Transcripts For KQED PBS NewsHour 20170118

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And by contributions to your pbs station from viewers like you. Thank you. Woodruff he has given his final major speech, and now, president obama has also held his final News Conference. He spent an hour before the White House Press corps today, two days before his presidency ends. John yang was there. Reporter in his 22nd, and final time facing reporters in the White House Briefing room, president obama today defended his decision to commute the sentence of Chelsea Manning, the former Army Intelligence analyst convicted of leaking u. S. Military and diplomatic secrets. Chelsea manning has served a tough prison sentence. So, the notion that the average person, who was thinking about disclosing vital classified information, would think that it goes unpunished i dont think would get that impression from the sentence that Chelsea Manning has served. Reporter most of the News Conference was spent looking ahead, to the fate of his own accomplishments, after president elect Trump Takes Office my working assumption is that, having won an election, opposed a number of my where its appropriate for him to go forward with his vision and his values and i dont expect that theres going to be, you know, enormous overlap. Reporter he also shed light on the counsel hes offered mr. Trump this is a job of such magnitude that you cant do it by yourself. You are enormously reliant on a team. Your cabinet, your senior white house staff, all the way to fairly junior folks in their 20s and 30s, but who are executing on significant responsibilities. Thats probably the most useful advice and constructive advice ive been able to give him. Reporter he expressed hope that he could take a pause from politics, but made clear hed speak out when compelled to do so certain moments, where i think our core values are at stake. I put in that category, if i saw systematic discrimination being ratified in some fashion, efforts to round up kids who have grown up here and for all practical purposes are american kids, and send them someplace else. I think that would merit me speaking out. Reporter and he weighed in one last time on an issue that has dogged president s for generations, the Israeli Palestinian conflict if you do not have two states, then, in some form or fashion, you are extending an occupation. Weve believed, consistent with the position take with previous u. S. Administrations for decades now, that it was important for us to send a signal. A wake up call, that this moment may be passing. Reporter mr. Obama also reflected on how america has changed during his presidency, on social issues, like attitudes on l. G. B. T. Q. Rights. I dont think it is something that will be reversible, because American Society has changed, the attitudes of young people have changed. That doesnt mean there are going to be some fights that arent important. Legal issues there are still battles that need to take place. Reporter the president lamented what he sees as undue restrictions on voting rights, which he said was a lingering vestige of slavery and jim crow this whole notion of voting fraud has constantly been disproved. This is fake news, the notion that there are a whole bunch of people who are out there and going out there and are eligible to vote and are not able to vows. We have a bunch of people who are eligible but dont vote. Reporter as mr. Obama, the nations first black president , prepares to leave office, after the first female president ial nominee was defeated, he expressed confidence that more barriers will be broken in the future. If in fact, we continue to keep opportunity open to everybody, then yeah, were going to have a woman president. Were going to have a latino president and well have a jewish president , a hindu president. Who knows what were going to have . I suspect well have a whole bunch of mixedup president s at some point, that nobody knows really what to call them. Once he becomes a former president , mr. Obama says he looks forward to writing, being what he calls quiet he says he doesnt want to hear himself talk so much in the future and also being a consumer of news rather than the subject of news. Judy . Woodruff john, i also thought the president acknowledged the role that economic inequality played in the results of the election. Yang thats exactly right. He spoke about that in the context of a question about inclusion and diversity. He said its important for all americans to feel a part of the growing economy. He said he thought there were a lot of people who voted for mr. Trump because they felt forgotten and disenfranchised and looked down upon. Woodruff john, you had a busy day because i know before the president s News Conference you attended a briefing by the trump transition team, and they were talking about getting ready for the inauguration. Yang thats right. Sean spicer who will be the press secretary here at the white house starting on friday said that mr. Trump has been rehearsing his inaugural address. He said that he wrote it himself with input from policy advisor Stephen Miller from kellyanne conway, from Reince Priebus whos going to be white house chief of staff, from steve bannon whos going to be white house counselor, he said its going to talk about common goals, and mr. Trump himself said the theme is going to be america first. Sean spicer was asked if any part of the speech is going to reach out to americans who didnt vote for mr. Trump. He said mr. Trump doesnt feel he should be judged on his rhetoric or symbolism but wants to be judged on his actions and successes. Woodruff all really interesting. John yang, keep holding down the force for us at the white house and are the trump transition team. Thank you. Well, this was a day for team trump to talk health and environment at two senate hearings. The Health Secretarydesignate, tom price, defended his investments in medical stocks and played down talk of overhauling medicare. And scott pruitt, nominated to run the Environmental Protection agencysaid he does not believe Climate Change is a hoax, as the president elect has suggested. We will have full reports, after the news summary. Regarding Climate Change, is news that Global Temperatures hit a record high in 2016, for the Third Straight year. The data is from nasa, the National Oceanic and Atmospheric Administration and the british. They say the average last year was more than 1. 