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Health August 1, 2019

How The Democratic Position On Health Care Has Moved To The Left

NPR’s Ari Shapiro speaks with Dr. Zeke Emanuel, an architect of the Affordable Care Act about the “Medicare for All” issue in the Democratic presidential debates.



ARI SHAPIRO, HOST:

Over the last two nights in Detroit, the biggest debate among Democrats had to do with health care. Some of the presidential candidates want to completely get rid of private insurance companies. Senator Elizabeth Warren of Massachusetts is in that camp.

(SOUNDBITE OF ARCHIVED RECORDING)

ELIZABETH WARREN: The basic profit model of an insurance company is taking as much money as you can in premiums and pay out as little as possible in health care coverage.

SHAPIRO: Other candidates, like former Vice President Joe Biden, want Americans to be able to choose their health care coverage.

(SOUNDBITE OF ARCHIVED RECORDING)

JOE BIDEN: No one has to keep their private insurance, but they – if they would like their insurance, they should be able to keep it.

SHAPIRO: Dr. Zeke Emanuel has heard all this before. He was part of the team that drafted the Affordable Care Act during the Obama administration. And he’s here in the studio. Hey there.

ZEKE EMANUEL: Nice to be with you, Ari.

SHAPIRO: Let’s start with terminology because the phrase “Medicare for All” is being used to describe a lot of different things. In its purest sense, what does true “Medicare for All” actually mean?

EMANUEL: Well, it is – that’s the Bernie Sanders’ sense, and that is, we get rid of private insurance. Everyone is in Medicare fee-for-service. And in Medicare fee-for-service, you get to choose your doctor. The government pays the doctor or the hospital, so there’s no co-pays, no deductibles; vision, hearing aids and other things that aren’t in traditional Medicare packages are covered.

SHAPIRO: Which other Democrats besides Bernie Sanders are on that end of the health care spectrum?

EMANUEL: Well, it appears that Elizabeth Warren is.

SHAPIRO: Right.

EMANUEL: Although, not necessarily all the time.

SHAPIRO: And those are really the only two. Everyone else is sort of on a scale somewhere in between those.

EMANUEL: Right, right. I might say on a scale somewhere in between, that has more government intervention than Barack Obama had in the Affordable Care Act.

SHAPIRO: Yeah.

WARREN: Everyone is further towards more – government taking more responsibility.

SHAPIRO: And I do want to ask you about why the Obama administration went the course that it did. But first, just to understand the facts, right now, when you look at American health coverage, what percentage of Americans get health coverage on the private market as opposed to some form of government-provided health care?

EMANUEL: So you have about 150 to -60 million people have employer-sponsored insurance, and then about another 15 million people have individual coverage or through the exchanges, and that gets you to something like 55 to 60% of the population has private insurance. And then you have another – call it 130 million people who have Medicaid or Medicare coverage. So that’s the breakdown. And we have roughly 89, 90% of Americans have health insurance.

SHAPIRO: So when you were working on the law that became known as Obamacare, there was no discussion of totally eliminating private coverage, but there was discussion of giving everybody the option of getting on Medicare, as is known as the public option. Why didn’t the Obama administration ultimately go that route?

EMANUEL: Politically impossible. The charge against it was led by Joe Lieberman, a senator from Connecticut, where a lot of health insurance companies were based.

SHAPIRO: He was an independent who caucused with the Democrats.

EMANUEL: Correct. But he wasn’t the only one who was opposed to that. There were other Democrats who didn’t take the lead the way Senator Lieberman did, and they were opposed. And it became clear we couldn’t get that provision enacted and passed the bill. And that, I might remind the audience…

SHAPIRO: (Laughter).

EMANUEL: …Was with 60 senators in the Senate and…

SHAPIRO: Sixty Democrats – excuse me.

EMANUEL: Sixty Democrats in the Senate, right, and an overwhelming number in the House. There are people who have other views, and they listen to their constituents. And many constituents, whether union members or people with employers who give them good benefits or, I just don’t want to think about it, and I’d rather let my employer deal with it, those people actually like their system, even if they have complaints about the insurance companies now and then.

SHAPIRO: So as you point out, this debate about political viability a decade ago is happening with 60 Democrats in the Senate. Right now Democrats don’t even control the Senate. We don’t know what the situation will be in 2020. But what do you think the political calculus is in this moment? I mean, do you think that a public option has become more politically viable in the last decade?

EMANUEL: Absolutely. I think it is…

SHAPIRO: Even without a supermajority in Congress?

