Football season is nearly here, and the Cleveland Browns are looking good.
SCOTT SIMON, HOST:
And time now for sports.
(SOUNDBITE OF MUSIC)
SIMON: The 78-game winning streak comes to an end. Football season about to begin. Will it include Carli Lloyd of U.S. women’s soccer on the field and new calls over the dangers on the gridiron?
NPR’s Tom Goldman joins us. Good morning, Tom.
TOM GOLDMAN, BYLINE: Good morning, Scott.
SIMON: And down under, the Australian national basketball team defeated the U.S. men’s basketball team 98-94 last night. The spirit of Luc Longley abides. Now, this…
GOLMAN: Luc.
SIMON: This…
GOLMAN: Luc (laughter).
SIMON: This is the first U.S. loss since 2006 – a warmup game. But some of the best basketball players in the world these days are from outside the U.S., so we can no longer assume U.S. – you know what I mean – can we?
GOLMAN: Goodness (laughter). We cannot. Hey, some exhibition, Scott. Fifty-two thousand people were at the game in Melbourne. How about that? First time Australia beat the U.S. in men’s basketball. This was a warmup for the upcoming World Cup.
A lot of the top NBA stars have pulled out of the competition. This is a huge NBA season coming up, as you know, with everyone assuming the league is wide open with all the crazy player movement and Golden State finally being vulnerable. So a lot of the top stars want to get their rest and be ready. But Scott, no excuse – Australia beat U.S. fair and square. And yeah, the World Cup victory is not a lock – going to be fun to watch.
SIMON: Official beginning of Division I college football season today. Clemson, Bama, blah, blah, blah. And what about Boise State?
GOLMAN: (Laughter). Your mighty Broncos in their blue turf. They haven’t cracked the top 25 in the preseason polls, but…
SIMON: I noticed.
GOLMAN: …Those are preseason polls. And at the end, they may be in the thick of things. Most likely, though, it will be blah, blah, blah – Clemson, Alabama – throw Georgia in the mix, too. And what is a certainty – count on fans who are sick of the usual suspects to clamor, once again, for more than four teams in the season-ending playoff.
SIMON: Carli Lloyd, one of the stars of the U.S. women’s soccer team, drilled a 55-yard field goal this week in a video that went viral. Can the NFL ignore someone who can kick a 55-yard field goal?
GOLMAN: Well, it shouldn’t. I mean, you know, Lloyd obviously has a live right leg. She’s proved that over and over for the U.S. women’s national team. Now, nailing a 55-yarder in practice certainly is different from having a bunch of huge people screaming toward you, trying to block the kick during a game. But – and you pointed this out earlier, Scott – she knows pressure.
SIMON: Yeah.
GOLMAN: She’s seen it all. And pressure is such an enemy of placekickers in the NFL.
SIMON: This week, Robert Cantu, who’s a neurosurgeon, Mark Hyman, a professor of sports management, wrote an op-ed in The Washington Post that urges the U.S. surgeon general to issue a warning about the dangers of tackle football for youngsters. I read this at your recommendation – a very compelling and important piece, I thought.
GOLMAN: Very much so. A reminder, as football season gets under way, that it’s still dangerous for younger kids to play tackle because of the repeated hits to the head. Cantu and Hyman note football and all sports have gotten safer due to the increased awareness about head injuries. But they cite studies showing the earlier kids play tackle and start getting those smaller subconcussive head hits that add up over a career, the earlier the onset of cognitive and mood and behavioral problems for the ones who are affected. Not all football players are affected, obviously.
Now, while the authors say high school football is still very popular, there is evidence that youth participation is declining. And an interesting note, Scott – new numbers by the Sports and Fitness Industry Association say participation by kids in baseball and softball went up by nearly 3 million between 2013 and 2018.
SIMON: Good – baseball. Tom Goldman, thanks so much.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
A man cools off in a fountain in New York’s Washington Square Park this summer. Death from all causes doubled during a heat wave in New York City in August 1975, with heart attacks and strokes accounting for a majority of the excess deaths.
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A little Shakespeare came to mind during a recent shift in the Boston emergency room where I work.
“Good Mercutio, let’s retire,” Romeo’s cousin Benvolio says. “The day is hot, the Capulets abroad, and, if we meet, we shall not ‘scape a brawl.”
It was hot in Boston, too, and people were brawling. The steamy summer months always seem to bring more than their fair share of violence.
But the ER was full of more than just brawlers. Heart attacks, strokes, respiratory problems — the heat appeared to make everything worse.
I wasn’t the first to notice this effect. In 1938, a statistician named Mary Gover found a surprising association between heat waves and increased mortality from all causes. Only about a quarter of deaths during these periods could be attributed to heatstroke, a dangerous form of heat illness that occurs when temperatures outstrip the body’s ability to shed heat.
In heatstroke, proteins begin to unravel once the core temperature exceeds 104 degrees. Enzymes become inert. Cells’ ability to produce energy fails near 106, ultimately causing multiple organ failure, shock and death.
Heatstroke is an important cause of heat-related deaths and tends to get the most attention during extreme heat waves. But other diseases are affected by the heat as well.
Gover found that a majority of the excess deaths occurring during heat waves were from “diseases of the heart, cerebral hemorrhage … and pneumonia.” That observation seemed right to me, and subsequent research has shown that she was on to something.
Three September heat waves in Los Angeles — 1939, 1955 and 1963 — were associated with increased total mortality of 271%, 445%, and 172% more than usual. Death from all causes doubled during a heat wave in New York City in August 1975, with heart attacks and strokes accounting for a majority of the excess deaths.
