A Biopsy Came With An Unexpected $2,170 ‘Cover Charge’ For The Hospital
An unexpected charge related to a biopsy threatened the financial security of Brianna Snitchler and her partner.
Callie Richmond for Kaiser Health News
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Callie Richmond for Kaiser Health News
Brianna Snitchler was just figuring out the art of adulting when she scheduled a biopsy at Henry Ford Hospital in Detroit.
Snitchler, 27, was on top of her finances: Her student loan balance was down and her credit score was up.
“I had been working for the past three years trying to improve my credit and, you know, just become a functioning adult human being,” Snitchler said.
For the first time in her adult life, she had health insurance through her job and a primary care doctor she liked. Together they were working on Snitchler’s concerns about her mental and physical health.
One concern was a cyst on her abdomen. The growth was about the size of a quarter, and it didn’t hurt or particularly worry Snitchler. But it did make her self-conscious whenever she went for a swim.
“People would always call it out and be alarmed by it,” she recalled.
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Before having the cyst removed, Snitchler’s doctor wanted to check the growth for cancer. After a first round of screening tests, Snitchler had an ultrasound-guided needle biopsy at the Henry Ford Health System’s main hospital.
The procedure was “uneventful,” with no complications reported, according to results faxed to her primary care doctor after the procedure. The growth was indeed benign, and Snitchler thought her next step would be getting the cyst removed.
Then the bill came.
The patient: Brianna Snitchler, 27, a user-experience designer living in Detroit at the time. As a contractor for Ford Motor Co., she had a UnitedHealth Group insurance plan.
Total bill: $3,357.52, including a $2,170 facility fee listed as “operating room services.” The balance included a biopsy, ultrasound, physician charges and lab tests.
Service provider: Henry Ford Health System in Detroit.
Medical procedure: Ultrasound-guided needle biopsy of a cyst.
What gives: When Snitchler scheduled the biopsy, no one told her that Henry Ford Health System would also charge her a $2,170 facility fee.
Snitchler said the bill turned out to be far more than what she had budgeted for. Her insurance plan from UnitedHealth had a high deductible of $3,250, plus she would owe coinsurance. All told, her bills for the care she received related to the biopsy left her on the hook for $3,357.52, with her insurance paying $974.
When Brianna Snitchler scheduled the biopsy for a cyst on her abdomen, no one told her that the Henry Ford Health System would charge a $2,170 facility fee, listed on her bill as “operating room services.” (Note: This photo has been edited to redact private information.)
Callie Richmond for Kaiser Health News
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Callie Richmond for Kaiser Health News
“She shrugged it off,” Snitchler’s partner, Emi Aguilar, recalled. “But I could see that she was upset in her eyes.”
Snitchler panicked when she realized the bill threatened the couple’s financial security. Snitchler had already spent down her savings for a recent cross-country move to Austin, Texas.
In an email, Henry Ford spokesman David Olejarz said the “procedure was performed in the Interventional Radiology procedure room, where the imaging allows the biopsy to be much more precise.”
“We perform procedures in the most appropriate venue to ensure the highest standards of patient quality and safety,” Olejarz wrote.
The initial bill from Henry Ford referred to “operating room services.” The hospital later sent an itemized bill that referred to the charge for a treatment room in the radiology department. Both descriptions boil down to a facility fee, a common charge that has become controversial as hospitals search for additional streams of income, and as more patients complain they’ve been blindsided by these fees.
Hospital officials argue that medical centers need the boosted income to provide the expensive care sick patients require, 24 hours a day, 365 days a year.
But the way hospitals calculate facility fees is “a black box,” said Ted Doolittle, with the Office of the Healthcare Advocate for Connecticut, a state that has put a spotlight on the issue.
“It’s somewhat akin to a cover charge” at a club, said Doolittle, who previously served as deputy director of the federal Center for Program Integrity at the Centers for Medicare & Medicaid Services.
Hospitals in Connecticut billed more than $1 billion in facility fees in 2015 and 2016, according to state records. In 2015, Connecticut lawmakers approved a bill that forces all hospitals and medical providers to disclose facility fees upfront. Now patients in Connecticut “should never be charged a facility fee without being shown in burning scarlet letters that they are going to get charged this fee,” Doolittle said.
In Michigan, there’s no law requiring hospitals and other providers of health care services to inform patients of facility fees ahead of time.
Snitchler’s procedure took place on campus at Henry Ford’s main hospital site. When she got her bill, with its mention of “operating room services,” she was baffled. Snitchler said the room had “crazy medical equipment,” but she was still in her street clothes as a nurse numbed her cyst, and she was sent home in a matter of minutes.
With Snitchler’s permission, Kaiser Health News shared her itemized bill, biopsy results and explanation of benefits with Mark Weiss, a radiologist who leads MediCrew, a company in Flint, Mich., that helps patients navigate the health system.
