AMERICA'S GOT TALENT - Zurcaroh

WOW

The acrobatic (non-professional) dance troupe from Austria perform a stunning routine.  This incredibly entertaining act earns a golden buzzer from Tyra Banks.

POLICING IN AMERICA - Gone Too Far?

"Has policing in America gone too far?" PBS NewsHour 5/26/2018

My answer:  Yes, including ICE.

Excerpt

SUMMARY:  While police departments across the country address reform, community groups in cities like Chicago and New York are also teaching people about alternatives to 9-1-1 for crises that can be exacerbated by police presence.  NewsHour Weekend’s Ivette Feliciano talked to author Alex Vitale of “End of Policing,” about the country’s reliance on law enforcement to solve complicated social issues.

OPINION - Shields and Brooks 5/25/2018

"Shields and Brooks on North Korea summit canceled, Trump’s attacks on Russia probe" PBS NewsHour 5/25/2018

Excerpt

SUMMARY:  Syndicated columnist Mark Shields and New York Times columnist David Brooks join Judy Woodruff to discuss the week’s news, including President Trump calling off his summit with North Korean leader Kim Jong Un, the outcome of Tuesday’s primaries for Democrats, and the effects of the President stirring controversy with claims of FBI spying on his campaign.

Judy Woodruff (NewsHour):  Now back to the political news of this week with the analysis of Shields and Brooks.  That’s syndicated columnist Mark Shields and New York Times columnist David Brooks.

Welcome to you both.

So, let’s talk first about this on-again/off-again summit with the North Korean leader.

David, it came about very quickly.  It seemed to spring out of the President’s mind on his own.  We didn’t — a lot of people were skeptical it was ever going to happen.  It’s off again, but the President said today, maybe it’s not off.

What do you make of his diplomacy?

David Brooks, New York Times:  When I went to buy my first car, somebody gave me advice.  You have got to walk out.  Walk out.

(CROSSTALK)

(LAUGHTER)

David Brooks:  Walk out.

And I never — I’m not that kind of guy, so I didn’t walk out.  But Donald Trump sort of walked out.  And so he does everything in public.  And he exerts pressure, he flatters, he threatens war.  He does everything in public.

And so I sort of sympathize with the idea to see if there can be some breakthrough with North Korea.  And I don’t blame him for going in and going out, trying to exert whatever pressure he can.

The problem is, it’s not real diplomacy.  In real diplomacy, you have your sherpas, your lower-level people sort of build up some sense of agreements.  You gather your allies.  You don’t burn them with trade deals, the Chinese just South Koreans.  You gather — and you exert real pressure.

But Donald Trump is a lone wolf, and so he’s doing it all on his own, basically, without allies, without too much help from the U.S. government, and it’s all by tweet and publicity.

And so I’m skeptical that you can get a real breakthrough without a full, stacked diplomatic and military effort, but — or at least sort of threats and pressure.  But I don’t totally blame him for trying.  Or, frankly, I don’t blame him for going in and out.

Anything that can dislodge something that’s stuck.

Judy Woodruff:  How do you size this up?

Mark Shields, syndicated columnist:  Well, Judy, it’s been 65 years since President Eisenhower on his promise to go to Korea negotiated a truce between North Korea and South Korea.

Since then, we have had 10 Presidents of both parties, five Democrats, five Republicans.  With varying degrees of commitment and intensity, they have all tried to deal with resolving Korea.  They have spent time.  They have used learned professionals, wise academics, businessmen who know, and business persons who know the area.

And even after that, there are no major breakthroughs that’s happened.  And Donald Trump, with no preparation, no knowledge, no background — I agree with David.  I cheered the hope — and it was only a hope — that we might have a breakthrough.

But the idea that this was going to happen, and that somehow Kim Jong-un, who has gotten now global respect because he’s got nuclear arms, was just going to say, well, that’s it, thank you so much, you know, I think, was unrealistic.

Now, the fact that Secretary Mattis says that there’s a possibility that the summit will occur, that gives me pause.  I mean, I give a lot more credence to what Secretary Mattis says than I do to the White House.

Judy Woodruff:  The President clearly — or seems, David, to believe that unpredictability can pay off sometimes.

David Brooks:  Well, sometimes, it can.

If we got a crazy person who is President, you may as well take advantage.  But, as I say, why should they give up nuclear weapons?  They have seen the Libya example and they saw what happened to Gadhafi.

The only — but at some point in history, and I don’t know if it will be in our lifetimes, they will say, we would rather have a middle-class lifestyle.  We would rather have what they have in South Korea.  I think, eventually, somebody is going to make that call.  I don’t know if it will be this guy, or his son, or grandson, or whatever.

But, eventually, that’s going to happen.  So, as long as we can keep knocking on the door, that seems fine.  And as long as we don’t disrupt our allies in the area, which we seem to have terrified the South Koreans…

Mark Shields:  And the Japanese.

David Brooks:  And the Japanese — then the door should always be open, the pressure should always be on.

But sometimes you don’t just have any good solutions.  And that’s why we have had 10 Presidents without much progress.

Mark Shields:  Yes, that’s it.

This isn’t the city council in Atlantic City or the zoning commission, where you’re trying to get a deal for the casino and better parking or a large parking lot or to invoke eminent domain on your behalf.

This is really — really — significance.  And it’s the difference between braggadocio and style and flash and substance.  And if you look at everybody — I mean, John Kennedy, who was far more a student of foreign affairs than Donald Trump, at his first encounter with Khrushchev came away humbled, came away — and, in retrospect, contributed, historians and I think many in the Kennedy administration agree, to the emboldened Soviet Union in both Berlin and in Cuba.

So these don’t come without some cost and without some price and especially, as David pointed out, the rupture with our allies.

NEWSHOUR BOOKSHELF - "Like Brothers"

"How the Duplass Brothers collaborate without killing each other" PBS NewsHour 5/25/2018

Excerpt

SUMMARY:  The Duplass Brothers have made more than two dozen films and TV shows together, largely on their own terms, and funded other directors' low-budget projects.  Now they've collaborated on a new book, "Like Brothers," about making it as independent filmmakers in Hollywood.  Jeffrey Brown talks with Mark and Jay Duplass.

IRELAND - Is Changing

"Vote over abortion ban underscores how Ireland is changing" PBS NewsHour 5/25/2018

"Irish abortion referendum: yes wins with 66.4%" The Guardian

Excerpt

SUMMARY:  In historically religious Ireland, the voting booths are in churches.  But this is not the same country once dominated by Catholicism.  A new constitutional amendment up for vote on Friday would allow Parliament to legalize unrestricted abortion during the first 12 weeks of pregnancy.  And according to initial exit polls, it has succeeded.  Nick Schifrin reports.

WALL STREET - Beware ‘Faux Experts’

"Why our financial decision-makers need ‘skin in the game’" PBS NewsHour 5/24/2018

Excerpt

SUMMARY:  Economic contrarian Nassim Taleb warned of a coming financial crisis more than a decade ago.  Now he believes there’s a big con going on, and that the Federal Reserve's response to the 2008 crash is part of it.  Economics correspondent Paul Solman catches up with Taleb to discuss his new book, “Skin in the Game” and hear his latest concerns.

RACE IN AMERICA - Force Used Against NBA Player Sterling Brown

"Sterling Brown arrest refuels debate on excessive force used against black Americans" PBS NewsHour 5/24/2018

Excerpt

SUMMARY:  Milwaukee police released body-cam footage showing NBA player Sterling Brown being arrested in January.  City officials admit his treatment by police was excessive, and his case is raising anger again about the treatment of African-Americans by law enforcement.  Amna Nawaz gets two views from civil rights activist DeRay Mckesson and David Klinger of the University of Missouri-St.Louis.