More recently, total mortality rose 26% in Philadelphia during 10 scorching days in July 1993, with mortality from cardiovascular disease nearly doubling. A 2018 analysis of 23 studies confirmed the association between cardiovascular mortality and heat waves. And in 2013, a study of 12 million Medicare patients found a strong association between heat and exacerbation of chronic respiratory diseases.
Other scientists began looking beyond heat waves. British researchers compared mortality rates with average temperatures throughout the year and found that death rates from heart attack, stroke and pneumonia increased steadily with temperatures over 70.
In 2002, another British team found that total mortality in London increased by roughly 3% for every 1 degree Celsius above 21.5 Celsius, or about 70 Fahrenheit. That same year, a team from Johns Hopkins confirmed that total mortality increases linearly above 70 degrees in a study of 11 U.S. cities.
Why would heat have such a profound effect on cardiovascular disease in particular? It may relate to the body’s own adaptive response to high temperatures.
When body temperature rises, blood becomes a critical means of ditching heat. Vessels near the skin dilate to increase peripheral blood flow. Heat is circulated from the core to the skin, where sweating helps to transfer heat to the environment.
The heart is the engine that drives this adaptation, and the added stress could prove fatal to a damaged one.
Heat also causes dehydration, which could in turn increase the risk of clotting by concentrating coagulation factors within the blood and by triggering the release of molecules that spur inflammation. Any predisposition to clotting could contribute to a heart attack or stroke.
Heat may also exacerbate mental illness. In 2014, Canadian researchers found that ER visits for mental illness increased 29% during periods of extreme heat in Toronto. Vietnamese scientists demonstrated in 2016 that risk of admission to a mental health facility increased 36% during weeklong heat waves. The following year, a team of Korean researchers estimated that nearly 15% of emergency admissions for mental illness over an 11-year period could be attributed to extreme heat.
And what about violence and aggression? Was Benvolio right to warn Mercutio against meeting any Capulets in the heat?
Associations between heat and violent crime have been noted since official crime statistics became available around 1900. In 1997, researchers used modern statistics to confirm that violent crime occurs more often in warmer years. Scientists used FBI crime data in 2004 to show that crime rose 5% for every 10-degree increase in weekly average temperatures. And a 2013 study found that violent crime increased 1% for every degree above average monthly temperatures in St. Louis.
Field experiments have also supported an association between heat and aggression. In 1986, researchers found that drivers were more likely to use their horns when it was hot outside. And in 1994, police officers exposed to elevated temperatures during firearms training were found to exhibit increased aggression and were more likely to discharge their weapons.
These are worrying trends, especially with temperatures projected to rise ever higher in coming years. Benvolio may have put it best. “For now, these hot days,” he says to Mercutio, “is the mad blood stirring.”
Clayton Dalton is a resident physician at Massachusetts General Hospital in Boston.
In rugged, rural areas, patients often have little choice about how they’ll get to the hospital in an emergency. “The presence of private equity in the air ambulance industry indicates that investors see profit opportunities,” a 2017 report from the federal Government Accountability Office notes.
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Wyoming, which is among the reddest of Republican states and a bastion of free enterprise, thinks it may have found a way to end crippling air ambulance bills that sometimes top $100,000 per flight.
The state’s unexpected solution: Undercut the free market, by using Medicaid to treat air ambulances like a public utility.
Costs for such emergency transports have been soaring, with some patients facing massive, unexpected bills as the free-flying air ambulance industry expands with cash from profit-seeking private-equity investors. The issue has come to a head in Wyoming, where rugged terrain and long distances between hospitals forces reliance on these ambulance flights.
Other states have tried to rein in the industry, but have continually run up against the Airline Deregulation Act, a federal law that preempts states from regulating any part of the air industry.
So, Wyoming officials are instead seeking federal approval to funnel all medical air transportation in the state through Medicaid, a joint federal-state program for residents with lower incomes. The state officials plan to submit their proposal in late September to Medicaid’s parent agency, the Centers for Medicare & Medicaid Services; the plan will still face significant hurdles there.
If successful, however, the Wyoming approach could be a model for the nation, protecting patients in need of a lifesaving service from being devastated by a life-altering debt.
“The free market has sort of broken down. It’s not really working effectively to balance cost against access,” says Franz Fuchs, a policy analyst for the Wyoming Department of Health. “Patients and consumers really can’t make informed decisions and vote with their dollars on price and quality.”
Freewheeling free market system
The air ambulance industry has grown steadily in the U.S., from about 1,100 aircraft in 2007 to more than 1,400 in 2018. During that same time, the fleet in Wyoming has grown from three aircraft to 14. State officials say an oversupply of helicopters and planes is driving up prices, because air bases have high fixed overhead costs. Fuchs says companies must pay for aircraft, staffing and technology, such as night-vision goggles and flight simulators — incurring 85% of their total costs before they fly a single patient.
But with the supply of aircraft outpacing demand, each air ambulance is flying fewer patients. Nationally, air ambulances have gone from an average of 688 flights per aircraft in 1990, as reported by Bloomberg, to 352 in 2016. So, companies have raised their prices to cover their fixed costs and to seek healthy returns for their investors.
A 2017 report from the federal Government Accountability Office notes that the three largest air ambulance operators are for-profit companies with a growing private equity investment. “The presence of private equity in the air ambulance industry indicates that investors see profit opportunities in the industry,” the report says.