Weiss said it probably wasn’t medically necessary for Snitchler to go to the hospital to receive good care. “Not all surgical procedures have to be done at a surgical center,” he said, noting that biopsies often can be done in an office-based treatment center.
Resolution: Hoping for a reasonable explanation — or even the discovery of a mistake — Snitchler called her insurance company and the hospital.
A representative at Henry Ford told her on the phone that the hospital isn’t “legally required” to inform patients of fees ahead of time.
In an email, Henry Ford spokesman Olejarz apologized for that response: “We’ll use it as a teachable moment for our staff. We are committed to being transparent with our patients about what we charge.”
He pointed to an initiative launched in 2018 that helps patients anticipate out-of-pocket expenses. The program targets the most common elective radiology and gastroenterology tests that often have high price tags for patients.
Asked if Snitchler’s ultrasound-guided needle biopsy will be included in the price transparency initiative, Olejarz replied, “Can’t say at this point.”
In addition to the pilot program to inform patients of fees, Olejarz said, the hospital also plans to roll out an online cost-estimator tool.
For now, Snitchler has decided not to get the cyst removed, and she plans to try to negotiate on her bill. She has not yet paid any portion of it.
“You should always negotiate; you should always try,” Doolittle said. “Doesn’t mean it’s going to work, but it can work. People should not be shy about it.”
“We are happy to work out a flexible payment plan that best meets her needs,” Olejarz wrote when Kaiser Health News first inquired about Snitchler’s bill.
The takeaway: When your doctor recommends an outpatient test or procedure like a biopsy, be aware that the hospital may be the most expensive place you can have it done. Ask your physician for recommendations of where else you might have the procedure, and then call each facility to try to get an estimate of the costs you’d face.
Also, be wary of places that may look like independent doctor’s offices but are owned by a hospital. These practices also can tack hefty facility fees onto your bill.
If you get a bill that seems inflated, call your hospital and insurer and try to negotiate it down.
Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
Facebook’s Dating App Rolls Out To U.S. Is There Appeal?
NPR’s Michel Martin speaks with Washington Post‘s Lisa Bonos about Facebook’s new dating app.
MICHEL MARTIN, HOST:
Yesterday, we talked about how Facebook has decided to monitor political speech. The answer – very little, if at all. Today, we want to tell you about an area where Facebook is boldly going forward – dating. Facebook recently launched this new feature in the U.S. after testing it overseas. We wanted to know how people should feel about trusting Facebook in this particularly sensitive area since the company has long been under scrutiny for the way it handles users’ data, so we’ve called Lisa Bonos. She writes about dating and relationships for the Washington Post.
Lisa, nice to have you back on the program.
LISA BONOS: Thanks for having me.
MARTIN: So, first of all, tell us a little bit about how Facebook dating works. And how is it different from the apps people might already know like Tinder or Bumble or Grindr? I take it there’s no swiping, but please tell me that Facebook doesn’t stroll down your contacts like your nosy relatives at a wedding and announce to everybody you’re single, you’re dating, you’re looking.
BONOS: (Laughter) No. You do have to opt into Facebook dating and create a separate profile. And you won’t be swiping left or right, yes or no on people. But it does work pretty similarly to other dating apps that are out there.
MARTIN: Does somebody have to match you in order for you to send that person a message…
BONOS: No, most…
MARTIN: …Or something like that?
BONOS: Yeah. Most dating apps do require both people to say yes, I like this person before you can exchange messages. But Facebook dating seems to not require that. You can like their photos and send a message.
MARTIN: So in a way, basically narrows your – it creates another Facebook universe for you. I mean, it basically says that these are the friends who are single and who are looking.
BONOS: Yes, but it actually doesn’t show you existing Facebook friends as potential dates. There’s a special feature called Secret Crush where you can put in names of people you are currently friends with, and if they also put your name on this list, you – it will tell you you have a match.
MARTIN: Wait. Wait. So you said – well, you wrote about this. You said, it appears to be hatched by your middle school nemesis who still acts like they’re 13. So please tell me, do they – they don’t have, like, a do you like me? Yes or no. Does it really do that?
BONOS: That’s essentially what it is, except the other person will never know that you put their name down unless they also put your name down.
MARTIN: OK.
BONOS: I mean, I make fun of it. I’m probably still going to use it, right? OK (laughter)?
MARTIN: So – well, to that end, though, what kind of feedback are you hearing about this so far from the other countries where it rolled out? And I know it just started here, but – so what are you hearing so far?
BONOS: Twitter was full of dread and skepticism about this because Facebook’s had so many problems with misinformation and security lapses and all of that. So people were not eager to do this very intimate thing on Facebook and to spend more time on Facebook and all of that. And also, none of the features are all – are any different from what you could currently find on dating apps that are already out there.
