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Report: Widespread Doping In Russian Track And Field

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The World Anti-Doping Agency has found evidence of “deeply rooted culture of cheating” and use of performance-enhancing drugs by Russian athletes and coaches. It is calling for Russia to be suspended from international track events. NPR’s Audie Cornish speaks with German journalist Hajo Seppelt, who helped break the story.

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Report Says Volkswagen Will Attempt To Compensate Defrauded Diesel Owners

A Volkswagen Touareg diesel is tested in the Environmental Protection Agency's cold temperature test facility in Ann Arbor, Mich. The EPA has charged that the emissions scandal goes further than first acknowledged by the company.

A Volkswagen Touareg diesel is tested in the Environmental Protection Agency’s cold temperature test facility in Ann Arbor, Mich. The EPA has charged that the emissions scandal goes further than first acknowledged by the company. Carlos Osorio/AP hide caption

itoggle caption Carlos Osorio/AP

Volkswagen is reportedly preparing to hand out a little cash to diesel car drivers, in an effort to buy some good will and put the scandal over its faked emissions tests behind it.

The website The Truth About Cars said diesel owners would get a cash card worth $500, and another $500 to $750 to spend at a Volkswagen dealer.

Volkswagen would not confirm the report but did say it would make an announcement on Monday, The New York Times reported:

“The company faces lawsuits from owners seeking compensation for the decreased resale value of the roughly 500,000 Volkswagen and Audi vehicles that were equipped with illegal software. It was not clear whether owners would have to give up any rights to sue if they accepted the cash.”

In addition, current owners of Volkswagen vehicles have been offered cash incentives to buy or lease new cars.

Volkswagen has been mired in controversy since acknowledging that software sold in Golf, Jetta, Beetle and Passat models had been programmed to cheat on emissions tests. The company has denied claims by U.S. regulators that some larger diesel vehicles also had software that was not allowed.

Last week, Volkswagen acknowledged that some “emissions inconsistencies” had been found in 800,000 cars. The findings were disclosed during an internal investigation.

The German newspaper Bild am Sonntag reported that several engineers at Volkswagen had confessed to altering carbon dioxide emissions data. The newspaper said that, starting in 2013 and continuing through last spring, the engineers manipulated tire pressure to make them use less fuel.

They did this because they were afraid they couldn’t achieve emissions goals set by former chief executive Martin Winterkorn, who had ordered a 30 percent reduction of carbon dioxide by 2015, the newspaper said.

The activity was reported by a whistle-blower who is still at the company, according to the newspaper.

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With Sombreros And Sidesaddles, Virginian Women Renew A Mexican Tradition

Before their performance, three members of the Amazonas del Dorado watch the men's roping and riding competitions.
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Before their performance, three members of the Amazonas del Dorado watch the men’s roping and riding competitions. Vanessa Rancaño/NPR hide caption

itoggle caption Vanessa Rancaño/NPR

They sit high on their imported sidesaddles, their ruffled skirts tucked neatly beneath them at a ranch in northern Virginia. Las Amazonas del Dorado — this riding group slated to perform — are preparing for their next ride.

These six women are preforming the sport of escaramuza, a group riding event performed only by women at Mexican rodeos.

“When you’re on the horse and performing, it gives me chills every time,” said 17-year-old Adriana Jimenez. “Inside, you feel this great happiness, and it fills me up with pride inside to be from a place so full of culture and life and color.”

While the star of the show is the cowboy, these cowgirls provide some of the sport’s most dazzling entertainment.

To hear more about these women and the sport, listen to the audio link above.

The Amazonas perform in the rodeo ring their family built in Catlett, Va.

The Amazonas perform in the rodeo ring their family built in Catlett, Va. Vanessa Rancaño/NPR hide caption

itoggle caption Vanessa Rancaño/NPR

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First 'Star Wars: The Force Awakens' TV Spot Puts Han Solo Back In The Freezer

There’s just a little over a month to go before Star Wars: The Force Awakens hits theaters, which means we are entering its most fertile marketing period. Just two days ago everyone was surprised by the sudden appearance of a Japanese trailer for the movie containing a bevy of new footage. And now we’ve got another new video with yet even more new footage.

