Transcripts For KQED PBS NewsHour 20131114

I dont have to stop treatment wooduff those are just some of the stories were covering on tonights pbs newshour. Major funding for the pbs newshour has been provided by my customers can shop around; see who does good work and compare costs. It can also work that way with healthcare. With united healthcare, i get information on quality ratings of doctors, Treatment Options and estimates for how much ill pay. That helps me and my guys make informed decisions. I dont like guesses with my business and definitely not with our health. Thats health in numbers. United healthcare. Supported by the john d. And catherine t. Macarthur foundation. Committed to building a more just, verdant and peaceful world. More information at macfound. Org and with the ongoing support of these institutions and foundations. And. This program was made possible by the corporation for public broadcasting. And by contributions to your pbs station from viewers like you. Thank you. Ifill six days of misery and desperation bred anarchy today in the philippines, where the typhoon death toll rose again to near 2,350. Survivors looted whole warehouses and even dug up water pipes around tacloban on hard hit leyte island. We begin our coverage with john irvine of independent television news. He spent the day on the islands easternmost tip. Reporter its the last place outsiders have reached, the eastern edge of this country, where the philippines meet the pacific. We headed into whats left. The soldier with us was a guide, not a guard. The people here could not have been more welcoming as they showed us the horrendous destruction. This location, normally a blessing, was on friday a terrible curse. Theres nothing to the east of this town, other than thousands of miles of pacific ocean, and it was from there that the typhoon came. The most powerful storm ever recorded by man first encountered mankind right here and dealt a terrible blow. Several people were killed here in a Sports Center designated as a shelter, a refuge that became a death trap as the typhoon blew the roof in. The monster storm killed at least 85 people. And the survivors still cant quite believe that they lived through it. Vincent, what was it like . It was like it was like eye dont know. It was like sunawmy and earthquake at the same time. It shook all our walls. It took all our roof. It took everything out. We we were all wet. We were some were dead, because of the walls the walls crumbled down. I thought i was never going to see the morning. I thought i was really not going to make it. Reporter the u. S. Marines came here to carry out an assessment of need, and their conclusion can only have been the same as ours send help, fast. Ifill our second report comes from john sparks, also of independent television news. He spent the day in ormoc, where things seem calmer, despite the need for outside aid. Reporter the city of ormoc has been devastated. But the people who live here have one thing going for them water. Clean, fresh water. A number of public pumps are still working. And thats something to smile about. How are you doing today . Were okay. Weve got no food. No electricity. But you know what . Were still happy. Reporter this community was torn apart by the typhoon and many here are hungry. But theres no sign of panic or looting thats afflicted other cities in the region. Outside ormocs main hotel, one of a small number of spots with a generator, people came to charge their phones and share stories of survival. This video was shot on a mobile by a 20yearold just before the store removed the second floor of his house. He said he was terrified. We also met a woman in the queue for a soact. Shes a single mother of two and pregnant, and shes now homeless. translated everything was destroyed. The only thing i could do was watch it happen. Reporter she took these pictures from her neighbors house. She told us the storm had left her with nothing. translated we have nowhere to live. Theres no food, and i really need help. Please, end us food. Im appealing to you. Reporter later, we headed towards the destructive epicenter of this storm, the city of tacloban. Its not an easy drive, however. The highway, a fearsome Obstacle Course of debris and downed power lines. We pulled off the highway in a town which has really been wiped out by the storm. And were told that there are more than 1,000 local people now living in the elementary school, so were going to go and see how theyre doing. Hello. The school is now home to half of the communitys population, and theres certainly no space for lessons here. We went to meet the new occupants of the grade five classroom. And asked one woman how many people lived inside. We have six families from inside. Reporter six families inside the classroom . Yeah. Reporter there cant be much space. We stand or reporter well, we have room to stand, she said. How long do you think youre going to be here . Were going to stay here maybe almost four months. We dont know exactly. Reporter and there is great uncertainty on the road to tacloban. People in these devastated communities told us they were hungry and thirsty, and they told us they have been overlooked as the government tend to other things. translated the relief convoy just pass us by. They dont stop. Theres nothing to do but look at them. I guess i cant get mad about it. Reporter we reached tacloban shortly before nightfall, a city of twisted steel, and shattered glass, a city of death, the smell of decomposing bodies lingers everywhere. The military were out in force after looting and mob violence, but people here have other concerns. The biggest problem here is that there is no food, no medicine. Water is very hard to come by. There is just only one source of water, and that is there at the city hall. And that leaves no food. Reporter unlike the public pumps of ormoc, this is the only place to find water in tacloban, a solitary filter station. Theres not enough to go around, and it is fueling a state of desperation here. Ifill and for more on that growing state of desperation in the wake of haiyan, we turn to richard