NPR’s Steve Inskeep talks to Caley Fretz, editor-in-chief of Cycling Tips, about this year’s Tour de France. It is the first time that a cyclist from Colombia has won the race.
STEVE INSKEEP, HOST:
For the first time in the history of the Tour de France, a Colombian cyclist has won. His name is Egan Bernal, and he is also the youngest rider to win the Tour in more than a century. In Bernal’s home country, thousands of people gathered to celebrate. Here is Colombian broadcaster Alfredo Castro.
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ALFREDO CASTRO: (Speaking Spanish).
INSKEEP: I hardly need translation there. But he’s saying, “the Colombian victory – Egan Bernal. Extraordinary what has happened today. My voice escapes me; my heart is exploding.” Maybe not the most unbiased journalism ever, but you get the point.
Caley Fretz is editor-in-chief of CyclingTips, and he was watching the Tour de France. He’s in Paris. Welcome to the program.
CALEY FRETZ: Thanks for having me.
INSKEEP: What was it like to be watching this event?
FRETZ: Oh, it was incredible. It was a fantastic, fantastic Tour of France for a whole bunch of reasons, not least the fact that it was capped by a victory I guess unlike we’ve seen in a very long time. Twenty-two-year-old Egan Bernal, as you said, took his first win at the Tour de France, sort of took the torch, so to speak, from his own teammate Geraint Thomas, who won it last year. And we had this whole story wrapped around French champion Julian Alaphilippe, who kept us all on the edge of our seats until the very end of the Tour de France.
INSKEEP: You know, it’s not unheard of to have a superstar athlete who’s 22 in some other sports. But it sounds like it’s pretty rare in cycling. Is there something about cycling that normally you need a little more maturity to win a race like this?
FRETZ: Yeah, and in particular the Tour de France because this is – it’s a three-week race. It’s 21 stages. They ride 3,500 kilometers over the course of those three weeks. It just takes a bit longer to kind of get the kilometers in your legs, the miles in your legs. So it is very unusual to have an athlete this good this young. It’s not unheard of. Laurent Fignon, one of the most recent French winners of the Tour de France, he won it at 23. So…
INSKEEP: OK.
FRETZ: …It’s not impossible.
INSKEEP: Got you. Now, there was an unusual event in the course of this race. As I understand it, the stage in which Bernal took over as the overall leader, they actually had to stop the race at one point. What happened?
FRETZ: Yeah. So we’re up in the Alps. And as often happens in the mountains, some storms came through. And we got about – I don’t know – 3 or 4 inches of hail in a very small area on the…
INSKEEP: Wow.
FRETZ: …Back of the Col de l’Iseran. And that caused massive flooding and a landslide. And so Egan Bernal was actually off the front already in the race. He was descending off the back of this climb and had about – I think a minute gap or so. And they had to shut down the race and take the time from the top of the climb. It was kind of the only option. There was absolutely no way for the Tour de France to get through.
INSKEEP: Landslides, flooding and hail – that’s pretty intense if you’re on a bike. I have to ask because there were allegations of doping over the years in the Tour de France. Does it seem like this was a clean race so far as anybody knows?
FRETZ: Oh, that’s a very difficult question. It is – it felt cleaner – it’s felt cleaner for quite some time. Cycling is – among international sport, I think it’s one of the best in terms of its antidoping efforts at this point. It’s been on the biological passport for a very long time. I do firmly believe that the sport is as clean as it’s ever been right now. But you never really know. It’s still international sport. I think we all – well, we all know what happens in international sport (laughter).
INSKEEP: I guess you learn…
FRETZ: So I’d like to believe, I would.
INSKEEP: You learn more things over time. But what we know now is that Egan Bernal, at the age of 22, is the winner – the champion of the Tour de France.
Mr. Fretz, thanks so much.
FRETZ: You’re welcome.
INSKEEP: Caley Fretz is the editor-in-chief of CyclingTips and joined us from Paris.
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.
Facebook CEO Mark Zuckerberg testifies before the House Energy and Commerce Committee on April 11, 2018.
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Andrew Harnik/AP
Updated at 1:23 p.m. ET
Facebook has a long track record in deception: telling people one thing, while doing another. That’s according to federal regulators, at least one of whom says the government missed its chance to find out why the company has repeatedly misled its users.
This past week, the Federal Trade Commission decided to enter into a settlement with Mark Zuckerbergwithout interviewing him first. The FTC secured a $5 billion penalty from Facebook but, FTC Commissioner Rohit Chopra says, the agency sacrificed discovering the truth about the CEO in the process.
“It’s still really a mystery to me as to what role [Zuckerberg] played,” says Chopra, who opposed the settlement.
The FTC complaint against Facebook highlights a prominent moment when Zuckerberg said one thing while his company did another.
“The thing is, we don’t ever want anyone to be surprised about how they’re sharing on Facebook. I mean that’s not good for anyone,” Zuckerberg told the audience of Facebook’s annual F8 conference in 2014.
Regulators at the FTC had investigated Facebook for taking the personal data of users and, without consent, handing it off to outsiders — third-party app developers. Following that and other embarrassing revelations, Zuckerberg made a promise.
“Now, everyone has to choose to share their own data with an app themselves,” he said. “We think that this is a really important step for giving people power and control.”