5 Degrees Higher than in the mid20th century. They say it was caused by manmade Greenhouse Gases and an el nino event. The nominee to be u. N. Ambassador says russia committed war crimes in syria, and cannot be trusted. South Carolina Governor Nikki Haley offered a harsher assessment today than mr. Trump has, at her own senate hearing. Russia is trying to show their muscle right now. It is what they do. And i think we always have to be cautious. I dont think that we can trust them. I think that we have to try and see what we can get from them before we give to them. Woodruff haley also blasted a u. N. Resolution that condemned israeli settlements, and she voiced support for moving the u. S. Embassy from tel aviv to jerusalem. Meanwhile, the nominee for commerce secretary, wilbur ross, put china on notice today. The billionaire investor told his confirmation hearing that the chinese are the most protectionist country among the major economies. They have both very high Tariff Barriers and very high nontariff trade barriers to commerce. So, they talk much more about free trade than they actually practice. We would like to levelize that Playing Field and bring the realities a bit closer to the rhetoric. Woodruff ross also said the Trump Administration will focus on renegotiating the north Atlantic Free trade agreement, very early on. Seperately, the Senate Armed Services committee easily approved the nomination of james mattis for defense secretary. It goes now to the full senate. In west africa, a suicide attacker drove a car bomb into a camp in northern mali, killing at least 60 people and wounding 115. The attack struck a base in the city of gao, where soldiers and former rebels are trying to enforce a 2015 peace treaty. Later, an Islamist Group linked to alqaeda claimed responsibility. In nigeria the International Red cross now says at least 70 refugees and aid workers died tuesday when the air force accidentally bombed a u. N. Camp. The military says it was trying to target fighters with the militant boko haram group. At least 46 severely wounded people remained at the camp today, near the border with cameroon. U. N. Officials have called for a full investigation. Iraqi Government Troops announced today they have taken full control of eastern mosul. The military said it drove Islamic State militants out of the last neighborhoods after a threemonth operation. Today, people cheered and took pictures with soldiers. And, commanders talked of the coming operation to liberate western mosul. translated in the last few days, our forces movements became quicker and clearing of districts became faster. The reason is that, when they were defeated, they retreated. I think the western side will be easier to liberate from the eastern side. Woodruff despite the militarys announcement, there were reports of continued fighting in mosuls eastern half. Back in this country, the u. S. Supreme court will decide whether barring racially offensive trademarks violates free speech. The justices heard arguments today over a 70yearold law. It is being challenged by an asianamerican band named the slants. The ultimate decision could also affect the nfls washington redskins. The u. S. Secret service has agreed to pay 24 million to settle a longrunning Racial Discrimination lawsuit. More than 100 African American agents are part of a suit filed back in 2000. They say the agency fostered racist culture and routinely promoted whites over qualified blacks. Under the settlement, the secret service does not admit any wrongdoing. On wall street, the Dow Jones Industrial average lost 22 points to close at 19,804. The nasdaq rose nearly 17 points, and the s p 500 added four. And, former president george h. W. Bush and his wife, barbara, are both hospitalized in houston this evening. Mr. Bush was admitted saturday with pneumonia, and moved into the intensive care unit today. A Spokesman Says hes stable. Mrs. Bush entered the same hospital today, as a precaution, for fatigue and coughing. Still to come on the newshour several trump cabinet nominees face tough questioning at their confirmation hearings; the exciting yet elusive possibilities of nuclear fusion, and much more. Woodruff lets turn to the confirmation hearings for the president elects cabinet, and one of mr. Trumps most repeated pledges is to repeal and replace obamcare, more formally called the Affordable Care act. Congressman tom price is he faced some tough questions today about his own record, when he appeared before the committee on health, education, labor and pensions. Lisa desjardins has our report. Reporter when tom price doctor, congressman and hopeful Health Secretary today faced the Senate Health committee, the spotlight fell equally on the fate of the Affordable Care act he wants to repeal and on prices own history. Senator patty murray launched a democratic theme you purchased stock in innate immunotherapeutics, a Company Working to develop new drugs, on four separate occasions between january 2015 and august 2016. You made the decision to purchase that stock, not a broker. Yes or no . That was a decision that i made, yes. Reporter price stressed that other Health Stocks he owned were chosen by his broker. The