tv PBS News Hour PBS June 20, 2017 3:00pm-4:01pm PDT
captioning sponsored by newshour productions, llc >> woodruff: good evening. i'm judy woodruff. on the newshour tonight: a looming deadline to pass a health care bill. republicans scramble to rally votes, but many senators on both sides of the aisle say they, and the public, are being kept in the dark. then, a tragic homecoming. american otto warmbier dies after being flown, in a coma, out of north korea. what it means for u.s. relations with the asian country, and for the three americans still being held there. plus, young people and social media. one school district wades into the tricky task of monitoring online activity, without infringing on students' privacy. >> it is very important to draw the line between punishing an
action that occurs on social media, versus thoughts that are expressed on social media. >> woodruff: and, jeffrey brown gets a glimpse into the life of author and comedian david sedaris, through his series of autobiographical essays. >> it used to be about racking up laughs, right? but, i think you need some sorrow to give the laughter a bit of weight. >> woodruff: all that and more, on tonight's pbs newshour. >> major funding for the pbs newshour has been provided by: >> bnsf railway. >> and with the ongoing support of these institutions:
>> this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. >> woodruff: the battle over tax cuts is heating up. house speaker paul ryan promised today that republicans are moving "full speed ahead," despite divisions over the issue. in a washington speech, he said the g.o.p. majorities in congress must press for "transformational tax reform." >> we need to get this done in 2017. we cannot let this once-in-a- generation moment slip by. yes, the defenders of the status quo-- and there are many-- are counting on us to lose our nerve, to fall back, or put this off altogether, but we will not wait for a path free of obstacles. because, guess what? it does not exist. >> woodruff: in turn, senate democrats warned they may balk at raising the national debt
ceiling, if republicans push for new tax breaks for the wealthy. voters in georgia went to the polls today, in a special election that is now the most expensive u.s. house race ever. total spending in the contest between republican karen handel and democrat jon ossoff reached at least $50 million. the seat in atlanta's northern suburbs came open when tom price became secretary of health and human services. it has been in g.o.p. hands since 1979. there's been another incident over syria: an american fighter plane shot down an iranian-made armed drone overnight. u.s. officials say it was flying near a u.s. training camp along the syrian-jordan border. on sunday, american planes downed a syrian military jet that bombed near u.s.-backed rebels. russia, in turn, warned it would target coalition planes. today, at the united nations, secretary general antonio guterres urged restraint.
>> the situation is so complex on the ground, indeed i am concerned. i hope this will not lead to any escalation of the conflict that is already as dramatic as it is. >> woodruff: one of the u.s. coalition members, australia, announced today it has suspended air strikes in syria, for now. the united states and russia traded accusations today over another incident. this one came monday, over the baltic sea. the pentagon says a russian fighter jet swooped within a few feet of an american reconnaissance plane. the russians say the u.s. plane swerved too close to their jet. back in this country, new federal data finds the opioid abuse crisis is swamping hospitals. according to the report, there were nearly 1.3 million emergency room visits and in-patient stays for opioid problems in 2014.
the emergency visits were up 64% from 2005, while in-patient stays nearly doubled. officials say the epidemic is still getting worse. the atlantic hurricane season is only three weeks old, and already, the gulf coast is bracing for a hit. tropical storm cindy formed today and should reach the texas-louisiana border region late tomorrow night. a foot of rain could fall as far east as the florida panhandle. the rain was already falling, and the sea churning today in new orleans. mayor mitch landrieu urged people to get ready. >> we've been through this many, many times before. i don't want anyone to panic. there's no reason to do that. but this is going to be a serious event. we could get lucky and it could turn out to be nothing. we don't expect that's going to happen. it could be one to three inches, or it could be three to 12. and if those bands us the wrong way, we could have some serious flooding. >> woodruff: at the same time, tropical storm bret weakened to
a tropical wave, as it blew across the southern caribbean. meanwhile, the southwest is seeing one of its worst heat waves in years, on the first day of summer. temperatures reached nearly 120 degrees in phoenix today, for the first time in 22 years. the conditions are also tough on fire crews battling wildfires in southern california and elsewhere. helicopters and tanker planes have reduced their loads because the super-heated air is thinner. wall street cooled off some today, as falling oil prices took the broader market lower. the dow jones industrial average lost nearly 62 points to close at 21,467. the nasdaq fell 51 points, and the s&p 500 slipped 16. and, barbie's longtime companion doll, ken, has a new look-- 15 of them, in fact. toy maker mattel unveiled the revamped dolls today, with a range of body types, skin tones and hair styles, from corn rows
to man buns. ken's makeover follows a similar effort to make barbie's image more realistic and diverse. it's about time. still to come on the newshour: two senators weigh in on the prospects for replacing obamacare. what an american's death means for u.s. relations with north korea. the fine line between monitoring students' social media and invading their privacy. and, much more. >> woodruff: the effort by senate republicans to replace the affordable care act picked up steam today as their leader promised a first look at their bill before the end of the week. so far, democrats remain unable to stop it on their own. but they mounted a public relations attack, as republicans counted votes.
