California Governor Signs Law To Make Drug Pricing More Transparent
The new law will require pharmaceutical companies to notify the state and health insurers if they plan to raise the price of a medication by 16 percent or more over two years.
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California Gov. Jerry Brown defied the drug industry Monday, signing the most comprehensive drug price transparency bill in the nation that will force drug makers to publicly justify big price hikes.
“Californians have a right to know why their medical costs are out of control, especially when pharmaceutical profits are soaring,” Brown says. “This measure is a step at bringing transparency, truth, exposure to a very important part of our lives, that is the cost of prescription drugs.”
Brown says the bill was part of a broader push toward correcting growing economic inequities in the U.S., and called on the pharmaceutical leaders “at the top” to consider doing business in a way that helps those with a lot less.
“The rich are getting richer. The powerful are getting more powerful,” Brown says. “So this is just another example where the powerful get more power and take more… We’ve got to point to the evils, and there’s a real evil when so many people are suffering so much from rising drug profits.”
The drug lobby fiercely opposed the bill, SB 17, hiring 45 firms to try to defeat it and spending $16.8 million on lobbying against the full range of drug legislation.
The new law is intended to shine light on how drugs are priced, requiring pharmaceutical companies to notify the state and health insurers anytime they plan to raise the price of a medication by 16 percent or more over two years. And, companies will have to provide justification for the increase.
The legislation was supported by a diverse coalition, including labor and consumer groups, hospital groups and even health insurers, who agreed to share some of their own data under the bill. They will have to report what percentage of premium increases are due to drug prices.
“Health coverage premiums directly reflect the cost of providing medical care, and prescription drug prices have become one of the main factors driving up these costs,” says Charles Bacchi, CEO of the California Association of Health Plans. “SB 17 will help us understand why, so we can prepare for and address the unrelenting price increases.”
Drug companies criticized the governor’s move, saying the new law focuses too narrowly on just one part of the drug distribution chain and won’t help consumers afford their medicine.
“It is disappointing that Gov. Brown has decided to sign a bill that is based on misleading rhetoric instead of what’s in the best interest of patients,” says Priscilla VanderVeer, spokesperson for the drug industry association, the Pharmaceutical Research and Manufacturers of America (PhRMA). “There is no evidence that SB 17 will lower drug costs for patients because it does not shed light on the large rebates and discounts insurance companies and pharmacy benefit managers are receiving that are not always being passed on to patients.”
This law is part of a long game toward developing a stronger web of drug laws across the country, says Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health who tracks drug legislation in the states. In that respect, it makes sense to start with the source of the drug prices: the drug makers themselves, he says.
“The manufacturers get most of the money — probably about three quarters or more of the money that you pay for a drug — and they’re the ones that set the price initially,” he says. “So they are not the only piece of the drug supply chain, but they are the key piece to this.”
California’s law will not stand alone, says state Sen. Ed Hernandez (D-West Covina), the bill’s author and an optometrist. “A lot of other states have the same concerns we have, and you’re going to see other states try to emulate what we did.”
California Governor Signs Law To Make Drug Pricing More Transparent
The new law will require pharmaceutical companies to notify the state and health insurers if they plan to raise the price of a medication by 16 percent or more over two years.
fotostorm/Getty Images
hide caption
toggle caption
fotostorm/Getty Images
California Gov. Jerry Brown defied the drug industry Monday, signing the most comprehensive drug price transparency bill in the nation that will force drug makers to publicly justify big price hikes.
“Californians have a right to know why their medical costs are out of control, especially when pharmaceutical profits are soaring,” Brown says. “This measure is a step at bringing transparency, truth, exposure to a very important part of our lives, that is the cost of prescription drugs.”
Brown says the bill was part of a broader push toward correcting growing economic inequities in the U.S., and called on the pharmaceutical leaders “at the top” to consider doing business in a way that helps those with a lot less.
“The rich are getting richer. The powerful are getting more powerful,” Brown says. “So this is just another example where the powerful get more power and take more… We’ve got to point to the evils, and there’s a real evil when so many people are suffering so much from rising drug profits.”
The drug lobby fiercely opposed the bill, SB 17, hiring 45 firms to try to defeat it and spending $16.8 million on lobbying against the full range of drug legislation.
The new law is intended to shine light on how drugs are priced, requiring pharmaceutical companies to notify the state and health insurers anytime they plan to raise the price of a medication by 16 percent or more over two years. And, companies will have to provide justification for the increase.
The legislation was supported by a diverse coalition, including labor and consumer groups, hospital groups and even health insurers, who agreed to share some of their own data under the bill. They will have to report what percentage of premium increases are due to drug prices.
