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Health July 22, 2019

Job Posting For Doctor At An Immigrant Detention Facility Catches People’s Attention

NPR’s Ari Shapiro speaks with Dr. Ranit Mishori, a family doctor, and a member of Physicians for Human Rights, about the job listing for a doctor to work at an ICE Processing Center.



ARI SHAPIRO, HOST:

Let’s talk about a job posting for a doctor to work at an immigrant detention facility in rural Louisiana. This opening has caught people’s attention for a few reasons. First of all, the job pays $400,000 for a doctor with just two years’ experience. And the company doing the hiring, GEO Group, wants someone who is, quote, “philosophically committed to the objectives of this facility.” The facility has a thousand beds for immigrant detainees.

Dr. Ranit Mishori noticed this listing on the Journal of the American Medical Association Career Center. She’s a professor of family medicine at Georgetown and a member of Physicians for Human Rights.

Welcome to the studio.

RANIT MISHORI: Thank you so much, Ari.

SHAPIRO: How unusual would it be for a doctor with two years’ experience to make $400,000 a year?

MISHORI: Well, it’s very unusual, especially for somebody who is a general practitioner. This is way more than I’m making, so the job really caught my attention for a variety of reasons.

SHAPIRO: And you’re living in D.C., a city with a cost of living much higher than rural Louisiana.

MISHORI: Exactly.

The other thing is they’re not asking for a board certification, which usually is a marker for competency of some sort.

SHAPIRO: Explain what a board certification represents.

MISHORI: Board certification are additional exams that people who graduate from residency programs have to take to show that they can deliver the best high-quality care. They’re not asking for that.

SHAPIRO: And then there’s that line – philosophically committed to the objectives of this facility. How do you interpret that?

MISHORI: Well, to me, when I read that ad after the initial surprise about the experience necessary and the salary, this was really very concerning – even chilling – to think about what I interpret to be a loyalty test. This, to me, was a very, very specific example of what we call in medical ethics dual loyalty.

SHAPIRO: Explain that concept of dual loyalty.

MISHORI: Dual loyalty is something that relates to the potential conflict between clinicians’ duties to their patients and their obligations to their employers. When these organizations have sometimes questionable tasks to fulfill, that becomes a very, very serious almost ethical minefield, I would say.

SHAPIRO: You and I have both been to immigration detention centers. What do you imagine the work will be like?

MISHORI: Well, I think when you talk about any correctional facility, especially immigration detention centers, there are a couple of hats that one has to wear. One is to take care of routine medical issues – so somebody has a headache, somebody has an infection, is vomiting. But also, we’re talking about people who are coming with immense trauma, people who may have injuries, people who have suffered from violence. You need to address that in some ways. There’s also making sure that there’s no spread of contagious diseases, that people are being nourished well. So it’s a very big job.

SHAPIRO: Isn’t it important to have the best medical personnel possible in those facilities? Wouldn’t you want somebody extremely qualified to be hired for a job like this?

MISHORI: Absolutely. You would want the most competent, the most compassionate physician that you can find. But those are not necessarily the physicians that they’re trying to hire based on the ad that I was looking at.

SHAPIRO: As you were talking about dual loyalty….

MISHORI: Yeah.

SHAPIRO: …Is there a specific example you can give us to help listeners understand how this plays out in the real world?

MISHORI: So it can start from you being a sports physician, and your star forward is injured, but you want to get her back in play because you want the team to win. So that’s one end. But it goes all the way to facilities where you are withholding treatment as a means of punishment, to giving people medications against their consent and without giving them the right to refuse.

SHAPIRO: We heard some of this at Guantanamo Bay, for example.

MISHORI: Exactly. So Guantanamo Bay is a really good example – also, force-feeding of hunger strikers.

SHAPIRO: And I guess the point is that while there may be black-and-white scenarios, there are a whole lot of gray scenarios, too. And when you’re in the middle of one, it can be hard to tell.

MISHORI: Right. And one of the grayest scenarios is you’re in a facility where you are the doctor. The person comes in for a headache, and you notice that they have scars on their back from being beaten. And you’re not doing anything. You’re not asking questions about it. You’re not documenting it in a chart, or you’re not reporting it to anybody. One of the things we try to teach in medicine is, really, the foundational idea that we need to always act in the best interest of the patient. And oftentimes, these scenarios do not lend themselves to doing that.

SHAPIRO: You can’t just keep your blinders on is what you’re saying.

MISHORI: You should not. People do, but you shouldn’t.

SHAPIRO: Dr. Ranit Mishori, thank you very much.

MISHORI: Thank you.

SHAPIRO: She’s a family physician and member of Physicians for Human Rights. We also asked GEO Group for comment about the amount of experience required and the philosophical commitment noted in the job listing. A spokesperson did not answer those questions but wrote in a statement, in part, (reading) we are deeply committed to delivering high-quality, culturally responsive services in safe and humane environments.

(SOUNDBITE OF LAMBERT’S “MANDAL”)

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 21, 2019

What’s Happening With New Abortion Regulations Under Title X

Clare Coleman, CEO of the National Family Planning and Reproductive Health Association, talks with NPR’s Sarah McCammon about recent changes to Title X regulations.