EMANUEL: I think both Republican and Democratic voters recognize that they want to have security, and a public option does communicate that security to them. It will always be there, and the government will stand behind it. And I do think that tells you – we learn from experience. If the marketplace isn’t working, let’s try something else. And I think that has to be the motivating factor behind any Democratic bill. We’re aiming for universal coverage, and as we learn, we’ve got to revise and reform the system based upon how it’s performing, not based upon some ideological commitment.

SHAPIRO: So how much is the debate that we’re seeing this week among Democrats just about the difference between what it takes to win a Democratic primary and what it takes to actually get legislation through Congress?

EMANUEL: I think most of what we’re hearing is about trying to differentiate your candidacy on health care from other candidates running. I might also say, one of the things that’s been bothering me about the quality of the debate we have is it really is focused on coverage, and I think a much bigger element is affordability. We haven’t had so much talk about the affordability argument, and that really has gotten a very small amount of the debate, and it needs a lot more of that debate.

SHAPIRO: Dr. Zeke Emanuel, one of the architects of the Affordable Care Act, Obamacare, and is now at the University of Pennsylvania. Thanks for coming in today.

EMANUEL: Thank you, Ari. It’s been a pleasure.

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.

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Health July 31, 2019

Trump Administration’s Prescription Drug Importation Plan Is Likely To Face Challenges

The Trump administration announced plans to allow the importation of prescription drugs from Canada. But the plan is just the first step and is likely to face challenges.



ARI SHAPIRO, HOST:

The Trump administration’s launching a process that could eventually allow lower-cost prescription drugs to be imported to the U.S. from other countries, including Canada. This comes as there’s intense bipartisan focus on lowering the cost of prescription drugs. NPR White House correspondent Tamara Keith reports.

TAMARA KEITH, BYLINE: Don’t expect to go to your pharmacy tomorrow and pick up cheap Canadian drugs. What the Department of Health and Human Services announced today is a plan to begin a lengthy rule-making process that could eventually see some pilot projects get the go-ahead. Or, as HHS Secretary Alex Azar put it in an interview on MSNBC, it’s an alert to interested parties that there’s a new historic open-mindedness.

(SOUNDBITE OF ARCHIVED RECORDING)

ALEX AZAR: So that they could start thinking about how they would plan for this because we want to see those plans right away as soon as the regs are ready.

KEITH: There’s been a law on the books for more than 15 years that made importation possible, says Bill Pierce, who was at HHS during the George W. Bush administration.

BILL PIERCE: The law allowed for drug importation. However, it could only happen if the HHS secretary certified it as safe and that it would provide significant savings.

KEITH: But through three administrations, no HHS secretary has made such a certification. And earlier in his tenure, Azar even called the idea of importing cheaper drugs from other countries a gimmick.

RACHEL SACHS: So the fact that he has now stated his intention to encourage its use is a big change for him.

KEITH: Rachel Sachs is an associate professor of law at Washington University in St. Louis who specializes in prescription drugs. Sachs says the Trump administration has made a lot of big announcements like the one today, but there isn’t much to show for it.

SACHS: They’ve already abandoned two of them, and the third is still in the really early stages of being proposed. So they haven’t yet implemented anything that would be particularly beneficial for patients.

KEITH: When it comes to prescription drugs, the politics are a lot simpler than the policy. Voters frequently list drug prices as a top concern. Just this past weekend, Democratic presidential candidate Bernie Sanders took a busload of people to Canada to buy insulin.

(SOUNDBITE OF ARCHIVED RECORDING)

BERNIE SANDERS: People here are paying one-tenth of the price for the vitally important drug they need to stay alive.

KEITH: A Kaiser Family Foundation poll from earlier this year found 80% of those surveyed think Americans should be allowed to buy drugs imported from Canada. But Pierce says importing drugs on a large scale is a lot more challenging than it sounds. U.S. drugs are carefully tracked from manufacturer to the pharmacy counter. But drugs not originally destined for the U.S. don’t have the same supply chain control.

PIERCE: Even though we trust the Canadians, we like the Canadians, we can’t say that. The FDA can’t tell the HHS secretary, I know where that pill’s been.

KEITH: Which could also open up concerns about counterfeit drugs. And Pierce says there’s another issue.

PIERCE: The Canadian government’s not that interested in helping us in any way, shape or form on this because their drug supply’s limited. It’s specific to Canada.

KEITH: The drug industry lobbying group PhRMA raised many of these same concerns in a statement, saying this importation scheme is far too dangerous for American patients. And in the past, the industry’s objections have proven potent.