“Health coverage premiums directly reflect the cost of providing medical care, and prescription drug prices have become one of the main factors driving up these costs,” says Charles Bacchi, CEO of the California Association of Health Plans. “SB 17 will help us understand why, so we can prepare for and address the unrelenting price increases.”
Drug companies criticized the governor’s move, saying the new law focuses too narrowly on just one part of the drug distribution chain and won’t help consumers afford their medicine.
“It is disappointing that Gov. Brown has decided to sign a bill that is based on misleading rhetoric instead of what’s in the best interest of patients,” says Priscilla VanderVeer, spokesperson for the drug industry association, the Pharmaceutical Research and Manufacturers of America (PhRMA). “There is no evidence that SB 17 will lower drug costs for patients because it does not shed light on the large rebates and discounts insurance companies and pharmacy benefit managers are receiving that are not always being passed on to patients.”
This law is part of a long game toward developing a stronger web of drug laws across the country, says Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health who tracks drug legislation in the states. In that respect, it makes sense to start with the source of the drug prices: the drug makers themselves, he says.
“The manufacturers get most of the money — probably about three quarters or more of the money that you pay for a drug — and they’re the ones that set the price initially,” he says. “So they are not the only piece of the drug supply chain, but they are the key piece to this.”
California’s law will not stand alone, says state Sen. Ed Hernandez (D-West Covina), the bill’s author and an optometrist. “A lot of other states have the same concerns we have, and you’re going to see other states try to emulate what we did.”
Today in Movie Culture: Gal Gadot Spoofs 'Wonder Woman,' 'Justice League' Stars Swap Roles and More
Here are a bunch of little bites to satisfy your hunger for movie culture:
Movie Parody of the Day:
Saturday Night Live and host Gal Gadot spoofed Wonder Woman with a sketch about how weird it is that Themyscira isn’t an island of lesbians:
[embedded content]
Role Swaps of the Day:
Speaking of DC movies, the stars of Justice League used a new Facebook filter themed to the movie in order to swap their roles. Gal Gadot as Aquaman is the best (via Heroic Hollywood):
Easter Eggs of the Day:
Speaking of Justice League, here’s Mr. Sunday Movies with the Easter eggs and other things you may have missed in the new trailer:
[embedded content]
Dream Casting of the Day:
Scott Eastwood wants to be the next Wolverine in the X-Men movies, so BossLogic shows us what that could look like:
Some weekend fun @ScottEastwood#wolverine, probably will refine more later on (there was articles about him expressing interest) pic.twitter.com/Jh5Tphed92
— BossLogic (@Bosslogic) October 7, 2017
Vintage Image of the Day:
Guillermo del Toro, who turns 53 today, directs Doug Jones on the set of Pan’s Labyrinth in 2005:
Cosplay of the Day:
Also in honor of del Toro’s birthday, here’s some great Hellboy cosplay from New York Comic Con over the weekend;
Hella cool Comic Con cosplay! #Hellboy#NYCCpic.twitter.com/k02I8Bpnv7
— Marshall Julius (@MarshallJulius) October 8, 2017
Filmmaker in Focus:
Edgar Wright is the latest director to be showcased in Joshua Maddock’s The Filmmakers video series:
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Remixed Movie of the Day:
Speaking of Wright, Eclectic Method took the sound effects, music and dialogue from Baby Driver and made a sweet dance mix:
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Supercut of the Day:
Dance some more with this Calvin Harris-soundtracked supercut of ’80s movies compiled by Peter Schneider:
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Classic Trailer of the Day:
Today is the 25th anniversary of Robert Redford’s A River Runs Through It. Watch the original trailer for the classic drama below.
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and
Dallas Cowboys Owner Jerry Jones: Players Cannot Disrespect Flag
On Sept. 25, 2017, the Dallas Cowboys, led by owner Jerry Jones, center, took a knee prior to the national anthem before an NFL football game against the Arizona Cardinals, in Glendale, Ariz. Now he says players who “disrespect the flag” won’t play.
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Matt York/AP
Two weeks ago he locked arms and knelt with his players during the national anthem, but now Dallas Cowboys owner Jerry Jones says players who “disrespect the flag,” won’t take the field.
“…If there is anything that is disrespectful to the flag then we will not play,” Jones said Sunday night, according to The Dallas Morning News. “You understand? If we are disrespecting the flag then we won’t play. Period.” Jones did not specify what he meant by disrespect.
The players’ union responded on Monday, with executive director DeMaurice Smith saying Jones’ comments contradicted those of NFL Commissioner Roger Goodell.
