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The Current Transcript for May 12, 2017

Host: Kelly Crowe

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

I know we have still not shattered that highest and hardest glass ceiling, but someday someone will and hopefully sooner than we might think right now.

KELLY CROWE: Hillary Clinton's dream was to become the first US female commander in chief—but that dream was shattered and her loss has been blamed on everything from sexism to the FBI’s investigation of her use of a private e-mail server. But one journalist with deep connections to the Clinton campaign says she was doomed from the start and that she bears much of the blame for her own loss. We'll have that story in an hour. Also today, it was supposed to be a miracle drug that relieved the worst pain with almost no risk of addiction according to its manufacturer. But soon after it came on the market, thousands of Canadians were hooked on OxyContin.

SOUNDCLIP

I tried to stop on my own and the sickness was unbearable.

KC: In half an hour, we're asking if the $20 million settlement reached in a class action suit against Purdue Pharma—the makers of OxyContin—is enough. But we're starting today in Venezuela where a life threatening shortage of drugs and medical supplies is leaving hospitals scrambling with devastating impact.

SOUNDCLIP

We used to attend 400 patients and now we only can do that with 120, something that you cannot accept because this is one of the richest countries in Latin America.

KC: Venezuela on the critical care list coming right up. I'm Kelly Crowe. This is the Friday edition of The Current.

'Our people are dying': Venezuela's health crisis leaves doctors without medicine

Guests: Dr. Maria Alejandra Torres, Marianella Herrara

SOUNDCLIP

Inside one of Venezuela's largest public hospitals, catastrophic conditions stalking patients the moment they step inside. Dr. Ronnie [unintelligible] details the long list of shortages—medicines of all kinds, syringes, saline solution, IVs, gurneys, even cleaning and sterilization supplies. Next door, we gather to meet Guiniver Mesa—just 21 with a horrifying tumour on her neck. She is clearly in pain. Her mother tells us they've been waiting for the operation but it was cancelled today—no medical supplies.

KC: CNN reporting this week on the life threatening result of Venezuela's dire economic and political crisis. A new study just released by the government reveals that Venezuela's infant mortality rose 30 per cent last year. That's more than 11,000 children under the age of one who died in 2016. Seven hundred and fifty-six women died in childbirth that year, an increase of 65 per cent from the year before. Cases of malaria jumped 76 per cent. Those staggering numbers are a reality that doctors in Venezuela are dealing with up close every day. Dr. Maria Alejandra Torres is a hematologist-oncologist. She is in Caracas. Hello.

DOCTOR MARIA ALEJANDRA TORRES: Hello.

KC: Is that description an extreme case or is that accurate?

DOCTOR MARIA ALEJANDRA TORRES: It's perfectly accurate. The situation in Venezuela is getting from bad to worse. This year, early this year maybe in March, we just received the first government publication of these numbers you referred in the [unintelligible]. And those numbers are surprising, were given through the health minister. Two days ago, this person, this woman who was the health minister was removed from her office because she gave these numbers to the public. This is a terrible situation. I think it is a little bit worse because we have two systems, two health systems in our country—the private one and the public one—and in the public we have those numbers that are terrible ones. But in the private sector we also have very bad numbers that are not recorded on these government publications.

KC: Now you didn't need to hear the numbers however, because you're seeing this on the ground every day. Tell us what you're seeing.

DOCTOR MARIA ALEJANDRA TORRES: That's right. That's right. That's right. I am going to tell you a regular day for a cancer patient. A patient has to come to the hospital. First of all, he has to take the blood tests outside the hospital because the hospital does not have the regular test in the institution. Okay? So after that you have to pay for that, of course. After that we just have an office visit and tell him do you need some treatment? So you have to go and look for everything for your treatment. I mean solution. I mean medications. Everything has to be sourced out of the hospital and they have to bring that to us and then we only give the service to apply the treatment. Do you understand? So the people in our country have to look for every medication. If the patient is diabetic, if the patient is hypertensive, he has to go to look for these medications also because we don't have that at the hospital. We don't have that at the regular pharmacy in our country. So we have to look for the medication through the border, the Colombia border or the [unintelligible] border, or some family that are living outside Venezuela have to try to get the medications and get them into our country to favour their families.

KC: How are you getting the medication across the border?

DOCTOR MARIA ALEJANDRA TORRES: Okay. We have people from Colombia from the border, the town. Typically it's called Cucuta. The Colombian people that have both citizens—Venezuela and Colombia—so they are able to cross the border easily. And this person goes to Colombia and in Colombia buy the medications and then they just cross the border and send them to us to Caracas, to Maracaibo, to Valencia, to whatever city we are needing. That favours the people that can afford these medications because if the person does not have the economic situations to afford that, this person just doesn't get anything.

KC: What's happening to your cancer patients who can't get the medication?

DOCTOR MARIA ALEJANDRA TORRES: They just are dying. Our people are dying.

KC: We spoke to you a year ago and you said it was hard then and that you were thinking of quitting. How have things changed since then?

DOCTOR MARIA ALEJANDRA TORRES: Well, a year ago to now, it’s getting from back to [unintelligible] because we have a rise in many mortality numbers. The maternal mortality rise five times. The neonatal mortality is high. It rise 33 per cent just this year but globally from 2015 to 2017, they rise 100 per cent. And the general mortality 10.7 times. The nutrition service in the hospital does not have milk formula and about 66 per cent of the hospital does not have any formula, any milk formula.

KC: So how are you finding it? Are you still considering quitting?

DOCTOR MARIA ALEJANDRA TORRES: Well, yes. Yes. I don't know if you are aware that right now we have 13,000 medical doctors that right now are out of the country working in different places. But most of them is because they have maybe a [unintelligible] parent or maybe an American one or maybe Peruvian, Costa Rican parents and that is going to be for them more easy to go outside. For us that just are Venezuelan for both parents, Venezuelan, just Venezuelan, it’s more difficult to take that decision. So we are just waiting that this scenario that is very, very adverse is going to be maybe better this year if we can just take out Maduro’s government from our country. Today I will say that I think we have some kind of hope because many people, the whole country is just getting together to fight, just to say we don't want this anymore. Maybe we are going to change a little bit of this whole crisis.

KC: Now what needs to happen to improve health care specifically?