questions arise from his financial disclosures, showing price invested in healthrelated companies in the past two years, as he pushed legislation in congress that benefited those companies. Your purchases occurred while the 21st century cures act, which had several provisions could that could impact Drug Developers like innate immunotherapeutics, was being negotiated. And again, days before you were notified to prepare for a final vote on the bill. Reporter price insisted those bills were consistent with what hes done for years, and that while he did get a private stock offer, he had no special knowledge of the company. I had no access to nonpublic information. Reporter minnesota senator al franken pointed to a recent wall street journal report finding that price traded more than 300,000 of healthrelated companies while simultaneously working on policy affecting those companies. These sound like sweetheart deals, and i think that our job, in this body and in congress and in government, is to avoid the appearance of conflict. And boy, you have not done this. Reporter the exchanges moved from calm to tense. Price pushed back, insisting he would never use his office for financial gain. What i did was comply with the rules of the house in an ethical and legal and transparent way. Reporter republican orrin hatch called the democratic push for an investigation hypocrisy, pointing out no rules in Congress Prevent stock trades. In fact, there are members on this committee who have, as i understand it, who have traded individual Health Stocks while serving on this committee. Now, this appears to be nothing more than a hypocritical attack on your good character. Thank you, sir. Everything that we have done has been above board, transparent, ethical and legal. And as you know, and the members of this committee know, theres an organization thats called the office of government ethics, that looks at all of for every cabinet nominee looks at all of the possessions, all the holdings and the like, and makes a recommendation as to what that cabinet member must do in order to make certain that theres no conflict of interest. The office of government ethics has looked at our holdings and given advice about what would need to be done in terms of divesting from certain stock holdings. Reporter as part of the nomination ethics process, price has pledged to divest from 43 companies, including those the democrats raised, within 90 days of his confirmation. I think some of the things that have occurred with the passage of the a. C. A. Have improved certain areas. The coverage is certainly improved. But the consequences of that, i mean, that many people, as ive mentioned before, have coverage but they dont have care. I think that the more involvement that patients and families and doctors can have in medical decisions, the Higher Quality care well have. Reporter mr. Price, who practiced as an Orthopedic Surgeon for more than two decades, proposed his own detailed plan last year, offering some tax credits and repealing the medicaid expansion. To him, that means Less Government interference, but to senator elizabeth warren, it means cuts to needy populations. What we believe is appropriate is to make certain that the individuals receiving the care actually receive it. I understand why you think youre right to cut it. Im not asking the question. Did you propose to cut more than a trillion dollars out of medicaid over the next 10 years . You have the numbers before you. Reporter mr. Price insisted that a republican replacement plan would ensure widespread access to care. My role in congress was to always make certain that individuals had the opportunity to gain access to the kind of coverage that they that they desired and that they had the financial feasibility to do so. Reporter but access, senator Bernie Sanders said, is not the same as coverage. I have access to buying a 10 million home. I dont have the money to do that. Reporter mr. Price next goes before the Senate Finance committee on tuesday. Woodruff scott pruitt also took his turn in the hot seat today. If confirmed, he would be the new head of the Environmental Protection agency, and the president elect has said he wants him to reverse eight years of president obamas environmental policies. Democrats wanted to see how far he plans to go. Jeffrey brown has the story. Reporter as the hearing began, democrats focused on todays announcement from nasa scientists that the earth had seen record temperatures for a Third Straight year. This exchange followed. Donald trump has called Global Warming a hoax caused by the chinese. Do you agree that Global Warming is a hoax . I do not, senator. So, donald trump is wrong . I do not believe that Climate Change is a hoax. Reporter but in his opening statement, scott pruitt had an important caveat science tells us climate is changing. The ability to measure that impact are subject to debate and dialogue, and well it should be. Reporter pruitt made clear he does believe strongly in states rights, and said hed work to return the federal watchdog to what he considers its proper role. Federalism matters. It matters because Congress Says so, and because we need it to achieve good outcomes as a nation, for air and water quality, we need the partnership of states. It is our state regulators who oftentimes best understand the local needs and the uniqueness of our environmental challenges. Reporter as Oklahoma Attorney general, pruitt filed 14 lawsuits against the e. P. A. And an array of Obama Administration environmental rules. And in the past, hes said he will work to repeal the president s centerpiece climate regulation, cutting Carbon Emissions from power plants. Today, several democrats raised concerns over the health ramifications. Weve had children die in new york city because none of their teachers, none of