Another shortcoming critics point out – the administration’s planned proposal won’t cover the class of drugs that includes insulin, the diabetes drug that has focused the public’s attention on the high price of prescription drugs.

Tamara Keith, NPR News.

(SOUNDBITE OF QUART’S “INSPIRATION”)

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.

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Business July 31, 2019

A New Trump Rule Could Weaken A Civil Rights Era Housing Discrimination Law

The Trump administration is moving to weaken the civil rights-era Fair Housing Act — making it much harder to bring lawsuits alleging discrimination in housing, according to housing advocates. But conservative groups applaud the move and say it would stop frivolous lawsuits.

A draft of the Department of Housing and Urban Development rule, obtained by NPR, would target a powerful weapon that’s used in discrimination cases. It’s called “disparate impact.” That means that to prove discrimination in a lawsuit, plaintiffs don’t have to prove, for example, that a bank employee is refusing to make loans to people of color. They just have to show that a company has a business practice that, on its face, may not purposefully discriminate but has a discriminatory effect.

Wanda Onafuwa says a house next door to her in Baltimore fell into disrepair after Bank of America foreclosed on the property.

Courtesy of Wanda Onafuwa


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Courtesy of Wanda Onafuwa

“It’s important because it allows us to really get at discrimination that’s not intentional,” says Nikitra Bailey, a lawyer with the nonprofit Center for Responsible Lending. She says the Trump administration’s new rule would severely restrict this very important tool for fighting discrimination in housing.

“It’s huge,” Bailey says, because it allows fair housing lawsuits to obtain remedies for large numbers of people “without having to demonstrate each individual action of discrimination.”

The proposal, which is not yet public, is expected to be released in August.

In one current case, a fair housing group is suing Bank of America, alleging that when the bank foreclosed on homes in recent years, it treated the vacant houses very differently in white neighborhoods than it did minority neighborhoods.

Wanda Onafuwa lives next to one of these houses in Baltimore’s Tremont neighborhood. She works in accounting, owns her house and raised her kids there. She says it’s a nice, quiet street. But then Bank of America foreclosed on the house next door, and it fell into worse and worse disrepair.

“The grass wasn’t being mowed, there were no windows upstairs,” Onafuwa says. “So you have a bad rainstorm, and I don’t know what was going on with the roof, water would get in.”

She says water would fill the basement and then spill over into her basement. “There were rats running around.”

Onafuwa says she called the city and the bank repeatedly, but not much changed. Then, she says, a squatter started living in the vacant house — “a guy going in and out.” That’s even though, she says, there was no electricity hooked up. “It just looked pitch-black,” she says.

Lisa Rice, president of the National Fair Housing Alliance, which is bringing the lawsuit, says her group looked at foreclosed properties in more than 70 communities across the country with comparable levels of owner-occupied homes and other similarities.

“In the white communities that we looked at, the story was completely different,” she says. “The grass was mowed, the doors were secure, the windows were not broken, we didn’t see trash and debris.”

Bank of America said in a statement that it denies the claims in the lawsuit. “Our commitment to sustainable homeownership for low- to moderate-income and multicultural clients and communities has always been a hallmark of Bank of America,” it said.

But in a disparate impact lawsuit, you don’t have to show that a company meant to discriminate. The company might have had the best of intentions but still have adopted a policy that has an unequal outcome with a discriminatory effect.

Rice says these types of Fair Housing Act cases go back more than 40 years. In 2015, the Supreme Court upheld the use of disparate impact while imposing some limitations. But many corporations and conservatives don’t like this legal approach.

“There are always going to be racially disproportionate results for any policy,” says Roger Clegg, president of the Center for Equal Opportunity, a conservative think tank that focuses on civil rights issues. Clegg, who worked in the Justice Department in the Ronald Reagan and George H.W. Bush administrations, says these disparate impact cases are often unfair to defendants because the cases find discrimination where it’s not actually happening.

“If you have a landlord who says, ‘I’m not going to rent to people with a history of violent crime,’ ” he says. “The fact that that has a racially disproportionate result does not make it discrimination.”

So he says this disparate impact approach results in a lot of unfair lawsuits. And he says the Trump administration’s new rule will provide clarity about the limits under the 2015 Supreme Court decision.

But Bailey, of the Center for Responsible Lending, says the proposed rule goes way beyond that. “It really makes it more difficult to bring disparate impact cases, and then it limits the damages for discrimination,” she says.

Bailey says with African American homeownership rates at their lowest level in 50 years, this could set up more roadblocks.

The Department of Housing and Urban Development says it can’t comment on the proposed rule yet. But in an earlier statement, HUD Secretary Ben Carson said the department “remains committed to making sure housing-related policies and practices treat people fairly.”