gordon, the chairman of the red cross in the philippines. I spoke to him a short while ago by telephone. Richard gordon, welcome, and thank you for joining us. You are now in manila, but were hearing reports about chaos breaking out in the hardest hit regions of the philippines. Is the desire for relief now turpg into desperation . Well, yes, a certain amount of desperation is going on because of the slowness of the relief effort, especially because of the difficulties in access, the fallen debris, trees. And then we have security issues. There has been a breakdown of peace and order, and stores are being looted. And there are difficult issues. You know, communications are down up to now. So theres great difficulty. People are getting very anxious because, you know, you see your homes totally demolished, and your children are hungry or dead, certainly people turn to desperation. Ifill how has the government response been. Unfortunately, the language element came in, and there wasnt very much explained to the public that there were going to be storm surges, and storm surges have been unknown. They might have been better if they described it as minitidal waves caused by the wind. So many people have suffered because of that and died. But the government is exacerbating the problem by not speeding up the efforts, and allowing more flights and ships to get in. The army and police would be able to have a very good grip and strong enforcement of peace and order. Ifill how is jur staff doing . How where they coping with the water, the food, the shelter, getting them to where they need to go . We have three containers of trucks, 25,000 liters of water. We have food were going to dring bring in. And also we have tents and provide hospitals for pregnant mothers or some privacy. And certainly, medicines, and were also helping out clearing, people clearing streets and going to towns with chain saws and concrete saws. Hopefully with about 65 people in place, we can be a lot better and more secure. Ifill richard gordon, chairman of the philippine red cross, thank you so much for joining us on the phone. Thank you very much. Ifill overall, it turns out, this has been just an average year for tropical storms. The u. N. Weather agency reported today there have been 86 storms worldwide three short of the annual average since 1981. The atlantic Hurricane Season was the quietest since 1994. But northwestern regions of the pacific ocean, have had more storms than usual, including typhoon haiyan. The First Official numbers on signups under the new Health Care Law are out and theyre far below the original targets. The department of health and Human Services reported today that fewer than 27,000 people enrolled on the federal exchange in october. It serves 36 states. Nearly 80,000 others signed up on state exchanges. Well have more on this, right after the news summary. The odds against Congress Acting on Immigration Reform this year, grew longer today. House Speaker John Boehner said the house will not act on the sweeping bill the Senate Passed in june. It provides a path to citizenship for the 11 million People Living here illegally. The idea that were going to take up a 1,300 page bill that no one had ever read, which is what senate did, is not going to happen in the house. And frankly ill make clear we have no intention of ever going to conference on the senate bill. Ifill meanwhile, president obama met with religious leaders to talk about immigration. The white house says they agreed theres a moral imperative to overhaul existing law. Secretary of state john kerry appealed to Congress Today to postpone action on new sanctions against iran. He spoke before joining Vice President biden in private meetings with the Senate Banking committee and democratic leaders. Kerry said sanctions wont help efforts to get iran to freeze its nuclear program. We now are negotiating, and the risk is that if congress were to unilaterally move to raise sanctions, it could break faith with those negotiations and actually stop them and break them apart. Ifill those Nuclear Talks between iran and six world powers are set to resume next week. Opium production in afghanistan has surged to record levels this year. The u. N. Drug control agency reported today its up nearly 50 since 2012. The poppy harvest produced more than 6,000 tons of opium, more than the rest of the world, combined. In kabul, a u. N. Official warned the huge supply is fueling the use of opium among afghans. translated afghanistan is confronted with an enormous addiction problem. They are hurting themselves. One million addicts and a growing population. We have the biggest opium cultivation witnessed ever and this in a consecutive three years time. Ifill cultivation of opium poppies in afghanistan has spread despite billions of dollars in International Aid to try to eradicate the crop. In iraq, a wave of new attacks marred the muslim holy day of ashura. At least 22 people died in bombings and shootings. Many were shiites commemorating the death of the prophet muhammads grandson in the seventh century. Militants also assassinated the mayor of fallujah, in western iraq. President obamas nominee to run the Homeland Security department told senators today its essential to fix the agencys internal problems. At his confirmation hearing, jeh johnson said filling personnel openings and boosting morale are even higher priorities than the core mission of fighting terrorism. Morale is driven in large part by just basic, economic issues. When somebody hasnt had a pay raise in a long time. And theyre threatened with sequestration or Government Shutdown that takes its toll. So i expect to address morale, but there are limits to what you can do without giving people some basic relief. Ifill most senators say they support johnson. Republicans Lindsey Graham and john mccain say theyll stall the nomination until they get more answers on Border Security and the attack on the u. S. Consulate in benghazi, libya. 