“I look forward to the day when everyone in management can unite and truly embrace and articulate what the flag stands for, liberty and justice for all, instead of some of them just talking about standing. We look forward to continuing our talks with them on this very issue.”
Good morning. My statement. pic.twitter.com/l7KXZrZi2o
— DeMaurice Smith (@DeSmithNFLPA) October 9, 2017
Last season San Francisco 49ers quarterback Colin Kaepernick started kneeling during the national anthem to protest of police shootings of people in the black community. His actions drew widespread criticism that he was anti-American. Kaepernick, now a free agent, has yet to be picked up by another team.
Other players joined him in taking a knee, and late last month during a speech in Alabama President Trump said that owners should fire the players who protest, igniting a national firestorm.
On Monday night, Trump tweeted support for Jones:
A big salute to Jerry Jones, owner of the Dallas Cowboys, who will BENCH players who disrespect our Flag.”Stand for Anthem or sit for game!”
— Donald J. Trump (@realDonaldTrump) October 10, 2017
ESPN’s Jemele Hill responded to Jones’ statement with several tweets suggesting fans boycott the team’s advertisers.
Don’t ask Dak, Dez & other Cowboys players to protest. A more powerful statement is if you stop watching and buying their merchandise.
— Jemele Hill (@jemelehill) October 9, 2017
The sports network responded with a two-week suspension for Hill, calling it the second violation of the company’s social media guidelines. Last month the network said that tweets Hill made calling Trump a white supremacist were inappropriate.
ESPN’s Statement on Jemele Hill: pic.twitter.com/JkVoBVz7lv
— ESPN PR (@ESPNPR) October 9, 2017
'Something Amazing' In Angola: War Scraps Become Steel Beams For Rebuilding
Aceria de Angola is a company that is turning old weapons — rifles, tanks — into steel beams. It was founded by a baker, whose business was destroyed by the bloody civil war. But the spoils presented an opportunity.
ROBERT SIEGEL, HOST:
Angola’s long civil war ended in 2002, and the country is still recovering today. There’s infrastructure to build. There are long-term injuries to mend. And there’s this question – what should be done with the old tanks and rifles that litter huge tracts of land? NPR’s Eyder Peralta has this story about a company that’s melting weapons and turning them into steel.
EYDER PERALTA, BYLINE: Aceria de Angola has a junkyard in a rural town about two hours from the capital, Luanda.
(SOUNDBITE OF TRUCK REVERSING)
PERALTA: To see the whole place we climb on a two-story scaffold. I see a vast wasteland. The red dirt is covered with crumpled metal, old, rusty cars, mounds of motorcycles and, in the distance, big chunks of tanks languishing in the sun.
(SOUNDBITE OF METAL CLANGING)
PERALTA: A bulldozer picks up the scraps like Legos and drops them into a machine that shreds them into tiny pieces.
(SOUNDBITE OF METAL CRUNCHING)
PERALTA: Luis Silva, the guy who runs this factory, puts his hands on his waist and looks around.
When you look out here, what kind of story does this yard tell you about this country?
LUIS SILVA: (Laughter) It tells me a story of poverty and war.
PERALTA: Silva has done this kind of work in Europe. Out there, he says, the yards are littered with junk that still has some life – cars with some paint left on them. And you also get the remains of a society on the move – steel beams from relatively new buildings and factories being destroyed to make way for new ones.
SILVA: You don’t see here industrial scrap. You look for that and just a small amount of pipes comes from the oil industry. But the rest is old; very old.
PERALTA: Aceria de Angola is the brainchild of Georges Choucair. During the war, he owned a big bakery, but his delivery trucks were destroyed. And when it was all over, he saw a country with the need and means to rebuild. In the steel business, he saw money. But he also saw a parallel between his old life and what would become his new one.
GEORGES CHOUCAIR: Steel is as much important than food. We need food because we need to live, but we need to have a home. And home without steel also nothing.
PERALTA: Of course, he faced many challenges building a factory in a country emerging from war. He had to invest in the power grid so he could get enough electricity, for example. But his love for Angola kept him going, he says. Once the plant was built, one of the first things they did was clear tons of war scraps from Cuito Cuanavale, the site of one of the most intense and historic battles during the Angolan Civil War.
CHOUCAIR: We now can recycle all the scrap, the war scrap, to something amazing, giving life to people.
PERALTA: Back at the factory, Luis Silva shows me how the metal scraps are melted in furnaces, how it’s poured out and turned into what look like long, black beams.
SILVA: After that we start the rolling process.
