Some 'Cheaper' Health Plans Have Surprising Costs
One health insurance startup charges patients extra for procedures not covered by their basic health plan. The out-of-pocket cost for a tonsillectomy and adenoidectomy might range from $900 to $3,000 extra, while a lumbar spine fusion could range from $5,000 to $10,000.
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One health plan from a well-known insurer promises lower premiums — but warns that consumers may need to file their own claims and negotiate over charges from hospitals and doctors. Another does away with annual deductibles — but requires policyholders to pay extra if they need certain surgeries and procedures.
Both are among the latest efforts in a seemingly endless quest by employers, consumers and insurers for an elusive goal: less expensive coverage.
Premiums for many of these plans, which are sold outside the exchanges set up under Affordable Care Act, tend to be 15 to 30 percent lower than conventional offerings, but they put a larger burden on consumers to be savvy shoppers. The offerings tap into a common underlying frustration.
“Traditional health plans have not been able to stem high cost increases, so people are tearing down the model and trying something different,” said Jeff Levin-Scherz, health management practice leader for benefit consultants Willis Towers Watson.
Not everyone is eligible for a subsidy to defray the cost of an ACA plan, and that has led some people to experiment with new ways to pay their medical expenses. Those experiments include short-term policies or alternatives like Christian-sharing ministries — which are not insurance at all, but rather cooperatives through which members pay one another’s bills.
Now some insurers — such as Blue Cross Blue Shield of North Carolina and a Minnesota startup called Bind Benefits, which is partnering with UnitedHealth Group — are coming up with their own novel offerings.
Insurers say the two new types of plans meet the ACA’s rules, although they interpret those rules in new ways. For example, the new policies avoid the federal law’s rule limiting consumers’ annual in-network limit on out-of-pocket costs. One policy manages that by having no network — patients are free to find providers on their own. And the other skirts the issue by calling additional charges “premiums.” Under ACA rules, premiums don’t count toward the out-of-pocket maximum.
But each plan could leave patients with huge costs in a system in which it is extremely difficult for a patient to be a smart shopper — in part, because they have little negotiating power against big hospital systems and partly because illness is often urgent and unanticipated.
If these alternative plans prompt doctors and hospitals to lower prices, “then that is worth taking a closer look,” says Sabrina Corlette, a research professor at Georgetown University’s Health Policy Institute. “But if it’s simply another flavor of shifting more risk to employees, I don’t think in the long term, that’s going to bend the cost curve.”
Balancing freedom, control and responsibility
The North Carolina Blue Cross Blue Shield “My Choice” policies aim to change the way doctors and hospitals are paid by limiting reimbursement for services to 40 percent above what Medicare would pay. The plan has no specific network of doctors and hospitals.
This approach “puts you in control to see the doctor you want,” the insurer says on its website. The plan is available to individuals who buy their own insurance and to small businesses with one to 50 employees. It’s aimed at consumers who cannot afford ACA plans, says Austin Vevurka, a spokesman for the insurer. The policies are not sold on the ACA’s insurance marketplace, but can be purchased off-exchange from brokers.
With that freedom, however, consumers also have the responsibility to shop around for providers who will accept that amount of reimbursement for their services. Consumers who don’t shop — or can’t because their medical need is an emergency — may get “balance-billed” by providers who are unsatisfied with the flat amount the plan pays.
“There’s an incentive to comparison-shop to find a provider who accepts the benefit,” says Vevurka.
The cost of balance bills range widely but could be thousands of dollars in the case of hospital care. Consumer exposure to balance bills is not capped by the ACA for out-of-network care.
“There are a lot of people for whom a plan like this would present financial risk,” says Levin-Scherz.
In theory, though, paying 40 percent above Medicare rates could help drive down costs over time if enough providers accept those payments. That’s because hospitals currently get about double Medicare rates through their negotiations with insurers.
“It’s a bold move,” says Mark Hall, director of the health law and policy program at Wake Forest University in North Carolina. Still, he says, it’s “not an optimal way” because patients generally don’t want to negotiate with their doctor on prices.
“But it’s an innovative way to put matters into the hands of patients as consumers,” Hall says. “Let them deal directly with providers who insist on charging more than 140 percent of Medicare.”
