Rep. Seth Moulton, D-Mass., Iraq veteran and presidential candidate, revealed at a campaign event Tuesday that he was treated for PTSD after his deployment and he continues to see a counselor monthly.
In the 1980s, AIDS activists demanded action from the U.S. government in a dramatic way, and got results. Now, they have a new goal: more affordable access to an HIV prevention pill.
At least 43 million Americans have overdue medical bills on their credit reports, according to a 2014 report on medical debt by the federal Consumer Financial Protection Bureau.
Hero Images/Getty Images
hide caption
toggle caption
Hero Images/Getty Images
Elham Mirshafiei was at the library cramming for final exams during her senior year at California State University, Long Beach when she grew nauseated and started vomiting. After the 10th episode in an hour, a friend took her to the nearest emergency room. Diagnosis: an intestinal bug and severe dehydration. In a few hours, she was home again, with instructions to eat a bland diet and drink plenty of fluids.
That was in 2010. But the $4,000 bill for the brief emergency department visit at an out-of-network hospital has trailed her ever since. Mirshafiei, 31, has a good job now as a licensed insurance adviser in Palo Alto, Calif. But money is still tight, and her priority is paying off her $67,000 student loan debt rather than that old hospital bill.
While a college student in 2010, Elham Mirshafiei turned to the emergency room of a hospital that wasn’t in her insurance network for treatment of an intestinal bug and severe dehydration. She still carries the $4,000 debt from that visit.
Courtesy of Elham Mirshafiei
hide caption
toggle caption
Courtesy of Elham Mirshafiei
Once or twice a year she gets a letter from a collection agency. She ignores the letters, and so far the consequences have been manageable. “It’s not like electricity that gets cut off if you don’t pay it,” she says.
Mirshafiei has plenty of company. At least 43 million other Americans have overdue medical bills on their credit reports, according to a 2014 report on medical debt by the federal Consumer Financial Protection Bureau. And 59% of people contacted by a debt collector say the exchange was over medical bills, the most common type of contact stemming from an overdue bill, according to the CFPB.
This month, the CFPB proposed a rule to frame what debt collectors are allowed to do when pursuing many types of overdue bills, including medical debt.
Federal law already prohibits debt collectors from harassing consumers or contacting them before 8 a.m. or after 9 p.m., among other things. But the law, which was passed in 1977, didn’t anticipate email and text messages. The CFPB’s proposal clarifies how debt collectors can use these communication tools. And it would allow consumers to opt out of being contacted through these means.
The rule also specifies that debt collectors can make no more than seven telephone calls weekly over a specific debt.
But some consumer advocates have panned the effort. “This really doesn’t go far enough to protect consumers and make sure that consumers are not abused or harassed or subject to unfair collection practices in debt collection,” says April Kuehnhoff, an attorney at the National Consumer Law Center who specializes in debt collection.
For instance, the center wants a limit of just three telephone attempts each week on a debt. The seven-call limit could be particularly tough on people with medical debt, Kuehnhoff said. They may accumulate bills from several providers for a single medical event — a hospital, doctors, a lab and a nursing home, for example — and all could be in collections separately, potentially resulting in dozens of calls each week.
Debt collectors aren’t necessarily in favor of the seven-call cap either, but for different reasons. They say that limiting the number of calls could lead to more litigation or adverse credit reporting rather than working out a payment plan.
Overall, the proposed rule seems to strike a good balance between the collection industry and consumer concerns, says Leah Dempsey, vice president and senior counsel for federal affairs at ACA International, a trade group representing 2,500 debt collectors, asset buyers and related professions.
The general consensus is that people should pay their debts. But taking responsibility for medical debt isn’t always as straightforward as paying off a large-screen TV that someone put on a credit card. Did health insurance pay the correct amount? Was the person screened for eligibility for Medicaid, charity care or financial assistance?
“The actual debt collector problem is often about the lack of accountability that providers have for the people that they pass their debt along to,” says Leonardo Cuello, director of health policy at the National Health Law Program.