RUSSIA INVESTIGATION - Trump Attorney at CLASSIFIED Briefings?!

"John Kelly, Trump attorney attendance at Russia probe briefing raises eyebrows" PBS NewsHour 5/24/2018

Excerpt

SUMMARY:  Lawmakers from both sides of the aisle received classified briefings from top Justice Department and intelligence officials on Thursday, following days of tense negotiations.  Did Congress members learn anything new about an FBI source who President Trump claims infiltrated his 2016 presidential campaign?  Lisa Desjardins joins Judy Woodruff.

AMERICAN POLITICS - Democrats Pretending

"Stacey Abrams: ‘Democrats can’t win by pretending to be Republicans’" PBS NewsHour 5/23/2018

Excerpt

SUMMARY:  Stacey Abrams (D-Ga) is the first African-American woman to be a major party nominee for governor in the U.S.  Abrams, former minority leader of the Georgia House of Representatives, joins Judy Woodruff to discuss her historic win, her platform, and why her strategy worked and what it means for Democrats around the nation.  [won 70+ % of the vote]

HEALTH IN AMERICA - Hepatitis C, New Drugs

"With highest hepatitis C mortality rate in U.S., Oregon expands access to life-saving drugs" PBS NewsHour 5/23/2018

Excerpt

SUMMARY:  New drugs can cure up to 95 percent of patients with hepatitis C, a virus that can be debilitating or deadly.  And there’s been a 20 percent rise in new infections from 2015 to 2016 due to the opioid epidemic.  In Oregon, a state hard-hit by the disease, new medicines combined with the big surge in those looking for treatment, has led to a unique care model.  Special correspondent Cat Wise reports.

NFL - Trash the Constitution is Their Solution

aka "The NFL goes to their knees to kiss Trump's......"

"Are new NFL penalties for kneeling purely about the bottom line?" PBS NewsHour 5/23/2018

Excerpt

SUMMARY:  NFL owners voted for a new policy on Wednesday that requires any players or team personnel who are on the field to "stand and show respect for the flag and the anthem."  The silent protests are meant to call attention to police brutality and racial inequality, but have drawn months of public criticism by President Trump.  Amna Nawaz gets reaction from LZ Granderson of ESPN's SportsNation.

RUSSIA INVESTIGATION - James Clapper

"Russia ‘turned’ election for Trump, Clapper believes" PBS NewsHour 5/23/2018

Excerpt

SUMMARY:  Russians not only affected the outcome of the 2016 presidential election — they decided it, says James Clapper, who served as the director of national intelligence in the Obama administration, and during the 2016 vote.

“To me, it just exceeds logic and credulity that they didn’t affect the election, and it’s my belief they actually turned it,” he told the PBS NewsHour anchor Judy Woodruff on Wednesday.

Clapper, who chronicles his life and career in his new book, “Facts and Fears: Hard Truths From a Life in Intelligence,” said Russians are “are bent on undermining our fundamental system here.  And when a foreign nation, particularly an adversary nation, gets involved as much as they did in our political process, that’s a real danger to this country.”

His comments come amid reports that the FBI used an informant while the bureau investigated possible ties between Russia and Trump’s 2016 campaign.

“That would be one of the biggest insults that anyone’s ever seen,” Trump told reporters Tuesday, calling the reports ‘spygate’ on Twitter.  The President demanded an investigation earlier this week into whether the FBI or Department of Justice infiltrated or surveilled his campaign.

Clapper called those accusations “distorted.”  He said there is a “a big gulf between a spy in the traditional sense — employing spycraft or tradecraft — and an informant who is open about … who he was and what the questions he was asking.”

“The important thing was not to spy on the campaign but rather to determine what the Russians were up to.  Were they trying to penetrate to campaign, gain access, gain leverage, gain influence, and that was the concern that the FBI had?  … I think they were just doing their job and trying to protect our political system.”

AMERICAN POLITICS - The Republican 'Maverick'

"Sen. John McCain wants us to see we are more alike than different" PBS NewsHour 5/22/2018

Excerpt

SUMMARY:  While Republican Sen. John McCain has lately undergone treatment for brain cancer, he still speaks his mind.  Judy Woodruff talks with Mark Salter, co-author of a new McCain memoir, "The Restless Wave," about his Senate service, Russian election interference, American society, and politics in the age of President Trump and much more.

"The Restless Wave" John McCain (excerpt):

"Before I leave, I would like to see our politics begin to return to the purposes and practices that distinguish our history from the history of other nations.

I would like to see us recover our sense that we are more alike than different. We’re citizens of a republic made of shared ideals, forged in a new world to replace the tribal enmities that tormented the old one.

Even in times of political turmoil such as these, we share that awesome heritage and the responsibility to embrace it. Whether we think each other right or wrong in our views on the issues of the day, we owe each other our respect, so long as our character merits respect.

And as long as we share, for all our differences, for all the rancorous debates that enliven and sometimes demean our politics, a mutual devotion to the ideals our nation was conceived of hold, that all are created equal, and liberty and equal justice are the natural rights of all."

From the Navy hymn “Eternal Father”:

Eternal father,

Strong to save,

Whose arm hath bound the restless wave.

John McCain - For Whom the Bell Tolls (HBO)

PERFORMRS - Put Down Your Phone

"No smartphones allowed?  That’s just how Dave Chappelle wants it" PBS NewsHour 5/22/2018

Excerpt

SUMMARY:  It's hard to go to a concert or show where people don't quickly pull out their phones.  But some artists and performers have had enough.  Jeffrey Brown reports on a startup that’s trying to dial back our phone use.

RETHINKING COLLEGE - Post Graduation, Worry What Ex-Students Do?

"Should high schools worry about what students do after graduation?  This city says yes" PBS NewsHour 5/22/2018

Excerpt

SUMMARY:  Chicago has a new plan to make sure kids pursue a college degree or have another viable career path after high school.  By 2020, in order to get a diploma from Chicago public schools, a student will have to prove that they have a job, will be joining a trade school, will go on to college, or join the military.  Hari Sreenivasan reports as part of our series Rethinking College.

SUPREME COURT - Betrays Workers Again

"Supreme Court delivers blow to workers’ rights, making it more difficult to sue employers" PBS NewsHour 5/21/2018

Excerpt

SUMMARY:  In its latest major ruling affecting corporate America, the Supreme Court split 5-4 in upholding the practice of arbitration, a blow for workers' ability to take collective legal action against their employers.  Marcia Coyle of The National Law Journal joins William Brangham to discuss what it means for the balance of power in the workplace.

INTERNET PRIVACY - New EU Rules Help Americans

"How Europe’s new online privacy rules could benefit Americans" PBS NewsHour 5/21/2018

NOTE:  Many American based internet companies have already modified their privacy protocol, and statements, to comply.

Excerpt

SUMMARY:  Long before the Cambridge Analytica scandal, new rules were being established by the European Union to give consumers greater control over their data.  Starting in May, every company, big or small, that keeps your information online or elsewhere must comply.  Special correspondent Malcolm Brabant reports.

AMERICAN POLITICS - Trump's Fake 'Spygate'

The Justice Department sent an agent to find out what the RUSSIANS were doing talking to Trump's campaign.  NOT what Trump was doing.  Since when is finding out what a foreign nation wants in regards to our elections process wrong?  It is not!

"What we know about Trump’s Justice Department meeting" PBS NewsHour 5/21/2018

Excerpt

SUMMARY:  President Trump met with top Justice Department officials after demanding on Sunday that they investigate whether the FBI infiltrated his 2016 campaign.  Last week, the Washington Post reported that a longtime U.S. intelligence source had contacts with several of Trump's advisors.  Amna Nawaz learns more from Devlin Barrett of The Washington Post.