But civil rights advocates say they’re worried. They say that beyond this proposed housing rule, the Trump administration is looking to roll back civil rights protections in education and in terms of which groups of people deserve protection from discrimination.

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Entertainment July 31, 2019

The Sisters Of A-WA Share Their Great-Grandmother’s Refugee Story

VuHaus

“Hana Mash Hu Al Yaman”

“Mudbira”

“Malhuga”

Tair, Liron, and Tagel Haim are three sisters who record as A-WA. They are Arab Jews who live in Israel and spread the Yemeni folk traditions of their heritage around the world through electronic music. On the group’s latest album, Bayti Fi Rasi, the sisters tell the story of their great-grandmother, Rachel, who fled Yemen and arrived in Israel as a refugee as part of Operation Magic Carpet in 1949. Many of the songs, like “Hana Mash Hu Al Yaman” (meaning “Here Is Not Yemen”) address the difficulties Rachel faced on both sides of her journey as a refugee.

The sisters dropped by World Cafe to perform inviting and unique songs from Batyi Fi Rasi and to talk about their own journey as musicians from a small desert village in Israel to the international stage.

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Sports July 30, 2019

U.S. Soccer Argues It Pays Women More Than Men In Latest In Pay Inequality Lawsuit

NPR’s Audie Cornish speaks with Rachel Bachman, senior sports reporter for the Wall Street Journal, about the dispute between the U.S. Soccer Federation and the U.S. Women’s Team over pay inequality.



AUDIE CORNISH, HOST:

There’s been controversy for years about how the women’s U.S. soccer players get paid less than the men. This is despite the fact that the women are World Cup champions and the men didn’t even qualify last time around. The women’s team sued the U.S. Soccer Federation over this pay gap in March of this year. And now the U.S. Soccer president, Carlos Cordeiro, released a letter yesterday saying that, in recent years, the federation paid the U.S. women’s players more than the men. Now, to talk about this, we’re joined by Rachel Bachman. She’s a senior sports reporter for The Wall Street Journal.

Welcome to the program.

RACHEL BACHMAN: Thanks so much, Audie, great to be here.

CORNISH: So before we get to the new information from the head of U.S. Soccer, why do the women believe they’re being paid less?

BACHMAN: What they’re mainly looking at is what the U.S. Soccer Federation pays to them for playing in national team games. They’re saying that U.S. Soccer pays us significantly less for playing in those games than it pays the men’s national team.

CORNISH: So now this letter, which was released by the U.S. Soccer president, Carlos Cordeiro, he’s saying that, hey, actually, the federation pays the women players more. What’s his claim?

BACHMAN: What U.S. Soccer is doing in this letter is it’s including the salaries that it pays the women to play in the professional league. Now, this is separate from these players’ play for the women’s national team. And the players are saying, look, you’re making an apples to oranges comparison. Our playing in the professional league is separate from what we get or should get from playing on the women’s national team. And U.S. Soccer is saying, no, we’re including everything we spend on you. And that’s the fair way to account for it.

CORNISH: You report that the men’s team has weighed in. What do they say?

BACHMAN: The men’s team has issued a statement today in support of the women saying that they’re fighting for fair compensation and they support them in that fight.

CORNISH: The timing of this is just before the mediation is supposed to begin over the pay discrimination lawsuit. Is the timing important? What’s next with this dispute?

BACHMAN: I think the timing is important, and you could say that U.S. Soccer is trying to defend itself against what’s been months of talk in the public about the U.S. women, certainly the public, many of them falling in love with the women watching them play and win the World Cup.

CORNISH: Right, chants of equal pay echoing through the stadium – right? – when they won.

BACHMAN: Yes and again in New York City during the ticker tape parade held to celebrate their victory. So I have no doubt that U.S. Soccer got sort of frustrated by seeing this groundswell feeling like their views weren’t represented. So I think this letter was partly their argument that, hey, our accounting should matter and this is the way we see things.

CORNISH: Is this a sign that U.S. Soccer is not willing to give up without a fight, that despite this kind of very public support that the women have embraced, U.S. Soccer still thinks it has a chance to make an argument here?

BACHMAN: Yes. And we know because Carlos Cordeiro, the federation president, emailed the players yesterday saying, look, we’re getting a lot of heat from our sponsors, from Congress, about this issue. And so we know they’re under extreme pressure, but at the same time, they don’t show signs that they’re going to, you know, shut up and go away. I think that they feel like these issues need to be debated and settled.

