Podcast Summary: “Capturing the Complicated Emotions of Life Insurance for HIV-Positive People”

Podcast: All Of It
Host: Alison Stewart, WNYC
Guests: Matt Nadell (Director, “Cashing Out”), Scott Page (Early Viatical Settlement Arranger)
Date: December 1, 2025
Episode Focus: Exploring the origins, impact, and moral complexity of viatical settlements during the AIDS crisis through the perspectives of those who arranged, benefited from, or invested in them.

Episode Overview

On World AIDS Day, Alison Stewart hosts a profound conversation about “viatical settlements”—the controversial practice of selling life insurance for upfront cash, which offered terminally ill AIDS patients both agency and relief. The discussion revolves around the documentary Cashing Out by Matt Nadell, featuring stories like that of Scott Page, whose personal quest for survival sparked an industry, and Matt’s own reflections on his family’s role as investors in these settlements. Together, they navigate tough questions about dignity, profit, legacy, and the unfinished story of AIDS in America.

Key Discussion Points & Insights

1. The Personal Genesis of “Cashing Out”

• Matt Nadell’s Entry Point
  • Matt reveals he discovered the story not as a scholar of gay history, but via a surprising family connection:
    • “It was a much more unlikely starting point, which was my straight dad.” (01:38)
  • The pandemic context (Covid-19) prompts Matt to draw parallels between AIDS and contemporary pharmaceutical profits, leading to a frank conversation with his father—an investor in viatical settlements.

2. Context: Living with HIV/AIDS in the 1980s and 90s

• Scott Page Recalls the “Death Sentence” Era
  • Scott paints a grim picture:
    • “If I had five friends, three of them are dead today because of AIDS... it just became a countdown.” (02:59)
  • For the afflicted, time was running out—a context vital to understanding why people turned to viatical settlements.

3. Explaining Viatical Settlements

• Origin and Meaning

  • Matt shares the etymological roots:
    • “It’s such a poetic word... from the Latin word viaticum, which means money for a long journey…” (03:49)
  • The ‘journey,’ of course, refers to imminent death—whether weeks or months away.

• How It Worked

  • Sell a life insurance policy for less than its value (e.g., $70,000 now for a $100,000 policy); the buyer gets the eventual payout.
    • “They do also pay your premiums for as long as you stay alive.” (05:33)

4. Scott Page’s Story: Reinventing Survival

• Path from Personal Need to Community Resource
  • After his partner Greg’s AIDS diagnosis, Scott realized they could leverage Greg’s $100,000 policy.
  • The first transaction—arranged after a letter to the Cleveland Plain Dealer—brought immediate relief for Greg and inspired others.
  • “We started working to help as many people as we could. And it was shocking, the amount of people that had life insurance... didn’t know they had life insurance.” (05:37-09:21)
  • Scott’s motivation:
    • “It was really determination to make sure that whatever time I had left with Greg... I wanted it to be the best possible it could.” (08:37)

5. Public Perception and Pushback

• Media’s “Ghoulish” Lens

  • Matt notes:
    • “The media narrative around this was totally negative... The word that these news anchors... used was ghoulish.” (09:46)
  • The documentary employs a montage of “ghoulish” sound bites, highlighting moral discomfort about profiting from death.
  • Matt’s personal arc mirrored public skepticism—until deeper research revealed the government’s neglect and the settlements’ role as a lifeline within the gay community.

• Headwinds for Pioneers

  • Scott describes the accusations:
    • “You are taking away their life insurance policy... you’re a fiend. I was called every name in the book.” (11:34)
  • The insurance industry, facing potential losses, actively obstructed these deals, despite legal precedent allowing such transactions.

6. The Unintended Consequences of Medical Advances

• Industry Turned Upside Down
  • When effective HIV treatments arrived, people lived far longer than investors had anticipated.
  • Matt captures the irony and outrage:
    • “There were investors who were raging in the press, angry that folks whose deaths they had bet on were still alive... What side of history do you want to be on?... Do you want to be on the side... angry in the press because somebody didn’t die?” (13:20)
  • Some investors abandoned policies; others begrudgingly continued to pay premiums.

7. The Insurance Industry’s Response

• Tactics of Delay and Hostility
  • Scott explains how insurers resisted:
    • “Life insurance companies would lose them [ownership transfers] or they would go past for two or three months...” (15:20)
  • The practice remains contentious—
    • “The insurance agency still today, insurance companies hate me. And I’ll wear that badge of honor...” (16:46)

8. Moral Reckoning and Inheritance

• Matt Becomes a Subject in His Own Film
  • Grappling with the realization that his childhood was “partially funded by the deaths of gay men from AIDS,” Matt steps in front of the camera.
    • “What is my moral inheritance?... I had to be in the film as my realizations were becoming so central.” (17:26)

Notable Quotes & Memorable Moments

• Scott Page on loss and determination:

  “If I had five friends, three of them are dead today because of AIDS… it just became a countdown… but it was also a countdown to figure out how much joy I have left that I can still find in my life.” (02:59)

• Matt Nadell on discovering his family’s connection:

  “I said… I can’t help but feel weird that some pharmaceutical executives are going to make a lot of money off of this pandemic… and my dad… was just like, ‘What do you mean?’” (01:56)

• Scott Page describing the survival logic:

  “It came in through a determination to survive… Back in those days, I knew… I would be dealing with someone who was dying of AIDS. I would be judged.” (05:37)

• On media bias (Matt Nadell):

  “The media narrative… was totally negative… the word… was ghoulish.” (09:46)

• Matt Nadell on medicine’s impact:

  “This is an industry built on the predictability of death. And all of a sudden these treatments came out that made someone’s… prognosis totally invalid… investors lost that bet.” (13:20)

• Scott Page’s badge of honor:

  “Insurance companies hate me. And I’ll wear that badge of honor, because… for me to make a difference and for them to lose a bet or two, I don’t think they’re suffering much.” (16:46)

Important Timestamps & Segments

• [00:09] Introduction and historical framing of viatical settlements
• [01:38] Matt’s personal entry into the story via his father
• [02:59] Scott on the emotional reality of the AIDS crisis
• [03:49] Explanation of the term “viatical”
• [05:37] Scott’s story: from Greg’s policy to a grassroots movement
• [09:46] Media perceptions & “ghoulish” narrative
• [11:34] Scott on external criticism and internal conviction
• [13:20] The industry faces the blessing and “risk” of new treatments
• [15:20] Insurance company resistance tactics
• [17:26] Matt’s moral reckoning as both a filmmaker and community member

Tone & Final Thoughts

The episode combines personal storytelling, policy analysis, and ethical exploration, all delivered with empathy and openness. Both guests express deep respect for the people who survived the crisis and contributed to a system that, however flawed and fraught, provided agency and comfort in desperate times. Alison Stewart’s hosting allows for moments of vulnerability, reflection, and hard questions—leaving listeners with a nuanced understanding of how culture, crisis, and commerce tangle in a moment of both tragedy and resilience.