MARTIN: You’ve been following this for some time now. What about those privacy concerns that many critics, not just in the dating realm, have raised about this? has Facebook done anything to address those concerns?
BONOS: Yeah. I mean, they say that the feature is going to have safety at the forefront and security. But we won’t really know until people get in and start using it and that sort of thing. And I think the bigger issue is that there’s not a lot of trust out there in the public for this company and this platform, so it makes it hard for people to want to do something so personal on there. I mean, you think trust is the backbone of relationships, right?
MARTIN: So before we let you go, though, because you cover this area, and you’ve been covering it for some time – I mean, you’ve been covering the whole, you know, single life and relationships for some time now. I just wondered if this says anything bigger. Does it say anything about single life, the single life, that this is here? Does it meet some need that isn’t being met? What do you think?
BONOS: Unfortunately, it doesn’t. I mean, dating apps have been out there for about five years, and when they came out, people were a little bit excited about them. Now we’ve reached this point of extreme dating app fatigue and frustration with the way that people can connect easily on these apps but then discard each other very quickly. And because this new platform doesn’t seem to change that in any way, I don’t know that it’s going to meet a need that wasn’t already met.
MARTIN: That is Lisa Bonos. She writes about dating and relationships for The Washington Post, and she was kind enough to join us here in our studios in Washington, D.C. And I do want to mention that Facebook has been a recent financial supporter of NPR.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Saturday Sports: Minnesota Twins, Santa Anita Horse Deaths
We have a recap on stories from the week in sports.
SCOTT SIMON, HOST:
I look forward all week to saying it’s time for sports.
(SOUNDBITE OF MUSIC)
SIMON: Homers a-poppin’ (ph) this baseball season. And for the first time, four teams have reached 100 wins. Yeah, guess who wasn’t one of those four. Meanwhile, racing resumes in Santa Anita after more than 30 horses died there last season. NPR’s Tom Goldman joins us. Good morning, Tom.
TOM GOLDMAN, BYLINE: Hi, Scott.
SIMON: And I was astonished to discover this week that apparently baseball season is going on for some clubs. I mean, I thought after that Cubs-Cardinals series, they would just call the rest of the season off. But…
GOLDMAN: Let it go. Let it go.
SIMON: There – (singing) let it go. There’s been a record number of homers this season. The Minnesota Twins became the first team to hit 300 in a season. Yankees overtook them last night. Is the ball juiced, or is just everybody taking that supplement Frank Thomas advertises?
GOLDMAN: (Laughter) And he looks great, doesn’t he?
SIMON: He does look great, yeah.
GOLDMAN: He really does.
You know, not too long ago, we would be wondering about supplements and more powerful substances, but we’re told the so-called steroids era in Major League Baseball is over. Testing is rigorous. Science and a lot of pitchers, Scott, say it’s the ball’s fault – not enough drag on the balls, so they’re flying out. And there’s growing concern that all these home runs are bad for the game – less action on the field when guys are doing a home run trot around the bases while everyone else on the field watches.
There’s speculation change is coming. The balls may be altered, perhaps adding more drag.
SIMON: I wonder – I shouldn’t ask you without – I wonder if anybody stole home this year. I don’t remember seeing it. Do you?
GOLDMAN: I don’t remember seeing it, but I did not see every game.
SIMON: Yeah, all right.
And all the talk about the Astros, Dodgers and Yankees. What a season for the Twins. My gosh. They beat Kansas City last night for their 100th win, 6-2. And this is a small-payroll team in a modest but wonderful market.
GOLDMAN: It is. And the only other time the Twins did this was in 1965. And this time, it’s history. First time there have been four teams with at least a hundred wins in a season. Now, at the same time, way at the other end of things, there were four teams that lost at least a hundred games, and that ties a record of most teams in the season with at least a hundred losses. That was back in 2002.
So you have this situation of haves and have-nots causing more fretting in baseball, which prides itself on parity in recent years.
SIMON: Yeah.
GOLDMAN: The baseball rulers don’t seem too worried. They say these kinds of extremes are cyclical, and they work themselves out.
SIMON: Santa Anita Park is up and running again after an array of reforms designed to make racing safer. A 23-day autumn meet is underway now. Track officials say that they’ve made changes for the safety of the athletes, who happen to be horses. What kind of changes?
GOLDMAN: Well, here are a few. All racing entries have to have a pre-race form signed by a veterinarian saying there are no known problems with a horse that should keep it from racing. Veterinarians are also expecting – inspecting all horses scheduled for training. Santa Anita track has a new drainage system that’s supposed to help with the track surface – making it safer for horses.
There’s a lot of scrutiny as this fall meet opens, Scott. Santa Anita can’t afford to have another spate of horse deaths like before. And there’s a lot of optimism that the troubles are behind. But we should note just 10 days ago, a horse had to be euthanized…
SIMON: Yeah.
GOLDMAN: …After a training injury, making it 31 fatalities since last December.