"What are the ramifications of Trump’s FBI spy claims?" PBS NewsHour 5/21/2018

Excerpt

SUMMARY:  The Justice Department has asked its internal watchdog to review President Trump's charge on Twitter that the FBI spied on his 2016 election campaign.  Amna Nawaz gets analysis and reaction from former Attorney General Michael Mukasey, former Justice Department official Jack Goldsmith, and retired FBI agent Frank Montoya.

HEALTH IN AMERICA - The Health Insurance Hustle

"Why Your Health Insurer Doesn’t Care About Your Big Bills" by Marshall Allen, ProPublica 5/25/2018

Patients may think their insurers are fighting on their behalf for the best prices.  But saving patients money is often not their top priority.  Just ask Michael Frank.

This story was co-published with NPR.

Michael Frank ran his finger down his medical bill, studying the charges and pausing in disbelief.  The numbers didn’t make sense.

His recovery from a partial hip replacement had been difficult.  He’d iced and elevated his leg for weeks.  He’d pushed his 49-year-old body, limping and wincing, through more than a dozen physical therapy sessions.

The last thing he needed was a botched bill.

His December 2015 surgery to replace the ball in his left hip joint at NYU Langone Medical Center in New York City had been routine.  One night in the hospital and no complications.

He was even supposed to get a deal on the cost.  His insurance company, Aetna, had negotiated an in-network “member rate” for him.  That’s the discounted price insured patients get in return for paying their premiums every month.

But Frank was startled to see that Aetna had agreed to pay NYU Langone $70,000.  That’s more than three times the Medicare rate for the surgery and more than double the estimate of what other insurance companies would pay for such a procedure, according to a nonprofit that tracks prices.

Fuming, Frank reached for the phone.  He couldn’t see how NYU Langone could justify these fees.  And what was Aetna doing?  As his insurer, wasn’t its duty to represent him, its “member?”  So why had it agreed to pay a grossly inflated rate, one that stuck him with a $7,088 bill for his portion?

Frank wouldn’t be the first to wonder.  The United States spends more per person on health care than any other country.  A lot more.  As a country, by many measures, we are not getting our money’s worth.  Tens of millions remain uninsured.  And millions are in financial peril: About 1 in 5 is currently being pursued by a collection agency over medical debt.  Health care costs repeatedly top the list of consumers’ financial concerns.

Experts frequently blame this on the high prices charged by doctors and hospitals.  But less scrutinized is the role insurance companies — the middlemen between patients and those providers — play in boosting our health care tab.  Widely perceived as fierce guardians of health care dollars, insurers, in many cases, aren’t.  In fact, they often agree to pay high prices, then, one way or another, pass those high prices on to patients — all while raking in healthy profits.

ProPublica and NPR are examining the bewildering, sometimes enraging ways the health insurance industry works, by taking an inside look at the games, deals and incentives that often result in higher costs, delays in care or denials of treatment.  The misunderstood relationship between insurers and hospitals is a good place to start.

Today, about half of Americans get their health care benefits through their employers, who rely on insurance companies to manage the plans, restrain costs and get them fair deals.

But as Frank eventually discovered, once he’d signed on for surgery, a secretive system of pre-cut deals came into play that had little to do with charging him a reasonable fee.

After Aetna approved the in-network payment of $70,882 (not including the fees of the surgeon and anesthesiologist), Frank’s coinsurance required him to pay the hospital 10 percent of the total.

When Frank called NYU Langone to question the charges, the hospital punted him to Aetna, which told him it paid the bill according to its negotiated rates.  Neither Aetna nor the hospital would answer his questions about the charges.

Frank found himself in a standoff familiar to many patients.  The hospital and insurance company had agreed on a price and he was required to help pay it.  It’s a three-party transaction in which only two of the parties know how the totals are tallied.

Frank could have paid the bill and gotten on with his life.  But he was outraged by what his insurance company agreed to pay.  “As bad as NYU is,” Frank said, “Aetna is equally culpable because Aetna's job was to be the checks and balances and to be my advocate.”

And he also knew that Aetna and NYU Langone hadn’t double-teamed an ordinary patient.  In fact, if you imagined the perfect person to take on insurance companies and hospitals, it might be Frank.

For three decades, Frank has worked for insurance companies like Aetna, helping to assess how much people should pay in monthly premiums.  He is a former president of the Actuarial Society of Greater New York and has taught actuarial science at Columbia University.  He teaches courses for insurance regulators and has even served as an expert witness for insurance companies.

The hospital and insurance company may have expected him to shut up and pay.  But Frank wasn’t going away.

Patients fund the entire health care industry through taxes, insurance premiums and cash payments.  Even the portion paid by employers comes out of an employee’s compensation.  Yet when the health care industry refers to “payers,” it means insurance companies or government programs like Medicare.

Patients who want to know what they’ll be paying — let alone shop around for the best deal — usually don’t have a chance.  Before Frank’s hip operation he asked NYU Langone for an estimate.  It told him to call Aetna, which referred him back to the hospital.  He never did get a price.

Imagine if other industries treated customers this way.  The price of a flight from New York to Los Angeles would be a mystery until after the trip.  Or, while digesting a burger, you’d learn it cost 50 bucks.

A decade ago, the opacity of prices was perhaps less pressing because medical expenses were more manageable.  But now patients pay more and more for monthly premiums, and then, when they use services, they pay higher co-pays, deductibles and coinsurance rates.

Employers are equally captive to the rising prices.  They fund benefits for more than 150 million Americans and see health care expenses eating up more and more of their budgets.

Richard Master, the founder and CEO of MCS Industries Inc. in Easton, Pennsylvania, offered to share his numbers.  By most measures MCS is doing well.  Its picture frames and decorative mirrors are sold at Walmart, Target and other stores and, Master said, the company brings in more than $200 million a year.

But the cost of health care is a growing burden for MCS and its 170 employees.  A decade ago, Master said, an MCS family policy cost $1,000 a month with no deductible.  Now it’s more than $2,000 a month with a $6,000 deductible.  MCS covers 75 percent of the premium and the entire deductible.  Those rising costs eat into every employee’s take-home pay.

Economist Priyanka Anand of George Mason University said employers nationwide are passing rising health care costs on to their workers by asking them to absorb a larger share of higher premiums.  Anand studied Bureau of Labor Statistics data and found that every time health care costs rose by a dollar, an employee’s overall compensation got cut by 52 cents.

Master said his company hops between insurance providers every few years to find the best benefits at the lowest cost.  But he still can’t get a breakdown to understand what he’s actually paying for.

“You pay for everything, but you can’t see what you pay for,” he said.

Master is a CEO.  If he can’t get answers from the insurance industry, what chance did Frank have?

Frank’s hospital bill and Aetna's “explanation of benefits” arrived at his home in Port Chester, New York, about a month after his operation.  Loaded with an off-putting array of jargon and numbers, the documents were a natural playing field for an actuary like Frank.

Under the words, “DETAIL BILL,” Frank saw that NYU Langone's total charges were more than $117,000, but that was the sticker price, and those are notoriously inflated.  Insurance companies negotiate an in-network rate for their members.  But in Frank’s case at least, the “deal” still cost $70,882.

With a practiced eye, Frank scanned the billing codes hospitals use to get paid and immediately saw red flags: There were charges for physical therapy sessions that never took place, and drugs he never received.  One line stood out — the cost of the implant and related supplies.  Aetna said NYU Langone paid a “member rate” of $26,068 for “supply/implants.”  But Frank didn’t see how that could be accurate.  He called and emailed Smith & Nephew, the maker of his implant, until a representative told him the hospital would have paid about $1,500.  His NYU Langone surgeon confirmed the amount, Frank said.  The device company and surgeon did not respond to ProPublica’s requests for comment.

