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The ties between Fox News and the Trump administration are strong as can be on-air. Documents show how producers ran questions and at least one script by staffers for former EPA chief Scott Pruitt.
AUDIE CORNISH, HOST:
Newly released documents underscore just how close the Trump administration is with Fox News. The documents show how Fox producers ran questions for former EPA chief Scott Pruitt by his staffers before he went on air. NPR media correspondent David Folkenflik has been following all this and more. He joins us now. And, David, what exactly have you learned about what Fox producers would do?
DAVID FOLKENFLIK, BYLINE: So this all goes back to the spring of 2017 when Pruitt was still in office. He later left under an ethical cloud. The Sierra Club obtained emails from producers for the popular morning show “Fox & Friends” in which they were basically in April and May of 2017 running questions by Pruitt’s top staffers, getting their approval on questions, making sure he got to make the talking points that he wanted to make and even in one case saying here’s the script with which we intend to introduce him – an unusual level of coordinations. And here’s what it sounded like when the questions that they approved ahead of time sound like on the air. We’re hearing from Steve Doocy here posing the first question.
(SOUNDBITE OF TV SHOW, “FOX & FRIENDS”)
STEVE DOOCY: The press made President Obama out to be the environmental savior. And yet when you look at the number of toxic dumps left on your plate, it’s a big number.
SCOTT PRUITT: Absolutely. In fact, Ainsley you said these sites across the country have some of the, you know, uranium and lead posing great risk to the citizens in those areas. An example…
FOLKENFLIK: Scott Pruitt making the talking points he wanted to make bashing the Obama administration. Similarly, Ainsley Earhardt did a follow-up question exactly going to a point that he wanted to make.
(SOUNDBITE OF TV SHOW, “FOX & FRIENDS”)
AINSLEY EARHARDT: Does this mean you can get cancer from – if you’re exposed to all of this?
PRUITT: Quite possibly, yes, and that’s why it’s so important to focus the core of the mission on those areas.
CORNISH: Now, the policy here at NPR is not to share questions with guests beforehand, right? But there are TV news shows where it’s quite common for hosts to at least confer with guests. So help us understand. What’s the harm here?
FOLKENFLIK: You don’t do it with public officials. You don’t do it with people in positions of power who you want to hold to account. Even if you’re sympathetic, even from a conservative outfit, there has to be some critical distance. Even Fox News – a spokeswoman texted me a statement to say this is serious. It’s being addressed internally. You can’t collaborate like that.
CORNISH: Is this part of a larger pattern?
FOLKENFLIK: I think there are too many examples to marshal all at once, but we don’t have to go far. Just think back a couple of weeks just before this month’s elections earlier this month, Sean Hannity and Jeanine Pirro, two of the network’s most prominent opinion hosts, were literally on the platform on stage with President Trump campaigning for Republican candidates.
CORNISH: Now, we also learned that Fox is still paying a former executive who is now at the White House. What more have you learned about that?
FOLKENFLIK: Bill Shine is the White House communications director, deputy chief of staff. He also was the president of Fox News and left the network, took this job and is still being paid significantly $3.5 million this year by the parent company of Fox News and $3.5 million next year while making decisions about the media, making decisions in fact about how the administration will handle Fox and its competitors. That’s, you know, the kind of payments that, in some cases, previous administrations, people would forego.
A point of irony – the woman that Bill Shine replaced, Hope Hicks, left the White House. She’s now headed to go to the parent company of Fox News to become their senior executive in charge of their communications policy – another sign of the close ties between the two institutions.
CORNISH: That’s NPR’s David Folkenflik. David, thanks.
FOLKENFLIK: You bet.
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Reigning chess world champion Magnus Carlsen (right), from Norway, plays Italian-American challenger Fabiano Caruana in the first few minutes of round 12 of their World Chess Championship match on Monday in London.
Matt Dunham/AP
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Matt Dunham/AP
The World Chess Championship is heading toward a dramatic conclusion on Wednesday, which could give the U.S. its first champion since Bobby Fischer took the crown in 1972.
The players will embark on a series of fast-moving tiebreaks at the event in London, which will get faster and faster if they continue to draw.
Fabiano Caruana, the 26-year-old Italian-American prodigy who grew up in Brooklyn, is definitely the underdog. For 12 games so far, he has taken on the current world chess champion, Magnus Carlsen. And each game has ended in a draw.
“I’ve had mediocre years, I’ve had good years,” Caruana said in a recent interview with The New York Times. “This year has been the best by far.”
According to the organizer World Chess, it’s the first championship match where nobody has won a game through the first 12 games of regular play.
Carlsen, who is 27 and from Norway, has been on top of the game for much of his adult life. He’s held the world champion title since 2013.
But some observers think he may be losing his edge. “He’s a shadow of himself, of his best times,” chess grandmaster Judit Polgár tells NPR’s Here & Now.
Carlsen raised eyebrows at a crucial moment in Game 12, when he appeared to be in a stronger position, yet suddenly offered to leave the game as a draw.