Sounds great. Only, it wasn’t true. According to the FTC, Facebook kept handing over user data secretly — without consent — to dozens of outside developers (like Cambridge Analytica, the political research firm that worked on President Trump’s campaign).
It wasn’t the only time Zuckerberg misrepresented the truth. In 2018, he did it again — this time not on his own stage, but in front of the entire country.
Zuckerberg — summoned to the U.S. Congress — apologized for enabling Russian interference in the American elections, for helping to spread fake news and hate speech, and for violating the privacy of users.
“It’s clear now that we didn’t do enough to prevent these tools from being used for harm as well,” he testified. “And that was a big mistake, and it was my mistake, and I’m sorry. I started Facebook. I run it, and I’m responsible for what happens here.”
Sounds great. Only, in the same month Zuckerberg gave that testimony (it was in April 2018), regulators say, the company began to use facial-recognition tracking on some 60 million users — again, without consent.
The FTC’s Chopra voted against entering the settlement with Facebook.
“We cut off this investigation too early, [and] Facebook was willing to pay more money in order to hide Mark Zuckerberg’s testimony from this investigation,” he says.
Three Republican FTC members voted in favor of settling. The FTC extracted a $5 billion penalty from Facebook. Agency officials say that’s more than the government would have gotten in court, if they’d litigated.
Chopra, a Democrat, says his agency underplayed its hand, and missed the opportunity to uncover if Zuckerberg’s misrepresentations were intentional. The FTC spoke to Zuckerberg’s lawyers, but not to him. He was not required to answer questions or turn over his emails; and the settlement lets the CEO off the hook for the many privacy mishaps the FTC scrutinized. Zuckerberg did not personally face charges for violating an earlier settlement his company had reached with the FTC in 2011, though he could have been.
“Facebook fully cooperated with the FTC’s investigation and provided tens of thousands of documents, files and emails—including from Mark Zuckerberg,” Colin Stretch, Facebook’s general counsel, said in a statement Sunday after this story aired.
The new FTC settlement includes provisions that could hold Zuckerberg liable, through civil and criminal penalties, for any future violations of the agreement with the commission.
Zuckerberg’s actions may stand at odds with the philanthropic, altruistic image he’s worked hard to cultivate. CEOs break rules all the time. The ousted chief of Uber appeared to take pride in bulldozing his way into cities, assuming the laws that apply to cabs didn’t apply to his operation. But Zuckerberg has worked very hard to project the image of model super citizen: Harvard dropout committed to connecting the world with an American brand that’s more omnipresent that Coca-Cola; funding woefully neglected school systems; and conducting a listening tour to hear real people.
(Facebook is one of NPR’s financial sponsors.)
It bothers Chopra that his agency didn’t pursue the truth because Zuckerberg isn’t just a CEO. He has structured the stock so that he controls the majority of votes in Facebook. Chopra explained in his written dissent that in other cases, when a chief calls the shots in a company, the FTC takes a hard look at them.
“We didn’t even want to look at something that seemed fundamentally important, and instead traded it away for a higher fine, and none of that money will actually go to Facebook’s users,” Chopra says. The $5 billion goes to the U.S. Treasury, as mandated by law.
Zuckerberg lauded the settlement, saying in a post that his company has a “privacy-focused vision” and that, while Facebook already works hard to protect people’s privacy, “now we’re going to set a completely new standard for our industry.” He did not mention that his company fought tooth and nail, according to regulators, against the fine and new external oversight the deal imposed on Facebook.
Meanwhile, Zuckerberg’s team is on Capitol Hill, trying to get permission to mint money — a new digital currency. This cannot succeed without the public trust. Facebook is making the case that lawmakers and regulators should trust it. But Chopra says he doesn’t trust Zuckerberg or his company.
NPR business desk intern Amy Scott contributed to this report.
Zara’s parent company Inditex announced new sustainability goals this month. But can a fast-fashion brand built on growth truly become sustainable?
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Marcos del Mazo/LightRocket via Getty Images
As a fashion brand, Zara has made a name for itself by democratizing the latest clothing styles for consumers at an affordable price. But the rapid pace of that trend-driven business model, known as “fast fashion,” can come at high environmental and social costs.
Last week, Zara’s parent company, Inditex, announced its plans to grow more sustainable.
The fast-fashion giant pledged that by 2025, all of its eight brands will only use cotton, linen and polyester that’s organic, sustainable or recycled, which is 90% of the raw materials its uses. CEO and executive chairman Pablo Isla said that renewable sources will power 80% of the energy consumed by the conglomerate’s distribution centers, offices and stores. It also plans to transition to zero landfill waste.
It’s a significant step for a company that churns out 500 new designs per week, says Elizabeth L. Cline, the author of two books on the impact of fast fashion.
“What they’re doing is they’re sourcing materials that do have a better environmental profile,” she says. “These are materials that use less water, less energy, less chemicals to produce.”
Cline says the move sends a powerful message down the supply chain to manufacturers about being more green.
Still, Cline cautions that the announcement should be taken with a grain of salt, arguing that fast fashion and sustainability are inherently incompatible.