21 nations in the middle east and nearby regions declared today that eradicating polio is an emergency priority. The virus recently paralyzed more than a dozen children in syria, and triggered mass vaccination campaigns in surrounding countries. The strain originated in pakistan, where militants have attacked polio workers, claiming theyre trying to sterilize muslim children. In economic news, the United States produced more oil than it imported last month for the First Time Since 1995. It follows several years of steadily rising domestic production. And on wall street today, the Dow Jones Industrial average gained nearly 71 points to close above 15,821. The nasdaq rose 45 points to close at 3,965. Still to come on the newshour the Technology Chiefs behind healthcare. Gov get grilled on capitol hill; another personal story of health reform; new guidelines in the fight against Heart Disease and stroke and the latest complications in the effort to bring all sides to the table in the middle east. Wooduff the rollout of the healthcare law took several hits today. Most significantly those low enrollment numbers of the 100,000plus people who enrolled in the new federal and state exchanges. A big part of the problem, of course, has been the plagued launch of the federal website, where at one point people could not even navigate healthcare. Gov. Well take a closer look at those figures in a minute. Republicans on capitol hill pressed the Obama Administration today on whether other motives played a role beyond the technical problems. Newshour Congressional Correspondent kwame holman has our report. This wasnt a small mistake. This was a monumental mistake to go live and effectively explode on the launch pad. Reporter and according to republican darrell issa chairing todays hearing the blame goes straight to Mission Control the white house. Ranking democrat Elijah Cummings fired back. Nobody in this room, nobody in this country believes that republicans want to fix the website. For the past three years, the number one priority of Congressional Republicans has been to bring down this law. Reporter still, republicans argued the websites woes are partially political. They suggested the reason people had to create accounts before they could shop for coverage was the administration feared sticker shock when they saw the cost. A Top Technology officer at medicare, henry chao, insisted the white house had no role in that decision. Absolutely not. It was a decision made on the results of testing. It would be pretty egregious and i understand that a lot of folks are wondering why the website is functioning the way it is, but to consciously know that it failed testing and to then put into production for people to use is not what we do. Reporter and the white house chief Technology Officer todd park, who appeared under subpoena, insisted theyre slowly getting the problems fixed. The website is Getting Better each week, as we work to improve its performance, its stability, and its functionality. As a result, more and more individuals are successfully creating accounts, logging in, and moving on to apply for coverage and shop for plans. Reporter park said the site now processes 1,700 new accounts an hour and handles 20,000 to 25,000 users at any given time, still less than half the original target. In fact, the Washington Post reported officials working on the troubled website now believe it is unlikely to be fully operational by the administrations november 30 deadline. Still, park maintained at the hearing they will meet the deadline. The team set a goal of having healthcare. Gov function smoothly for the vast majority of americans. The team is working incredibly hard to meet that goal. I thank the gentleman. With secure information . With secure information. Reporter that point will be crucial. A separate House Committee heard today that healthcare. Gov already has been targeted unsuccessfully, at least once, by a denial of service attack. The days hearings came as republicans and some democrats ratcheted up pressure on the administration over the cancellations of millions of existing policies. President obama promised repeatedly people who like their coverage could keep it. And just yesterday, former president clinton urged him to make good on the pledge. On the senate side, democrats Diane Feinstein and Mary Landrieu are cosponsoring legislation to guarantee that happens. Still, at the white house, press secretary jay carney cautioned today against legislative action. Again we dont believe that proposed legislation that actually causes more problems than it fixes is the right way to go. The president tasked his team as he mentioned last week to come up with proposed solutions and you can expect us to be announcing something sooner rather than later. Reporter and Senate Majority harry reid announced his Democratic Caucus will meet with white house officials tomorrow. Meanwhile, the house plans to vote friday on a bill letting people keep their existing coverage. Wooduff beyond the issue of cancellations, the question of expanded coverage looms large. The Obama Administration had hoped to get seven million more people enrolled in the first year of the new exchanges. Many experts are asking whether thats still doable. But during a Conference Call today, health and Human Services secretary Kathleen Sebelius told reporters that when the state of massachusetts passed its own law, enrollment there started very slowly, just 123 people in the first month. We know experience in the bay wooduff Mary Agnes Carey of Kaiser Health news is with us again tonight. Its an editorially independent news organization. Mary agnes, welcome back to the program. So what did we learn today from the administrations official release of these numbers . Well, theyre lower than expected. Administration officials for days, for weeks, have been trying to dampen expectations. These numbers would be great, and they certainly were not. Of the 10 6,000 people that have enrolled, you have about a quarter of those through the federal exchanges, and those are in 36 states. Thats really a big chunk of states that are being run by the federal government, the exchanges, and then the remaining threefourths were three the state exchanges set up in about 15 states and the district