U.S. health care is broken at every level. Can it be fixed?

Summary

Apple News Today: Episode Summary – "U.S. Health Care is Broken at Every Level. Can it be Fixed?"

Host: Shamita Basu
Release Date: December 13, 2024

In this compelling episode of Apple News Today, host Shamita Basu delves into the multifaceted crises plaguing the United States healthcare system, explores the potential resurgence of family separations under a possible second Trump administration, examines significant shifts in the reality television industry concerning workers' rights, and highlights a groundbreaking advancement in HIV prevention. Below is a detailed summary of the episode, structured into clear sections to provide an in-depth understanding of each topic.

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1. The Crumbling U.S. Healthcare System

Shamita Basu opens the episode by addressing the pervasive dissatisfaction with the American healthcare system. The recent tragic killing of United Healthcare CEO Brian Thompson and the subsequent arrest of his alleged shooter have ignited nationwide frustration. Basu highlights that confidence in U.S. healthcare is at an unprecedented low:

• Public Trust Decline: According to Gallup, approval ratings for doctors and hospitals have plummeted by over 10% in the past decade. Furthermore, only 18% of the public views the pharmaceutical industry favorably.

• Consumer Nightmares: Dylan Scott from Vox articulates the common struggles faced by Americans navigating their health insurance:

  Dylan Scott [01:21]: "When people go through those experiences, it's one of the most fraught moments of their lives. Like they or somebody they love is probably experiencing a medical emergency. And on top of that, they're entering this, you know, Kafka-esque bureaucratic nightmare."

• Blame Game within the Industry: Scott explains that the systemic issues arise partly because no single entity can be held accountable. Instead, various stakeholders—insurance companies, hospitals, doctors, and pharmaceutical firms—are entangled in a relentless cycle of finger-pointing:

  Dylan Scott [02:01]: "There's this ongoing blame game within the healthcare industry that makes it just really confusing to understand, like why this problem exists in the first place."

• Policy Missteps: A recent policy change by Anthem, Blue Cross and Blue Shield, which proposed not covering anesthesia if a procedure exceeded a certain time limit, backfired. Public backlash branded Anthem as the stereotypical "big bad insurance company," leading to the withdrawal of the policy. However, Vox clarifies that the policy aimed to protect patients from being overbilled by anesthesiologists, underscoring how miscommunication and loss of goodwill can derail constructive policy initiatives.

• Comparative Metrics: Scott emphasizes that the U.S. spends more on healthcare compared to other wealthy nations but achieves worse health outcomes:

  Dylan Scott [03:06]: "The bottom line is like you can look across a bunch of different metrics, but one consistent finding across them. When you compare the United States to healthcare in other wealthy countries, what you always find is that the US Pays more money for healthcare and on average, you know, taken collectively, gets worse outcomes."

• Path to Reform: Addressing these systemic flaws requires collective accountability from all sectors of the healthcare industry. Additionally, voter engagement is crucial, as historical attempts at healthcare reform have often faltered due to political backlash:

  Dylan Scott [03:40]: "That's been the pattern of healthcare politics is people get really mad about it, but then either nothing happens or somebody tries to change something and then voters punish them."

Scott advocates looking to other countries for successful healthcare models that ensure comprehensive coverage irrespective of individuals' financial capabilities, noting that the U.S. remains an outlier among wealthy nations in this regard.

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2. The Threat of Family Separations Under a Second Trump Term

Basu transitions to a deeply emotional and controversial topic: family separations at the U.S.-Mexico border, a policy starkly associated with Donald Trump's first term. She recounts the harrowing images and recordings that brought widespread condemnation to the administration's immigration policies.

• Trump's Stance on Family Separation:

  In an interview with NBC's Kristen Welker, former President Trump addressed concerns about potential future family separations:

  Donald Trump [05:56]: "We don't have to separate a family. Excuse me, Kristen. Yeah, we don't have to separate families. We'll send the whole family very humanely back to the country where they came. That way the family's not separated."

