>> Braude: TONIGHT ON "GREATER BOSTON," THE CASE OF C.J.

RICE, A PHILADELPHIA MAN SENTENCED TO 30 TO 60 YEARS FOR A SHOOTING HIS DOCTOR AT THE TIME SAYS HE PHYSICALLY COULD NOT HAVE CARRIED OUT.

THAT DOCTOR IS THEODORE TAPPER, WHO'S BEEN CHAMPIONING RICE'S CAUSE EVER SINCE.

ALONG WITH HIS SON, CNN ANCHOR JAKE TAPPER, WHO ARGUES IN "THE ATLANTIC," THAT RICE'S LAWYER WAS THOROUGHLY INCOMPETENT.

FATHER AND SON JOIN ME AHEAD.

THEN LATER, DOCTOR KEDAR MATE, THE PRESIDENT AND C.E.O.

OF THE BOSTON-BASED INSTITUTE FOR HEALTHCARE IMPROVEMENT, JOINS ME ON THE HEALTHCARE INEQUITIES EXPOSED BY THE PANDEMIC, AND THE WORK HIS TEAM IS DOING TO ADDRESS THEM.

>> Braude: WE'VE TALKED ON THIS SHOW WITH MANY MEN WHO HAVE SPENT DECADES OF THEIR LIVES WRONGFULLY IMPRISONED BEFORE THEIR CONVICTIONS WERE OVERTURNED.

PEOPLE LIKE SEAN ELLIS, 22 YEARS, DARRELL JONES, 32 YEARS, AND FRED CLAY, 38 YEARS.

BUT THE MAN WHOSE CASE WE'RE GOING TO TALK ABOUT TONIGHT, 28-YEAR-OLD C.J.

RICE, FROM MY HOMETOWN OF PHILADELPHIA, IS STILL IN PRISON FOR A SHOOTING HE HAS ALWAYS MAINTAINED HE HAD NOTHING TO DO WITH.

BACK IN 2011, FOUR PEOPLE WERE SHOT ON A STREET IN SOUTH PHILLY, ALL OF WHOM LATER RECOVERED.

THERE WAS NO PHYSICAL EVIDENCE TYING ANYONE TO THE CRIME.

AND WITNESSES TOLD POLICE MULTIPLE TIMES THAT THEY DIDN'T KNOW WHO WAS RESPONSIBLE, ONLY ABLE TO DESCRIBE TWO FIGURES, BOTH BLACK, WEARING HOODIES AND SWEATPANTS.

BUT AFTER POLICE SAID THEY GOT A TIP FROM A CONFIDENTIAL INFORMANT NAMING RICE, THE WITNESSES CHANGED THEIR STORIES, IDENTIFYING RICE AND A FRIEND.

ACCORDING TO A COVER PIECE IN "THE ATLANTIC" BY CNN ANCHOR JAKE TAPPER, RICE, THEN 17, YEARS-OLD, WASN'T ACTUALLY WORRIED ABOUT THE CASE AT FIRST.

HE THOUGHT THE MATTER WOULD BE CLEARED UP QUICKLY, BECAUSE HE HAD STILL BEEN RECOVERING FROM SURGERY, AND SOME MAJOR COMPLICATIONS, AFTER HAVING BEEN SHOT HIMSELF.

HE WAS WRONG.

AND RICE'S COURT-APPOINTED ATTORNEY DIDN'T HELP.

JUST ABOUT THE ONLY THING SHE DID IN THE CASE WAS CASH HER CHECK.

RICE WAS CONVICTED OF ATTEMPTED MURDER AND SENTENCED TO 30 TO 60 YEARS IN PRISON.

TAPPER ARGUED, RICE LACKED LEGAL REPRESENTATION WORTHY OF THE NAME."

JAKE JOINS ME, ALONG WITH HIS FATHER, DOCTOR THEODORE TAPPER, WHO HAD MR. RICE AS A PATIENT FROM CHILDHOOD, UNTIL RIGHT AFTER HE WAS SHOT.

DOCTOR, JAKE, THANKS SO MUCH FOR BEING HERE.

>> THANK YOU.

>> Braude: DOCTOR, YOU SAW CJ A COUPLE OF WEEKS AFTER HE HAD GOTTEN TREATMENT FOR GETTING SHOT HIMSELF.

WHAT KIND OF CONDITION WAS HE IN?

>> HE COULD BARELY WALK.

HE WAS WALKING WITH A GREAT DEAL OF PAIN.

HE HAD TROUBLE GETTING FROM THE SEAT IN THE EXAM ROOM UP THE EXAM TABLE AND CON COMMENTLY GETTING BACK FROM THE EXAM TABLE TO THE SEEVMENT AND WHEN HE WALKED OUT OF THE OFFICE HE WALK WADE SHUFFLING GATE ALL BENT OVER.

WHEN FEELING HIS ABDOMEN, HE WAS IN A GREAT DEAL OF PAIN AND HE HAD SOME ORIGINALLY 35, AND 40 STAPLES THAT STAPLED HIS BELLY TOGETHER AFTER THE SURGERY.

>> Braude: SO JAKE, LESS THAN A WEEK AFTER THAT MOMENT, THAT EXAMINATION BY YOUR FATHER, THIS SHOOTING OCCURS FOR WHICH CJ RICE ASK IS ACCUSED, TRIED, CONVICT.

AS I SAID, SENTENCED TO 30 TO 60 YEARS.

AT FIRST THERE IS NO PHYSICAL EVIDENCE.

AT FIRST THE EYE WITNESSES WERE UNABLE TO MAKE AN IDENTIFICATION.

WHAT CAUSED THE EPIPHANY?