SARAH MCCAMMON, HOST:

Family planning clinics around the country that provide health services to low-income Americans have been getting some mixed messages recently from the federal government. This past week, the Trump administration said it would immediately begin enforcing new rules for the Title X family planning program, which would eliminate funding to organizations that provide or counsel patients about abortion. Then this weekend, we learned that Trump administration officials are now saying they will not immediately take action against groups deemed to be working in good faith to comply.

Clare Coleman is the CEO of the National Family Planning and Reproductive Health Association, which represents family planning clinics around the country. She joins us now.

Welcome.

CLARE COLEMAN: Thank you. It’s nice to be here.

MCCAMMON: So first, let’s talk about Title X. What is its role in providing reproductive health services, and how is the Trump administration trying to change the program?

COLEMAN: Well, the Title X program is now in its 49th year, and it was established to equalize access to modern forms of contraception and to help people both achieve pregnancy and prevent pregnancy. Last year, the Trump administration introduced a new set of rules, which represent the most consequential changes to the Title X program since it was enacted in 1970.

It changes the rules around how we can speak to patients about their contraceptive care. It allows providers to select the range of contraceptive methods that are offered and would allow providers to exclude methods that they object to, even if patients are interested in those methods. And it also limits the conversation that clinicians can have with patients once they have a positive pregnancy test.

MCCAMMON: Now, President Trump and other Republicans have run on promises to, quote, unquote, “defund Planned Parenthood.” This policy change is an effort to move in that direction, not just for Planned Parenthood but for other groups, of course. Now, the objection – I covered this issue quite a bit, and the objection from anti-abortion rights groups is that they say that funding for abortion should in no way be commingled or overlapping with other services. And so I would ask, why couldn’t these groups just stop providing abortions or referring patients for abortion?

COLEMAN: Well, the Title X program has prohibited use of Title X dollars for abortion care since its inception, and current grantees and some recipients follow very detailed rules that help you demonstrate when you have Title X funds that support family planning services, STI treatment and screening, cancer screening and then any abortion care that is provided in the same organization. Those rules go down to the very detail of financial reporting, and our grantees report quarterly. The administration has not been able to document either in the rule, in testimony before Congress or in any public documentation that there is any abuse whatsoever of the prohibition on Title X funds.

MCCAMMON: And what does this mean for the patients?

COLEMAN: It can be very confusing. And, candidly, it may be invisible. But I think for many low-income people, they know exactly how much cash they have in the bank, but they’re not necessarily tracking the rules. And one of our great fears is that folks are going to begin to encounter this when a service that used to be available to them is suddenly not available, or they’re presented suddenly with a bill.

So I’m concerned, and I think lots of us are concerned that all the decisions and considerations and guidance and coming back and forth between the feds and additionally the litigation that continues that patients won’t really begin to feel the impact until they ask for something that is no longer available to them where they live.

MCCAMMON: Clare Coleman is the CEO of the National Family Planning and Reproductive Health Association.

Thank you so much.

COLEMAN: You’re welcome. It’s my 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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Sports July 21, 2019

Ireland’s Shane Lowry Wins British Open In His First Major Title

Shane Lowry of Ireland celebrates with the Claret Jug during the final round of the British Open held at Royal Portrush Golf Club, just a few hours from where he grew up.

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Irishman Shane Lowry won the British Open on Sunday by six strokes in his first major title.

Lowry, who brought out loud cheers from the sellout crowd on every shot, began the day with a four-stroke lead. He shot one-over 72 and finished with a 15-under 269 total.

He marked the moment he became a major champion with a wide smile and an embrace of his caddie.

The 32-year-old took the title at the Royal Portrush Golf Club in Northern Ireland, just a few hours from where he grew up.

Despite rainfall and gusty winds, Lowry beat Tommy Fleetwood of England, who applied pressure to Lowry but ended in second place, having shot 74.

Lowry’s win signaled the first Open played in Northern Ireland since 1951, and he became the second player from south of the border to lift the Claret Jug.

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Business July 20, 2019

ProPublica Report: Black Americans Lose Big Under Longtime Property Provision

NPR’s Sarah McCammon speaks to ProPublica reporter Lizzie Presser about heirs property, a form of land ownership that has cost black Americans billions of dollars in land loss.



SARAH MCCAMMON, HOST:

The issue of reparations is back in the news. Democratic presidential hopefuls are talking about it. Senator Cory Booker and Congresswoman Sheila Jackson Lee proposed legislation this year that would create a commission to study reparations. And this week, Senator Chuck Schumer said he’d support that bill. Proponents of the concept argue that reparations are not just about slavery but also injustices black Americans have endured since the Jim Crow era and beyond. One of those injustices includes the losses of enormous amounts of property to a form of land ownership called heirs property, which some economists say has cost black Americans hundreds of billions of dollars in lost land over the past century.

Joining us now to talk about this is reporter Lizzie Presser, who investigated heirs property in a collaboration between ProPublica and The New Yorker. She followed the case of Melvin Davis and Licurtis Reels, who spent eight years in jail fighting for the land they call home. And she joins us now from our New York bureau. Hi, Lizzie. Welcome.

LIZZIE PRESSER: Hi, Sarah. Thanks for having me.

MCCAMMON: One of the people you spoke to in your reporting called heirs property the worst problem you never heard of. Can you tell us more about what it is?