When a debt collector calls, consumers who are confused about the bill should ask — in writing and generally within 30 days — that the debt be validated. Debts are often bundled and sold multiple times to different collectors, which means errors may be introduced along the way.
“There are no magic words. You don’t need to cite the statute,” says Justin J. Lowe, legal director at Health Law Advocates, a nonprofit law firm in Boston that helps people with low incomes who are having trouble accessing or paying for medical care.
At that point, the collection agency has to stop activities until it proves what the consumer owes. The proposed CFPB rule would spell out verification information that must be provided along with instructions for consumers about how to dispute the debt.
The proposal would also address other practices, including the collection of what is sometimes called zombie debt. That term refers to a bill that has passed a time limit — or statute of limitations — for bringing legal action, often between three and six years, depending on the state. In many states, if a collector sues someone for such a time-barred debt, consumers can raise the issue in court in their defense. If a judge agrees, the case could be dismissed.
Consumer advocates have long wanted debt collectors to be prohibited from trying to collect zombie debt. After several years, it can be difficult for patients to locate records or remember whether a bill has been paid, they argue.
The proposed CFPB rule would prohibit debt collectors from suing or threatening to sue consumers for zombie debt, but only if the collectors knew or should have known that the statute of limitations had expired. That puts the onus on the consumer to prove what was in the debt collector’s mind rather than merely show that too much time had passed to collect.
As the federal government moves ahead with the rule to address various types of debt collection activities, legislators in a few states have introduced bills that specifically target medical debt. Their efforts often focus on improving access to financial assistance for medical care and limiting predatory debt collection tactics.
Last month, Washington Gov. Jay Inslee signed a law that reduces the maximum interest rate on medical debt prior to a court judgment from 12% to 9%. It also prohibits sending a medical debt to collections until 120 days after the patient is sent the initial bill, and it requires collection agencies to provide itemized statements to patients for medical and hospital debts and to notify them of their possible eligibility for charity care.
In Oregon, a bill sponsored by Rep. Andrea Salinas would require nonprofit hospitals and affiliated clinics to provide care free of charge to families with incomes up to 200% of the federal poverty level (about $43,000 for a family of three) and charge a sliding scale for families earning up to 400% of the poverty level (about $85,000 for a three-person family).
Like the Washington law, the Oregon bill places limits on the interest charged for medical debt. It also requires health care facilities to screen patients for eligibility for financial assistance and insurance.
The bill passed the House in Oregon last week.
Some hospitals already have strong financial assistance policies, but the playing field needs leveling, Salinas says. “We really need hospitals to be a part of the solution to prevent consumers from going into bankruptcy over medical debt.”
It’s unclear how the proposed changes announced by the CFPB might affect Mirshafiei’s situation. The statute of limitations in California on written contracts is four years.
One thing someone in Mirshafiei’s situation should be aware of is that making a payment could reset the statute of limitations, Lowe says. The debt collector could argue that by making a payment, the person is affirming that he or she owes the debt.
Because of her damaged credit, Mirshafiei needed a relative to cosign for student loans for graduate school. She worries that if she tries to buy a house, she’ll have trouble getting approved.
“I just hope that in the next chapter of my life, I don’t have to be denied things because of this stain on my record,” she says.
Kaiser Health News is an editorially independent nonprofit program of the Kaiser Family Foundation and is not affiliated with Kaiser Permanente.
Eleven people have died climbing Mount Everest so far this year, amid long lines to reach the peak last week. The mountain is seen here on Monday.
Prakash Mathema/AFP/Getty Images
hide caption
toggle caption
Prakash Mathema/AFP/Getty Images
Nepal’s tourism board is defending the number of permits it issued to climb Mount Everest for this season in which 11 people have died. And the country says it has no plans to restrict the number of permits issued next year, but rather that it hopes to attract still more tourists and climbers.
“There has been concern about the number of climbers on Mount Everest but it is not because of the traffic jam that there were casualties,” Mohan Krishna Sapkota, secretary at the country’s Ministry of Tourism and Civil Aviation, told the Associated Press. He instead pointed to weather conditions, insufficient oxygen supplies and equipment.