Frank then called and wrote Aetna multiple times, sure it would want to know about the problems.  “I believe that I am a victim of excessive billing,” he wrote.  He asked Aetna for copies of what NYU Langone submitted so he could review it for accuracy, stressing he wanted “to understand all costs.”

Aetna reviewed the charges and payments twice — both times standing by its decision to pay the bills.  The payment was appropriate based on the details of the insurance plan, Aetna wrote.

Frank also repeatedly called and wrote NYU Langone to contest the bill.  In its written reply, the hospital didn’t explain the charges.  It simply noted that they “are consistent with the hospital’s pricing methodology.”

Increasingly frustrated, Frank drew on his decades of experience to essentially serve as an expert witness on his own case.  He gathered every piece of relevant information to understand what happened, documenting what Medicare, the government’s insurance program for the disabled and people over age 65, would have paid for a partial hip replacement at NYU Langone — about $20,491 — and what FAIR Health, a New York nonprofit that publishes pricing benchmarks, estimated as the in-network price of the entire surgery, including the surgeon fees — $29,162.

He guesses he spent about 300 hours meticulously detailing his battle plan in two inches-thick binders with bills, medical records and correspondence.

ProPublica sent the Medicare and FAIR Health estimates to Aetna and asked why they had paid so much more.  The insurance company declined an interview and said in an emailed statement that it works with hospitals, including NYU Langone, to negotiate the “best rates” for members.  The charges for Frank's procedure were correct given his coverage, the billed services and the Aetna contract with NYU Langone, the insurer wrote.

NYU Langone also declined ProPublica’s interview request.  The hospital said in an emailed statement it billed Frank according to the contract Aetna had negotiated on his behalf.  Aetna, it wrote, confirmed the bills were correct.

After seven months, NYU Langone turned Frank’s $7,088 bill over to a debt collector, putting his credit rating at risk.  “They upped the ante,” he said.

Frank sent a new flurry of letters to Aetna and to the debt collector and complained to the New York State Department of Financial Services, the insurance regulator, and to the New York State Office of the Attorney General.  He even posted his story on LinkedIn.

But no one came to the rescue.  A year after he got the first bills, NYU Langone sued him for the unpaid sum.  He would have to argue his case before a judge.

You’d think that health insurers would make money, in part, by reducing how much they spend.

Turns out, insurers don’t have to decrease spending to make money.  They just have to accurately predict how much the people they insure will cost.  That way they can set premiums to cover those costs — adding about 20 percent to for their administration and profit.  If they’re right, they make money.  If they’re wrong, they lose money.  But, they aren’t too worried if they guess wrong.  They can usually cover losses by raising rates the following year.

Frank suspects he got dinged for costing Aetna too much with his surgery.  The company raised the rates on his small group policy — the plan just includes him and his partner — by 18.75 percent the following year.

The Affordable Care Act kept profit margins in check by requiring companies to use at least 80 percent of the premiums for medical care.  That’s good in theory but it actually contributes to rising health care costs.  If the insurance company has accurately built high costs into the premium, it can make more money.  Here’s how: Let’s say administrative expenses eat up about 17 percent of each premium dollar and around 3 percent is profit.  Making a 3 percent profit is better if the company spends more.

It’s like if a mom told her son he could have 3 percent of a bowl of ice cream.  A clever child would say, “Make it a bigger bowl.”

Wonks call this a “perverse incentive.”

“These insurers and providers have a symbiotic relationship,” said Wendell Potter, who left a career as a public relations executive in the insurance industry to become an author and patient advocate.  “There’s not a great deal of incentive on the part of any players to bring the costs down.”

Insurance companies may also accept high prices because often they aren’t always the ones footing the bill.  Nowadays about 60 percent of the employer benefits are “self-funded.”  That means the employer pays the bills.  The insurers simply manage the benefits, processing claims and giving employers access to their provider networks.  These management deals are often a large, and lucrative, part of a company’s business.  Aetna, for example, insured 8 million people in 2017, but provided administrative services only to considerably more — 14 million.

To woo the self-funded plans, insurers need a strong network of medical providers.  A brand-name system like NYU Langone can demand — and get — the highest payments, said Manuel Jimenez, a longtime negotiator for insurers including Aetna.  “They tend to be very aggressive in their negotiations.”

On the flip side, insurers can dictate the terms to the smaller hospitals, Jimenez said.  The little guys, “get the short end of the stick,” he said.  That’s why they often merge with the bigger hospital chains, he said, so they can also increase their rates.

Other types of horse-trading can also come into play, experts say.  Insurance companies may agree to pay higher prices for some services in exchange for lower rates on others.

Patients, of course, don’t know how the behind-the-scenes haggling affects what they pay.  By keeping costs and deals secret, hospitals and insurers dodge questions about their profits, said Dr. John Freedman, a Massachusetts health care consultant.  Cases like Frank’s “happen every day in every town across America.  Only a few of them come up for scrutiny.”

In response, a Tennessee company is trying to expose the prices and steer patients to the best deals.  Healthcare Bluebook aims to save money for both employers who self-pay, and their workers.  Bluebook used payment information from self-funded employers to build a searchable online pricing database that shows the low-, medium- and high-priced facilities for certain common procedures, like MRIs.  The company, which launched in 2008, now has more than 4,500 companies paying for its services.  Patients can get a $50 bonus for choosing the best deal.

Bluebook doesn’t have price information for Frank’s operation — a partial hip replacement.  But its price range in the New York City area for a full hip replacement is from $28,000 to $77,000, including doctor fees.  Its “fair price” for these services tops out at about two-thirds of what Aetna agreed to pay on Frank’s behalf.

Frank, who worked with mainstream insurers, didn’t know about Bluebook.  If he had used its data, he would have seen that there were facilities that were both high quality and offered a fair price near his home, including Holy Name Medical Center in Teaneck, New Jersey, and Greenwich Hospital in Connecticut.  NYU Langone is one of Bluebook's highest-priced, high-quality hospitals in the area for hip replacements.  Others on Bluebook’s pricey list include Montefiore New Rochelle Hospital in New Rochelle, New York, and Hospital for Special Surgery in Manhattan.

ProPublica contacted Hospital for Special Surgery to see if it would provide a price for a partial hip replacement for a patient with an Aetna small-group plan like Frank’s.  The hospital declined, citing its confidentiality agreements with insurance companies.

Frank arrived at the Manhattan courthouse on April 2 wearing a suit and fidgeted in his seat while he waited for his hearing to begin.  He had never been sued for anything, he said.  He and his attorney, Gabriel Nugent, made quiet conversation while they waited for the judge.

In the back of the courtroom, NYU Langone’s attorney, Anton Mikofsky, agreed to talk about the lawsuit.  The case is simple, he said.  “The guy doesn’t understand how to read a bill.”

The high price of the operation made sense because NYU Langone has to pay its staff, Mikofsky said.  It also must battle with insurance companies who are trying to keep costs down, he said.  “Hospitals all over the country are struggling,” he said.

“Aetna reviewed it twice,” Mikofsky added.  “Didn’t the operation go well?  He should feel blessed.”

When the hearing started, the judge gave each side about a minute to make its case, then pushed them to settle. 

Mikofsky told the judge Aetna found nothing wrong with the billing and had already taken care of most of the charges.  The hospital’s position was clear.  Frank owed $7,088.

Nugent argued that the charges had not been justified and Frank felt he owed about $1,500.

The lawyers eventually agreed that Frank would pay $4,000 to settle the case.

Frank said later that he felt compelled to settle because going to trial and losing carried too many risks.  He could have been hit with legal fees and interest.  It would have also hurt his credit at a time he needs to take out college loans for his kids.