PERALTA: He says there are still lots of problems here. There are few roads to get scraps out of the center of the country. There are lots of power cuts, and employees often lose family members to what should be treatable diseases. He stops to show me the presses. They squeeze warm steel into thin rebars.
SILVA: And this is the finished product.
PERALTA: There are still problems, he says. But when he sees this new steel made from old scraps, it gives him hope. Eyder Peralta, NPR News, Luanda.
(SOUNDBITE OF TRACEY CHATTAWAY’S “SHIMMER”)
Copyright © 2017 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.
Trump Rescinds Obamacare Birth Control Mandate
David Greene talks to Planned Parenthood President Cecile Richards, who has denounced the Trump administration’s rollback of the Affordable Care mandate to cover birth control.
DAVID GREENE, HOST:
And the Trump administration is making it easier for employers to opt out of covering birth control in their health insurance plans. The coverage was guaranteed under the Obama administration with the exception of employees at some religious organizations. Attorney General Jeff Sessions said the Trump administration is leading by example on religious liberty. But this was a troubling development for Planned Parenthood Federation of America. And its president Cecile Richards is on the line. Good morning.
CECILE RICHARDS: Good morning.
GREENE: Let me just talk through the impact of this. The Trump administration said Friday that 99 percent of women will still have the same access to birth control. And they said less affluent women can still get free or subsidized contraceptives through Medicaid and other programs. I mean, do you agree with those numbers. Or what’s your estimate for the number of women who might be affected by this?
RICHARDS: Well, David, I mean, it’s incredibly ironic that they would now refer to programs that they’ve been trying to end through Trumpcare for the last, you know, several months – access to, you know, Planned Parenthood, access to Medicaid and access to the Family Planning Program. And the basic fact here is that millions and millions of women – now about 62 million women – have access to birth control and their insurance plan at no cost. And it’s led to amazing successes. Women have saved a lot of money. The estimates are 1.4 billion dollars alone the first year. We’ve reduced unintended pregnancy – the lowest rate of teen pregnancy in the history of the United States. And women are getting better birth control. All of these are good things. They allow women to plan their families and stay in the workforce. And this decision is basically now going to turn the reins over to your boss to decide whether or not women can get birth control. And that’s just not going to be good for women.
GREENE: But do you expect a lot of bosses to actually change that much? I mean, the Trump ministration is saying that this, in terms of numbers, is probably going to have very little impact. I mean, do you accept that?
RICHARDS: Well, one, I don’t think they – they don’t – certainly don’t know. And in fact, I mean, all of the things that they have put out are messages that send – that basically say birth control is dangerous for women, which is really crazy. More than 90 percent of women in this country use birth control for a whole host of reasons. I think the problem is, you know, we fought so hard under Obamacare to get women equal access to health care, including family planning. Because until that bill passed, many, many employers did not provide birth control for women. And again, women are now half the workforce in this country. And a big reason that we’ve been able to participate and work and go to school is because we’ve been able to plan our families. And that’s really what’s at risk here. And frankly, the Trump administration has been on a war against birth control and women’s health from day one.
GREENE: You feel like they’re sending a message that birth control can be dangerous because it seems the message they’re sending to some is that this is a matter of religious liberty and employers not being forced to, you know, sacrifice their religious beliefs.
RICHARDS: Well, I mean, that’s not – this is not what that rule says. The rule basically says if any employee or objects to birth control, they don’t have to provide it. And look. I think the problem is – you look who’s been in charge of Health and Human Services with the Trump administration. It has been filled with key positions, folks who have been against birth control from the very beginning. In fact, ironically, the woman who was appointed to run the National Family Planning Program has said herself she doesn’t believe in birth control. This is just the beginning. And I think many of us expect this will not end here. There are rumors of all kinds of other ways in which they’re going to restrict birth control access. And I just don’t understand it. It’s good for women’s health. It’s good for the economy. And this kind of attack is something that you would have expected in the 1930s, not in 2017.
GREENE: And we just have a few seconds left. But I mean, the Obama administration issued this mandate to cover birth control. Religious organizations filed suit. The Supreme Court ruled that the government can’t force private companies, nonprofits to pay for birth control against their religious beliefs. Are you concerned that the law is on the administration’s side here?
RICHARDS: Well, I mean, obviously we’ll be challenging it along with the ACLU, and that’s really important. But there were all kinds of accommodations made for a religious employer. The danger is you have things now like universities that provide birth control for women that are students. You have all kinds of organizations who may have their own political or religious views. Why should they be able to impose that on American women? It’s simply not right. And we’ll be fighting it every step of the way and ensuring that women continue to get birth control at Planned Parenthood.