While precise data on air ambulance costs is sparse, a 2017 industry report says air ambulance companies spend an average of $11,000 per flight. In Wyoming, Medicare pays an average of $6,000 per flight, and Medicaid pays even less. So air ambulance companies shift the remaining costs — and then some — to patients who have private insurance or are paying out-of-pocket.
As that cost-shifting increases, insurers and air ambulance companies haven’t been able to agree on in-network rates. So the services are left out of insurance plans.
When a consumer needs a flight, it’s billed as an out-of-network service. Air ambulance companies then can charge whatever they want. If the insurer pays part of the bill, the air ambulance company can still bill the patient for the rest — a practice known as balance billing.
“We have a system that allows providers to set their own prices,” says Dr. Kevin Schulman, a Stanford University professor of medicine and economics. “In a world where there are no price constraints, there’s no reason to limit capacity, and that’s exactly what we’re seeing.”
Nationally, the average helicopter bill has now reached $40,000, according to a 2019 GAO report — more than twice what it was in 2010. State officials say Wyoming patients have received bills as high as $130,000.
Because consumers don’t know what an air ambulance flight will cost them — and because their medical condition may be an emergency — they can’t choose to go with a lower-cost alternative, eitheranother air ambulance company or a ground ambulance.
A different way of doing things
Wyoming officials propose to reduce the number of air ambulance bases and strategically locate them, to even out access. The state would then seek bids from air ambulance companies to operate those bases at a fixed yearly cost. It’s a regulated monopoly approach, similar to the way public utilities are run.
“You don’t have local privatized fire departments springing up and putting out fires and billing people,” Fuchs says. “The town plans for a few fire stations, decides where they should be strategically, and they pay for that fire coverage capacity.”
Medicaid would cover all the air ambulance flights in Wyoming — and then recoup those costs by billing patients’ insurance plans for those flights. A patient’s out-of-pocket costs would be capped at 2% of the person’s income or $5,000, whichever is less, so patients could easily figure out how much they would owe. Officials estimate they could lower private insurers’ average cost per flight from $36,000 to $22,000 under their plan.
State Rep. Eric Barlow, who co-sponsored the legislation, recognizes the irony of a GOP-controlled, right-leaning legislature taking steps to circumvent market forces. But the Republican said that sometimes government needs to make sure its citizens are not being abused.
“There were certainly some folks with reservations,” he says. “But folks were also hearing from their constituents about these incredible bills.”
Industry pushback
Air ambulance companies have opposed the plan. They say the surprise-billing problem could be eliminated if Medicare and Medicaid covered the cost of flights and the companies wouldn’t have to shift costs to other patients. They question whether the state truly has an oversupply of aircraft and warn that reducing the number of bases would increase response times and cut access to the lifesaving service.
Richard Mincer, an attorney who represents the for-profit Air Medical Group Holdings in Wyoming, says that while 4,000 patients are flown by air ambulance each year in the state, it’s not clear how many more people have needed flights when no aircraft was available.
“How many of these 4,000 people a year are you willing to tell, ‘Sorry, we decided as a legislature you’re going to have to take ground ambulance?’ ” Mincer said during a June hearing on the proposal.
But Wyoming officials say it indeed might be more appropriate for some patients to take ground ambulances. The vast majority of air ambulance flights in the state, they say, are transfers from one hospital to another, rather than on-scene trauma responses. The officials say they’ve also heard of patients being flown for medical events that aren’t an emergency, such as a broken wrist or impending gallbladder surgery.
Air ambulance providers say such decisions are out of their control: They fly when a doctor or a first responder calls.
But air ambulance companies do have ways of drumming up business: They heavily market memberships that cover a patient’s out-of-pocket costs, eliminating any disincentive for the patient to fly. Companies also build relationships with doctors and hospitals that can influence the decision to fly a patient; some have been known to deliver pizzas to hospitals by helicopter to introduce themselves.
Mincer, the Air Medical Group Holdings attorney, says the headline-grabbing, large air ambulance bills don’t reflect what patients end up paying directly. The average out-of-pocket cost for an air ambulance flight, he says, is about $300.
The industry also has tried to shift blame onto insurance plans, which the transporters say refuse to pay their fair share for air ambulance flights and refuse to negotiate lower rates.
Doug Flanders, director of communications and government affairs for the medical transport company Air Methods, says the Wyoming plan “does nothing to compel Wyoming’s health insurers to include emergency air medical services as part of their in-network coverage.”
The profit model
Other critics of the status quo maintain that air ambulance companies don’t want to change, because the industry has seen investments from Wall Street hedge funds that rely on the balance-billing business model to maximize profits.
“It’s the same people who have bought out all the emergency room practices, who’ve bought out all the anesthesiology practices,” says James Gelfand, senior vice president of health policy for the ERISA Industry Committee, a trade group representing large employers. “They have a business strategy of finding medical providers who have all the leverage, taking them out of network and essentially putting a gun to the patient’s head.”
The Association of Air Medical Services counters that the industry is not as lucrative as it’s made out to be, pointing to the recent bankruptcy of PHI Inc., the nation’s third-largest air ambulance provider.
Meanwhile, Blue Cross Blue Shield of Wyoming is supportive of the state’s proposal and looks forward to further discussion about the details if approved, according to Wendy Curran, a vice president at the health insurance firm. “We are on record,” Curran says, “as supporting any effort at the state level to address the tremendous financial impacts to our [Wyoming] members when air ambulance service is provided by an out-of-network provider.”
