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- [00:05]
A
Good morning. It's Tuesday, October 7th. I'm Shemitah Basu. This is Apple News today. On today's show, the country's disaster relief agency faces its own crisis. A cost saving tool in private health insurance is coming to Medicare. And there's good news for clumsy. But first, today marks two years since Hamas attacked Israel, killing more than a thousand people and sparking a new era of conflict that has become, in the words of the UN Secretary General, an endless death loop. Over 67,000 Palestinians are reported to have been killed in Israel's retaliative war, and 48 hostages remain in the hands of Hamas militants, 20 of whom are thought to be alive. Negotiators will meet again today in Egypt to discuss President Trump's ceasefire proposal in what feels to many like a decisive moment in the war. On Sunday, Secretary of State Marco Rubio described it as, quote, the closest we've come to getting the hostages released, and described the talks as having two parts.
- [01:18]
B
Phase number one, which Hamas has accepted, is the President's framework for release. The hostages are released and Israel pulls back to what's been called the yellow line, roughly where they were in August of last year. And that exchange happens. And, and that's the first phase of these talks because you have to work through the logistics of that.
- [01:33]
A
But the second part, as Rubio pointed out, poses much more complicated questions to resolve.
- [01:39]
B
What happens after Israel pulls back to this line? What happens with this international group that's going to come in and create an international governance structure led by Palestinian technocrats, etc. That's the part that I think is going to be a little tougher to work through, but that's what's going to provide permanency to the end of the conflict.
- [01:56]
A
And that phase, under the current proposal requires Hamas to disarm and give up any role in shaping Gaza's future. CNN's international diplomatic editor Nick Robertson is in Cairo where the talks are happening, and told NPR that it would be an act of faith for Hamas to give up the hostages and their leverage in the way that's being proposed.
- [02:18]
C
Hamas does not want to cease to exist. It sees the talks as a potential existential moment for their group. Netanyahu's strategy and struggle is going to be to show that he has completely defeated Hamas. On the contrary, Hamas's struggle will be to prove to their Palestinian supporters they have not been defeated. These are competing ideas.
- [02:44]
A
Recent reporting suggests that the White House has high hopes for this round of talks. Over the weekend, various outlets published different versions of the same story that Trump placed heavy pressure on Israeli Prime Minister Benjamin Netanyahu to accept this deal. And Netanyahu's increasing international isolation left him with little option but to line up with the US and some analysts suggest it was Israel's strike against Hamas militants in Qatar about a month ago that brought the two sides to today's talks. Here's Anshul Pfeffer, Israel correspondent for the Economist, on their podcast the Intelligence I.
- [03:21]
C
Think that really changed everything for Donald Trump. I think he suddenly realized that this war is not just a tragedy for the people of Gaza and Israelis for two years now. It also risks spiraling out and drawing in other allies of America in the region.
- [03:38]
A
Trump's desire for a quick deal reflects the fatigue and shifting sentiment toward the war from within the United States, including among Jewish people. A new survey from the Washington Post found that 61% of American Jews said that Israel has committed war crimes in its assault on Gaza. And in a recent New York Times poll, 40% of Americans surveyed there said they believed Israel was intentionally killing civilians in Gaza, a number that is nearly double when the same poll question was asked in 2023. The government is shut down for a seventh successive day today, and it's come at a tricky time for the nation's disaster preparedness and response. In failing to reach a funding deal, Congress allowed for the National Flood Insurance Program to lapse. As it sounds, the program provides more than $1 trillion in coverage to about 4.5 million homeowners, renters and businesses. Without it, policies can't be renewed, leaving people exposed to potential losses. And new policies can't be written, freezing sales that require such coverage. This all comes at a moment when FEMA has been undergoing major changes during Trump's second term, shedding staff and shifting respons for disaster response to local communities.
- [05:00]
D
There's just been a huge amount of chaos roiling through fema.
- [05:06]
A
Scott Patterson is a reporter at the Wall Street Journal.
- [05:09]
D
It's led to this atmosphere of deep concern about what's going to happen in the coming months and years.
- [05:17]
A
Patterson and his colleague at the Journal spoke to more than a dozen FEMA employees and local officials and reviewed internal government documents to paint a picture of the agency's current status. The A number of critical senior staff have exited FEMA as part of buyouts offered by DOGE earlier this year, and DHS Secretary Kristi Noem, who oversees FEMA, instituted a policy where any expenditure of $100,000 or more needs approval, in some cases requiring a dozen layers of review.
- [05:47]
D
So that's a big concern is that the speed of a response that's required to a major disaster isn't going to happen because you're going to have all this paperwork that's sitting on Kristi Nunn's desk and it's not going to be approved with the efficiency and speed that would be required.
- [06:07]
A
A spokesperson for DHS told the Journal that the requirements are in place to root out fraud and that they haven't had an impact on disaster response. Patterson traveled to St. Louis to see the aftermath of areas hit by a mile wide tornado earlier this year. More than four months later, residents and officials have still been clearing rubble as they say FEMA has been largely absent from the area. The city estimates that the Tornado caused about $1.6 billion in damage. It took two weeks for the Trump administration to approve a disaster declaration in the city, and for months FEMA didn't provide the requested financial assistance to remove debris from streets and yards throughout the city. In September, the Journal reported, the city said FEMA agreed to cover the bulk of those costs, but as a test case for decentralizing disaster response and moving more responsib to local governments. Patterson said the results in the city left a lot of questions.