PRESSER: So heirs property is a form of ownership. And essentially what happens is that someone dies without a will, and their descendants inherit an interest in the land. So instead of owning a physical piece of it, they’re owning a share, kind of like holding stock in a company. And as that land is passed down through generations, that can mean that dozens or hundreds of family members co-own a piece of land. And it creates a very unstable form of ownership.

MCCAMMON: And why is it structured that way?

PRESSER: Intestate succession is what it’s called legally, and essentially that’s just what will happen if you die without a will. And so families often believed, actually, that if they owned land in this way, they were protecting it from being taken from them. But in reality, it made their ownership very vulnerable to takings.

MCCAMMON: In the heart of your investigation is the case of the Reels family, two brothers – Licurtis Reels and Melvin Davis in Carteret County, N.C. Tell us a little bit about how their story starts and then how it starts to unravel.

PRESSER: So Melvin and Licurtis’s great-grandfather bought 65 acres in 1911. And in 1970, their grandfather Mitchell Reels died without a will. What ended up happening was a distant uncle who hadn’t lived on the property in two decades used an arcane law called the Torrens law to carve out the most valuable slice of the property right on the river. And this is a family of shrimpers and crabbers and fishers. And so that’s – that wasn’t just the most valuable property in terms of its value to sell, it was also the way in which these men made their money and fed their community. Once he was able to take that land, he very quickly sold it off to developers. And that’s really when the trouble started for the Reels family.

MCCAMMON: And so the two brothers get their day in court in 2011. What happens next?

PRESSER: The brothers had been occupying the waterfront. They didn’t really understand that their uncle had taken it. And, in fact, they lived with the belief that the land was theirs, and they weren’t going to let go. So even when there were court orders that required the brothers to remove their homes, they refused. In 2011, they went to court thinking that they were just going to argue their case again. But the judge found them guilty of civil contempt, and he ordered them sent to jail.

MCCAMMON: You document multiple ways, both judicial and extrajudicial, in which black Americans have had property taken from them. I want to turn to another legal mechanism you describe that really seems to allow developers to take advantage of heirs property landowners. It’s called partition action. Can you explain that?

PRESSER: So in a partition action, any single heir to the property or a speculator who buys the interest of a single heir can go to the court and ask for a sale of the entire property. So imagine if you have 15 relatives, and one person says, I want to sell. And then they get to go to the court and say, I want to sell, and the court says, sure, you can. And everyone then is dispossessed. This is what was happening and continues to happen across the South. But in many cases, what you see are speculators, companies, developers who buy off interests of individual heirs and then bring it to the court.

MCCAMMON: And if I could just ask one last sort of bigger-picture question – as you hear candidates in the 2020 campaign talking about issues of racial justice and reparations, do you think this issue of heirs property, though it’s less understood, do you think it helps to make that case?

PRESSER: Absolutely. I think what I was hoping to convey with this piece is that black families had very good reason to be suspicious of white southern courts under Jim Crow. And as a result, we have seen this unstable form of land ownership take hold across the South. And it’s a very significant example of how racial discrimination and segregation has fueled a legal system that is stacked against African American landowners.

MCCAMMON: That’s ProPublica Lizzie Presser. Lizzie, thanks so much for joining us.

PRESSER: Thanks for having me.

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 20, 2019

Former Planned Parenthood CEO On Leadership Upheaval

NPR’s Sarah McCammon talks to Pamela Maraldo, former CEO of Planned Parenthood. She left the organization under similar circumstances as Dr. Leana Wen, who was ousted from her position this week.



SARAH MCCAMMON, HOST:

In July of 1995, the opening paragraph of a New York Times article read, quote, “at a time when both abortion rights and federal financing of family planning are under attack in Congress, Planned Parenthood, which has long led the fight for both, is in upheaval.” That story marked the departure of Planned Parenthood’s leader at the time, a woman with a medical background whose philosophy ran afoul of the organization then.

If that sounds familiar, it may be because this week, Planned Parenthood announced the departure of its most recent president, Dr. Leana Wen. Wen has said she was forced out over philosophical differences with the organization, including her desire to expand Planned Parenthood’s focus to a broader array of health issues. Almost exactly 24 years ago, Pamela Maraldo resigned over her own differences with Planned Parenthood. She has a Ph.D. in nursing, and she’s now CEO of the nonprofit group Girls Inc. Of New York City. Maraldo joins us now from our New York bureau.

Hello.

PAMELA MARALDO: Hello.

MCCAMMON: Now, the New York Times report that described your resignation in 1995 said that sources at the time said you had aroused opposition with your, quote, “emphasis on reshaping Planned Parenthood into a broad health organization that could compete in the era of managed care” – a focus that some of the group’s affiliates felt would inevitably diminish their role as advocates for abortion rights and low-income women’s access to health care.

Now, this week, in a letter explaining her ouster from Planned Parenthood, Dr. Leana Wen said she had come to the organization to work on a broad range of health care issues but that, quote, “the new board leadership has determined that the priority of Planned Parenthood moving forward is to double down on abortion rights advocacy.” She’s also said in an op-ed for The New York Times that she wanted to depoliticize abortion but that her approach seemed at odds with the direction the board wanted to go. What does this say about the trajectory of not just Planned Parenthood but also the abortion rights movement?