GREENE: Cecile Richards is the president of Planned Parenthood Federation of America. We appreciate your time this morning. Thanks a lot.
RICHARDS: Good to see you, David. Thanks.
Copyright © 2017 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.
First Listen: Rudresh Mahanthappa's Indo-Pak Coalition, 'Agrima'
Rudresh Mahanthappa’s Indo-Pak Coalition’s Agrima comes out Oct. 17.
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Rudresh Mahanthappa’s Indo-Pak Coalition, Agrima
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Courtesy of the artist
Indo-Pak Coalition, an improvising trio led by the alto saxophonist Rudresh Mahanthappa, finds its purpose in myriad forms of convergence. A decade ago the group released its auspicious debut album, Apti, announcing an inspired accord between Mahanthappa, a second-generation Indian-American; guitarist Rez Abbasi, who was born in Pakistan but raised in Los Angeles; and Dan Weiss, an Anglo-American drummer with a deep interest in Indian percussion.
The name of the trio was an inside joke — a nod to immigrant-owned family businesses with names like Indo-Pak Movers and Indo-Pak Super Market — but it carried a genuine note of solidarity. Britain’s Partition of the Indian subcontinent took place 70 years ago this summer, and along with creating two sovereign nations, Hindu-majority India and Muslim-majority Pakistan, the event left bitter legacies of displacement and bloodshed. That history isn’t the point of the Indo-Pak Coalition, but it can’t help but hover somewhere in the background.
Agrima is the trio’s second album, a step forward in every respect. The clearest update is a broadening of timbre. Where Apti featured a fixed range of instrumental sounds — alto saxophone, tablas, cleanly processed electric guitar — this album gives each musician more of an open canvas. Mahanthappa, whose sound on alto can be mournful or biting, delves into electronics with an expressive subtlety. (Hear what he does on the title track.) Abbasi employs distortion, back-masking and other effects, unfurling his jazz-rock freak flag.
And Weiss can be heard not only on tablas but also behind his drum kit, in a synthesis that few other musicians could credibly manage. He plays an enveloping tabla solo toward the end of “Revati,” and then applies a similar discipline to the rat-a-tat of his snare drum on “Can-Did.” Weiss was born and raised in New Jersey but has apprenticed for years with a percussive guru, Pandit Samir Chatterjee. His adaptive process as a musician isn’t all that different from that of his band mates, who access the music of their heritage by way of a dynamic continuum.
There are echoes of folk wisdom in some of Mahanthappa’s compositions on Agrima: certainly “Showcase,” with its ambulatory cadence, and “Rasikapriya,” with its fluttery melodic incantation. And there is individual virtuosity, at almost every turn. But the larger point of this album is the transformation of materials in a process of real-time exchange — a meeting of minds and methods that takes no possibilities for granted.
Agrima is available digitally for pre-order on Oct. 17, as a $2.50 download, and as a limited-edition double LP at rudreshm.com.

Rudresh Mahanthappa’s Indo-Pak Coalition, Agrima
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First Listen: Rudresh Mahanthappa’s Indo-Pak Coalition, ‘Agrima’
01Alap
02Snap
03Showcase
04Agrima
05Can-Did
06Rasikapriya
07Revati
08Take-Turns
Businesses To Benefit From Addressing 'Loneliness Epidemic,' Doctor Says
Former surgeon general Dr. Vivek Murthy says that underlying many of the most critical public health issues facing America today is an epidemic of loneliness. NPR’s Michel Martin speaks with Dr. Murthy about what that means, and what he thinks should be done about it.
MICHEL MARTIN, HOST:
Let’s talk about health and well-being for a few minutes. Often, when we talk about the issues that most concern the leading figures charged with addressing the nation’s health, we think about excess weight or smoking or violence. But the former surgeon general, Dr. Vivek Murthy, would like to add something else to that list – loneliness. That’s a subject of a new cover story in The Harvard Business Review. Some 40 percent of American adults say they feel lonely. And a rising number of people say they have no close confidant in their lives.
That’s one reason why Dr. Murthy argues that America is in the midst of a loneliness epidemic. And the consequences of that, he says, are significant enough that businesses, managers and workers should rethink the way they work to think about how to foster more meaningful relationships with colleagues, with whom many people spend more time than with family. To hear more about that, we’re joined now by Dr. Vivek Murthy in our studios in Washington, D.C. Dr. Murthy, thanks so much for speaking with us.
VIVEK MURTHY: Thank you for having me.