“In the next season we will work to have double rope in the area below the summit so there is better management of the flow of climbers,” he told the news service.
The image of a crowded Everest linked to the death toll was spurred by a viral photo last week that showed climbers in their neon gear, packed in a tight, unforgiving queue to the highest point on Earth.
A long queue of mountain climbers line a path on Mount Everest on May 22. Nepal’s tourist board says weather conditions and other factors, not crowds, were to blame for eight deaths on the peak in two days last week.
Nirmal Purja/AP
hide caption
toggle caption
Nirmal Purja/AP
“You essentially have something that looks like people are waiting in line for concert tickets to a sold-out show, only instead of trying to get in to see their favorite artist, they’re trying to reach the top of the world and are running into traffic,” Outside magazine editor at large Grayson Schaffer told NPR’s Weekend Edition.
It’s a traffic jam that can turn fatal. “The danger there is that, at that altitude, the body just can’t survive,” Schaffer said. “They’re breathing bottled oxygen. And when that oxygen runs out because you’re waiting in line, you are at much higher risk for developing high-altitude edemas and altitude sickness — and dying of those illnesses while you’re still trying to reach the summit.”
Everest’s very highest reaches are known as the death zone. And once a climber reaches it, all bets are off.
“Once you get above about 25,000 feet, your body just can’t metabolize the oxygen,” said Schaffer, who has been to Everest but not the death zone. “Your muscles start to break down. You start to have fluid that builds up around your lungs and your brain. Your brain starts to swell. You start to lose cognition. Your decision making starts to become slow. And you start to make bad decisions.”
And that breakdown in cognition is happening to people who have often flown hundreds or thousands of miles and paid significant sums of money to achieve their dream of reaching the top.
“The reason that people try to climb Mount Everest is because it grabs a hold of them and they feel like they just have to make the summit,” Schaffer said. “And so you’ll have some people in distress and not necessarily getting help from the people who are around them. It’s this kind of bizarre thing to be surrounded by hundreds of people, and yet totally alone at the top of the world.”
Nepal’s government doesn’t put a specific limit on permits. This year 381 people were permitted to climb – a number the AP says is the highest ever. Foreign climbers must pay a fee of $11,000 for a spring summit of Everest, and provide a doctor’s note attesting to their fitness.
A few reasons made last week on Everest such a crowded one, in which eight people died in two days. One factor is that China has limited the permits for the Tibetan side of the mountain, driving more people to the Nepalese side.
Another factor is weather. Alan Arnette, a four-time Everest climber, told CNN that bad weather left just five days ideal for reaching the summit. “So you have 800 people trying to squeeze through a very small window,” he said.
Hence the traffic. “There were more people on Everest than there should be,” Kul Bahadur Gurung, general secretary of the Nepal Mountaineering Association, a group comprising all expedition operators in Nepal, told the AP.
Now Nepal’s tourist board finds itself working to counter the narrative of that viral photo. On Tuesday, the tourism board’s social media accounts shared a tweet by Nepali climber Karma Tenzing.
“Everest unfairly trashed via viral image of ‘traffic jam’ on May 22 2019,” he wrote. “Below are REAL photos of my climb to Summit on May 15. Devoid of jams & I spent an HOUR at summit. With only a 3-4 day weather window & ~300 Everest Summiteer annually, jams will exist. Spread the truth!”
#Everest unfairly trashed via viral image of “traffic jam” on May 22 2019. Below are REAL photos of my climb to #Summit on May 15. Devoid of jams & I spent an HOUR at summit.
With only a 3-4 day weather window & ~300 #EverestSummiteer annually, jams will exist. Spread the truth! pic.twitter.com/wwrhSlP5hL
— Karma Tenzing (@karma10zing) May 28, 2019
In a statement Monday, the tourism board expressed condolences to the bereaved family and friends of those who died, and added that it takes the matter seriously and was “disturbed” by the news.
“Nepal recognises the need to work closely with expedition companies and teams to control safety of climber flows in the face of climatic risks and sensitivities,” it said.
Nepal Tourism Board extends deepest condolences for the loss of lives at Everest, 8,848 m, during recent expeditions.