MARALDO: Certainly everybody would agree that reproductive rights are hanging the balance right now. It’s a tough time, and there are two schools of thought. I think that the leadership at Planned Parenthood has to do what it thinks is right. I don’t think there’s a right or wrong. For my part, I would do what I did, you know, last time around.

I think that when you look at the number of young people and poor women in the country that don’t have adequate health care, and you look at not the polarity in the debate but what women need on a day-to-day basis, it’s really rare that poor women have just one problem. It’s always accompanied by depression or hypertension or diabetes. So a public health physician who is a commissioner of health like Dr. Wen is going to see the world through that lens. I mean, she took an oath to do that. And similarly for a nurse, someone like me, you see the world in terms of health care delivery.

I think there is an argument to be made that the president of Planned Parenthood has to be strong in the advocacy arena right now when the media is so ever-present in all of our social issues – and certainly abortion’s at the top of that list. I think you have to be a strong advocate for reproductive rights, there’s no question about it – reproductive control and privacy, as Justice Ginsburg recently said. So we have to speak up and make sure that line in the sand is maintained, especially now with the Supreme Court having the constitution it has.

On the other hand, you could argue that, strategically, moving in the direction of broader health care will mitigate against, will, you know, help fight that fight in a much more integrated way, in a way that’s much more – that the American people would be receptive to.

MCCAMMON: And you talk about these two schools of thought, about how political to be versus how focused on health care, at least in terms of messaging. Is that a split that’s always been there within Planned Parenthood? Or is it just an old issue that was kind of dormant and has resurfaced, do you think?

MARALDO: I would say that your quote in the beginning was accurate. It’s resurfaced because I think they hired a physician. But it’s always dormant. And the fact is, their instincts were right, I believe, to hire a physician, a public health physician, because at the end of the day, if it weren’t a health care delivery network, they would be NARAL. And there is a great deal of credibility because Planned Parenthood does deliver other health services and an array of health services like, you know, prenatal care and pap tests and breast cancer screening and immunizations. Planned Parenthood has always provided a wide array of health care services. And so they can’t be de-emphasized It’s got to be based on women’s health and what they need.

MCCAMMON: You reference NARAL, of course, which is an abortion rights advocacy organization.

MARALDO: Right.

MCCAMMON: How do you think the mission of Planned Parenthood is and should be different from a group like NARAL and some of the others that do similar work?

MARALDO: I think that’s the point. Planned Parenthood delivers a wide array of services. And I think that – not that they don’t want to be good, strong voices and advocates for reproductive rights. I think, though, that there’s got to be a parallel concern about the health care of women in general and the services they deliver. So I had women come up to me and say, you’re so concerned about whether I’m going to have another baby or not. Why don’t you be more concerned about my prenatal care or the adequate, you know, nutrition? And I say, as a matter of fact, I am, and we are.

MCCAMMON: Dr. Wen’s departure after less than a year at Planned Parenthood came in a week when the Trump administration said it would start enforcing federal family planning rules that in effect cut a substantial amount of funding to Planned Parenthood.

MARALDO: Right.

MCCAMMON: You know, given that kind of landscape, how much of a role should the organization play, though, in lobbying against these kinds of policies that directly affect their health care mission?

MARALDO: Well, that’s what’s tricky. And that, they really do have to speak up now. Those voices need to be heard. They need a strong, vocal leader in support of reproductive rights, in support of family planning funds, in support of Medicaid funding for abortion. You know, poor women have, you know, two, three times the number of abortions, and they’re not provided for. So I think right now, times are critical, and we do need a strong voice of Planned Parenthood.

I’m not sure that Dr. Wen couldn’t have been that. I’m sure she understood that there – I don’t know this for a fact, but I can’t imagine that she was hired and knew the organization and didn’t understand that there was a strong role for – to speak up in the – in advocacy forums all over the country.

MCCAMMON: At the time when you were serving as CEO of Planned Parenthood in the early Clinton years, many Democrats were aligned with President Clinton, who famously said, abortion should be safe, legal and rare. As these issues continue to be debated in the public sphere, would you like to see a return by Planned Parenthood and other advocates to that kind of framing of this issue?

MARALDO: Yes, Sarah, I would – and reason being that I think with any medical procedure, any surgical procedure, the watchword should be prevention. I think the best practice is to try and prevent the thing in the first place. So I agree. I think that people that are pro-choice are afraid of stigmatizing abortion when they say it should be rare. And that’s not where I’m coming from. I’m coming from a place that too many trips to the doctor’s, medical procedures, surgical procedures, could be and should be prevented.

MCCAMMON: That was Pamela Maraldo, CEO of Girls Inc. of New York City. She was also a former president of Planned Parenthood back in the early 1990s.

Thank you so much.

MARALDO: Thank you, too, Sarah.

MCCAMMON: And we invited Planned Parenthood’s interim president, Alexis McGill Johnson, to appear on this program. We’re told she’s not available this weekend, but we are hoping to talk with her in the coming 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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Sports July 20, 2019

Sports Roundup: Previewing Sunday’s Baseball Hall Of Fame Induction

NPR’s Scott Simon speaks with ESPN’s Howard Bryant about the 2019 baseball season so far and about Mariano Rivera, baseball’s first unanimous Hall of Famer.



SCOTT SIMON, HOST:

Now, time for sports.

