women from different political— this is more later after The Feminine Mistique when she co-founded NOW. Her idea about NOW was to unite women from different political perspectives, including conservative women, Republicans, and housewives, and also radicals. And a lot of women on the left did not want to do that. They only wanted to talk to radicals and progressives. And that’s another reason why Betty parted ways with them. I mean, to me that was extraordinary that she wanted to do that. And I don’t think we’ve succeeded.
ZK: Betty wanted a big tent, but the people in the tent only wanted a big tent with people like them. That’s an interesting question of— the progress question is always challenging, right? Because we live in the moment that we live in and we’re faced with the constraints that we’re faced in. And then that magical mystery to our question that’s such a great parlor game because it will never be answered of what would that person who is now dead feel about the future, which is now our present. If you plopped her down in 2023, would she go, wow, there has been movement here, there’s been regress. Would it be just kind of a muddy mix of all of it? And to your ageism point, by the way, it’s fascinating because ageism was so intense that her book on ageism, nobody read, right?
ZK: They just ignored it. They still listened to a lot of other things, she said, but nobody was very interested about Betty Friedan talking about age when she was [inaudible].
RS: No one wants to talk about age, period, Zach, is what I would say.
ZK: It’s a perfect QED for the statement you just made.
RS: [laughs] Yeah.
ZK: But so I gather from what you’re saying, Rachel, that you think that she would, and you certainly do see there at best incomplete and at worst regress, right?
RS: Certainly. Can you argue that reproductive rights is not a regress— I mean, and childcare, in the United States, we have nothing. I think Betty’s response would be, okay, if we had passed the ERA, it would be a totally different picture. And that is a sort of also an answer to your question. I think she was devastated, like many other feminists of that time, that the ERA did not pass. And she considered that to be a huge failure. She hoped that it would galvanize the women’s movement to regroup. And it didn’t really, it didn’t really do that.
ZK: For those listeners who don’t know, ERA is Equal Rights Amendment, which I do feel some people probably don’t know anymore. It’s like another thing that’s faded.
RS: Yeah. Well, the Equal Rights Amendment was an attempt to put women’s rights in the constitution. And Betty thought that, and many other feminists, not just Betty, thought that really would solve a number of these problems that we’re talking about. When it didn’t happen, I think she began to get upset about her legacy and also the legacy of the women’s movement and to really be thinking about, I don’t know, like what had they really accomplished in the ’60s. And so I think if she were to comment on today, I think yeah, she would be thinking about that even. At the end of her life, she was certainly thinking about it. She was very upset that there was on her mind so much work to be done.
EV: And most of the fight these days has gone on to sexual politics as we were talking about before.
EV: I think there’s definitely an organized pushback against reproductive rights in red states, but it is striking to hear you speak about the lack of organization around maternal leave, childcare, as you say. I think when people think of feminists these days, they think about Me Too. They don’t think about-
EV: -let’s close the gender pay gap by providing better maternal leave and options for mothers returning to the workforce.
EV: I was gonna ask you about a critique for Friedan that you raised in the book that I believe an Israeli feminist raises to her on a trip to Israel that she takes, whether she had made it possible for women to pursue their passionate journey or had she merely displaced women’s enslavement from housework to their professional functions. I particularly wanted to ask you about it because that is the number one pushback I see on social media when The Progress Network posts videos that are about any kind of feminist issue. Usually, we do talk about social attitudes, if women should work outside the home, how those have changed, or the gender pay gap, things like that. The number one pushback is women work outside the house and society has collapsed and the family has collapsed. And women now just have to be slaves, just like men used to be [laughs]. So what do you make of that?
RS: Right. I mean, yeah, I think that critique is a really smart critique of Betty, and I wish I could be on a panel about it somewhere or see a panel or something. I mean, I think— this is really maybe is not exactly in Betty’s defense, but it’s more a kind of explanation of what she was talking about. When she was talking about women going to work in The Feminine Mystique, it wasn’t really about women going to work in factories or in some slave labor. And I think that reveals her class origins, but it also reveals her individualism, which maybe these days is something of a dirty word. I don’t know. Again, it comes back to she wanted women, yes, to be financially self-sufficient, but she also wanted them to fulfill their potential, whatever that was.