For more: https://t.co/dw9bDb2MrF pic.twitter.com/1zp67wxLI2— Nepal Tourism Board (@nepaltourismb) May 28, 2019
But it also pushed back on the idea that it was to blame. It said it had limited the number of permits and had issued them under stringent rules.
“As is known, climbing Everest is a hardcore adventure activity, a daunting experience even for the most trained and professional climbers,” it said in the statement. And the tourist board said it had a request for the travel industry, the media, and potential future climbers: “be aware of all the risk factors included in climbing peaks above 8,000 m. Intense training, precautions and attention to every minor detail, are of extreme importance for climbing the Himalayan peaks.”
In other words: no one ever said climbing Everest was safe.
This year has been the deadliest on Everest since 2015. An avalanche in 2014 killed of 16 Sherpas. And the mountain’s most famous tragedy happened in 1996, when eight climbers died in one day, a harrowing event recounted by Jon Krakauer in Into Thin Air.
Since then, little has changed, Schaffer says – except “it’s gotten exponentially worse.”
“In that incident, there was actually a storm that came. And that’s why you had eight people die in that tragedy. Now what we’re seeing and what we will probably see every year forward is eight to 10 people dying just in a routine manner, just because of the sheer number of people trying to fit onto the route.”
Planned Parenthood says it might have to stop providing abortion services in Missouri. That would make Missouri the first state in the country without a clinic that performs abortions.
NPR’s Ari Shapiro speaks with Leana Wen, president of Planned Parenthood about how Missouri could become the first state without a clinic providing abortions.
Copies of the Sports Illustrated swimsuit issue for sale on a bookstore shelf Tuesday in New York City. Media company Meredith has announced that it has agreed to sell the magazine brand to entertainment company Authentic Brands Group for $110 million.
Drew Angerer/Getty Images
hide caption
toggle caption
Drew Angerer/Getty Images
Sports Illustrated has been sold for the second time in less than two years. This time, however, the $110 million purchase by Authentic Brands Group places far more importance on the iconic magazine’s reputation than the publication itself — pushing the name further into such ventures as gambling and live events.
The Meredith Corp. acquired Sports Illustrated in January 2018 along with a bunch of other titles as part of its purchase of Time Inc. Meredith moved to unload most Time Inc. magazines that were not focused on its primary audience: female readers. And those moves also reflected the flagging finances of major legacy publications.
So Meredith sold Time magazine to Salesforce co-founder Marc Benioff and his wife, Lynne Benioff; it dealt Fortune to a Thai entrepreneur, Chatchaval Jiaravanon, and it killed Money magazine’s print edition.
Sports Illustrated dominated sports journalism for decades, featuring the articles of such powerful writers as Frank Deford, George Plimpton and Gary Smith, and the photojournalism of such photographers as Neil Leifer. The magazine incorporated clear-eyed looks at civil and human rights, politics, power and money through the prism of professional, collegiate and amateur sport. A cover was considered a feat the equal to many accomplishments on the field of play.
Yet the immediacy of sports news, on cable television and online, in particular, from nimble and caustic websites to TV giant ESPN, chipped away at its seeming indispensability. So did larger societal shifts in how people consume information and news.
“Sports Illustrated had so much residual goodwill among its readers and entire audience,” Terry McDonell, the former top editor over the magazine, tells NPR. “Everybody remembered something about sports in relationship to Sports Illustrated. I don’t think that’s gone away. It might have shrunk a bit.”
A Meredith spokeswoman says Sports Illustrated remains profitable with a 27-issue-per-year schedule. Yet the company has now sold Sports Illustrated to Authentic Brands in a deal that hinges on the acquisition of the magazine’s intellectual property. That includes its photo archive, its past sportsman and sportswoman of the year covers, and the annual swimsuit issues, which feature female models in bikinis — including supermodels from Cheryl Tiegs and Christie Brinkley in decades past to Tyra Banks.
“As a trailblazer and cultural phenomenon, Sports Illustrated has created moments and experiences for its readers that are unmatched by any other sports brand,” Nick Woodhouse, president and chief marketing officer of Authentic Brands, said in a statement. “We look forward to working with Meredith to extend Sports Illustrated’s legacy and connect the brand with new audiences around the world.