Blue Cross spokesman Vevurka says My Choice has telephone advisers to help patients find providers and offer tips on how to negotiate a balance bill. He would not disclose enrollment numbers for My Choice, which launched Jan. 1, nor would he say how many providers have indicated they will accept the plan’s payment levels.
Still, the idea — based on what is sometimes called “reference pricing” or “Medicare plus” — is gaining attention. Under that method, hospitals are paid a rate based on what Medicare pays, plus an additional percentage to allow them a modest profit.
North Carolina’s state treasurer, for example, hopes to put state workers into such a pricing plan by next year, offering to pay 177 percent of Medicare. The plan has ignited a firestorm of opposition from hospitals in the state.
Montana recently got its hospitals to agree to such a plan for state workers, paying 234 percent of Medicare, on average.
Partly because of concerns about balance-billing, employers aren’t rushing to buy into Medicare-plus pricing just yet, says Jeff Long, a health care actuary at Lockton Companies, a benefit consultancy.
Wider adoption, however, could spell its end.
Hospitals might agree to participate in a few such programs, but “if there’s more takeup on this, I see hospitals possibly starting to fight back,” Long says.
What about the bind?
Minnesota startup Bind Benefits eliminates annual deductibles in its “on-demand” plans sold to employers that are opting to self-insure their workers’ health costs. Rather than deductibles, patients pay flat-dollar copayments for a core set of medical services, from doctor visits to prescription drugs.
In some ways, it’s simpler: There is no need to spend through the deductible before coverage kicks in or wonder what 20 percent of the cost of a doctor visit or surgery would be.
But not all services are included.
Patients who discover during the year that they need any of about 30 common procedures outlined in the plan, including several types of back surgery, knee arthroscopy or coronary artery bypass, must “add in” coverage, spread out over time in deductions from their paychecks.
“People are used to that concept, to buy what they need,” said Bind CEO Tony Miller. “When I need more, I buy more.”
According to a company spokeswoman, the add-in costs vary by market, procedure and provider. On the lower end, the cost for tonsillectomy and adenoidectomy ranges from $900 to $3,000, while lumbar spine fusion could range from $5,000 to $10,000.
To set those additional premiums, Bind analyzes how much doctors and facilities are paid, along with some quality measures from several sources, including UnitedHealth. The add-in premiums paid by patients vary depending on whether they choose lower-cost providers or more expensive ones.
The ACA’s 2019 out-of-pocket maximums — $7,900 for an individual or $15,800 for a family — don’t include premium costs.
The Cumberland School District in Wisconsin switched from a traditional plan, which it purchased from an insurer for about $1.7 million last year, to Bind. Six months in, according to the school district’s superintendent, Barry Rose, the plan is working well.
Right off the bat, he says, the district saved about $200,000. More savings could come over the year if workers choose lower-cost alternatives for the “add-in” services.
“They can become better consumers because they can see exactly what they’re paying for care,” Rose says.
Levin-Scherz at Willis Towers says the idea behind Bind is intriguing but raises some concerns for employers.
What happens, he asks, if a worker has an add-in surgery, owes several thousand dollars, then changes jobs before paying all the premiums for that add-in coverage? “Will the employee be sent a bill after leaving?” he wonders.
A Bind spokeswoman says the former employee would not pay the remaining premiums in that case. Instead, the employer would be stuck with the bill.
Kaiser Health News is a nonprofit news service and editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.
Sports Stadium Shrinkage Is A Trend. Who's To Blame For Attendance Drop?
Some baseball teams, the Tampa Bay Rays for example, have torn out seats because of a drop in attendance. Teams have explanations for stadium shrinkage, but commentator Mike Pesca has his own ideas.
STEVE INSKEEP, HOST:
Attending a major league baseball game is expensive. Bringing the whole family can be almost impossible for some, so many people don’t. Although some teams, like the Yankees, still attract big crowds, the Tampa Bay Rays are acknowledging a new reality. Having priced many fans out of the park, they’ve torn out many of the seats. Commentator Mike Pesca sees a trend.