And she used herself as a model. That’s the sort of— whatever. Some people consider that to be shortsighted or that say that she was universalizing something that could not be reproduced and make that sort of critique. But I actually find something kind of hopeful in her idea that women should try to live up to their full potential in the work world because, I don’t know, I feel like this idea of individualism these days, again, it’s really kind of shoved to the side. And Betty was talking about how yeah, you have to compete. Yes, in capitalism. We live in capitalism. You have to compete there. And so if you’re being an artist, you should just try and do everything you can to succeed. If you’re being a media person, you should do everything you can.
Her idea was you should not be relying on a man, your spouse, your partner, whoever, to bolster you up and in some ways, you should not be sitting back. You should have your own identity. This is another point of contention about The Feminine Mystique. She did not really think that working class women could lead the feminist revolution because they were overworked. [laughs] That was her argument. They were overworked. And that’s an argument that this probably does not play very well on progressive social media either. But that was her argument, and she made it several times throughout the course of her life.
ZK: Which was another, I guess, critique of her and others in the ’70s, that it was white middle-class movement predicated on the luxuries of time and bare necessities being taken care of or having been met, which I think has become much more deeply entrenched in contemporary gender sexual politics. The idea that we should all be self-actualized and make your own adventure is a luxury that many systems don’t afford many people. And that’s the pushback, right? And it’s, I think, very entrenched today. Maybe one of the reasons that she has faded in some sense is that’s not in vogue anymore, right? Most people don’t believe that all you have to do is find your own voice and your own courage and step out of the framework that you’ve been forced into. It’s not so simple, I think a lot of people today would say. Not only is it not so simple, that’s naive. Most people are literally structurally unable to do that even if they were internally capable of doing that. What do you make of that?
RS: I agree with you that the perspective today is, I don’t know, anti-middle class in that way. And I agree with you, that’s one reason, again, why Betty seems more distant. I guess also we have much less of a middle class than we did in the ’60s, right? I also think, again, people are so much more tribal now. I think the idea of having a women’s movement that somehow unites the concerns of many different women is practically unimaginable to me.
EV: I agree with that. It’s very hard to imagine Candace Owens linking arms with [laughs] the hardcore left, but you know, the centrists, whoever they are now.
ZK: Rachel, thank you so much for the conversation today. You’ve had an interesting series of books now from the evolution of striptease to one of the leading architects of our contemporary, I guess, gender politics, for lack of a better word. Before we go, is this a throughline that you’re gonna continue?
RS: I don’t know. I like writing about these contrarian figures, and I think I can do that. So I would like to write about a different contrarian figure, maybe even a man, if anybody would like to read that. I don’t know.
ZK: All right, well, keep us posted on the hunt for the contrarian figure, the search for the contrarian-
RS: Okay. [laughs]
ZK: -which we certainly in our way try to do gently at The Progress Network. But thank you so much for your thoughts and for your book.
RS: Thank you guys for having me. I appreciate it.
EV: Thank you, Rachel.
Audio Clip: Women, persons, family of Smith. I’m glad to be able to speak to you today that you’ve invited me to speak to you today. This is a very crucial time. I thought to myself in the middle of the night thinking, you know, you have to give a cheerful speech at commencement. How can I possibly give you a cheerful, hopeful, optimistic speech today? There are those who think you take it all for granted, all the rights, all the marvelous choices, all the options that you enjoy, that you think that they are your due, the world is your oyster, that your own exceptional ability has won you those things, that nothing further has to be done. And you don’t even realize that they come to you, not from your own ability alone, as great as that may be, but because of the many years of battle, the long centuries, long line of women’s movement preceded you, I don’t think that’s true.
There are those that say you will be superwomen, you will be a new breed of women and you’re going to go on, you know, and be corporation presidents and before the century out, we’re going to have a woman as president and no problems. And then there are those who think that the women’s movement is over, that the nation has turned in reaction and although we can’t quite figure out how it happened in another few years, you’ll be home again and it will all be a dream. None of these things is true. Your situation is much more complex. I believe that we indeed have come to the end of the beginning, that you must move into the second stage, that the first stage of the sex role revolution that has changed the lives and the possibilities of life of women culminated in the modern women’s movement.
EV: We’ll be right back after this break.
Welcome back to What Could Go Right?