DOCTOR MARIA ALEJANDRA TORRES: First of all, Chavez make a big mistake in his government in the past because he didn't apply any money to the public hospitals. He just gave to the population insurance to get to the private [unintelligible] and get attended there. So first, we have to invert many money to recover the public system. Second, we have to move to recover the confidence from pharmaceutical companies because we just pay many credits from them and never pay them back. So we have just to restore this kind of situation. Maybe they have to counter many of our debt but we need to recover more of this relationship that the second situation. And the third one, we have to prepare new doctors because with this diaspora of medical doctors outside our country, we are running out of many persons working in hematology, in oncology, in pediatrician, in cardiology, et cetera.

KC: Okay. Well, thank you so much for talking with us.

DOCTOR MARIA ALEJANDRA TORRES: Okay. Thank you very much.

KC: Dr. Maria Alejandra Torres is a hematology-oncologist. She was in Caracas.

SOUNDCLIP

[Through translator] They don't eat. They tell me they are tired because they got up early to stand in the food line with their parents. They can't concentrate on their tasks because they are hungry and tired. Last night I went to bed without dinner. My son ate but I did not. I can barely afford to buy my child anything. I spent 4,000 bolivars for 100 grams of cheese. That's all I can afford.

KC: That's Vanessa translated by one of our producers. She's a Grade Two teacher in Caracas. She spoke with ABC News about the food shortages she, her family and her students are facing every day. Some of them have dropped out of school because of hunger. And like thousands of Venezuelans, she is angry. In March, a single basket of basic grocery items such as eggs, milk and fruit cost close to 800,000 bolivars which is four times the monthly minimum wage, according to the Venezuela-based Center of Social Analysis and Documentation. The steep prices place these staples firmly out of reach for most Venezuelans if they can even be found on the increasingly bare supermarket shelves. Marianella Herrara is a doctor and the director of the Venezuelan Health Observatory. She is in Caracas. Hello.

MARIANELLA HERRARA: Hi, Kelly. How are you?

KC: I'm very well. Thank you. We just heard Vanessa talk about not eating so her son can eat. How common is that?

MARIANELLA HERRARA: That is very, very common unfortunately. And we have been trying to put some numbers to the meals people here are eating per day and we found that at least 32 per cent of Venezuelans are not eating complete meals three times a day. So there are at least more than nine million of Venezuelans eating two meals a day or less.

KC: So in particular, how is the food crisis affecting children?

MARIANELLA HERRARA: Well, the first thing we have to mention is that the school lunch program is not working very well. Many teachers have complained that either the meals don't arrive on time to school or if something arrives, it’s insufficient or contaminated and they cannot give that to the children. So in addition to this, families cannot afford proper meals and they prefer not to send the children to school because they are fatigued and they have to diffidence because they haven't eaten in several days properly and they cannot function very well at school.

KC: Now what kind of food are people eating?

MARIANELLA HERRARA: Well, the food pattern is completely impaired and we have seen the substitution of protein, the essential proteins such as beef or eggs or dairy products, for things like pumpkins or cassava or potatoes which are carbohydrates and we all know that a protein has a function and a carbohydrate has a different function. So we cannot substitute protein for carbohydrate. But that's what the majority of people are eating in this moment because it's what they can afford.

KC: Give us a sense of the prices and the accessibility of some of these things like milk and bread.

MARIANELLA HERRARA: Yes, of course. This is [unintelligible] literally because you have to first find out where can you find food and then to check if you can afford that. And if you can, you have to queue for long hours—you or even your family—in order to get the amount of food you need for feeding your family because sometimes everything is so restricted that if you have a family of six and they give you just a package of the product you are looking for, that wouldn’t be enough for feeding your family.

KC: Now what are the long term health effects for the people of Venezuela if this food crisis continues?

MARIANELLA HERRARA: The biggest concern we have is how this will affect this generation and the next one because we all know from recent research that early years are key for proper development. And we also are very concerned that those early years are not doing very well at the moment. Since pregnancy, children are experiencing in utero deficiencies and then they are newborns with low birth weight which in the next two years and complete the first thousand days, they have deficiencies of nutrients and caloric deficiencies. So this increases the risk of having cardiovascular diseases or type 2 diabetes or even obesity later in life.

KC: We're also hearing of a rise in diseases such as malaria. What can you tell us about that?

MARIANELLA HERRARA: Yes. The rates of malaria has been outrageous and because of malaria was literally eradicated in Venezuela several decades ago, we are very, very extremely alarmed that the numbers of 2016 are more than 200,000 cases of malaria and more than 200 deaths from the disease which is huge. That's comparable of what the country had in the 1940s. That’s a critical condition because again, we don't have any prevention and we don't have any treatment.

KC: So how did the malaria numbers get to be so high? Is it a shortage of medication?

MARIANELLA HERRARA: Shortage of medication and loss of the control program because Venezuela is a tropical country and has all the characteristics that promotes certain diseases if not controlled. And Venezuela used to be very strict in the control of malaria and it was once declared a malaria free country.

KC: Now how did Venezuela end up in this crisis in your view?

MARIANELLA HERRARA: In our view, we got here because there was a change in the economic mode of production and it was in 2007, there was the expropriation land law which means that many productive lands were converted to unefficient and were owned by the state and they didn't get any efficiency on that change. And that's one thing and the other thing is, at least in terms of health, is that in 2007 there was a parallel health system called Barrio Adentro that was incorporated to the health system in a way that couldn’t be monitored and that was a terrible mistake because when you cannot make monitor and evaluation of something, you cannot address any situation that is impaired or altered. And I think that two things were the main stream of the huge crisis at least in the health sector and [unintelligible] sector in the country.

KC: Is this the sort of thing you ever expected to see happening in your country?

MARIANELLA HERRARA: I've never expected to see this. I grew up in a very, very different country.

KC: And what do you think could happen now? Would you like to see some help from the international community and what kind of help could that be?

MARIANELLA HERRARA: Yeah, absolutely. It's good that epidemiological bulletins were released in the last days because I think that an objection many international aid agencies had for helping Venezuela because we didn't have any official governmental data. But now we have it and now the challenge is for at least FAO that has been giving awards to the government in the past to see what they are going to do with these numbers because we need international help. We need to recover a beautiful and nice country, a country with good people that need so much help.

KC: Marianella Herrara, thank you so much for talking with me.

MARIANELLA HERRARA: Thank you so much. Marianella Herrara is a doctor and director of the Venezuelan Health Observatory. She was in Caracas. We requested an interview with the Venezuelan Embassy in Ottawa. It declined our request.

[Music: Bridge]

KC: The CBC News is next. Then it was hailed as a miracle drug for those trying to escape pain.

SOUNDCLIP

We have a new drug that's on the market called OxyContin. It's not as addicting as Percocet because of the slow release.