This first TV spot (which actually premiered on Twitter) is only 30 seconds long, but it contains new shots of Han Solo and some battles, including Rey firing a blaster at Kylo Ren. Perhaps most importantly, though, it contains some new voice over from Lupita Nyong’o’s mysterious new character, Maz Kanata, alluding to the multi-generational nature of the story.

Check it out.

The force is calling to you… Check out the first official TV spot for #StarWars #TheForceAwakens. https://t.co/tsKiEvZAK7

— Twitter (@twitter) November 8, 2015

Follow @PeterSHall Follow @MoviesDotCom

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Doctor Treats Homebound Patients, Often Unseen Even By Neighbors

Home care physician Roberta Miller loads up her 2002 Honda Odyssey minivan, which has more than 250,000 miles, to prepare for a day of visiting patients at their homes.

Home care physician Roberta Miller loads up her 2002 Honda Odyssey minivan, which has more than 250,000 miles, to prepare for a day of visiting patients at their homes. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

Dr. Roberta Miller hits the road at 8 a.m. to see her patients.

Many are too old or sick to go to the doctor. So the doctor comes to them.

She’s put 250,000 miles on her Honda minivan going to their homes in upstate New York. Home visits make a different kind of care possible.

Miller examines Donald Lacross, 48, who has had multiple sclerosis for almost 20 years. Miller has been his home care physician for three years.

Miller examines Donald Lacross, 48, who has had multiple sclerosis for almost 20 years. Miller has been his home care physician for three years. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

“You can evaluate the person as a whole,” says Miller, who has been a home care physician in Schenectady, N.Y., for more than 20 years. “You see everything that influences their health and well-being: the environment, the surrounding people, the support system, whether they had or didn’t have food.”

Miller spends about an hour at each house call. Conversation with patients and their family members flows so naturally that it’s easy to miss that she’s also checking vital signs, gently stretching a hand, noting which pill bottles are empty.

Miller (clockwise from upper left) checks what her patient Calla Osborne, 92, had to eat by reading notes kept by Osborne's daughter; Miller explains to John Toombs, 78, that canned soup can be high in sodium; Divina Gaskin, 71, tells Miller about the side effects of her pills; Miller checks in on Gordon Laymon, 76, who lives alone.

Miller (clockwise from upper left) checks what her patient Calla Osborne, 92, had to eat by reading notes kept by Osborne’s daughter; Miller explains to John Toombs, 78, that canned soup can be high in sodium; Divina Gaskin, 71, tells Miller about the side effects of her pills; Miller checks in on Gordon Laymon, 76, who lives alone. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

Although Miller’s practice may harken back to the country doctor of decades past, it could be the future of medicine. In 2013, about 2.6 million Medicare claims were filed for patient home visits and house calls. That’s up from 2.3 million visits in 2009 and 1.4 million visits in 1999, according to Medicare statistics.

The trend is expected to accelerate as baby boomers grow older. One in 20 people over the age of 65 is homebound in the U.S., according to a study published in July in JAMA Internal Medicine.

“That’s just the nature of the population we treat,” Miller says. “They’re extremely ill. Homebound patients often have up to 12 or 13 problems, not just one.”

And they’re often invisible. These people could be living just down the block, and you’d never know it. Many of them never leave their homes.

Patricia Gillihan, 71, lies in her home hospital bed while Miller checks her medical records.

Patricia Gillihan, 71, lies in her home hospital bed while Miller checks her medical records. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

Miller in her 1971 Phillips Beth Israel School of Nursing graduation photo. She worked as a nurse in New York City before going to Rutgers Medical School and becoming a doctor. (At right) Miller heads back to her van after visiting a patient in Troy, N.Y.

Miller in her 1971 Phillips Beth Israel School of Nursing graduation photo. She worked as a nurse in New York City before going to Rutgers Medical School and becoming a doctor. (At right) Miller heads back to her van after visiting a patient in Troy, N.Y. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

Miller’s patients include a 55-year-old woman with ALS who can communicate only with her eyes, a 27-year-old former quarterback left quadriplegic after surgery on an Achilles tendon, a 92-year-old woman cared for by her daughter and a severely depressed man who lives alone.