CORNISH: That’s Rachel Bachman of The Wall Street Journal.

Thank you so much for your reporting.

BACHMAN: Thank you, Audie, appreciate it.

CORNISH: And one more piece of news about the women’s team today – coach Jill Ellis announced she’s stepping down in October. In a statement, she said, quote, “the timing is right to move on.” She also thanked the federation for its support and investment in the program.

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.

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Business July 30, 2019

U.S.-China Trade Talks Resume

As slow-moving trade talks with China resume this week, NPR’s Ari Shapiro speaks with Wendy Cutler, a veteran U.S. trade negotiator.



ARI SHAPIRO, HOST:

Trade negotiators from China and the U.S. are resuming talks in Shanghai, and both sides are downplaying chances for a real breakthrough.

(SOUNDBITE OF ARCHIVED RECORDING)

LARRY KUDLOW: I wouldn’t expect any grand deal.

SHAPIRO: That’s Larry Kudlow, director of the White House National Economic Council speaking Friday on CNBC.

(SOUNDBITE OF ARCHIVED RECORDING)

KUDLOW: I think talking to our negotiators, they’re going to kind of reset the stage and hopefully go back to where the talks left off last May.

SHAPIRO: Wendy Cutler is a veteran U.S. trade negotiator, and she joins us to preview the latest season of this long-running drama. Welcome back, Wendy.

WENDY CUTLER: Thank you, Ari.

SHAPIRO: Did last season end on a cliffhanger? Remind us what happened when talks left off in May.

CUTLER: Well, the talks broke down last May, and this was really over the issue of which negotiating text to work off of. The U.S. had sent China a text with about 150 pages of what the U.S. thought had been agreed upon and was quite surprised when China sent the text back with about 30 pages just crossed out of the text. And as a result, the talks broke down.

SHAPIRO: What’s the issue that is making it so difficult for negotiators to make a deal?

CUTLER: There are a lot of difficult issues on the table, including how to address the current tariffs that have been put in place. China wants all those tariffs lifted. The United States wants to keep some in place. And there’s a whole range of what we call structural issues whereby the United States is asking China to curtail its industrial subsidies, to stop its practices of forcing U.S. companies to turn over their technology and to strengthen its intellectual property protection regime, as well as enforcement of its intellectual property laws.

SHAPIRO: Yeah. The U.S. is asking China to make some really sweeping changes beyond who buys what and what they pay for it. Is China seriously entertaining any of this?

CUTLER: My understanding is yes they are. With respect to forced technology transfer, I think China is coming to grips with the fact that this is an unfair trade practice and that they need to change their existing practices trying to force our companies to hand over their technology secrets to their potential Chinese competitors.

SHAPIRO: Wow. If China really did enforce technology transfer, that would be huge. I mean, we’ve heard a lot of American farmers saying, yes, this is painful, but it’ll be worth it in the long run if we get a big breakthrough. That sounds like if it happened, it would be a big breakthrough.

CUTLER: It would be a tremendous breakthrough. But what will be key is that China actually enforces the obligation that it’s undertaken. And that has prevented progress in the past. And that’s why this administration is pressing so hard for a strong enforcement mechanism.

SHAPIRO: President Trump has been very black and white, as he is on so many things, when he discusses this. He says trade wars are easy to win. The standoff has been good for American manufacturers, even though the evidence suggests that’s not necessarily true. Yesterday, he tweeted that, for China, until now, the U.S. has been easy pickings. Is his objective clear here?

CUTLER: I don’t think so, and I think China is confused about what the U.S. is seeking in these negotiations. Some days, it seems to be that the U.S. just wants to see increased purchases and the reduction in the U.S. bilateral trade deficit with China. Other days, it seems these structural issues are the most important. And so this has confused the Chinese, and I think as a result has made this negotiation unnecessarily even more difficult than it would be.

SHAPIRO: President Trump also told reporters today the companies are leaving China to avoid the U.S. tariffs. Is that true? And if so, are they coming to the U.S. or are they going to some other country like Vietnam that doesn’t have similar tariffs?

CUTLER: Well, there are anecdotes of U.S. companies but also Chinese companies that are leaving China in order to evade these tariffs. But at least for China, it seems that they’re moving their operations to Southeast Asia and countries like Vietnam and not coming to the United States.

SHAPIRO: And is China making moves to try to be less reliant on the U.S. market as these talks drag on?