their administrators in their schools knew what to do when they had an asthma attack. Its a huge problem. So, i need you to care about human health and really believe that the cost, when human health is at risk, when people are dying, is far higher than it is the cost to that polluter to clean up the air. I need you to feel it as if your children sitting behind you are the ones in the emergency room. I need you to know it. And senator, i would say to you, there is certain instances where cost cant even be considered, as you know. Those criteria pollutants that are in the acts program. Cost is not even a factor because human health is the focus. Reporter environmental protesters interrupted the proceedings several times. One was forcibly removed into the hallway. At various points, some democrats showed their irritation at what they saw as pruitts vague responses. For their part though, republicans praised pruitt for his work in oklahoma, including his handling of a dispute involving poultry industry run off into the illinois river. Pruitt negotiated a deal and ordered further study, ending the legal fight. Democrats pointed to Campaign Contributions pruitt had received from Poultry Company officials. But republicans focused on what they see as economic harm and bureaucratic barriers raised by the e. P. A. Republican senator deb fischer of nebraska as a result of the activist role the e. P. A. Has played for the past eight years, families are concerned about the futures of their livelihood. What steps will you take as e. P. A. Administrator to provide relief for American Families that are faced truly with an onslaught of e. P. A. Rules . Its very important that process be adhered to, to give voice to all americans in balancing the environmental objectives we have, but also the economic harm that results. The Supreme Court has spoken consistently of that. I would seek to lead the e. P. A. In such a way to ensure openness and transparency. Reporter scott pruitt is expected to confirmed by the full senate, with support from all 51 senate republicans. For the pbs newshour, im jeffrey brown. Woodruff we also wanted to follow up on the confirmation hearing for the president elects pick for education secretary, betsy devos. Last night, we told you about some of her basic ideas, but after our broadcast, we learned some Important Information as her hearing continued. When pressed, she would not rule out using public funds for private schools. She also seemed opposed to free tuition for community college. She was asked about her commitment to civil rights for students who are l. G. B. T. Q. , and past contributions to groups opposed to same sex marriage. She also faced a tough exchange from democratic senator chris murphy of connecticut on whether guns should be carried on schools campuses. One final question, do you think guns have any place in or around schools . I think thats best left to locales and states to decide. If the underlying question is you cant say definitively today that guns shouldnt be in schools . I will refer back to senatorrensy and the school he was talking about in wyoming. I think probably there, i would imagine that theres probably a gun in the school to protect from potential grizzlies. If President Trump moves forward with his plan to ban gunfree school zones, will you support that proposal . I will support what the president elect does, but, senator , if the question is around gun violence and the results of that, please know that i my heart bleeds and is broken for those families that have lost any individual due to gun violence. I look forward to working with you but i also look forward to you coming to connecticut and talking about the role of guns in schools. Woodruff woodruff devos was also asked repeatedly about how she would enforce the disabilities law for education. At times, she did not seem certain about some provisions. Senator tim kaine of virginia, a democrat and the former Vice President ial candidate, had this exchange. Should all schools that receive taxpayer funding be required to meet the requirements of the individuals with disabilities in education . I think thats a matter thats best left to the states. So some states might be good to kids with disabilities, and other states might not be so good, and then, what, people could just move around the country if they dont like how their kids are being treated . I think thats an issue best left to the state. I think all schools who receive federal funding, public or charter, should be required to meet the conditions for individuals with disabilities and education act. Do you agree . I think thats worth discussion. So you cannot yet agree with me. Woodruff lets conclude all of this with a look at where things stand for the trump cabinet. There has been talk that while most of his picks will be confirmed, possibly one or two could face trouble. And we are joined for that again by lisa desjardins, who joins us from capitol hill. Lisa, theres also news today about president elect trumps pick to be head of the office of management and budget. Thats right, someone not with the hearing today is making the headlines, representative Mick Mulvaney of south carolina. We know senator mulvaney in early 2000 failed to pay taxes for one of his household employees. It was a baby sitter, a Childcare Provider for he and his wifes triplets. Mulvaney disclosed this information to the snalt Budget Committee about a month ago and has paid some back taxes, about 15,000. H hes waiting for the bill from his state as well. This is significant because issues like this have scuttled nominations for others including another former member of congress tom daschle, the nominee for h. H. S. Secretary and zoe bared under president clinton who was nominee for attorney general. We are not hearing anything from senate