Transcripts For WMPT PBS NewsHour 20121024

Improving patient care by rethinking the services a hospital provides. Waiting rooms are total waste. There is no reason for a waiting room. Its just an embarrassing reminder of how inefficient we are in healthcare delivery. Brown and Judy Woodruff gets an inside look at the closed kingdom of saudi arabia from journalist and author karen elliot house. Its a country were very dependent upon for oil and dependent upon to keep its people from becoming terrorists and trying to kill us. Brown thats all ahead on tonights newshour. Major funding for the pbs newshour has been provided by computing surrounds us. Sometimes its obvious and sometimes its very surprising in where you find it. Soon, computing intelligence in unexpected places will change our lives in truly profound ways. Technology can provide customized experiences tailored to individual consumer preferences, igniting a world of possibilities from the inside out. Sponsoring tomorrow, starts today. 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. Brown the countdown to election day brought new jibes, new ads and new urgency today. The president ial contenders and their running mates raced from state to state, looking to nail down 270 electoral votes with just 13 days to go. For president obama, it was the busiest day yet of his re Election Campaign and it began with a flight from washington to davenport, iowa. This is the first stop on our 48hour flyaround Campaign Marathon extravaganza. cheers and applause were going to pull an all nighter no sleep. Brown before the day was done, the president planned to fly more than 5,000 miles from iowa he was headed to colorado, california and nevada. Republican challenger mitt romney was also on the move in the opposite direction starting with an event in nevada, and planning to end the day in iowa. President obama won iowa in 2008, but its a tossup this year. He argued today the choice is between a known quantity and a candidate who keeps changing his views. Trust matters. And. And. And heres the thing. Iowa, you know me. You know. You know that i say what i mean and i mean what i say. You could take a videotape of things ive said 10 years ago, 12 years ago and youd say, man, this is the same guy, has the same values, cares about the same people. cheers . Doesnt forget where he came from. Knows who hes fighting for. cheers brown the president also told the Des Moines Register that if he wins, a big reason will be that republicans alienated the fastestgrowing Demographic Group in the country, the latino community. He predicted the g. O. P. Will join him in finally passing major immigration reform. For his part, romney fired back in reno, nevada. He said the president s been reduced to misplaced attacks on his record. With four. Four debates behind us, including the Vice President ial debate, the president s been unable to find an. An agenda and to communicate an agenda and to defend an agenda. And thats one reason why i think we all know that hes out of ideas and out of excuses. And in november, youre going to put him out of office. Reporter for both sides, the steppedup pace was a sign of just how tight the race is, in the closing stage of the campaign. Over the next 13 days, both candidates will barnstorm a series of swing states where the white house will be won or lost. Perhaps none more important than ohio, where the Vice President ial candidates were campaigning. Well, folks, you probably heard the rumor that ohio is going to pick the next president of the United States of america. And im happy about that. Reporter Vice President biden talked up the president s economic ideas before a crowd in marion, ohio. Folks, heres the deal, when the middle class is doing well, everybody does well. The poor have a way up they got a ladder up and the wealthy do very, very well. And weve created a lot of millionaires. And its a good thing, not a bad thing. But thats how you do it. You dont grow from the top down. Reporter at roughly the same time, republican Vice President ial nominee paul ryan was also addressing poverty 120 miles away, in cleveland. So what is the alternative approach that mitt romney and i are offering . Well, to hear some tell it, we think everybody should just fend for themselves. Thats just a false argument. Its a straw man set up to avoid a genuine debate. The truth is mitt romney and i believe in true compassion and upward mobility. And were offering a vision based on real reforms for lifting people out of poverty. Reporter a new wave of t. V. Ads also debuted in key states. The proromney Group American crossroads began airing this spot in seven states with actor clint eastwood. When someone doesnt get the job done, youve got to hold them accountable. Obamas second term would be a rerun of the first and our country just cant survive that. Brown the Obama Campaign countered with a reminder that just 537 votes in florida swung the election of 2000 and led to the george w. Bush presidency. If youre thinking your vote doesnt count, that it wont matter, well, back then, there were probably at least 537 people who felt the same way. Reporter meanwhile, aides said the president would himself be calling voters tonight from air force one before starting the day tomorrow in florida. Mitt romney will be headed to ohio tomorrow. Ifill still to come on the newshour some unexpected tossups for senate