(SOUNDBITE OF MUSIC)

SIMON: The 2019 baseball season heats up the summer – the first unanimous Hall of Famer – joined now by Howard Bryant of ESPN, who gets a vote in the Hall of Fame ballot. Howard, thanks so much for being with us.

HOWARD BRYANT: Good morning, Scott. How are you?

SIMON: I’m fine, thank you, sir. I saw two games at Wrigley Field this week. I’m great.

BRYANT: (Laughter).

SIMON: Three teams, now with more than 60 wins in Major League Baseball – the Yanks in the AL East, the Dodgers in the NL West, the Astros in the AL West – they’re scorching, aren’t they?

BRYANT: Yeah, they are. And once again, this is my second-favorite time of the year where you come out of the All-Star break and you start looking at teams and wondering, OK, who’s built for the entire season, and who’s going to wilt as the dog days of August commence?

And I kind of feel like these three teams are great. They’re really, really good. I mean, I – you look at the Dodgers. They’re an incredibly hungry team. They went to the World Series back-to-back years. They got beat twice. The Astros got them in 2017. The Red Sox got them last year.

You look at the Astros, who, of course, won the World Series two years ago and then, of course, the Yankees, who have been building and building for this for the last couple years. They sort of surprised everyone a couple years ago. The Red Sox got them last year. And now they are just an amazing offensive team, and they’re doing it with a lot of – well, a lot of their best players have been injured. Giancarlo Stanton isn’t even on the field right now, and the Yankees are just steamrolling everybody.

SIMON: Washington Nationals have really caught fire, too – haven’t they? – without Bryce Harper.

BRYANT: Exactly, and that’s the team that – they were, I think, 11 or 12 games under 500 earlier in the season, and now they’re in second place. They lost a tough one last night to the Braves. But I feel like this is another team that – they’ve got something to prove, as well. And especially, you’ve got those two pitchers – you’ve got Scherzer, you’ve got Strasburg – and that’s a pretty good start. I think any team in baseball would like their chances when you start the rotation with those two guys.

SIMON: And…

BRYANT: So – and let’s not forget the Twins in…

SIMON: Yep.

BRYANT: …The American League Central. And right behind them is Cleveland. There’s – and of course, the team that I used to cover, the Oakland A’s, are probably the second-hottest team in baseball. So it’s really funny, Scott. You have so many times that people talk about baseball and – oh, there’s no salary cap, and no one’s got a chance to win. And look at all of these teams that are out there who are – exactly. And by the way, they say it in that accent, as well. They say…

SIMON: I know.

BRYANT: …It just like that, right? But it’s true.

SIMON: NL Central, I just want to mention, ’cause you have a great three-way race between the Cubs…

BRYANT: And I didn’t even mention your Cubs. Exactly.

SIMON: …Who aren’t first, but the Brew Crew from Milwaukee and the Cards are close. And even the Bucs have a chance.

BRYANT: Well, and let’s not forget that last year, the Brewers were in the NLCS. So they’re close, as well. There’s a lot of teams that could win this thing, so instead of just talking about baseball being, you know, one team or two teams that can’t win – baseball actually has the most parity of all the sports.

SIMON: Baseball’s Hall of Fame abduction – abduction (laughter) – Area 51 stuff…

BRYANT: (Laughter) Baseball’s induction.

SIMON: …Induction is tomorrow. I know you get a Hall of Fame vote. Mariano Rivera, the great Yankee, is the Hall’s first unanimous inductee.

BRYANT: Indeed. And I had been withholding my vote for a couple of years because I was conflicted about steroids and conflicted about the commissioner and company inducting themselves into the Hall of Fame while allowing us the players – the voters to punish the players. And I hadn’t been a fan of that. But when it came to Rivera and also the death of Roy Halladay, I felt like I needed to vote. And so I voted this year.

And Mariano Rivera – I covered Mariano and Mike Mussina, who are both getting in. I covered both of them in the – with the Yankees in the early 2000s. And it should have happened before, but the fact that it’s Rivera – you can’t argue that. Edgar Martinez – everybody in Seattle would be very happy about that. And, Scott, you should be – what should I say? – ashamed that you’ve never been to Cooperstown. You got to go.

SIMON: Yeah. All right. Well, we’ll go together sometime. Howard Bryant of ESPN. Thanks so much.

BRYANT: 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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Business July 19, 2019

Why Taquerias Are Making Guacamole Without Avocados

NPR’s Ailsa Chang speaks with journalist Javier Cabral of L.A. Taco about taquerias using avocado-less guacamole.



AILSA CHANG, HOST:

Imagine going into your favorite taco joint and loading up on your favorite salsas and guacamole only to find out that there is absolutely no avocado in that guacamole. What? I am totally serious. That is exactly what is going on in some taquerias in Mexico and Los Angeles right now. Javier Cabral looked into this culinary deception and wrote about it for the site L.A. Taco. He joins us now.

Hey, Javier.

JAVIER CABRAL: Hey. What’s up?

CHANG: Hey. So I’m kind of flabbergasted because I am guacamole addict. I have eaten buckets and buckets of guacamole over the course of my lifetime. I don’t see how anyone can get away with this. How do restaurants even make guacamole without avocados?

CABRAL: Well, the secret ingredient that I’m sure, you know, no taqueria would ever be 100% proud to admit is Mexican summer tender, little squash.

CHANG: Squash.

CABRAL: Squash, yeah, squash.