Cline says that even if Zara is using materials that are more ethically sourced or have a lower environmental impact, the vast majority of the carbon footprint of fashion comes from the manufacturers who supply brands with their materials. When a business is built on a fast turnover of styles, making those products still swallows a lot of energy, regardless of whether it’s using organic cotton or selling products in more eco-efficient stores.
“The business model will have to change and evolve for them to operate sustainably,” she says.
Agriculturally, growing cotton impacts soil health, carbon emissions and water consumption, says Mark Sumner, who lectures on fashion and sustainability at the University of Leeds in England. Polyester, a popular and cheap synthetic material in fast fashion, requires the oil industry’s extraction and refinement of petroleum, processes known to fuel climate change. Then there’s the energy-intensive processes of converting that raw material into wearable garments. Dying the fabric can also introduce harmful chemicals.
“When we add up all of those different impacts we then start to get to see a picture of those environmental issues associated with clothing,” he says.
What complicates things even more, says Sumner, is that depending on who you ask, the definition of sustainability can vary.
“The fashion industry isn’t actually just one industry, it’s a whole raft of other industries that are used and exploited to deliver the garments that we’re wearing now,” he says in an interview with NPR’s All Things Considered.
Which is why Cline thinks any excitement over Inditex’s announcement needs to be tempered.
“They’re acting overly confident about a subject that we’re still figuring out,” she says. “We are still gathering data. We are still figuring out best practices. So for Zara to kind of come out of the gate and say we’re going to be sustainable by 2025 belies the long road ahead of us that we have on sustainability and fashion.”
Inditex is committing $3.5 million to researching textile recycling technology under a partnership with the Massachusetts Institute of Technology, an investment Cline supports.
At the same time, Cline says it can’t be up to the fast-fashion industry alone. Consumers and government regulators have a role to play too.
Inditex’s announcement is a response to consumer pressure, Cline says. “We’re in the midst of a consumer-led revolution in fashion sustainability.”
Unfortunately, she says, a big part of that movement is tilted toward greenwashing — a term that refers to a deceptive marketing ploy in which companies spend more effort on its eco-consciousness image than actually being eco-conscious.
The fact that Zara’s parent company has gone public with its sustainability targets is a good sign, Sumner says.
“Over time, they’ll be held accountable by their shareholders, by NGOs, by media by commentators,” he says. “Hopefully, what they will do is also encourage other brands and retailers to be bold and to make these statements as well.”
NPR’s Leena Sanzgiri and Tinbete Ermyas produced and edited the audio of this story.
Two boxing deaths in one week, a preview of Olympic swimming, and a check-in about the WNBA: Host Scott Simon gets an update from NPR sports correspondent Tom Goldman.
SCOTT SIMON, HOST:
And now it’s time for sports.
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SIMON: Swim records fall in Korea. The WNBA season reaches its halfway mark with today’s All-Star Game. And twin tragedies in the grisly business of boxing. NPR’s Tom Goldman joins us. Tom, thanks for being with us.
TOM GOLDMAN, BYLINE: Thank you, Scott.
SIMON: Not one, even, but two boxing deaths this week.
GOLDMAN: Yeah. Russian Maxim Dadashev and Argentine Hugo Santillan both died from brain injuries a few days after their fights last weekend. Certainly not the first boxing deaths, but being so close together – just two days apart – that’s very dramatic and has the boxing world split once again between those calling for reform and those saying, it’s tragic, but it’s just part of the game.
SIMON: You and I have both reported on the human damage in boxing over the years, and I daresay it’s one of the reasons we don’t talk about it a lot here. We – you know, we both recoil at this sometimes really being called a sport, and you and I love sports. We often talk about what boxing should do. Is there something fans can do to make it less destructive?
GOLDMAN: You know, I suppose they can take their money out of the sport. As long as there’s demand, boxing will continue and not see a need to change. But if fans stop betting, if they stop buying pay-per-view, stop attending fights and let the powers that be know this is a protest, maybe that would spur the kind of reform that might help reducing the length of fights, zero tolerance of performance-enhancing drugs, which there isn’t now, ringside doctors with neurological and concussion training at all fights and ensuring boxers train safely. Brain injuries may happen initially in training and not be detected by the time they fight.
But, you know, Scott, even if meaningful reform happens, death happens too. You know, it’s the nature of a sport where the goal is to hit someone to the point of unconsciousness. And in the words of Hall of Fame boxing writer Nigel Collins, it’s up to each of us to face that reality and decide whether or not it’s worth the price.
SIMON: Yeah. Las Vegas this afternoon, the WNBA All-Star Game means the women’s basketball season’s halfway through. What teams have been most successful so far?
GOLDMAN: Well, it’s been a very competitive season so far, led by Connecticut and Las Vegas, both with 13 and six records, but not leading by much. Eight of the 12 WNBA teams go to the playoffs. And the eighth team, Minnesota, is only three and a half games out of first place. The contenders include defending champion Seattle, which lost league most valuable player Breanna Stewart and star Sue Bird before the season to injuries. There were predictions of doom, but the Storm have stayed together. They’ve played well, and they’re in the thick of the race right now.
SIMON: And, Tom, we’re a year out from the 2020 Olympics.
GOLDMAN: Yeah.
SIMON: The World Swimming Championships are – I know you’ve just begun to pack – World Swimming Championships are taking place in South Korea right now. What might we see in these championships that can help us look forward to next year in Tokyo?