the word came from majority leader mitch mcconnell that a draft of the senate g.o.p.'s health care package was on its way. >> well, we're going to lay out a discussion draft thursday morning. and i wouldn't want to compare it to the house bill. it'll speak for itself. it'll be different, and take a different approach based upon these endless discussions we've had with the only people interested in changing the law, which is republican senators. >> woodruff: he spoke as democrats, in the minority, were making their own symbolic stand on health care on the senate floor. minority leader chuck schumer quoted what the president reportedly said about the house health care bill, to attack republican efforts broadly. >> for once, on the topic of healthcare, i find myself agreeing with the president. his health care bill is mean. cutting medicaid to the bone is mean.
>> this is an insult to the american people. >> woodruff: democrats and their allies held the senate floor yesterday, well into the night, and took republicans to task for keeping their work behind closed doors. >> so i say to the republican leadership, what are you afraid of? >> woodruff: today, the number two republican in the senate, texas' john cornyn, turned the focus back to the democrats, charging that their speeches were just that-- talk. >> unfortunately, they're spending their time and energy giving speeches to each other on the senate floor, and absolutely contributing nothing toward a solution to this problem. >> woodruff: no details from the republican discussions have been publicly released. but, the "washington post" and others reported the senate version would make deeper medicaid cuts than those passed in the house. they also would be phased in more slowly. the house bill calls for cutting $800 billion over 10 years. at the same time, senators are
also reportedly considering offering more generous insurance subsidies, especially for older americans, as well as eliminating some-- but not all-- of the taxes put in place by obamacare. whatever the eventual bill looks like, republicans don't expect any democrats to support it; thus they cannot afford to lose more than two of their own members. yet some g.o.p. senators, like tennessee's bob corker, have said that, even up to now, they remain out of the loop. >> have you seen the republican health care bill? >> i have not. have you? have you? >> i have not. >> i would have liked, as you already know, for this to be a more open process and have committee hearings. but that's not what we're doing. >> woodruff: making sure corker and other republicans not in on the drafting process are on board is a priority for the republican leadership-- especially mcconnell-- as they prepare for a possible vote next week.
and just a short while ago, i spoke with two key voices in the senate about this health care debate. john barrasso is an orthopedic surgeon from wyoming, and the chairman of the senate republican policy committee. and, senator chris van hollen, a democrat from maryland. he played a key role in the house leadership when obamacare was passed in 2009. senator barrasso, senator van hollen, thank you both for joining us. senator barrasso, we just heard the majority leader say that this bill takes a different approach than the bill that came out of the house. what makes it better? >> well, look, the pain of obamacare is getting worse every day. we're seeing it all across the country as premiums continue to go up and choices continue to go down. we're looking at ways to make sure that anyone with a preexisting condition is protected. we're looking for ways to stabilize the market and also lower the sky rocking cost of insurance and then stabilize medicaid for the long run, because we need a safe and
secure program there. it has to be strong, and it's not strong now. >> woodruff: senator van hollen, is there any part of that the democrats can support? >> well, judy, of course we don't know what's in the senate republican bill because it's been kept in deep secret from the american public. no hearings, no amendments in committee, but senator cornyn, one of the members of the republican leadership, said it was going to be 80% like the house bill. the house bill is a bill that president trump celebrated in the rose garden but then behind closed doors said was mean, and it is mean because it will mean 23 million americans who will not have access to affordable care act, who would otherwise have it, people with preexisting conditions will go back to being able to be victims of discrimination by insurance companies. it is why virtually every patient advocacy organization, i think 100%, are against that legislation, and every provider group i've heard from is also
against it. it will provide huge tax cuts for the wealthiest americans. if you're a millionaire, you'll get a $50,000 on average annual healthcare and cuts medicaid by $830 billion. this is going to wreak havoc on our healthcare system. >> woodruff: take a part of that. senator barrasso, what about the medicaid cuts? again, we haven't seen what the senate is coming up with, but the reporting is that it is going to be deeper medicaid cuts than what the house bill has. >> well, first of all, it's hard to stand here and hear chris talk about a bill he hasn't seen. he'll see it thursday. he's made a number of attack against it, but in his own state of maryland insurance rates are going up 58%. i don't know how somebody with a straight face can call that affordable. they went up 24% last year, and the president of the maryland care insurance company has said we're in the beginning of the throes of a death spiral of
insurance. they've lost $600 million. obamacare has failed in maryland. it's failing all across the country, and for people with preexisting conditions, judy, when you see all of these counties across the country where no one is even willing to sell obamacare insurance, if you have a preexisting condition and nobody is going to be willing to sell you insurance, even with a subsidy, your preexisting condition is not covered and you've been deceived by obamacare. >> i'm glad john brought that up. yes, blue cross blue shield, the largest insurer in the state of maryland asked for a whopping 50% increase. here's what the president of blue cross blue shield told us, that well over half of that increase is due to deliberate sabtage by the trump administration and cuts republicans made to obamacare, affordable care act payments. a full 20% of the increase they're asking for is because the president issued an executive order on first day of his administration saying that
they would not enforce the individual mandate provision. you tell people they don't have to join, including healthier people, it means sicker people will pay a lot more, and by the way, that's why aarp is on the warpath against this healthcare bill, because they're going to see dramatic increases, and, yes, john, i have not seen the senate bill, neither has the country, which is a shame on the democratic process. finally, john didn't answer your specific question about medicaid, which has nothing to do with the exchanges. it's a whopping cut. i know his state of wyoming did not take the medicaid expansion, but this will wreak havoc on tens of millions of americans. >> woodruff: senator barrasso, what about the criticism that it's what republicans have done that have undermined obamacare, but also the medicaid question? >> well, insurance company executives prior to the election, prior to the november election were saying they're thinking of pulling out in 2018, so this is nothing new.