seats; an issue candidates arent addressing the housing crisis; the rest of the president ial field debates; costcutting in a Seattle Medical Center and a portrait of saudi arabia. But first, with the other news of the day. Heres hari sreenivasan. Sreenivasan the u. S. Economy is improving moderately, but hiring remains sluggish. That assessment came from the Federal Reserve today, after a twoday policy meeting. The fed stopped short of taking any further action. Instead, its proceeding with a new bondbuying program it launched last month in a bid to bolster growth. On wall street, the feds assessment of the economy put a brake on efforts to recover from yesterdays big selloff. Instead, the Dow Jones Industrial average lost 25 points to close at 13,077. The nasdaq fell more than eight points to close at 2,981. Europes economic troubles are getting even worse. The European Union reported today that the overall Government Debt of eurozone countries has hit 90 of their total economic output for the year. Thats the highest level since the euro was launched in 1999. Five of the nations that use the euro are already officially in recession greece, spain, italy, portugal and cyprus. An Islamist Group was quick to claim it attacked the u. S. Consulate in benghazi, libya and the white house was told almost immediately. The Associated Press reported that today. It said the state department e mailed the information to the white house two hours after the attack. The email cited claims by ansar alsharia, on social media. But secretary of state Hillary Clinton said today the information was not solid. Posting something on facebook is not in and of itself evidence, and i think it just underscores how fluid the reporting was at the time and continued for some time to be. What i keep in mind is that four brave americans were killed and we will find out what happened. Sreenivasan republicans charge the president and top aides knew it was a terrorist attack early on, but played down that angle for political reasons. A new burst of violence has erupted along gazas border with israel. Fighters from hamas and a smaller militant Group Launched more than 70 rockets and mortar rounds at southern israel. Two Foreign Workers were critically wounded. The Israeli Military answered with air strikes inside gaza that killed at least two palestinians. The israelis also warned they will launch a ground offensive, if the rocket fire does not stop. A lateseason hurricane struck a blow at jamaica late today. It was expected to head on to cuba tonight. Hurricane sandy brought heavy rain and strong winds to eastern jamaica, especially around the capital, kingston. The storm prompted airports to close and cruise ships to change course. Those are some of the days major stories. Now, back to gwen. Ifill the president ial race is not the only Campaign Working its way toward a photo finish this year. In competitive contests from east to west, the race for the senate has turned out to be tight, expensive and slippery. In arizona, democrat and former Surgeon General Richard Carmona is running neck and neck with republican congressman jeff flake. In connecticut, former wrestling executive Linda Mcmahon, a republican, is battling democratic congressman chris murphy. In indiana, republican Richard Mourdock, who defeated incumbent senator Richard Lugar in the primary, is in a fight to the finish with democratic congressman joe donnelly. And in north dakota, former state attorney general Heidi Heitkamp is staring down republican freshman congressman rick berg. The outcome in these and a handful of other races, including in massachusetts, montana, nevada, virginia and wisconsin, could easily determine who controls the senate and the president s agenda come january. Here to walk us through the stakes, are Shira Toeplitz of roll call newspaper, who joins us in the midst of a rust belt reporting tour. And nathan gonzales, who keeps track of senate races for the rothenberg political report. Welcome to you both. Shira, its not an accident you happen to be in indiana while news is being committed. I suspect youre responsible for some of it. In fact, its Richard Mourdock, the Republican Senate candidate, who at a debate last night in indiana, was quoted as saying this when he was asked about whether there should be an exception for rape in abortion. He said, i think even when life begins in that horrible situation of rape, that it is something god intended to happen. Why did he say that . What did he mean . Ask what was the fallout today, shira. Reporter right, so right after he said that, and after the debate, he went to the spin room and he spoke with reporters, myself included, we tried to get some clarification for those remarks, and he basically stood by the remarks. I think his intent was clear, but he thought he was being misunderstood. The confusion led to a Second Press Conference this morning in indianapolis, more than two hours away, where he sought to clarify his comment agains and he ended up policies for them, but only only to those people who misunderstood him. Ifill it not only stirred up members of another republican candidate who made dubious comments with rape, but reverberated all the way to mitt romney and his campaign. Reporter it did, it did. And its especially for theinent because mitt romney recently cut a Television Ad for Richard Mourdock here just last week, and that was