The Wyoming proposal also has been well received by employers, who like the ability to buy into the program at a fixed cost for their employees, providing a predictable annual cost for air ambulance services.
“It is one of the first times we’ve … seen a proposal where the cost of health care might actually go down,” says Anne Ladd, CEO of the Wyoming Business Coalition on Health.
The real challenge, Fuchs says, will be convincing federal officials to go along with it.
Kaiser Health News is a nonprofit, editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.
Alabama Coach Nick Saban roams the field during practice in Tuscaloosa. The Crimson Tide enters the season ranked No. 2 and aiming to reclaim its national championship throne.
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The University of Alabama’s Crimson Tide have won five national championships in the past 10 years. “That’s too many!” shout the haters, who especially love to pillory Alabama’s stern head coach Nick Saban. But in Alabama — and especially the team’s hometown of Tuscaloosa — there’s mostly devotion.
A new college football season begins Saturday, and for the Crimson Tide, there is a renewed sense of mission. In last season’s national championship game, Alabama got walloped by rival Clemson. With a new season upon us, Saban and his team are determined to, as he likes to say, “not waste a failure.”
Coach Nick Saban barks plays during a recent Alabama football practice.
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A season approaches
It’s a sweltering mid-August morning in Tuscaloosa, and the Alabama campus is largely deserted. Bryant-Denny stadium is empty, but you can hear a football season approaching.
T-shirts are already stained with sweat as members of the Alabama marching band drumline rip their way through morning practice.
Five, six, seven, eight…one, two, three, four, five, six, seven, eight. Band members count off as they move in formation without drums. Once the drumming starts, the rat-a-tat sound reverberates for blocks. This morning session is the first of three. That’s right: three-a-days for the group known as the Million Dollar Band.
Members of Alabama’s Million Dollar Band practice three times a day gearing up for football season. Like the team, the drummers keep playing until they’re nearly perfect.
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On the same morning, business is bustling at the Waysider. It’s the city’s famous Alabama football-themed restaurant where a small black chalkboard out front marks the number of days ’til the next kickoff.
Inside, the walls are crowded with photos and paintings of players and coaches. Diners order from a menu with “Breakfast of Champions” written on the front. Including a woman whose striped shirt and lipstick match the school colors.
“Every day you need to wear a little bit of crimson,” says Mary Jo Mason, a real estate professional who has lived in Tuscaloosa for 51 of her 78 years. She’s been a season-ticket holder for all 51 years and has cheered many national championships. Under the legendary Alabama head coach Bear Bryant, and since 2007, Nick Saban.
Throughout the Alabama Football administrative building, there are reminders of the Crimson Tide’s dominance. Magazine covers highlight the team’s success.
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Mason is buzzing about the upcoming season.
“We’re riding high,” she says. “We have a great recruiting class and nobody ever questions Saban’s ‘process.’ And we’re looking forward to being in the [college football] playoffs and going into the national championship which is in New Orleans this year.”
Indeed, for ‘Bama fans, heading into a new season these days isn’t a question of ‘how will we do?’ It’s more, who are we going to play for the title?
Amidst her optimism, Mason doesn’t mention last season’s Clemson game. When asked to consider the national championship drubbing, Mason says she doesn’t have revenge on her mind.
The 2017 National Championship trophy is the fifth Alabama has won under Coach Nick Saban. It’s displayed in a hall showcasing the team’s four other trophies and other notable accomplishments.
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“I don’t care who we have [as a title game opponent],” she says, adding, “I just want to win the national championship. [Beating Clemson] should not be our focus. Our focus is us, and what we have to do to get there.”
She sounds a lot like the head coach she reveres.
“I felt like I personally needed to do a better job of keeping people focused,” Saban said a few hours later. He was talking about what he learned from the 44-16 beat down by Clemson.
“I think one of the most difficult things is for the players to stay focused on not the outcome, but what does it take to do to get the outcome.”
Trusting the process
Thatis the foundation of his success. Getting young men to do what’s required to accomplish a lofty goal. At Alabama, it’s called “the process” and it’s a hallowed term in Tuscaloosa, albeit a big vague.
Alabama Coach Nick Saban preaches “the process” to his players. This sign near the team’s practice facility gives reminders about what it takes to win.
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Ask what the process is exactly, and you get different answers. But you’re not wrong if you say the process involves accountability, coachability, effort, discipline. Doing things the right way so many times and with such little deviation that you can’t do it wrong.
“We’ve had good players who buy into the things that we do here,” Saban says, “to help them be more successful as people, students and players. And it’s worked fairly well for us.”
In his 12 years in Tuscaloosa, Saban’s won five national titles [he also won one coaching at LSU earlier in his career]; he’s got 141 wins against only 21 losses; and he’s had more players drafted into the NFL than any other coach. His recruits are regularly among the best in the country.
Inside Alabama’s “recruiting hall,” 32 helmets of every NFL team scroll through the names of Crimson Tide players who have played in the league.
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But there’s another important factor that links Saban’s success to Bear Bryant’s decades ago.
“The one way in which they’re alike is that they had 100% confidence in what they’re doing,” says sports writer Cecil Hurt. He’s covered Alabama football for the Tuscaloosa News since 1982.
“But they also had the ability that very few people have,” Hurt continues, “to convey that confidence onto the people that they are leading. It’s one thing for you to be confident in yourself. It’s another thing for a room full of 18-to-21 year olds to be confident along with you.”