Jahmel Tarver, 27, is in a coma caused by complications from surgery for a torn Achilles tendon. Tarver is a former quarterback for the Troy Fighting Irish, a semipro football team.

Jahmel Tarver, 27, is in a coma caused by complications from surgery for a torn Achilles tendon. Tarver is a former quarterback for the Troy Fighting Irish, a semipro football team. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

It’s challenging to visit one patient after another, many of whom are at the end of the line, Miller says. What helps keep her going is the deep relationships that develop, where she acts as family, friend and physician.

“Many times, like this gentleman, he’s all alone. You are it — you are the contact. And in that sense, sometimes it’s overwhelming,” Miller says after visiting a patient who has no family nearby. “You have to set limits, and when you do that, you can have a really excellent working relationship with people.”

Being on-call for her patients 24/7 can be a challenge, but Miller feels responsible, knowing there are so few home care doctors out there. She and her husband, Dr. David Hornick, who’s also a home care physician, have close to 300 patients right now. There’s a long waiting list for care.

There aren’t enough home care doctors to go around. One reason is reimbursement. “Health care systems are attracting primary care providers to their networks by salary packages that can’t currently be sustained in a home care practice,” Miller explains.

Miller listens to Budd and Terri Wyman. Terri, 55, can only communicate with her eyes using a speech-generating device.

Miller listens to Budd and Terri Wyman. Terri, 55, can only communicate with her eyes using a speech-generating device. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

After a long day visiting patients, Miller takes a rare rest on a canopied hammock in her backyard. Her workday usually starts at 8 a.m. and ends at 1 in the morning. At right, Miller and her husband, Dr. David Hornick, also a home care physician, check incoming text messages from patients during dinner at their favorite Italian restaurant, Mario's.

After a long day visiting patients, Miller takes a rare rest on a canopied hammock in her backyard. Her workday usually starts at 8 a.m. and ends at 1 in the morning. At right, Miller and her husband, Dr. David Hornick, also a home care physician, check incoming text messages from patients during dinner at their favorite Italian restaurant, Mario’s. Misha Friedman for NPR hide caption

itoggle caption Misha Friedman for NPR

Home care skills are rarely taught in today’s medical education system, Miller says, but that doesn’t mean there’s not a need.

After the Affordable Care Act took effect in 2014, Miller saw a spike in new patient requests. Low-income Medicaid patients had sought house calls in the past, but the government insurance wasn’t enough to cover the cost of Miller’s visits, including travel expenses.

“Now we can afford to see them and take care of them. Because they haven’t had medical care, they have multiple medical needs and psychosocial needs,” she says. “It has given us access to a group of people, but more importantly, they have access to us.”

The Affordable Care Act affected Medicare patient coverage, too, Miller says. Medicare reimbursements increased in 2014 for people who are disabled or 65 and older. But reimbursements declined in 2015 because of sequestration. And now Medicaid reimbursements rates starting to decrease as well.

Miller believes the shortage of physicians who are willing to make home visits is directly attributable to this inadequate payment for service.

“The big question is: Is there ever going to be a system where home healthcare providers can be reimbursed appropriately so that we can create a greater workforce of home care providers?”

She sure hopes so.


Photographer Misha Friedman says he tries to “look beyond the facts, searching for causes, and asking complex and difficult questions.” His work has been featured by many media organizations, including NPR, The New Yorker, Sports Illustrated, Spiegel and GQ.

Freelance writer Nadia Whitehead contributed to this report.

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This Weekend in Movie Culture: The Sound of 'Star Wars,' Ghostbuster Iron Man and More

Here are a bunch of little bites to satisfy your hunger for movie culture:

Star Wars of the Day:

It’s no wonder the original Star Wars received a special Oscar for its sound effects. It’s surprising that more of the movies weren’t nominated for Best Sound Editing, though. Here’s a great supercut of the sounds of Star Wars (via Live for Films):

[embedded content]

Movie Mashup of the Day:

In case The Avengers ever have to bust some ghosts, Tony Stark is prepared with this new Iron Man armor (via Geek Tyrant):

Concert Tour Trailer of the Day:

If you love movie scores, especially the billion of them by Hans Zimmer, you probably don’t need this trailer to make you want to see Zimmer in concert, but it’s still pretty cool (via Geek Tyrant):

[embedded content]

Cosplay of the Day:

More people should cosplay as (good) movie poster art, a la this guy going as the iconic imagery for John Carpenter‘s The Thing (via Live for Films):

Supercut of the Day:

Watch a bunch more movie posters based on actual movie scenes come to life in another video by Whoispablo:

[embedded content]

Movie Art Fail of the Day:

When home video artwork all looks the same … whoever wins we all lose:

there is an opportunity for a VERSUS movie here that needs to be exploited pic.twitter.com/Ev3GWh6KM0

— Max Landis (@Uptomyknees) November 5, 2015

Filmmaker in Focus:

Watch Alfred Hitchcock direct the strangling scene from Frenzy in this rare opportunity to see the master at work:

[embedded content]

Fan Art of the Day:

If it’s good enough for co-director and star Jemaine Clement, it’s definitely good for the rest of us What We Do in the Shadows fans:

Love this fan art by HarryBuddhaPalm pic.twitter.com/iutRGLNyHS

— Jemaine Clement (@AJemaineClement) November 6, 2015

Pro Art of the Day:

Who doesn’t want a Muppet Babies type cartoon based on Mad Max: Fury Road? See more of Joey Spiotto’s Little Golden Book inspired artwork at /Film.

Classic Trailer of the Day:

In honor of the release of SPECTRE, let’s revisit the first movie starring Daniel Craig as James Bond. Watch the original trailer for 2006’s Casino Royale below.

[embedded content]

Send tips or follow us via Twitter:

and

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'Tribal' Book Looks At College Football's Rabid Fans

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Florida State University Professor Diane Roberts talks about her book “Tribal: College Football and the Secret Heart of America” which examines the communities of rabid fans around college football.

Transcript

MICHEL MARTIN, HOST:

You are a football fan. Tell me if anybody’s ever said this to you – you are an intelligent, cultivated person. You cannot like college football. You don’t like college football. Well, Diane Roberts is an intelligent woman. She holds a doctorate from Oxford and she teaches literature and creative writing at Florida State University. And she can love football, and she does. And now to all you haters out there, she’s written a book to tell you why. It’s called “Tribal: College Football And The Secret Heart Of America,” and she is with us now.

Welcome, thanks so much for joining us.

DIANE ROBERTS, BYLINE: Thank you.

MARTIN: Tell me about that opening sentence. So somebody actually said that to you – a colleague of yours, I take it?

ROBERTS: It was actually a distinguished historian who said it to me, who was just absolutely appalled. How could you like this game? It’s a terrible game. And obviously, you’re not as smart as we think you are. So there you go.

MARTIN: So you’re quite open about your love for the game?

ROBERTS: Oh, yeah. Oh…

MARTIN: You’re not in the closet at all?

ROBERTS: Oh, my God. I was born into it. This is – these are my people. And, you know, everybody likes to be part of a group or a tribe or whatever.

MARTIN: You write about that in the book. You say I’m a Seminole lifer. I grew up in Tallahassee looking forward to the rhythm of fall Saturdays, making potato salad for the tailgate, making sure for the 14th time that we had the tickets and the parking pass and the corkscrew. But here’s what’s funny about your book – you then go on to tell us every terrible thing there is to know about football, including the very early deaths that resulted from people playing football. In fact, you talked about this contest between – tell me about that – it was in – what – in 1897?

ROBERTS: Well, which one? There are so many that people actually died. But Harvard-Yale games used to be particularly horrible, but there were firearms.

MARTIN: You wrote about the one from – gosh – Georgia against Virginia who fell and – well, go ahead.

ROBERTS: Oh, that poor boy, yes. There was a guy named Richard Gammon. He went by Von, which was part of his middle name. And yeah, he died, basically, of massive brain hemorrhage. And this was 1897, and he, you know, he collapsed on the field. He died later. The state of Georgia was prepared to ban college football, just ban the game. And there was a bill, the governor was going to sign it. It’s all about to happen. And then this poor boy’s mother wrote in and said please don’t ban the game. It’s what he thought manliness was all about. And he would just hate that, so don’t ban it.