seen as a real boon to Richard Mourdocks campaign because murdochs fate, in many ways, relies on the president ial contest. But you brought up todd achin who several weeks ago made a horrific gaffe about abortion. Its the similar case because the words both are to do with abortion but its a different set of words and i think its important to make those distinctions. Richard mourdock said he was talking about his beliefs, and todd akin was stating a factual inaccuracy about biology. Ifill that womens bodies shut down and there is not pregnancy. He said he made a mistake. Today, thats not what we heard Richard Mourdock say. One more thing i want to ask you before i move back to nathan here, which is his competitor, joe donnelly, the democrat, he is also prolife, right . Reporter year, absolutely. Joe donnelly is anti does favor excuse me, he is pro life, he does, however, unlike murdoch allow for exceptions for the life of the mother, incest and rape. Ifill how close is this race and how much would Something Like this matter . I think before the debate even happened as we analyzed it this was an extremely close race. We had it in a tossup tilting category where we gave murdoch the advantage because of the fundamental nature of the state. We believed by the time we got to election day a mitt romney victory would pull Richard Mourdock across the line, and before the debate, it looked like murdoch was starting to coalesce the republicans still on the sideline, whose loyalty was to senator lugar. Now were in this Holding Pattern waiting to see whether those moderate republicans, the loyal lugar, and thats why we moved the race to a pure tossup. I think its unfair to say now that murdoch has a distinct advantage, and i think this is going to be a close race and one the republicans couldnt afford to be worrying out this late in the game. Ifill a lot of tossups. Lets smar start in connecticut, where Linda Mcmahon, is spending a lot of money to have at least a really good shot on it this time. I think the democrats made a miscalculation this time around. I think because they thought Linda Mcmahon ran and lost in 2010. She spent 50 million of her own money. They thought if she couldnt get across the line in a good republican year, theres no way he wilshe will win this time shs now in a competitive race with chris murphy. He will have the advantage of the president ial race, but its still competitive. Ifill shira, you have written about the north dakota of senate race, another one of these tight races, Heidi Heitkamp, jrs rick berg, the republican, and energy is a big issue in that race. Reporter absolutely. North dakota has lowest Unemployment Rate of any state in the country, and thats because the oil industry is absolute booming out there, especially in the western part of the state. Now, this plays into both candidacies. Obviously, rick berg, a freshman congressman, but he was a longtime state lawmaker in the state. He was dealing with a lot of these issues. And hide, former state attorney general let Public Office temporarily, obviously shes running again now, in 2000 and went to work at an energy company. Energy is huge in the state and huge if the race. Ifill thanks for correcting me on the candidates name. I called him Something Else but its rick berg. Gled lets move to arizona, and thats also very tight in a state which hasnt elected a democrat to the senate in house long . Its because, you know, this is a surprise retirement with senator keil, and i dont think republicans were expecting to defend here. But this is a close race. What were looking at there is carmona had his own debate gaffe where he basically insulted cnns candy crowley, even though she wasnt in the room at the time. I mean, at best it was a crude remark, and were seeing whether it was it will have further ramifications. Its a close race, but jeff flake went through a late republican primary, piled up a lot of negatives from his opponent spending millions of dollars against him, and it looked like flake will have the advantage there, but its very close, and republicans cant afford to lose their own seats if they want to take over enough democratic seats in order to win back the majority. Ifill they need four seats to take over the majority if the president wins, and three seats if mitt romney wins. Correct. And Vice President paul ryan would be the tiebreaker. Ifill chirac, of course we cant talk about anything in politics without talking about ohio. You have been to ohio where there is a surprisingly close race going on. The incumbent, democratic senator brown, against republican tea partybacked candidate josh vandle. This is another competitive race, and similar to indiana, but in a different way, the fate of this race is tied closely to the president ial contest. Another really unique thing about this race is how much outside money has poured into this contest. Sherrod brown on the trail likes to talk about the 24 million in advertisement, important to the state, into his specific senate race, starting as early as six to eight months ago. Obviously, ohio voters who have been watching their Television Sets and sick of seeing the president ial contest ads, theyre sick of seeing these ohio senate ads, too. Ifill and pennsylvania, you must have driven through this, bob casey running against tom smith, the republican who no one gave a shot to but had the airwaves all to himself for