KC: That drug is no longer on the shelves in Canada and this month, the makers of OxyContin settled a $20 billion class action lawsuit stemming from how the medication was marketed. We'll hear from a man who was addicted to OxyContin and from a physician about lingering concerns over the pain medication’s use. I’m Kelly Crowe and you're listening to the Friday edition of The Current.

[Music: Sting]

Recovering addict still concerned after $20M class-action payout over OxyContin

Guests: Stephen Macgillivray, Dr. Nav Persaud

KC: Hello. I'm Kelly Crowe and you're listening to the Friday edition of The Current.

[Music: Theme]

KC: Still to come, the odds seemed to be firmly in her favour but on November 9^th, 2016, Hillary Clinton lost her bid for the US presidency. In half an hour, we'll delve inside Hillary Clinton's doomed campaign with a Washington journalist who chronicled her surreal and dramatic run. But first, when OxyContin first arrived in Glace Bay, Nova Scotia, the painkillers seemed too good to be true and it was.

SOUNDCLIP

VOICE 1: I’ve been addicted for probably over five years now. It started off the doctors gave it to me and then I kept going.

VOICE 2: How many times a day would you do this?

VOICE 1: Anywhere from two to 10? It all depends how much money I can get.

VOICE 2: At first it’s cool, then you know.

VOICE 1: Now it’s not even cool. You just do it to be normal. I don’t get high no more. Like I never got high off doing this in months, man. It’s just if you don’t do it, you’re deadly sick.

KC: Well, that's just one of the many voices in a 2006 National Film Board documentary called Cottonland—the nickname given to the town of Glace Bay, Cape Breton that was devastated by widespread OxyContin addiction. According to the Nova Scotia government, when OxyContin was first introduced there, prescriptions for the drug went up by 270 per cent over three years. Those alarming numbers were not confined to Cape Breton alone. A Canadian Medical Association study released in 2009 found deaths related to oxycodone use increased five times after OxyContin was introduced to Ontario's public drug plan. This month the makers of OxyContin, Purdue Pharma, paid $20 million to settle a class action lawsuit involving allegations about how the pain pills were marketed. It ends a decade-long court battle on behalf of some 2,000 Canadians who got hooked on the drug after their doctors prescribed it. Purdue Pharma maintains it makes no admissions of liability despite this settlement. Now some are calling on the provincial and federal governments to take their own legal action against the OxyContin manufacturer. Stephen Macgillivray is one of the people who took part in the class action lawsuit. He was also featured in the NFB Cottonland chronicling his own battles with OxyContin. He is in Glace Bay, Nova Scotia. Hello.

STEPHEN MACGILLIVRAY: Hi. How are you?

KC: I'm fine. What were you thinking as you heard that clip from Cottonland?

STEPHEN MACGILLIVRAY: I knew a couple of those guys that I wasn’t sure when you were playing the Cottonland and a couple of them are still around and they’re living one day at a time. It brings you back though. It seems like it was just yesterday but that was 10 years ago.

KC: What was happening at the time? Can you describe what that was like?

STEPHEN MACGILLIVRAY: Well, I don't know .It seemed like—and I don't want to say the honest and the dishonest—but it seemed like the people that were generally like prescribed medication especially if they were given something like hard that they were that they were given OxyContin and then all of a sudden people found it, other people found the drug to be more better than the drug that they were taking. And it just was a drug that was never seen before on the streets or basically in the pharmacies. And it just kind of—like you said, 270 per cent—it just kind of just blew up from there.

KC: Take me through your journey with the drug. Why were you first given OxyContin?

STEPHEN MACGILLIVRAY: In 1997, I worked for the CBRM, the Cape Breton Regional Municipality. I sustained a fractured clavicle at work. So it was a broken collarbone, a shattered collarbone. I went to see my doctor and he asked me how the pain was. And I said you know it was bad, but it was treatable. They did the operation and when I went to his office, he told me he was going to give me two Oxycontin 20, he told me. I will never ever forget that because I didn't know what they were. Before that I was on a smaller drug like a Percocet and for an OxyContin 20, to put that into Percocet, that would be the equivalent of four Percocet. So two a day would be the equivalent of eight a day. But not thinking, you know he's a doctor. So I was taking two every 12 hours and it went from there.

KC: Well, what happened next?

STEPHEN MACGILLIVRAY: Well, it not only took the pain away. It took a lot of things away. It took a lot of worries away. It definitely took the pain away. I don't think anything can actually take the pain away and that's where we got to be vigilant for that. But what happened was it just became kind of my life. It overtook my life to the point where probably in month three, I was going back to my doctor and looking for the OxyContin before I was due the drug. He was looking at it and kind of wondering why I was coming back early. And you would say that you know you lost some or some fell down the drain and stuff like that. You'd come up with some really great excuses. And all of a sudden, it's got a hold of you and it's got a hold of you like nothing. One of the guys, Tommy was talking and it's just that overwhelming. At the end of it you don't take that to get “high”. You just take that to get normal. And then when you take it, then the next thing is okay, so where do I get my next one? And of course you know they’re illegally on the street and they are a lot of money. And so you have to do things to get it. It was just like one great big horror show.

KC: What happened to you in terms of the other aspects of your life? Your job and that sort of thing.

STEPHEN MACGILLIVRAY: Well, basically I walked away from my job. I was that sick. If I didn't have a hundred dollars worth of OxyContin at six-thirty, seven o'clock in the morning, I just couldn't go to work and people couldn't understand why. They said jeez, you walked away from a great job. Also, I wasn't offered a lot of help and for the CBRM, they come back and they were great. They were generous and I did end up getting my job back. They were fantastic. But I lost my family. I was out on the street for a guy that had a lot going for him. My mom and dad were great people in the town. My dad, he was a councillor. He was the deputy mayor of the town. We were looked on as good people. But OxyContin and drugs, they don't discriminate. As we learned, it's not a man or a woman or black or white or tall or short. They just don’t discriminate. And so anyway, I end up going off island to go to a methadone maintenance program because at the time, there was no methadone in Cape Breton and basically methadone, personally for me saved my life.

KC: Now looking back, who do you blame for the addiction?

STEPHEN MACGILLIVRAY: Well, you know I can sit back and I can be on my high horse and I can blame a lot of people. I look at me a lot of the times like I didn't see this coming. I was really mad at the doctors for a while. We had doctors that were prescribing it hand over fist.

KC: Now looking at looking at the court settlement, what do you think about the $20 million dollars?