>>WELL, THERE WERE TWO WITNESSES, AND AS YOU NOTED IN YOUR INTRODUCTION, NEITHER OF THEM IDENTIFIED OR SAID THEY KNEW WHO THE SHOOTERS WERE, MULTIPLE TIMES.

BUT THEN A CONFIDENTIALAL INFORMANT SUPPOSEDLY TOLD THE POLICE CJ WAS INVOLVED.

THE NEXT DAY THE DETECTIVES INVESTIGATING THE CASE WENT TO VISIT THESE TWO WOMEN IN THE HOSPITAL AND PRESENTED THEM WITH PHOTO POLICE LINE-UP, AND LO AND BEHOLD ONE IDENTIFIED CJ AND THE OTHER ONE IDENTIFIED CJ'S FRIEND TYLER WHO WAS A CODEFENDANT IN THE KAITION.

ALTHOUGH HE WAS COMPLETELY ACQUITTED.

AND THERE IS, I SHOULD NOTE, THE ONLY EVIDENCE AGAINST CJ, THE ONLY EVIDENCE.

AND YET BECAUSE THE COURT APPOINTED ATTORNEY WAS SO INCOMPETENT, SHE WAS NOT ABLE TO, OR SHE JUST SIMPLY DID NOT VISIT THE CRIME SCENE, APPARENTLY.

DID NOT UNDERLINE THE FACT THAT THE EYE WITNESS TESTIMONY WAS SHAKY AT BEST.

DID NOT MAKE THE BEST USE OUT OF MY FATHER AS A WITNESS.

BECAUSE SHE NEVER MET HIM BEFORE THE TRIAL.

AND ON AND ON IT WAS A LIT NEE OF MISTAKES.

AND SOME OF THOSE MISTAKES ESPECIALLY WHEN IT CAME TO THE ALIBI WITNESSES ACTUALLY ENDED UP MAKING CJ LOOK MORE GUILTY BECAUSE SHE WOULD CALL-- SHE CALLED AT LEAST ONE PERSON TO THE STAND WHO WAS NOT WITH CJ AT THE TIME.

IT WAS A TRAVESTY OF JUSTICE.

NO POLICE FORCE IN MY VIEW WOULD HAVE ARRESTED ME OR THE EXACT SAME CRIME WITH THAT LITTLE EVIDENCE.

AND IF THEY HAD, THEY, I WOULD HAVE BEEN ABLE TO AFFORD AN ATTORNEY WHO WOULD HAVE GOTTEN THE CASE DISMISSED VERY QUICKLY.

>> Braude: AND I ASSUME MOST OF OUR VIEWERS KNOW THERE IS A 6th EAMENTD TO THE CONSTITUTION WHICH GUARANTEES A RIGHT TO COUNSEL.

WE'LL TALK ABOUT THAT IN A COUPLE OF SECONDS.

EVEN THOUGH THE LAWYER DID NOT SPEAK TO YOU, DR. TAPPER, YOU DID TESTIFY AT THE TRIAL.

IN YOUR OPINION, AND BY THE WAY THOSE WITNESSES SAID THE ASSAILANT SPRINLTED AWAY SPR THE SCENE.

WAS CJ RICE PHYSICALLY CAPABLE OF EITHER COMMITTING THE CRIME OR SPRINTING AWAY FROM THE SCENE A WEEK AFTER YOU SAW HIM?

>> IT WAS APPROXIMATELY FIVE DAYS AFTER I SAW SHIM WHEN THE INCIDENT OCCURRED.

THERE IS NO WAY HE WAS EVEN WALKING FAST.

THERE IS NO WAY HE WAS RUNNING.

LET ME ADD ONE OTHER THING.

THE ONLY REASON THAT CJ IS SENTENCED TO 30 TO 60 YEARS IS BECAUSE THE DISWRUJ WHO WAS THE ONE IN CHARGE OF THIS, DECIDED THAT THE CONCURRENT POTENTIALLY SENTENCES OF TEN TO 15 WERE TO BE RUN CONSECUTIVELY.

SO 10 TO 15 PLUS 10 TO 15 PLUS 10 TO 15 ENDS UP TO 30 TO 60.

IF THE JUDGE HAD SENTENCED HIM TO THREE CON CENT TERMS OF 10 TO 15, WE HAVE BEEN OUT BY NOW BECAUSE IT WOULD HAVE BEEN 10 TO 15.

>> Braude: THIS MAY BE AN IMPOSSIBLE OR EVEN A STUPID QUESTION TO ASK, JAKE TAPPER, BUT EVEN THE MOST SIMPLE THING, FOR EXAMPLE, GETTING HER CLIENTS PHONE RECORDS, WHICH MIGHT HAVE HAD LOCATION INFORMATION, SHE FAILED TO DO.

WHAT DO YOU ATTRIBUTE THIS, WHAT YOU CALL RANK INCOMPETENCE TOO?

>> I DON'T-- SHE HAS PASSED AWAY, SON JAY LEVER, SO I DON'T KNOW.

I CAN TELL THAT YOU SINCE THIS STORY CAME OUT IN THE ATLANTIC I WAS CONTACTED BY SOMEBODY WHO SERVED IN THE PROSECUTOR'S OFFICE WHO KNEW A LOT OF THE PLAYERS, WAS SHOCKED BY THE CASE.

BUT ALSO SAID TO ME THAT HE, THAT SONJAY WEAVER WAS KNOWN AS A BAD LAWYER.

SHE WAS COMMONLY KNOWN AS A CRUMBY LAWYER.

AND WITHIN OF THE THINGS THAT THIS RESEARCHING THE STORY REALLY MAID ME AWARE OF, SO I GUESS I HAD KNOWN IT INTELLECTUALLY, YOU REALLY DON'T SEE IT UNTIL YOU SEE IT.