After the Clemson loss, Saban didn’t lose confidence in the process. It just needed shoring up.
“We didn’t have as good of accountability and preparation,” he says. “We have to have everybody put the team first. [And] those are all the things that we’ve tried to re-emphasize, to get our players to stay focused on.”
The message has gotten through to players like senior defensive back Shyheim Carter.
“People think just because we [are], you know, Alabama, we just going to walk in the stadium and win,” Carter says, adding, “it doesn’t work like that. We have to prepare just [like] everybody else, just [like] every other game.”
Alabama defensive back Shyheim Carter, left, chats with Trevon Diggs during a Crimson Tide practice.
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Saban urges his players not to dwell on losses, or wins. But Carter says the Clemson defeat has come in handy.
“When leaders on the team feel like practice is going sluggish,” he says, “they always say ’16 to 44.’ Remember that. And you know that kind of gives everybody an extra boost.”
16 to 44. Alabama is first, even in defeat.
Don’t waste time
There was nothing sluggish about practice on this day. A loud horn sounded off when players were supposed to move to the next drill. Quickly. Saban was in the thick of it, wearing a straw hat with crimson-colored band, working with his defensive backs. He moved well, despite recent hip replacement surgery. That was in April. He was back at work within 36 hours of the operation.
Saban doesn’t like to waste time.
Indeed, before our interview, one of his assistants advised us not to meander with questions. Be direct. How will we know if it’s not working? His leg will bounce, we were told. Fast.
There are moments of levity too. But those don’t always make it onto the highlight shows. We’re left with the snarl, which, in Alabama-unfriendly territory, has earned Saban nicknames like “satan” or the “Nicktator.”
What does he think about his reputation as the dour leader of what’s been called a joyless juggernaut?
“I don’t think that’s fair,” Saban says. “I think in this day and age it takes about 40 seconds for anything that you say or do to get out there publicly to be evaluated one way or the other. Obviously you can’t always please everybody but hopefully we can please the people in our organization and help them be more successful.”
Before a practice this month, Nick Saban reflects on last season’s national championship drubbing. He’s worked all summer to get ready for this season to “not waste a failure.”
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And, Saban says, they do have fun at Alabama.
“It depends on how you describe fun. You know is it fun cutting up and doing crazy stuff that is not going to help you sort of be successful in the future? Or is [it] fun knowing you did your best to be the best you could be at whatever you choose to do? And that doesn’t mean you don’t laugh and enjoy yourself and the relationships that you develop while you’re doing it.”
It also doesn’t mean it’s not hard.
Saban is a perfectionist, which he says he got from “great” parents.
“I worked for my dad in a service station,” he says, “and if you didn’t wash the car right you wash it again. If you didn’t do things the right way, you know there were consequences for it. So I guess it just became a part of how things are supposed to be done and need to be done for you to create any value for yourself and your future.”
An admirable trait but it can be wearing on others. Saban certainly can be tough on his team. Thirteen assistant coaches have left Alabama in the past two years. They are in high demand, and many went to more prominent jobs, after having worked for a demanding boss.
Outside Coach Nick Saban’s office there are enlargements of five Sports Illustrated covers that highlight notable Alabama wins under Saban.
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Former Crimson Tide offensive coordinator Michael Locksley told the Wall Street Journal, “Every day you walk in that building you better bring your ‘A’ game. My goal was to show up every day and not have Saban have to rip my butt.”
There are seven new coaches this season, and a renewed dedication to the process. Will it be enough for a seventh national title, giving Saban the most of any college coach in history?
A final answer won’t come until January, when Alabama may be playing for another championship. But don’t ask Saban about that now, eight days before ‘Bama’s opening game of the season against Duke.
It would ignore “the process,” and for sure get that leg working overtime.
NFL commissioner Roger Goodell and Jay Z at Roc Nation’s Manhattan headquarters on August 14, announcing a partnership between the sports league and the rapper’s entertainment company.
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Kevin Mazur/Getty Images for Roc Nation
Ever since Jay-Z announced a partnership between his Roc Nation entertainment company and the NFL — ostensibly to help the league step up its Super Bowl halftime show and amplify its social justice program platform — the whole thing has played out like a tragic blaxploitation flick. One powerful scene in particular from the era keeps replaying in my mind, like an eerie precursor to last week’s press conference and the resulting fallout. It comes from The Mack, that 1973 cult classic about an ex-con who turns Oakland into a pimper’s paradise while dodging both the clutches of The Man and the revolutionary angst of The Brother Man. With the opening notes of Willie Hutch’s “Brothers Gonna Work It Out” stirring in the background, Goldie the pimp (Max Julien) and his movement-minded brother Olinka (Roger E. Mosely) square off in a war of words pitting black capitalist against black activist — one thriving off the system’s inherent inequality, the other dead-set on dismantling it piece by unconscionable piece.
“You really don’t understand, do you?” Olinka asks in his red, black and green knitted beanie. “Hey man, don’t you realize in order for this thing to work, we’ve got to get rid of the pimps and the pushers and the prostitutes? And then start all over again clean.” Goldie, his wide brim tilted to the side, strikes back: “Nobody’s closing me out of my business,” he says. “Being rich and black means something, man. Don’t you know that? Being poor and black don’t mean s***.”