STEPHEN MACGILLIVRAY: Well, that’s made to be seen—like we really don't know. It's a start. And like I said before on one of the interviews, it's a start of a healing process. It's something.

KC: What would you like to see happen next then? What would you like to see the Canadian government do?

STEPHEN MACGILLIVRAY: In Nova Scotia, we have a triplicate drug program for narcotics. I know every province is different. I know we have to get a lot more stringent on our narcotics. They are given way too much. And not only on narcotics, on our benzodiazepines. These drugs are killing people every day. When you look at obituaries and you see somebody under 30 or maybe over 30 and you're seeing died suddenly, you can bet nine out of 10 times that that person died of a drug overdose. And it is scary. The government's got to wake up. I always said Health and Welfare Canada should have took some of the blame but that was just me saying that. Having said that, I would just like to see a lot more programs. You know it's easy to throw money at people and say here we go, this is what you get and have a happy life. But at the end of the day, there has to be stuff done with this money.

KC: Okay. Stephen Macgillivray, thank you for talking with me.

STEPHEN MACGILLIVRAY: Great. Thanks, Kelly. Have a good day.

KC: You too. Stephen Macgillivray is recovering from an OxyContin addiction and he's one of the claimants in a now-settled class action lawsuit against Purdue Pharma. He was in Glace Bay, Nova Scotia. Ontario Health Minister Eric Hoskins says he plans to speak to his federal and provincial peers about the fact that Purdue Pharma has accepted responsibility for its actions in the US. Almost exactly 10 years ago, the company agreed to pay $600 million after three executives pleaded guilty in federal court to criminal charges that they misled regulators, doctors and patients about the drug’s risk of addiction. It's one of the largest amounts ever paid by a drug company in such a case. The toll from OxyContin abuse has been grim and costly here in Canada. A 2011 Canadian Health Policy Institute report showed that the annual federal cost of OxyContin abuse was $504 million dollars. In Ontario alone, the abuse of the painkiller cost the province $318 million dollars and that's to say nothing of the human toll. My next guest has witnessed stories like Stephen Macgillivray’s up close. Dr. Nav Persaud is a staff physician at St. Michael's Hospital and an assistant professor in the Department of Family and Community Medicine at the University of Toronto. He's with me in our Toronto studio. Hello.

DOCTOR NAV PERSAUD: Good morning.

KC: What are some of the ways that you've seen OxyContin abuse impact some of your own patients?

DOCTOR NAV PERSAUD: I've cared for families that have lost loved ones to addictions to OxyContin and other opioid medications, cared for people who have become dependent on the medication after taking it in some cases for a minor element like an ankle sprain and years later become addicted to the medications, lost their jobs, lost their lives.

KC: So what's your reaction to the $20 million settlement that was reached?

DOCTOR NAV PERSAUD: It seems very small when you think about the suffering of people like Mr. Macgillivray, people like my patients. And it also seems small when you think about the numbers. There are estimates of the total revenue generated by OxyContin being around $30 billion. In Canada we spend hundreds of millions of dollars each year in the direct costs paying for these medications. So the $20 million doesn't seem like it will go very far and only $18 million of that will go to the people who have suffered, and the two million dollars will be divided among the 13 provinces and territories as per this conditional settlement.

KC: Now how do you tally the human toll in Canada?

DOCTOR NAV PERSAUD: Well, it's impossible to do that. It's impossible to do that. But given the number of people who are a member of this class action suit right now, it seems like people will be getting somewhere between three and six thousand dollars each. And when you listen to stories like Mr. MacGillivray’s, it's hard to imagine that that could compensate people for the ways in which their lives have been altered by this medication.

KC: Now Purdue Pharma has lost past lawsuits because of the way OxyContin was marketed in the US. What were some of the ways it crossed the line?

DOCTOR NAV PERSAUD: It was about the abuse potential, the risks associated with this medication. So according to the agreed statement of facts in the United States guilty plea, Purdue had determined that doctors were reluctant to prescribe these medications because of fears about addiction. And so Purdue marketed this medication as having lower abuse potential than other opioid medications. And we can see from the prescribing patterns that that was a very successful marketing strategy. In Canada, the prescribing rate for oxycodone increased eightfold after this medication was released on the market and the death rate increased by fivefold for oxycodone in Canada.

KC: Now Purdue Pharma stopped selling OxyContin in Canada in 2012. Does that give you any relief?

DOCTOR NAV PERSAUD: Well, it's interesting to look back on when OxyContin was first released. The idea then was that it was safer than other medications. And now this new medication that has replaced the old OxyContin is also being advertised as being safer than other medications. And what we haven't seen is any improvement in the harms. We haven't seen any reductions in the death rates, reductions in the rates of addiction. Unfortunately this opioid crisis continues and it is really sad to think that 10 years ago in the United States, there was a guilty plea and yet here in Canada, very little has happened and all that we have 10 years later is a $20 million settlement.

KC: Now we did request an interview with Purdue Pharma. No one was available but it sent us a statement and I'll read part of it: “By resolving this suit, Purdue Pharma Canada makes no admissions of liability and maintains its focus on developing and providing innovative medicines to patients and on supporting quality education for the safe and appropriate use of its products. As reports of OxyContin abuse became prevalent, Purdue took a number of steps to address abuse and diversion as well as misuse by patients or their caregivers. In 2001, development work began on a new product with the same medicinal ingredient and efficacy as OxyContin, but with certain features intended to discourage misuse and abuse which culminated in the launch of OxyNEO in 2012 and subsequent discontinuation of OxyContin.” What do you make of that response?

DOCTOR NAV PERSAUD: Well, we know there was a guilty plea in the United States in 2008 and here in Canada, it's the same company, it's the same medication and we have the same problems. And I think there should have been an investigation into the marketing in Canada and there could have been one. There still could be one actually by the Canadian governments. And when we think about the settlement, this was a group of people who were going against a multinational company, a billion dollar company, and what they ended up getting was better than nothing. Up until now these people haven't been compensated in any way. But it was a total of a $20 million settlement and it includes just two million dollars to be divided among all of the governments in Canada. And when you compare that two million dollar settlement to either the costs associated with these medications—hundreds of millions of dollars that governments are directly paying for these medications every year—hundreds of million dollars in treating people every single year for the consequences of opioid addictions, the two million dollars divided by all of the governments in Canada seems like a ridiculously small number. Another way to put it in context is to consider that in 2008, just one year after the guilty plea in the United States, the government of Ontario awarded a grant to Purdue Pharma to expand its plant in Pickering, Ontario and the value of that grant was $4.9 million. That's greater than the amount that all of the governments in Canada are going to share as per this conditional settlement.