CHANG: How does that even come close to feeling and tasting like avocado?

CABRAL: Well, the Mexican variety is light in color, almost the color of, like, a nicely, buttery avocado. And when you have a nice, tender one and you blister some jalapeno or serrano chile in the oil a little bit and you blend it, the oil emulsified beautifully into the sauce and with some tomatillos that add, like, kind of tang that we all love and that cilantro that adds that kind of refreshing herbaceousness and the garlic that just kind of seals the deal. And it’s pretty scary, to be honest.

CHANG: You mean it’s scary how much it does taste like the real thing.

CABRAL: Yes, it’s scary how much this fake guacamole tastes like the real guacamole. And I want to make it a point to say that when I’m talking about this fake guacamole, I’m talking about fake – what everyone calls a taqueria guacamole. A taqueria guacamole is different in the sense to your, you know, homemade guacamole that someone makes, you know, with tomato and onions because it’s blended up.

CHANG: Yeah.

CABRAL: And it’s kind of made to sauce a taco and not so much…

CHANG: Right.

CABRAL: …Kind of scoop it on a taco unless we’re talking about…

CHANG: It’s a little more liquidy (ph).

CABRAL: Exactly. It’s liquidy for the right reasons because it doesn’t take away too much from the actual meat in the taco so that way you’re not having a guacamole taco, but you’re having a taco de carne asada with a little bit of guacamole flavor.

CHANG: So if you were, like, a guacamole connoisseur like yourself and you knew that this was not real guacamole and you really focused on it, what would be a dead giveaway that this is fake, that it actually is from squash, not avocado?

CABRAL: Well, that’s the thing. You know, it’s eerily similar. The one thing that you will only be able to tell when doing a side-by-side taste comparison is that Mexican summer squash is sweeter so that it – when you blend it up with the rest of the ingredients, you have a subtly sweet flavor that is not in the avocado guacamole.

CHANG: If this fake guac (ph) tastes as good, if not better, to some people, is it bad that it’s happening?

CABRAL: I think the only thing that’s bad about it is that it’s not disclosed. No one’s proud to admit that, you know, like, ’cause obviously zucchini guacamole or a Mexican squash guacamole does not sound as sexy as just guacamole. But also think about the last time you’ve had taqueria guacamole. Did you see any label…

CHANG: No.

CABRAL: …That said that’s a guacamole, or was it just a green…

CHANG: Yes.

CABRAL: …Like, thinned-down salsa in the salsa bar that…

CHANG: Exactly.

CABRAL: …You just spooned over because it’s second nature to you? So you know, maybe there isn’t much duping going on because we’ve taken taqueria guacamoles for granted. So what I recommend is if you’re curious about it, try it. And honestly I understand that avocados sometimes aren’t cheap. And this recipe can definitely get you through that tough time.

CHANG: I still think it’s sacrilege. That’s Javier Cabral, a food journalist with L.A. Taco.

Thank you so much for joining us today.

CABRAL: Thank you so much. I appreciate it.

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 18, 2019

Toys R Us Is Coming Back But With A Different Approach

The retailer is rebranding itself with smaller stores and a focus on events and activities.

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Toys R Us is rising from the ashes. Now Americans may not have to go another Christmas without its once beloved toy store.

The retailer is making a comeback in time for the 2019 holiday season with a new approach. Instead of providing mile-long aisles filled with a plethora of toys, the company is switching its focus to smaller stores that will feature interactive toy demonstrations, spaces for special events like birthday parties, new activities every day and open play areas.

The plan was announced Thursday after Tru Kids Brand, the parent of Toys R Us, entered a joint venture with the startup b8ta, which owns a chain of “experiential” stores. The retailer has relaunched its website, touting an experience “centered around product discovery and engagement.”

Although preferences and consumer shopping habits have changed over the years, “what hasn’t changed is that kids want to touch everything and simply “play,” said Phillip Raub, president of b8ta and interim co-CEO of the Toys R Us joint venture.

Consumers will have the opportunity to play with toys displayed out of the box before potentially purchasing them. The company believes that this immersive experience, for example, will help it track patterns and measure how in-store retail experiences effect online sales.

The first new stores will be in Texas and New Jersey.

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After officially closing its doors in nearly 200 locations in 2017, Toys R Us open the two new stores in The Galleria in Houston, Texas, and in the Westfield Garden State Plaza in Paramus, N.J.

The stores will be nearly 6,500 square feet — roughly one third the size of its big-box stores.

The joint partnership plans to open 10 additional stores in “prime, high-traffic retail markets” within the U.S. throughout 2020. Future store locations are planned to be about 10,000 square feet.

They’ll be “the most progressive and advanced stores in its category in the world, and we hope to surprise and delight kids for generations to come,” Vibhu Norby, CEO of b8ta said.

As NPR previously reported, the chain employed more than 30,000 people in the U.S. before the bankruptcy. Tru Kids Brands said it wants to give hiring priority to former employees.

Toys R Us declared bankruptcy after struggling with a heavy load of debt caused by a buyout in 2005, including competition from Amazon, Target and Walmart. The company owed more than $5 million.

Even as it went bankrupt, the original Toys R Us accounted for about a fifth of toy sales in the U.S.

Tru Kids Brands currently operates more than 700 stores outside the U.S.