MARTIN: So – but you go on to describe, not just on the field, but also hazing incidents. There’s this terrible incident involving the Florida A&M drum major who was beaten to death in a hazing incident – you talk about that.

ROBERTS: Yeah, that’s one of the saddest things. It’s just so sad.

MARTIN: And you also turn a very – you are unsparing about a recent top pick – top draft pick.

ROBERTS: Jameis Winston.

MARTIN: Jameis Winston, who has been accused of rape. It’s really – your subject is not just what he is alleged to have done, but how the universe around him responded to it.

ROBERTS: Football players do occupy a special place on a college campus in a college town, especially if they’re really, really good, like Jameis Winston is. And he – we just didn’t want to believe that he was capable of any such thing. And I should make clear, he was never charged with rape. But, you know, there it was; it was out there. And one of the big problems was that the university didn’t exactly trip over itself to help with the investigation, sadly. The local cops, they didn’t try real hard either. And by the time anybody did seem to try hard, a lot of the evidence had gone away or was erased or, you know, too much time had passed. So we will never know if Jameis Winston did anything really bad or not. And what I do know is that the young woman who accused him was treated disgracefully; she was more or less hounded off campus and sent death threats and other things. I mean, come on, death threats. It was just absurd.

MARTIN: Have you ever faced a moment where you said to yourself, I’m just not sure I can do this anymore?

ROBERTS: Yeah. I do that every time there’s an accusation of a player hitting a woman, assaulting a woman. I do that every time, you know, some coach goes off on, you know, what a tough life he has and it’s really hard to live on $4 million a year. I do it sometimes when a coach yells at the fans for not being fan-ish enough. You know, that’s like, come on, bud, that’s ridiculous. You know, this is all out of whack. So I can perfectly well hold that in my head and I can disparage it and I mean it. At the same time, I can really, really sulk when Florida State loses. So I know that the game is going to have to change, and yet I can still – maybe I’m just a hypocrite, I haven’t figured this out yet – I can still enjoy it. I can still sit there and just find a well-thrown pass caught way down the field just the most beautiful thing. It’s just gorgeous.

MARTIN: So have you figured out what it is that you actually do love about it?

ROBERTS: I suspect what I love about it is that I’m part of it, which is odd. It’s part of my identity, and I don’t mean that in a narcissistic way. What I mean is that it connects me to my father, who died when I was very young, and I inherited his season tickets. It connects me to a whole community of people, many of whom I don’t have that much in common with except for the football. It connects me with the university, and that – you know, that we are often very good at this game is nice. But even when we’re not good – you know, we sat through the 0 and 11 season, which, I’ll tell you, that’ll toughen up your soul.

MARTIN: (Laughter) Diane Roberts is author of “Tribal: College Football And The Secret Heart Of America.” And we reached her at the studios of WFSU in Tallahassee, Fla.

Diane, thanks so much for speaking with us.

ROBERTS: Thank you so much.

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New And Old Sounds From Mexico's Festival Internacional Cervantino

Taraf de Haidouks, a Romanian group that recently celebrated 25 years together, performs at the 2015 Festival Internacional Cervantino in Guanajuato, Mexico.
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    Taraf de Haidouks, a Romanian group that recently celebrated 25 years together, performs at the 2015 Festival Internacional Cervantino in Guanajuato, Mexico.
    Betto Arcos
  • Cécile McLorin Salvant gives a festival performance at the Teatro Juárez.
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    Cécile McLorin Salvant gives a festival performance at the Teatro Juárez.
    Betto Arcos
  • Argentina's Camerata Bariloche chamber ensemble performs at the Templo de La Valenciana.
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    Argentina’s Camerata Bariloche chamber ensemble performs at the Templo de La Valenciana.
    Betto Arcos
  • Cuban saxophonist Paquito D'Rivera and Mexican composer Armando Manzanero join forces on stage.
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    Cuban saxophonist Paquito D’Rivera and Mexican composer Armando Manzanero join forces on stage.
    Betto Arcos
  • An angel walks the streets of Guanajuato.
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    An angel walks the streets of Guanajuato.
    Betto Arcos

Betto Arcos — world-music connoisseur and host of the Cosmic Barrio podcast — is a frequent guest of weekends on All Things Considered, where he shares the music he’s discovered in his travels.