ZK: So much to talk about in that particular episode. And as you mentioned, Emma, during it, it’d be kind of cool to have a conversation with her and Richard Reeves about kind of the state of men and the state of women today and where that has all gone. Although it might not be the happiness conversation in that both of them probably feel like things have gotten worse for everyone, which is not— maybe that’s a step in the direction of things getting better for everyone. You have to reach a nadir before you achieve your apex, but it still would be an illuminating conversation, right? Because they both come at these issues of identity and how much is gender identity a thing that is central in contemporary culture. It certainly was central when Betty Friedan is writing in the ’60s or it became central as a thing in the ’60s and the ’70s.
And I was also struck by your— this mix of all of these ideas feel very familiar, but the individuals and the history behind it don’t. And that may just be just the reality of growing up in any society. We remember certain things and forget others, but the core content of it becomes part of the cultural waters in which we’re swimming.
EV: Yeah. I think the core content of your whole life doesn’t have to revolve around being a traditional wife has definitely stuck around to the point where we were saying before, it’s such a given that I think almost everyone my age, if you ask them who Betty Friedan is, unless they have done feminist studies or they’re involved in that history in some way, would not know. And I think a lot of my friends also wouldn’t know what The Feminine Mystique was, but they certainly would be like, yeah, no, if I’m just gonna have to stay home with the kids, I just might like fall down and die. And I don’t mean that as a derogatory, again, statement about women who do that. It’s very important. It’s just that it’s not for everybody to do that.
ZK: And the absence of choice that was part of that.
EV: Exactly. The ability to choose what you wanna do is the most important. I think we have achieved that today as far as you are able to choose. Choosing sometimes might require a decent amount of sacrifice, economic sacrifice, maybe it’s not possible for everybody, but it’s possible for significant portions of the population.
ZK: But as you know, there are also a lot of people who would push back on your statement, not in its particulars, but in just the overall assumption that anybody has an ability to choose within oppressive systems, right? That’s a big left critique of kind of what you just said, that there are these systems, whether it’s economics or society and rules that are mitigating against that choice, right?
EV: I mean, yes. I mean there’s certainly a segment of the population that either has to work because otherwise there’s not food on the table, like that’s not a choice. I think that for a lot of people, they are able to make the choice that if they wanna stay home, they can. And if they don’t wanna stay home, they can. That might not necessarily mean that choice isn’t hard. The people I know where they have one person staying at home and the other person on one salary that’s, let’s say, pretty decently under 100K, that’s hard, but it’s possible.
ZK: And then this whole question of— we’ve joked before on the podcast of the tendency to look at Northern Europe and Scandinavian countries and go, why can’t we just be more like them? Because it’s a clear example of much more robust maternity leave, much more robust childcare, much more awareness of if there’s gonna be anything resembling structural, economic, and power equality between men and women, one of the things you have to equalize for is whatever period of time where women are caring and caring for, particularly caring, but yeah, someone’s gotta care for young children, right? Doesn’t necessarily have to be mothers. And that societies that have accomplished that, or at least integrated that into their framework, have more women in government and they’ve got more— there seems to be a very direct correlation between providing that and all these things that people have been talking about for the past 50 years in terms of more structural equality, including pay equality. But it’s hard for us to become Scandinavia.
EV: I don’t know if it really is that hard for— I mean, look, we don’t have to become Scandinavia, right? We can just become a better version of the United States. I do take Rachel and sort of Betty Friedan’s point very well and what you’re bringing up now that the lack of focus in the United States about maternal leave, and, as you’re saying, how that relates to representation and how that relates to the gender pay gap because the labor department says that a decent chunk of the pay gap is not from discrimination, that’s also a chunk, but a decent chunk is coming from people taking time off work to have kids and coming back in. And if that were taken care of, we would be in a much better place. And I do kind of wonder, if we did refocus on that, what would happen even on a state by state level.
ZK: Absolutely. So on that completely unresolved note about our past and contemporary issues, let’s turn to the news and the stories that people may have missed that you have found.
EV: So we are starting this week’s good news roundup with something that started really terribly, but I promise it has a bright ending.
EV: So let’s go back to the 1950s when Egypt accidentally gave a bunch of its citizens hepatitis C.
ZK: I hate it when that happens.