of column ja. Woodruff three to one that number reflects the state exchanges. To what extension is this consistent with what the administration has been saying . They have been saying publicly they did not expect to have, allw all the problems noted on healthcare. Gov, they didnt expect great enrollment numbers. Last month at a house waims and Means Committee hearing, dave camp, who chairs the committee, hadhad released the centers for medicare and Medicaid Services estimate that they expected by the end of october, around 494,000 people would have enrolled. This is way below expectations. Woodruff what are they saying about the progress they expect to make . They have this november 30 deadline to get it up are running. They were saying they continue to make fixes, they are confident the web site will work for the majority of users. They caution this is a sixmonth ren olement period so lets not make too much of the fact of the numbers that were announced today, and they talk about early enrollment for programs that are popular Medicare Prescription Drug programs for example. Those were pretty low in the early days. So this is more of a marathon than a sprint. Woodruff did we learn much more today about what the obstacles are . Whats holding this back . Or do we just assume its computer problems . It was very interesting, on the call itself, one of the reporters said he had just tried to create an account and couldnt do it, and one of the officials of the administration said thats an anomaly. Youre an outlier. Most people can get on to create an account. Its clear from the hearings on capitol hill and peoples experiences they still have a lot of problems with the web site that they have to correct and smooth out. I think when people are frustrated they dont necessarily go back. Woodruff but they also eye mean, i did listen to part of the call, and you heard them talking about the they gave some larger numbers for people who have begun the process of signing up. Right, exactly. Woodruff who were looking, exploring. Does that tell us something about the interest in this or did they have any speculation did bthat . There are about one million folks who signed up and created accounts and got eligibility determination. They havent yet made up their mind, and as the secretary was saying, people are look, theyre shopping, theyre looking at their options, trying to figure out if they qualify for a subsidy. That does provide . Comfort for the administration and they talk about all the interest, all the people coming to the site, the medicine checking it out, kind of kicking the tires to see if it works for them. Woodruff and theyre saying, again, this is what happened in massachusetts. Right, exactly, and theyre a little farther along than massachusetts was at this point. Woodruff mary agnes, stay with us. Ifill this brings us to another chapter in our series featuring reactions to the Affordable Care act, as more people become aware of the details. Yesterday we aired the story of a washington, d. C. Lawyer who was angry that her current insurance policy had been cancelled. Tonight we hear from a colorado woman who was diagnosed with cancer just before her husband lost his job and his health care plan. Heres some of what she told us i am martha monsson. Im 59 years old. I was diagnosed when i was 54, january of 2008, with multiple myeloma, which is a bone marrow cancer. The treatments for that mainly are chemotherapy, both oral and what the chemois for essentially, is reduce the number of cancer cells. This treatment is life saving. I would have died probably in february 2008 without it. When i was diagnosed, my husband was the county attorney in morgan county, and we had insurance through them. His job was eliminated, so since then he has been doing contract work which has kept income coming in, but for insurance, all weve had is through cobra, and that expires at the end of february. If he does not have another job by the end of february, which would give him insurance, we would have to apply for private insurance, we would get turned down because of my preexisting condition. Even if they were going to take me because of the preexisting condition, it would be hugely expensive. The Affordable Healthcare Act means that i have a chance, that i dont have to stop treatment once the insurance runs out, we will be able to get something. Yeah, yeah. But well have to pay more. Its huge, and i think particularly to my family, because they would not like to have to pull the plug. This law is very much a game changer for us. I am hoping that in january, when this comes into effect, that it will give me more of a chance, that i will not have to worry about the insurance we have not ending in february, that i will be able to keep getting treatment. Theres methadone, which is a pain pill for my spinal degeneration. When i was first diagnosed when i was first diagnosed well obviously the first reaction was to wish it hadnt happened but the second reaction was to wish it had happened someplace civilized, like france, or canada, where you get healthcare kind of as a matter of course, and it isnt as expensive as it is here. The problem, i think, is and frankly i was a little bit like that if theyre healthy, theyre going to say healthy forever, and even though i had insurance, i thought i was going to stay healthy forever. People who oppose it, i think very definitely dont have the bigger picture, they dont see that it can happen to them, and either they dont care, or they dont see what it does to other people. People are one diagnoses away, and they dont realize it to a large degree, but its very true. What i tell people who oppose the Affordable Care act is fine. If you want to abolish it, you can pay my medical bills. That would be wonderful. Give me a mailing address, and i will forward my bills to you. Wooduff Mary Agnes Carey of Kaiser Health news is still with us, to help put ms. Massons story in perspective. I want to say, our heart go out to her. Absolutely. Woodruff is and we appreciate her talking to us. Tell us, why is the Affordable Care act a welcome thing for someone like her . Because in the individual market before the Affordable Care act she would most likely be rejected for coverage, because she has cancer and her medical expenses are so high. This is a problem about 20 or so of people in the individual market applying for coverage get these rejection, based on medical status. That is no longer allowed. You cant be rejected because of medical condition. Woodruff this is a story that hasnt been told i think in many respects. People are aware of it, i think, but we dont hear about it that often. She put it out very well. Were all one diagnosis away from this sort of thing, and unless youve experienced it directly in your fleam or personally you may not think about the hardship that comes from this kind of diagnosis, and the fact that you can exawcht your limits pretty quickly on coverage and if you had to go out and buy it yourself you cant get it. Woodruff literally, mary agnes, what would someones option be in her situation if it had not been for the Affordable Care act . What could she have done . She talked about cobra, which is coverage you can buy from an employer. Once that ran out, she could go to an Insurance Agent to try to buy coverage in the individual market. She might have been denied. She might have gone into something called a hive risk pool. Theyre state run in many cases and they are there to help handle the high risk but that would also be an extremely expensive option for her. Depending on her family income, they may or may not have qualified for medicaid. Again, all of these are really tough choices. Woodruff and she mentioned her husbands situation. So much depends on where you live, your spouse or your familys situation. Right. Woodruff its not a cookie cutter one size fits all. Its very much geared towards your circumstances. That is the million underwriting going away with the Affordable Care act. Woodruff talk, mary agnes, about how big a part of the entire market of people, number of people looking for coverage are people like mismonson. You have about 14 Million People on the individual market. That represents about 5 of everyone who is insured. Of the 14 million, of those who apply, about 20 would be rejected based on their health care status. So its a small group, but a very powerful group because of the dhaj this does if you dont have Health Coverage and what it does for your medical treatment, what it does for your personal finances. Whats interestings to me is is this provision, even people who dislike the Affordable Care act, they like the idea that someone cannot be rejected on the basis of a medical condition for Health Insurance. Its a provision of the law that polls very well. Woodruff so is it literally the case that you are accepted under the Affordable Care act, no matter what your Health Condition is . Right. Woodruff no matter how far along an illness may be . Thats correct. They may have some adjustments based on your age or whether or not you smoke or live in the country, but are you allowed to have coverage in the Affordable Care act. An important think to know, as we talked about last night of niesht the whole stirk shock idea, this i this is one of the provisions driving up the cost for health premiums. Its an expensive provision but this plus the essential Health Benefits are two of the factors behind the sticker shock were hearing about. Woodruff part of the larger picture here, though swe know for this new law to work, not everyone can have can be sick. There have to be Healthy People signing up, too. Right. Woodruff explain how that works and that balance works. Its a balance of risk. The healthier individuals get into the same risk pool as the sicker individuals and help balance the risk out over time. Thats why you need someone like martha who is really circ who may or may not have problems signing up with healthcare. Gov, theyre going to hang in there to get coverage. The folks they also need to come into the risk people are people who currently have coverage and are healthier, may have had fewer medical problems, but stay in Health Coverage to help balance that risk. Woodruff but, of course, for those who are healthy, its harder to as youve just been saying its harder for them tond why it is something for them to seriously consider signing up. Right, and if theyve done well in the individual market as a healthier person, their premiums may increase. That was the woman we talked about last night. Her premiums are increasing. She had a few medical issues this year but overall had been a healthy person. If you had lower premiums in the individual market and you have been healthier, you may pay more under the Affordable Care act. Woodruff pulling back again, and thinking about what we talked about a foot of few minutes ago about what we learned today about the enrollment numbers, as the Insurance Companies watch all this that is happening, where the enrollment numbers, with the stories were telling about the individuals, like the woman we heard from last night and mismonson, how does it affect the behavior of these companies and their ability to take on new insurance policies . Theyve based their premiums for 2014, when the exchanges begin and the Medicaid Expansion begins and so on, based on an assumption that sick people would come in and Health People would come in, that people currently in plans that are not deemed to be up to snuff with the Affordable Care act, that theyll transition to new plans. So all this conversation we heard about, for example, letting people st on their Current Health insurance plans, that is going to undermine the risk pool, and could affect premiums in 2015 and beyond. So insurers are very closely watching this. Woodruff as are we all and i know are you. Absolutely. Woodruff Mary Agnes Carey, thank you very much. Sure, thank you. Ifill now, what people need to know about new guidelines concerning cholesterollowering drugs. Hari sreenivasan has the story. Sreenivasan the recommendations by the nations leading heart organizations are the first new cholesterol guidelines released since 2004. For decades, doctors have prescribed cholestrollowering statins