GOLDMAN: Well, you know, it might be a good preview, although Americans hope not too much of a preview for super swimmer Katie Ledecky. She’s had a really tough time of it in South Korea. Illness forced her to drop out of two events. But just today, Scott…
SIMON: Yeah.
GOLDMAN: …Some redemption.
SIMON: I saw.
GOLDMAN: Yeah, she won the 800-meter freestyle for the fourth straight time, a four-peat, at the World Championships. And for those who love controversy, there’s been plenty of that related to China’s Sun Yang. There are strong doping suspicions about him. He served a drug ban five years ago. And fellow swimmers haven’t been shy about speaking or acting out.
Competitors who won medals in races he won refused to stand on the victory stand with him. And after he won the 200-meter freestyle, British swimmer Duncan Scott, who tied for third, wouldn’t have his picture taken with Sun as they left the stage. Sun turned around and called Scott a loser and said he, Sun, was a winner. Now, Scott, whether this all plays out at the Olympics depends on an upcoming hearing where Sun could get a lifetime…
SIMON: That – I mean, this is, like, really dramatic. Who wouldn’t watch this?
GOLDMAN: (Laughter) Well, he could get a lifetime ban, though, for a strange incident with drug testers who showed up to give him a drug test, but he reportedly destroyed blood samples with a hammer…
SIMON: Yeah.
GOLDMAN: …That he’d given to those testers. So we’ll see if that plays out in Tokyo.
SIMON: Well, that gets the job done. NPR’s Tom Goldman. Thanks.
GOLDMAN: (Laughter).
SIMON: What do you think we do with – they do with our interviews? NPR’s Tom Goldman, thanks so much.
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.
Altovise Ewing, who has a doctorate in human genetics and counseling, now works as a genetic counselor and researcher at 23andMe, one of the largest direct-to-consumer genetic testing companies, based in Mountain View, Calif.
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Karen Santos for NPR
Altovise Ewing was a senior at Rhodes College in Memphis, Tenn., when she first learned what a genetic counselor was. Although she had a strong interest in research, she suspected working in a lab wasn’t for her — not enoughsocial interaction.
Then, when a genetic counselor came to her class as a guest lecturer, Ewing had what she recalls as a “lightbulb moment.” Genetic counseling, she realized, would allow her to be immersed in the science but also interact with patients. And maybe, she thought, she’d be able to help address racial health disparities, too.
That was 15 years ago. Ewing, who went on to earn a doctorate in Genetics and Human Genetics/Genetic Counseling from Howard University, now works as a genetic counselor for 23andMe, one of the largest direct-to-consumer genetic testing companies. As a black woman, Ewing is also a rarity in her profession.
Genetic counselors work with patients to decide when genetic testing is appropriate, interpret any test results and counsel patients on the ways hereditary diseases might impact them or their families. According to data from the U.S. Department of Labor’s Bureau of Labor Statistics, the number of genetic counselors is expected to grow by 29% between 2016 and 2026, compared with 7% average growth rate for all occupations.
23andMe’s Ewing says the lack of ethnic diversity among genetic counselors in the U.S. reduces some people’s willingness to participate in clinical trials, “because they’re not able to connect with the counselor or the scientist involved in the research initiative.”
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Karen Santos for NPR
However, despite the field’s rapid growth, the number of African Americans, Hispanics and Native Americans working as genetic counselors has remained low.
As genetics’ role in medicine expands, diversity among providers is crucial, say people working in the field. “It is well documented that people want medical services from people who look like them, and genetic counseling is not an exception,” says Barbara Harrison, an assistant professor and genetic counselor at Howard University.
Ana Sarmiento, who wrote her master’s thesis on the importance of diversity among genetic counselors, has seen this firsthand.
“I can’t tell you how many times I’ve seen the look of relief on a Spanish-speaking patient’s face when they realize they can communicate with me,” says Sarmiento, a recent graduate of Brandeis University’s genetic counseling program. “It’s what keeps me passionate about being a genetic counselor.”
Ethnic and gender diversity among providers can also increase the depth and scope of information patients are willing to share in the clinical settings — information that’s important to their health.
“In my opinion,” says Erica Price, who just received her master’s in genetic counseling from Arcadia University, “no one fights for the black community the way other black people do. I encounter a lot of other African Americans who don’t know what genetic counseling is. But when they find out that I’m a genetic counselor, they will give me their entire family medical history.”
Bryana Rivers, who is African American, recently graduated from the University of Cincinnati’s genetic counseling program, and wrote last year about her experience with a black mother whose two children had undergone extensive genetic testing to try to determine the cause of their developmental delays.
Having a firm diagnosis, the mother explained to Rivers, could help the children get access to the resources they needed in school. The mom wanted to know if the genetic variant that had been identified in her children — one that geneticists had decided was a “variant of unknown significance” — had been observed in other black families.
That question, which she hadn’t brought up in earlier discussions with health providers who weren’t African American, led to a broader, candid discussion of what these unknown variants mean and don’t mean, and why they are more common among members of understudied minorities.
“I cannot stress enough how important it is for patients to feel comfortable, to feel heard, and to know that they will not be ignored or discriminated against by their providers based on the color of their skin,” Rivers wrote in her blog post.