republicans. Senate democrats are going after this very strongly. I did talk to senator john mccain who is the chairman of the Armed Services committee, and he tells me he thinks this is fairly serious. Woodruff so, lisa, one other thing, you were telling me earlier that there were pretty there are pretty serious negotiations going on between the democratic and Republican Leaders in the senate over the order that these nominees will have a confirmation vote. Yes, and specifically how many are confirmed day one. We know President Trump has been looking at president obamas number, seven confirmations on day one. Doesnt look like he will come close to that. Democrats are negotiating whether they will allow any nominees to be confirmed on day one. They can hold up a nomination over the course of a sing daily or more, and this theyre talking about the doubts they have and the problems they have with what they say the way these confirmation hearings have been rushed through. Republicans say thats not fair and they want the same treatment the obama nominees received. I think whats important to watch for, judy, is especially the defense on Homeland Security positions, those are the most important to republicans. Well see if any of those are confirmed on day one. All of that is in the air even just two days out from inauguration. Woodruff a lot to follow, lisa desjardins, thank you very much. January 20th, 2017, the inauguration of donald j. Trump, the 45th president of the united states. Day one of a new era. Join pbs newshour for live coverage and analysis you wont find anywhere else. Friday, january 20th at 11 00 a. M. , 10 00 central, only on pbs. Woodruff stay with us. Coming up on the newshour an entirely new level of gridlock in new york city, surrounding trump tower; and the importance of treating Health Problems over long periods of time. But first, the hunt to create Fusion Energy. While many people remain worried about pursuing further development of nuclear power, some researchers believe fusion could hold the key to clean and plentiful energy. There have been many false starts before. But some see reason for hope. Reporter in southern california, this complex, power hungry machine is hard at work on a seemingly quixotic mission, akin to catching lightning in a bottle. It is a plasma generator. Its builders hope its a key step in the long journey to the holy grail of Energy Production fusion. Fusion is natures preferred way of making power. Reporter Michl Binderbauer is chief Technology Officer for a startup called tri alpha energy, that is making a 500 million bet on fusion. Think of this like a mini sun, a very hot minisun, and it radiates, and its that radiation that is intercepted on the surface of the machine, and then it becomes heat, and then you can process that into electricity. Reporter the promise no less than limitless power, with virtually no Greenhouse Gases or radioactive waste. If that sounds too good to be true. It is. No one knows that better than Nuclear Engineer steve dean. Fusion is not low tech. Its not going to be easy to prove that its reliable, maintainable and costeffective, because it is complicated. Reporter dean is president of fusion power associates, a foundation focused on research and education. He joined the fusion industry in 1962, working for the u. S. Atomic energy commission, which coordinated and funded the u. S. Fusion effort. For me, it seemed like it was something i could spend my career on and we would have electricity on the grid by the time i retired. Thats what i thought. So, it didnt happen that way. Fusion is as old as the cosmos. It is the Nuclear Reaction that takes place in our sun and all the other stars in the universe. In a fusion reaction, Hydrogen Atoms collide at high speed, fusing together, forming a helium atom, releasing one neutron. Since the mass of the helium atom is less than the combined mass of the two atoms that collided in the first place, energy is released. explosion the dawn of manmade fusion broke over the pacific in 1952, with the first explosion of a Hydrogen Bomb. The Hydrogen Bomb was a quick success. And so, derivative of that was euphoria. A few more years, we could do civilian Energy Production out of fusion. And while there were glimmers of hope along the way, we all now know painfully that hasnt happened. Reporter in the 1950s and 60s, researchers looked for ways to control, confine and sustain fusion so that it could be used as an energy source. They tried newlyinvented lasers, a u. S. Design called stellarator, and then a russian design called tokamak a big circular racetrack that uses powerful electromagnets to suspend and accelerate particles, prompting fusion generating collisions. Over the years, they have gradually answered many of the questions. Right now, there are still physics issues that have to be proven, but the physics is very wellknown. The only thing that isnt known is when you do something thats a little bit more closer to a power plant, whether theres something new will show up in the physics. You cant really predict that. Reporter thats what this huge project is all about. It is the biggest tokamak ever designed, under construction in france the International Thermonuclear experimental reactor, or iter. A joint project of 35 nations, including the u. S. , it is the First Engineering test of a fusion power plant. Iter is a 14 billion endeavor that is six years late and 10 billion over budget. It is designed to one day use 50 megawatts of electricity to generate 500 megawatts for 15 minutes. At some point, in order to get to a power plant, you have to build what we call an engineering test reactor, or something that really works, thats putting out lots of Fusion Energy and has a lot of the engineering thats needed for a power plant. And iter and the tokamak is the only track