to their patients, based on their laboratory numbers. But the new recommendations focus on risk factors, including whether individuals have diabetes or Heart Disease, or if they have a level of so called bad cholesterol, known as l. D. L. Thats 190 or higher. Dr. Harlan krumholz is a cardiologist and a professor of medicine at the yale school of medicine who has long studied this issue. Dr. Krumholz, how significant are these new guidelines . These guidelines are profound. Theyre a marked difference from the prior guidelines. Again, the ones were talking about are ones about decision about the use of medications. And we really have changed from a singular focus on targets, pushing people to get their cholesterol levels to a certain point, to thinking more holistically about the patient, their risk and what they stand to benefit from the use of drug therapy. Suarez when it doms l. D. L. , is that a bad measure . Should we not be keeping that in control . First i want to say the guideline getting all the attention is the one about drugs. We remain steadfast in our advocacy for people who fur sue Healthy Lifestyles and we prefer not to use medications at all. We like the population to lower their risk just by being healthier, by being more active and achieving the right weights and not smoke. But with regard to these drugs and thinking about cholesterol, the cholesterol hypothesis, the idea that cholesterol is important in Heart Disease remains. In cholesterol, the bad cholesterol and the good cholesterol turn out to be predictors of Heart Disease. But what weve recognized is maybe weve been treating some of the wrong people. Because by a singular focus on your lab test, we have perhaps often been treating people with mild elevations of bad cholesterol who were otherwise at low risk. And had relatively little to gain. And there have been others with low cholesterol who could have benefitted from some of these medications but who we may have neglectd not recognizing they had a lot to gain. Lets talk a little bit about those congratulations. Who now qualifies under the new risk calculator . So, the way that this works and there is a calculation, but i think its good to think about this as a general for instance pel, trying toidentify people wt to gain that is, those people for whom medication is likely to lower the risk so its worth taking the medication every day, worth exposing yourself to some of adverse effects. They said, look, if your cholesterol is markedly elevated, that should probably qualify you. By definition, youre at high risk if your bad cholesterol, the l. D. L. Cholesterol is markedly rel elevated. Although not everyone with diabetes is at high risk, if general we tend to think of it as elevating your risk, and we think people with diabetes would be best served by also being on these drugs. By the way on these drugs means statins. Another piece of the guidelines was deemphasize the drugs we have that lower l. D. L. Cholesterol but are unknown with respect to their benefit, like zetia, or some of the other drugs, the nonstatin derision drugz. They said if you have diabetes, thats another group that might be more likely to benefit. And after that, they said if you dont have diabetes or markedly elevated cholesterol, lets take a look at all of your risk factors and figure out if youre in a range where it might be worth it for to you take a statin. And then they have introduced a calculator thats online that people can use. But the general principle is trying to figure out am i someone who is likely to have a big benefit from taking these drugs. Because if youre not, and especially if the benefits really small, it may not be worth it to you. Sreenivasan how significant is the population size that may not be prescribed statins anymore or i should say the additional medications . I think theres some controversy right now. My own view is that the guidelines are just guidelines. Theyre helping us to think about what these experts when they sat in the room felt were the right thresholds for treatment where is my risk high enough to treat . The truth is we should be personalizing those decision. That takes place between a patient and their doctor. And it each person may have a different perception on whether its worth it to be treated. My sense of whats high risk that would make it worth it for me to take a medication may be very different than yours. For this guideline, they settled on a number. They said if your risk over 10 years of heart attacks and strokes was 7. 5 or greater about one in 12, one in 13 they thought it was probably worth it for to you take a statin. And they recommended it. My own view is that depend. I mean tfendz on you, and it should be personalized. I dont know at the end of the day whether more people or fewer people are going to be take statins, but i do know well be make wiser choices if were tailoring our treatments to what you stand to gain. And if youre making an informed choice base ode whether its really worth it to you, whether youre likely to benefit. Thats really where were turning from a singular emphasis on the lab test to trying to look ought as a whole about whether or not youre going to be able to avoid a heart attack or stroke and how big is the benefit for you . How likely is it youre going to be the one who will avoid prathat problem . Sreenivasan if we increase the pool of people who might qualify for statins, is there a chance that well have increased numbers of adverse side effects . Well, these drugs are fairly safe. Look, any drug we take has the potential for adverse effects, and staints, like all drugs, do have some rare adverse effects and they have some others that may cause problems. We know they can sometimes raise sugar levels, glucose levels. But the trials are fairly unequivocal. These drugs, by and larm, lower risk, and they lower risk by about 20 . They are tried and true. Theyre among the best drugs that we have. That being said, for someone who has got little to gain, i dont eye dont think that they should take them. These arent for everyone. I dont think they should go in the water. And it really is a