He recently returned returned from the Festival Internacional Cervantino, a major performing arts festival in Guanajuato, Mexico. From Argentinian chamber music to American jazz, he joins host Michel Martin to share some of his favorite acts from the event. Hear their conversation at the audio link, and listen to the songs below.

Hear The Music

camerata

camerata Courtesy of the artist hide caption

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La Muerte Del Angel

  • Artist: Camerata Bariloche
  • From: Piazzolla Collection
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Cover for For One To Love

Wives And Lovers

  • Artist: Cécile McLorin Salvant
  • From: For One To Love
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Fields Are Blooming

  • Artist: Taraf de Haïdouks
  • From: Of Lovers, Gamblers & Parachute Skirts
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Somos Novios

  • Artist: Paquito D’Rivera
  • From: Paquito & Manzanero
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Examing The Motivations Behind Obama's Keystone XL Decision

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NPR’s Scott Detrow talks with host Scott Simon about the politics, perceptions, and reality of President Obama’s move to reject the Keystone XL pipeline project.

Transcript

SCOTT SIMON, HOST:

The Keystone XL pipeline project has been in front of Barack Obama for most of his administration. Yesterday, President Obama said it won’t be built.

(SOUNDBITE OF ARCHIVED RECORDING)

BARACK OBAMA: America’s now a global leader when it comes to taking serious action to fight climate change. And frankly, approving this project would have undercut that global leadership.

SIMON: The announcement has implications for U.S. politics and also global negotiations. NPR’s Scott Detrow joins us in our studio. Scott, thanks very much for being with us.

SCOTT DETROW, BYLINE: Thanks for having me.

SIMON: How important is this decision to the U.S. energy resources?

DETROW: Well, I would say it’s very important and also not really important at all. The Keystone XL pipeline has become the political flashpoint when it comes to environmental and climate policy and energy policy here in the United States. Supporters have said it would create tens of thousands of jobs. Opponents of the pipeline say that the oil coming through it, going to the market, would just put the world over the top in terms of carbon dioxide that’s being emitted from energy extraction. And that overcharged debate is an issue that President Obama addressed when he made this announcement.

(SOUNDBITE OF ARCHIVED RECORDING)

OBAMA: For years, the Keystone pipeline has occupied what I, frankly, consider an overinflated role in our political discourse. It became a symbol too often used as a campaign cudgel by both parties rather than a serious policy matter.

DETROW: But because of that – because of the role that Keystone plays in the conversation, President Obama can use this decision to send a very clear message to the rest of the world – that climate implications matter a great deal when he and the United States are making decisions about energy policy.

SIMON: But realistically, isn’t in the oil already on its way?

DETROW: Yeah, that’s accurate. This oil is being extracted in Alberta. It’s going to the global market. It’s being consumed anyway. And that was an argument in favor of it. Folks were saying that this is coming by barge. It’s coming by train. Why not have it come in a pipeline that you could argue is safer and less vulnerable to spills and crashes and things like that?

SIMON: And why do you think the decision comes now? We’ll note, of course, the president doesn’t have to run for re-election anymore.

DETROW: That’s right. He doesn’t. I think he’s – you can make the argument that he’s timing this in a very symbolic way. This comes on the eve of a very important climate summit that’s going to happen in Paris. It begins later this month. And that’s the United Nations’ latest attempt to get a global game plan in place to lower carbon dioxide to address climate change.

There have been several of these summits before, and they haven’t really gone too well. And historically, the United States has kind of been the bad guy here. Historically, more emissions come from the United States than any other country. And you could view this as a way of – for President Obama to make a statement to other world leaders that this time around, the United States is going to be very serious about coming out of these negotiations with a solution and a real game plan.

SIMON: What are the significant policy issues right now?