KC: Now we're talking a lot about money, but is money the way to deal with this now? Is that all we're talking about?

DOCTOR NAV PERSAUD: There should be an investigation into the way that this medication was marketed and there are actions that the Canadian government can take to help curb this crisis. First of all, looking back, the original reason for putting this medication on the market in the first place was the claim that it was safer than other opioid medications. That isn't true. It was never true. There was never evidence to support that and our experiences over the last few decades have shown that it's definitely not true. So why are these medications still on the market? Why aren’t they withdrawn from the market immediately? There are lots of other opioid products that can be used for people with pain and these products that have been marketed inappropriately can be removed. That's the first action and it could be taken very soon.

KC: Well, one of them was removed. So which ones specifically are you talking about?

DOCTOR NAV PERSAUD: The long-acting opioids that are marketed as being safer, even marketed today as being abuse deterrent formulations of the medication made by the same company that we're talking about today. Those could be removed and there would be other medications that could be used by people who have pain. The problem with this medication—there's nothing wrong with the medication itself. The problem is the way that this medication was marketed and there's no way to undo the marketing as we've seen. Even after these papers were published showing all of the harms in Canada, that the death rate increased, the overall opioid related death rate increased by more than 40 per cent and the OxyContin-related death rate increased five times. There hasn't been a decrease in the prescribing and there hasn't been a decrease in the rate of harms. I think that shows that the marketing cannot be undone. You can't take back these messages that have been received by doctors and by others. And so the way to address them that's open to the government is to remove these particular products from the market. They could also send a message to this company and to other companies by doing an investigation. If that had been done, if the government had done an investigation before the settlement, probably the settlement would have been much greater and these people who have been harmed would be better compensated.

KC: Now we also requested an interview with federal Health Minister Jane Philpott. She was not available but sent this statement: “Canada is facing a national public health crisis that stems from a number of causes and is why our response to this crisis needs to be comprehensive, collaborative, compassionate and evidence based. We will continue to work with all of our partners across the country to explore any and all options in order to combat it.” So what's your response to that?

DOCTOR NAV PERSAUD: There are lots of things that should be done now that we have this big crisis and that should include providing support for people who have already been harmed. The reality is providing support for people who have already been harmed is not the way to stop the crisis. If we want to stop this crisis, we have to think about how it started in the first place and it did start with the approval by Health Canada and by regulators in other country of these products and the subsequent inappropriate marketing of these medications. And since we can't take back the marketing messages, the regulatory approach of withdrawing approval for these medications is one way to send a message.

KC: Are you saying no pain medication on the market then or what would you like to see?

DOCTOR NAV PERSAUD: There are lots of opioid medications that are approved and are absolutely required by people in pain and those will continue to be prescribed. But there are some particular products—these long acting medications like OxyContin—that could be removed from the market without consequences for people with pain because there would still be lots of pain medications available to people.

KC: What is it about those particular ones that are problematic?

DOCTOR NAV PERSAUD: It’s the marketing. It's the way that they were marketed. They were marketed as being safer than other medications and that claim was never true.

KC: So what would be ideal in terms of pain management in your view right now?

DOCTOR NAV PERSAUD: There are other medical and non-medical treatments for pain. And I'm not suggesting any change in the way that pain is treated. What I'm suggesting is that these particular medications that we know have been marketed inappropriately could be removed from the market and that all of the options for treating pain including non-medical treatments, medical treatments that are not opioids and opioid treatments would still be available to people if these specific products that have been marketed inappropriately were removed from the market.

KC: Okay. Dr. Nav Persaud, thank you for talking with me.

DOCTOR NAV PERSAUD: Thank you.

KC: Dr. Nav Persaud is a staff physician at St. Michael's Hospital and an assistant professor in the Department of Family and Community Medicine at the University of Toronto. He was in our Toronto studio.

[Music: Bridge]

KC: You might have to put your phone laptop or tablet away when you listen to Monday's show. We're talking about technology addiction. The average person spends about three hours and 42 minutes on their electronic devices every day and that number is only getting higher. On Monday, Anna Maria Tremonti speaks with Adam Alter, an associate professor of marketing and psychology at New York University's Stern School of Business. His new book is called Irresistible: The Rise of Addictive Technology and the Business of Keeping us Hooked. He says it's still not clear what the effects of all of this screen time will be.

SOUNDCLIP

When you talk to psychiatrists, they say that the two big events were the introduction of the iPhone in 2007, so 10 years ago and the iPad in 2010, seven years ago, that they started to see big spikes in especially issues among kids—social and developmental delays. That means that for a few years now, researchers have been really interested in those effects. And we know things like for example, kids who seem to use screens a lot, a recent study suggested that they were more delayed in acquiring language, the ability to speak. We know that there's some evidence that kids who spend a lot of time socially on screens are not as skilled as communicators. They find that a lot of the nuances escape them. And it's easy to see why that would be. If you are texting, say someone sends you something that you think is funny. You have this very mathematical clinical way of communicating with them where you can say you know “lol” in lower case letters means one thing. “LOL” in caps means another. The number of exclamation points you use at the end of that tells the person in mathematical terms precisely how funny it is and there's no risk there of miscommunicating because there's this sort of language, a very precise language. But if someone says something funny in front of you and they're sitting in front of you, the way you crease your forehead, the way your eyebrows move, the way you laugh, the lilt in your laugh, the way your eyes move—everything is a cue. And we don't even think about that if we're skilled communicators who have spent a lot of time face to face. But if your early use of communication is spent lol-ing and you don't acquire those nuances, it's very hard to acquire them later on. And that for me is the biggest concern, that kids who when they’re young spend too long in front of screens. I think it takes them a long time if they ever acquire the same skills that those of us who are not on screens as kids take for granted.

KC: That's Adam Alter, author of Irresistible: The Rise of Addictive Technology and the Business of Keeping us Hooked. Monday he'll speak to Anna Maria Tremonti about the ugly side of technology. I'm Kelly Crowe and you're listening to the Friday edition of The Current.

[Music: Sting]

Why did Hillary Clinton lose to Trump? New book looks inside failed campaign

Guests: Jonathan Allen

KC: Hello. I'm Kelly Crowe and you're listening to the Friday edition of The Current.

SOUNDCLIP

If Hillary Clinton had won the election—which thank God she didn't—but if she had and she had been in the same position, she would have fired Comey immediately and the very Democrats that are criticizing the president today would be dancing in the streets celebrating.