“I don’t want to suggest that a genetic counselor who wasn’t black wouldn’t have listened to her, but there are factors outside of what we do and say that can have an impact on our patients. Just the fact that she was able to lower her guard a bit because we share the same racial background as her speaks volumes.”
In an interview Rivers also recounted a recent session conducted by a white female genetic counselor that Rivers was shadowing that day. The patient, who was a black woman, addressed all of her answers to Rivers, although Rivers’ official role was to merely observe the appointment.
“I do feel a responsibility as a black provider to look out for my black patients and make sure they are receiving the appropriate care,” Rivers says. “Not everyone is willing to go that extra mile, and they may be more dismissive of the concerns of black patients and may not actually hear them.”
Ewing, who also conducts research, adds that the lack of diversity among genetic counselors has had a negative impact on research.
“The lack of diversity has an effect on the willingness of minorities to pursue clinical trials, because they’re not able to connect with the counselor or the scientist involved in the research initiative,” she explains. “We are now in the era of precision and personalized medicine and we need people who are comfortable talking about genetic and genomic information with people from all walks of life, so that we’re reaching all demographics.”
In 2019, 90% of survey respondents identified as Caucasian, while only 1% of respondents identified as Black or African-American. Just over 2% of respondents identified as Hispanic, 0.4% identified as American Indian or Alaskan Native.
Some genetic counselors cite a lack of awareness among underrepresented minorities of genetic counseling as a profession as a major barrier to diversity in the field. Rivers says she had little exposure to genetic counseling as a future career path while enrolled as a biology major at the University of Maryland.
“My university stressed medical school, nursing school, or a Ph.D. in the biological sciences,” Rivers recalls. “I only had one professor in four years bring up genetic counseling.”
Samiento concurs. “You don’t have 6-year-olds running around saying ‘I want to be a genetic counselor’ — because it’s not a high visibility profession,” she says. “There are also very few minority professionals in the training programs and it takes a brave minority to look at the sea of white female faces and say ‘yes I can fit in here.’ “
“Genetic counseling is still a relatively new profession and there hasn’t been enough time and exposure for people to view [the field] the way they view other medical professions,” says Price. “People have asked me why I would pursue genetic counseling when I could be a physician assistant or a nurse or go to medical school.”
After Price’s acceptance to graduate school, one of her undergraduate professors questioned her chosen career path. “She said to me, ‘You’re a black woman in the sciences. We could have gotten you into a Ph.D. program or something where you’re making more money.’ “
As a part of its strategic plan for the years 2019-2021, the NSGC has identified diversity and inclusion as one of its four areas of strategic focus. Specific plans include developing mechanisms to highlight genetic counseling as a career in hard-to-reach communities by the end of the year. Erica Ramos, who is the immediate past president of the NSGC and serves as the board liaison to the task force, says she is optimistic that the numbers of underrepresented minorities in the field will improve.
“People in the profession have realized that we have blinders on,” she says. “But as an organization, the NSGC has been asking questions about how we can improve on diversity and be supportive of existing minority genetic counselors. We had 100 people apply to serve on the task force.”
A number of genetic counselors from diverse backgrounds have also come together to form their own support and advocacy networks. In November 2018, the Minority Genetic Professionals Network was formed to provide a forum for genetic counselors from diverse backgrounds to connect with one another.
Erika Stallings is an attorney and freelance writer based in New York City. Her work focuses on health care disparities, with a focus on breast cancer and genetics. Find her on Twitter: @quidditch424.
NPR’s Ari Shapiro talks with Damian McCall of the Agence France Presse to give us the latest developments from the Tour de France after a stage of the race was cancelled due to extreme weather.
ARI SHAPIRO, HOST:
Cyclists in this year’s Tour de France have faced some of the hottest temperatures in France’s history. Then, today, it was snow and hail that led officials to stop the race midway through. That decision meant a new cyclist is now wearing the yellow jersey just two days before the race wraps up. Agence France Presse’s Damian McCall is in the Alps covering the race.
Welcome back to the program.
DAMIAN MCCALL: Hello, everybody. Here from the Alps. You’re quite right. The heat wave yesterday, when it was about 100 Fahrenheit, made way to hail, rain and floods. It’s pretty cold here. It must be about 55 degrees Fahrenheit.
SHAPIRO: And what impact did that have on the riders?
MCCALL: Well, it had a massive impact on the writers because a key stage of the race, about – let’s say about 5 kilometers after the young Colombian Egan Bernal launched his astonishing attack, there was a sudden hailstorm on the other side of the mountain. So there was two riders racing downhill at 90 kilometers an hour. That’s very fast, indeed, on racing bicycles.
SHAPIRO: And that’s dangerous in good weather, but when you’ve got ice and snow on the road, that seems extremely treacherous.
MCCALL: Yeah. There’s been a kind of slide. You know, we’re above the tree lines, so you’ve got this sort of gray rock on the mountains. Imagine the kind of shale on the mountainsides that sort of poured down onto the roads. So for about 100 meters of hailstone and shale blocking the road, it was impassable. There was no way they could have done anything with it. The race organizers scrambled to send the motorbike after the two leaders and tell them to stop.
SHAPIRO: Just to stop in the middle of the race? Wow.