had hillary clinton gotten elected president of the united states, we'd be having to make major changes to obamacare, trying to clean up the mess that has been created by the obama healthcare law. that's where we are right now. the current status is not sustainable. >> woodruff: what about the republican bill? >> we're working on it in the senate. it's a different way to deal with medicaid to make sure that states that did expand, because there are a number of states that did and states that didn't, the states that did will have a smoother dplied -- glide path to getting to the point for anyone on medicaid in those states they're reimbursed in the same way as was set up initially for people who are disabled, blind, the elderly and children. that's who medicaid was set up for originally. plus i was in the state senate in wyoming, andly tell you, judy, we always felt if we had more control of that money rather than the one-size-fits-all that comes out of washington, we could have helped a lot more people and a lot better ways with giving some
of the flexibility and the freedom of choice that a state has instead of having to listen to the mandates of washington. as to chris's point of the individual mandate, it is the most hated part of obamacare, and the judges that say how do they count the numbers, they say if you get rid of the individual mandate, which i am committed to do and the republicans did, they say millions and millions of people will not buy a mandated government product they don't think... >> the whole idea of insurance, as john knows, is everybody has to be part of the pool. that's the whole idea of social insurance and health insurance. the core of the republican bill in the house that we suspect in the senate is rotting. here's why: it cuts medicaid by $830 billion. that's huge. it provides tax cuts of about $900 billion. you tell me how cutting taxes to millionaires and giving them an average tax break of $50,000, has anything to do with making healthcare bet center in fact,
it takes two years off of the medicare trust fund because as part of the affordable care act, we asked wealthier americans to put some of their unearned income into shoring up medicare. the republicans give them a big tax break. they hurt millions of americans in the process. and it is a bad deal. >> woodruff: senator barrasso, what about those tax cuts for wealthier americans that one realized under presumably under the senate plan? >> that's still part of the debate we're having, and the bill will come out friday. we want the eliminate all the taxes that raise premiums for people, the medical device tax, the health insurance tax, the tax on prescription medication. but getting back the medicaid, judy, one-third of the doctors, and i've practiced medicine for 25 years, one-third of the doctors in this country will not take new medicaid patients, and major hospitals around the country have said, look, if you have to make an appointment for somebody with medicaid or who has traditional insurance, don't give that appointment to
somebody with medicaid. this is what the mayo clinic said, because we have reached a tipping point where we can't continue even paying the salaries at the rate that medicaid reimburses. medicaid is failing. we need to strengthen it for the long term. >> their answer is it's failing, so cut it by another $180 billion. it's not sufficient to completely reimburse doctors now, so give them even less. while you're giving tax breaks to the very wealthy. that's nuts. and i think the american people know it. i think that's why this has been kept in secret in the senate for so long. i hope that at long last we'll have chance to debate this. >> woodruff: just finally, to both of you, when the public is told that the senate version is going to stabilize the healthcare coverage in this country, quickly, senator barrasso, how does it do that? >> well, there are a number of different provisions to do exactly that, to people with a significant high risk of high medical cost. it's worked successfully around
the country. part of this is it gives more flexibility to the states so they can make decisions about what insurance can be bought and sold in those states to allow people to get what they want and they need and is right for their family, not what the democrats who voted for obamacare said they have to have. >> well, listen, judy, there are issues with some of the exchanges. we can fix them. there are common sense things you can this about that. rather than blow them up. and with respect to medicaid, in maryland i can tell you of the people directly benefiting from the affordable care act, more than half are from medicaid. john hasn't said anything that's going to explain how those people are going to be better off when they cut 830 billion or whatever amount they're going to cut from the medicaid program. medicaid already has lots of waivers and already has lots of flexibility. we're using it in the state of maryland. his state of wyoming did not take the expansion, so maybe, you know, that's something he doesn't feel strongly about, but i can tell you we're hearing
from republican governors in states that have, and they're saying, "do not do that kind of damage to the medicaid program." >> somebody may have a medicaid card, but it doesn't mean they can't see a doctor. >> i tell you when they take $830 million away from them and give it to wealthy americans, they will not be better off. they will be a lot worse off. >> woodruff: gentlemen, our first peek at at the bill on thursday. senator kris van chris van holl, senator john barrasso, thank you for joining us. >> thank you for having us. >> woodruff: now, to the quiet and tragic end to the sad story of otto warmbier, and the implications for the united states' dealings with his former captors in north korea. john yang has that. >> yang: speaking in the oval office, president trump condemned the death of otto warmbier, who had been detained in north korea for nearly a year and a half. >> it's a total disgrace, what
happened to otto. it should never, ever be allowed to happen. >> yang: he also indirectly blamed the obama administration for not getting him home sooner. >> he should have brought home that same day. the results would have been a lot different. >> yang: the president's spokesman said warmbier's death casts a shadow on mr. trump's stated willingness to talk to his north korean counterpart "under the right conditions." >> clearly we're moving further away, not closer, to those conditions being enacted. >> yang: later, in a tweet, the president seemed to abandon his goal of enlisting china to pressure north korea: "while i greatly appreciate the efforts of president xi and china to help with north korea, it has not worked out. at least i know china tried!" north korea's release of the 22-year-old warmbier has increased-- not eased-- tensions with pyongyang: he arrived in ohio last week in a coma. doctors said warmbier suffered a "severe neurological injury" with extensive loss of brain