a long time. Reporter, absolutely. Tom smith is a former coal executive from southwestern pennsylvania. Hes quite wealthy. Hes put 17 million of his own money into the race and he did something very key. He went up o Philadelphia Media market and did it before casey could afford to do so and it really gave him an edge. We saw in this race, when Republican Senate candidates were faltering at the end of september when the president was on the uptick, tom smith was actually going the other direction. He was gaining ground on bob casey. And now most people in the straight stale think bob casey is going to pull it out but its going to be by a much smaller margin than many anticipated. Ifill what do you think of pennsylvania . The drippancy lies if you think mitt romney is going to win pennsylvania, those are the same polls showing tom smith running close to bob casey. We think a romney victory in pennsylvania is unlikely, and, thus, i think casey will be okay. I think its important to remember on Election Night because we have so many of these close cases. We could have recowntsz. We could be waiting on former governor king in maine who he is going to caucus with, and we may not know who will be in the majority until days, maybe even weeks after election day. Ifill is there any connection to be made between whats happening at the top of the ticket and happening in the races. It seems in some cases you cant take whats happening in the National Scene and connect it. There are tens of millions of dollars spent in the Competitive Senate races and enough where they can almost stand alone, where voters can get familiar with the candidates, choose between candidate quality, campaign qualities. It does affect on the margins. Ohio and florida looked like they were slipping away from mitt romney. Those senate races started to slip away from republicans. When you look at the crossover vote in north dakota, where Heidi Heitkamp, the better mitt romney does, i think the harder it is for Heidi Heitkamp to win that race. Ifill nathan gonzales, and Shira Toeplitz, crossing the country there for roll call, thank you so much for joining us. Brown and we turn to another kind of look at the election. We call it missing issues important topics on the american agenda that neither candidate is spending much time discussing. Tonight, our subject is housing. It was the housing bubble that helped lead to the financial crisis in 2008 and has continued to drag on the national economy. The president ial candidates have theres been better news recently as the housing sector has shown new signs of life. Just today a new report found sales of new homes rose 5. 7 in september to an annual rate of 389,000. Thats the best pace since april of 2010, and continues an upward trend in recent months. And, the average price of new homes has risen more than 14 in the last year. But big problems remain. More than 20 of u. S. Homeowners are underwater on their mortgages, meaning they owe more than the value of their home and some 950,000 homes are in the process of being foreclosed on currently. Last october, mitt romney took a largely handsoff approach to the problem. Dont try and stop the foreclosure process. Let it run its course and hit the bottom. Brown but by january, the republican hopeful was quoted by the New York Times as saying, the idea that somehow this is going to cure itself, all by itself, is unreal. In a republican primary debate if he is reelected im convinced you will see the value of your homes going to the basement and qualifyings for a mortgage will be difficult as brown the Obama Administration has made several attempts to address the housing problem, with only limited success. More than one Million People have received a permanent loan modification through one key initiative, but thats far short of the three million plus that it was expected to help. Last february, the president pushed to expand refinancing options. I am sending congress a plan that will give every responsible homeowner in america the chance to save about 3,000 a year on their mortgage by refinancing at historically low rates. Brown the proposal went nowhere and, like romney, the president has not spent much time discussing housing on the trail. Thats despite the fact that four of the swing states in the president ial contest have some of the highest foreclosure rates in the country. Meanwhile, theres action in the courts. Federal prosecutors in new york sued bank of america for 1 billion today. Its countrywide unit allegedly sold fraudulent mortgagebased loans to fannie mae and freddie mac, prior to being acquired by bank of america. Why so little focus on this . And what should the candidates be proposing, if anything . We examine that with james carr, a senior fellow at the opportunity agenda, a policy and advocacy group. Hes a former senior Vice President for financial innovation at the fannie mae foundation. And Mark Calabria is director of Financial Regulation studies at the cato institute. He worked on housing policy as a Republican Senate staffer and at the department of housing and urban development. Welcome to both of you. I want to start with this question of the why question, jim carr. Why does this get so little attention . First of all, jeff, thanks for inviting me and thank you for actually having this conversation which has been missing from the airwaves. I think one of the reasons