After the hearing, Nugent said a technicality might have doomed their case.  New York defendants routinely lose in court if they have not contested a bill in writing within 30 days, he said.  Frank had contested the bill over the phone with NYU Langone, and in writing within 30 days with Aetna.  But he did not dispute it in writing to the hospital within 30 days.

Frank paid the $4,000, but held on to his outrage.  “The system,” he said, “is stacked against the consumer.”

ACLU - Amazon Rekognition and the Secret Surveillance State

Imagine attending a protest, and the police automatically identify and label you as suspicious from a photo of the crowd.  Or you start a new life in this country, and ICE watches you in real time.  You may not be suspected of criminal activity, but the government tracks your whereabouts – and the whereabouts of anyone they want.

This disturbing surveillance state is exactly what Amazon is powering with its facial recognition technology, Rekognition.

Amazon's own marketing materials tout Rekognition's alarming tracking capabilities, and documents that the ACLU recently obtained demonstrate just how eager Amazon is to hand this product over to the government.  Amazon isn't just actively selling to law enforcement, it's partnering with them to ensure that authorities can fully utilize Rekognition's capabilities.

Amazon's Rekognition WEB page (link above):

Amazon Rekognition makes it easy to add image and video analysis to your applications.  You just provide an image or video to the Rekognition API, and the service can identify the objects, people, text, scenes, and activities, as well as detect any inappropriate content.  Amazon Rekognition also provides highly accurate facial analysis and facial recognition.  You can detect, analyze, and compare faces for a wide variety of user verification, cataloging, people counting, and public safety use cases.

Amazon Rekognition is based on the same proven, highly scalable, deep learning technology developed by Amazon’s computer vision scientists to analyze billions of images and videos daily, and requires no machine learning expertise to use.  Amazon Rekognition is a simple and easy to use API that can quickly analyze any image or video file stored in Amazon S3.  Amazon Rekognition is always learning from new data, and we are continually adding new labels and facial recognition features to the service.

ACLU Petition:

AMAZON: GET OUT OF THE SURVEILLANCE BUSINESS.

Amazon has entered the surveillance business, and they're selling to the government.

Amazon's product, Rekognition has the power to identify people in real time, in photos of large groups of people, and in crowded events and public places.  At a time when we're joining public protests at unprecedented levels, and discriminatory policing continues to terrorize communities of color, handing this surveillance technology over to the government threatens our civil rights and liberties.

Facial recognition is not a neutral technology, no matter how Amazon spins this.  It automates mass surveillance, threatens people's freedom to live their private lives outside the government's gaze, and is primed to amplify bias and inequality in the criminal justice system.

Amazon has no business allowing governments to use Rekognition – and powering a surveillance state.

Already, Rekognition is in use in Florida and Oregon.  Government agencies in California and Arizona have sought information about it, too.  And Amazon didn't just sell Rekognition to law enforcement, it's actively partnering with them to ensure that authorities can fully utilize Rekognition's capabilities.

Amazon has branded itself as customer-centric, opposed secret government surveillance, and has a CEO who publicly supported First Amendment freedoms and spoke out against the discriminatory Muslim Ban.  Yet, Amazon is powering dangerous surveillance that poses a grave threat to customers and communities already unjustly targeted in the current political climate.

We must make it clear to Amazon that we won't stand by and let it pad its bottom line by selling out our civil rights.

AMERICAN POLITICS - Trump's Sponsor, Russia, Given Free Pass

Hay, Putin got Trump elected.  What do you expect?

"The U.S. Considered Declaring Russia a State Sponsor of Terror, Then Dropped It" by Sebastian Rotella, ProPublica 5/21/2018

After an attack on a former spy, the State Department pondered placing that label on Putin’s government.  Instead, the Trump administration continued a longtime U.S. policy of treating Russia as a partner in fighting terrorism even as evidence of its misbehavior mounts.

The attempt to kill a former Russian spy in England bore an ominous signature: The assailants used a lethal nerve agent of a type developed in the Soviet Union, and British investigators quickly concluded that only the Kremlin could have carried out such a sophisticated hit.

Soon after the March attack, Rex Tillerson, then the U.S. secretary of state, ordered State Department officials to outline the case for designating Russia as a state sponsor of terrorism under U.S. law.  Experts in the department’s Bureau of Counterterrorism began to assemble what they thought was a strong case.

But almost as quickly as the review began — within about two days — the secretary of state’s office sent new instructions to drop the initiative, according to State Department officials familiar with the episode.

“There are a lot of issues that we have to work on together with Russia,” a U.S. official said.  “Designating them would interfere with our ability to do that.”

The State Department’s reluctance to impose the terror designation was not a product of Trump administration sympathy for Russian President Vladimir Putin, U.S. officials say.  Rather, it reflected an ambivalent and at times contradictory policy toward Russia on terrorism issues that stretches back more than a dozen years, American intelligence officials and foreign-policy experts said.

Even as Washington [DC] has grown more concerned about an array of Russian security threats, it has continued to seek Moscow’s cooperation in combating terrorism.  Although the approach has yielded few victories against the Islamist militants that the two countries vowed to fight after 9/11, advocates of the policy argue that it has been one of the few areas of common ground in which cooperation remains possible during a period of increasing confrontation.

“Russia is clearly a bad actor on the world stage,” said David McKean, a former director of policy planning at the State Department.  “But terrorism is an area where we have to keep trying to talk to them.  They can either play a negative role or not play a negative role — or occasionally play a positive role.”

Yet, as Tillerson’s order for the review suggested, the calculus in Washington [DC] has begun to shift.  Throughout the civil war in Syria, Russia has strengthened its backing for the regimes in Damascus and Teheran, which Washington [DC] has long accused of supporting terrorism, and their ally Hezbollah, an officially designated terrorist group.  Russia has intervened more directly in Afghanistan, Pentagon officials have said, shipping arms to the Taliban with little apparent regard for the geopolitical consequences.  And the Kremlin has methodically pursued its enemies overseas, ordering a series of assassination attempts in Europe, Turkey and the Middle East, national security officials said.

As the evidence of Russian support for terrorism has grown, the Putin regime’s campaign of cyberattacks and other subversion in the United States, Europe and elsewhere has raised new questions about the utility and viability of narrow efforts at cooperation on issues such as counterterrorism.

“We assume the Russians are like us, and if we would just do a better job of explaining ourselves, they would come around and be allies on counterterrorism,” said John Sipher, a former deputy chief of Russian operations at the CIA.  “Russia has been more consistent.  They have seen us, not terrorism, as the main enemy all along.”

In the case of the former Russian spy poisoned in the English town of Salisbury, Sergei Skripal, the Trump administration eventually joined Britain and other allies in retaliating for the attack.  Washington [DC] and its allies expelled scores of Russian diplomats and imposed financial sanctions on oligarchs and political leaders.

To formally name Russia as a state sponsor of terrorism, however, would represent a more significant step.  The State Department’s list, which now includes North Korea, Iran, Syria and Sudan, reflects a formal determination that a foreign government has repeatedly supported acts of international terrorism.  (Secretary Tillerson was fired days after he ordered up the aborted review, apparently for reasons that were unrelated.  His replacement, Mike Pompeo, has not commented publicly on the prospect of such a designation.)

Under a process first implemented in 1979, the designation results in sanctions barring the country from U.S. foreign aid, arms sales and various forms of commerce.  It also restricts U.S. trade and diplomatic contact with nations that do business with countries on the list.

But both Republican and Democratic administrations have wielded the State Department’s terrorism sanctions primarily against countries where the United States has limited interests.  Washington [DC] has used the tool far more sparingly against powerful nations like Russia, where U.S. relationships include substantial competing equities.