To pimp or be pimped, that’s the eternal question — and from the cheap seats, it’s hard to tell which role Jay-Z has cast for himself. When it comes to espousing the ideals of free market enterprise, there is no bigger cheerleader in hip-hop than the rapper born Shawn Carter, who has come a long way from Brooklyn’s Marcy projects. But when the oppressed find themselves sitting in the seat of their oppressors after two decades of musical chairs, that’s no anomaly: It’s the system replicating itself as designed. For his part, Jay-Z helped raise a whole generation of fans on a don’t-hate-the-playa-hate-the-game ethos of black capitalism that doesn’t even begin to account for how rooted the system is in white supremacy and inequality. Can’t knock his hustle, but the dangerous thing about Jay’s latest deal is that it comes at the cost of a struggle already in progress. Whatever his intention, he’s only succeeded so far in further polarizing the movement that made Colin Kaepernick a modern-day Muhammad Ali.
“I think we’re past kneeling. I think it’s time for action,” Jay-Z stated while announcing the deal last week, sitting alongside NFL commissioner Roger Goddell at Roc Nation’s Manhattan headquarters on Aug. 14, three years to the day after Kaepernick’s first protest. The partnership has effectively turned one of the NFL’s most vocal (and certainly one of its most powerful) critics into a paid contractor. Two years ago, Jay wore a Kaepernick jersey during his Saturday Night Liveperformance. Last year, he thumbed his nose at the league with the line, “You need me / I don’t need you,” on the song “Apes***” that he released with Beyoncé. And when he urged artists like Travis Scott not to entertain Super Bowl performance offers, the assumption was that he was motivated by the same social politics in doing so. Now, the deal he’s struck for an as-yet undisclosed amount has raised questions what his motives were before.
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“Jay-Z Helps the NFL Banish Colin Kaepernick,” sports journalist Jemele Hill headlined her piece for The Atlantic. Indeed, the quarterback continues to pay the price of daring to use the NFL’s platform to bring visibility to social and racial injustice in America. Jay claimed last week that he had had a conversation with Kaepernick before closing the NFL deal, but refused to share the details of their talk. Kaepernick’s girlfriend, radio personality Nessa Diab, called that “a lie,” saying that Kaepernick was “never included in any discussion” with Jay-Z or the NFL about their eventual partnership. An anonymous source close to Kaepernick told Jemele Hill that he and Jay-Z did talk, but “it was not a good conversation.”
It’s easy to imagine that conversation going about as well as the one between Goldie and his brother in The Mack. Reactions to the deal have been equally explosive, especially on social media where age-old arguments about black America’s best path forward for true liberation — be it market-driven or movement-driven — were reignited. “F*** Colin Kaepernick,” rapper Freddie Gibbs posted on Instagram earlier this week while making it clear that he’s riding with Jay-Z. (He later tweeted that he’d had an enlightening conversation with Jemele Hill, after she posted that his response was exactly what the NFL wanted.) Other vocal Jay-Z supporters have included Vic Mensa and Cardi B, but with the caveat that they both believe Jay’s involvement will ultimately help Kaepernick get back into the league. Roc Nation’s own J. Cole and filmmaker Ava DuVernay have been among the high-profile supporters of Kaepernick in the past week, while Carolina Panther Eric Reid, who was the first to join Kaepernick’s protest, called Jay-Z “asinine” for saying the time for kneeling has passed. On the day of the press conference, Kaepernick himself wrote on Twitter,”I continue to work and stand with the people in our fight for liberation, despite those who are trying to erase the movement!”
According to Jay-Z, his switch from staunch NFL critic to potential ally came not as an abrupt about-face but through a series of conversations with Goodell over the last several months. He credits Patriots owner (and President Trump supporter) Robert Kraft with helping to start their talks; Kraft has also played an active role in Roc Nation’s criminal justice reform initiatives, most notably as a supporter of Meek Mill. Plans for collaboration include expanding on the league’s existing Inspire Change initiative by adding a program of unofficial anthems (“Songs of the Season”) from select artists to be played during NFL broadcasts, a podcasting platform for players (“Beyond the Field”) and a visual album of Super Bowl halftime shows. Those plans have already been criticized as a platform designed to move player protests off the field, and it already seems to be having the subtle effect of silencing NFL players on the field. One day after Miami Dolphins player Kenny Stills criticized Jay-Z for “choosing to speak for the people, [as if] he had spoken to the people,” Dolphins head coach Brian Flores reportedly had his team play eight straight Jay-Z songs to open up practice.
Maybe it’s easy to forget due to the narrative being hijacked by critics, but Kaepernick was never protesting the NFL. He was protesting police brutality and racial injustice, and for good reason: Young black men in America are now more than twice as likely to get killed by police than their white peers, according to a recent study. Clearly, this stuff is bigger than football. What remains to be seen is how Roc Nation’s collaborations with the NFL will address these systemic issues, and actually help bring us past the time for kneeling. As it stands, the deal feels like the NFL attempting to invalidate Kaepernick’s sacrifice, without extending him the courtesy of a seat at the table. And its success hinges on Jay’s ability to leverage black cultural capital for the benefit of a league that has spent the last three years publicly devaluing it.
At one point during last week’s press conference, Jay-Z turned the questions on the reporters in the room, asking several of them: “Do you know what the issue is?” It was a rhetorical question, meant to highlight his belief that Kaepernick’s protest has already done the job of highlighting what’s at stake. But the real question is whether Jay-Z truly understands the issue. After receiving pointed criticism from Harry Belafonte for a lack of social responsibility several years ago, Jay’s done admirable work pushing for criminal justice reform, producing documentaries on Trayvon Martin and Kalief Browder, and bankrolling legal defenses for Meek Mill’s probation case and 21 Savage’s immigration case. But he’s also been known to oversimplify the ways that money, power and racism intersect to marginalize Americans who look like him.