tissue, likely as a result of a lack of blood to his brain. >> it's a state of unresponsive wakefulness. >> yang: he'd been sentenced in march 2016 to 15 years hard labor for allegedly taking a propoganda poster from a pyongyang hotel. in a statement, warmbier's parents said, "the awful torturous mistreatment our son received at the hands of the north koreans ensured that no other outcome was possible." in an interview broadcast today on cbs news, newly-elected south korean president moon jae-in joined in the condemnation of the north. >> ( translated ): i believe we must now have the perception that north korea is an irrational regime. >> yang: moon, who had campaigned on engaging north korea, said all options are on the table. >> when it comes to pre-emptive strike, this is something we may be able to discuss at a later date, when the threat has become even more urgent.
>> yang: north korea still holds three other americans as prisoners. today , a pair of u.s. b.-1-b. bombers, like these, flew over south korea, just below the demilitarized zone, in a show of force. so, what effect will the death of otto warmbier have on the wider, and seemingly- intractable, question of how the u.s. should deal with north korea? what options are left? to probe those questions, and more, we turn to veteran diplomat kathleen stephens. she was u.s. ambassador to south korea from 2008 to 2011. she's now at stanford university. that's where she joins us from tonight. ambassador stephens, thank you. what about that question? is this tragic story of otto warmbier going to affect, have any impact on the way the united states approaches north korea? >> well, i certainly think it's a reminder to us that the threat
and the danger that north korea poses, not just to the united states, but to the region and the world, goes even beyond its nuclear missile programs, which we've been so rightly focused on in recent weeks and months. i also need to add, i myself want to express my deepest condolences to the warmbier family and to all the friends, and i know there are many of otto, the treatment that he received while under north korean custody for a year and a half was appalling and outrageous, and i think the north koreans owe a full explanation to his family and to the united states of what happened. >> yang: is the approach complicated by the fact that there are three americans still being held? >> well, i think it concentrates the mind certainly of the united states, and i hope in pyongyang, as well, that this is untenable. and i would hope that in the coming days and i believe this will happen that there will be a
renewed pressure and effort to win the release of these three americans who are being held. there are others of other nationalities, as well. north korea in an area of allowing access to foreigners who have been arrested while in north korea, which it is obligated to do under standard diplomatic procedure, it hasn't met those obligations as it does not meet its obligations in other areas. it needs to do that, but it really needs to stop the practice of holding, arresting and holding businesses, not allowing representatives in their countries to have access and often using them or hoping to use them as leverage, as hostages essentially and as bargaining chips. it needs to stop. it needs to be a part of our overall approach and effort. it has been, but it needs to be reemphasized going forward that this too is part of the effort to get north korea to live up to some minimal standards of international behavior. >> yang: live up to some
minimal standards. we've had sanctions in place for a long time. we've had people describe it as an irrational regime. what are the real pressure points on north korea? what can make a difference to north korea? >> well, that's a very challenging question. i think one thing that remains very important is notwithstanding maybe some welcome realism about perhaps the limits of what china can or will do. china does remain an important actor in this, as does south korea. so i think with meetings coming up tomorrow in washington, secretary tillerson and mattis are meeting with their chinese counterparts. next week the new south korean president, moon jae-in, will be meeting with president trump. clearly north korea will be very much on the agenda, but in the context of what's happened, these are going to be even more somber meetings, and i think the effort will be to look both at better implementation of the
pressure and sanctions now in effect and also into some new ones that high bring greater pressure to get north korea to take a different path and a path that will lead to some discussion of how it can meet its international obligations. >> yang: president moon ran on a campaign of engagement with north korea. he wanted to pressure north korea to the negotiating table, while president trump talks about pressuring north korea to get rid of its nuclear program. what are the chances or the likelihood that these two leaders can find a common approach to north korea when they meet here in washington next week? >> well, it's their very first meeting. they're both very new in office. president moon in particular. i think a lot will depend on the kind of relationship and rapport they're able to establish with each other. president trump established a good rapport with the japanese prime minister, of course with the chinese president, mr. xi, although today he seemed to be disappointed in him. so i think one, personal
relationship is important. but, two, i think it will be important for president moon to explain that the south korean perspective. the south koreans over many decades have seen thousands and thousands of their citizens abducted and held in the north, and six are being held right now just within recent months and years. so this is a heartfelt issue for south korea as well as the continuing security threat of north korea. so they're under no illusions about the threat. challenge will be, as you suggest, how to harmonize these approaches and also harmonize them with china's approach in the region, which certainly sees the need for a change in behavior in north korea, but they're roar wind about instability. it's not going to be easy, but having these meetings is an important first step. >> yang: ambassador kathleen stephens, thanks for join us.