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Health July 18, 2019

U.S. Overdose Deaths Dipped In 2018, But Some States Saw ‘Devastating’ Increases

Nationally, drug overdose deaths reached record levels in 2017, when a group protested in New York City on Overdose Awareness Day on August 31. Deaths appear to have declined slightly in 2018, based on provisional numbers, but nearly 68,000 people still died.

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Good news came out from the Centers for Disease Control and Prevention Wednesday: Preliminary data shows reported drug overdoses declined 4.2% in 2018, after rising precipitously for decades.

“It looks like this is the first turnaround since the opioid crisis began,” says Bertha Madras who served on President Trump’s opioid commission, and is a professor of psychobiology at Harvard Medical School.

She says it won’t be entirely clear until the CDC finalizes the numbers but, “I think the tide could be turning.”

But not everyone was celebrating. Some states actually saw double-digit increases.

“It’s deflating,” Rachel Winograd says. She’s an associate research professor at the University of Missouri-St. Louis. “It’s incredibly discouraging to see the increase in Missouri in 2018 that happened at the same time as we really ramped up so many efforts to save lives and improve lives in our state.”

The provisional data shows Missouri deaths increased by 17% — one of 18 states that saw a year-over-year increase.

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Over the last several years, Missouri has received $65 million in federal grants to address the opioid crisis, Winograd says, and she has helped the state decide where and how to spend that money. They’ve focused on expanding access to medication-assisted treatment, and “saturating our communities with naloxone — the opiate overdose antidote,” she says.

“Any scholar who’s been studying this epidemic will tell you that those are effective tools at saving lives. We’ve drastically increased access to those services and we know we’ve saved thousands of lives.

“The fact that the numbers didn’t go down and that people were dying at an even higher rate — it was devastating,” Winograd says.

The numbers out Wednesday are not final, notes Farida Ahmad, mortality surveillance lead of the National Center for Health Statistics at the CDC. She says they should be close to the final numbers, though. For provisional data, “our threshold is for 90% completeness,” she says.

Michael Botticelli, the executive director of the Grayken Center for Addiction at Boston Medical Center and formerly President Obama’s drug czar, says the geographic variation in drug deaths is troubling.

“I think it’s important to pay attention to and really understand what is happening in each of these states, and why are some states seeing dramatic increases versus those seeing dramatic decreases?” he says.

The reasons for this geographic variation are numerous. For one, this data only reflects the difference from one year to the next, so states that had a bad year in 2017, can show an improvement in 2018, even if the overall picture is still grim.

Another variable is fentanyl, the highly potent synthetic opioid that’s been responsible for a rising number of overdoses in recent years. Some states have a lot of fentanyl in their drug supply, and others do not.

“We saw increases all along the Mississippi river, and I would not be surprised if that was due to an increase in the proportion of fentanyl in their drug supply,” Winograd says. Deaths from fentanyl continue to rise, according to Ahmad from the CDC.

Other variations in the drug supply could contribute to the differences from state to state, says Christopher Ruhm, a professor of public policy at the University of Virginia. He notes stimulants have a different geographic spread than fentanyl, and those deaths are also on the rise.

“Some of this may be due to the nature of the drug epidemic in different places, some of it may also be due to how much we are providing medication-assisted treatment, and engaging in other policies to try to address this problem,” Ruhm says.

The social safety net also plays a role, says Winograd. In Missouri, “we just have fewer resources to help people in need,” she says.

“We have a lack of housing, incarceration rates are increasing — these are all connected and making the most vulnerable people in our society at highest risk of overdose deaths.”

Missouri was among five states that showed increased overdose numbers and had not expanded Medicaid, Winograd notes. Medicaid expansion means more people have coverage for addiction treatment, and research shows it’s making a difference.

Ohio was a bright spot on the 2018 map, showing a 22% decrease in 2018, although in raw numbers, it still had 4,000 reported deaths.

“It is still a nightmare. And the danger in media over-portraying this is actually quite substantial,” says Shawn Ryan, an addiction doctor in Ohio and past-president of the Ohio Society of Addiction Medicine. “If we look at just that decrease nationally — which is not that big — we’re missing the point. In order to get back to baseline, we have a very long way to go.”

In the CDC’s preliminary national numbers, 67,744 people are reported to have died from drug overdoses in 2018. Even though that’s several thousand less than died from drug overdoses in 2017, it’s still many, many more people than died of AIDS in the worst years of the crisis.

The decline should not be a signal to slow down efforts — or funding — to combat the epidemic, Ryan says.

He cites the proposed CARE Act, a legislative effort led by Senator Elizabeth Warren, D-Mass., and Representative Elijah E. Cummings, D-Md., which would allocate $100 billion over 10 years for addiction and recovery services. The CARE Act is modeled on the Ryan White Act, put in place to combat the AIDS epidemic.

“That’s actually much more in line with what’s needed,” says Ryan.

$100 billion would dwarf past federal funds for the epidemic. Grants from the State Targeted Response to the Opioid Crisis program, authorized by the 21st Century Cures Act, totaled $1 billion. In 2019, State Opioid Response federal grants are set to total $1.4 billion.

“If you look at the dollars spent to date, the fact that we’ve had the impact we’ve had is actually because of people being invested and working very hard for not that many dollars,” says Ryan.