MARTIN: So I would imagine that a lot of people wouldn’t think about loneliness as a public health issue. So first of all, tell us why you think it is a public health issue, and then help us understand how you got to thinking that yourself.
MURTHY: Well, years ago, I wouldn’t have thought about loneliness as a public health issue either. But two big things happened in my life that changed that. Number one, I began practicing medicine and seeing patients and quickly realized that the greatest pathology that I saw was not heart disease or diabetes. It was, in fact, loneliness, and it was impacting the ability of my patients to live healthy and fulfilling lives.
But the second thing that happened is, when I began my tenure as surgeon general, I visited communities all across the country – big and small. And what I heard everywhere I went was that people were, in fact, struggling with loneliness. They used different words to describe that feeling and that experience, but the experience was often the same. Some people were struggling with loneliness in the face of illness.
You know, I met moms and dads, for example, who had lost children to drug overdoses and felt profoundly alone in part because of this terrible stigma that surrounds addiction. But even people who weren’t struggling with illness often felt that they were on their own. And this is quite striking despite the boom that we’ve had in technology, especially social technology.
So these two experiences really led me to see that loneliness is not only a profound problem. But when you look at the literature and you understand the science, there are powerful impacts that loneliness can have on our health. And that’s why I began to look at it as an important public health issue that we need to address.
MARTIN: Well, in fact, you used the language of health – like you said, it’s a pathology. I mean, I think when people think of an illness, they think of something that is something physical that has specific symptoms. I mean, does loneliness have those things?
MURTHY: When you look at the data, you find that loneliness is associated with shorter lifespan. And, in fact, the reduction in lifespan from loneliness is similar to the reduction associated with smoking, and it’s, in fact, greater than the impact of obesity. But if you delve even deeper, you see that there’s an association between loneliness and cardiovascular disease, dementia, anxiety and depression. And if you look at even more deeper at the physiology, it’s not too difficult to understand how this may, in fact, come about because loneliness, in fact, creates a stress state in our body.
As human beings, we evolved to be social creatures, and there was a very practical reason for that because, in ancient times, if we had other people that we were connected to, we had a stronger guarantee of a stable food supply. We also had a greater chance of being protected from predators at night. We could all take turns keeping watch around the fire instead of having one person stay up the entire night. And over hundreds and thousands of years, that need for social connection became baked into our nervous system. And so if we are in a lonely state, it actually places us in a state of stress, and chronic stress is associated with increases in cortisol, increases the inflammation in the body, which can damage tissues and ultimately increase our risk of heart disease, obesity and a number of other illnesses.
MARTIN: Why do you say that the work environment needs to address this? Why is that a business problem or work problem?
MURTHY: Well, the truth is that all of us have to think about how we can address the loneliness epidemic across all sectors. But in particular, we need to look at where people spend the bulk of their time, and people are spending the bulk of their time with families, in the workplace, in schools, in social organizations like faith-based organizations. And for many people, spend at least eight hours a day at work. Many spend many more than eight hours a day at work. And for this reason, the impact that the workplace has on our social connections becomes very, very important.
Now, one might think, OK, well, it’s not the job of an employer to really think about whether your employees are lonely or not. There are a couple of reasons you might be interested in doing that. Number one, you recognize that loneliness has an impact on your health. Then, you know that employees who are not healthy can contribute less to the actual business and to the bottom line. The second reason, though, is loneliness is not a phenomenon that occurs in isolation.
But in many ways, loneliness has network effects. When individuals are lonely, they can impact whether people around them feel lonely as well. And so that is, in part, why I think of it as an epidemic. But if you’re an employer, you want to make sure that people in your workplace are feeling connected, so that they can be happier, more productive, healthier and have reduced health care costs and, ultimately, so you have a community that’s thriving instead of a community that’s groaning under the yoke of stress.
MARTIN: That’s Dr. Vivek Murthy. He was the 19th surgeon general of the United States. He was appointed by former President Obama. And he was kind enough to join us in our studios in Washington, D.C. Dr. Murthy, thanks so much for speaking with us.
MURTHY: Thank you for having me.
Copyright © 2017 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.
Mike Pence Takes A Stand (And Walks Away) After NFL Players Kneel
Vice President Pence and his wife, Karen, stand for the national anthem before Sunday’s game between the Indianapolis Colts and the San Francisco 49ers in Indianapolis.
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Vice President Pence was so offended by kneeling professional football players that he left a game Sunday between the Indianapolis Colts and the San Francisco 49ers in Indianapolis.
“I left today’s Colts game because President Trump and I will not dignify any event that disrespects our soldiers, our Flag, or our National Anthem,” Pence, a former governor of Indiana, said in a statement.