>> woodruff: stay with us. coming up on the newshour: improving health care in the nation's most rural communities. and from the "newshour bookshelf," humorist david sedaris and his book of autobiographical essays. but first, schools are paying a lot more attention to what students post online, and that can have severe consequences for students and schools. harvard university pulled the admittance of at least ten incoming freshman who had reportedly posted violent, racist and sexually explicit content in a private facebook group. high schools are cracking down, too, with some hiring outside companies to police social media posts. but monitoring online behavior is difficult, and civil rights groups are watching. special correspondent lisa stark, with our partner "education week," visited a school district in arizona. >> reporter: it's just before summer break at dysart high
school in surprise, arizona, outside phoenix. students are eating lunch, signing yearbooks, and they're immersed in social media. more than 90% of teens say they go online every day, and nearly a quarter are online almost constantly. let me ask you, first of all, do you all have phones? >> yeah. >> yes we do. >> reporter: do you ever not have a phone with you? >> no, it's always on. >> reporter: we sat down with four dysart students to talk about how they use social media. >> snapchat. i post every single day. every day, all day. >> i always post my thoughts, certain ways i'm feeling, depending on how i'm feeling that day. >> when i'm done with all my work, and if i don't have any work from other classes, i just get on my phone and see what's going on. >> i don't really care who sees it, i'm just posting because i think it's public, i'm open about it. >> reporter: the problem for schools-- what happens on social media, doesn't always stay on social media. >> i see a lot of bullying on
facebook that-- it transfers to the school. and then, at the beginning of this year, this girl got into an altercation on facebook and she ended up fighting the girl at school. >> when something's posted on social media and it's being talked about on campus and it disrupts learning, that's when we have to step in and decide if there's something we need to react to. >> reporter: nationwide, a growing number of districts are watching what's posted online for anything that might impact their schools. principal amy hartjen says the number one concern is safety. okay, like, what's we have to get involved here? bullying, would that be a red line? >> absolutely, threats and intimidation. >> reporter: what if someone posts offensive language, racist, sexist? >> absolutely. >> reporter: really, and why would that be a red line? >> because that is-- just, it's against the campus culture. >> reporter: students threatening to harm others or themselves sometimes telegraph
that on social media, and districts have been sued for not paying attention to online posts. these days, the school yard has new boundaries. the information space is just as important as the physical space because it has that ability to snowball at a really rapid pace. zachery fountain is the dysart district communications chief, and point man on social media. he trains staff on how to document troublesome posts. >> that's teaching them things like asking for a screenshot of what has happened, understanding that a message could disappear in five seconds, as soon as it's brought to their attention by a student. >> reporter: nationwide, both public and private schools keep tabs on social media in a variety of ways: hiring firms to actively monitor students' accounts, encouraging students to report anything worrisome, friending students to gain access to posts that may not be public, and through simple alerts every time the district and its schools are mentioned in
any type of media. there's anecdotal evidence, but no hard data to show that early identification of troubling social media posts can help schools head off problems. school officials here insist they are most concerned about safety, that they're not trying to pry into students' lives. but civil rights and privacy groups say it can be a slippery slope. and taht some districts have gone too far, and have violated students' constitutional rights. students have been disciplined for liking other posts, for private online chats that others made public, for forwarding racists posts, even in order to denounce them. >> schools need to think about, how do we take on these issues in an appropriate way, that doesn't have the collateral damage effect of destroying student's privacy and free speech rights? >> reporter: chad marlow is with the american civil liberties union. he says first and foremost, school should not have open-
ended access to students' social media accounts. you're saying no fishing expeditions? >> no fishing expeditions. the way to do that is by not allowing passwords to be turned over, or what we call shoulder surfing. log onto your account, and the teacher will stand over the student's shoulder and say, scroll, scroll, scroll, scroll. >> reporter: are you asking students for passwords? >> no. >> reporter: or log-in information? >> no. >> reporter: school resource officer wendy klarkowski is assigned to shadow ridge high school in the dysart district. her morning routine includes searching for school-related posts on social media. she's uncovered criminal activity. >> a young man decided to bring some marijuana-laced brownies to school, and he advertised them on twitter and said, meet me in the cafeteria. we got him with all the brownies still on him. >> reporter: and possible campus disruptions. >> some kids were going to protest something they thought was unfair, and was all over twitter so we were able to get the kids that were leading it. actually, the night before, so that they put an end to that, so it didn't disrupt the campus.