In November, for example, the Trump administration aggressively pushed through the designation of North Korea as a sponsor of terrorism, despite what officials in the State Department and other experts considered a relatively weak evidentiary case.

“Russia much more neatly meets the definition of a state sponsor than North Korea does,” said a national security official familiar with the issue.

The Trump administration cited a series of complaints against North Korea, including the mistreatment of an American college student who died after being released from North Korean custody.  But the primary new evidence of repeated support for terrorism was an act that some officials and experts consider insufficient: the 2017 assassination of North Korean leader Kim Jong-Un’s half-brother at Kuala Lumpur International Airport.

“I am delighted to see us get tough with North Korea,” said Daniel Byman, a professor at Georgetown University’s School of Foreign Service.  “I’d rather we chose another label.”

Pakistan, by contrast, has been spared from inclusion on the State Department list despite what U.S. officials say is a well-documented history of funding, training and protecting terrorist groups including the Taliban and Lashkar-e-Taiba.  Even after U.S. counterterror agencies have directly implicated Pakistani intelligence officials in such flagrant activity as the 2008 terror attacks that killed 166 people — six of them Americans — in Mumbai, the U.S. government has continued to treat Pakistan as an indispensable, if untrustworthy, partner.

Russian leaders have bristled at the idea that they might qualify for inclusion on the terror-sponsors list.  Particularly since the 9/11 attacks, the Putin government has cast Russia as a Christian bulwark against the threat of Islamist militancy.  Putin was the first foreign leader to call President George W. Bush to express his sympathies after the attacks.  As the Bush Administration scrambled to strike back against al-Qaida, the Kremlin provided diplomatic and logistical support for the U.S. military’s operations in Afghanistan.

Russian security forces also worked with Western counterparts to track threats related to Chechnya.  And Moscow avoided criticizing the Americans’ use of brutal interrogation methods and secret detentions, despite years of U.S. human rights criticism of Russia’s own counterterror operations.

From the start, however, some U.S. intelligence experts warned that Moscow played by different rules.  Sipher, the former deputy chief of Russian operations, recalled his reaction after learning that the then-CIA director, George Tenet, had told Bush that Russia would be a key ally in the new war on terrorism.

“Tenet asked us to put together a paper on how the Russians were going to help us,” Sipher recalled.  “We were dumbfounded.  We said someone needs to tell the President they are NOT going to be an ally.  They are not going to help on counterterrorism.”

It was not long before signs of Russian duplicity began to surface, Sipher recalled.  In the mid-2000s, the CIA learned that Russia had given its allies in Central Asia a database of suspected extremists that included the names of some CIA undercover officers.

“When our officers showed up in certain countries at the airport, they were handcuffed because we popped up on the list as terrorists,” Sipher said.

In what some U.S. intelligence veterans see as a reflection of Putin’s background as a career officer in the Soviet KGB, Russia has mixed fierce tactics against Islamist militants in Chechnya with cooperation and collusion, officials said.

Russian opposition leaders and journalists have accused the Kremlin’s security forces of masterminding a string of mysterious bombings in Russia in 1999.  About 300 civilians were killed in the explosions at apartment buildings.  The attacks, which the government blamed on Chechen militants, helped then-Prime Minister Putin bolster his standing ahead of the Presidential election he won in 2000.

The U.S. case against Russia as a sponsor of terrorism has grown substantially over the past decade, national security officials said.

As Islamist militants began moving into Syria in 2012 to join that country’s civil war, law enforcement agencies in Europe arrested scores of would-be jihadists.  By contrast, U.S. officials have said, Russia’s principal internal security agency, the FSB, appeared to encourage militants from predominantly Muslim regions like Dagestan to go to Syria ahead of the 2014 Winter Olympics in Sochi.  The FSB carried out this activity to reduce the threat at home during the Winter Games, according to U.S. officials, despite the fact that such militants were likely to join the Islamic State’s fight against the Syrian government, a close Russian ally.

“There must have been senior approval,” said Michael Carpenter, who served as National Security Council director for Russia during the Obama administration.  “There was facilitation, payment, passports.  There were hundreds, at a minimum, who went to Syria during this period.”

There have been more direct examples of state-sponsored violence in the pursuit of Chechen rebel leaders and other Kremlin enemies far beyond Russia’s borders, U.S. officials said.  Russian spies have been convicted of or accused of murdering suspected Islamist extremists in Dubai, Qatar and Turkey, according to officials, court verdicts and published reports.

Both the United States and Israel have often killed suspected terrorists overseas, notably in drone strikes conducted by the Pentagon or the CIA.  But Russia has targeted its own exiled political dissidents with growing frequency — an action that would qualify as terrorism under U.S. law if there is an intent to intimidate a group of people.

In the Skripal case in England, Carpenter said, the seemingly obvious signature of the nerve agent used to try to kill the exiled Russian spy on March 4 was integral to the plot.  “I think the Russians planned it as a hit that would lead everyone to think the Kremlin was behind it, and that would spread a chill among former spies,” he said.  “Is it terrorism?  Yes.  It targets that population of former Russian spies and dissidents and sends a message to stop cooperating with the West.”

Russia had convicted Skripal of working as a British double agent, but released him from prison and sent him to Britain in a spy swap in 2010.  The former military intelligence officer, 66, had lived quietly for eight years in the riverfront town of Salisbury until, British officials say, suspected Russian agents smeared the nerve agent Novichok on the handle of his front door.

Skripal was in critical condition for weeks before his health began to improve.  On Friday, he was released from the hospital.  Authorities moved him to a secret location to continue his recovery.  The other two victims — his 33-year-old daughter and a British police officer — were released from the hospital weeks ago.

Prime Minister Theresa May has said that only Russia had the weapon, motive and operational experience to carry out the plot, an assertion that U.S. intelligence officials have endorsed.  Because the Russian state tightly controls access to Novichok, American intelligence officers think the order to use it had to have come from high-level officials, a U.S. intelligence official said.

Russian leaders have denied any involvement in the case, and have even accused the British security services of staging the attack themselves in order to frame Russia.  After the director of the MI5 domestic intelligence service said last week that the Kremlin was at risk of becoming an “isolated pariah,” the Russian embassy in London declared: “This shows to what lengths London is prepared to go in order to keep the Western bloc in the UK-led confrontation with Russia.”

The Skripal attack recalled the 2006 assassination in London of Alexander Litvinenko, a former FSB officer who had also worked with Western intelligence services.  After fleeing to London in 2000, Litvinenko had publicly accused Putin of plotting the 1999 bombings in Russia, among other crimes.  He was killed by two Russian operatives who poisoned his tea with polonium-210, a rare radioactive substance produced by a Russian military laboratory.  A British court convicted the two Russians in absentia, but one of them, Andrei Lugovoy, a retired KGB officer, received a medal from Putin and was elected to the Russian parliament.

A dozen other suspicious deaths in Britain — the victims were Russian expatriates or Britons linked to them — drew less attention over the past 15 years.  In the aftermath of the Skripal attack, however, British authorities said they would reexamine those cases, which prominently include the death of Boris Berezovsky, an exiled Russian oligarch and enemy of Putin who was initially ruled to have committed suicide in 2013.

When Tillerson ordered the review of Russia’s record on terrorism in March, State Department experts examined a history of Russian-sponsored violent activity in neighboring Ukraine as a key element of a case for designation.

In 2004, an anti-Putin presidential candidate, Viktor Yushchenko, blamed Russian operatives for trying to kill him with dioxin.  The poison badly disfigured Yushchenko, but he survived and won the Ukrainian election.  In another case last October, Ukraine’s attorney general accused the Russian FSB of teaming with a politically connected gangster to assassinate a fugitive Russian legislator in Kiev.

