tv Consider This Al Jazeera October 1, 2013 1:00am-2:01am EDT
>> welcome to al jazeera america. here are the top stories we are following at this hour. the u.s.g. is in shut down mode for the first time in 17 years. a live look from washington as congress misses the deadline. the house and senate fail to come to an agreement on part of the legislation that would effect the affordable care act. the partial shut down will not effect all government employees. despite the shut down, health exchanges are rolling out. the exchanges are the bread and butter of the affordable care act. also known as obama care. a top level meeting between the u.s. and
israel israeli prime minister and president obama met monday in the oval office. the israeli leader had a warning to the u.s., don't trust iran. they will address the u.n. general assembly on tuesday. an explosion shook the campus at u.c. burkely today as students were in the midst of their afternoon campus. a few people received minor injuries and one has been taken to the hospital. the explosion is believed to have been caused by the underground facilities. "consider this" is coming up next.
[[voiceover]] from lucrative defense contracts to behind-the-scene lobbyists. >>did egyptians ever think that aid would actually be cut? >>never. [[voiceover]] fault lines explores the enduring relationship between the american and the egyptian militaries. >>i don't think we will suffer now. we already have airplanes, tanks ... >>they haven't changed the nature of what they provide us. why would we want to change what we provide them? millions who need assistance now. we appreciate you spending time with us tonight. up next is the golden age of hollywood going golden but elsewhere.
the ages of 18 and 35 in exchange plans to balance risks and hold down costs. will they enrol come 1 october - should they pay the face. >> joining me now is jen mishory, deputy director of young invincibles, she's in washington d.c. and yevgeniy feyman, a research assistant at the manhattan institute. thank you for being with us. i want to start with you yevgeniy feyman. the young people are crucial to the success of obamacare. >> absolutely. they'll balance out the risk pool, they'll keep premiums that need the insurance, and the administration is reaching out to them. >> jen, the young invincibles are in the 18-34 group. [[voiceover]] from lucrative defense contracts to behind-the-scene lobbyists. >>did egyptians ever think that aid would actually be cut? >>never. [[voiceover]] fault lines explores the enduring relationship between the american and the
egyptian militaries. >>i don't think we will suffer now. we already have airplanes, tanks ... >>they haven't changed the nature of what they provide us. why would we want to change what we provide them? while mitt romney was governor. does it offer a good indicator of what we can expect nationally? dr. john kingsdale, these days he is the director of the wakeley consulting group, knows the sides of the debate in
massachusetts and nationally. really appreciate can you being with us. we want to talk about the positives and negatives in massachusetts. shortage in primary care physicians and specialists and even hospital beds. do you think that's the case? and do we have growing pains on a federal level that could lead to that? >> certainly not nurses and hospital beds. there are some shortages in the capan islands and the areas of massachusetts, access to care what we newly ensured about 400,000 residents put a little bit more strain there. but you know massachusetts frankly has a very high and healthy ratio of clinicians to
populations, and most of the uninsured frankly get their care at community health centers and those have been staffed up and doing a really tremendous job of taking care of the newly insured and certainly the four years i was running the exchange here, we did not see any complaints in core areas of massachusetts for access to primary care. >> but one of the main objectives of obamacare is to control costs and last year health care in massachusetts maids up approximately 43% of the state budget. if that were to happen at a federal level that would be catastrophic. are opponents wrong when they point to that number as a concern? >> if they draw the comparison to the federal budget they are certainly wrong. yes it is substantial in massachusetts as it is in many state budgets. neck and neck with education in many state budgets. it is really the relevant comparison for the federal cost,
and the cost of the affordable care act is borne almost entirely by the federal government as opposed to states, is really before and after. and here in massachusetts the cost to the state budget went up about $350 million, net net, with the ability to ensure another eight or so percent of our population, get our uninsurance rate down to about 2%. that $350 million is significant but in the context of a $30 billion state budget that's a little over 1%. so was it a significant commitment on the part of the taxpayers in massachusetts, yes, was it a budget buster, absolutely not. >> still individual health care cost has grown more than the national average, premiums rose by 9.7% and benefits decreased by 5% while at the same time deductibles rose by
40%. if romney care is not controlling costs in massachusetts do we have an expectation that obamacare will do it nationally? >> wow, there are about four different questions rolled into that one. so let me give you a brief answer to each one of those. romney care as you call it was really not developed to control cost. it was developed primarily to ensure the uninsured at a reasonable cost. and i just went over some of the increased cost with you. in fact the increased cost in health care in massachusetts have come down in the five or six years of the last decade and since health care was enacted have been coming down and down and down. in fact in the last couple of years they have been to the 2 to 3% range and one of the largest
health insurers announced a rate decrease for the parts affected by the affordable care act, small group and felon group rates. i would say compared to the past, it hasn't made much of a difference, if anything a little bit downward pressure. and then there's the question you asked about, so what's the implication for affordable care act in cost containment? and there the affordable care act has a lot of elements frankly that was left out of massachusetts health reform in 2006-2011. but -- 2011. 2007. what we are seeing is a significant uptick in the level of competition among the health insurers, some new insurance companies and very much focused on price competition as opposed to sort
of consumer add-ons that only confuse folks so i'm optimistic. >> another concern is the number of people covered by employer health plans has decreased in massachusetts. estimates are that under obamacare there will be decreases of about 7 million over the first decade that will fall off of employer covered plans because of employers not wanting to pay health insurance under obamacare. concerns there? >> well, the numbers i know, from having led health reform here for several years, were that we actually saw an increase of about 100,000 covered lives through employers through group insurance in the first two years of reform. 2006 to 2008. then of course whole country got hit by the big recession. and we lost some jobs and we lost some coverage then. so we went down to about the
2006 level by 2010. >> right. >> i actually have -- >> in talking about jobs, that was one of the concerns about romneycare and that seems not so have come through, only job related losses, it seems that massachusetts has really not lost any jobs because of romney care and in fact 90% of doctors there are happy with the system. >> well, that's true about physician support and i think it's also true that it was not a job killer by any -- in any sense of the word. in fact i think a lot of the criticisms and some of the claims of success, frankly for what massachusetts did, and what the aca is going odo are completely overblown. the impact frankly on employment here was noddest one way or the other. -- modest one way or the other. i don't think the impact of the affordable care act is going to be significant one way or the other frankly.
