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Dr. Ben Carson, 63, is among the most renowned physicians in the world. As director of pediatric neurosurgery at Johns Hopkins University Medical Center, he led the only successful separation of Siamese twins joined at the back of the head. He achieved that success despite growing up poor in a single parent household in Detroit, excelling in high school and graduating from Yale University and the University of Michigan's medical school.
Now retired from medicine, he seized attention in conservative circles for a 2013 speech at the National Prayer Breakfast in Washington. Before announcing his candidacy in Detroit on May 3, he sat down with me at the Harbor House restaurant downtown. Below is a condensed, edited transcript of our conversation.
HARWOOD: You were very into the '68 Detroit Tigers. Tell me about your favorite player and your favorite moment in that season.
CARSON: They were all my favorite players. I remember I went to the stadium one day and I got a Bill Freehan bat, and so that was pretty cool. I remember they were playing a game, it was the ninth inning and the Tigers were behind 4-1. It was two outs, the bottom of the ninth, the bases were loaded, and Willie Horton hit a grand slam.
That year was a miracle year. Every time they were in a hole, some new hero would come along and do something. The other cool thing was, the year before had been the Detroit riots, really fractured the city. Having a winning team brought the city together.
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HARWOOD: What was that experience like for you? Did you get caught up in any of that?
CARSON: I was 16. It was pretty horrendous, seeing tanks and military people on the streets of Detroit. No, if I had gone out there you would have seen my mother being like that mother in Baltimore. Believe me. There's no way she would've tolerated that. The next year, after Martin Luther King was killed, there was a riot in my school. The kids just kind of went mad.
HARWOOD: One of the things that gave you confidence you could succeed as a surgeon was tremendous hand-eye coordination. Where else did that show itself?
CARSON: Where I really saw it was in college playing table soccer, or foosball. (LAUGH) I was extremely good. They even named shots after me.
Then, the summer between college and medical school, I worked at the steel company. And they actually allowed me to operate a crane in the factory, which requires a tremendous amount of eye-hand coordination. You drive these tons of steel through these columns and onto these truck beds, in between other things. Just one little mistake, and disaster. For them to let a kid who had just graduated from college, who had no experience doing that—I recognize that in retrospect, they would only do that if they saw something pretty amazing in me.
HARWOOD: Explain to me what's wrong with our country—the short version.
CARSON: This country was founded of, for and by the people. It was supposed to be peoplecentric. And the government was only supposed to be there to facilitate life, liberty and the pursuit of happiness. Now what we have is a country that is governmentcentric. Where the government kind of controls everything, and tells the people to jump, and the people say, "How high?" It's just totally turned out to be very different.
Reagan was responsible for me changing from a Democrat. Growing up in the environment where I grew up, going to the college that I went to, everybody was a Democrat. The traditional mantra was that Republicans were horrible people. They were racist, and they hated anybody who was down and out. Then I started listening to [former President Ronald] Reagan. I said, "My god, he doesn't sound like that." Where in the world does this come from?
At the same time, I was seeing a lot of patients who were caught up in the whole social welfare net, whose lives were in shambles. Able-bodied people who could be making a good life for themselves. I started wondering, was all of this a good thing? And I started looking at whole communities, and particularly in Baltimore—the black community there. It was pretty dismal after decades of social welfare. And I just started thinking, you know, "We need to start concentrating on how we get people out of these situations, not how we maintain them in it." I began to change my thinking.
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HARWOOD: If you're president, there's a lot riding on every single thing you say. Financial markets react to it, and other countries react to it. I'm sure you have a lot of confidence, but are you sobered by the idea that, "Wow, I'm really new to this, and stakes are pretty high, and I could mess this up?"
CARSON: You're sobered by it, but you also recognize that—let's say you were talking to somebody and they thought that you didn't know who the members of NATO were. Well, before there was any big reaction, you could sit there and tell them the whole history of NATO, tell them that in the Baltic Rim, you know, Sweden has had a stormy relationship with NATO, that France and Spain have come and gone, that they're back with it now. And if that was something that would satisfy them, you could have that whole conversation and straighten that out pretty quickly.
We think the only people who can handle the kinds of decisions that need to be made are people who are steeped in politics. When I go back and I look at the Constitution, they never thought that there should be this political class or this political pedigree that was necessary. I think what they felt was necessary was wisdom, and a love for our Constitution, a love for our country and common sense.