SIMON: Oh, my word. Well, NPR’s Tom Goldman, thanks so much.
GOLDMAN: You’re welcome.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
The Health Benefits At The Center Of The United Auto Workers Strike
A key issue in the contract dispute between General Motors and the United Auto Workers is health benefits. Workers have had famously great health plans, paying just 3% of costs.
SCOTT SIMON, HOST:
The United Auto Workers strike of about 50,000 General Motors workers is about to enter its third week. A key issue in the contract dispute is health benefits. The company argues that it cannot shoulder rising health costs. Union members want to hang onto their famously great health plans. Workers mostly pay no premiums, $25 for a doctor’s visit and just a few dollars for prescriptions. NPR’s Selena Simmons-Duffin wondered how’d they get those plans.
SELENA SIMMONS-DUFFIN, BYLINE: To answer that question, let’s go back to 1950. The country had just made it through the Depression, two world wars…
ERIK LOOMIS: By 1950, the economy is pretty much booming.
SIMMONS-DUFFIN: Erik Loomis is a history professor at the University of Rhode Island.
LOOMIS: It creates a massive consumer market for a lot of products in the United States, very much including automobiles.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED PERSON #1: More and more people are driving this car and buying this car.
SIMMONS-DUFFIN: Automakers were scrambling to meet the demand, but they had to bargain with the unionized workforce. The UAW was well-organized, had connections in high places. And what it wanted to get with this leverage was a role in automakers decisions – how many workers to hire, what kind of cars to make, whether to keep factories open.
LOOMIS: And the companies totally resisted this.
SIMMONS-DUFFIN: So the UAW called lots of strikes, which were costly. Finally in 1950, a historic agreement.
LOOMIS: The Treaty of Detroit. And that is a compromise between the UAW and the Big Three automakers that basically says that the UAW will give up its demands to open company books and have control over production decisions. In exchange for that, the workers themselves will get massive wage increases and significant benefit packages.
SIMMONS-DUFFIN: One of those benefits, health insurance, which was kind of a new-fangled idea. Medical care was just starting to be something that might cure you and cost you. Insurers were cropping up saying, hey, why not pay a little at a time instead of all at once.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED PERSON #2: What I don’t worry about is our health care. We’ve joined Cigna Health Plan.
SIMMONS-DUFFIN: These benefits were actually a good deal for employers. There were tax advantages. More and more companies began to offer health plans to their employees. And union autoworkers, with their benefits, got back to building cars.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED PERSON #3: Modern assembly is timing and teamwork as well as organization.
SIMMONS-DUFFIN: Loomis says back in the 1960s, the idea of a company covering the full cost of health benefits wasn’t that unusual.
LOOMIS: You don’t really see workers have to begin to cover large chunks of their health care until the 1980s.
SIMMONS-DUFFIN: The incredible thing is that the UAW hung on to their low-cost benefits as the rest of us began to pay more and more. Today, workers on employee plans pay about 30% of their health care costs. UAW workers pay about 3%. Not that it’s been easy for the unions, says Kristin Dziczek. She’s vice president of the Center for Automotive Research.
Is it a struggle in every contract negotiation or is it…
KRISTIN DZICZEK: Yes, absolutely. Every time this is a big struggle.
SIMMONS-DUFFIN: Especially as health care costs have gone up for everyone. Dziczek says today GM and other automakers argue the cost of these health benefits is unsustainable. GM told NPR it cost $900 million in 2018.
DZICZEK: The impression is that the employer is paying. But in reality, the employees, the union is paying here as well because the increasing costs of medical care and benefits is eating into their ability to get wage or other benefit gains. It eats up a bigger and bigger share of the amount of money that’s on the table.
SIMMONS-DUFFIN: Even if this time the union manages to preserve their enviable health benefits, next time the contract is up, they’ll have to fight to keep them once again. Selena Simmons-Duffin, NPR News.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
U.S. Justice Department Charges 35 People In Fraudulent Genetic Testing Scheme
In the alleged scheme, Medicare beneficiaries were offered, at no cost to them, genetic testing to estimate their cancer risk.
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Al Drago/Bloomberg/Getty Images
In announcing a crackdown Friday on companies it says were involved in fraudulent genetic testing, the U.S. Department of Justice brought charges against 35 individuals associated with dozens of telemarketing companies and testing labs.
The federal investigation, called Operation Double Helix, went after schemes that allegedly targeted people 65 and older. According to the charges, the schemes involved laboratories paying illegal kickbacks and bribes to medical professionals who were working with fraudulent telemarketers, in exchange for the referral of Medicare beneficiaries.
DOJ officials say the schemes cost the Medicare program more than $2 billion in unnecessary charges.
Among those charged were 10 medical professionals, including nine doctors.
“The elderly and disabled are being preyed upon,” says Joe Beemsterboer, senior deputy chief of the fraud section in the criminal division of the DOJ.