“For whatever reason, he chose not to invest the energy and, instead, proposed a draw after 31 moves, which Caruana accepted,” according to a write-up from World Chess.
That decision was baffling to legendary chess grandmaster Garry Kasparov.
In light of this shocking draw offer from Magnus in a superior position with more time, I reconsider my evaluation of him being the favorite in rapids. Tiebreaks require tremendous nerves and he seems to be losing his.
— Garry Kasparov (@Kasparov63) November 26, 2018
“In light of this shocking draw offer from Magnus in a superior position with more time, I reconsider my evaluation of him being the favorite in rapids,” Kasparov wrote on Twitter. “Tiebreaks require tremendous nerves and he seems to be losing his.”
At the same time, World Chess pointed out that even though computer calculations say Carlsen was more likely to win when he offered the draw, “the position was complicated and it was clear that it would take a lot of maneuvering, and many hours, if Carlsen hoped to break through.”
“I wasn’t in a mood to find the punch,” Carlsen said after the game, according to FiveThirtyEight.
Polgár said Carlsen has previously been known for avoiding draws. She says the two players are very evenly matched. “I think he lost the appetite of winning, or it is not so much important for him to win again, somehow he cannot motivate himself so much as he could before,” she said.
These past 12 games have been played according to time regulations that mean each game can take hours. The players have 100 minutes each for the first 40 moves, with even more time added after that.
But on Wednesday, the pace of the game is going to speed up – a lot. The challenge of the tie-breaks is that play happens in smaller and smaller amounts of time.
The faster play is expected to work in Carlsen’s favor. He’s higher-ranked in styles of chess with tighter time regulations.
The first four tie-breaker games start with 25 minutes each on the clock, and 10 additional seconds after each move.
After those four games, if the scores are still tied, it moves to even faster rounds called “blitz games.”
First, the players play two games with five minutes each plus three seconds after each move. If they’re still tied, they’ll play another two games, and this could continue up to 10 games total.
And if it’s still even after the end of the blitz games, they’ll go to a round referred to as “Armageddon.”
The player who has white pieces gets five minutes on his clock, one more minute than the player who has black. But, should the game end in a draw, the player with black pieces is automatically the winner.
And unless the referee decides otherwise, according to the rules, the players will have just 10 minutes between each of these tie-break games.
Besides the coveted title of world champion, there’s a lot of money on the line. The players are duking it out for a prize fund of 1 million euros ($1.1 million). If it had been decided in regular games the winner would get 60 percent and the loser 40 percent — now, because it has gone to tie-break games, the winner will get 55 percent and the loser 45 percent.
It’s worth noting that it’s highly unlikely that the matches will actually get to the epic conclusion of a sudden death round.
In fact, according to calculations by FiveThirtyEight, there’s a 0.02 percent chance this World Chess Championship will end in Armageddon.
We’ll just have to watch to find out. Games kick off Wednesday at 10 a.m. ET.
Shereese Hickson was diagnosed with multiple sclerosis in 2012 and is unable to work. She supports herself and her son, Isaiah, on $770 a month.
Shane Wynn for KHN
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Shane Wynn for KHN
Shereese Hickson’s multiple sclerosis was flaring again. Spasms in her legs and other symptoms were getting worse.
She could still walk and take care of her son six years after doctors diagnosed the disease, which attacks the central nervous system. Earlier symptoms such as slurred speech and vision problems had resolved with treatment, but others lingered: She was tired and sometimes fell.
This summer, a doctor switched her to Ocrevus, a drug approved in 2017 that delayed progression of the disease in clinical trials better than an older medicine did.
Do you have a bill for us to look into?
If you have a billing experience that you’d like to share with NPR and Kaiser Health News, you can submit it here.
Genentech, a South San Francisco, Calif.-based subsidiary of Swiss pharmaceutical giant Roche, makes Ocrevus. The drug is one of several for multiple sclerosis that are delivered intravenously in a hospital or clinic. Such medicines have become increasingly expensive, priced in many cases at well over $80,000 a year. Hospitals delivering the drugs often make money by charging a premium on top of their cost or adding hefty fees for the infusion clinic.
Hickson received her first two Ocrevus infusions as an outpatient two weeks apart in July and August. And then the bill came.
Patient: Shereese Hickson, 39, single mother who worked as a health aide and trained as a medical coder, living in Girard, Ohio. Because her MS has left her too disabled to work, she is now on Medicare; she also has Medicaid for backup.
Total bill: $123,019 for two Ocrevus infusions taken as an outpatient. CareSource, Hickson’s Medicare managed care plan, paid a discounted $28,960. Hickson got a bill for about $3,620, the balance calculated as her share by the hospital after the insurance reimbursement.
Medical service: Two Ocrevus infusions, each requiring several hours at the hospital.
Service provider: Cleveland Clinic, a nonprofit, academic medical center based in Ohio. (Cleveland Clinic has provided financial support for NPR.)