Authentic Brands also controls the rights to a wide array of brands, including such pop cultural figures as Marilyn Monroe and Elvis Presley; such sports figures as Julius Erving and Shaquille O’Neill; and such fashion lines as Juicy Couture.
Meredith will continue to publish the magazine and run its website for now — paying Authentic Brands a licensing fee to do so while maintaining editorial independence, according to both companies. Meredith’s president of national media said he would integrate SI‘s print and digital products into Meredith’s operations.
In a memo to staff, Sports Illustrated editor in chief Chris Stone wrote that the magazine would seek to reach greater audiences on other platforms — including in live events, conferences, gambling and video games. He also cited the development of television shows from SI material. And he praised Meredith for striking a deal that honored the magazine’s work.
“This deal only made sense if we continue to generate premium journalism and storytelling,” Stone said. The guarantee that the magazine would continue to publish under Meredith, however, lasts just two years.
NPR’s Mary Louise Kelly talks with Wall Street Journal reporter Sara Randazzo about how Johnson & Johnson ended up at the center of the first big trial in the opioid crisis, which opened Tuesday.
Boston Red Sox first baseman Bill Buckner is shown in March 1986.
AP
hide caption
toggle caption
AP
Being remembered for a mistake is hard. Being the living symbol of 86 years of futility is just about impossible.
But that’s exactly what Bill Buckner was to Boston Red Sox fans for nearly 20 years.
Buckner, an All-Star and Gold Glove baseball player who played in the major leagues for 22 years, died Monday. He was 69.
“After battling the disease of Lewy Body Dementia, Bill Buckner passed away early the morning of May 27th surrounded by his family,” according to a statement from his family shared by the Red Sox. “Bill fought with courage and grit as he did all things in life. Our hearts are broken but we are at peace knowing he is in the arms of his Lord and Savior Jesus Christ.”
Buckner built up an impressive record as a player, with more than 1,000 runs scored during his career. He was an All-Star in 1981 while playing for the Chicago Cubs. But Buckner found it hard to shake a mistake he made during game six of the 1986 World Series against the New York Mets.
The Sox had a two-run lead, and were one strike away from winning their first World Series championship since 1918. But the Mets clawed back from the brink to tie the game in the 10th inning. With a runner on second base, a base hit would give the Mets the win and force a game seven.
It turns out they only needed the most famous error in baseball history.
YouTube
Mets player Mookie Wilson hit a grounder toward first base — as the announcer called it, “a little roller up along first.” Buckner ran toward the ball, took a wide stance, reached down to scoop it up — and the ball rolled right between his legs.
“It gets through Buckner!” the announcer says, shocked, as a Met crosses home plate. “The Mets win it!”
The error forced a game seven, which the Mets won. And the error turned Bill Buckner into New England’s scapegoat.
“People always ask me what I thought about when I missed the ground ball,” he told NPR in 2011. “My first thought was, ‘Wow, we get to play in the seventh game of the World Series … We’ll get ’em tomorrow.’ “
Buckner played for a few more years, retiring in 1990 and moving his family to Meridian, Idaho — where most people hadn’t heard of him, or his World Series gaffe. It wasn’t until 2004 that Buckner finally found redemption, once the Red Sox finally won their first World Series in 86 years.
Time and winning heal all sports wounds — and the fans and media were no longer so angry at Buckner. When Buckner returned to Fenway Park for the 2008 Red Sox home opener, he was greeted with open arms — and a two-minute ovation.
“It was awesome,” Buckner told NPR. “The real cool thing about it was the fans … were sincere,” he said. “I think they understood all the crap I went through, and they were always good to me.”
Perhaps the fans’ sentiment was best summed up by the the next day’s cover headline in the Boston Herald: “All is Forgiven.”
Former Boston Red Sox first-baseman Bill Buckner has died at 69. Best known for a fielding error that helped cost Boston the 1986 World Series, Buckner was cheered by Red Sox fans in recent years.