WHICH IS THE RIGHT TO COUNSEL THAT WE HAVE IN THIS COUNTRY, IS KIND OF A JOKE.

THE STANDARDS ARE VERY VAGUE.

AND INDIVIDUALS WHO HAVE BEEN FOUND DURING THEIR TRIAL, DEFENSE ATTORNEYS, WHO HAVE BEEN DRINKING THE EQUIVALENT OF 20 SHOTS INVOLVE CA A DAY, FELT, PEOPLE WHO FELL ASLEEP DURING THE TRIAL, PEOPLE WHO WERE DISBARRED DURING THE TRIAL, ALL OF THEM WERE FOUND BY APPEALATE COURTS TO HAVE BEEN SUSPICIOUSLY GOOD COUNT THE STANDARD IS VERY, VERY, VERY LOW.

>> Braude: I JUST WANT TO CLARIFY.

WHEN YOU SAID PEOPLE FELL ASLEEP DURING THE TRIAL, THE PEOPLE YOU ARE TALKING ABOUT, IS THE LAWYER HIMSELF OR HERSELF, CORRECT?

WHO FELL ASLEEP DURING THE TRIAL.

>> YES, THE DEFENSE ATTORNEY FELL ASLEEP DURING A TRIAL, THE APPEALATE COURT RULE, SAYS THAT IS FINE.

PEOPLE CAN GOOGLE IT, THERE IS CASE AFTER CASE OF THIS WHERE THE STANDARD IS IF THE ATTORNEY HAS A PULSE AND IS IN THE ROOM, PRETTY MUCH THAT'S GOOD ENOUGH.

>> Braude: I AM A FORMER LEGAL SERVICES, CIVIL LEGAL SERVICES LAWYER MYSELF.

AND I KNOW A LOT OF PUBLIC DEFENDERS, FOR PEOPLE THAT DON'T KNOW THE SYSTEM, PENNSYLVANIA, MY HOME STATE, MASSACHUSETTS, MY ADOPTED STATE, HAVE THE SAME SPLIT, ROUGHLY 20% OF INDIGENT DEFENDANTS ARE REPRESENTED BY SALARY PUBLIC DEFENDERS.

THE REST BY COURT APPOINTED LAWYERS.

MANY OF WHOM ARE TERRIFIC.

BUT ALL OF WHOM HAVE TO WORK FOR CHICKEN FEED AND IN PART, THAT WAS APPARENTLY PART OF THE PROBLEM HERE.

THIS WOMAN HAD HUGE FINANCIAL PROBLEMS AND I GET THE SENSE FROM YOUR STORY, SHE, HER GOAL WAS TO MOUNT UP AS MANY CASES AND FEES AS SHE COULD RATHER THAN WORRY ABOUT THE REPRESENTATION.

>> YEAH, LOOK, AS YOU NOTE, PUBLIC DEFENDERS ARE OFTEN QUITE EXCELLENT AND I DON'T WANT TO CAST DISPERCENTS ON COURT-APPOINTED ATTORNEYS.

STUDIES INDICATE THEY HAVE A MUCH WORSE TRACK RECORD THAN PUBLIC DEFENDERS.

BUT WHAT WE KNOW ABOUT SAN JAY IS SHE HAD TO DECLARE BANKRUPT SEE SEVERAL TIMES AND CJ'S IMPRESSION WAS THAT SHE, SHE ONLY VISITED HIM TWICE IN JAIL WHILE, BEFORE TRIAL, TWICE.

>> Braude: IN 15 MONTHS.

>> YEAH, VERY SHORT AMOUNT OF TIME AND ACCORDING TO CJ SHE WOULD COME WITH JUST A GIANTS STACK OF FOLDERS AS IF SHE WAS VISITED SEVERAL CLIENTS.

AND AS YOU KNOW, THEY GET PAID BY THE CASE, NOT BY THE RESULT.

>> Braude: AND NOT ABOUT THE AMOUNT OF WORK YOU PUT INTO T I'M SORRY, DOCTOR, GO AHEAD.

>> NOT BY THE TIME THEY PUT IN EITHER.

>> RIGHT.

>> Braude: ONE OF THE THINGS THAT REALLY SURPRISED ME, SO THE LEGAL APPEAL, CORRECT ME IF I'M WRONG, GENTLEMEN, VEES A VEE THE RIGHTS OF COUNSEL BEING VIOLATED HAVE BEEN EXHAUSTED.

SO IT APPEARS THE ONLY AVENUES LEFT FOR MR. RICE IS THE PROSECUTOR IN THIS CASE, ONE OF THE PROGRESSIVE PROSECUTORS LIKE WE HAD RACHAEL ROLLINS NOW PROMOTED TO U.S. ATTORNEY.

LARRY CRASSNER THERE AND A COME TAITION PROCEEDING.

I WANT TO TALK ABOUT BOTH.

CRAZENER IT APPEARS TO ME HAS TOTALLY WASHED HIS HANDS OF THIS.

AND I DON'T QUITE GET IT, DO YOU?

>> WELL, I MEAN, HE CAME TO OFFICE SAYING THAT HE WAS GOING-- HE IS SETTING UP THIS THING CALLED A CONVICTION INTEGRITY UNIT, THE CIU.

THAT UNIT HAS PRETTY MUCH FOCUSED ON THE MOST-- MUCH INJUSTICE, CROOKED COPS, EVIDENCE THAT INDIVIDUALS DIDN'T DO IT.

HE IS NOT TAKING ON-- BY THE WAY, HE IS ALSO IN THE MIDDLE OF A POLITICAL CRISIS HIMSELF BECAUSE THE LEGISLATURE IS THREATENING TO IMPEACH HIM, THEY ARE INVESTIGATING HIM, SO HE HAS HIS HANDS FULL WITH A LOT OF THINGS.