It was one of the largest health care fraud schemes in U.S. history, Beemsterboer, says, and it worked on many levels, involving many players — from “those collecting patient information, to those selling it, to those doctors corruptly prescribing these genetic tests, to the labs corruptly billing the Medicare program.”
According to Shimon Richmond, assistant Inspector General for investigations with the U.S. Department of Health and Human Services, this is how the alleged scheme worked: First, telemarketing companies trolled elderly Medicare beneficiaries online, or called them on the phone or even sent people to approach beneficiaries face-to-face at health fairs, senior centers, low-income housing areas or religious institutions like churches and synagogues.
Seniors were offered, at no cost to them, genetic testing to estimate their cancer risk or determine how well certain drugs would work for them. All they had to do, the elderly people were told, was provide their Medicare information, a copy of their driver’s license and a bit of DNA collected from a swab of saliva from inside their cheek.
The sales pitch also included lots of aggressive scare tactics, Richmond says, such as telling patients that if they didn’t have the testing done they could end up suffering from a variety of possibly fatal conditions.
Once recruiters got the information they wanted, they would try to get the patient’s own health care provider to write a prescription for the test. If that didn’t work, the recruiters asked one of their own cadre of doctors to write prescriptions for patients they didn’t know.
“And these doctors, in many cases, have zero contact with the patient and no knowledge of their health care situation or needs,” Richmond says.
The genetic test may have been offered free to the patients, but there was money to be made from Medicare reimbursement. Typically that payment – anywhere from $10,000 to $18,000 or more, Richmond says — would be split between the worker who recruited the patient, the doctor writing the prescription, the lab that did the test and the telemarketing company that organized the alleged scheme.
Often, the labs didn’t even send results to patients, Richmond says. And when they did there was no counseling or help interpreting the findings.
“So patients were left with a report that’s meaningless to them, and is certainly not providing them with any benefit in terms of their health care,” says Richmond.
The testing could also financially harm the patient down the road, he adds. For example, if, in the future, the patient’s legitimate doctor determines that the patient actually needs a genetic test for a certain condition, Medicare likely won’t cover it, citing an earlier payment.
The U.S. Department of Health and Human Services Office of Inspector General has previously issued a fraud alert for consumers in an effort to educate the public about such schemes.
Richmond says people who believe they may have been victimized by the schemes can call 1-800-HHS-TIPS, or they can file a complaint online.
If convicted, the defendants arrested Friday could face decades in prison, Beemsterboer says.
U.S. Income Inequality Worsens, Widening To A New Gap
The view from the balcony of a house listed at $5.5 million in San Francisco. Income inequality in the U.S. grew worse in California and eight other states in 2018, the U.S. Census Bureau says.
David Paul Morris/Bloomberg via Getty Images
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David Paul Morris/Bloomberg via Getty Images
The gap between the richest and the poorest U.S. households is now the largest it’s been in the past 50 years — despite the median U.S. income hitting a new record in 2018, according to new data from the U.S. Census Bureau.
U.S. income inequality was “significantly higher” in 2018 than in 2017, the federal agency says in its latest American Community Survey report. The last time a change in the metric was deemed statistically significant was when it grew from 2012-2013.
While many states didn’t see a change in income inequality last year, the income gap grew wider in nine states: Alabama, Arkansas, California, Kansas, Nebraska, New Hampshire, New Mexico, Texas and Virginia.
The disparity grew despite a surging national economy that has seen low unemployment and more than 10 years of consecutive GDP growth.
The most troubling thing about the new report, says William M. Rodgers III, a professor of public policy and chief economist at the Heldrich Center at Rutgers University, is that it “clearly illustrates the inability of the current economic expansion, the longest on record, to lessen inequality.”
When asked why the rising economic tide has raised some boats more than others, Rodgers lists several factors, including the decline of organized labor and competition for jobs from abroad. He also cites tax policies that favor businesses and higher-income families.
Income inequality is measured through the Gini index, which measures how far apart incomes are from each other. To do that, the index assigns a hypothetical score of 0.0 to a population in which incomes are distributed perfectly evenly and a score of 1.0 to a population where only one household gets all of the income.
In the U.S., the Gini index figure had been holding steady for the past several years. But it moved from 0.482 in 2017 to 0.485 in 2018. While that change may seem small, it’s statistically significant, the Census Bureau says. The agency notes that back in 2006, the figure stood at 0.464.
The Census Bureau says five states — California, Connecticut, Florida, Louisiana and New York — and the District of Columbia and Puerto Rico had higher inequality rates than the rest of the U.S. in 2018. Of that group, California is the only state that saw its income gap grow even wider last year.
U.S. median household income has never been higher, coming in at $61,937 for 2018, the Census Bureau says. But in 29 states and Puerto Rico, the median household income was lower than the national level.