MCCALL: Yeah. So what they did was they neutralized the race, and they took the times at the crest of the summit that they’d just crossed. And the riders didn’t know what was going on. And Bernal and Yates refused to stop initially. They said – they’re two young riders saying, no, no, no. No way, not now. We’re not stopping now (laughter). And they said, it’s OK, mate, don’t worry. You’re going to have the yellow jersey because we’re taking the times from the final crest.
So it was very peculiar. It’s unprecedented in the Tour de France. So we do now have a new yellow jersey. Julian Alaphilippe’s 14-stage tenure is done and dusted. France’s dreams are in tatters (ph).
SHAPIRO: And do you think this is going to change the final calculation of who wins?
MCCALL: Absolutely. So whoever comes out on top tomorrow night will be the winner. And right now Bernal has a 46-seconds lead. If – there may be one last twist in the tale. You never can tell with sport, sport being sport being sport. But my money, firmly – you know, mortgage your house; put it on, again, Bernal.
SHAPIRO: For a long time in this race, it looked like it was going to be the first time in years a Frenchman won. Now that that Frenchman no longer looks to be the favorite, are French people feeling a little bit crushed?
MCCALL: They will be feeling crushed because what happened today was really heartbreaking for them. Before Alaphilippe snapped on that climb, the other French rider they thought would be in with a chance if Alaphilippe snapped pulled out of the race with a torn muscle in his thigh. You know, he was actually in tears on the bicycle. And these guys are some of the toughest athletes you can possibly imagine. For him to clamber into the back of a team car, absolutely broken, really hurt a lot of French fans. And so, yeah, their dreams are gone. There’s no Frenchman in the reckoning.
SHAPIRO: Damian McCall is a reporter with Agence France Presse covering the Tour de France.
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 U.S. is a big place, nearly 1.9 billion acres. Stacey Vanek Smith and Cardiff Garcia from NPR’s daily economics podcast, The Indicator, look at how all that land is divvied up.
MARY LOUISE KELLY, HOST:
There are 1.9 billion acres of land in the continental United States. But how does that land get used? The co-hosts of NPR’s daily economics podcast The Indicator, Stacey Vanek Smith and Cardiff Garcia, use a familiar fast-food meal to answer that question.
CARDIFF GARCIA, BYLINE: The U.S. is enormous. It’s hundreds of millions of acres big, and it’s full of resources, not to mention some of the most productive land on Earth.
STACEY VANEK SMITH, BYLINE: And this got us thinking. The U.S. has all of this land, and it’s been such an amazing resource for the country and for the economy. How exactly are we using this resource? And Cardiff, I will present you with the object that I think best represents how we use land in the U.S. But, first, I want to speak with Lauren Leatherby. She’s a data journalist from Bloomberg News. And she went through the reports issued from the U.S. Department of Agriculture.
It’s about 1.9 billion acres of land that we’re dealing with, entirely. What was the biggest use of land in the U.S.?
LAUREN LEATHERBY: Cattle.
VANEK SMITH: Cattle (laughter).
LEATHERBY: Just livestock in general. About 41% was used for either grazing or to grow food for livestock – was, really, pretty surprising to us.
VANEK SMITH: What was the second biggest use of land in the U.S.?
LEATHERBY: Forestland. And that’s a combination of unprotected forestland, which means that it’s not a part of a national park or state park, and about 14% was owned by corporations. But it was quite striking to see this massive chunk of the U.S. designated as forestland, and about 2% of that goes away and then comes back every year (laughter) – gets replanted.
VANEK SMITH: (Laughter).
But that still leaves us with about 700 million acres. So what is the third biggest use of land in the U.S.?
LEATHERBY: So that’s cropland. Cropland is about a fifth of the U.S. But what’s interesting is that the amount of food that we eat from all of that cropland, a lot of it is used for livestock. And so that’s corn for livestock, soy for livestock.
VANEK SMITH: All told, that is nearly 1.6 billion acres of land for just those three uses. And then we get to a relatively small category, which is urban areas.
LEATHERBY: That’s by far the fastest growing. In the past 10 years, it’s been growing at a rate of about 1 million acres per year. So that’s the size of about Phoenix and LA and Houston combined, every year, growing in urban area.
VANEK SMITH: After going over the land use data myself, I came up with this object that I think really represents in one word – I guess it’s actually two words – how we use land in the U.S. It’s a Happy Meal. OK, so the main events of the Happy Meal is of course the beef burger.
GARCIA: Yes.
VANEK SMITH: And this is of course the largest use of land in the U.S. – that is, cow pasture – 654 million acres, plus the feed for the livestock, which is 127.4 million acres. And then of course there is the paper that the Happy Meal box is made out of. That is the second largest use of land in the U.S. – unprotected forest. That’s 538.6 million acres. Wheat for the bun – 21.5 million acres. Also in the box – the fries. A million acres of potatoes are grown in the U.S.
But also, private land ownership, which is also on the rise. Most of the top landowners in the U.S. are cattle ranchers and oil barons. So if we add all of these things up together, that is roughly 1.5 billion acres of land of the 1.9 billion available all wrapped up in this Happy Meal.
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.