Boticelli agrees that the only way to ensure the national trend continues is to adequately fund it. “We can’t look at a 5% reduction and say our work is done. I think it basically shows us that we have to redouble our efforts,” he says. “How are we going to ensure that states have the resources that they need to continue to focus energy on this epidemic?”

In a statement Wednesday, Health and Human Services Secretary Alex Azar celebrated the decline and indicated that federal funding won’t be going away. “By no means have we declared victory against the epidemic or addiction in general. This crisis developed over two decades and it will not be solved overnight,” Azar wrote.

Rachel Winograd says for her, the increase in deaths in Missouri is an indication that there’s much more to do.

“I am very proud of what Missouri has done. I don’t think we should have done anything differently,” she says. “And I do think that we’ve been even more aggressive than many of the states that saw decreases, in terms of our focus on evidence-based solutions.

“It’s not that we did the wrong thing — it’s that we didn’t do enough of the right thing,” she adds. “And we need more sustainable funding to do that.”

Carmel Wroth contributed reporting to this story.

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Sports July 18, 2019

Frenchman Julian Alaphilippe Leads Tour De France As Race Enters Second Half

NPR’s Ari Shapiro speaks with Damian McCall, a reporter for the Agence France-Presse, about this year’s Tour de France and the Frenchman currently in the lead, Julian Alaphilippe.



ARI SHAPIRO, HOST:

French people are more riveted than usual to the Tour de France this year. A French cyclist has not won the Tour in 34 years, and this year, there are two grabbing the world’s attention. Damian McCall is a reporter with Agence France-Presse, and he’s been covering the tour.

Welcome to the program.

DAMIAN MCCALL: Hello, everybody.

SHAPIRO: Let’s start with the cyclist who is currently in the lead as the race enters its second half. Who is he? Tell us about him.

MCCALL: This is a guy called Julian Alaphilippe, and he is, in fact – in terms of road racing, cycling, he is the world’s No. 1. And Julian – he’s riding for a Belgian team called Quick-Step, and he’s been wearing something called the yellow jersey, which the overall leader of the Tour de France wears so the public on the roadside can pick out the fast-moving peloton sweeping past them. Alaphilippe is in the lead – his eighth day he’s going to be wearing the yellow jersey.

SHAPIRO: But even though he’s in the lead, he’s not expected to win. Explain that to us.

MCCALL: All right. He’s basically a one-day racer. His team go for one-day races. There are many prizes on offer in the Tour de France. The team that are expected to win it are not trying to win at all stages. They’re trying to get the best overall time. And they have two contenders for that – very different men. One’s the 33-year-old Welshman, the defending champion. The other one’s a 22-year-old Colombian whiz kid, Bernal. He’s currently third. So they’re second and third.

But Alaphilippe seems to be digging deeper every day. He’s a former soldier. And he’s extremely tough, really affable, straight-talking. The things he’s done – they’ve set on fire the passions of the people, really. He’s just sort of gone on a rampage – these break-for-the-border dashes for the finishing line. And he’s succeeded three or four times, and everybody’s talking about him.

SHAPIRO: And then there is another Frenchman who is one of the favorites to win the race. Tell us about him.

MCCALL: That’s right – Thibaut Pinot, very different, a very emotional man. And he fell into a trap a few days ago and lost a bit of time. But he’s still in with a very big shot. So he’s vowed to fight back on Saturday and may well get back into a position. Thibaut Pinot is about 28, 29 years old. He hasn’t raced here for a while. He’d been racing in Italy. He really is a very, very popular man. And if he does win the Tour de France, he will be the most popular man in France.

SHAPIRO: Now, as we’ve said, the race is just past its halfway point, and a Frenchman has not won the Tour de France in 34 years. So what’s the attitude and sentiment like among people in these small French towns where the cyclists are whizzing past?

MCCALL: I had the great opportunity just yesterday, in fact, to cover the 200-kilometer stage on the back of a motorbike. I mean, the roadsides are just packed. It’s a very popular sporting event. There’s no pay. You don’t – it’s not in a stadium. The stadium is the country itself. Today at the finish line – I went down to the finish line when we arrived at the finish town, and there was about 4 kilometers packed four, five deep towards the finishing line three hours before the guys arrived.

SHAPIRO: Wow.

MCCALL: There was drinking and singing and families, grandparents – and the kids are having their school holidays here.

SHAPIRO: Do French people seem particularly attuned to the possibility of a French cyclist possibly winning it?

MCCALL: Well, can I tell you something very French?

SHAPIRO: Of course.

MCCALL: No (laughter).

SHAPIRO: No. They don’t care.

MCCALL: Well, I think they care. They care deeply. They’re just skeptical because they haven’t won it since Bernard Hinault won his fifth in 1985.

SHAPIRO: The French people don’t believe this is actually their year. They’re not allowing themselves to hope.

MCCALL: Well, Julian Alaphilippe is in the yellow jersey. They’re starting to believe that maybe he can take it down to maybe the last three days. But, you know, I’m not sure he can concentrate all the way. They’re not sure he can concentrate. He’s too emotional.

SHAPIRO: Damian McCall is a reporter with Agence France-Presse.

Thank you for joining us.

MCCALL: Thank you very much. Bye-bye.

(SOUNDBITE OF KRAFTWERK’S “TOUR DE FRANCE ETAPE 1”)

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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