  However, his response included a caveat:

  Donald Trump [06:09]: "It depends on the family. The family may decide to say, I'd rather have dad go and we'll stay here, and in which case they have that option."

• Critical Analysis by Jacob Soboroff:

  NBC correspondent Jacob Soboroff provides a nuanced critique of Trump's assurances, arguing that family separations could persist in different forms:

  Jacob Soboroff [06:28]: "While family separation at the border was ripping children away from parents, mass deportation in the interior is family separation because it will rip parents away from children in their homes or at their workplaces or outside of their schools."

  Soboroff, together with filmmaker Errol Morris in their documentary Separated, underscores the legislative inaction that allows such policies to resurface:

  Jacob Soboroff [07:01]: "They can, with one piece of legislation, bar the immigration enforcement apparatus from using family separation as a tool of immigration enforcement, and they haven't done that. It was proposed, most notably by Julian Castro, but the bill went nowhere."

• Lack of Accountability:

  Soboroff highlights the absence of legal repercussions for those responsible for the family separation policies, despite widespread condemnation:

  Jacob Soboroff [07:24]: "President Biden famously said in the final presidential debate of 2020 that he believed that the family separation policy was criminal, and Merrick Garland, during his confirmation hearings to become the attorney general, said he couldn't imagine anything worse than ripping parents apart from their children. And yet there has been no criminal investigation, as far as we know, opened from within the Justice Department into the family separation policy, despite everything that we know about it."

This segment underscores the persistent vulnerability of immigrant families and the critical need for legislative measures to prevent future separations.

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3. Workers’ Rights in Reality Television: The Love is Blind Case

Shifting focus to the entertainment industry, Basu discusses a landmark decision by the National Labor Relations Board (NLRB) concerning the popular Netflix dating show Love is Blind. This ruling could revolutionize labor standards within reality television.

• NLRB’s Ruling:

  The NLRB determined that Love is Blind violated contestants' workers' rights, potentially granting them federal legal protections. This decision may catalyze unionization efforts across reality TV genres, which have long suffered from inconsistent compensation and protection standards.

• Industry Response and Legal Battles:

  Production companies have traditionally defended their treatment of cast members, asserting that participants have full autonomy over their decisions. However, lawsuits have emerged, highlighting exploitative conditions:

  A Season Two Contestant: Alleged receiving only $1,000 a week while working up to 20-hour days, seven days a week.

• Insights from Emily Nussbaum:

  Emily Nussbaum, a New Yorker writer specializing in reality TV, was featured earlier in the episode. She explains that the issues faced by Love is Blind contestants are emblematic of broader industry practices:

  Emily Nussbaum [09:45]: "On Love is Blind, contestants live together. They go on blind speed dates, which in some cases end with an engagement and a dramatic first meeting followed by a whirlwind of dates before couples go to the altar to decide if they'll actually get married. The whole season is filmed over just a few weeks, and I can personally attest that with the right attitude, you can watch a whole season in just a few days. Most reality shows have strict rules that contestants must follow."

• Confidentiality and Legal Constraints:

  Contestants are often bound by non-disclosure agreements (NDAs), preventing them from discussing their experiences or criticizing how they are portrayed. This secrecy can mask exploitative practices, as exemplified by Renee Pochet's case:

  Renee Pochet's Experience [10:49]: After being paid only $8,000 for eight weeks of filming and facing severe personal challenges, Renee sued the production companies for unfair treatment. The NLRB ruled that Love is Blind issued unlawful contracts regarding non-compete and confidentiality clauses, recommending that production companies compensate former cast members for lost wages.

This section sheds light on the precarious conditions faced by reality TV participants and the potential for significant industry-wide reforms sparked by the NLRB's decision.