“While everyone is entitled to their own opinions, I don’t think it’s too much to ask NFL players to respect the Flag and our National Anthem,” the statement opposing the protest continued. “I stand with President Trump, I stand with our soldiers, and I will always stand for our Flag and our National Anthem.”
But first, the moment was commemorated with a photo of himself and second lady Karen Pence while they stood, hand over hearts, for the anthem.
We were proud to stand – with all our @Colts – for our soldiers, our flag, and our National Anthem ?? pic.twitter.com/mkZiKMkPDD
— Vice President Pence (@VP) October 8, 2017
It appears the choice to leave did not belong to Pence or his wife alone. According to Trump, it was his idea.
“I asked @VP Pence to leave stadium if any players kneeled, disrespecting our country,” Trump tweeted, adding that he was proud of the couple.
I asked @VP Pence to leave stadium if any players kneeled, disrespecting our country. I am proud of him and @SecondLady Karen.
— Donald J. Trump (@realDonaldTrump) October 8, 2017
Only members of the 49ers knelt for the rendition of “The Star-Spangled Banner” — a symbol of protest not against the flag or the song but against institutional social injustice and the violence perpetrated by police against black men. Colts players stood, linked arm in arm.
The controversial practice of kneeling during the anthem was started by former San Francisco quarterback Colin Kaepernick, who has yet to be signed to a new team after his contract with the 49ers expired last year.
In an on-camera report on Sunday, CBS reporter Jason La Canfora said Kaepernick would stand for the anthem if he was signed to an NFL team.
“He’s not planning on kneeling … and he’s planning on standing for the anthem,” La Canfora said.
But after the story began making headlines, La Canfora backtracked tweeting, “Standing for Anthem wasn’t something that I spoke to Colin about.” He was merely relaying what had already been reported about Kaepernick in other outlets, La Canfora wrote, adding, “what he would do during the Anthem I do not know.”
Standing for Anthem wasn’t something that I spoke to Colin about sat. I relayed what had been reported about him standing in the future…
— Jason La Canfora (@JasonLaCanfora) October 8, 2017
Kaepernick has not denied La Canfora’s claim outright, but he has been retweeting others who have responded to the CBS sports reporter. Among them is the quarterback’s own girlfriend, Nessa Diab, who wrote, “The reports that Colin will stand for the anthem are completely false! He has never discussed this with anyone.”
Howard Bryant, an ESPN Magazine columnist, also weighed in on Twitter with what he said was confirmation from Kaepernick.
“Just got a message from @Kaepernick7 who says he has not discussed with anyone his plans in the event he is signed by an NFL team,” Bryant wrote.
1) Just got a message from @Kaepernick7, who says he has not discussed with anyone his plans in the event he is signed by an NFL team.
— Full Dissident (@hbryant42) October 8, 2017
The president has been railing against the NFL over the league’s tolerance of the sustained demonstration. Trump has repeatedly called on team owners to fire all players who kneel during the national anthem.
At a campaign rally in Alabama last month, Trump shouted, “Wouldn’t you love to see one of these NFL owners, when somebody disrespects our flag, to say, ‘Get that son of a b**** off the field right now’?” he said to roaring applause.
The statement by the president, and the subsequent Twitter storm he unleashed, renewed a national debate over players’ First Amendment rights and also pitted NFL owners and players against the president, inspiring many of them to kneel or link arms in the game that followed.
By walking out over the kneeling, Pence hasn’t just stirred the stoked the flames of the controversy, it has also kicked up a new dust storm: criticism over the cost of the vice president’s protest of the protest.
Hawaii Democratic Sen. Brian Schatz was the first to raise the issue.
“Wait,” Schatz wrote on Twitter. “This was orchestrated to make a point? That’s not an inexpensive thing to do.”
The Painful Side Of Positive Health Care Marketing
Lori Wallace says it’s frustrating to constantly hear messages in ads for hospitals that imply her cancer would go away if she were just more positive and tried harder.
Sam Harnett/KQED
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Sam Harnett/KQED
Lori Wallace is sitting on a couch with her 11-year-old son and his new pet snake. It’s burrowing under his armpit, as if it were afraid. But Wallace says it’s not.
“If he was terrified, he would be balled up,” Wallace says. “See, that is why they are called ball pythons. When they are scared, they turn into a little ball.”
Wallace is dying of breast cancer, but a stranger couldn’t tell. She has a pixie haircut and a warm tan. She is vibrant and chatty and looks you right in the eyes when she talks. Wallace doesn’t shy away from what is happening to her. She shows me her cracked feet. They bleed from the chemotherapy pills she takes.