(SOUNDBITE OF SONG, “TAKE ME OUT TO THE BALLGAME”)
MIKE PESCA, BYLINE: “Take Me Out To The Ballgame” was written 101 years ago, and most of the sentiment still stands. You can still buy peanuts and Cracker Jack. It’s still one, two, three strikes, you’re out. The only update might be the line, take me out with the crowd. Sixty-seven million fans attended a regular season baseball game last year, but those numbers were down from the year before. And some of that is, actually, by design, as in the design of ballparks. The seating capacity of stadia across American sports – not just baseball – is shrinking. The Tampa Bay Rays will be playing for about 26,000 fans maximum. That’s 5,000 fewer seats than they have now. The Las Vegas Raiders will soon debut in a stadium that will be among the three most compact in the game. All 16 major league teams that have moved in the past 20 years are playing in tighter confines than they once did.
The reason for this shrinkage, the leagues will tell you, is that televised sport has beaten the live experience. As the TVs got better, the traffic got worse, I guess. And the couch beckoned. I just got back from Disney World. Disney movies are clearly cheaper and easier to get to than the live experience. And yet millions more people flock to the Magic Kingdom than did 10 years ago. There is an “Avatar” ride that had a wait time of – let me check the app. It’s on an app now – three hours, five minutes. But with baseball and football, there is so little attention paid to the experience in the park. How about good Wi-Fi or some milling-about zones and food that challenges our collective delusion that Dodger Dogs aren’t inferior, cylindrical foodstuffs? We have been gaslit about Fenway Franks.
Then there’s the gouging. The New York Jets will charge you 40 to $50 for parking. And when you enter the stadium, you have to watch the New York Jets. Owners can continue to shrink their stadiums and their ambitions or they can start rewarding fans who literally give their teams the home field advantage as something other than chickens to be plucked or geese to be fattened before slaughter. Don’t the fans have enough experience with slaughter, especially when we’re talking about fans of the Jets, Rays and Raiders?
(SOUNDBITE OF BILLY JOEL’S “TAKE ME OUT TO THE BALLGAME”)
INSKEEP: (Singing) Take me out…
No, I’m not going to do that. Commentator Mike Pesca hosts the Slate podcast The Gist, which is still very affordable and welcomes new fans. He also wrote the book “Upon Further Review.”
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
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.
U.S. Cities Skeptical Of FDA Warnings Against Medicine Imports From Canadian Firm
The Food and Drug Administration suggests consumers who get prescription drugs mailed to them via CanaRx are at risk of getting mislabeled or counterfeit drugs. But consumer watchdog groups say the FDA has supplied no evidence that’s happened.
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Cities and local governments in several states say they will continue to use a Canadian company to offer employees prescription drugs at a highly reduced price, even though officials from the U.S. Food and Drug Administration have raised safety concerns about the practice.
The municipalities use CanaRx, which connects their employees with brick-and-mortar pharmacies in Canada, Great Britain and Australia to fill prescriptions.
In a letter sent last week to CanaRx, the FDA said the company has sent “unapproved” and “misbranded” drugs to U.S. consumers, jeopardizing patient safety.
The FDA also urged consumers not to use any medicines from CanaRx, which works with about 500 cities, counties, school districts and private employers in the United States to arrange drug purchases. Some of these employers started using the service as far back as 2004.
Prices of drugs from overseas pharmacies can be as much as 70 percent lower than what people pay in the U.S. because the costs are regulated by the foreign governments.
FDA officials would not explain why they waited more than a decade to act. They acknowledged the agency had no reports of anyone harmed by drugs received through CanaRx.
The FDA made its warning as Congress and the Trump administration look into ways to lower drug prices. Last month, Florida Republican Gov. Ron DeSantis said he has President Donald Trump’s backing to start a program to begin importing drugs from Canada for state residents.
After DeSantis’ comments, White House officials stressed that any such plan must get state and federal approvals.
The FDA says that in most cases importing drugs for personal use is illegal, although it very rarely has tried to stop Americans from bringing drugs across the Canadian border. It has not stopped retail stores in Florida that have helped consumers buy drugs from Canada since 2003. Nine storefronts were raided by FDA officials in 2017, although the FDA has allowed them to continue operating.
Schenectady County in New York, which has worked with CanaRx since 2004, defended its relationship and has no immediate plans to end it, according to Chris Gardner, the county attorney. “We will wait to see how this plays out, but right now it’s status quo,” Gardner says.