When I look at the issues that are facing us—the economic issues, for instance—it's unclear to me that—somebody who has been a senator or a congressman or even a Cabinet member for a long period of time has any superior wisdom. What you really need to understand are things like GDP-to-debt ratio, and what that does to economic growth. They don't seem to understand those things.
HARWOOD: The fundamental thing you want to accomplish, if you're elected, is a move towards self-reliance and a return to values of individual discipline. Do you have any concern that your view is so shaped by your own life, the tremendous success you had, that in a nation where not everybody can be Ben Carson, maybe that's not the best or only prescription for people in need?
CARSON: One of the things that I've learned as a neuroscientist is that the human brain is an amazing organ system. If you have a normal one, you really shouldn't be thinking about what you can't do. Just be thinking about what you can do. The capabilities are there. And what we have to do is start removing from people the victim mentality: "I'm not as good as everybody else. I'm not as smart as everybody else. I can't do things. I can't take care of myself. Somebody needs to take care of me."
As you probably know, in several states you can get as much or more on government assistance as you can by working a minimum wage job. I don't necessarily blame people for saying, "Look, I can stay at home and I can make this money, or I can go and work this little chicken job that doesn't have many benefits." Recognize that if you go and take that chicken job, you gain skills, relationships, the possibility of moving up the ladder. So a year or two or five down the road, you're no longer in that position. This is what people have forgotten.
HARWOOD: How would you as president lead to a reversal of that phenomenon?
CARSON: You need, in communities, reliable day care centers. Because that's what will allow that woman to go back, get her GED, her associates degree, bachelor's, master's, and learn to be independent and to teach her children to be independent. That's the only way you're going to break that cycle.
Those organizations should be established and run by business, industry, Wall Street, academia, churches and community groups. Government can help facilitate it, but those are the people who need to do it. It's those personal relationships, more than it is throwing money at things, that make things work. There are ways to incentivize those companies to do that.
HARWOOD: It sounds as if your preferred alternative, both to Obamacare and to Medicare, is a system of self-reliance built around health savings accounts. Do you think that's something you could make happen politically? Medicare is pretty popular.
CARSON: When people are able to see how much more freedom they will have, and how much more flexibility they will have, and how much more choice they would have, I think it's going to be a no-brainer.
The reason that I've come up with the health savings account system, utilizing the same monies that we use to pay for health now, (it) provides a very different paradigm. Eighty percent-plus of your encounters are going to be between you and the health-care provider, with no third-party in there sucking out the resources. When that happens, there's a fiduciary responsibility and relationship that develops between the patient and a care provider. You're going to have much more transparency, much more responsibility. That's going to bring the whole system into a more free economic model. That's how you control price and that's how you control quality.
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You also give people flexibility to transfer money within a family. So if you were $500 short, your wife could give it to you, your daughter could give it to you, your uncle, your cousin. The only thing that comes out of your insurance is catastrophic events. How often do you have those? Not very often. So the cost of that drops dramatically. If you make it possible to buy it across state lines, it drops even more.
Now you've got a system where people begin to pay a lot more attention to how they're going to utilize their dollars. You've got a system where members of the family are going to be concerned about you. "Grandpa, how come you're smoking all those cigarettes? You may be affecting me."
You get a diabetic foot ulcer, instead of going to the emergency room and spending a big chunk of your HSA, you're going to go to the clinic. You're going to be incentivized to do that. And of course, the difference is the emergency room patches you up and sends you out. The clinic says, "Let's get your diabetes under control so you're not back here in three weeks." That's how you save money.
HARWOOD: At some point you referred to [President Barack] Obama as a psychopath. What did you mean by that?
CARSON: I said he reminds you of a psychopath, because they tend to be extremely smooth, charming people who can tell a lie to your face. It looks like sincerity, even though they know it's a lie. He knows full well that the unemployment rate is not 5.5 percent. He knows that. He knows that you can manipulate that number, and he knows that people who are not well-informed will swallow it hook, line, and sinker—even though they are sitting there in the city and can't find a job. He plays fast and loose with the facts.
HARWOOD: In your book there was a passage where you said, "What's the worst act of racism? What happens when a police officer mistreats you, or the society that denies opportunity and thinks that you're less because you're African-American, thinks that you can't achieve?" Is that still a major barrier for those kids in Baltimore and here in Detroit?
CARSON: The biggest problem is economic. There is no question that racism still exists in our society—of course it does. It exists in lots of places, amongst particularly liberals who think that if you're black you have to think a certain way. You don't have a possibility of thinking any other way, and if you do, you're crazy. That's very racist, but they don't recognize it.