The report reflects some positive changes for the nation’s poverty rate, which fell in 14 states and Puerto Rico. And in four states — California, Florida, Georgia and North Carolina — the poverty rates dropped for the fifth consecutive year.
Poverty rates did not grow worse in the 25 largest U.S. cities in 2018, the Census Bureau says. And in seven of those metropolitan areas, it fell.
In some cases, Rodgers says, the reason the poverty rate fell is likely due to a growing number of local and state governments that have raised their minimum wage — something the federal government hasn’t done since 2009.
In the three most populous U.S. metropolitan areas — centered on New York City, Los Angeles and Chicago — the percentage of people in poverty fell for the fourth year in a row.
Kapadia’s Latest Film ‘Diego Maradona’ Examines Soccer Legend
Constructed from over 500 hours of footage, director Asif Kapadia tells NPR’s David Greene his new documentary centers around one of the most celebrated, and hated, soccer players: Diego Maradona.
DAVID GREENE, HOST:
I want to travel with you to Naples, Italy, in this raucous crowd.
(SOUNDBITE OF CROWD CHATTER)
GREENE: This is a city that had faced years of discrimination and racism from fellow Italians. Some called Naples the country’s sewer. But here, in the 1980s, Naples was celebrating its hero, a man named Diego Maradona.
(SOUNDBITE OF CROWD CHATTER)
ASIF KAPADIA: This is a story about a guy and a city. Really, those are the two characters. It’s about the perfect match between the kind of very dysfunctional character and a very dysfunctional city, which at the time, in Europe, was one of the poorest places in Europe, one of the most violent places. There’s a serious gang war going on between different gangs. Cocaine is everywhere. And the most expensive soccer player in the world ends up at one of the poorest clubs in Europe.
GREENE: That’s the voice of the film director Asif Kapadia. His new documentary, “Diego Maradona,” follows one of the world’s most talented and tragic soccer stars. Maradona, an Argentinean soccer prodigy, was bought by Naples’ soccer club in the 1980s. And Naples became addicted to the glory he brought them.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED CROWD: Diego. Diego. Diego. Diego. Diego. Diego. Diego.
KAPADIA: But it’s kind of a love-hate relationship. You know, they need each other. They do great things together. But everything that is dark that is in that city – he will then be drawn to, and that will mess him up, you know. He will come out broken.
GREENE: Diego Maradona is just the kind of complicated life that fascinates Asif Kapadia. He did an Oscar-winning film about the British music star Amy Winehouse. As for Diego Maradona, well, the filmmaker says he lived a life of extremes from the beginning.
KAPADIA: He’s from, you know, what we would know as slums or favelas, that type of place on the outskirts of Buenos Aires – very poor, you know, no running water, no electricity, large family living in a shack- you know, that’s his background – eight of them in total.
And he, from a very young age, becomes the breadwinner. From a age of about 15, he’s the reason why his family get a home, get a door key for the first time in their lives. His dad was a very much a kind of manual worker. His mom brought up the kids. So part of it, for him, was he played in order to get his mum a home and get them out of poverty.
GREENE: Which is, like, to me, is just learning about him, the maddening part. Like, you love him so much, and he wants to do the right thing by his family. And then there are moments in his life and his career that makes you just hate him so much.
KAPADIA: This is why he’s interesting for me, you know. The reason why I’m interested in these characters is because they’re not just these good guys. He is this kind of two sides of the same coin. Football, famously, like we call it, you know, it’s a game of two halves. So half Diego, you got his kind of angel, really nice, sweet guy – really, really endearing and cares about his family.
And then on the other side, he has a dark side. He has an edge. He – you know, he does drugs. He hangs around with gangsters. He gets into prostitution. You know, he denies his own child. So you’ve got this guy who’s a genius, but he’s a cheat.
GREENE: It’s really two different people – Diego and Maradona. Kapadia says Diego, this poor kid from Argentina, had to create an entirely different persona to deal with the overwhelming weight of that much fame. As time went on, that alter ego, Maradona, began to take over.
KAPADIA: So if you look at the young man who arrives in 1984 and then you look at the man that leaves seven years later, he’s changed so much. He’s broken. He’s really out of shape. And he leaves as an addict as well, which is a problem he has to deal with for the rest of his life. But even now, you know, he’s really struggling with this.
I would say, you know, while I was making the film, I met him. He was living in Dubai at a time. So I interviewed him about four or five times, went to his home. And I did feel, you know, towards the ending, that the person I was meeting and talking to was at one end of the spectrum of the kind of Maradona scale.
But it was – it made it quite complicated because he would essentially deny anything was wrong, or he wouldn’t want to talk about certain things. Even if I just brought up a person’s name, he’s like, don’t talk about her. I never want to hear about her. She’s a liar. OK.
GREENE: Wow.