>> reporter: why isn't that their free speech right to protest something they're not happy about? >> it is their right to protest, but it is not their right to disturb an educational institution. >> reporter: the a.c.l.u.'s marlow worries about districts stifling free speech. >> it is very important to draw the line between punishing an action that occurs on social media versus thoughts that are expressed on social media. once you start policing and punishing thoughts, you are into very, very dangerous territory. >> reporter: two of the dysart students we spoke with say they tread more carefully online after each posted a disparaging remark about one of their teachers. >> i made a reference to one of my teachers last year on facebook, and i almost got a referral for it, for what i said about her. and then me and the teacher ended up talking, and now she's my favorite teacher ever. >> it was funny at first, then i was like, i need to take some precautions for next time, when i'm angry about something, not mention names or anything-- i could say english teacher as opposed to saying their name.
>> reporter: you are censoring yourself in a way? >> yeah, kind of. >> reporter: how do you feel about having to do that? >> i don't really have a problem with it, because it's not that serious of an issue. >> reporter: superintendent gail pletnick insists the district is careful not to violate free speech or privacy rights. >> we're not crossing that line. we're not monitoring people 24/7. we're not the social media police. but we are concerned about anything that we feel will be harmful to our students. >> reporter: pletnick says technology changes so quickly that schools can find themselves operating in a gray area. >> those laws, those rules, those guidelines that we're going to have to use are being developed. we're really not only flying this plane while we build it, while it's being designed. >> reporter: it can be a rough ride, so dysart, and other districts are increasingly starting to teach digital citizenship, the responsible use of technology, to impress upon
students to think before they click. >> i like that, that's cute. >> reporter: for the pbs newshour and "education week," i'm lisa stark in surprise, arizona. >> woodruff: 50% of health care spending in the u.s. can be traced to just 5% of the population. those are the sickest and often poorest americans who spend much of their time cycling in and out of costly emergency care. while congressional leaders square off toward a vote next week on the future of the health care law, there are pilot projects on the ground that are focused on how to improve treating this group of patients and also save money. that's even the case in remote areas. special correspondent jackie judd has our report from kalispell, montana. >> reporter: not so long ago, sheran greene and her beloved
dog were living in a car in downtown kalispell, montana, and routinely heading to the local emergency room because of chronic lung disease and the need for an electrical outlet. >> i was there like clockwork every day. sometimes being treated, sometimes having to charge up my oxygen machine, which i used, because i had no electricity. sometimes just getting out of the cold. >> reporter: it is this cycle of some patients going in and out of the hospital, at great cost with not much benefit, that the group around this table is trying to break. >> how can we avoid some of these emergency room visits that really are not necessary? >> reporter: a pilot program, funded by the government and a foundation, began late last year in kalispell, billings and helena. health care players already in the community now team up in a very deliberate way to identify
high-needs patients and to go well beyond the traditional bounds of medical care. >> do you think you find housing that'll take your section 8 voucher? >> oh, yeah. >> reporter: lara shadwick directs the montana program. >> some of the themes really rest on social determinants of health. lack of transportation, housing insecurity, food insecurity, economics, finances. those are really some of the drivers that are the commonalities for these patients. >> reporter: the kalispell care team runs lean. there are community health workers, like jane emmert, who are trained to manage non- medical issues works. and the head of the team, registered nurse lesly starling. together, they aim to reset the paths these patients are on. >> they're so sick, they've gotten so used to the way that, that they live, i, i do feel like that patients get very used to their environment, and they get very used to their, to their choices. they get very used to their
lifestyle, and it, it's not, it's almost like they build up an immunity to what their life looks like. >> reporter: david dixon was once a member of an emergency medical team, and a fishing and hunting guide. since a disabling motorcycle accident, he struggles with chronic pain and nausea, overuse of medications and episodes of depression and anxiety. in a 14-month period he went to the e.r. 42 times. >> i just want to have a better life. i want to be able to wake up in the morning and have a halfway decent day. i'd like to be able to make plans for tomorrow morning. >> reporter: in just a few weeks, the team has helped dixon to reconnect him with a pain specialist and link him up to a pharmacist to sort out the many medications he is on. >> are you taking that one also pretty regularly? >> there's so many medicines i'm taking that, i don't know which
ones are really helping and which ones aren't at this point. >> reporter: dixon, like so many high-needs patients, has mental health issues. specialists in kalispell are in short supply, so starling typically gets advice from an expert some distance away about how best to work with patients. >> it sounds like you've been using a lot of those, some of the motivational interviewing skills we've been talking about, you know, finding what kind of barriers there are for him, finding what his goals are. >> reporter: sometimes that need is as basic as a roof over one's head. the team found sheran greene an affordable apartment, which is no easy task in kalispell. starling acts as a liaison to greene's primary care doctor, and other community workers literally deliver greene to dr. jonathan anderson's door. >> so do i have a heart? >> it's still beating.