This is the same black billionaire, after all, who encouraged a concert hall full of his own skinfolk to, “Gentrify your own hood / Before these people do.” The freestyle was meant to pay homage to Nipsey Hussle’s economic revitalization efforts in South Central Los Angeles. But it failed to contextualize how property values and racial privilege remain tethered together in ways that overwhelmingly leave black folks displaced and erased in the process. Nor did it mention his own previous role in that same erasure: The 1% minority ownership stake he held in the Brooklyn Nets helped pacify concerns about the future economic impact of Barclays Center, a development that has helped gentrification creep into Biggie Smalls’ old hood just a few blocks away.
Despite the criticism, there’s still room for the Roc Nation / NFL initiative to do impressive work. The current fallout is largely about optics rather than execution. And Jay does have a history of shaky rollouts: Remember the live-streamed Tidal launch, anyone? His streaming service has not only survived alongside big boys Spotify and Apple, it’s built up its own brand loyalty by catering to an urban demographic. (As a longtime subscriber, I should know.)
Only in black America are entertainment moguls tasked with being as astute in the political arena as they are in concert arenas. Every individual decision a black celebrity makes is weighted with the responsibility of representation. There’s a long history in this country of black artists being used to quell protests or co-opt movements; the question is whether Jay-Z fully grasps what’s at stake. You can’t be critical of the status quo — and the NFL definitely represents the status quo in this country — if you’re working to uplift it. The new deal shouldn’t let the NFL off the hook for mishandling Kaepernick, and Roc Nation shouldn’t be taken as a proxy for the people, even if its work does ultimately benefit the people. It’s clear that Jay-Z knows his worth, but hip-hop’s first billionaire must learn to wield his power in ways that don’t undermine the efforts of activists putting in ground work.
If you haven’t seen The Mack in its entirety, the ending — spoiler alert — is a revelation. Despite competing worldviews about how to uplift the black community, Goldie and Olinka end up linking to defeat their common enemy: corrupt cops. Resolving the distance between capitalists and activists is easier to romanticize on the big screen, but the truth is hustlers, club owners and entertainers helped bankroll and bail out the leaders of the civil rights movement, too.
Instead of sitting with Roger Goodell at last week’s press conference, Jay-Z should have been sitting with Colin Kaepernick. Even if their methods are different, we needed to see Jay working to reconcile the NFL’s relationship with the player who spearheaded the fight for social justice on the field before working to repair the NFL’s reputation off the field.
If the brothers gonna work it out, they’ve gotta stick it to The Man together.
The Centers for Disease Control and Prevention estimates that most new heroin addicts first became hooked on prescription painkillers, such as oxycodone, before graduating to heroin, which is cheaper.
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John Moore/Getty Images
Nearly 2,000 cities, towns and countiesacross America are currently participating in a massive multidistrict civil lawsuit against the opioid industry for damages related to the abuse of prescription pain medication. The defendants in the suit include drug manufacturers like Mallinckrodt, wholesale distributors McKesson and Cardinal Health, and pharmacy chains CVS and Walgreens.
Evidence related to the lawsuit was initially sealed, but The Washington Post and the Charleston Gazette-Mail successfully sued to have it made public. Pulitzer Prize-winning Washington Post journalist Scott Higham says the evidence, which was released in July, includes sworn depositions and internal corporate emails that indicate the drug industry purposely shipped suspiciously large quantities of drugs without regard for how they were being used.
Higham says one sales director at the pharmaceutical manufacturer Mallinckrodt was jokingly called “ship, ship, ship” by colleagues because of the amount of oxycodone and hydrocodone he sold: “His bonus structure was tied to the amount of sales that he made,” Higham notes. “And that was a time when there was no secret about how many people were dying in places across the country, and the opioid epidemic was raging.”
Higham and his colleagues at the Post were also able to access data from the Drug Enforcement Agency that trace the path of some 76 billion opioid pain pills sold between 2006 and 2012. In analyzing the movement of those pills, they made a gruesome discovery.
“When you line up the CDC death [by overdose] database with the DEA’s database on opioid distribution, you see a clear correlation between the saturation of towns and cities and counties and the numbers of deaths,” Higham says. “A lot of these towns and cities, small cities and counties in places like Ohio and Pennsylvania have just been devastated. … The death rates just soared in those places where the pills were being dumped.”
Interview Highlights
On the picture emerging from recently unsealed DEA database
A lot of people thought they knew that their communities were being saturated by these opioids, but I don’t think they really knew the extent of the saturation, and who was responsible. So this database pulls the curtain back on that for the first time. We obtained data that goes from 2006 through 2012. So over that seven-year period … you can see exactly which manufacturers were responsible, which distributors were responsible, and which pharmacies were responsible. And we took that database and we turned it into a usable, public-facing database, so now anybody in the country can go onto our website and they can see exactly what happened in their communities. …
Dozens and dozens of local news organizations have done stories about their own communities — which companies flooded their communities with pills, which pharmacies were responsible for dispensing the most tablets of oxycodone and hydrocodone. Those are the two drugs that we looked at, because they are the most widely abused drugs by addicts and by drug dealers.