>> of course the biggest positive is massachusetts has the highest rate of insured residents, 98%, that is a tremendous jump. what do you think will happen, you don't think obamacare will quite get to those numbers but it will make a big difference. >> i was going to say 98% is almost civilized. that would be considered poor performance by most of the other industrialized world but the 16 or so% across the country which is 50 million people across this country without insurance. the goal that the backers have said is to get to 95%, that will take three or four years. 95% insured and that still leaves about 5% of the country uninsured. some of those are illegal residents and others just won't be reached by this reform. >> there have been some kinks that they were working out in massachusetts. there were issues about access
to doctors and time of access. but a lot of those complaints have certainly gone down over the years. is that what you see happening with obamacare, it will take a few years before things settle down? >> i think i have to tell you that my experience was most much those complaints were articulated by right wing editorialists, there was very, very little complaining here. i'm glad you think it settled down, i'm not sure it was ever there. i think the national -- >> to be fair, the massachusetts medical society said about one in five residents said they waited longer than usual to see a doctor. it's now one in five down from one in four in 2008. so that's not a right wing commentator but certainly things are getting better. >> yeah, if you went back to their 23s in 2003 you would find something similar. i'll just leave it at that. but i do want to make the distinction with the state and
the national implementation. i think the job national is far, far more difficult than it was in massachusetts. it's just a much bigger hill to climb in the terms of the number of uninsured, the diversity of the country versus one state, the level of support throughout even the republican party in massachusetts. you know scott brown, senator brown, voted for health reform, and it was supported by a republican governor here and paid for in part by a republican administration in the nation's capital. so i think the challenges for the affordable care act frank reply are a lot more significant and i think the road through implementation is going to be bumpier. >> we will cover that road as it goes along. john kingsdale, we appreciate you sharing the massachusetts situation with us.
>> breaking bad, how does it on august 20th, al jazeera america introduced a new voice in journalism. >> good evening everyone, welcome to al jazeera. >> usa today says: >> ...writes the columbia journalism review. and the daily beast says: >> quality journalists once again on the air is a beautiful thing to behold. >> al jazeera america, there's more to it.
>> in light of sunday night's breaking bad finale, don't worry no spoilers here. 10.3 million viewers tuned in to see walter white's conclusion. the sought after 18 to 49 age bracket. it's clear cable networks can compete with the best of broadcast channels. ratings have drastically changed thanks to dvrs and to streaming sites, including netflix and amazon prime. hard to predict when viewers will watch their shows or what to watch them on. audiences have splintered, mash,
my favorite show ever said good-bye in 1983, as 105.9 million viewers watched. but ten years later another huge hit cheers had a massive audience but 25 million fewer than mash. seinfeld dropped in 1998 and friends got a send off but half of mash's audience two decades before. and these cable fares did as well as their cable brethren, sopranos did better than breaking bad and sex and the city took in 10.6 million in 2004. the broadcast networks, lost was the big event in 2010, desperate housewives, only had 11.2 million watching it say going. the
>> you've all heard how powerfully addictive drugs are. you've probably learned how using crystal meth or heroin even once creates a habit that is hard to break. but arguing a scapegoat of deeper problems of poverty and race, that neuroscientist is the author of high price, a neuroscientist's journey of self discovery that challenges everything you know about drugs and society. carl thank you for being here. >> thank you for having me.
>> you say 80% of people who use drugs like crack and heroin are not really addicted to them. you hear so many stories you use crystal meth once, heroin once and you are addicted forever. why is that not the case? >> we have learned that the majority of people, 80, 90% of people that use drugs that you name do not become addicted. we think about why we believe that people become addicted to these drugs after one hit, it's mainly based on anecdotal hysteria. but when we critically think of it we think about the last three guys who occupied the white house, for example, president clinton, president bush, president obama, they used illegal drugs but didn't become addicted. >> didn't immediately become addicted.