He says CanaRx, which is headquartered in Windsor, Ontario, helped the county save $500,000 on drug costs in 2018. About 25 percent of the county’s 1,200 workers use the program and get their drugs with no out-of-pocket costs. If they use American pharmacies, they generally have a copayment.
“This is a good program, and on the merits it looks lawful, and they are not doing the terrible things that the FDA is suggesting,” Gardner says.
CanaRx officials deny they have been breaking any laws or putting Americans’ health at risk. They say they are not an online pharmacy but a broker between U.S. employees and brick-and-mortar pharmacies in Canada, Australia and Great Britain. People can buy drugs via CanaRx only with a prescription from their doctor.
The company says it has no plans to stop distributing drugs.
“The FDA’s characterizations of the CanaRx business model and operating protocols are completely wrong,” says Joseph Morris, a Chicago-based lawyer for the company. “It is not possible to place an order via any CanaRx website; the websites are informational only.”
Morris says the FDA notice has prompted calls from many municipalities; but so far all say they plan to stick with the company.
The FDA warning says online pharmacies that purport to sell drugs from Canada, Britain and Australia may actually get their drugs from other countries, which would increase the risk consumers are dealing with counterfeit drugs.
CanaRx says that “it contracts with government-licensed physicians, pharmacists and pharmacies in Canada, the United Kingdom, and Australia … to supply brand name medications, packaged and sealed by the original manufacturer, for direct delivery to all participants.”
Gabriel Levitt is president of pharmacychecker.com, an independent website for U.S. consumers that verifies international pharmacies offering drugs online. He notes that the FDA’s warning letter offered no evidence CanaRx has distributed any counterfeit drugs since it began business almost 20 years ago.
Columbia County, N.Y., has been using CanaRx for about a decade and says the savings allows it to offer employees drugs with no out-of-pocket costs, instead of requiring them to pay as much as a $40 copay in local pharmacies.
“This is bull,” Stephen Acciani, an insurance broker who works with the county, says of the FDA crackdown. “They are not selling unsafe medications.” His recommendation would be for the county, which has more than 600 employees on its health plan, to continue using CanaRx.
Acciani notes that employees receive the medicine through the mail in its original packaging from the manufacturer.
“It will give some clients pause,” says Kate Sharry, a benefits consultant to the city of Fall River, Mass., and more than 100 other municipalities in the state. “How can you not pay attention to this from the FDA?” But she expects the local governments to stay with CanaRx.
Federal health officials under both Republican and Democratic administrations have blocked efforts to legalize importing medication, saying it’s too risky.
“Sometimes a bargain is too expensive,” says Peter Pitts, a former FDA associate commissioner (from 2000 to 2004)who is now president of the Center for Medicine in the Public Interest, a New York-based nonprofit that receives some of its funding from drugmakers.
Pitts, who applauds the FDA action, says it’s difficult for consumers to know when their pills from foreign pharmacies don’t have the correct potency or ingredients. He says doctors may also not realize a patient’s problem stems from issues with the medicine. Instead, the physicians may just change the medication’s dosage. He says it is not safe for Americans to buy drugs that are imported through foreign pharmacies.
Levitt says CanaRx is one of the safest ways for Americans to get drugs from legitimate pharmacies in Canada and other industrialized counties.
The FDA is likely trying to intimidate CanaRx and its clients in local government, Levitt says.
“My biggest fear is they will scare consumers, [who then] won’t take their very safe and effective medications because they hear about this bogus warning,” says Levitt.
“The FDA’s action,” he says, “which appears to try and make those programs look unsafe and sinister, seems to have a political and public relations purpose — one that is perfectly allied with the lobbying agenda of drug companies.”
Levitt points to testimony FDA Commissioner Scott Gottlieb gave to a House subcommittee last week — just a day before the CanaRx warning, and ahead of his announcement that he will be leaving the FDA next month.
When asked about importing Canadian drugs, Gottlieb did not mention CanaRx, but did say that people going to a “brick and mortar” pharmacy in Canada “are getting a safe and effective drug. I have confidence in the Canadian drug regulatory system.” He added that his concerns are with online pharmacies.