BUT THE BOTTOMLINE IS THIS IS AN INDICTMENT OF THE SYSTEM, NOT AN INDICTMENT OF A CROOKED COP OR DNA EVIDENCE, LIKE AN OPEN AND SHUT.

>> BUT HE'S NOT PRECLUDED FROM LOOKING INTO THESE KINDS OF ISSUES.

NOR IS ANY DA WITH THESE UNITS.

I WANT TO MENTION ONE OTHER THING IF I CAN, GENTLEMEN.

THE WHOLE COME TAITION WHICH I KNOW LAYS OUT THERE FOR POTENTIAL FOR MR. RICE, WHICH IS ALSO LADEN WITH LOTS OF INSTITUTIONAL PROBLEMS.

I MEAN WE HAD A WILLY HORTON HERE THAT MANY PEOPLE THINK MIGHT HAVE COST MICHAEL DU CASS -- DUKAKIS THE PRESIDENCY, A GUY WHO WENT ON WEEKEND FURLOUGH, COMMITTED ARMED ROBBERY, RAPED A WOMAN AND IT BECAME A HUGE ISSUE IN THE CAMPAIGN.

MANY PEOPLE THINK, I MYSELF INCLUDED, RACISM CONJURED UP BY GOVERNOR DUKAKIS' OPPONENT.

BLUE REGINALD McFADEN IN PENNSYLVANIA PENN-- PERSON PENN, SIMILAR SITUATION, WHERE THE DEMOCRAT RUNNING AGAINST TOM RIDGE WAS WINNING BY 8 OR 10 POINTS AND HIS CAMPAIGN TOTALLY DISAPPEARED ONCE A COMPARABLE SITUATION CAME OUT WHERE A GUY WAS RELEASED, A MURDERER AND THEN COMMITTED MURDER AGAIN.

THE SYSTEM IS SUCH, JAKE, THAT EVEN PROGRESSIVE GOVERNORS LIKE DEVAL PATRICK HERE, VERY FEW COME TAITIONS AND PARDONS, CHARLIE BAKER IS ONLY DOING THEM IN HIS 8th AND FINAL YEAR.

THAT IS THE SYSTEM THAT ALSO NEEDS A BILT OF A SPOTLIGHT, DON'T YOU THINK?

>> YEAH, AND LOOK, THE POLITICAL INCENTIVE TOO OFTEN, NOT JUST WHEN IT COMES TO COME TAITIONS AND PARDONS, BUT ANYTHING IN OUR POLITICAL SYSTEM, THE INCENTIVES ARE ALL WITH DOING NOTHING.

>> Braude: RIGHT.

>> NOT TAKING ANY RISKS.

GOING WITH THE FLOW.

AND OBVIOUSLY, THAT IS NOT HOW GREAT LEADERS ARE MADE.

BUT OF COURSE WITH THE McFADEN CASE AS YOU NOTE, THAT RUINED THE, NOT JUST THE ELECTION BUT THE POLITICAL CAREER OF THEN LT.

GOVERNOR MARK SINGLE WHO IS RUNNING FOR GOVERNOR.

AND NOBODY WANTS TO HAVE THAT KIND OF RECORD.

BUT THAT SAID, WE'RE JUST SAYING THAT CJ DID NOT GET A FAIR TRIAL.

>> UNDERSTOOD.

>> AND MY DAD IS OF THE OPINION THAT CJ COULD NOT HAVE PHYSICALLY DONE THIS.

I'M SAYING LOOK, I HAVE MY CONCLUSIONS ABOUT WHETHER OR NOT THERE WAS AN EXCESS OF REASONABLE DOUBT AND I INVITE PEOPLE TO READ THE "THE ATLANTIC" STORY TO SEE HOW HE CAME TO THAT CONCLUSION.

BUT THE BOTTOMLINE IS HE DIDN'T GET A FIRST FAIR TRIAL.

>> Braude: YOU KNOW, BEFORE YOU GO, DR. TAPPER, YOUR SON WAS UNABLE TO COEX OUT OF YOU AN ANSWER TO THE QUESTION AS TO WHETHER OR NOT YOU OUT OF THE KINDNESS OF YOUR HEART HAVE BEEN FINANCING PART OF LAWYERING FOR MR. RICE AFTER THIS WEAVER REPRESENTATION.

DO YOU WANT TO ANSWER THE QUESTION FOR ME?

>> HE HAD AN INITIAL LAWYER AFTER WEAVER BOWED OUT.

AND HE IS BECOME PAID AS A DEFENSE ATTORNEY BY THE STATE OF THE CITY, WHOEVER, AND HE NOW HAS A HABEAS COR PUS LAWYER WHO SAW CJ IN PRISON TODAY FOR THE FIRST TIME, AND I TALKED TO HIM MAYBE AN HOUR AGO.

AND IS HE VERY HOPEFUL THAT A HABEAS COR PUS COMPETITION WILL BE SUBMITTED NEXT MONTH AND THAT IS ONE AVENUE.

AND THE OTHER AVENUE IS THE BOARD OF PARDONS OF PENNSYLVANIA.

THEY HAVE TO VOTE UNANIMOUSLY 5-0, A 4-1, 3-2 VOTE DOES NOT CUT IT.

SO EITHER THE BOARD OF PARDONS OR HAB YESES CORPUS ARE THE TWO AVENUES OPEN.

AND POSSIBLY THE CIU WILL REVIEW THE CASE WITH ALL THE HEAT THAT HAS BEEN PUT ON PUBLICLY BECAUSE OF JACOB'S ARTICLE.

