On today’s show: Vox’s Dylan Scott reports on the deep roots of Americans’ hatred of their health-care system. Jacob Soboroff and Errol Morris discuss whether Trump could revive his family-separations policy during his second term, in this week’s episode of Apple News In Conversation. The National Labor Relations Board says contestants on Netflix’s ‘Love Is Blind’ are employees. Deadline has more. And the New Yorker’s Emily Nussbaum, a recent Apple News In Conversation guest, speaks with us about how the ruling could transform reality TV as we know it. Plus, a DOJ report says the FBI did not incite the Jan. 6 attack on the Capitol, why the electrification of the U.S. Postal Service’s fleet will take longer than expected, and an incredible breakthrough in the fight against HIV. Today’s episode was hosted by Shumita Basu.
Chapter 1: What are the current issues with the U.S. health care system?
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 UnitedHealthcare CEO Brian Thompson and the arrest of his alleged shooter. Americans have been feeling this way for a while now.
Chapter 2: Why do Americans feel betrayed by their health care?
Confidence in the quality of U.S. health care 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 percent. Only 18 percent 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.
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.
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 U.S. health care system. And everyone involved is busy pointing fingers at each other.
Chapter 3: What is the blame game within the healthcare industry?
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.
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.
Chapter 4: How do U.S. health care outcomes compare internationally?
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.
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 U.S. pays more money for healthcare, and on average, you know, taken collectively, gets worse outcomes.
Chapter 5: What are the potential reforms for the U.S. health care system?
Reforming the system to deliver better care will require some accountability from every sector of the industry. Scott says voters play a role too.
That's been the pattern of health care 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 with Democrats in 2008 and 2010.
He says it's good to look at what other countries have done to design health care that works for everyone, if only to remind us that it is, in fact, possible.
Chapter 6: What is the controversy around family separations under Trump?
There's not just one blueprint for doing it. A bunch of different countries do it in 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 what. 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.
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 U.S.-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.
Chapter 7: Will family separations be revived in Trump's second term?
Or you might remember hearing this recording, first released by ProPublica, of children crying, calling for their parents.
Bye-bye.
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.
We don't have to separate a family. Excuse me, Kristen. 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 is not separated. So no more family separations. You're not reviving the zero tolerance policy. 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.
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.
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 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.
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.
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