CUTLER: Absolutely. And I think important signal of this is that this coming weekend, China will be for the first time hosting the ministers of the Regional Comprehensive Economic Partnership negotiations, trying to unlock those negotiations so a deal could be reached by the end of this year. Unclear about whether this meeting will be successful but, wow, in the same week for the trade minister to be meeting with Ambassador Lighthizer and Secretary Mnuchin and then later in the week meeting with 15 ministers from all around Asia – what a busy week he’s having.

SHAPIRO: That is former U.S. trade negotiator Wendy Cutler. She’s now vice president of the Asia Society Policy Institute.

Thanks for speaking with us.

CUTLER: Well, thank you.

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.

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Health July 30, 2019

Trump Signs Extension To Sept. 11 Victims Compensation Fund

After years of legislative gridlock, the victim compensation fund has been extended to ensure permanent funding for rescue workers whose jobs after the terror attacks caused health problems.



STEVE INSKEEP, HOST:

A 9/11 first responder has a chance to savor victory. President Trump signed a measure ensuring a compensation fund never runs out of money. NPR’s William Jones reports on how that moment looks to a man who fought to bring it about.

WILLIAM JONES, BYLINE: John Feal was a construction worker until his career was cut short in 2001. In the days after 9/11, he was a demolition manager at ground zero when a piece of steel crushed his leg. Part of his foot had to be amputated. And in the years since, he’s been lobbying lawmakers to approve permanent funding for first responders, whose illnesses continue to mount.

JOHN FEAL: Two-hundred and seventy-eight trips to D.C. We’ve been at this for almost two decades now because of poor leadership and bad politics.

JONES: Feal was at a congressional hearing in June. He watched on as his colleagues, some gravely ill, addressed a House committee. He remembers thinking that some lawmakers seemed disengaged, which he told his friend, the comedian Jon Stewart, just as he arrived to testify.

(SOUNDBITE OF ARCHIVED RECORDING)

JON STEWART: Your indifference cost these men and women their most valuable commodity – time.

JONES: Stewart’s comments came as an existing $7.4 billion fund was rapidly depleting, as thousands were becoming ill.

RICHARD ALLEYS: These aren’t just normal cancers; we call it cancer on steroids. They get diagnosed with stage 4. These are aggressive, aggressive cancers, and that’s why we’ve lost so many people.

JONES: That’s Richard Alleys. He was a firefighter at ground zero, and he believes Stewart’s testimony was a turning point.

ALLEYS: He just had that innate ability to put the spotlight on the legislators that could no longer hide.

JONES: After that hearing, legislation extending funding through 2092 to pass the House, but it faced a slightly stiffer opposition in the Senate, where Republicans Rand Paul and Mike Lee led a vote, questioning whether the bill was fiscally responsible. It eventually passed overwhelmingly, leaving the president to sign it into law.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: For your entire lives, you have gone far beyond your duty to us. And today, we strive to fulfill our sacred duty to you.

JONES: After signing the bill, the president handed the pen to John Feal.

FEAL: The financial burden, it’s going to be lifted. This bill is going to help people for decades.

JONES: It ensures his almost 300 trips to D.C. will now have a lasting legacy.

William Jones, NPR News, in Washington.

(SOUNDBITE OF AMBIENT JAZZ ENSEMBLE’S “ELEVEN DAYS”)

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.

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Entertainment July 29, 2019

Watch U.K. Jazz Group Sons Of Kemet Deliver An Explosive Midnight Set

“Jazz built for arenas.”

A friend and former rock critic shared this admiring assessment of Sons of Kemet, after seeing the band for the first time at this year’s Big Ears Festival. There’s obviously truth in it: Over the last eight years, Sons of Kemet has not only fueled the fires of a raging London jazz scene; it has also scaled up the pyrotechnics, in strictly musical terms.

With Shabaka Hutchings on tenor saxophone, Theon Cross on tuba, and Eddie Hick and Tom Skinner on drums, it’s a hardy combustion engine that also feels like a breathing organism. Arenas, sure, but this is also jazz built for street parties. And certain proudly eclectic fests.

At Big Ears in Knoxville, Tenn., Sons of Kemet brought its exultant blend of carnival rhythm, club abandon and jazz improv to a midnight show that packed The Mill & Mine, a cavernous room that once housed the Industrial Belting and Supply Company. The set drew from a knockout recent album, Your Queen Is a Reptile, but with a spirit of freedom in the moment — whatever setting you think suits it best, it’s music made for a perpetual now.

