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--:-- Steve Inskeep: What does a change at the top mean for the FBI? Director Christopher Wray is resigning. President-elect Trump appointed him in 2017, but now he wants a nominee who promised retribution for Trump's critics. I'm Steve Inskeep with A. Martinez, and this is Up First from NPR News.
--:-- A. Martinez: Shooting an insurance executive in the back produced a disturbing response, and that includes real-life conversations about health care. So our correspondent pursues a question. Why do we spend so much on health care for a life expectancy that is comparatively low? And what do Democrats want from their next party chair? The Democratic National Committee is meeting in Washington over the next two days to reflect on the election results and hear pitches from candidates. Stay with us. We've got all the news you need to start your day.
--:-- Steve Inskeep: We've got a message from BetterHelp. President Fernando Madeira describes how BetterHelp Online Therapy has helped him.
--:-- Fernando Madeira: For me, sometimes I just need to go and talk to somebody that is not going to judge me, right? Is going to be there and going to listen to me. And I can start just saying, look, I'm not feeling right today. And it feels natural. I love it.
--:-- Steve Inskeep: To get matched with a therapist, visit BetterHelp.com slash NPR for 10% off your first month.
--:-- A. Martinez: We now know how the FBI director will respond to the president-elect who wants to replace him. President-elect Trump appointed Christopher Wray during his first term back in 2017, but now Trump wants to nominate a loyalist, Kash Patel, and made it clear he wants Wray to go. The director says he will step down at the end of the Biden administration next month and three years before the end of his term. NPR Justice correspondent Ryan Lucas is covering this story, and he's come by our studios very early this morning.
--:-- Ryan Lucas: Good morning. So how did Ray explain his decision?
--:-- Steve Inskeep: Well, Ray made this announcement in a town hall that he had yesterday with FBI employees. And what he said is that he's given this a lot of thought. And he came to the conclusion that stepping down in January with the change in administration is the right thing to do for the FBI. He said this is the best way to avoid, as he put it, dragging the Bureau deeper into the fray. He also said this. This is not easy for me. I love this place. I love our mission. And I love our people. But my focus is and always has been on us and on doing what's right for the FBI.
--:-- Ryan Lucas: Now, Ray said the FBI's work is critical. That won't change. And he also said that the FBI's commitment to independence, to objectivity and its defense of the rule of law, he says that those things must not change Which of course Trump critics fear that exactly what Trump wants to change with this new appointee
--:-- Steve Inskeep: What has Trump said about Ray's decision?
--:-- Ryan Lucas: Well, Trump was quite happy with it. He called it a great day for America and said that Ray's departure means an end to what Trump says is the weaponization of the justice system. Now, Trump, of course, is the guy who made Chris Ray FBI director after he fired James Comey in 2017. Ray came on, tried to steady the FBI at what was a very tumultuous time. Now, this job, of course, comes with a 10-year term, something that in theory is supposed to insulate it from partisan politics. Ray certainly defended the Bureau's independence. He tried to keep it out of the political fights on Capitol Hill. But that was almost impossible to do with a sort of politically charged investigations that the FBI has been involved in over the past several years. And I'm thinking here of the Russia investigation, the investigation into the January 6th attack on the U.S. Capitol, the investigation into President Biden's son Hunter. And then, of course, there are the investigations into Trump's efforts to overturn the 2020 election, as well as his handling of mishandling of classified documents.
--:-- Ryan Lucas: Trump was and remains, as we noted at the top, a fierce critic of Ray and the FBI. But I have to say he's not alone. Republicans on Capitol Hill have also soured on Ray over the seven years that he's led the FBI. Some of that relates to Trump and some of it is because of separate issues.
--:-- Steve Inskeep: Okay, so now the confirmation fight is over Kash Patel, the nominee to replace Ray. What are his prospects?
--:-- Ryan Lucas: Well, look, Patel is a polarizing figure. He's a close ally of Trump. He worked at the Justice Department then on Capitol Hill and held several positions in the first Trump administration. He is seen as a loyalist. He's talked a lot in public about dismantling the deep state, going after Trump's perceived political enemies. That includes in the FBI, the Justice Department, elsewhere in the government, but also in the media, something, of course, that Democrats are concerned about. Like Trump, Patel claims that the justice system has been weaponized against Trump and conservatives more broadly. A lot of Republicans agree. They are frustrated with the FBI. They think it needs a shakeup. And they see Patel as someone who wants to do that. So at this point, at least, Patel doesn't appear to be generating the sort of blowback that some of Trump's other picks have. Have, but we're still more than a month away from Trump's inauguration, so we're going to have to see how this all plays out.
--:-- Steve Inskeep: And Pierre's Ryan Lucas will be covering it, whatever happens. Good to see you. Thanks, Steve.
--:-- A. Martinez: At first, the targeted killing of UnitedHealthcare CEO Brian Thompson triggered a flood of posts about America's health insurance industry. Yeah, even disturbing celebrations. Now, since suspect Luigi Mangione's arrest, some attention has turned to a handwritten note that police say they found on him. According to the AP, which obtained a copy, the note talked about the disconnect between the expensive health care system and low life expectancy in the United States. And that is something NPR's Selena Simmons-Duffin has reported on a lot. So she's here to tell us more about it.
--:-- Selena Simmons-Duffin: Well, the Centers for Disease Control and Prevention's latest calculations put America's life expectancy at 77 and a half years. And that's quite low compared to the life expectancy for countries like Canada and Japan and Australia. The average for high-income countries is 80 years. So at 77 and a half years, American life expectancy is on par with countries like Ecuador and Croatia.
--:-- A. Martinez: So what more does that figure tell us though?