KC: Deputy White House Press Secretary Sarah Huckabee Sanders calling out Democrats who are enraged at President Donald Trump's abrupt firing of FBI Director James Comey this week. Democrats are convinced James Comey was fired because of his aggressive investigation of alleged ties between Russia and the Trump campaign. It's a charge President Trump denies and in his first interview since the firing yesterday on NBC, he spoke of the FBI being in turmoil under James Comey’s leadership. But as to what Hillary Clinton would have done had she been elected? Well, we will never know. What we do know is that she and others blamed her defeat on the now former FBI director’s handling of the investigation into her use of a private e-mail server. And so on November 9^th, the first ever female presidential candidate of a major US party faced her heartbroken supporters.

SOUNDCLIP

Last night, I congratulated Donald Trump and offered to work with him on behalf of our country. I hope that he will be a successful president for all Americans. This is not the outcome we wanted or we worked so hard for. And I'm sorry that we did not win this election for the values we share and the vision we hold for our country. But I feel pride and gratitude for this wonderful campaign that we built together—this vast, diverse, creative, unruly, energized campaign.

KC: The story behind that dramatic and surreal election is told in the new book Shattered: Inside Hillary Clinton's Doomed Campaign by Washington journalist Jonathan Allen and Amie Parnes. The two have been tracking and writing about Hillary Clinton's career for years. I spoke with Jonathan Allen from Washington earlier this week before James Comey was fired and I began by asking his reaction to the election result.

JONATHAN ALLEN: It was surprising. I and my co-author both thought that she was going to win on election night. She thought she was going to win on election night. You know one of the important things though in reporting this book which we had been reporting since late 2014, was we really dedicated ourselves to just telling the story as it went along and trying not to think about who was going to win and who was going to lose. And so once that outcome was clear, we didn't have to go back and tear up chapters and it's actually interesting—our editor was very concerned in October because he said that the chapters he'd seen so far had this sort of sense of impending doom and that didn't match up with what we were all seeing, which was polling numbers that suggested she was going to win and win handily. And you know my co-author and I just told him look, this is the story we've reported and we'll see what happens on election day and then we'll deal with what we have to once we have knowledge there. But you know as it turned out, there were some signs of what was to come. While we both expected her to win, we really tried to—and again because we'd written so much of it before the election—tried to just stick to what were the stories we were hearing from the people inside the campaign, outside the campaign, in the Democratic universe and from Republicans.

KC: So let's talk about some of those stories. So what about the e-mail controversy? What was happening inside the campaign when that story first broke, that is Secretary of State Hillary Clinton had been using a private e-mail server for all of her work?

JONATHAN ALLEN: I think they underestimated the power of that story on a couple of levels. Number one, they certainly couldn't have imagined when that story broke in March of 2015 that it would continue to be a cloud of doom over the campaign. All the way up until a couple of days before the election, it really sort of set the tone and continued to be an undercurrent the entire time. I don't think they had any idea that that was the case. In fact, there were some of them who wanted to joke about it when it came out. They wanted Hillary Clinton to go out and try to ease some of the tension with humour. And they certainly also couldn't anticipate that it would end up sparking an FBI investigation into a certain presidential candidate. As we have found out since the election, there was also an investigation into Donald Trump by the FBI and his campaign's potential ties to Russia. So I think they really underestimated the impact of this story and also the other piece of that is the impact that it had on her honesty ratings among the American public. First the story broke and for months and months, she held firm that she hadn't done anything wrong and then finally after her approval ratings and her poll numbers had taken a really significant hit, she finally sort of apologized over the course of a few interviews. I don't think they had any clue how much damage that was going to do to Americans’ view of her trustworthiness and of course she's somebody who has struggled with that in the past at times. So it reconfirmed the worst suspicions of those who believed she always had something to hide.

KC: There was much hand-wringing inside the campaign about getting her to apologize, it seemed. When would she, why won’t she, that sort of thing.

JONATHAN ALLEN: That's right. Her aides believed that the only way to get past the e-mail scandal and start talking about the things she wanted to on the campaign trail—particularly the economy—was to issue a full throated apology and they couldn't get her to do it. In fact, we report on the scene previously unreported where she and President Clinton get on the phone with some of their aides and this is in August of 2015 and they give them a tongue lashing for the aides’ inability to find a way to break through the e-mail scandal with a message that will resonate with the public. And of course these aides know that that's never going to happen as long as she hasn't apologized for the e-mail scandal. And it took several more weeks, but finally one by one, there was a real effort, sort of a campaign to get her to relent and ultimately she did, but too late to save her honesty ratings.

KC: Now what were they thinking about Bernie Sanders?

JONATHAN ALLEN: You know she always looked at him as somebody who would have a chance to run a real campaign against her and I think she wanted to go more aggressively against him earlier on. But her campaign aides thought that that would create a backlash against her, that she would be seen more negatively because Bernie Sanders, not only did he have a lot of voters starting to come behind, but even people who weren't voting for him in the Democratic Party, a lot of them liked him. So going negative on him they feared would have a backlash. I think in retrospect, some of them would concede that they did not fully appreciate the threat that he would become. And of course, Bernie Sanders’ message overlapped with Donald Trump's message in a couple of key areas. Number one, the idea that the United States should sort of pull back from the world a little bit and number two—and more important for Clinton in the general election, I think, though not way, way more important—was this idea that she was corrupt. It's something Bernie Sanders hit her with in the primary campaign. It was something that Donald Trump was hitting her from on the Republican side. And the two of them sort of acted as the right and left speakers on a stereo, sort of blaring a chorus of “you're corrupt, you're corrupt” and I think that did her real damage.

KC: But she also didn't—it sounds like from your reporting—pick up on the mood of the public during those primary days.

JONATHAN ALLEN: There's really an amazing moment that happened and is related in the book which is right after the New Hampshire primary where she lost by 22 points—a stunning defeat for somebody who was headed for the nomination—she was on a plane with one of her close friends, Minyon Moore, who had been brought to travel with her basically to listen to her. And Secretary Clinton said I don't really understand what's going on with the electorate right now. I can't get my arms around it. And that was a motif for her throughout this campaign. She saw the populism. She saw the anger. But she really couldn't put her finger on what it was she could do to harness that or to at least thwart it.

KC: So then what happened when it became clear that Donald Trump was going to be the Republican challenger?