she's allowing people into her life, is what she's doing. before, it was basically the e.r. and the hospital, and then she'd come in for follow-up visits here, and then she'd bounce around and come back. now, she's allowing people from the community to come in, and allow them to help-- either help her move things, allow them to kind of check in on her and make sure she's doing all right. >> reporter: when greene was homeless, in one six-month period, her medicare charges were a $100,000. since november, hospital charges are less than $6,000. by the time this pilot program ends, the hope is over $2 million will be saved. programs like these first came to urban areas. rolling it out in a huge, rural state like montana is a very different kind of experiment, with very unique challenges, starting with simple geography. >> sometimes we're going on mountainous roads that are icy and treacherous, sometimes they're narrow dirt roads that you aren't sure that you want to go down.
>> reporter: to get to a patient can be a 60 mile round trip. so emmert frequently heads out on her own to their homes, as she did on this day, to visit 25-year-old mackenzie kramer, who is slowly recovering from major surgery. >> so if you try to do any of this, and it's tough for you, just know what we'd be glad to help you fill it out. >> reporter: emmert is there to help him manage the paperwork for disability, and to put him in touch with starling, who can check up on many more patients if she stays behind in her kalispell office. >> how has the pain been? >> it's been manageable. it's getting better, i think. >> reporter: the team also gently pushes kramer to think about his future, once his health stabilizes. >> he's got to have something to look forward to.
so that's why we're looking into possibilities with college, or a job, that he can reclaim the life of a 25-year-old again. >> reporter: progress comes in fits and starts. less than 24 hours after a home visit filled with encouragement to manage his illnesses differently, dixon takes himself back to the e.r. >> what happened? >> i got sick again last night. i woke up nauseous and vomiting, and took my medicines and couldn't keep my medicines down, so i went for a trip to the hospital again. >> reporter: dixon's team was not surprised that he went to the hospital; his visit, a reminder of how fragile these patients are and how much work it takes to break the cycle. >> it's taken years to get me
where i am. they're starting to understand it, they're starting to get programs together that fill in the gaps in the medical profession, where i had problems before. they don't know everything, it's not a magic wand, but at least they're trying. >> reporter: the pilot program has another year to prove these intensive interventions can succeed and, if so, whether there is the funding and the will to make them a new standard of care for the most challenging people to treat. for the newshour, this is jackie judd in kalispell, montana. >> woodruff: two quick notes about jackie's story: it is not yet clear whether the moves by the president and republicans to replace the affordable care act will affect the funding of programs like this one. and, for the record, the robert wood johnson foundation, which helps to fund the kalispell pilot program, is also a funder of the newshour.
>> woodruff: finally tonight, humorist david sedaris plumbs his own diaries for his latest book showcasing life's idiosyncrasies. jeffrey brown sat down with sedaris recently, amidst his performing around the country in some 120 cities. >> brown: a 60-year-old hugely successful writer, looking back at his younger self... ...the one before the millions of books sold, the countless live appearances, before adoring audiences and, often in his culottes, the regular appearances on late night tv. on a recent morning, we joined david sedaris at the archives of la mama theater in lower manhattan, one of the small stages where he first told stories. in a new book titled "theft by
finding," sedaris offers a kind of fractured portrait of the artist behind the stories, through his personal diaries. >> trying this persona on and that persona on. you know, trying acting and, oh, now look, i'm trying sculptor, and now, all the sudden, i'm a painter. but that you could kind of settle on being yourself, completely yourself, and have that be the thing that works, is being yourself, is, to me, incredible. >> brown: sedaris was raised in a large family in raleigh, north carolina, and many of his stories involve his parents and siblings, including sister amy, a well-known humorist in her own right. his colorfully-titled story collections, including "me talk pretty one day," "dress your family in corduroy and denim," and "let's explore diabetes with owls," are perennial bestsellers. and, npr regularly replays
perhaps his most famous story, "santaland diaries," about the time he worked as an elf at macy's. that experience appears in his diaries beginning on october 31, 1990, when he is told: "congratulations, mr. sedaris. you are an elf." so you can't not write and keep a diary? >> it's funny because, sometimes people say, oh, that's very disciplined. but it's not a discipline, it is a compulsion. i should be out doing things, but i have to write about these people i saw at dinner the night before. i have to write about the bellman at my hotel. i have to write about something that ultimately doesn't matter at all. but, i don't know, i can't move on until i get that down. >> brown: when you overhear something or you record something in your diary, is
there kind of an "aha, this is something i can use"? >> i flew here from london yesterday. i was at newark airport waiting for someone to pick me up, and i saw a couple, and they were in their mid-60s. and then she said to him, "where's the other suitcase?" and he said, "what other suitcase?" she said "you left home dragging two suitcases behind you. now you've got one. the other one is mine. where's my suitcase? you lost my suitcase!" i thought, wow. i mean, i've been in a similar situation, right? and just, the entire look on her face, like, if i could leave you now, or if i could kill you now, i would do it. and, so i had to write about that.