EV: Yeah. They had a mass vaccination campaign that used unsterilized needles, and they accidentally spread hep C everywhere. And this whole story I learned about, by the way, in The New York Times, an article by Stephanie Nolen. It’s an amazing article, so after we summarize it, I do recommend people go and check it out. So what happened after that oopsie, is that it spread so much in the population that by 2007, 1 in 10 Egyptians had a chronic infection of hepatitis C, which if you don’t know anything about hepatitis C, which I didn’t really before I read the article, a chronic infection can lead to pretty severe liver problems like cirrhosis or liver cancer or stuff like that. So not good. And they just had this massive chronic problem that they didn’t really know what to do with and that the government itself had caused.
So in 2013, an American pharma company made an antiviral, which The New York Times calls the first cure for a viral infection in the history of medicine. The antiviral was massively expensive. And I don’t know how this happened, and I wish the article had gone into this a little bit further, but maybe they also don’t know how this happened. Egypt somehow managed to negotiate a deal for the pill on only $10 a pop. Usually, it was $1,000 for its once a day pill. And then they arranged for Indian and Egyptian drug companies to make a cheaper generic version in exchange for a royalty.
After 2013, some more companies made similar antivirals for hep C. Egypt did this massive screening of the population, massive uptake of the antivirals. Fast forward to now, they’ve basically wiped it out. There’s a 0.4% prevalence in the population, and they’re gonna help other countries with a high hep C burden essentially copy what they did. But the article points out that it’s very unusual. Usually in the global health field, you have high-income countries helping out low-income countries, but in this case, Egypt is the sort of the leader and the big major player here, which is kind of crazy how it all started, but good to see them cleaning up their mess.
ZK: Literally in this case, right? Yeah. We did have this brief moment, of course, in 2020, 2021, where the attention of the world turned toward these sort of massive technological innovations in the way we develop vaccines and in the ways in which vaccines have been essential to the spread of public health throughout the 20th century. The reality is, and I think this was part of the discussion and why subsidies for the COVID vaccines were necessary, is that vaccines have never been particularly good business for companies, although at $1,000 a shot, there’s certainly a lot better business, but mass vaccines have tended not to be. There’s not as huge a financial incentive for biotech companies and the research companies that support them to develop mass vaccines as opposed to very high-end cures, treatments for end of life cancer, as you said, $1,000 per pill or $50,000 to $250,000 for a course.
And that remains a problem in the way in which we do drug development, drug discovery, and then of course the commercialization of cures because we certainly have the scientific and pharmaceutical capacity to deal with many more diseases than we deal with. But we don’t necessarily have the right capital structure to lead to the deployment of those. And some of that, you know, the case you mentioned is often enabled by governments that that say, look, there’s a public health necessity for this so we’re gonna short circuit or do an end run or close the gap between whatever the free market incentives are and what the public health incentives are.
It’s interesting to note that since 2021, the leading proponent and developer of the RNA vaccines, the mRNA vaccines, Moderna, which was treated as this darling of both the financial markets and the media, its stock has completely imploded since it’s high even though it developed— it did exactly what it was gonna do, it’d spent years working on these mRNA vaccines.
So you do have this example in the Egypt case of some necessity of public and private, that if it’s all public, governments aren’t gonna develop the R&D and the research and the raw science that leads to vaccine development. But the free market alone is likely either gonna price them in a way that doesn’t allow them to be widespread or developed in the first place. So the lesson here is somewhat what the lesson was in 2021, that these are one of the cases, along with infrastructure, where public, private really needs to be working in conjunction.
EV: Yeah. And putting aside the extra special case of the US healthcare system, which I talked to a pharmacist friend about this article because she saw our TikTok about it, and she told me that, to your point about the free market not being enough, in the US, still, the price, maybe not that the patient is gonna be paying, but the price overall for a full hep C treatment in the States is $33,000. So it’s just massively expensive. And it’s really surprising and unusual, as you’re pointing out, that Egypt was able to manage this deal because normally, that wouldn’t happen. And I’m so curious about how that came about. If anyone knows, tell us. [laughs]
ZK: Yeah, let us know. And even that $33,000, it’s not like that’s the cost of goods sold, right? It doesn’t cost $33,000 to develop a hep C treatment. It costs $33,000 within the US healthcare system to obtain, administer, go through the insurance, go through the multiple stages of who’s paying what, and then you get that 33. But if you’re just looking at the cost of manufacturing those drugs, let alone the cost of just getting them into someone’s body, it’s nowhere near that headline number, right? It’s because we have this incredibly complicated system. Anybody knows who has looked at what the cost of a hospital bed is if you were to pay without insurance versus the cost of a hospital bed with, because the rates are partly set based on what the insurance reimbursement rate is not based on what the actual cost of it is. So yeah, we don’t live in the most rational system.