PERFORMERS
Shabaka Hutchings: saxophone; Theon Cross: tuba; Tom Skinner: drums; Eddie Hick: drums

CREDITS
Producers: Sarah Geledi, Colin Marshall, Katie Simon; Head of Recording: Matt Honkonen; Lead Recording Engineer: Jonathan Maness; Assistant Recording Engineer: Ryan Bear; Concert Audio Mix: David Tallacksen, Josh Rogosin; Concert Video Director: Colin Marshall; Videographers: Tsering Bista, Annabel Edwards, Nickolai Hammar, Kimani Oletu; Editor: Maia Stern; Project Manager: Suraya Mohamed; Senior Producers: Colin Marshall, Katie Simon; Supervising Editors: Keith Jenkins, Lauren Onkey; Executive Producers: Gabrielle Armand, Anya Grundman, Amy Niles; Funded in Part By: The Argus Fund, The Andrew W. Mellon Foundation, The Ella Fitzgerald Charitable Fund, The National Endowment for the Arts, Wyncote Foundation

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Business July 29, 2019

Boeing 737 Max Grounding Takes Toll On Airlines And Passengers

Boeing 737 Max airplanes are stored in an area adjacent to Boeing Field, on June 27, in Seattle. Airlines around the world are cutting flights because of the grounding of the plane.

Stephen Brashear/Getty Images


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When Nancy Dunne goes to see her family outside Chicago, she likes to fly Southwest Airlines from Newark Liberty International Airport near her home in Maplewood, N.J.

Starting in November, she’ll need to make alternate arrangements.

Last week, Southwest announced it would no longer fly to Newark. The grounding of the Boeing 737 Max after two deadly crashes in Ethiopia and Indonesia has forced the airline to cancel flights and consolidate routes into places such as Newark, which are less profitable.

“For me this is really a big thing. I’ll figure something out. Maybe it’s time for me to move back to Chicago,” says Dunne with a laugh, as she stands near the airport’s Southwest counter.

When the 737 Max was taken grounded last March, carriers around the world were forced to adjust suddenly, canceling thousands of flights and delaying the retirement of some older planes.

Now, the impact of the grounding on airlines and their passengers is becoming more clear: smaller profits and more crowded planes.

“Obviously it was a shock to everybody in the industry,” says airline analyst Richard Aboulafia. “But of course this has grown significantly as a problem over the past few months.”

In recent days, airlines have begun releasing their earnings reports for the second quarter, and some major carriers have taken a big hit.

No longer able to use their 737 Maxes, airlines have been forced to reduce the number of routes they serve. American Airlines has cancelled 115 flights per day, potentially affecting about 23,000 passengers daily.

Foreign carriers have been hit as well. Flydubai, a low-cost Middle East airline serving 95 destinations, has canceled 17% of its flying schedule. European budget airline Ryanair warned Monday that it may have to lay off employees because of the grounding.

With so many cancellations, flights are naturally becoming more crowded. Southwest, which flies more 737 Maxes than any other U.S. carrier, said last week that the number of passengers per jet had risen during April, May and June.

“For customers, what people will notice compared with the same season of last year is the airplanes have become fuller,” says Yi Gao, associate professor in the School of Aviation and Transportation Technology at Purdue University.

The cancellations are also having an impact on the airlines’ bottom line. Southwest said the grounding had reduced its second-quarter profit by $175 million.

Boeing has set aside nearly $5 billion for losses tied to the grounding, and some part of that will go toward compensating the airlines for their losses. But how much it will pay is to be negotiated individually.

Fortunately, these are good times for the airline industry, with heavy demand for seats, and airlines such as Southwest are still making money.

“At the moment the U.S. economy is strong, so people are traveling. No matter [if it’s] business persons or leisure travelers, they’re all traveling,” Gao says.

But the longer the grounding goes on, the more precarious each airline’s positions will be.

Aboulafia notes that the 737 Max is part of a new generation of planes that were supposed to be much more fuel efficient than their predecessors. Being forced to use older planes will make operations more costly, he says.

“Increasingly, there are other airlines that have new-generation Airbus jets, and they’re at a competitive advantage” in terms of efficiency, he says.

That’s bad news for carriers like American, United and Southwest that rely on the 737 Max, and good news for those — such as Delta Airlines — that don’t.

And right now, no one can say for sure when the 737 Maxes will be back in the air. While Boeing hopes to get them flying by October, the 737 Max’s fate remains in the hands of regulators.

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Health July 29, 2019

Doctors In The U.S. Use CRISPR Technique To Treat A Genetic Disorder For The 1st Time

For the first time, doctors have used the gene-editing technique CRISPR to treat a genetic disorder in the U.S. The patient, who has sickle cell disease, spoke with NPR about her treatment.