The Pharmaceutical Research and Manufacturers of America, the industry trade and lobbying group, has cheered the FDA action but denies it had any role in it, says spokeswoman Nicole Longo.
“PhRMA supports the FDA’s efforts to crack down on organizations that are circumventing its robust safety and efficacy requirements,” Longo says. “Drug importation schemes expose Americans to potentially unsafe, counterfeit or adulterated medicines.”
Kaiser Health News is a nonprofit news service and editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
How Much Is Today's HIV Research Centered Around The Search For A Cure?
For the second time ever, a man’s HIV infection has been sent into remission. NPR’s Mary Louise Kelly talks with Rowena Johnston, director of research for the Foundation for AIDS Research.
Bone Marrow Transplant Renders Second Patient Free Of HIV
A color-enhanced scanning electron micrograph shows HIV particles (orange) infecting a T cell, one of the white blood cells that play a central role in the immune system.
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Doctors in London say they have apparently eradicated HIV from a patient’s body. It’s only the second time this has been accomplished, despite many attempts over more than a decade.
While some commentators are calling this a “cure” for HIV, the scientists who performed the experiment say it’s too soon to say that. Instead, they say the patient is in remission.
Both cases involved a risky procedure called a stem-cell transplant (otherwise known as a bone marrow transplant). The first recipient, Timothy Brown, gained fame as the so-called Berlin patient after transplants in 2007 and 2008 rid him of HIV. He remains free of HIV today.
That result raised hopes that HIV could be eradicated through a medical procedure and cure people of HIV infection. Yet Brown’s case remained the lone success since then. Other attempts had failed.
Now, researchers at University College London report in a paper being published Tuesday in Nature that they have apparently eliminated HIV in a second person.
That man had been diagnosed with HIV in 2003. Then, in 2012 the unidentified patient was diagnosed with a cancer, Hodgkin lymphoma. After standard treatments failed, they gave the patient a stem-cell transplant — essentially killing off his old immune system and giving him a new one.
The doctors selected a donor who had two copies of a particular mutation in the CCR5 gene that prevents HIV from infecting T-cells, a part of the immune system where the virus takes hold and does its damage. As a result, the man ended up with an immune system that was naturally resistant to HIV.
Sixteen months after the man’s transplant, doctors found no sign of HIV in his body. They decided to stop treating him with antiviral drugs after he volunteered to stop taking them. It has now been more than 18 months and the infection hasn’t reappeared, the scientists say.
Ravindra Gupta and his colleagues write, “it is premature to conclude that this patient has been cured,” but they are hopeful that will prove to be the case.
“This is a highly significant study,” Aine McKnight, a professor of viral pathology at Queen Mary University of London, said in a statement. “After a ten year gap it provides important confirmation that the ‘Berlin patient’ was not simply an anomaly.”
But McKnight cautioned that this won’t necessarily lead to a treatment for anyone with HIV. For one thing, the rare mutation in this case, a variant of a receptor called CCR5, only blocks one variety of HIV. A second, less common form of HIV could still cause infection despite a transplant like this.
This receptor was recently in the news after Chinese scientist He Jiankui claimed he had edited the genes of embryos to include a protective version of CCR5. This experiment raised an ethical furor.
AIDS researchers have known about this CCR5 mutation for years and have tried to think of ways to exploit it as a treatment for HIV.
“Although it is not a viable large-scale strategy for a cure, it does represent a critical moment in the search for an HIV cure,” Anton Pozniak, president of the International AIDS Society, said in a statement. “These new findings reaffirm our belief that there exists a proof of concept that HIV is curable.”
Stem-cell transplants are expensive and risky, because they involve wiping out a patient’s immune system with powerful drugs or radiation and then reconstituting it.
The benefits of this treatment outweigh the risk for cancer patients, which is where it is most commonly used. But HIV drugs have become so effective that many people carrying this infection have a normal lifespan if they take these medications for a lifetime.
The scientists note in their study that the treatment for the second patient was less harsh than the one used for the Berlin patient, raising the possibility that they could develop a less risky procedure for stem-cell transplants for HIV-positive patients.
They say this procedure could be useful now for those rare people with HIV who have also been diagnosed with cancer and are in need of a stem-cell transplant to reconstitute their immune systems. Those patients could benefit if they can find a donor with the rare mutation in CCR5 that protects them from HIV reinfection.