Sovereign Valentine, a personal trainer in Plains, Mont., needs dialysis for his end-stage renal disease. When he first started dialysis treatments, Fresenius Kidney Care clinic in Missoula charged $13,867.74 per session, or about 59 times the $235 Medicare pays for a dialysis session.
Tommy Martino/Kaiser Health News
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Tommy Martino/Kaiser Health News
Fresenius, one of the two largest dialysis providers in the U.S., has agreed to waive a $524,600.17 bill for a man who received 14 weeks of dialysis at a clinic in Montana.
NPR, Kaiser Health News, and CBS This Morning told Sovereign Valentine’s story this week, as part of the “Bill of the Month” series, a crowdsourced investigation that seeks to understand the exorbitant health care bills faced by ordinary Americans.
On Thursday, a representative from Fresenius told Sovereign’s wife, Dr. Jessica Valentine, that the company would waive their unpaid bill. Instead, they will be treated as in-network patients, and Fresenius will seek to negotiate with their insurer a rate higher than what the insurer has already paid. The Valentines are responsible only for their $5,000 deductible, which Sovereign, who goes by “Sov,” has already hit for the year. That leaves them with $0 left to pay on their in-network deductible.
“It’s a huge relief,” Sov said. “It allows me to put more energy back into just taking care of my health and not having stress hormones raging.” Sov said he hopes his experience will shed light on the problem of balance billing and help other patients in similar situations.
A 50-year-old personal trainer, Sov was diagnosed with kidney failure in January and sent for dialysis at a Fresenius clinic 70 miles from his home in rural Plains, Mont. A few days later, Sov and Jessica learned that the clinic was out-of-network and that they would be required to pay whatever their insurer didn’t cover.
The Valentines initially could not find an in-network option, and Sov needed dialysis three times a week to survive. After he underwent 14 weeks of dialysis with Fresenius, the couple received a bill for $540,841.90. Their insurer, Allegiance, paid $16,241.73, about twice what Medicare would have paid. Fresenius billed the couple the unpaid balance of $524,600.17 — an amount that is more than the typical cost of a kidney transplant.
Fresenius charged the Valentines $13,867.74 per dialysis session, or about 59 times the $235 Medicare pays for a dialysis session.
Fresenius spokesman Brad Puffer said that the Valentines should always have been treated as in-network patients because their insurer, Allegiance, is a subsidiary of Cigna, which has a contract with the dialysis company. Under this contract, Fresenius would have been paid a higher rate than what Allegiance paid. The Valentines, he said, were caught in the middle of a contract dispute between the companies.
“In the future, we pledge to better identify situations where we believe the insurer has incorrectly classified one of our facilities as being out of network,” Puffer said in a statement. “This will allow us to address the matter directly with the insurer in the first instance, without them placing the patient in the middle.”
Allegiance declined to comment for this story. Jessica Valentine questioned whether they may owe an out-of-network deductible and is waiting to hear what her insurer says about that.
Like her husband, Jessica is relieved that their bill seems to be resolved but worried that other people with bills like theirs might not be so lucky. She’s also grateful for all the attention their story has garnered. Montana Sen. Jon Tester’s office and their hospital’s insurance broker both offered to advocate for them. “And a nephrologist from Pennsylvania called me at work and expressed outrage and said she forwarded on our story to the medical director of Fresenius on our behalf,” Jessica wrote in an email.
Now that his bill has been resolved, Sov said he’ll be focusing on the next step in battling his kidney disease: a transplant. “I can just save my energy for that,” he said.
Bill of the Month is a crowdsourced investigation by NPR and Kaiser Health News that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
I was thrilled to have the gifted voice of Tamino gracing the Tiny Desk. But as charged as I was, that didn’t match the excitement that Colin Greenwood expressed as we rode up the elevator. The Radiohead bassist (and bassist for this special performance) shared a brief text exchange with his son, basically telling his hugely accomplished dad that playing the Tiny Desk was “the coolest thing he’d ever done!” That made us all smile.
The attraction that brought Colin Greenwood and these other musicians to bond with Tamino, a young singer of Belgian, Egyptian, and Lebanese descent, is his voice; it’s inescapable. For me a reference point is Jeff Buckley; they both have a way of soaring into the upper registers and into the ether; it’s stunning. I first heard Tamino perform live at a convention center in Austin; he transformed and transcended the relatively soulless space.
The songs performed at the Tiny Desk by the 22-year-old singer come from both a 2018 EP titled Habibi and later that year an album titled Amir. His use of that falsetto had some faces in the NPR audience gasping in astonishment. There’s a yearning in Tamino’s songs that I don’t often hear in popular music — he makes every vowel count. There’s nothing casual about his expressions, whether he’s singing about a sweetheart in the song “Habibi” or despair turned to joy in “Indigo Night.”
Some of the inspiration for Tamino’s approach comes from his heritage and in particular his grandfather Muharram Fouad, a well-known Egyptian singer known as “The Sound of the Nile.” It was his late grandfather’s old guitar that Tamino had first played. He got to know his grandfather’s music through his cassettes. Tamino would later incorporate what he heard into his songs. It’s ageless music that Tamino makes — it’s melodies feel well worn, but it’s also vibrant and intoxicating.