>> Braude: ARE YOU FINANCING PART OF THAT EFFORT, DOCTOR?

>> PLEFER NOT TO ANSWER.

>> Braude: I HAD A FEELING YOU WOULDN'T.

JAKE, BEFORE YOU GO.

THIS PIECE I ASSUME IS NOT JUST WRITTEN ABOUT CJ RICE BUT ALL THE CJ RICE'S THAT DON'T HAVE TWO TAPPERS AS THEIR ADVOCATES, IS THAT A FAIR STATEMENT IN.

>> 100 PERCENT.

ONCE YOU SEE AND YOU KNOW THIS OBVIOUSLY FROM YOUR LIFE'S WORK.

BUT ONCE YOU SEE THE UNFAIRNESS IN THE CRIMINAL JUSTICE SYSTEM, YOU CAN KNOT UNSEE IT.

NOBODY WANTS GUILTSY PEOPLE WALKING THE STREET.

WE JUST THINK THAT PEOPLE ARE ENTITLED TO THE SAME KIND OF JUSTICE THAT I WOULD BE ABLE TO AFFORD OR YOUR VIEWERS WOULD BE ABLE TO AFFORD.

SO I BELIEVE THAT CJ IS VERY UNLUCKY.

BUT HE HAD THE FORTUNE OF HAVING A PHYSICIAN WHO IS CONVENTIONED OF HIS INNOCENCE, WHO HAPPENED TO HAVE A SON WHO IS A JOURNALIST.

BUT I CAN'T EVEN IMAGINE HOW MANY PEOPLE THERE ARE OUT THERE IN PRISON CELLS ALL OVER THE COUNTRY, ALL OVER THE WORLD, THAT DIDN'T HAVE, EVEN THOUGH THEY HAVE BAD LUCK, AT LEAST THAT SMALL FORTUNE.

>> Braude: JAKE, YOUR PIECE IN THE ATLANTIC IS TERRIFIC, I'M SORRINESS.

>> I WAS IN A FEDERAL PRISON THIS MORNING I PERIODICALLY VISIT ONCE OR TWICE A MONTH BECAUSE I VISIT INCARCERATED INDIVIDUALS IN FEDERAL PRISON.

THERE IS NO QUESTION IN MY MIND THAT THERE ARE PEOPLE THAT BELONG IN STATE OR FEDERAL PRISON, THAT IS NOT THE ISSUE?

THE CJ CASE.

THERE ARE OVER 2 MILLION AMERICANS WHO ARE LOCKED UP.

IF 1 PERCENT OF THEM ARE INNOCENT, THAT MEANS WE WHERE LOCKING UP 20,000 PEOPLE CURRENTLY, THAT WE ARE DOING.

>> Braude: I WANT YOU TO BE MEI DOCTOR AND GOOD TO MEET YOU BOTH.

JAKE, TERRIFIC PIECE IN THE ATLANTIC.

I URGE EVERYONE TO READ T THANKS FOR YOUR TIME, GENTLEMEN.

>> THANK YOU.

NEXT UP, RACIAL DISPARITIES HAVE DEFINED THE COVID PANDEMIC SINCE THE VIRUS WAS FIRST DETECTED IN THE U.S.

IN EARLY 2020.

BUT MEDICAL SEGREGATION, AND OUTRIGHT RACISM IN HEALTHCARE DELIVERY DIDN'T BEGIN THERE.

NOW THOUGH IT IS FINALLY BEING TALKED ABOUT.

BUT WILL WORDS BE MET WITH ACTION AND FUNDING?

JOINING ME IS DOCTOR KEDAR MATE, PRESIDENT AND C.E.O.

OF THE BOSTON-BASED INSTITUTE FOR HEALTHCARE IMPROVEMENT, WHICH HAS FOCUSED ON THE ISSUE.

AMONG OTHERS, PLEASURE TO YOU HAVE, THANKS FOR BEING HERE.

>> THANKS FOR HAVING ME.

>> Braude: WE TALKED ALMOST NONSTOP AND ABOUT RACIAL INEQUITY DURING COVID BUT GO BACK A FEW YEARS BEFORE THIS, I WILL NEVER FORGET THIS STUDY THAT SAID WHITE DOCTORS THOUGHT THE SKIN OF BLACK PATIENTS WAS THICKER.

THAT THEIR NERVE ENDS WERE LESS SENSITIVE.

AND THE SENSE I GOT OF THAT, PLEASE CORRECT ME IF I'M WRONG.

IT WAS SORT OF DISMISSED BY THEIR FELLOW HEALTH CARE PROFESSIONALS SAY STG JUST THEM, THEY ARE OUTLIARS, NO SYSTEMIC PROBLEM HERE.

IS THAT A FAIR STATEMENT?

>> I THINK THAT SAY REASONABLE STATEMENT, YEAH.

>> Braude: AND YOU FROM WHAT I UNDERSTAND, YOU BELIEVE THE CURE FOR THIS, IF I CAN CALL IT SORT OF SYSTEMIC RACISM DENIAL, IS DATA.

IS THAT-- DO FACTS REALLY MATTER.

>> FACTS MATTER, DATA MATTERS.

BRINGING DATA TO THE ISSUE OF INEQUITIES ACTUALLY RACES THE VISIBILITY, RACES THE UNDERSTANDING OF THE FACT THAT THESE INEQUITIES EXIST.

I WILL TELL YOU A BRIEF STORY, WHENEVER WE WORK ON THIS IN OUR HOSPITAL, WE ALWAYS GET THE INITIAL REACTION TO ANY KIND OF DATA PRESENTED ABOUT INEQUITIES THAT IS PRESENT IN YOUR ENVIRONMENT.