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4. Additional Highlights

While the episode primarily focuses on healthcare, immigration policies, and reality TV, Basu touches upon several other important stories featured within the Apple News app:

• January 6 Investigation:

  An independent watchdog report from the Department of Justice (DOJ) concludes there is no evidence the federal government incited the January 6 Capitol attack. This finding challenges persistent claims by far-right figures alleging FBI involvement. Although the FBI had confidential informants on site, they were not directed to incite the riot. Despite these revelations, former President Trump has threatened to pardon January 6 rioters, adding tension to the political landscape.

• U.S. Postal Service Truck Replacement Delays:

  The Washington Post reports significant delays in replacing the Postal Service's aging fleet of mail trucks. Of the planned 60,000 mostly electric vehicles, only 93 have been delivered due to manufacturing issues. This project, a crucial element of President Biden's climate agenda, has seen billions in federal funding stalled, raising concerns about the administration's ability to fulfill its environmental commitments.

• Breakthrough in HIV Prevention:

  The journal Science has named the HIV drug Lenacapavir as its breakthrough of the year. Clinical trials demonstrate that biannual shots of Lenacapavir achieve an unprecedented 100% efficacy in preventing HIV infections. While not a vaccine, the drug offers hope for drastically reducing global HIV infection rates, potentially moving the world closer to eradicating HIV/AIDS as a public health crisis.

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Conclusion

Shamita Basu's episode of Apple News Today provides a thorough and insightful exploration of some of the most pressing issues in contemporary America. From the deep-seated flaws within the U.S. healthcare system and the alarming specter of renewed family separations under a second Trump term, to the evolving landscape of workers' rights in reality television and inspiring advancements in HIV prevention, the episode offers listeners a comprehensive overview of significant societal challenges and developments. With expert commentary, poignant quotes, and a balanced presentation of facts, this episode serves as an invaluable resource for anyone seeking to understand the complexities shaping today's news landscape.

Transcript

[Shamita Basu]

Good morning. It's Friday, December 13th. I'm Shamita Basu. This is Apple News today. On today's show, what family separations could look like under a second Trump term. How treating reality TV stars as paid employees could change the industry. And an incredible breakthrough in preventing the spread of hiv. But first, to the American health care system, which has left so many people feeling overwhelmed, helpless, and in some cases, betrayed. Over the past week, we've witnessed a tremendous public outpouring of that frustration after the killing of United Healthcare CEO Brian Thompson and the arrest of his alleged shooter. Americans have been feeling this way for a while now. Confidence in the quality of US Healthcare is at an all time low. According to Gallup, public approval of doctors and hospitals has dropped over the last decade by more than 10%. Only 18% of the public views the pharmaceutical industry favorably. Vox's Dylan Scott told us. So many people can relate to the dread of having to call up your health insurance to figure out whether an urgently needed procedure is covered.

[Dylan Scott]

When people go through those experiences, it's one of the most fraught moments of their lives. Like they or somebody they love is probably experiencing a medical emergency. And on top of that, they're entering this, you know, know, Kafka esque bureaucratic nightmare.

[Shamita Basu]

He says part of what makes our current system such a nightmare for consumers and what makes it so hard to correct is that no single person or industry is responsible for the failures of the US Healthcare system. And everyone involved is busy pointing fingers at each other.

[Dylan Scott]

There's this ongoing blame game within the healthcare industry that makes it just really confusing to understand, like why this problem exists in the first place.

[Shamita Basu]

He says insurance companies blame hospitals and drug companies when consumers are upset about high premiums and out of pocket costs. Meanwhile, doctors say dealing with insurance companies and trying to convince them to pay for their patients care is getting worse and hospitals blame drug companies for charging high prices. We saw an example of this blame game gone wrong recently, just in the past week when Anthem, Blue Cross and Blue Shield announced it would no longer pay for anesthesia if a procedure goes past a certain time limit. The public response to this was overwhelmingly negative. Typical big bad insurance company, people were saying. And Anthem ended up walking back the new policy. But Vox points out this is an example of wrongly placed blame. The policy was actually looking out for patients who are sometimes overbilled by anesthesiologists. Sometimes good policy loses out when you've already lost any shred of goodwill. Scott says blame game aside, we've got to focus on results and the numbers don't tell a good story.