Producers: Bob Boilen, Morgan Noelle Smith; Creative Director: Bob Boilen; Audio Engineer: Josh Rogosin; Videographers: Morgan Noelle Smith, Kara Frame, Bronson Arcuri; Associate Producer: Bobby Carter; Production Assistant: Paul Georgoulis; Photo: Shuran Huang/NPR
NPR’s Mary Louise Kelly speaks with lawyer Mike Moore, who is representing several states, counties and cities that are suing opioid manufacturers.
MARY LOUISE KELLY, HOST:
Litigation over the opioid crisis is heating up. A verdict in the first state case, Oklahoma, is expected next month. Meanwhile, in Ohio, a federal judge is overseeing litigation brought by more than 2,000 local governments – states, towns, counties – across the country.
Well, we’re going to spend these next few minutes with a man who has worked to convince all those governments to sue and who is working now to coordinate their efforts. A recent profile on “60 Minutes” called Mike Moore the unofficial commanding officer of opioid litigation in the U.S. And if his name sounds familiar, might be because he played a similar role two decades ago when he persuaded states to take on big tobacco.
Mike Moore, welcome back to ALL THINGS CONSIDERED.
MIKE MOORE: Thank you, Mary Louise. Glad to be here.
KELLY: So you represent several of the states that are suing – Arkansas, Louisiana, Mississippi, Ohio – also, several of the counties and cities who are litigating. And I wonder – how hard has it been to get all of your different clients, which must have different laws, different aims – how hard has it been to get them all on the same page?
MOORE: Well, it’s taken a long time. The defendants in these cases, as you might imagine, are not anxious to go to trial. With the revelation of where all the pills went, you know, that’s been in the newspaper and TV recently, there’s really nowhere for them to hide. We know what the story is. We know who’s at fault. So it’s really time for folks to focus on the public health crisis and come together and solve the problem. I mean, litigation is great. But it really is, you know, a tool that is used to try to get the truth out and to try to hold people accountable.
KELLY: You said we know who’s at fault.
MOORE: Sure.
KELLY: But when I last interviewed you a couple of years ago, in 2017, you acknowledge there is plenty of blame to go around in the opioid crisis, from doctors who overprescribed to pharmacists who filled out all those prescriptions to the government that failed to regulate and so on. Just make the case as simply as you can, why should the drug companies – manufacturers and distributors – be the ones held accountable above all those other parties?
MOORE: Well, first off, because the manufacturers are the ones who made the most money…
KELLY: And presumably, who can also pay out in a big settlement.
MOORE: Yeah, billions of dollars. And truthfully, the manufacturers probably made less money than the distributors. The distributors really made a mother lode of money. And then the Walgreens, CVSes, Walmarts, Ride Aides – they made a lot of money, too, dispensing these drugs and didn’t take the steps that they should have. The Controlled Substance Act is there for a reason. These are controlled substances. And frankly, everybody failed to control the flow of these drugs.
KELLY: Yeah. I mean, these companies, as you know – to sum up their defense in a line is that these were controlled substances. These were legal substances sold to legit patients who had prescriptions.
MOORE: They are. But in our country, the law pretty much says you have to tell the truth. And it’s clear that Purdue Pharma and the other companies – Johnson & Johnson and others – they didn’t tell the truth about the addictive nature of these drugs or what they should be used for. You know, they’re fine for long-term cancer pain and those type things. But you’re not supposed to get a 60-day supply for a tooth extraction and the like. And that’s what they kind of marketed these things for.
KELLY: How big a payout are you looking for to count as a success?
MOORE: You know, I think a better way to say it is – what does it take to start saving lives? You know, how do we get naloxone, you know, the antidote for overdoses, out to everybody that needs it? How do we get buprenorphine and treatment drugs out? How do we get a prevention education program out there to try to reverse the negative statements that were made by these companies years ago?
KELLY: All right. What’s that number?
MOORE: Well, that number is going to be in the multi-multi-multibillions of dollars. But we need to do it now. We don’t need to do it five years from now.
KELLY: Are the pockets of the opioid manufacturers being targeted in these suits deep enough to make that kind of payout? My impression is they’re – they don’t have as much money as, say, big tobacco manufacturers who you were suing back in the ’90s.
MOORE: Yeah, Purdue Pharma is close to bankruptcy, probably rightfully so. Their OxyContin sales are way down. Sacklers have some money that can be retrieved. Johnson & Johnson is a huge pocket. Then the distributors are big pocketbooks. The Walgreens, the CVS are big pocketbooks, and they all have some responsibility.
KELLY: What about your personal goal out of all this, Mike Moore? And I ask because when you and I spoke before, you talked about how this feels personal to you – that members of your family have overdosed, friends of yours have overdosed.
MOORE: Yep. For me, I really want to do something that makes a difference in saving people’s lives.
KELLY: You also said that whatever money might flow to you, you would be would be happy to donate in the…
MOORE: Absolutely.
KELLY: …Service of public health. Is that still where you stand?
MOORE: Absolutely. You know, I’m doing this for one reason. I don’t need to do this anymore. And I’m trying to make this a public crisis rather than just a big lawsuit. This isn’t a lawsuit. This is something to try, frankly, to solve a public health epidemic.
KELLY: Lawyer Mike Moore talking there about the efforts, which he is leading, to hold prescription drugmakers and distributors accountable in court for the opioid epidemic.
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.