if i were going to remember yesterday, i flew here on an airplane and i did this and, that but that was really the moment yesterday where i felt like i was living my life, like i was in the moment. i wasn't thinking about the past or about the future. i was just right there living, watching those people have an argument. >> brown: and that sense is important to you somehow? >> well, because i spend so much time in the past or the future. i think most people do, really. and the moments when you're really present in your life can be pretty rare, really. >> brown: sedaris' stories appear regularly in the "new yorker." on the day we got together, he was just finishing a new one. so, in the printed stories and on stage, you're presenting, in
some sense, a character named david-- david sedaris, right? your family members, your partner, hugh. talking to you now, i'm not sure if you think of them as "characters" or you're just writing yourself. >> well, i think people are people in real life, but the second you put them on a page, on the page they become characters. >> brown: and how worked over are your stories? >> gosh, the story that i sent in a draft this morning for this "new yorker" story that we're closing, it's the 21st draft. >> brown: 21st draft? is it tinkering over words? or jokes? >> it's tinkering over words. i'll go on tour with, let's say three new stories, and i'll read them and go back to the room and rewrite them, and read them and rewrite them. >> brown: and what does a story in the end have to have, to be successful, to work for you? >> it used to be about racking up laughs, right?
but i think you need some sorrow to give the laughter a bit of weight. and that's when you remember things. that's when i remember things, at least. >> brown: so people come and they want, you think they want laughter, but you want something more? what is that "more?" >> i suppose i want them to feel something. i want to connect with them. i want them to-- usually, it's the worst thing you can admit about yourself, that most people can relate to. it was so surprising to me when i realized that. that when i thought, well, if you write about, say, your own jealousy, people aren't going to think, "oh, he's a horrible person because he's jealous." they'll think, "that's me." >> brown: was there always an ambition? was there always a kind of craving to not only get to a bigger world, but reach people? >> yeah, it's all i ever wanted.
it's all i ever thought about. when i go on tour and i'm on stage and the lights come up at the end and i see those people, people say "oh, that must be awful, you go on tour and you go to 40 cities in 41 days, and then you have the book signing." and that's people standing in line to say how much they love you. >> brown: for hours, sometimes. >> i don't see any part of that that's negative. it's all i ever dreamed about from age six up. >> brown: david sedaris will continue to tell his stories and write his diaries, in his travels at home and abroad this summer. for the pbs newshour, i'm jeffrey brown in new york. >> woodruff: online right now: six members of the presidential advisory council on
h.i.v.-aids recently resigned, saying president donald trump "does not care" about the disease. pbs newshour's pamela kirkland interviews one of those members who quit the council. you can watch that on our facebook page: facebook.com/newshour. and that's the newshour for tonight. i'm judy woodruff. join us online, and again right here tomorrow evening. for all of us at the pbs newshour, thank you, and we'll see you soon. >> major funding for the pbs newshour has been provided by: >> bnsf railway. >> the ford foundation. working with visionaries on the frontlines of social change worldwide. >> carnegie corporation of new york. supporting innovations in education, democratic engagement, and the advancement of international peace and security. at carnegie.org.
>> and with the ongoing support of these institutions and individuals. >> this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. captioning sponsored by newshour productions, llc captioned by media access group at wgbh access.wgbh.org >> you're watch
. >> welcome to the program. charlie is traveling tonight, i'm david leonhardt of "the new york times." we begin this even with senator ron wyden of oregon. >> nobody has done the damage to the trump presidency than donald j. trump. i mean the fact is i never thought that we would have a president say i'm being investigated, and then tweet it around the world. so this is breaking, you know, new ground. and my sense is that the president is calling the shots here. and very often i think that the president instead of being somebody who thinks he's been vindicated with hiring new lawyers, but i gather his lawyers are telling him to knock off the tweeting. >> we continue with a discussion about health care with sarah