thats at that stage. Three, two, one, go. Reporter but there is a lot of fusion progress on a smaller scale. Teams in germany, china and south korea have recently reported longer sustained fusion reactions than ever before. Tri alpha is the largest of about a dozen startups trying to make it work. We partner up with some of the best and brightest in the field. Reporter Michl Binderbauer began his work in academia, but believes the private sector might have a better chance of success. It made us lean. It made us focused. It made us an organization that was nimble to react to small changes quickly and think on our feet very quickly. And i would attribute part of our success to exactly that. And theyre also building on many more years of physics understanding and progress. So they can be smarter now, whereas in the past, a lot of times, their ideas were interesting but there wasnt any physics basis for having confidence. Reporter the fundamental fusion problem is, it is not easy to get nuclei to collide and fuse. They are all positively charged, so they naturally repel each other, like two magnets. So we use Magnetic Fields to provide that magnetic bottle, if you will, into which you put the charged clouds of particles. The gas wants to escape and distribute out and were holding that in with magnetic force. This is not like how its done in the sun, where you have massive gravity, does the same job. So here its all electroMagnetic Fields. Reporter it takes a lot of energy to create those Magnetic Fields. In fact, the real challenge in fusion is creating plasma that generates more energy than it takes to make it in the first place. Historically, scientists have opted to go big, like iter. One event makes a very small amount of practical energy. You have to have billions of these events. That means you have lots of these things happening in a large volume. Reporter tri alpha is taking a different approach, that would not require such a huge structure. The idea is to fire two footballshaped plasma clouds at each other at supersonic speeds. At the center of the chamber, they collide violently, fusing into a larger football. Additional particles are fired at right angles, making the plasma ball spin like a well thrown pass. The particles always come in like this, and they go into the rotation of the main object. So, it feeds in like this to maintain that rotation rate. Reporter the rotation suspends the plasma in place. They are testing constantly, sometimes 50 times a day. Each shot requires about 20 megawatts of electricity enough to power all the lights and appliances in 5,000 homes, but for only a few thousandths of a second. Gleaning data from a hot ball of nothing that lasts for much, much less than the blink of an eye requires a lot of clever testing tools. Ultimately, physics is an experimental science. And as such, it relies on hardcore evidence coming out of an experiment. At the stage where we are at, we are dabbling a fine line between learning what works and tweaking that and advancing it in another step. Reporter binderbauer believes a commercial fusion system will be available in a decade. Our great, great, Great Grandkids are going to live in a world powered by fusion almost exclusively. Reporter but industry graybeards like steve dean are less willing to make such predictions. After all, Fusion Energy has remained decades away, for many decades. Is it inevitable in your view . Yeah. Reporter just a matter of time . I think its just a matter of time. I used to say, in my lifetime, then i started saying, in my childrens. And now i think, before a wide scale use, as to being at least my grandchildren. I cant predict. Reporter right now, we do not have an Energy Crisis to spur the effort, but we do have a climate crisis. Fusion remains an alluring yet still elusive way to power the planet, the same way nature does. Miles obrien, the pbs newshour, foothill ranch, california. Woodruff with just a couple days left until the inauguration, the nations attention is on president elect trumps move into the white house. But midtown manhattan residents are still focusing on the gold skyscraper of trump tower which will continue to be a home for the trump family. Producer rhana natour looks at the unprecedented challenges of securing that residence, and the financial fallout. Reporter this is the new reality along the storied fifth avenue in midtown manhattan. Dogs, chains, security. The president elect has used trump tower as a base for transition meetings since the election, and while he will relocate to the white house after the inaugural, his wife melania and 10yearold son barron plan to stay in trump tower. Evy poumpouras, a former secret Service Agent for 12 years, was part of the president ial detail for president s obama, clinton and both bushes. We want to control whats coming into the area of trump tower. One of the biggest issues are large vehicles that can actually have large amounts of explosives, and a truck would be a perfect thing, a perfect i. E. D. , a vehicle device to use. What theyll do is, youll typically have the vehicles stopped. Theyll search the vehicle, make sure theres nothing inside the vehicle, underneath the vehicle, make sure its clean. Reporter trump tower stretches 57 stories with 26 floors of offices, three Retail Stores and hundreds of tenants. It is also surrounded by other skyscrapers, compounding the security challenge. Right now, planes arent allowed to fly over trump tower, same thing that happens over at the white house, but then you have that variable. Hes up top, hes high on the floor, planes are a concern. Drones, which is a huge, huge issue that were having in general when it comes to security can somebody use a drone, not just to go up there and, you know what, i want to see the future president , but also you can actually strap