personal choice, whether you think the potential benefit is big enough. But youre right if we treat lower people and in the past i think weve done that by focusing on the lab test those people may have more harm than good. Thats why we have to focus on those most likely to of benefit. Sreenivasan all right, harlan krumholz, thank you so much for your time. Thank you. Wooduff tensions have been mounting between the u. S. And israel, over the iran Nuclear Talks and recent stumbling blocks in peace negotiations with the palestinians. Jeffrey brown has the story. While i understand the skepticism, i dont share it and i dont think we have time for it. Brown that was secretary of state john kerry in july, announcing the restart of israelipalestinian talks, aimed at reaching a twostate solution by next may. Im convinced from my conversations today with Prime Minister netanyahu as well as with president abbas that this is not mission impossible. This can happen. Brown and that was kerry in bethlehem last week, pressing for progress despite rising tensions. Only two days earlier, israel had announced plans to construct 1,700 new homes for jewish settlers in the west bank. Palestinians angrily accused the israelis of not negotiating in good faith. translated we want peace and we want negotiations but peace should be fair, and guarantee the right of return, selfdetermination, a palestinian state, the release of all prisoners, and Settlement Expansion should stop. Brown after meeting with kerry, israeli Prime Minister Benjamin Netanyahu charged its the palestinians whove failed to live up to their promises. Im concerned about the progress because i see that the palestinians continuing with incitement, continuing to create artificial crisis, continuing to avoid and run away from the historic decisions that are needed to make a genuine peace. Brown but on israeli television, kerry bluntly warned of what might happen if there is no progress. The alternative to getting back to the talks is the potential of chaos. I mean, does israel want a third intifada . Brown then, yesterday, the Housing Ministry announced plans to build another 24,000 homes in disputed territory. But within hours, netanyahu halted the move, saying it would create unnecessary confrontation with the International Community. Today, palestines chief negotiatior said the damage has been done and that his team is resigning. Hanging over all this are the ongoing talks with iran about its nuclear program, watched warily by the israelis and other key regional players. So where does the Peace Process stand, and what is the state of u. S. Israeli relations . Were joined by robert satloff, executive director of the Washington Institute for near east policy. And hussein ibish, senior fellow at the American Task force on palestine. Welcome to both of you. Thank you. Brown robert satloff, lets pick up on that last part, the iranian element. How large a shadow does that cast over any potential peace talks between israel and the palestinians . It castaise very, very broad shadow. We are in unchartered waters in the u. S. Israel relationship today. Brown unchartered waters. After all these years . After all these years, after all the different ups and downs, this is a new scenario in which the United States and israel are at loggerheads over an Immediate National Security Initiative of the United States namely, the negotiation of a first step agreement with iran. The Prime Minister of israel says its dangerous not just for American Interest but for his interest. The United States president and the spokesman for the white house has said that if you are opposed to what is being put on the table, are you a warmonger. And so this is a clash unlike any ive seen in 30 years in washington. Brown and your sense is that holds00, in a sense, any peace talks with the palestinians . To be precise, israels confidence in america as a mediator in the israelipalestinian negotiations is totally derivative of its confidence in the iran talks. Brown lets get hussein ibishs assessment of that. I think thats a very good summation of what the Prime Minister of israels Office Thinks and says. They have, i think, framed everything to do with the israelipalestinian negotiations, including the cancellation of this extraordinary 24,000unit plan, including this very sensitive e1 construction area, which would be a strategic game changer on the ground, in terms of their confidence in the United States deriving from in other words, everything gets refracted through iran. But that is not the american perspective. That is the israeli perspective, and it might be an understandable one, but the american perspective, which has been articulated by president obama many times and by secretary of state kerry, is that if the two issues are linked, theyre actually linked the other way around. In other words, that making progress between israel and the palestinians helps the International Community deal more robustly with iran. I actually think that everything is linked together. But such a straightforward binary linkage, as was described by mr. Satloff, and as is being provided by Prime Minister netanyahu, is the kind of crude linkage that weve been trying to get away from for the past 20 years. Brown go ahead. Its not that the israelipalestinian issue is in any way linked to the iran issue. Thats not it. What is the connection is that any confidence that israel will have in an american mediation, any ideas that the United States will put on the table to solve, say, the security challenges, which americas been looked to, to provide answers will be totally dependent that america is looking out for the best security interests in the Biggest Issue facing world today, which is the iran negotiations. Brown bring the palestinian side into this. Where does that leave them and what role are they playing at this point . Theres not much they can do visavis iran. They really are not part of the equation, and that sort of underscores the except to which while youre absolutely right, theres a question of confidence in not only that israel has, saudi arabia has, and other regional