JONATHAN ALLEN: I mean this was a dream come true for Democrats, they believed. They looked at Donald Trump and thought this is a guy that can be beaten. He makes so many mistakes on the campaign trail, says so many things that are impolitic and they believe that they could disqualify him from the presidency and that became her strategy in the general election. But as it turned out, a fifth of his voters said that they didn't believe that he was fit for the presidency and voted for him anyway. In that way, I think one of the key problems for Secretary Clinton was her inability to articulate a message to voters to let them believe that she was in it for them and not for herself.

KC: But there were all these amazing moments in the campaign. For example, when the Access Hollywood tape was released where Donald Trump brags about being able to grab women by their private parts because he's a celebrity, did the Clinton campaign appreciate the importance of that?

JONATHAN ALLEN: It's really fascinating. There was a day—October 7^th, 2016—where there were three big news stories that hit in a row. The first was 17 US intelligence agencies coming out and saying that the Russians were trying to interfere with the US election and essentially that they were doing it on behalf of Trump, that they had attributed these intelligence agencies, had attributed the hacking of the Democratic National Committee to the Russians. That came out and the Clinton folks thought here there's proof of collusion between Trump and the Russians and that's going to turn voters’ minds. Voters are not going to accept the candidate that they believe is being controlled by Moscow. But then within a couple of hours of that, you also had two other news stories pop. One was that Access Hollywood video of Donald Trump saying the vile thing about women, essentially bragging about sexual assault. And then right after that, the first WikiLeaks of Clinton campaign chairman John Podesta’s e-mails began trickling out. Those would continue to be released once a day, every day for the final 30 days of the campaign. At the time, the Clinton people looked at the Russia-Trump connection as the big story. They thought the Access Hollywood Video would be helpful to them but kind of a distraction from the main point. I don't think they appreciated at all how much damage those Podesta e-mails would do, which was basically putting them in a position of having to defend against the contents or choose not to defend against the contents of each of those e-mails for the period of the last 30 days.

KC: Now tell us about the room of tears.

JONATHAN ALLEN: [Chuckles] I'm glad you asked about that. That's one of my favourite nuggets in the book, that there was a campaign staffer named Glen Caplin who basically was given the job of going through all of John Podesta’s e-mails to try to figure out what scandals might erupt as a result of the release of each of these e-mails for the last 30 days. And he had a small team about 10, maybe a dozen people that were going through all of the released e-mails, scouring them to try to figure out what was in them and how the campaign might respond or not respond. And they worked in a room that was dubbed the Room of Tears. And Kaplan kept this big whiteboard listing all of these potential lines of difficulty for Secretary Clinton coming out of these e-mails and it was big enough that it was on wheels and he rolled it from room to room, almost like he was carrying a ball and chain behind him.

KC: And there was a sense in the campaign that they just couldn't get a break. One person kept repeating, “We're not allowed to have nice things.”

JONATHAN ALLEN: There again you've got this sense of impending doom, that every time something goes well for them, every time Secretary Clinton does something good. And by the way, this book has a lot of shining moments for her—the presidential debates, her performance against the House Benghazi Committee that was investigating her. She did 11 hours—I think folks will remember—11 hours of testimony before a hostile panel. But every time she did something that they thought was good for her or that Donald Trump did something they thought was bad for him, they were waiting for the other shoe to drop. There was always something that would come behind it that was bad for her, good for him. And they just got into this mindset that there was never going to be anything easy on the campaign trail.

KC: Now I want to play a clip from Hillary Clinton. She was interviewed earlier this month and this is what she said about why she thinks she lost the election.

SOUNDCLIP

It wasn’t a perfect campaign. There is no such thing. But I was on the way to winning until the combination of Jim Comey’s letter on October 28^th and Russian WikiLeaks raised doubts in the minds of people who were inclined to vote for me but got scared off. And the evidence for that intervening event is, I think, compelling, persuasive.

KC: Jonathan Allen, what do you think of Hillary Clinton's analysis of why she lost the election?

JONATHAN ALLEN: I think it's incomplete. Certainly the Comey intervention and Russia are factors in the American election in 2016. She traces her sliding poll numbers to Jim Comey coming out and saying he was reopening the investigation into her e-mail on October 28th. But my co-author Amie and I spoke to sources a couple of days before that actually on the Republican side who said they were starting to see a significant uptick in Donald Trump's performance in key battleground states. So that trend was already starting. There are some things that she left out also that were coming at the same time. All across the country, Americans were getting letters and notices that premiums for Obamacare, for health insurance through Obamacare were rising, in some cases by eye popping percentages. That's something Democrats don't talk about a lot because they don't want to concede that Obamacare was an issue in the election and obviously they are defensive of that policy. And the other thing is if you look the Russian intervention, as we were talking about earlier, this is something that was known. This is something Secretary Clinton talked about in the presidential debate. She called Donald Trump a Russian puppet. She pointed to the intelligence community findings. Any voters who were paying even mildly close attention to the election would have heard something about that. So I think that was baked in a little bit. What she didn't talk about is some of these larger issues: the e-mail server which prompted the entire involvement by Jim Comey. He wouldn't have been there had it not been for her setting up this e-mail system outside the government system and that system having classified information on it. And in addition to that, this inability to develop a message that was clear, concise and about her reason for being president, her rationale for being president—these are factors that allowed Donald Trump the opportunity to beat her.

KC: So you describe kind of a battle between old and new in the campaign—the idea of the old fashioned door knocking, even old fashioned polling that Bill Clinton seemed to be arguing for—and then the analytics and the sort of modern data analysis. Can you talk a little bit about that?

JONATHAN ALLEN: Absolutely. So the campaign manager Robby Mook is a disciple of the data analytics folks of the Obama era where there was a lot of innovation in that area and they really believe that they can essentially win elections by finding out who the potential voters are and turning out their side. There was an older school set on the campaign, including President Clinton and some of his old allies, who believe there's a fair amount of art in politics and particularly, basically that numbers aren't static. That when you see polling or you see data coming in and you don't like it, that it's not good for you, that you need to change people's minds. And I think like in many other venues, there is room for both science and art in coming up with solutions and in this case trying to win an election. But her campaign really focused on the data part of it and this comes from her. She believed that President Obama had beaten her in 2008 in part because he had been so much more technologically advanced than she was. And that may have been part of what did it for him, but in addition to that he ended up being a candidate who was more appealing to a broader swath of the Democratic electorate or at least in the right places. And so I think she may have overlearned a lesson from 2008.

KC: Now some people, as you know, have said that the real reason is because that Americans weren't willing to vote for Hillary Clinton was because she's a woman. What do you think about that?