KAPADIA: And that’s, like, his ex-wife, you know. OK. These are like my easy questions on Day 1. So with him, what we found is that he has a particular way of existing and living – is he never looks back. He never admits he’s made a mistake. And that is what his trainer, Signorini, says in the film. That’s kind of full Maradona. He’s never able to show weakness.
GREENE: There was such intimacy, I mean, seeing his face in moments. I mean, some of the moments of silence just looking at his face were the most powerful. And I know it took you something like three years to make this film and collect all of this. How did you manage to uncover all of that footage?
KAPADIA: Yes. So this is a key part of this film. There’s a cameraman who had all of these tapes on this old format called U-matic in the back of his house which had never been seen for 30 years.
GREENE: How’d he get – how did this guy have all this footage sitting there?
KAPADIA: So he transpires that Diego Maradona’s first agent when he was young, Jorge Cyterszpiler, in Argentina – he’s like, this kid’s going to be a star. So at the time, you know, they were still trying to break soccer in the U.S. You know, late ’70s, early ’80s, there was still this idea that football was going to become big in the USA. So he thinks, if I make a movie about this young kid, I’ll be able to break America.
So in 1981, he hires two Argentinian cameraman to follow Diego Maradona around, on the pitch and off the pitch. And then they go on to Naples, and they keep filming him through Naples.
GREENE: Wow.
KAPADIA: But the agent then gets fired by Diego. The cameraman probably were never paid for doing all their work, so they run off with the tapes. The tapes get kind of split somewhere around the world. There’s these rumors that the tapes are out there, but no one’s been able to do a deal with the cameramen and with Diego. And my producers were able to do both.
GREENE: Does he know that firing that guy, like, inadvertently gifted you a lot of this footage?
KAPADIA: Do you know? I’ve had these conversations with him, but he hasn’t seen the film yet. Diego…
GREENE: I was going to ask you…
KAPADIA: …Hasn’t seen the film yet.
GREENE: …He hasn’t seen it?
KAPADIA: Yet – there’s still time. One day, when he sees the film, maybe he’ll understand how we put this all together. What I should say is that everyone around him – his trainer, Signorini, his biographer, Daniel Arcucci, his ex-wife, his girlfriends, his children – everyone around him, I’ve shown the film to, and they all say it’s honest. It’s tough, but it’s very honest. And so they’ve all given it the thumbs up.
GREENE: Is it important for you that he sees it at some point?
KAPADIA: The honest truth is, as time goes by, I kind of feel less and less important because, you know, he is Diego Maradona. And he just will never do what you expect him to do. And with Maradona, it was always going to be tricky to get his reaction.
GREENE: Well, best of luck with the film. And thanks so much for talking to us.
KAPADIA: Great to be on. Thank you.
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UNIDENTIFIED PERSON: (Foreign language spoken).
(SOUNDBITE OF DOCUMENTARY, “DIEGO MARADONA”)
GREENE: Sound there from one of his many goals. We were talking to the film director Asif Kapadia. His new film is called “Diego Maradona.”
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Mattel Launches New Gender-Neutral Dolls
Mattel’s new Creatable World dolls.
Mattel
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Mattel
Mattel’s Barbie dolls represented the traditional female image, and preteens embraced the hairstyles, thick eyelashes and spike heels that came with her. But now, Mattel is introducing dolls that let kids form the gender expression of the toy themselves. The doll is fully gender neutral and can be accessorized to be a boy, a girl, neither or both.
The company released six dolls with different skin tones, hair and clothes, calling the doll line Creatable World. Mattel said that it aims to reflect and celebrate “the positive impact of inclusivity.”
“This line allows all kids to express themselves freely, which is why it resonates so strongly with them,” said Kim Culmone, senior vice president of Mattel fashion doll design. “We’re hopeful Creatable World will encourage people to think more broadly about how all kids can benefit from doll play.”
While researching the dolls, Mattel spoke to over 250 families with children who identify across the gender spectrum.
Adults who identify as nonbinary didn’t have toys like these when they grew up. Molly Woodstock, a gender educator and co-host of the podcast Gender Reveal, is one of those people.
“It’s unarguably good that all children are being given the option to play with some sort of doll that doesn’t have a neatly assigned gender or gender roles,” Woodstock said. “Just the social and cultural validation of trans and nonbinary gender identities through this doll feels really powerful.”
Woodstock, who started identifying as nonbinary three years ago, thinks that this kind of representation at a young age could have helped them figure out their gender identity at an earlier age.
On the other hand, Woodstock is hesitant to fully accept the doll, saying that it still has some ways to go before being fully inclusive.
“I really worry that the cultural concept of nonbinary is this singular third androgynous gender, which is what this doll is portraying.” Woodstock said. “That’s not the reality of a lot of nonbinary people. We can’t be liberated from the gender binary if we’re just making it a gender ternary.”