One of the most serious elements of the case against Russia, U.S. officials said, may be the government’s alleged involvement in the shoot-down of a Malaysia Airlines flight by Russian-backed separatists in eastern Ukraine in 2014.  A Russian-made missile killed all 298 people aboard and was part of a wave of separatist bombings and other violence against civilians blamed on Russia after its forces occupied the Crimea region.

“It is the current Russian regime that provided the missiles, the launcher, the software, the training, and perhaps even the triggerman to shoot down Malaysia Airlines Flight 17,” Carpenter testified before a House Foreign Affairs subcommittee in November.

U.S. military commanders have also accused Russia of increasing support for the Taliban.  Although the Afghan insurgency originated with the Islamic militant fighters who battled the Soviets during their occupation of Afghanistan in the 1980s, Russian forces have provided funding and small arms to the Taliban as part of an effort to undermine U.S. policy in the region, Pentagon officials have said.

Amid calls for stronger retaliation against Russia for the Skripal case and its meddling in the 2016 elections, some members of Congress have pushed the Trump administration to consider designating Russia as a state sponsor of terrorism.  Even if the case seems strong, U.S. officials say the action would imperil remaining lines of communication with Moscow and create legal problems for the United States in dealing with nations that do business with Russia.

The Trump administration recognizes Russia’s record, officials said, but senior intelligence officials have emphasized their continued support for a better counterterrorism partnership with the Putin regime.

U.S. intelligence agencies went so far as to extend a highly unusual invitation to Russian spy chiefs, which resulted in a meeting between the sides in January to discuss counterterrorism cooperation.  The directors of the FSB and the SVR, Russia’s foreign intelligence service, held talks in Washington with the then-CIA director, Pompeo, and the director of national intelligence, Dan Coats.  The Americans reminded the spy chiefs that the CIA had relayed a lead that foiled a terrorist plot in Saint Petersburg in December, but the Russians have so far declined to share any comparable intelligence, a U.S. intelligence official said.

“The intelligence agencies want to have a channel open to the Russians,” the official said.  “Historically, at times of political tensions, the spy services have been able to de-escalate while Presidents like Putin are playing to domestic audiences.  It’s important to keep that back channel.”

Critics of the meetings took a less optimistic view, saying the U.S. intelligence community sent a message that it is not serious about confronting Russia’s aggressive conduct.  The Salisbury attack just weeks later underscored the futility of the outreach effort, those experts said.

“These are the guys behind the interference campaign in the U.S. elections, the guys directing Russian operations in Syria and Ukraine and ordering hits like the one on Skripal,” Carpenter said of the meetings.  “Words escape me to express how bad it was.”

OPINION - Shields and Brooks 5/18/2018

"Shields and Brooks on Jerusalem embassy conflict, Mueller investigation takeaways" PBS NewsHour 5/18/2018

Excerpt

SUMMARY:  Syndicated columnist Mark Shields and New York Times columnist David Brooks join Judy Woodruff to discuss the week’s news, including a forthcoming rule from the Trump administration on family planning, the opening of the U.S. Embassy in Jerusalem and the deadly protests along the Israel-Gaza border, plus what we know about the Russia investigation, one year on.

JUDY WOODRUFF (NewsHour):  Now back to political developments, both here in the United States and beyond, with the analysis of Shields and Brooks.  That is syndicated columnist Mark Shields and New York Times columnist David Brooks.

Welcome, gentlemen.  We haven’t all three been together in a little while.  It’s great to see you.

Let’s start, Mark, with the story we led off as a segment earlier, and that is the administration moving to close down, essentially, or close funding for clinics that either provide abortion services or refer women to clinics that do.

It’s the early phases of this, but it’s something the Trump administration seems determined to do.

MARK SHIELDS, syndicated columnist:  Determined, Judy, to make a political issue out of.

I think that Donald Trump, if I’m not recalling — recalling correctly, as a candidate, made the issuing of executive orders by Barack Obama something noxious, pernicious and to be avoided.

That was when Obama did issue executive orders, obviously.  We had Republicans controlling both houses of Congress.  Donald Trump has both houses of Congress in his party.  He tried and Republicans did unsuccessfully in their attempts to repeal and replace the Affordable Care Act, to defund completely Planned Parenthood, and to achieve these objectives.

Now he’s moving — all of these occurrences, I hate to sound cynical, happened to occur in an election year, not simply with President Obama, but it did with President Clinton, with President Obama, with President Trump.  It did with President Bush.  And it began with President Reagan.

The one person who had clean political hands in this was Richard Nixon, who in 1971, invoked Title X, and to provide health care and to provide family planning advice to poor women who couldn’t afford it.

JUDY WOODRUFF:  So it’s become a political football.  Is that what we’re talking about here?

DAVID BROOKS, New York Times:  Yes, I’m not sure I totally agree with that.

It has an election year — it has obvious political benefits for each party’s base, but for Ronald Reagan, I’m pretty sure it was probably a sincere belief that taxpayers shouldn’t be paying for abortions.  For Bill Clinton, it was probably a completely sincere belief that this is a program should be longstanding.

I’m not sure where Donald Trump actually stands in his heart of hearts on this issue.  I do know he has made a deal with social conservatives that you’re going to have put up with a lot of lies and payoffs to adult film actresses, but I’m going to give you — on policy, you will get — and he’s been very consistent on giving social conservatives policy victories.

This is something they have wanted for a long time.  And Donald Trump is handing it to them.  And so a lot of social conservatives who are willing to swallow his personal failures are going to feel vindicated that this was a deal worth making.

I don’t particularly agree with that, but I think social conservatives will say, yes, if we’re going to get wins like this, which are for, in their case, for the good of the country and for the good of humanity, they’re willing to swallow a lot from Donald Trump.

MARK SHIELDS:  I’m not questioning the sincerity of all involved.

I do — their motives — but I think there is a strong political element to it.  And it has to be noted of Planned Parenthood, while it provides cancer screening, all sorts of health care, it does provide also 330,000 abortions a year.  So it’s a major element in the — in abortion-providing.

DAVID BROOKS:  Yes.  The tradeoff here is that Planned Parenthood, which does a lot of all sorts of health stuff, also does the abortions.

JUDY WOODRUFF:  An array of services.

DAVID BROOKS:  And so you get — say you’re a social conservative.

You get what you want on the abortion.  It’s going to be harder to get an abortion and some of them will get less funding.  But in places where they have done this — and we have now seen what happens when you do this — when you take people away from Planned Parenthood, you also — you do see a sharp rise in pregnancies, because contraception isn’t prescribed as much.

You see some health — deleterious health benefits down the side.  So, on the plus side, people who really find abortion morally abhorrent don’t have to pay for it.  On the minus side, there are negative health effects.
-----
JUDY WOODRUFF:  An anniversary this week.  We have only got a couple of minutes left.

But, David, Robert Mueller started his Russia investigation a year ago this week.  Where are we after a year of that?  Of course, it’s all been behind closed doors.  We have seen indictments.  We have seen some pleas.  Where does it stand?

DAVID BROOKS:  Well, we have had a year of speculation about what is about to happen.

What we have learned is that it’s a pretty broad-ranging investigation.  There’s a lot of dirty businesses, a lot of guilty pleas already, a lot of people brought under indictment.  So it’s a real investigation, investigating what looks like real crimes.

As for the collusion charge, we know there were many more meetings between the Trump people and the Russians than we thought before.  There was a meeting in Trump Tower.  And so there’s clearly more smoke there than we knew before a year ago.

What we don’t have is actual evidence of real collusion, and particularly by an awareness of the President himself.  That may be still out there, but that part, we still don’t have.

JUDY WOODRUFF:  And we know he may be pursuing other charges as well.

DAVID BROOKS:  Right.