JONATHAN ALLEN: Well, just for a moment, I'll step out of my white male privilege and try to give an analysis of that. And we do this a little bit in the book. There are states where she lost, where the numbers among men, the drop off between her performance from Barack Obama's performance was precipitous, where basically in Pennsylvania for example, she and Obama ran about the same among women—both winning women significantly—but I believe she ran something like 17 points behind him among men in Pennsylvania. And that is a state that has never elected a United States senator who's a woman or a governor who is a woman. So I think there are states where it was more of a challenge for her than in other states, but I would just say with this caveat, in a political race part of your chore as a candidate is to get people to overcome the biases they might have against you whether they are based on gender, race, ethnicity or anything else.

KC: Let's talk about election night. I'm sure as everyone watched the results come in, one couldn't help but wonder what it would be like inside Clinton's campaign. Can you talk about what you learned about that night? I mean one would think that it would be quite tense and that Hillary might actually be quite upset and anxious, but you portray a different picture.

JONATHAN ALLEN: We did the first real deep reporting in tick-tock of election night in her suite at the Peninsula Hotel in Manhattan where she was awaiting the results. And before results started coming in, she had gone over her victory speech with her aides and added some things and President Clinton added some things and they never looked at the concession speech. They didn't think she was going to have to give it and her aides believed that it was just sort of bad karma to have her look at it. So she had never even looked at the victory speech. As the results start coming in, Florida is the real bellwether where they start to see bad signs. Not only are they going to lose Florida, but there are things that they can extrapolate from who's voting for them and who's voting against them in Florida that they can sort of take and graft on to other parts of the country and to other states. I think there was a pretty strong sense of dread once Florida was in because of how they saw that vote breaking down and the particular parts of Florida and how they related to other parts of the country. What we were told about her is that she was very stoic, very reticent, said very few words as she was being told about each sort of development through the evening and about how the mountain to climb to win was getting higher and higher. And then there was a debate within her campaign about once it became clear that Trump was likely to win, there was a debate among her aides about whether she should concede or whether she should wait until the morning and see if it was possible that some of those close elections in states in the Midwest would turn the other direction with more votes coming in, or perhaps an automatic recount’s triggered because the votes were so close. At the White House, there was an urgency to get her to concede because Donald Trump had talked about the election perhaps being rigged. President Obama felt that it was very important to make sure it was clear that there was going to be a peaceful transfer of power and no contesting of the election. One of his aides, David Simas, his political director placed a call to Secretary Clinton's campaign manager Robby Mook and said the president doesn't think that you should drag this out. And Mook replied that Clinton wasn't ready to go out and give a concession speech yet, which was sort of a little bit of a fig leaf. I mean they were still having a debate internally about whether or not she should concede, not just whether she could go out and give a speech. President Obama, knowing that his aide had failed to get the message across, called Secretary Clinton himself and told her that she needed to concede and sort of made the same argument. Not being convinced that he had really gotten her on board with that, he then called John Podesta, her campaign chairman who had just gone out and told the audience, her “victory party”, that they were going to wait until the morning to see what happened. And Obama called Podesta who had worked for him in the White House and said look, it is important to American democracy, it's important for the country that she concede. The writing is on the wall here. Around the same time, Clinton herself was coming to the conclusion that it was over. Presumably President Obama's call had some influence on that. And she cut off the debate among her aides and said I'm going to call him. And so they got Trump on the phone and she said those two words she thought she would never ever say: Congratulations, Donald. Their phone call lasted about a minute. He told her she'd run a good race. And then she sat down to look at her concession speech for the first time and she was interrupted by Huma Abedin, her closest aide, who came over to her with a cell phone in her hand extended and said it's the president. And Secretary Clinton visibly winced. She didn't want to take this call. This was the consolation call from the president to the candidate of the losing party. And it all sort of struck her at once. She had let herself down. She let her party down. She let the president down and his legacy and she, in her view, had let the country down by allowing Donald Trump to be elected president. Finally she took the phone and walked away from the table into a private area and said Mr. President, I'm sorry.

KC: Okay. Well, fascinating story. Jonathan Allen, thanks for talking with me.

JONATHAN ALLEN: It's my pleasure, Kelly.

KC: Jonathan Allen is the co-author of Shattered: Inside Hillary Clinton’s Doomed Campaign. He was in Washington, DC. That's our program for today. Stay tuned to Radio One for q. Tom Power talks to author Jo Nesbo, the bestselling Norwegian writer, musician, economist, journalist, footballer and rock climber about his latest book, The Thirst. And remember you can always take The Current with you to go on the CBC Radio app. It lets you browse through past episodes of our show and start listening in just a few seconds. You can search for stories you missed or want to hear again or listen live to your local CBC station right from your smartphone or tablet. You can also live stream all of our programs on the Radio Player Canada app. These apps are free from the App Store or Google Play. We were talking about Hillary Clinton's loss of the 2016 presidential election. Well, back in 1992, she sat down for an interview with Katie Couric of The Today Show. At the time, her husband Bill Clinton was running for the US presidency. Much of what the then-aspiring First Lady said more than 20 years ago rings true today. Hillary Clinton gets our last word. I'm Kelly Crowe. Thanks for listening to the Friday edition of The Current.

SOUNDCLIP

KATIE COURIC: He said he would consider you for a cabinet position.

HILLARY CLINTON: Well, I'm proud of him and he's proud of me and I think that was a very flattering thing to say. But I don't think that was realistic. He was trying, I think, to convey the level of commitment we both feel to the kind of issues that got us into this campaign and that I'm going to try to work on.

KATIE COURIC: As we just heard, some people say some not so flattering things about you. They say you are the power behind the throne, overly ambitious. What's your reaction to comments such as those?

HILLARY CLINTON: Well, I regret them because I think they come out of a sense of stereotypes about women's roles, that a woman who does have opinions and who expresses them is somehow still off base. I hope that's not the case because there are many, many women in this country who are doing a terrific job fulfilling all of their various responsibilities and they also think about the issues that affect them and their families.

KATIE COURIC: Do you think those kinds of reactions, Ms. Clinton, are the result of good old-fashioned sexism?

HILLARY CLINTON: Oh, I think there's some of that because I think it is different. This country is undergoing tremendous change and certainly what has happened in women's lives over the last generation has been a sea change. And all of us, we’re trying to find our way—those who are full-time mothers and homemakers, those who are full-time career and those who are the majority of us, trying to balance both. And I think that we're all trying to come to grips with it.

[Music: Ending theme]

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