[Dylan Scott]

The bottom line is like you can look across a bunch of different metrics, but one consistent finding across them. When you compare the United States to healthcare in other wealthy countries, what you always find is that the US Pays more money for healthcare and on average, you know, taken collectively, gets worse outcomes.

[Shamita Basu]

Reforming the system to deliver better care will require some accountability from every sector of the industry. Scott says voters play a role, too.

[Dylan Scott]

That's been the pattern of healthcare politics is people get really mad about it, but then either nothing happens or somebody tries to change something and then voters punish them. We saw this like back in the 90s with the Clinton health reform effort. We even saw it in with Democrats in 2008 and 2010.

[Shamita Basu]

He says it's good to look at what other countries have done to design healthcare that works for everyone, if only to remind us that it is in fact possible.

[Dylan Scott]

There's not just one blueprint for doing it. A bunch of different countries doing it a bunch of different ways, but they share that sort of underlying understanding or goal that we are going to cover everybody and provide some level of baseline medical coverage and services to anybody, no matter their ability to pay. But the United States kind of stands alone as the wealthy country that has not done that. Like, there are all kinds of ideas about what to do to try to make healthcare better, but getting everybody to agree on what to prioritize and where to focus is really hard when you've got this finger pointing within the healthcare industry about what the problem really is.

[Shamita Basu]

Let's turn now to one of the most controversial policies during Trump's first term in office. His decision to separate more than 5,000 children from their parents at the US Mexico border. You might remember seeing the images of kids held behind chain link fences, sleeping on mattresses, on the floor covered by foil blankets. Or you might remember hearing this recording, first released by ProPublica, of children crying, calling for their parents. Once it went public, the policy was met with widespread condemnation, from religious figures like the Pope to all of the living former first ladies and many Republican leaders. Trump, recently, in his first network TV interview since his reelection, was asked by NBC's Kristen Welker about whether his plans for mass deportations in a second term would lead to families being separated again.

[Donald Trump]

We don't have to separate a family. Excuse me, Kristen. Yeah, we don't have to separate families. We'll send the whole family very humanely back to the country where they came. That way the family's not separated.

[Kristen Welker]

So no more family separations. You're not reviving the separation.

[Donald Trump]

It depends on the family. The family may decide to say, I'd rather have dad go and we'll stay here, and in which case they have that option.

[Shamita Basu]

NBC correspondent Jacob Soboroff says it's disingenuous to suggest families won't be separated again, particularly for kids who are citizens but their parents are not.

[Jacob Soboroff]

While family separation at the border was ripping children away from parents, mass deportation in the interior is family separation because it will rip parents away from children in their homes or at their workplaces or outside of their schools.

[Shamita Basu]

Zoboroff has reported extensively on Trump's family separation policy, and he recently teamed up with Academy Award winning filmmaker Errol Morris to make a documentary called Separated. Based on his reporting. He told us, part of the reason we could see separations again is because Congress has not taken action on this issue.

[Jacob Soboroff]

They can, with one piece of legislation, bar the immigration enforcement apparatus from using family separation as a tool of immigration enforcement, and they haven't done that. It was proposed, most notably by Julian Castro, but the bill went nowhere.

[Shamita Basu]

He also emphasized that no one involved in this policy has ever been held responsible for the harm done to children by the US Government.

[Jacob Soboroff]

President Biden famously said in the final presidential debate of 2020 that he believed that the family separation policy was criminal, and Merrick Garland, during his confirmation hearings to become the attorney general, said he couldn't imagine anything worse than ripping parents apart from their children. And yet there has been no criminal investigation, as far as we know, opened from within the Justice Department into the family separation policy, despite everything that we know about it.