Woodstock would also like to see the dolls produced with body diversity in mind.
While the number of people who identify as nonbinary is not clear, a Pew Research Center study found that a third of people who were born between 1995 to 2015 know someone who goes by gender-neutral pronouns.
Mattel has been criticized for its lack of diversity and unrealistic portrayal of women in the Barbie doll line. The company has taken steps to address this, such as releasing a hijab-wearing Barbie and introducing different body types.
Fire Hero In Philadelphia Calls Out Eagles’ Receiver Nelson Agholor
A Philadelphia man who helped firefighters rescue people from a burning apartment building used his moment in the spotlight to call out one of the Eagles’ wide receivers, who had dropped key passes.
STEVE INSKEEP, HOST:
We have evidence today that sports fans in Philadelphia are serious about their teams. Around 2 o’clock in the morning on Monday, a fire broke out in a West Philadelphia apartment. And an Eagles fan, Hakim Laws, was walking nearby.
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HAKIM LAWS: Smoke started getting worse. Then I seen a guy hanging out the window, you know, screaming that his kids was in there and things like that.
NOEL KING, HOST:
OK. We should mention that Mr. Laws used to be a firefighter, so he rushed into action. He ran into the burning building and tried to climb up the steps. But then smoke turned him back, so he ran back down. At that point, the fire department arrives on the scene. And here’s what he told a news team afterward in a video that has gone viral.
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LAWS: The ladder truck was pulling up, and ironically then my – one of my old coworkers took the ladder off the truck, raised it up. And he was assisting people down. My man just started throwing babies out the window.
INSKEEP: And then Hakim Laws chose to use this moment to call out his team, specifically Eagles wide receiver Nelson Agholor. In the last two games, Agholor has dropped a few key passes. Laws, as you’ll recall, was being thrown babies.
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LAWS: We was catching them, unlike Agholor and his mishaps. I’d like to put that out there.
KING: Someone on Twitter called that comment, the most Philly thing I’ve ever seen. Nelson Agholor, the Eagles receiver, was a pretty class act about it, though.
INSKEEP: Yeah. He’s – he tweeted, thank you for being a hero in the community. Would like to invite you and your family to the next home game.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Status Of Health Benefits Remains Unclear As United Auto Workers’ Strike Continues
While the United Auto Workers strike continues, General Motors and the union are telling different stories about what’s going on with the health benefits of striking workers and their families.
ARI SHAPIRO, HOST:
It is Day 9 of a strike that involves nearly 50,000 General Motors workers. While contract negotiations continue between the company and the United Autoworkers, there is a more immediate dispute. GM and the union are telling different stories about what’s going on with the health benefits of striking workers and their families, benefits that are famously generous. NPR’s Selena Simmons-Duffin reports.
SELENA SIMMONS-DUFFIN, BYLINE: Brooke Wilkerson’s husband Tyler took his job with GM partly because of the health benefits. Two of their kids were born with heart conditions.
BROOKE WILKERSON: They both require lifelong cardio care.
SIMMONS-DUFFIN: At his old job, managing their kids’ care put them thousands of dollars in debt. As an electrician at GM’s plant in Spring Hill, Tenn., they pay no premiums.
WILKERSON: The insurance is phenomenal. It covers pretty much everything except for the co-pays.
SIMMONS-DUFFIN: Twenty-five dollars for a doctor’s visit. When the strike started, she thought they’d be covered until the end of the month, then she saw on social media that GM had cut off health benefits. She called her insurer, Blue Cross Blue Shield of Michigan.
WILKERSON: They said it had been canceled by GM.
SIMMONS-DUFFIN: This was just a few days before heart appointments for her kids. Her 2-year-old daughter has a hole in her heart.
WILKERSON: She had her well check visit a few weeks ago, and her pediatrician was concerned about how her heart murmur sounded. So for a few days there, we didn’t know what was going to happen.
SIMMONS-DUFFIN: She says her husband scrambled to sign up for COBRA to extend their coverage, which will be paid out of the union’s strike fund. And yesterday, they made it to their daughter’s appointment.
In a statement, GM stressed to NPR that workers should have no interruptions in their coverage and said asserting that GM cut off benefits is, quote, “absolutely false.” The UAW told NPR this is not how benefits are usually handled during a strike and that its members were caught off guard.
Meanwhile, at the bargaining table…
KRISTIN DZICZEK: Health care benefits are really a go-to-war issue for the UAW.
SIMMONS-DUFFIN: That’s Kristin Dziczek, vice president of the Center for Automotive Research.
DZICZEK: However, the company is facing increased costs. They’re paying about a billion dollars a year for active health care, and they don’t have any way to really control that.
SIMMONS-DUFFIN: So this is the bigger question: After the strike, will workers like Tyler Wilkerson and his family have the same phenomenal health benefits to go back to?
Selena Simmons-Duffin, NPR News.
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Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