>> i'm saying 10% of these folks will become addicted, who use drugs, that's a fact. but we have overblown the extent to which these drugs are addicted. >> you did experiments, why don't you explain those for us. >> we did a number of experiments but those -- >> where you offered a little bit of money. >> one of the things i believed when i started doing this research was that one hit of cocaine perhaps for a crack cocaine addict, had them going off on a bing e, you can't avoid that behavior. when you have a sexually receptive mate, sweet treats and whatever, you can provide alternative behavior. if you provide something like $5 versus a hit of crack cocaine, you can get people to choose $5 about half of the time. but when you up that to about
$20 you can get -- they won't take drug anymore, they'll take the money on all occasions. >> so people who might have thought they were addicted you actually proved they were not? >> it's not that they weren't addicted. it's that even people who are addicted -- >> you can break it? >> we can disrupt this behavior when you provide the appropriate alternatives. >> one of the ves interesting is rat park -- >> there were a number of studies but rat park is one of the places that people talk about. canadian bruce alexander provided rats with a choice to take morphine or some animals had a choice between morphine and playing with other rats, or in cages that were not isolated, but when the animals were isolated they took the morphine. but when they weren't isolated they chose to play with their other rat colleagues. >> now if they are not as addictive as we thought then why do so many people get addicted to drugs and have as many
approximate as they do have? >> i don't know that i would say so many people. >> about 20%. >> any behavior, any type of behavior that concerns society, people who drive their cars too fast, who drive reckless and so forth? there are a no. number of people who do that. we do that safely. but most of the focuses on drugs, you have shows like breaking bad, shows that highlight aberrant behavior, it is not representative, it is without thinking the fact that that relative or that person life was already screwed up before they were using crack cocaine. >> their society, their environment makes a big difference on whether they get addicted or not. we have a viewer question, let's
go to our social media producer hermella aregawi for that. >> i've read stories about addiction thinking that addicts are actually ill not suffering from a lack of moral come pats. how does that play into your research that only a small portion of drug users become addicts. >> the fact is people become addicted for a variety of reasons. the fact remains that ten to 20% of these people will become addicted, they will become addicted for other reasons, because they have co-occurring other diseases like skits frain schizophrenia. i'm not saying it's a simple sort of explanation for addiction because that's not true. >> one thing you do talk about is when teenagers bet caught or thrown into jail or thrown into
juvenile detention and there's also a vancouver injection study where teens who do drugs and not get caught, seem to do better than those are, you agree? >> the last three guys who occupied the white house those guys did drugs. and we did not get caught, we wert put in the lockup, we weren't incarcerated. but those who were likely to be reincarcerated , incarceration, you have lack of supervision all of these things. >> your experience in a poor neighborhood, you used some drugs even sold some drugs. >> that's right. >> you were not at any point detained and that made a big difference in your life where others who were -- >> i try to describe i have
friends many of whom were smarter than me, they were caught and incarcerated, and as a result whereas i didn't, i did better in life than they did. that's not to glorify what i did but just to point out. >> you are not in any way advocating drugs we should make that clear. but you do call for decrilzation. not legalization, you are basically saying if somebody buys drugs uses drugs that that should not be a problem. >> when we think about the united states for example, each year we arrest 1.5 million people for drugs and 80% of those people are arrested for simple position. that means they have a blemish on their record, they can't get jobs, are not going to be paying taxes. one way to deal with this, particularly since the assumptions on which our drug policies are baysed are
applaud. it's not legal, it's just when people get caught they get the equivalent of a traffic violation. they get a fine. >> what about the argument that by buying drugs, that anybody who buys drugs is basically fueling the drug industry which is an incredibly violent industry that's responsible for thousands of deaths worldwide and for terror in some places, the areas around the mexican border, terrible situation, that by buying drugs you are contributing to that? >> that is hyperbole, we sell cars to people who drive recklessly, the automobile industries are being careless. that's -- that argument for me holds no weight. >> but you -- are you against legalization? you wouldn't want to go as far as legalizing drugs and having control?
>> in the book i argue against legalization. i argue more for decriminalization. i do that because the american public is so ignorant about drugs. not that the drugs themselves might have a problem but we would attribute some of the problems to drugs when in fact it is not drugs. it is because we have more available i availability it is about the drugs and we are ignorant as to what drugs do and do not do. >> unfortunately we are out of time. you are worried about the consequence rather than the control by the government. >> i'm worried lack of education. >> i understand but we got to leave it there. read the book. the show may be over but the conversation continues,
♪ ♪ . >> this speaker is now midnight, and the great government of the united states is now closed. >> at 12:01 in the morning the u.s. government officially shut down. why it happened and what it really means for americans. the president's controversial plan to provide healthcare to millions of americans is set to officially go into effect later today. there are a lot of questions about how it is going to work, and why it is at the center of the government's shut down, and after major diplomatic developments between the u. and iran, the prime minister of israel comes to america calling for caution.