ARI SHAPIRO, HOST:

One of the most eagerly awaited medical experiments has begun in Nashville. For the first time, scientists have used the gene-editing technique called CRISPR to try to treat a genetic disorder in the United States. NPR is the only news organization to have learned the identity of the first patient and to talk with her. NPR health correspondent Rob Stein is here with more.

Hey, Rob.

ROB STEIN, BYLINE: Hey, Ari.

SHAPIRO: Who is this woman, and why is she undergoing this experimental treatment?

STEIN: Her name is Victoria Gray, and she’s 34 and lives in Forest, Miss., with her husband and four kids. And here’s a little bit about what she told me about herself when I met with her recently at the Sarah Cannon Research Institute in Nashville.

VICTORIA GRAY: Well, I don’t work. I’m a stay-at-home mom. But before I got too sick, I was working in the beauty department at Walgreens, and I was going to school to become a nurse. But that got put on hold for health reasons.

SHAPIRO: Tell us about her sickness. What is her condition?

STEIN: Yeah, so Victoria has sickle cell disease, and it’s a terrible genetic disease that primarily affects African Americans in the United States. And instead of having normal red blood cells – you know, the cells that carry oxygen in your body – sickle cell patients have a hard, sticky – it’s a sickle-shaped red blood cell that causes terrible bouts of agonizing pain and can cause lots of really serious health problems.

GRAY: Well, I’m high-risk for strokes, and I’m high-risk for heart attacks. And these things can happen to me in a blink of an eye. And my pain episodes can just come on out of the blue. I can just be laughing, and next minute, I’m crying, you know, in some of the worst pain that you could ever imagine. It’s a heavy load to carry, you know?

SHAPIRO: That sounds really tough. So how are doctors trying to use CRISPR to help people like Victoria Gray?

STEIN: Right, so this is how it works. The doctors – they take cells out of the bone marrow of sickle cell patients, and they use this CRISPR editing tool to edit a gene in those cells to turn on the production of something called fetal hemoglobin, which is usually only produced by fetuses when they’re in the womb and babies for a short time after they’re born. And then they infuse billions of these genetically modified cells from the patient back into their bodies, hopefully, to help treat their disease.

Dr. Haydar Frangoul, who’s running the study in Nashville – he explained a little bit more about how this is going to work.

HAYDAR FRANGOUL: What we are trying to do here is we are trying to introduce enough fetal hemoglobin into the red blood cell to make the red blood cell go back to being happy, squishy and not sticky and hard and can go deliver oxygen where it’s supposed to.

SHAPIRO: So she is the first sickle cell patient to get this treatment. What does it involve? What was the process like?

STEIN: Yeah, so parts of it were really pretty hard. She had to go through chemo, first of all, to wipe out her own bone marrow to make room for these CRISPR-edited cells. And then Dr. Frangoul infused more than 2 billion of those gene-edited cells into her body, and this was just a few weeks ago.

GRAY: They had the cells in a big syringe, and when it went in, my heart rate shot up real high. And so that was a little scary, tough moment for me. And just after that, I cried, but it was happy tears.

STEIN: What was that feeling like?

GRAY: It was amazing. You know, it was kind of overwhelming after all that I had went through to finally, you know, get what I came for.

STEIN: And Victoria – she calls her new gene-edited cells – she calls them her supercells.

Why do you call them supercells?

GRAY: Well, I have sickle cell, so just replacing it with a better S (laughter) makes it supercells.

SHAPIRO: Rob, it sounds like there’s a lot of potential here. But what are the concerns?

STEIN: Yeah, so, you know, there are always concerns about any new, experimental treatment. Is it safe? Will it work? And this is all really magnified with something that’s this new. Here’s Laurie Zoloth. She’s a bioethicist at the University of Chicago. And I talked to her about that.

LAURIE ZOLOTH: I am optimistic about the success of CRISPR. I just want it to be done carefully.

STEIN: Yeah, so they’re going to monitor her very closely, first of all to make sure the edited cells are safe, they’re not causing any health problems on their own, and then to try to get any clues to see if they might be working. And researchers are planning to study dozens of patients at medical centers in this country and in Canada, in Europe. It could take months, and maybe even years, to know how well it’s working.

And I talked to Victoria about that. She says she knows the risks and that it is a very early study, but she can’t help but hope that it helps her.

GRAY: I feel like the way everything had been, it was kind of fate. And I feel special to be the first to do it.

STEIN: And we’re going to be checking back with Victoria just to see how things are going.

SHAPIRO: That’s NPR’s Rob Stein with that exclusive story about CRISPR gene-editing technology.

Thank you, Rob.

STEIN: You bet, Ari.

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