That being said, it’s not as if multiple public health systems, I think we talked about this briefly in our first season, one of the really astonishing things about COVID was that the public healthcare systems that many Americans, particularly on the left, had looked at with envious eyes, like, oh, if only we could have a public healthcare system like Europe other than the Scandinavian countries, and we’ve talked about this too, it’s not like public health systems in Italy and France and Spain did so much better than our messed up American health system. Same thing in Canada, which did a really good job in some respects, but in actually deploying vaccines during COVID did a really bad job. So you’d be hard pressed to find a very large healthcare system outside of Singapore, Norway, Denmark, that does these things particularly well. But it’s certainly worth noting [laughs] the ways in which the American healthcare system does them really badly.
EV: Yeah. And I think for our particular purposes with What Could Go Right?, where we talk about the narratives of, you know, fear and doom mongering in the media, I think that the other thing that I’ve noticed about the US healthcare system is the fear factor. I remember like 15, 20 years ago when I had surgery in the US and they do show you all the things that they actually cost before the insurance jumps in. And when you see the numbers, it’s terrifying. We have to run through them before you get to the end line. And some people don’t get to an end line where you’re like, don’t worry, most of this was covered. And just that fear that something won’t be covered or the insurance will fight you about, it leads to weird decision making and it leads to this psychological state where you’re like, I’m afraid to go to the doctor. You know?
ZK: I mean that’s a really good point. One of the advantages of some of the public healthcare systems is it removes all that from the equation. So they may not do a very good job. There may be waits, it takes you four months to get an appointment for a knee operation, whatever the is that’s a problem, it does remove some of that anxiety around, oh my god, am I gonna go bankrupt? Can I afford this? What’s my out of pocket versus the insurance? And also never knowing what that is. It’s not as if it’s a transparent formula.
EV: Oh. Yeah, I’ll never forget I was seeing those charges for like the scalpel, they’re like scalpel, $1.25, I was like, I have pay for that? [laughs]
ZK: They charge me for the scalpel? Really?
EV: Yeah. The sheets, everything. Everything.
ZK: It’s like ordering a peanut butter and jelly sandwich and they charge you for the knife.
EV: The knife, yeah. [laughs] Exactly. So anyway, moving on from that nightmare, I’m sure no one really wants to hear any more about that, let’s talk about the death penalty, another—
ZK: Oh, yeah, another thing that people, we always wanna talk about.
EV: [laughs] Let’s change track to something uplifting. So we’ve talked on the podcast before about the death penalty being in long-term decline in the United States. The Associated Press just did an update about this because the Death Penalty Information Center released new numbers for 2023. And it’s interesting to see the absolute numbers of what’s actually happening in the States because the numbers, for me anyway, were surprisingly low. So in 2023, the AP says, via Death Penalty Information Center, there were 24 executions in the US and 21 people were sentenced to death in 2023, which was the ninth consecutive year, they say, where fewer than 30 people were executed and fewer than 50 people received death sentences.
And as we’ve talked about before, this is happening in only a small handful of states. So it’s just five states that conducted executions this year, those states being Texas, Florida, Missouri, Oklahoma, and Alabama. And that was the lowest number in 20 years. More Americans than ever are anti-death penalty, so I think that will ring as positive for a lot of people. I will also include the kind of nasty stuff that was going in the other direction, which is that Alabama has set a January date for the nation’s first attempt to execute someone with nitrogen gas, and Idaho, for some reason, authorized executions by firing squad, becoming the fifth state to do so, although we haven’t actually executed anyone that way since 2010.
ZK: I think some of the reasons for that is apparently, it’s increasingly hard to get the drug cocktail, and that some of the drug makers have ceased to make the components of the drug cocktail. So states that wished to end people’s lives via judicial execution are in need of alternate ways of doing so. So if you’re a European listening to this, and we do have quite a few listeners outside the United States, the very fact that the United States has a death penalty and executes anyone is seen as intensely retrograde and somewhat barbaric. And it is definitely true that amongst developed nations, the United States is something of an outlier in even having a death penalty that’s legal at a federal level, even though, as you said, not really prevalent in most states of the union. I mean, it could be, it just isn’t because most states prefer not to do so and don’t have populations that’s support it.