JUDY WOODRUFF:  Mark, how do you see it?

MARK SHIELDS:  What we do know, Judy, is that the Senate Intelligence Committee is composed of grownups and led by Senator Burr and Senator Warner, and they deserve credit.

The House Intelligence Committee is led by just outrageous adolescents who are about as deep as a birdbath.

At the same time, I think what we learned is that the defense of Donald Trump, led by himself and Rudy Giuliani, is to savage and torment, denigrate, vilify and libel Bob Mueller.

Bob Mueller happens to be an American who turned down an eight-figure income to be a major corporate lawyer, instead became a public servant.  He’s a man who volunteered and carries the wounds of battle from having been a Marine platoon leader in Vietnam.  He is a public servant.

He has not said a word.  He has not given an interview.  He has not leaked to anybody.  And he stands vilified by Trump and Giuliani and their cohorts and their outriders.

It is indefensible.  And they are trying to exact the same damage upon the Justice Department of the country, the FBI and this country that Joe McCarthy did on the State Department, which has never fully recovered from his libelous attacks.

JUDY WOODRUFF:  Twenty seconds.

DAVID BROOKS:  Yes, I don’t disagree with that.

I would just say, I observe politically, I do think if Trump fired Mueller tomorrow, the Republican Party would back him.

MARK SHIELDS:  Do you really?

DAVID BROOKS:  Because I think FOX News has created a predicate.  They have done thousands of surveys and investigations about Mueller as a political operative.

UK ECONOMY - The Royal Wedding

"Why the royal wedding is a gift for the UK economy" PBS NewsHour 5/18/2018

This is one of those 'DUH' questions.

Excerpt

SUMMARY:  Saturday's wedding between Prince Harry and American actress Meghan Markle has provided a much-needed boost for Britain’s economy during the uncertainty of its separation from the European Union.  From those hawking commemorative knickknacks to the cucumber industry, special correspondent Malcolm Brabant explains what the windfall means for the U.K.

The Royal Wedding of Prince Harry and Meghan Markle (9:33:14)

SCHOOL SHOOTING, AGAIN - Galveston, Texas

When are YOU (the voter) going to say enough, and through out politicians who do nothing to protect your children?

"Texas school shooting days before graduation draws governor’s call for new gun laws" PBS NewsHour 5/18/2018

Excerpt

SUMMARY:  Students, parents and teachers suffered the agony of a school shooting on Friday morning near Galveston, Texas, where at least 10 people were murdered and 10 more wounded.  The suspect, a 17-year-old according to media reports, is being held on a capital murder charge.  Judy Woodruff learns more from Gail Delaughter of Houston Public Media.

BRIEF BUT SPECTACULAR - Parents of Child With Cancer

"How being a parent to a child with cancer changes your life" PBS NewsHour 5/17/2018

Excerpt

SUMMARY:  What is it like to have your child diagnosed with cancer?  Monica McGuiness and Aaron Rodriguez spent two years traveling 80 miles to a hospital so that their 8-year-old son could receive treatment.  McGuiness and Rodriguez share their Brief but Spectacular take on childhood cancer and how they coped.

SOCIAL MEDIA - Should We Be More Like Cats?

"Why we should be more like cats than dogs when it comes to social media" PBS NewsHour 5/17/2018

Excerpt

SUMMARY:  Computer scientist and virtual reality pioneer Jaron Lanier doesn't mince words when it comes to social media.  In his latest book, "Ten Arguments for Deleting Your Social Media Accounts Right Now," says the economic model is based on "sneaky manipulation."  Economics correspondent Paul Solman sits down with Lanier to discuss how the medium is designed to engaged us and how it could hurt us.

TRUMP TRADE - China, U.S. Companies' Stake

"What’s at stake in China trade talks for U.S. companies" PBS NewsHour 5/17/2018

Excerpt

SUMMARY:  Prospects for averting an all-out trade war grew dimmer as the second round of negotiations between the U.S. and China kicked off in Washington [D.C.].  The President said China had been “spoiled" by lenient U.S. trade policies for too long.  Yamiche Alcindor reports, and Judy Woodruff talks with David Lampton of Johns Hopkins University about questions surrounding Chinese telecom ZTE and more.

BORN IN THE USA - Declining Birth Rates

"The surprising thing about the declining U.S. birth rate" PBS NewsHour 5/17/2018

Excerpt

SUMMARY:  More than 3.8 million babies were born in the U.S. last year, but the birth rate drop was the largest one-year decline since 2010.  Why hasn’t the downward trend changed direction, even though economic conditions have improved?  Amna Nawaz explores some of the factors with Hans-Peter Kohler of the University of Pennsylvania.

NEWS HOUR SHARES - Perception, 'Yanny' vs "Laurel'

Our ears hear reality, our brains 'hear' an interpretation.

"Yanny vs. Laurel spotlights our brains’ desire to fill in the gaps" PBS NewsHour 5/16/2018

Excerpt

SUMMARY:  It's the auditory debate taking the internet by storm.  The PBS NewsHour's Nsikan Akpan and Julia Griffin explain how one sound can create two different experiences.

MY EXPERIENCE:

On my iPhone I hear "Yanny."  On my TV home entertainment system connected to a HI Def Surround Sound Amplifier, I hear "Laurel."  The device does make a difference.

FACEBOOK - News or Junk?

"Inside Facebook’s race to separate news from junk" PBS NewsHour 5/16/2018

Excerpt

SUMMARY:  At Facebook, there are two competing goals; keep the platform free and open to a broad spectrum of ideas and opinions, while reducing the spread of misinformation.  The company says it's not in the business of making editorial judgments, so they use fact-checkers, artificial intelligence and their users.  Can they stop junk news from adapting?  Science correspondent Miles O'Brien reports.

AMERICAN POLITICS - Vote 2018, Women & Progressives

"Women, progressive Democrats score wave of primary wins.  What will that mean for midterms?" PBS NewsHour 5/16/2018

Excerpt

SUMMARY:  Tuesday's primaries spanned the country and the political spectrum, from more liberal Oregon, to conservative Idaho and Nebraska, to swing-state Pennsylvania, where wins by women were particularly notable.  Lisa Desjardins learns more from Dave Davies of WHYY in Philadelphia.

RUSSIA INVESTIGATION - As the 'Noose' Tightens

"Where Robert Mueller’s Russia investigation stands, one year later" PBS NewsHour 5/16/2018

Excerpt

SUMMARY:  As Robert Mueller’s special counsel probe marks its first year, the Senate Judiciary Committee released thousands of pages of documents providing the most comprehensive look at an undisclosed meeting in Trump Tower with a Russian lawyer.  Nick Schiffren talks with Wired magazine contributor Garrett Graff, and Matt Olsen former director of the National Counterterrorism Center.

TRUMP AGENDA - It Starts Falling Apart, North Korea Summit

aka "Another North Korean Monkey Wrench"

Once North Korea had missiles that could hit the United States they are NOT going to give that up.  It was their primary goal.

"North Korea casts doubt on Kim-Trump summit, rejects total disarmament" PBS NewsHour 5/16/2018

Excerpt

SUMMARY:  North Korea upset months of thawing relations on Wednesday by threatening to cancel the June summit with President Trump if the U.S. continues to push Pyongyang to abandon its nuclear weapons.  Judy Woodruff reports on the response from the White House.

"Why North Korea is threatening to pull out of the U.S. summit" PBS NewsHour 5/16/2018

Excerpt

SUMMARY:  What seemed like a sure thing a week ago in now up in the air.  A top North Korean official released a statement saying that they are not interested if the U.S. insists on complete nuclear disarmament.  Judy Woodruff talks with former State Department official Joel Wit about the recent back and forth and the prospects for productive talks.