[Shamita Basu]

You can hear more from my conversation with Jacob Soboroff and Errol Morris on this week's episode of Apple News In Conversation. If you're listening in the news app, that episode is queued up to play for you next. Now to a major development in the world of reality television, where the National Labor Relations Board is weighing in on working conditions for the people who make these shows so popular. Earlier this week, the NLRB found the hit Netflix dating show Love is Blind violated the workers rights of its contestants, which could mean cast members are now entitled to federal legal protections for workers. That could open the door to more efforts to unionize across the entire reality TV genre, which is a big deal because from the beginning it's been pretty inconsistent about compensation and protection protections. The New York Times reports that the production companies have long defended their treatment of the cast members, arguing that every decision the contestants make is up to them. Several Cast members from Love is Blind have filed lawsuits over this. A lawsuit from a season two contestant alleged he was paid $1,000 a week while being filmed for up to 20 hours a day, seven days a week. New Yorker writer Emily Nussbaum, who covers reality tv, says this is pretty typical industry wide. She was our guest on Apple News in conversation earlier this year.

[Kristen Welker]

The conditions of the cast members, the hours they work, and the ways in which producers mess with their heads and the ways in which editors cut them out of order. Those aren't just things that happen on Love is Blind. Those are things that are normal for reality television, especially dating shows like the Bachelor.

[Shamita Basu]

On Love is Blind, contestants live together. They go on blind speed dates, which in some cases end with an engagement and a dramatic first meeting followed by a whirlwind of dates before couples go to the altar to decide if they'll actually get married. The whole season is filmed over just a few weeks, and I can personally attest that with the right attitude, you can watch a whole season in just a few days. Most reality shows have strict rules that contestants must follow. Pretty much everyone has to sign an NDA, which means they can't talk about making the show or complain about how they're represented or how production treated them. And they can't complain if something gets edited in that didn't really happen in real life. All of this can make it easier for potential abuse to fly under the radar, since many issues are handled in private arbitration.

[Kristen Welker]

A woman named Renee went through the whole process, got engaged and then was cut from the show. And when she spoke about it on various podcasts and she was engaged to a guy who was unemployed, abusive, it was a terrible situation. When she spoke out about it, she was sued for $4 million.

[Shamita Basu]

This woman, Renee Pochet, was paid $8,000 for eight weeks of filming the show. She's one of the contestants who brought ACC against the production companies who make Love Is Blind to the nlrb and the board said the show issued unlawful contracts regarding its non compete and confidentiality rules. It's asking production companies to pay former cast members for lost wages. Next, the case goes to an administrative judge who will determine if these production companies broke the law. Before we let you go, a few other stories being featured in the Apple News app. A new January 6 report from an independent watchdog at the DOJ says there is no evidence the federal government incited the attack on the U.S. capitol. ABC News reports the findings undercut years of baseless claims by far right figures who said the FBI played a significant role in sparking the incident. The investigation did find the FBI had confidential informants on site, but they were not instructed to join or encourage the riot. President Elect Trump has said he will pardon January 6 rioters within hours of assuming the presidency. The US Postal Service's efforts to replace its aging fleet of mail trucks is way behind schedule. The Washington Post reports that of the 60,000 mostly electric trucks the Postal Service is slated to purchase, only 93 have been delivered. The defense contractor building the vehicles cites manufacturing problems for the delay. Billions in federal funding went into this project, and it's a cornerstone of President Biden's climate agenda. And finally, the journal Science has named the HIV drug Lenacapavir as its breakthrough of the year. A large trial found the twice yearly shots reduced HIV infections to zero, an incredible 100% efficacy, according to the journal. A second study yielded similar Results. More than 1 million people a year are infected with HIV globally. And while Lenacapavir is not a vaccine, scientists are hopeful the drug can drive down infection rates dramatically and bring us one step closer to ending HIVAIDS as a global health crisis. You can find all these stories and more in the Apple News app. And if you're already listening in the news app right now, stick around for the rest of my conversation about Family Family Separations with Errol Morris and Jacob Soboroff. Enjoy your weekend and I'll be back with the news on Monday.