The Exchanges

Q You can't fight to fix it unless you actually see what's happening. Exactly. So you had this experience, and then you had a very top show on Fox for a while, and what was that transition? Why'd you do that?

A So finally off, it was connected to Brexit, because as I mentioned, when we moved here, um, I'd, I'd, uh, had some conversations actually enabled and facilitated by someone I'd met in the Obama administration, who happened to be, who I'd worked with on some policy issue, And I remember them saying that they were going back to Stanford to teach. Um, and so I said, well, that's nearby. Maybe they can help, um, you know, help me think through what I would do. So I ended up at Stanford for a couple of years, including at the D school at Stanford, which is an amazing, amazing institution where I really learned in order to teach it. I learned the methodology of innovation, which really has informed so much of the amazing success of, of the tech sector here in, in, in the Bay area. Um, it was, it was, um, Founded by, um, David Kelly, who's the founder of IDEO, which is the kind of original, you know, so amazing experience teaching at the d.school. Um, and it was during Brexit that I was back in the UK, I think the paperback version of my book, More Human, had come out, um, in which I came out publicly in favor of Brexit, and I was doing some, some TV stuff around that, and someone Pretty significant, was in the UK at the time, watching, uh, called Rupert Murdoch, and he just reached out and said, you know, would you like to have a conversation? And we did, um, got on well, and then a …

AI assessment note: “called Rupert Murdoch, and he just reached out and said, you know, would you”

Q We need some kind of asylum for them, not a jail, right?

A Well, here's the problem. So because of the asylum word and the stigma associated with that, remember that most of the people we're talking about in this situation are low income, therefore it's all Medicaid. And as so often in government, you ought to follow the money. So local governments plan provision based on, on their reimbursements from federal Medicaid for this mental health treatment. When Medicaid was set up in 1965, There was a rule put in place because there was public outcry against insane asylums and all of that, right, that says we don't want these big institutions. So there's a rule called the IMD rule, Institutions for Mental Disease, which says that you cannot, states cannot get Medicaid reimbursement for any facility offering mental health care with more than 16 beds, very precise number, which is tiny. So you end up with these very inefficient Outpatient kind of services instead of modern, effective mental health treatment.

AI assessment note: “So there's a rule called the IMD rule, Institutions for Mental Disease”

Q mentioned, obviously, uh, prop-thirty-six passed by a landslide to take away the 900 dollar, you know, free stealing stuff every day. But we also talk a lot about the homeless crisis. I think there was over twenty four billion dollars spent on it. It seems to have made it worse. It seems like there's a lot of corruption around this area. Like, like what, what should we be doing here?

A So it's a massive, massive scandal that this has been going on for so long. I mean, as I like to point out, we're now in the 23rd year of Gavin Newsom's 10 year plan to end homelessness in San Francisco, which has just got worse. And he's, it's his seventh year as governor, and he keeps saying he's going to do something about it. The numbers actually go up and up, and there's another number, which is thirty two billion. Um, spent on homelessness. So the components of the problem are these. Number one, it's illegal to camp and live on the streets. In, in, in most cities in California, we have not enforced the law. Um, they've hid behind the Ninth Circuit Court ruling, which was the Boise ruling.

AI assessment note: “The components of the problem are these. Number one, it's illegal to camp”

Q So you studied at Oxford, which means you climbed up to the, the British elite there, and you worked in UK politics. What sparked your interest to come out to the United States and into Silicon Valley?

A Yeah, it was, it was interesting. Um, exactly as you say, I, in fact, my, I wrote about that in a book about 10 years ago, um, More Human, and I was, uh, really at the beginning of, you know, I supported Brexit and, and Donald Trump and all of that, at the beginning of that populist Um, uprising, the revolution that's really sort of playing out now in so many different ways. Um, and whilst railing against the elite and the establishment, acknowledge that of course, you know, I was going to Oxford University and working in 10 Downing Street, it kind of makes you part of that. Um, but I, the way I was put it is I never forget where I came from, and that's been a really important part of the story. Um, in terms of California, we moved in 2012. Um, I'd be, I was, I was working in Downing Street at the time, I was senior advisor, To the Prime Minister, I was mainly focused on our kind of domestic policy plans and trying to help implement them after working for many years kind of developing those ideas and developing the plans. I was in 10 Downing Street, um, for a couple of years. He became Prime Minister in 2010. It was a coalition government with the Liberal Democrats. I, I shared an office in 10 Downing Street with my opposite number from another party, and we were trying to work together to make stuff happen. But at the same time, um, My wife was, um, working at, she had a big j…

AI assessment note: “she was doing her global job from London because of my, uh, my work”