You can contact NPR Science Correspondent Richard Harris at rharris@npr.org.
Governments Struggle To Find A Way To Pay Retirement Pension Bills
There’s a growing fiscal crisis hitting cities, counties and states across the U.S. It’s all about generous retiree health benefits that historically haven’t been fully funded.
Jon Champion On Calling Play-By-Play Soccer
Lulu Garcia-Navarro speaks with renowned British soccer commentator Jon Champion, who is joining ESPN as the new play-by-play voice for Major League Soccer.
LULU GARCIA-NAVARRO, HOST:
For almost two decades, Jon Champion has called the play-by-play on some of the most watched soccer games in the world.
(SOUNDBITE OF ARCHIVED RECORDING)
JON CHAMPION: Trying to run Georginio, making a great job of it. Solo away. What a fabulous goal lighting up Wembley.
GARCIA-NAVARRO: From the Premier League to FIFA games to the World Cup and Olympic Games. Now Champion is taking his family and moving across the pond to the U.S. to cover Major League Soccer for ESPN and, as he puts it, to live the American dream. Jon Champion, welcome to WEEKEND EDITION and to the United States (laughter).
CHAMPION: Thank you so much. It’s lovely to be here.
GARCIA-NAVARRO: What brings you to our shores?
CHAMPION: I think a challenge and an opportunity to have an adventure, both on a personal and a professional level. So as you rightly pointed out, I’ve been commentating on soccer matches for 34 years now. I started when I was at university as a teenager. But you do get to a stage where you’re recognizing that you’re covering an event or a storyline for the fifth, sixth, seventh, maybe eighth time. And I just got to the stage where, in 2014, ESPN hired me to cover the World Cup in Brazil. And off the back of that, the suggestion was made that maybe I’d like to consider, at some point, coming and making my home here and commentating full time on American soccer rather than European or, specifically, British soccer. And that was the gestation, really, of an idea that took four years to grow into a fully fledged offer to come in and work here full time.
GARCIA-NAVARRO: Do you have to remind yourself to call it soccer, though?
CHAMPION: I do at the moment. I do and…
GARCIA-NAVARRO: (Laughter) I can just imagine, I’m afraid, you slipping up because, obviously, the rest of the world does not call it soccer.
CHAMPION: No, no, no. It is football around the rest of the world, and I’m in the midst of the penalty or PK debate. What do I call a penalty kick?
GARCIA-NAVARRO: (Laughter).
CHAMPION: So I’m somewhere betwixt and between. I’m mid-Atlantic at the moment.
GARCIA-NAVARRO: (Laughter) All right. U.S. soccer is gaining in popularity, but it is definitely not at the level of the Premier League or other leagues around the world. You’ll be calling matches for a sport that is not watched by everyone, as it was back home. How do you feel about that? What is your plan to bring soccer to everyone’s living room?
CHAMPION: Well, I’m not sure…
GARCIA-NAVARRO: You’re responsible for this alone, by the way.
CHAMPION: Personally?
GARCIA-NAVARRO: Yes, absolutely.
CHAMPION: Oh, that is…
GARCIA-NAVARRO: I’m going to put it all on you.
(LAUGHTER)
CHAMPION: I mean, I’m fortunate in that my voice is associated with big, worldwide soccer events. So if my voice becomes associated with big, American soccer events, there is a school of thought that that helps to add a certain validity to the occasion and to the broadcast. Now, whether that’s the case is probably not for me to say, but that is the suggestion and the theory behind this.
GARCIA-NAVARRO: But why do you think it hasn’t really caught on here in America the same way? Because kids do it. You have soccer clubs all over the United States. Kids grow up playing soccer. And then, it kind of just stops.
CHAMPION: Yeah. It does at the moment, or it has done up until this point. And it is the most played sport in that age group. For teenagers, soccer is the No. 1 participation event. And, gradually, that is translating into a greater interest in the professional game of soccer in this country. So one of the attractions of this job coming now, for me, is that if you look at the context of league soccer in this country, it began, effectively, in 1996. So this is season number 24 that begins over this weekend. If you translate that into the English game, league soccer there started in 1888. So, in the same terms, we’re in 1911 now, here in America. So…
GARCIA-NAVARRO: We’re a young country in many ways (laughter).