explosives, weapons, to those drones, fly them up, and then cause harm in that way. And then also, even cyber security. Radiation, contamination in the air, any type of chemical airborne attack, thats also an issue. The tower itself, one of the things we look at is what we call the h. V. A. C. System, which is where the air intake system is, thats super dangerous as well. Reporter while the secret service is working on threats from within the tower, the new York Police Department guards the exterior and directs traffic in the fourblock radius where the vehicles are being limited. The protective measures are causing a dramatic slowdown in business here, where the rents are among the highest in the world. Robert smith runs operations for uncle jacks steakhouse, which has developed a faithful following for years on west 56th street, within view of trump tower. The owner was so excited by the trump win that he named menu items after him we were down 20 right off the bat, right after the election. Once the security came in, barricades went up. People werent allowed to walk into the restaurant or even near the block. Reporter what are you hearing from your regulars . Obviously, my regular clientele isnt coming in as often as they used to. I had bar clientele at lunch that would come every day, that dont. We have a lot of tourists that come, very touristcentral located neighborhood. A lot of them dont even want to get anywhere near barricades and dogs and giant police bomb trucks. And it doesnt make anybody want to come near the place. Reporter a short distance away on 6th avenue, jimmie tarzy at allen m. Jewelers worries about what will happen to business if trump returns to his penthouse residence each weekend. You have to take precautionary measures, and i can understand that, i really do. But being the president or president elect, you have to say to yourself, youre supposed to do for the people. Go live in washington, thats it. Reporter some are calling Trump Tower White House north. Just how security will be transformed here is still a work in progress. At a new York City Council meeting last week, questions on how to prepare and who should pay went unanswered. Does the secret service have the right to close down a street on its own . Im not sure. If the n. Y. P. D. Were to decline to provide service around trump tower because of cost or lack of reimbursement, what would happen . Were unable to answer that question. We have to have some idea of what it is going to cost. Because right now, we are just spending on credit. Maybe the federal government will pay for it, maybe not. Reporter the n. Y. P. D. Estimates that for every day the president resides in trump tower, it costs the city 500,000. So far, congress has agreed to reimburse new york city 7 million for the cost of providing n. Y. P. D. Security to trump tower and the surrounding area. This is far less, however, than the 35 million the city initially requested. Councilman dan garodnick, who represents the trump tower neighborhood, objects why is new york city bearing the cost of security for the president elect . We have some very significant businesses on fifth avenue that employ hundreds of new yorkers each. And we want to make sure that these jobs and these businesses do not become a casualty of the trump presidency. Reporter its a balancing act between keeping the legendary Business District humming and protecting the first Family Living at the heart of it. In new york city, im rhana natour for the pbs newshour. Woodruff finally tonight, a conversation about changing the way we think about health care. In a article in the latest issue of the new yorker titled tell me where it hurts, doctor atul gawande, a surgeon and author, makes the case for the value of incremental medicine to deal with chronic conditions. Its the kind of medicine that is rarely hailed as heroic measures. William brangham spoke with dr. Gawande recently and asked him about whats changed. When you think about the future of health care and where were going at this moment of debate theres a transformation going on that involves a recognition that our focus in medicine has been on heroic interventions like the kind i do now as a surgeon but the biggest gains are coming now from incremental medicine, from a commitment to the kind of steady, overtime management of complex problems like chronic illnesses that can add years to peoples lives, but thats work done by some of the people with the least resources in our Healthcare System. So who practices incremental medicine in our Healthcare System today . Good examples. Look at the list of the lowest paid people. Pediatricians are at the bottom. You would look at internists, psychiatrists, you would look at family physicians, h. I. V. Specialists, people who take care of chronic illnesses by seeing people carefully over time, those are the people who get the least money. The people who have the most are people like Orthopedic Surgeons, interventional cardiologists. My point isnt, you know, that there is something wrong with heroism. My own son has a congenital heart condition where his life was saved by a cardiac surgeon stepping in to eleven days of life to save his life. But he is now 21 years old because of constantly working with him and monitoring by a primary care physician, people who controlled his Blood Pressure, recognized problems before they arose, dealt with learning issues related to his condition, and thats the only reason hes getting to live a long and healthy life. They dont have the kind of rousers and commitment that we are giving to people like me. I have millions of dollars of equipment available to me when i go to work every day in an operating room. The clinicians who keep my son going are lucky if they can have a nurse. Brangham so if that care is so valuable, why are the