DETROW: Well, if the Keystone XL pipeline is kind of overblown and also not critically important to the big picture energy landscape in the United States, there’s another policy that started taking place that’s kind of the opposite. It’s very important, and it’s probably going to shift the way that energy is produced in the U.S., but it doesn’t get as much attention. And that’s something called the Clean Power Plan. That is an EPA regulation that is going to require states to shift away from coal and to lower carbon sources like solar, wind power, but also a lot more natural gas in the way that big-scale utilities produce their energy. And that policy, which is in the very long process of going into a codified EPA regulation, is kind of the backbone of the plan that the United States is going to take to Paris later this month.

SIMON: NPR’s Scott Detrow, thanks so much.

DETROW: Thank you, Scott.

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Confusion And High Costs Still Hamper Obamacare Enrollment

Vernon Thomas, a part-time music producer, is trying to decide whether it's worth it to sign up for health insurance.
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Vernon Thomas, a part-time music producer, is trying to decide whether it’s worth it to sign up for health insurance. Fred Mogul/WNYC hide caption

itoggle caption Fred Mogul/WNYC

Recording and mixing music are Vernon Thomas’ passions, but being CEO and producer of Mantree Records isn’t his day job.

He’s an HIV outreach worker for a county health department outside Newark, N.J. He took what was to be a full-time job in May because the gig came with health insurance — and he has HIV himself.

But then the county made it a part-time job, and Thomas lost health coverage before it even started. “Benefits are more important than the money you’re making,” he says.

The Affordable Care Act’s third open enrollment season started Nov. 1, and federal officials are hoping to reach about a million uninsured people nationwide before it closes on Jan. 31.

Newark has an estimated 112,000 uninsured people, including Thomas, around one-third of the city’s population. Newark is one of five areas – along with Houston, Dallas, Chicago and Miami – where the federal government is focusing enrollment efforts.

Altogether, Washington will spend more than $100 million dollars on marketing and enrollment nationwide.

Why has Thomas stayed on the sidelines for Obamacare’s first two years? He values insurance and regular health care, but he says he didn’t fully understand what the law had to offer him. He’s still trying to make up his mind about signing up for coverage this time around.

He has been getting HIV medications, care of the federal government’s AIDS Drug Assistance Program. It doesn’t cover anything else, though, and Thomas says he’d like more medical care, particularly a regular doctor who could keep an eye on issues that worry him.

“Prostate cancer runs in my family on both sides,” Thomas says. “My mother and her mother and her brother all had diabetes. My mother had hypertension also. Fortunately, I have low blood pressure. But now they’re saying I have high cholesterol.”

Thomas’ part-time job doesn’t pay a lot, yet he makes too much to get free health care from Medicaid. He’s eligible to buy a plan on the exchange, but he says it’s too expensive because the cost of living in Newark is high for him.

So he has gone without coverage and kept his fingers crossed. “I try not to think about it — getting sick,” he says.

Thomas didn’t know the health law’s benefits for people in his income bracket. He qualifies for subsidies that would bring his premium down to $100 or less and also cost-sharing support that would pick up much of the deductible and other out-of-pocket expenses.

Brian McGovern, head of the North Jersey Community Research Initiative, says overcoming misconceptions about Obamacare has been one of his staff’s biggest jobs. “It’s always been about trust with some of our patients,” he says.

Susan Nash, a partner at the McDermott Will & Emery law firm in Chicago, says that health insurance is still too expensive for millions of people living paycheck-to-paycheck.

“These individuals are having difficulty affording food and housing, and so it’s a calculus: ‘Do I need health insurance? Do I think I’m going to have a catastrophic event or have some large health care expenditures this year?’ ” Nash says.

The government says about 8 in 10 of these eligible but uninsured people qualify for subsidies. But some of them will get only a little help from the government — and others will get none at all.

Middle-income people can spend hundreds of dollars a month on a high deductible, if they need significant care. And they wouldn’t qualify for the same help with out-of-pocket expenses that Vernon Thomas would. That means they often spend additional hundreds of dollars before coverage actually kicks in.

Still, under the law, most people have to get insurance – or face a tax penalty next year of either 2.5 percent of income or $695 per adult and $347.50 per child under 18, with a maximum of $2,085. Even if people have a sense of these fines, they still might not worry about it. The fines don’t actually hit until Tax Day, 2017. And for many of people, that’s just too far away – and just too abstract.

This story is part of a reporting partnership that includes WNYC, NPR and Kaiser Health News.

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