CHAMPION: Yeah. But it means that it is an evolution. And, obviously, the American game is at a very early stage of that evolution. But I think the graph shows that the acceleration in interest in the game – it’s gathering pace. It’s quite attractive to come and be a little part of trying to tell the story of a growth of a sport that’s conquered the world with one exception, and we’re sitting right in the middle of that exception. And I’d love to play a very, very small role and be a close observer of the breakthrough of soccer. I’m not suggesting that it’s going to displace the NFL, but it is capable of nibbling at the heels, perhaps, of baseball and of ice hockey, certainly. It’s very exciting to be at the stage of one’s career where one’s been lucky enough to do most things, but this is an unconquered frontier.
GARCIA-NAVARRO: Jon Champion, longtime British soccer commentator and now ESPN’s lead announcer for Major League Soccer, thank you very much.
CHAMPION: It’s been a great joy. Thank you.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
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.
Underdiagnosed Male Eating Disorders Are Becoming Increasingly Identified
NPR’s Michel Martin talks with journalist Soledad O’Brien about her recent reporting on eating disorders among male athletes.
Saturday Sports: SheBelieves Cup, Enes Kanter
NPR’s Tom Goldman discusses the sports stories that grabbed his attention this week – including the SheBelieves Cup.
SCOTT SIMON, HOST:
And now a sober, contemplative look at sports.
(SOUNDBITE OF MUSIC)
SIMON: The U.S. women’s soccer team takes on England today – no Brexit once they get on the field. And the Portland Trail Blazers are the latest to light up the NBA. NPR’s Tom Goldman joins us. Morning, Tom.
TOM GOLDMAN, BYLINE: Good morning, Scott.
SIMON: The SheBelieves Cup is underway – U.S. women’s national team plays England today in Nashville. Earlier this week, team USA opened the cup. They had a 2-2 tie against Japan. England beat Brazil 2-1. I know, Tom, this is a sensitive topic in your family, but is Enguland (ph) favored? And notice I pronounced that with a U in the middle.
GOLDMAN: Is that how I’m supposed to pronounce that?
SIMON: I believe so, yes.
GOLDMAN: Well, done from now on. Yeah. In answer to your question, I don’t think any team playing the top-ranked U.S. is the favorite going in. But England is sitting atop the SheBelieves Cup standings. And Phil Neville, the English coach, is sounding like he wants the Lionesses, as they are called, to act like they’re the favorites. He wants his team to emulate the swagger of the U.S. And that U.S. swagger is because, Scott…
SIMON: Rrr (ph).
GOLDMAN: …Once again, it is a very – roar – it is a very talented American team, especially on offense. Now, defense needs to shore things up before the World Cup, which is coming up – just a little over three months away. In that draw against Japan that you mentioned, the U.S. gave up the lead twice due to some defensive miscues. And U.S. coach Jill Ellis says it’s critical the back line and the goalkeeper start building cohesion. We’ll look to see if they make strides today.
SIMON: NBA – the Portland Trail Blazers lost to the Toronto Raptors by just two points last night at the last second in Toronto. And that left Portland fans crying in their Willamette Valley pinot noirs.
GOLDMAN: (Laughter).
SIMON: Portland center Enes Kanter has been on this show. He’s welcome back any time. He couldn’t go to Canada because he’s an outspoken critic of the repressive regime in his native Turkey. He could have made a two-point difference, right?
GOLDMAN: You know, Portland fans like to think so, and they may have a case. In his four games since joining the Blazers from the Knicks – lucky him – Kanter has averaged nearly 13 points and seven rebounds a game as a backup center. It might have helped but not to be. Kanter couldn’t play because he says outside the sanctuary of the U.S., he’s worried that he could be harmed by Turkish agents – which he told you in January – or else nabbed due to what’s called a red notice, which Interpol uses to locate and arrest a person pending extradition. After the game, Kanter tweeted (reading) man, freaking hate that #DictatorErdogan.
Guaranteed a lot of Blazer fans feeling the same way. Although, there probably are better reasons to feel that way beyond basketball.