What gives: Hickson researched Ocrevus online after her doctor prescribed the new medicine. “I’ve seen people’s testimonies about how great it is” on YouTube, she said. “But I don’t think they really go into what it’s like receiving the bill.”
That was particularly shocking because, covered by government insurance for her disability, she had never received a bill for MS medicine before.
“I have a 9-year-old son and my income is $770 a month,” said Hickson. “How am I supposed to support him and then you guys are asking me for $3,000?”
Even in a world of soaring drug prices, multiple sclerosis medicines stand out. Over two decades ending in 2013, costs for MS medicines rose at annual rates five to seven times higher than those for prescription drugs generally, found a study by researchers at Oregon Health & Science University.
“There was no competition on price that was occurring,” said Daniel Hartung, the OHSU and Oregon State University professor who led the study. “It appeared to be the opposite. As newer drugs were brought to market, it promoted increased escalation in drug prices.”
With Ocrevus, Genentech did come up with a price that was slightly less than for rival drugs, but only after MS medicines were already extremely expensive. The drug launched last year at an annual list price of $65,000, about 25 percent lower than that of other MS drugs, Hartung said. MS drugs cost about $10,000 per year in the 1990s and about $30,000 a decade ago.
“We set the price of Ocrevus to reduce price as a barrier to treatment,” said Genentech spokeswoman Amanda Fallon.
It was also probably a response to bad publicity about expensive MS drugs, Hartung said. “Now companies are very aware at least of the optics of releasing drugs at higher and higher prices,” he said.
Patients starting Ocrevus get two initial infusions of 300 milligrams each and then 600 milligrams twice a year. Cleveland Clinic charged $117,089 for Hickson’s first two doses of Ocrevus — more than three times what hospitals typically pay for the drug, said John Hennessy, chief business development officer at WellRithms, a firm that analyzes medical bills for self-insured employers.
As is typical of government programs such as Medicare, the $28,960 reimbursement ultimately collected by the Cleveland Clinic was far less — but still substantial.
“We kind of got ourselves in a pickle here,” he said. “We’re more excited about the discount than we are about the actual price.”
Hickson’s nearly $3,620 bill represented the portion that Medicare patients often are expected to pay themselves.
Last year, the Institute for Clinical and Economic Review, an independent nonprofit that evaluates medical treatments, completed a detailed study on MS medicines. It found that Ocrevus was one of three or four medicines that were most effective in reducing MS relapses and preventing MS from getting worse. But it also found that patient benefits from MS drugs “come at a high relative cost” to society.
At the same time, deciding which MS drug — there are about a dozen — would best suit patients is something of a shot in the dark: The science showing the comparative effectiveness of MS drugs is not as strong as it could be, researchers say.
“In general, there’s a real lack of head-to-head studies for many of these drugs,” said Hartung. The [Food and Drug Administration] has no required comparison standard for MS drugs, an agency spokeswoman said. Sometimes they’re rated against placebos. With everyone able to charge a high price, the companies have little incentive to see which works better and which worse.
Resolution: After Hickson questioned the charges over the phone, the billing office told her to apply to the hospital for financial assistance. Hickson had to print a form, provide proof of her disabled status, mail it and wait.
Hospital officials told her in October she qualified for assistance based on her income through a state program funded by hospital contributions and federal money. Cleveland Clinic wiped out the $3,620 balance.
“I’m grateful that they approved me for that, but not everybody’s situation is like that,” she said. She was worried enough about being billed again for her next Ocrevus infusion that she considered switching back to her old medicine. But her doctor wants her to give it more time to gauge its effects.
The takeaway: Always ask about charity care or financial assistance programs. Hospitals have different policies and wide discretion about how to apply them, but they often do not even tell patients such programs exist.
Because health care costs can be so high, you may be eligible even if you have a decent salary. Cleveland Clinic gives free care to everybody below a certain income, said spokeswoman Heather Phillips. But it wasn’t until Hickson called that the hospital agreed to erase the charge.
“I’ve seen people’s testimonies about how great it is” on YouTube, said Hickson about the drug Ocrevus. “But I don’t think they really go into what it’s like receiving the bill.”
Shane Wynn for KHN
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Shane Wynn for KHN
While there are multiple new drugs to treat serious chronic conditions, they have often not been tested against one another. Moreover, your doctor may have no idea about their prices. But he or she should.For newer drugs, all options may well be very expensive.
Keep in mind that drugs that must be infused often come with facility fees and infusion charges, which can leave patients with hefty copayments for outpatient treatment. Ask about oral medicines or those you can self-inject at home.
NPR produced and edited the interview with Kaiser Health News’ Elisabeth Rosenthal for broadcast. Marlene Harris-Taylor, from member station Ideastream in Cleveland, provided audio reporting.
Do you have an exorbitant or baffling medical bill that you’d like KHN and NPR to look into? You can tell us about it and submit a copy of the bill here.
KHN is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that isn’t affiliated with Kaiser Permanente.