THE INITIAL REACTION ISN'T S THIS ISN'T MY DATA, THIS ISN'T MY INFORMATION, YOU START TO DIG IN AND REALIZE THESE INEQUITIES ARE PREVALENT IN HEALTH SYSTEMS ALL OVER THE PLACE.

THEY ARE HAPPENING EVERY DAY IN THE WORK THAT WE DO IN OUR CLINICAL INTERACTIONS WITH OUR PATIENTS.

IF WE DON'T ACTUALLY START TO LOOK AT THAT DATA AND START TO MAKE IMPROVEMENTS WITH IT, WE ARE GOING TO REPLICATING THOSE STORIES OF THE PAST.

>> Braude: I LOVE THE PHRASE USED, STAGES OF GRIEF AROUND DATA, THAT MEANS IT TAKES A WHILE TO SETTLE IN KIND OF THING.

>> THAT'S RIGHT.

>> Braude: ONE OF THE THINGS I KNEW NOTHING ABOUT UNTIL I KNEW YOU WERE COMING HERE, BLUE CROSS HAS PUT THEIR MONEY WHERE THEIR MOUTH IS, 16.5 MILLION, CHANNELED THROUGH YOU, WHICH IN TURN GO TO 12 HEALTH CARE DELIVERY.

>> WHAT IS THAT MONEY INTENDED.

WE WILL PUT UP A GRAPHIC THAT SHOWS SOME OF THE THINGS WE READ THAT THE MONEY GOES FOR, TELL ME IN YOUR OWN WORDS WHAT IS IT INTENDED TO DO.

>> WE HAVE A GROUP OF-- HOSPITAL HEALTH SYSTEMS THAT ARE COMMITTING THEMSELVES TO IMPROVING HEALTH EQUITIES AND REDUCING INEQUITIES THAT THEY SEE IN CANCER CARE, HYPERTENSION, DIABETES, ET CETERA.

BUT THEY NEED SUPPORT FROM THEIR PEERS FROM THE HEALTH CARE, THAT-- WHAT BLUE CROSS SAYS IS THIS IS AN IMPORTANT PRIORITY, WE WANT TO REDUCE INEQUITIES IN THE CARE WE FINANCE.

WE WILL PUT OUR MONEY WHERE OUR WORDS ARE.

AND I'M REALLY THRILLED TO BE WORKING TOGETHER WITH BLUE CROSS BLUE SHIELD OF MASSACHUSETTS TO TRY TO MAKE THIS PROGRAM HAPPEN.

THEY HAVE SUPPORTED US TO HELP PROVIDE GUIDANCE AND SUPPORT TO THE PROVIDERS THEMSELVES SO THAT THEY CAN ACTUALLY CONDUCT EQUITY IMPROVEMENT ACTIVITIES IN THEIR ENVIRONMENT.

>> Braude: BUT IF THE PROVIDERS ENGAGE IN HEALTH EQUITY IMPROVEMENT BEHAVIORS, AS YOU DESCRIBED A MINUTE AGO, WITHIN THEIR FOUR WALLS, IT ONLY DOES SO MUCH.

WHAT I HAVE HEARD FROM EVERYBODY SITTING ON THAT CHAIR IN THE LAST FEW YEARS, IS IF YOU DON'T ADDRESS THE SOCIAL DETERMINE ANTS, THE KIDS, THE PATIENTS HAVE NUTRITIOUS FOOD AT HOME, DOES HE FEEL SAFE WALKING TO SCHOOL, DOES SHE LIVE IN DECENT HOUSING, THAT IS THE BIG TICKET, ALMOST IMPOSSIBLE NUT TO CRACK, WITHOUT WHICH THESE OTHER THINGS NEVER GO FROM HERE TO THE GOAL LINE, DO THEY?

OR DO THEY?

>> WELL, IT DEPENDS A LITTLE BIT ON THE NATURE.

CLIRCH KAL PROBLEM.

SO IF SOMEBODY COME NOOSES YOUR EMERGENCY DEPARTMENT WITH A STROKE, RIGHT, AT THAT POINT IN TIME, THERE IS A POTENTIAL SITUATION THAT MIGHT ARISE WHERE YOU COULD HAVE A SIGNIFICANT DISPARITY AND STROKE OUT.

WE SAW THIS WITH THE ORGANIZATION WE WERE WORKING WITH IN THE PACIFIC NORTHWEST.

THIS HEALTH SYSTEM, BLACK PATIENT, WHITE PATIENTS ARRIVING IN THE EMERGENCY ROOM WITH THE SAME SIZE AND SYMPTOMS OF STROKE.

THE BLACK PATIENTS HAD A DELAY IN THEIR CARE OF OVER 20 MINUTES COMPARED TO WHITE FOLKS.

AND THAT CAUSES A SIGNIFICANT AMOUNT OF LOSS OF BRAIN FUNCTION THAT CAN LEAD TO LONG-TERM DISABILITY AND POTENTIALLY EARLY MORTALITY.

>> Braude: AND THAT CAN BE FIXED.

>> -9D CONTAINS.

>> IF YOU ARE TALKING ABOUT ASTHMA CARE OR CHRONIC DISEASE LIKE HYPERTENSION, CARDIOVASCULAR DISEASE, SOME CANCERS, YOU ARE RIGHT, YOU THEED TO ACTUALLY WORK OUTSIDE OF THE FOUR WALLS OF THE HEALTH SYSTEM TO START PARTNERS WITH SOCIAL SCARE INSTITUTIONS TO TRY TO WORK ON THOSE SOCIAL DETERMINE ANTS.

YOU CAN'T ACCOMPLISH BETTER CARE FOR THOSE KIENSD OF CONDITIONS WITHOUT ENGAGING THOSE, A WIDER ARRAY OF ACTORS IN THE ENVIRONMENT WZ WE TALKED AT THE BEGINNING ABOUT DOCTORS, WELL, POOH POOHING, SORT OF THEM, IT'S NOT US.