- [07:03]
D
I witnessed entire city blocks that look like a bomb had gone off in the northern part of the city and there's still people living in some of those homes. There are citizen groups who've organized and are raising money to help people, but people in the city say they don't think this is the way it should be. They shouldn't be left on their own to deal with something of such a huge magnitude and destructive force.
- [07:28]
A
As of early last month, the Journal reports that about 1,000 contracts and grants were still pending approval, many of which were central to disaster response. Let's turn now to healthcare and a closer look at how a cost saving process in private healthcare will soon be piloted in Medicare. The practice, called prior authorization, might be something you've experienced. It's an unpopular feature of the private health industry that requires physicians to get insurance approval before moving ahead with a test or procedure. Critics say it causes delays and creates barriers to people getting treatment. But next year a prior authorization pilot is launching for Medicare in six states and they're planning to use AI to sift through some of the claims people submit.
- [08:21]
E
I think it's reasonable to say that private industry uses it, at least in part to drive profits. And Medicare doesn't operate as a for profit company. Obviously it's a government program.
- [08:36]
A
Lauren Sausser is a reporter for KFF Health News.
- [08:40]
E
The traditional version of Medicare hasn't really relied on prior authorization. This is a common tool that the private health insurance industry uses. If you are a Medicare beneficiary under the traditional version of the program and your doctor recommends a test or a procedure, a prescription drug, Medicare historically hasn't denied that they've just paid those claims.
- [09:01]
A
A recent national survey conducted by the American Medical association found that 78% of physicians reported that this process sometimes or often resulted in patients abandoning a recommended course of treatment.
- [09:14]
E
It's no surprise to anyone that patients and doctors hate this system. It tends to delay care at the very least, and in the worst case, it can cause really bad outcomes. I mean, I've been following patients for years, some of whom have died because their insurance companies have either delayed care initially and then approved it when it was too late, or denied treatments that their doctors have recommended altogether.
- [09:43]
A
And the pilot's use of artificial intelligence raises the question of how potentially important decisions about people's health might get decided.
- [09:52]
E
There'S a possibility that it could really help speed things up. But the algorithm only works insofar as it's programmed to work. So if it's programmed to deny care, that is not going to be great for patients whose doctors say they need some of these services.
- [10:10]
A
Some Democratic lawmakers have raised questions as to how the technology will work, and the co chair of the House GOP Doctors Caucus told KFF he would always err on the side that doctors know what's best for their patients. An agency spokesperson told KFF that no Medicare request would be denied before it gets reviewed by a qualified human clinician. When HHS launched this pilot, it said its goal was to avoid unnecessary or inappropriate care and cited figures from nonpartisan Medicare analysts that suggested in 2022, around $5.8 billion was spent on medical services with minimal benefit. But while the department draws inspiration from prior authorization, it's also been criticizing its misuse. HHS Secretary Robert F. Kennedy Jr. And Medicare and Medicaid administrator Dr. Mehmet Oz announced that they had reached a deal with private health insurance companies to begin to change this practice to simplify it and reduce rejected claims.
- [11:10]
E
This was the Trump administration's way of saying, this is how we are addressing this really big problem, and we're not setting down any mandates for insurance companies, but we've gotten to them to agree to a number of different things. Interestingly, four days after that press conference, the Trump administration issued a press release saying that they were launching this pilot next year in six states.
- [11:35]
A
The pilot program will run in Arizona, Ohio, Oklahoma, New Jersey, Texas and Washington. It will only apply at first to certain Medicare services, which the federal government says are particularly vulnerable to fraud, waste and abuse. Notably, for now, it would not apply to procedures that could pose risks to patients if delayed. Before we let you go, a few other stories were following. The CDC says people will now have to talk to a doctor, pharmacist or other health professional before they can get a Covid booster shot. The change comes weeks after Health Secretary Robert F. Kennedy Jr's vaccine panel recommended the move, NPR reports. Acceptance of the recommendations was the final step before the CDC could send out vaccines to doctors and other providers who administer shots through the Vaccines for Children program that covers about 40% of kids in the U.S. it also guarantees public and private insurance will cover shots. Anyone 6 months or older can now get a shot after consulting a health professional. At least 200 hikers remain trapped on Mount Everest after a brutal blizzard hit the mountain over the weekend, the Guardian reports. The hiker hikers are at a campsite on the eastern side of the mountain in what's called the Everest Scenic Area on the Tibetan side of the border. The site sits at more than 16,000ft of elevation. 350 hikers have already been rescued and one hiker says it was the most extreme weather he's ever seen. Images after the storm showed hikers wading through waist deep snow as they descended, the Guardian notes. Media access is strictly controlled by the Chinese government on the Tibetan side of Everest. And finally, good news for clumsy ones out there. Experts now say learning to fall the correct way could actually help you live longer. About 1 in 4 people over the age of 65 experience falls every year, and it's the main cause of injury related death in older adults. Some researchers are now turning their focus away from prevention and instead are teaching people how to fall better. NatGeo has a list of tips those scientists say could help you be a better faller. They include practicing in a safe and soft place, lowering your center of gravity and protecting your wrists. 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, we've got a narrated article coming up next as the LA Dodgers continue their quest to repeat as World Series champions. Rolling Stone has the story of the bookmaker at the center of the gambling scandal that ensnared the team biggest star Shohei Ohtani. If you're listening in the podcast app, follow Apple News plus narrated to find that story. And I'll be back with the news tomorrow.