On the communities that were flooded with opioids
It’s just heartbreaking to see these once thriving communities. They’re almost like zombielands, where people are just walking around in a daze and picking through garbage cans and falling down, and overdosing in public parks and inside of cars and inside of streets and on street corners. It’s a very upsetting scene that’s happening. …
These communities need help — desperately need help. Their hospitals need help. Their foster care agencies need help — because so many parents have perished and their kids have no family or [are] being raised by grandparents. Police departments, paramedics, fire departments that used to fight fires all the time now are fighting against the opioid epidemic and carrying Narcan with them, which is an overdose reversal drug, and “Narcaning” people all day long.
On how drug distributors generated billions in revenue from the opioid epidemic
They’re making massive amounts of money. Many of them are Fortune 500 companies. In fact, the No. 1 drug distributor in America, McKesson Corp., is the fifth-largest company in the United States — fifth-largest of all companies in the United States — and it’s a company that most people have never heard of. And they are a huge, huge player in this world, and of the distributors that sent these drugs downstream they were No. 1. And they were followed by two other companies that a lot of folks probably have not heard of. One is called AmerisourceBergen and another is called Cardinal Health. … Together those three companies are the three biggest drug distributors in the United States. And they were followed by Walgreens, CVS and Walmart as the top six drug distributors in the United States.
On “pill mills” that popped up in Florida, where people could get opioids from corrupt doctors — and then resell them on the street
All of a sudden, all these drug dealers realize that there was another way to peddle these pills, and they began to open up these so-called pain management clinics, and most of them were in South Florida, heavily concentrated in Broward County, which is where Fort Lauderdale is. … These things … were basically storefront operations in strip malls where you had corrupt doctors and rogue pharmacists working hand in hand inside of a store. So on one side of the store you’d come in, you’d get a cursory examination, the doctor would write you a script. And you literally go next door and get it filled. And these places just became huge open-air drug markets. The parking lots were filled with people who were driving down from Kentucky and West Virginia and Ohio to pick up their prescriptions. And along the highway that goes up through Florida, I-75 and then also I-95, a lot of these storefronts began putting up billboards along the highway at exit ramps saying, “Pain management clinic, next exit.”
On the Justice Department’s history of fining drug companies instead of filing criminal charges
[Investigators at the DEA’s Office of Diversion Control] started to see a pattern, and it’s a pattern that they see that continues to this day, that there are people within the Justice Department who are not very aggressive when it comes to these cases. They feel that some of them are a little too close to the industry; that maybe some of the people in the Justice Department want to work for the industry one day, so they don’t go as hard against these companies as perhaps they should. … If you take a look at the revolving door between the Justice Department, the DEA and the drug industry, it’s a very impressive revolving door. You have dozens and dozens of high-ranking officials from the DEA and from the Justice Department who have crossed over to the other side and they’re now working directly for the industry or for law firms representing the industry. So if you’re a DEA investigator or a DEA lawyer or a Justice Department lawyer making $150,000 a year, you cross over and you can triple, quadruple your salary overnight.
Amy Salit and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Deborah Franklin adapted it for the Web.
NBA star Steph Curry is the man behind one of the biggest charitable gifts in Howard University history. The money will fund Division 1 golf teams for men and women at the school for the next 6 years.
U.S. forward Alex Morgan celebrates her hat trick with defender Tobin Heath (17) and other teammates during the second half of a Tournament of Nations soccer match against Japan in July 2018.
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The U.S. women’s soccer team is still savoring its victory after capturing the World Cup championship this summer. But off the field, the players continue to battle a gender discrimination case against their employer, the U.S. Soccer Federation.
The women are demanding pay equal to that of their counterparts on the men’s national soccer team. U.S. Soccer says it pays women more than men in salaries and game bonuses.
Last week, mediation efforts between the two sides broke down, so on Monday a federal judge set a trial date: May 2020, just weeks before the women’s team will begin play at the Tokyo Olympics.
Women’s team co-captain Alex Morgan says she doesn’t see the trial as a distraction.
“I don’t think we know soccer without distraction. We feel like we have always been fighting for a seat at the table and we have always fought for everything that we’ve earned, so having the case be pushed up to May I think is good overall,” Morgan tells NPR’s David Greene.
Interview Highlights
On whether the rift between her team and U.S. Soccer can be healed
Obviously, as it gets closer to trial, it’s probably going to get uglier, so I think that will take more time to heal. However, knowing that U.S. Soccer is our employer and we want to represent our country on the highest level and we want to move forward together … I’m hopeful in the next nine months that we can find a resolution that suits us both in that the women and the men are paid equal in compensation. If not, then I can see it continuing on this path until trial.
On whether the rift could get in the way of attracting more kids to the sport
We’re not going to reap the benefits from equal pay. Who’s going to reap the benefits is that next generation. So I think those young girls and that next generation should feel confident that they’re in good hands and that we are setting up this structure and this compensation and this true equality for them.
On her plans to participate in a fourth World Cup
I’m really confident that I can continue to play at the top of my game for another four years, so I’m really excited to continue on this journey with the national team, and with my club team, Orlando Pride, in 2023, whether that’s in Australia or wherever else because there’s currently 10 countries bidding for the 2023 [Women’s] World Cup. I hope to be there.
Milton Guevara and Jessica Smith produced and edited this story for broadcast. Heidi Glenn adapted it for the Web.
The world’s top 11 and 12-year-old baseball players are battling it out in South Williamsport, Pa., in the Little League World Series. The winners will be decided this weekend.
One of the ways Native tribes in the West celebrate their history and culture is through annual summer horse races. They’re known as Indian Relays, and tribes call them America’s first extreme sport.