PEOPLE HERE WERE SEEING THE REPORTING, MY COLLEAGUE, FILL LIP MARTIN ABOUT TWO DOCTORS WHO CONFRONTED IT HEAD ON AT BRIGHAM AND WOMEN.

ONE OF THEM CAME UP WITH A STUDY THAT SHOWED IF YOU ARE BLACK AND MORE LIKELY TO DIE FROM A HEART PROBLEM, YOU ARE PUT ON A GENERAL FLOOR.

IF YOU ARE A WHITE PERSON AND LESS LIKELY TO DIE, YOU ARE PUT ON A CARDIAC FLOOR, WITH LIKELY BETTER OUTCOMES.

AS YOU KNOW, THESE NEO-NAZI'S PICK ETED THEM, DEATH THREATS, THOSE KIND OF THINGS.

WHAT DID THE HEALTH CARE COMMUNITY DO TO PROTECT PEOPLE LIKE THEM SO THAT THERE ARE OTHER PEOPLE LIKE THEM?

>> SO THAT ACTUALE, THAT PROSWRECT THAT WORKED ON CON GUESS SHIF HEART FAILURE IN THE CONFINES OF PURSUING-- I THE TWO DOCTORS THAT WERE PART OF THAT INITIATIVE I AM DESCRIBING WHERE WE STARTED TO WORK WITH EIGHT HEALTH SYSTEMS ON IMPROVING HEALTH INEQUITIES.

SO BRINGHAM PICKED CON GUESS TIFF HEART FAILURE AS THE TOPIC TO WORK ON.

FOUND THOSE INEQUITIES, DOCUMENTED THEM, STARTED TAKING ACTION.

AND YOU SAW WHAT HAPPENED.

YOUR QUESTION IS HOW DO WE ENSURE THAT DOCTORS LIKE BRAWM AND MICHELLE CONTINUE TO DO THAT WORK.

IN FACT, MORE DOCTORS CONTINUE TO DO THAT WORK.

I THINK THAT IS ABOUT FINDING COMMUNITY AND ACTUALLY ELEVATES THE IMPORTANCE OF EQUITY AND IMPROVEMENT AS PART OF WHAT WE DO IN HEALTH CARE.

>> Braude: IS THERE NOT A FEELING THAT WE SHOULD KEEP OUR HEDS DOWN AND WE DON'T HAVE TO WORRY ABOUT THOSE KINDS OF MOMENTS, IS THERE NOT A WAVE OF THAT.

>> WHEN YOU LOOK AT THE DATA AND SEE THE FACT WE HAVE PREVALENT INEQUITIES ACROSS YOU ARE OUR SYSTEM, HOW DO YOU AVOID THINKING ABOUT IT, WORKING ON IT HERE IS THE THING, ONCE CLINICIANS ARE PROVIDED THAT DAILT AND THEY GO THROUGH THOSE STAGES OF GRIEF ABOUT, ONCE THEY GET THROUGH THAT, AND IF THESE DATA ARE REAL, THERE SAY NEED FOR IMPROVEMENT, CLINICIANS ARE OBLIGATED BY THEIR OATH AND COMMITMENT TO TAKE ACTION.

AND THEY DO IT INVARIABLY IN THE SITUATIONS.

>> THOSE ARE HEALTH CARE WORKERS DOING EXTRAORDINARY THINGS.

LET'S TALK ABOUT HEALTH CARE WORKERS DOING TEUJLY IMPORTANT BUT ORDINARY THINGS, JUST DOING THEIR JOB.

WE'VE ALL SEEN THE NUMBERS.

YOU CAN PUT THESE UP TOO.

DOCTORS DESCRIBING BURNOUT CONDITIONS, UP MORE THAN 50% IN A YEAR FROM 20 TO 21.

SUICIDE RATES UP.

WHAT IS BEING DONE ON THAT FRONT OTHER THAN PEOPLE LEAVING THE PROFESSION?

>> THIS SAY REALLY IMPORTANT AREA OF EMPHASIS.

THERE IS SO MUCH GOING ON RIGHT NOW ABOUT WORKFORCE SAFETY, PHYSICAL SAFETY, NOT ONLY JUST LITERAL PHYSICAL SAFETY, OSHA STUFF BUT ALSO VIOLENCE AGAINST PHYSICIANS AND NURSES AND OTHER HEALTH-CARE PROVIDERS AS WELL AS MENTAL HEALTH AND WELL-BEING, DOCTORS AND NURSES AND ALL CLINICAL PROVIDERS, A TON OF CONDITIONS GOING INTO THIS, VERY PROBLEMATIC, WE HAVE 93% OF CLINICIANS REPORTING SOME SIGNS OR SIEM TOMORROW-- SYMPTOMS OF STRESS OR BURNOUT, SIGNIFICANT NUMBERS ASKING OR SUGGESTING THEY WANT TO LEAVE IN THE NEXT YEAR, 25%.

>> Braude: WHAT ARE YOU DOING ABOUT IT.

>> RIGHT NOW WE ARE WORKING ON A MULTIPART PROGRAM BOTH ON VIOLENCE PREVENTION AND PHYSICAL SAFETY, AS WELL AS ON ENSURING MENTAL HEALTH PROVISIONS FOR HEALTH CARE WORKERS.

AND WORKING ON HELPINGS HEALTH CARE WORKERS TO TAKE CARE OF ONE ANOTHER.

>> IS THERE, SOUNDS ODD, ASKING THIS QUESTION TO PEOPLE WHO PROVIDE HEALTH CARE FOR AW A LIVING.