incentives seemingly going in the opposite direction . Mainly because our Health System was built at a time when we couldnt do this work. Go back to the 30s, 40s, 50s, it was the discovery of heroic interventions, the ability to cure people with penicillin or go an operation to stop a disease is what saved the day. Primary care physicians couldnt do all that much that really demonstrated a difference. Now, weve had the data to track people for a long time, the computational power that recognized that, you know what . High Blood Pressure which we didnt even know was a huge problem, we discovered it affects a third of all americans and its our biggest killer, that years down in the future, that that is our cause of everything from not only Heart Disease but dementia and of kidney disease. So, you know, the people who control and work with you to control your Blood Pressure, theyre not rewarded for doing that or to be innovative about doing that. So the result is half of americans have uncontrolled high Blood Pressure despite seeing clinicians. The Affordable Care act tried to move the needle in this direction, to put more incentives towards the exact kind of care youre talking about. How successful has that effort within . Heres what i would describe it as we now have 30 , for example, of medicare patients who are seeing doctors who are rewarded for doing this kind of work, which is a dramatic change from six or seven years ago. So the Affordable Care act has pushed this direction down the road. It has also offered protections that allow for preexisting conditions, as people know, that if you have preexisting conditions like my son does, that youre provided coverage and you can maintain steady coverage, and thats an important part of being able to stay in care and do better over the long run. So do you think if the republicans and president elect trump go forward and repeal this, do you think some of these incentives will stay in it . Or what do you fear coming down the road . My biggest fear so, first of all, where we are right now, 27 of americans under 65 have an existing Health Condition that, without the protections of the aca, would mean they would be automatically excluded from Insurance Coverage. Before the aca, they would not have been able to get Insurance Coverage on the individual market you know, if youre a freelancer or had a Small Business or the like. Brangham because of preexisting conditions . Because of preexisting conditions. So the first thing is that the aca protections have to be preserved or those people get pitched out. But the big thing thats happened is, in the time since the aca has been going on, our medical science has been advancing. We have now genomic data, we have the power of big data about what your Living Patterns are, whats happening in your body, even your smartphone can collect data about your walking or pulse or other things that could be incredibly meaningful in being able to predict whether you have disease coming in the future and help avert those problems. That is the transformation thats coming, but one of the consequences of if the aca is repealed is that all of us now are at risk of being a preexisting of having a preexisting condition waiting to happen. Life, increasingly, is a preexisting condition waiting to happen, now that we have more and more of this data available. Brangham dr. Atul gawande of the new yorker magazine. Thank you so much. Thank you. Woodruff on the newshour online right now as many as 200,000 people are expected to attend the womens march on washington the day after president elect donald trump takes the oath of office. Organizers say its a nonpartisan event aimed at a specific policy agenda. We delve into the issues driving the movement. All that and more is on our website, www. Pbs. Org newshour. Later tonight on Charlie Rose Charlie sits down with House Speaker paul ryan. And finally, a member of the newshour family has died. Filmmaker and cameraman john knoop passed away last week in el cerrito, california. In the 1990s, working with correspondent elizabeth farnsworth, he helped produce and shoot more than 30 documentary reports for the Macneil Lehrer newshour in cambodia, peru and haiti, among other countries. John knoop was 77 years old. And thats the newshour for tonight. On thursday, a making sense report about what life is like for middleincome people on the edge of financial ruin, and their efforts to grapple with it. Im judy woodruff. Join us online, and again here tomorrow evening. For all of us 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. Lincoln financial committed to helping you take charge of your financial future. Xq institute. Supported by the rockefeller foundation. Promoting the wellbeing of humanity around the world, by building resilience and inclusive economies. More at www. Rockefellerfoundation. Org. And with the ongoing support of these institutions and individuals. This program was made possible by the corporation for public broadcasting. And by contributions to your pbs station from viewers like you. Thank you. Captioning sponsored by newshour productions, llc captioned by Media Access Group at wgbh access. Wgbh. Org you are watching pbs. Rose welcome to the program. From washington, a conversationy advisor to president obama, susasusan rice. The the lessons i want to impart is the necessity of running a transparent process and to serve the soon to be president with the integrity and the fairness this position requires. Secondly, it is essential to be a consumer of the substance. There are no short cuts in this business. Even if your vehicle for communication is a short cut the substantive policy work has to be serious and rigorous. Ive also tried to impart the quality of the staff that were handing off to the new team. The National Security Council Staff is 90 car