SIMON: Beyond – right. Beyond…
GOLDMAN: Yeah (laughter).
SIMON: …Basketball. The Trail Blazers are on a five-game winning streak. Where did this come from?
GOLDMAN: Yeah. Well, Kanter’s been a big part of this post All-Star Game surge that’s starting to turn NBA heads toward the remote Pacific Northwest with its very nice red wines. The knock on Portland has been if you stop its great guards, four-time All-Star Damian Lillard and CJ McCollum, you stop the Blazers. But suddenly with Kanter and starting center Jusuf Nurkic of Bosnia and others on the team playing well, Portland’s become less predictable and tougher to handle. Now, no one’s talking championship, Scott, as long as Golden State walks the Earth. But Portland could be tougher in the playoffs.
SIMON: And it’s – this league is a team in Portland that looks like it will stay together for a while.
GOLDMAN: Yeah, it does. It’s a small market with a very loyal fan base in Portland. And Damian Lillard is the team’s leader. And he has endeared himself even more with his recent comments about being happy in Portland and not thinking about leaving for a super team. You know, that’s been the rage in the NBA in recent years. The speculation continues about which other stars will join LeBron in LA to form a super team, you know, that can challenge Golden State. But there are players, like Lillard or Bradley Beal in Washington, Russell Westbrook in Oklahoma City, who’ve stayed committed to their non-championship winning teams. And the fans seem to love them even more for it.
SIMON: Bryce Harper, $330 million to join the Phillies – good idea?
GOLDMAN: (Laughter) Anytime you signed a six-time All-Star, yeah. That’s a good idea. I’d say so.
SIMON: It’s not a clown question, bro?
(LAUGHTER)
SIMON: That’s a Bryce Harper quote. NPR’s Tom Goldman, thanks so much.
GOLDMAN: You’re welcome.
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U.S. Women's Soccer Team Takes Next Step To World Cup
U.S. Women’s National Soccer Team forward Megan Rapinoe, right, tries to get around Japan’s Risa Shimizu, left, with the ball during the first half of SheBelieves Cup soccer match, Wednesday, Feb. 27, 2019, in Chester, Pa. The U.S. tied Japan 2-2 in a friendly match in the run-up to the World Cup in June.
Chris Szagola/AP
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Chris Szagola/AP
The top-ranked U.S. Women’s National Soccer Team is back on the field Saturday afternoon playing against number four England in Nashville, Tenn. The SheBelieves Cup also includes top-ten powerhouses Brazil and Japan. The U.S. and Japan played to a 2-2 tie on Wednesday.
While the U.S. is hoping for a better result today, the real focus is on preparations for June. That’s when the Women’s World Cup begins in France. The U.S. is heavily favored as the defending champion (and three-time winner of the event).
At a news conference on Friday, Coach Jill Ellis said these ‘international friendly’ games in the round-robin tournament are a good gauge to see where the team is strong and where it’s not. “The most important piece is we’re playing against world class teams before we get ready for the summer,” Ellis said. “All of the experiences we take in now are massive in terms of having us be ready.”
Against Japan, the U.S. attacked repeatedly and controlled the game at key moments. But it gave up two late goals including the equalizer in the 91st minute when it appeared the U.S would finish with a victory.
Veteran forward Megan Rapinoe said the squad needs to do a better job controlling the game and keep its focus. “I feel good where we are in our preparation,” she said. “We’ll forever have stuff to work on. But I feel like things are coming together well and we’re having a more solidified idea of the way we want to play and I think you can see that on the field.”
During the team’s pre-game training on Friday at Nissan Stadium in Nashville, the U.S. team looked loose and relaxed, despite overcast skies and a chilly wind in the 40-degree weather. Teammates joked and smiled and mugged for photographers. Defender Abby Dahlkemper said, while the team isn’t worried, the squad does need to tighten up: “Really taking advantage of every single minute we can on the field together. Tweaking the things we need to tweak, getting better and learning and really hitting our peak in June.”
FOX will broadcast the U.S./England game at 4:30pm E.T. Brazil and Japan play at 2pm E.T — the latter available to stream on ussoccer.com. The SheBelieves tournament wraps up Tuesday in Tampa, Fla., when the U.S. takes on Brazil.