WE KNOW ABOUT THE STIGMA, IF YOU ARE IN THE MILITARY, YOU TALK ABOUT PHYSICAL PROBLEMS, YOU DON'T TALK ABOUT MEN TAM HEALTH ISSUES.

WE CAN TALK ABOUT ALL THE DIFFERENT INDUSTRIES, SAME PROBLEM EXISTS IN THE HEALTH CARE WORLD?

>> QUITE A BIT-OF-IT.

WE HAVE ACTUALLY THERE ARE STIGMATIZING QUESTIONS WE GET ASKED WHEN WE CERTIFY IN OUR STATE LICENSING BOARD ABOUT WHETHER WE HAVE SEEN A BEHAVIORAL HEALTH PROVIDER.

THAT QUESTION ALONE STARTS TO RAISE THE ANXIETIES OF OUR HEALTH-CARE PROVIDERS AS TO WHETHER OR NOT IT IS OKAY FOR ME TO SEE A BEHAVIOR HEALTH PROVIDER.

ST A REAL PROBLEM RIGHT NOW.

>> AND YOU THINK SOME DON'T BECAUSE FOR FEAR OF WHAT IS CONSEQUENCES MAY BE FOR ADMITTING IT.

>> ADMITTING THAT I NEED A BEHAVIORIST, ADMITTING I NEED TO SEE A THERAPIST IS POTENTIALLY A SIGN OF A CONCERN THAT MIGHT LOSE, RESULT IN THE LOSS OF MY LIFE.

>> ARE THEY RIGHT TO BE WORRIED?

>> I DON'T KNOW, A LOT OF THAT KIND OF THREAT HAS ACTUALLY BEEN REALIZED.

WE ARE SEEING CLINICIANS LOSE THEIR LICENSES IN THESE CASES.

BUT I THINK WHAT IS HAPPENS RIGHT NOW, WE HAVE TO ENSURE THAT WE HAVE A LOT MORE MENTAL HEALTH SERVICES FOR OUR CLINICIANS, ST OKAY TO ASK FOR HELP, IT IS NORMALIZED FOR CLINICIANS TO SEEK SERVICES, TO ENHANCE THE WELL-BEING, AND THAT IS A PART OF WHAT WE HAVE TO BE DOING.

I WILL SAY ONE LAST THING ABOUT THIS WHICH IS THAT SOME PART OF THE EQUITY STORY CONNECTS TO THIS ISSUE AROUND BURNOUT AND IT CONNECTS THROUGH THE NOTION OF MORAL DISTRESS.

WHEN YOU SEE A PATIENT COMING IN AND OUT WITH THE SAME SIGNS AND SYMPTOMS GETTING DISPARRALITY AND INEQUITABLE CARE AND YOU DON'T HAVE THE PO TER TO SOLVE FOR THOSE THAT WE TALKED ABOUT EARLIER AND SENDING A PERSON OUT INTO THE COMMUNITY WITH A TREATMENT PLAN THAT YOU KNOW THEYARE NEVER GOING TO BE ABLE TO FOLLOW, AND THEY COME BACK RIGHT INTO YOUR ER NEXT WEEK WITH THE SAME SYMPTOMS, YOU DO THAT OVER AND OVER AGAIN, YOU ARE GOING TO EVENTUALLY BURNOUT.

ST NOT BECAUSE DOCTORS AND NURSES AND OTHER CLINICAL ADVISORS AREN'T USED TO SPENDING HUNDREDS OF HOURS SOMETIMES WORKING REALLY HARD, BUT IF YOU ARE WORKING REALLY HARD, AND YOU ARE NOT MAKING A LOT OF PROGRESS, THAT KIND OF THING IS ULTIMATELY INCREDIBLY DISRUPTIVE.

>> HOW WORRY READY PEOPLE LIKE YOU WORRIED ABOUT SHORTAGE OF STAFF.

WE KNOW PRIMARY DOC, FAMILY PHYSICIANS ARE A PROBLEM, HOW BIG A PROBLEM.

>> NUMBER ONE PROBLEM, ANY C.E.O.

I TALK TO IN HEALTH CARE, INCH ONE PROBLEM IS STAFFING, OF ANY KIND,.

>> O'Connell: 15 SECOND WHAT ARE THEY DOING TO IT.

>> STARTING TO PROVIDE THESE SERVICES, MENTAL HEALTH SERVICES, FOR JOBS THAT THEY NEED TO DO STARTING TO CREATE CONNECTIVITY AND CONNECTIONS IN THE COMMUNITY TO SOLVE THE PROBLEM THAT THESE PATIENTS ARE EXPERIENCE AND THAT IS THE KIND OF THING THAT ACTUALLY GIVES LIFE AND CREATES ENERGY IN THE HEALTH CARE WORKFORCE.

>> Braude: REALLY GOOD TO SEE YOU, HOPE YOU COME BACK SHALL APPRECIATE IT.

THANKS SO.

THAT'S IT FOR TONIGHT, BUT COME BACK TOMORROW.

FORMER ASSOCIATE JUSTICE ON THE STATE'S HIGHEST COURT, ROBERT CORDY, JOINS ME ON HIS LATEST WORK AS A MEMBER OF UKRAINE'S PRESIDENTIAL ETHICS COUNSEL.

PLUS, A FORMER OBAMA SPEECHWRITER ON HIS NEW BOOK: "GRACE: PRESIDENT OBAMA AND TEN DAYS IN THE BATTLE FOR AMERICA."

THAT AND MORE, TOMORROW AT 7:00.

THANKS FOR WATCHING, AND PLEASE DON'T FORGET UKRAINE.

Captioned by Media Access Group at WGBH access.wgbh.org