allies have in the United States has been somewhat disrupted by various different policy scenarios over recent months. Its still the case that the israelipalestinian conflict is a pressing need that exists in a regional context, needs to be resolved in a regional context, but that also cannot be shelved. It cant be said by anyone seriously, that palestinians just have to wait until the Nuclear Issue with iran is resolved, or that somehow thats a key. And even if it were a question of, say, bringing the sowdez into the mix through the arab peace initiatives or bringing egypt into the mix because of their relative importance in the arab world and their control over the gaza crossing, it would still be an issue that has to be dealt with. There are really important things that need doing here on their own. Brown bring the u. S. Back into the mix. Because we saw secretary of state kerry with some pretty hard language, harsh language, referring to a potential third intifada. How much lonch does he have in this case . I think its quite regrettable what happened over the last 10 days as we saw a u. S. Israel breach on both israelipalestinian issues and the iran negotiations. It really didnt have to be this way. I think in retrospect, the secretary probably regrets suggesting the bona fidies of israel, the israeli brown thats how it was taken. When you want a third intfeuda youre not serious. When you took the settlement issue im not going to defend israeli settlement policy, but what the secretary did is he took the announcement of 1900 departments, only 200 of which are east of the security fence, east of the barrier, and turned this into the greatest attack on the potential for peace ever. Its it was it wasnt wise at a moment when he needed israels understanding from what was about to happen with iran . And now israel thinks, my gosh oiran, theyre going in a different direction. On the Peace Process theyre in a different direction. Maybe theyre really not the Strategic Partnership that we thought we had. Well, thats got to cut both ways. Obviously, if israels disappointed in the United States, its very likely the United States is disappointed with israel. Look, our regional allies israel, saudi arabia, egypt these are regional powers with regional interests. We are a global power with global interests. Its understandable if israel is obsessed with iran, and thinks only in terms of iranian issues. The United States cant do that. We have to deal with multiple issues. We have to deal with syria. We have to deal with the israelipalestinian crisis. We have to deal with repairing our relations with saudi arabia and egypt. And many other things, all over the world. So youve got to come back to the israelipalestinian file as one that the United States takes seriously on its own. It cannot be held hostage. Brown very briefly, do you think that will happen . I do, actually. I think there is an ability that the United States has to make this issue to bring this issue to the fore. If the United States wants to focus on it, the parties will focus on it. And i think clearly the intervention to stop this Settlement Expansion is inspired by washington in one way or another. Brown okay, we are going to have to leave it there, but well keep watching, robert satloff, and hussein ibish, thank you very much. Thank you. Thank you. Wooduff again, the major developments of the day the typhoon death toll in the philippines neared 2,350, and survivors ransacked whole warehouses for food. The Obama Administration reported fewer than 27,000 people enrolled for Health Insurance, during october, on the problemplagued federal website. Nearly 80,000 others signed up on state exchanges. And secretary of state kerry urged congress not to impose new sanctions on iran for now. He said any such move would damage negotiations to freeze Irans Nuclear program. Ifill on the newshour online right now, nearly half of boomers dont have enough savings to cover basic expenses in retirement. What can be done to make up the difference . One of our making sense regular columnists has some ideas. All that and more is on our website newshour. Pbs. Org. Woodruff this week and next, pbs is airing many special programs to mark the 50th anniversary of president john f. Kennedys assassination. Tonight, two of them feature newshour alumni, jim lehrer and Robert Macneil. They were both in dallas covering the events of november 22, 1963. Jim appears on nova, as it searches for fresh clues to the assassination. Ifill and robin recalls details about how carefully the news media handled the announcement of the president s death on secrets of the dead. Food for thought in this age of twitter. Check your local listings for the times. Woodruff and thats the newshour for tonight. On thursday, well have an exclusive. The first t. V. Interview with the new head of the a. T. F. Plus, Robert Macneil is with us to talk about his latest book. Im judy woodruff. Ifill and im gwen ifill. Well see you online and again here tomorrow evening. For all of us here at the pbs newshour, thank you and good night. Major funding for the pbs newshour has been provided by moving our economy for 160 years. Bnsf, the engine that connects us. And with the ongoing support of these institutions and foundations. And. This program was made possible by the corporation for public broadcasting. And by contributions to your pbs station from viewers like you. Thank you. Captioning sponsored by Macneil Lehrer productions captioned by Media Access Group at wgbh access. Wgbh. Org  this is nightly Business Report with Tyler Mathisen and susie gharib brought to you in part by. Thestreet. Com. Up to the minute Stock Market News and in depth analysis. Our quant Ratings Service provides objective independent ratings daily on over 4300 stocks. Learn more at the street. Com nbr. Numbers game, the department of health and Human Services tells how many people bought policies on the troubled federal Health Insurance exchange. Critical mass or critical list for the new Health Care Law. Ch change, comments about the upcoming holiday season. Is the consumer stronger than first thought