As Wallace’s cancer has progressed over the past seven years, she has become more critical of what she sees as excessive positivity in health care marketing. It’s everywhere: TV ads, radio commercials, billboards. The advertisements feature happy, healed patients and tell stories of miraculous recoveries. The messages are optimistic, about people beating steep odds. Wallace says the ads spread false hope, and for a patient like her, they are a slap in the face.
A couple of decades ago, hospitals and clinics did not advertise much to customers. Now, they are spending more and more each year on marketing, according to university professors who study advertising, and are keeping track.
Wallace, who lives in San Jose, Calif., says she used to be a hopeful person, someone who believed you could fight through any misfortune. Then she was diagnosed with breast cancer. Wallace was 39. Her son was 4. She couldn’t believe it.
The chemotherapy treatment makes her brain foggy, Wallace says. She is now in her fifth round. Her cancer is Stage 4 and has spread throughout her body. It’s going to kill her, she tells me.
“The median survival of a woman with metastatic breast cancer is 33 months,” Wallace says. “My 33 months would have been Dec. 6 last year. So I am on bonus time right now.”
Wallace pulls up an ad on her computer from UCSF Benioff Children’s Hospital, in San Francisco. An announcer intones, “Amid a thousand maybes and a million nos, we believe in the profound and unstoppable power of yes.”
There is a similar kind of optimism at the heart of a lot of the ad campaigns by health care providers — with slogans like “Thrive” and “Smile Out.” Wallace says the subtext of the ads is that people like her — who get sick and will die — maybe just aren’t being positive enough.
“I didn’t say ‘yes’ to cancer,” Wallace says. “I have tried everything I can. I have done clinical trials. I have said ‘yes’ to every possible treatment. And the cancer doesn’t care.”
Karuna Jaggar is executive director of Breast Cancer Action. She says health care providers are following in the footsteps of other companies.
“It’s the basics of marketing,” Jaggar says. “In order to sell products or services, you have to sell hope.”
She says health care advertisers are adopting the kind of optimistic messaging that really began in force with the pink ribbons and rosy depictions of breast cancer.
“Thirty years ago, breast cancer was the poster child of positive thinking,” Jaggar says. ” ‘Look good, feel better, don’t let breast cancer get you down. Fight strong and be cheerful while you do it.’ “
Back then, health care providers marketed to physicians more than consumers. The ads were drier, more factual, says Guy David, an economist and professor of health care management at the University of Pennsylvania.
“When the ads are more consumer-facing as opposed to professional-facing, the content tends to be more passionate,” David says.
The hospital ads Wallace is objecting to tug at emotions, just like other advertising that is trying to win over consumers. With increasing health care costs and choices, patients are shopping around for care. Tim Calkins is a professor of marketing at Northwestern University. These days, he says, hospitals have to sell themselves.
“Right now in health care, if you don’t have some leverage, if you don’t have a brand people care about, if you don’t have a reason for people to pick you over competitors — well, then you are in a really tough spot,” Calkins says.
Hospitals are spending more than ever on advertising, he says, and, as with other products, that advertising is filled with lots of promises. He says you don’t see the same promises in the pharmaceutical industry. Their ads are regulated by the Food and Drug Administration, which is why they have to list all those side effects and show scientific backing for their claims.
“Hospitals aren’t held to any of those [FDA] standards at all,” Calkins says. “So a hospital can go out and say, ‘This is where miracles happen. And here’s Joe. Joe was about to die. And now Joe is going to live forever.’ “
Lori Wallace is not going to live forever. Before cancer, she says, she would have been attracted to the messages of hope. But now, she says, she needs realism — acceptance of both the world’s beauty and its harshness. She wrote an essay about that for the women in her breast cancer support group.
The essay is titled “F*** Silver Linings and Pink Ribbons.” Wallace reads me the whole piece from start to finish. We are sitting at her kitchen table. Her son is nearby with his pet snake.
Toward the middle of the essay, Wallace writes, “My ovaries are gone, and without them my skin is aging at hyperspeed. I have hot flashes and cold flashes. My bones ache. My libido is shot and my vagina is a desert.” The essay is open, funny and unflinching, just like Wallace.
She reads me the final paragraph: “I will try to be thankful for every laugh, hug and kiss, and other things, too. That is, if my chemo-brain allows me to remember.”
“That’s what I wrote,” Wallace says. “That’s what I wrote. Brutal honesty.”
This story is part of NPR’s reporting partnership with KQED and Kaiser Health News.