What is intriguing in all this is that even in states that are quite supportive of the death penalty, there’s very little actual executions as in there’s far more people on death row than there are people who will ever be executed because, well, one, there has been really a beneficial, I think, effect part to quantify precisely of groups like the Innocence Project, which went through old DNA samples and just the sheer number of past convictions that have been invalidated by subsequent DNA evidence that shows that eyewitness accounts have been wrong, I think has led to an awareness of it’s one thing to wrongly imprison someone who can then be set free, but if you’ve executed someone, it’s very hard to do that. That’s meant to be a profound understatement. It’s hard to release an executed person. So there has been increasing caution over you better be sure that the person that you’re doing this ultimate punitive sentence for is guilty of whatever they’ve been found guilty of.
And I will say one other caveat to this discussion, which is the United States is also unusual in its use of solitary confinement, unusual in developed nations, right? I mean, Brazilian prison conditions, Indian prison conditions, lots of the world’s prison conditions are significantly worse than the United States, although the United States is hardly a shining beacon. And life imprisonment as a technique [inaudible] consecutive sentences without the hope of parole. Prison populations are going down. Prison reform, there’s a lot to be said of it even with the sliding back after COVID, given that the rise of public safety concerns and challenges to bail reform, we’ve talked about this on a few of our episodes. So there’s less people in prison in the United States per capita than there were. United States still imprisons more people per capita than most developed nations. So there’s a lot of yes and no, yes and but, one step forward two steps back, two steps forward one step back.
I do think the death penalty one is fascinating because, in this case, it’s almost as if most states, even with the death penalty, have held to the principle of having a death penalty more than an aggressive rush to actually execute people. And, again, if you’re European, you’re probably going, this is like discussing different ways to torture someone nicely. So I get the fact that there are people who probably object to the whole premise of this conversation, which is the very fact that you have a death penalty removes you from consideration as having made any productive changes. But yeah, we’re also in the society we’re in and any movements toward a more balanced approach toward criminal justice is a good thing.
EV: Yeah. And they also mentioned that public perception is changing too. You mentioned the Innocent Project and other things. Gallup started asking the question, I believe, in 2000, do you believe that the death penalty is applied fairly? And the amount that do believe that it’s applied fairly has been inching downward over the years. So there’s definitely some of that work, as you mentioned, has been filtering into the public. And I do think slowly we will see that across all the states. I think 20 states right now have made the death penalty illegal or are following moratoriums on the death penalty. So we’re almost at half.
ZK: So there you go. Thank you all for listening. We will be back next week. And, again, comments, thoughts, ideas, suggestions, criticisms, venting politely into the ether, all are welcome at The Progress Network and What Could Go Right? Please sign up for our newsletter weekly, also called What Could Go Right? So go onto to theprogressnetwork.org and sign up. It’s free. It will cost you only your time, time that we think is well spent, so.
EV: And speaking of writing in, people do that and we do love it and appreciate it. For instance, we got a YouTube comment on our episode that talked about child mortality rates, and I wanted to just give a quick mention of that where we had talked about child mortality rates in the 1950s being around 27%, which I said was 1 in 3 kids, more like 1 in 4, that’s closer to 25% not 30%. So thank you for the correction. I believe Richard is his name and we appreciate your eagle eye on our data presentation because we do try to be specific and precise here.
ZK: Keeping us honest ’cause otherwise we would of course be dishonest.
EV: Well [laughs] hopefully not, but-
ZK: Okay, fine, fine, fine.
EV: -we do appreciate a public fact checking. [laughs]
ZK: We do in fact appreciate a public fact checking. That is absolutely correct. So fact check us. Go on, fact check us. Thanks again for listening, and we will be with you next week.
EV: What Could Go Right? is produced by Andrew Steven. Executive produced by Jeff Umbro and The Podglomerate. To find out more about What Could Go Right?, The Progress Network, or to join the What Could Go Right? newsletter, visit theprogressnetwork.org. Thanks for listening.
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