--:-- Selena Simmons-Duffin: Well, life expectancy isn't just do elderly people live to 77 or 80, just a few years difference. It really captures people dying at all stages of life. And in the U.S., there are a few things that researchers say pull our life expectancy numbers down. All of the problems everybody knows about about how expensive and fragmented and frustrating our healthcare system is, that contributes but it is not the whole story Here is Dr. Stephen Wolf of Virginia Commonwealth University who written a lot on this topic Research shows that about 10 to 20 percent of health outcomes are attributable to health care So the majority of the reason for poor life expectancy in the United States exists outside of the health care space. Outside of the health care space.
--:-- Selena Simmons-Duffin: So, you know, what are those factors? Well, there's everything from poor diet and physical inactivity to child poverty, to traffic fatalities. It would be nice if there was just one simple answer, but the truth is it's really complicated. Wolf worked on a landmark report about 10 years ago on this. It's 400 pages long. It's called Shorter Lives, Poorer Health. He says public policies also play a role. For example, lax regulation of industries and products can lead to health problems. We see it in the food industry. We see it in the firearm industry, the opioid epidemic. Began with the licensing of OxyContin, a drug that other countries throughout Europe and elsewhere would not approve. Drug overdoses account for many deaths of young people, people in their prime, and that is one thing that drives U.S. life expectancy down compared to countries that don't have an opioid epidemic.
--:-- Selena Simmons-Duffin: But I heard Dr. Wolfe mention the firearm industry. So what role does gun violence play?
--:-- A. Martinez: Well, gun deaths in people in their youth and midlife is another big reason why the U.S. has lower life expectancy. Guns have been the leading cause of death for Americans under age 17 for several years now. One expert I've spoken with estimates that two years of the difference between the U.S. and other countries could be attributed to the ready availability of guns here. So there is an irony to this. The victim in this case, the case that sparked this conversation, UnitedHealthcare CEO Brian Thompson, was only 50 years old when he was fatally shot.
--:-- A. Martinez: The next chair of the Democratic National Committee will have their work cut out for them. Yeah, the party lost control of the White House and the Senate and failed to retake control of the House of Representatives. They're also out of power in most states. Over the next two days, top DNC members will meet in Washington to discuss rules for picking new leadership and reflect on 2024. NPR's Stephen Fowler has been talking with Democrats across the country about last month's election results and also about what might come next.
--:-- Stephen Fowler: So, Stephen, the future of the Democratic Party is probably not going to be solved in the next few months, but its leader will be. What's that process going to look like?
--:-- A. Martinez: So today the DNC Rules and Bylaws Committee meets. It's going to be very mundane. They're working through logistical things like how many signatures you need to be nominated for these positions, key deadlines, and other procedural stuff. There's also going to be four forums for leadership candidates in January ahead of the vote, both virtually and in person, for people to make their pitch ahead of the vote February 1st.
--:-- Stephen Fowler: It's important to note, A, that those with a say here are not everyday Democrats, but rather about 450 Democratic lawmakers, elected committee members, activists, and state party chairs like the head of the Mississippi Democrats, State Representative Sheck Taylor. He told me this week it's also important to note that Democrats aren't in the White House or in control of either chamber of Congress. And that means that the next DNC chairman will be able to rule this party, Karl Blanc, which is actually pretty exciting if you choose the right person.
--:-- Stephen Fowler: So with that kind of power, though, I mean, what do these Democrats want from their next party chair? The last few election cycles have seen the National Party fade in relevance and strategy Campaigns and super PACs have taken the lead in highly specific and very expensive battleground races But Taylor one of several Dems that I spoken with who say that there growing recognition that the DNC has to invest more into things like year-round organizing and candidate recruitment and fundraising, and to help state parties, especially in Republican-controlled states, with those efforts too.
--:-- Stephen Fowler: That's an area that Shosti Conrad, chair of the Washington State Democrats, says she wants to focus on as she runs for a vice chair position. You have got to move the money out of the beltway. It cannot just stay in the same sort of consultant class that have been getting it wrong over and over and over again. There's also a feeling among a lot of party leaders I've spoken with that the next DNC chair needs to be someone with experience leading that type of always on campaigning style. So it is no surprise that two of the leading candidates are current state party chairs as well. That's Ken Martin of Minnesota and Ben Wickler of Wisconsin.
--:-- Stephen Fowler: Stephen, I mean, right after the election, there was a lot of finger pointing about what went wrong and what could be changed. So it's been a month. How are Democrats feeling now?
--:-- A. Martinez: Depends on who you ask. Electing a new head of the party is not going to magically solve the political issues laid bare in November's election. But a look under the hood shows that 2024 did not create a mandate for Republicans or sound a death knell for Democrats. I mean, control of the White House, the Senate and the House of Representatives came down to a very, very small number of votes spread across a very few number of districts and areas. Also, a Donald Trump is Donald Trump. Democrats already have nearly a decade's worth of a playbook they feel they can use to win back more voters, both Democrats that stayed home and those that might have voted for a Republican this time.
--:-- A. Martinez: That's NPR's Stephen Fowler in Atlanta. Stephen, good to talk to you again. Thank you.
--:-- A. Martinez: Do you use the NPR app? It lets you keep public radio in your pocket. You find a mix of local, national, and international news, plus the best podcasts from the NPR network. You download that app on your phone. You can listen to NPR anywhere. You can get stories to read as well. You can download the NPR app at your app store today.
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--:-- A. Martinez: Today's episode of Up First was edited by Anna Yukhananov, Diane Weber, Megan Pratz, H.J. Mai, and Alice Wolfley. It was produced by Zia Butch, Nia Dumas, and Ben Abrams. You get engineering support from Nisha Hines. And our technical director is Carly Strange. Join us again tomorrow.