candidates havent been held accountable by the press, by the media. You look at the fact weve had three president ial debates and not a single question on the state of the Housing Market. I think the second thing is the Housing Market has so many problems were trying to fig out the fix is politically challenging and controversial. The banks have their solution. With the has theirs, housing consumer groups have theirs, liberals and conservatives have theirs. Its a sticky political environment to tread into unless someone forced you to go there. Brown i guess, Richard Mourdock, the candidates dont want to talk about it too much. Well, the most simply, the negatives outweigh the positives. Lets think about some of the negatives. The president has had a number of programs that havent lived up to his own expectations and i think theyve been roundly criticized so for him not talking about that is probably a preference. For mr. Romney the issues are partly devices. So to go out and talk about helping one homeowner versus another. A number of people need help. A number of people are tired of the bailout. They want to bail out their neighbors. One of the reasons its divisive is many of the solution offer read redistributive. You will help citizen a. At the expense of citizen b. , citizen b. Will not be happy with you. A lot of the Real Estate Industry, tend to be very Small Business and very pro republican. What romney is trying to balance is i dont want to irk the Tea Party Folks and say i will give bailouts but i dont want to talk it down too much because my friends in the Real Estate Industry want to see the prices go up. Brown what should people know about the state of the housing sector today . We were ticking off some of the negatives and positives. What is your overview we should know . I think the public should know several things, despite the good news, the Housing Market remains in big trouble. We have lost 7 trillion of housing equity. We are nowhere near having regained that. More than 30 of households are upside down on their mortgages. We have 700 billion of loans that are literally underwater, the value 700 billion of mortgage credit that is in excess of the actual value of the homes underneath. And so and trying to get a loan has never been harder. Typical down payment now, 20 or above, typical Credit Scores are 750. In a sense, the banks are overcompensating for the reckless underwriting that happened before the crisis to the point where people who are eligible for a loan just simply cant get one. And the other thing id say is theres not a real focus on the value and the significance of a strong Housing Market to job creation and the economy. And i think that conversation is missing from this debate. Brown what would you add to that and you can start our look at what they should be talking about. Absolutely. The first thing to keep in mind, i think as far as prices, the worst is behind us. We have declines in some markets and increases in some markets. I cant over emphasize every Housing Market is different. Phoenix is not atlanta is not new york. You really do need to look at local conditions. But flay broader sense, one of the things that concerns me is ultimately whether its five, six, 10 years well get to the point where people believe housing prices will never go down again. Housing can be a great investment. It can be a stable investment. It can also be a very risky investment. I think people need to go into this with their eyes clear, making sure what theyre buying is really based on their needs and not the ability to flip it. Brown why dont you start, what do you wish you had heard in the debate . What do you wish you heard outo the campaign trail today . What do you want to hear . To tell you quite frankly, i was far more sympathetic to where governor romney started out, which is is a process that needs to work its way out. The prices need to hit bottom. I think this is a problem of we built too much housing and the only way you work off excess supply, in my opinion, prices fall. And i appreciate and respect that he said that first. I think he is starting to recognize the politics of it after that. As an economist, they call economics the dismal science not because we say happy things but because people dont want to hear. Brown that market not working means a lot of people are hurt. It absolutely does. We have lost 6. 5 trillion in wealth. There is no magic wand. There is no way to bring that wealth back. You need to have the market recover and that is going to be painful. I would have liked to have heard, a. , the market is going to go through adjustment. Its great for renters who want to get into the market and when the prices look good again it will prevent opportunities. The it should be how do we find help people whose position is not sustainable, how to transition to a better life, a better world. I think id like to hear the concernef keeping the market in limbo indefinitely is not a solution. Trying to fight the fundamentals of the market is not a solution, but trying to work with the way the market is going is the direction to go. Brown youd like to hear a little more government proactive. Absolutely. Just to create one of the statistics i gave, i meant to say house prices remain more than 30 below their peak and more than 20 of households you are upside down on ther loan. I think when you look at we have 11 million foreclosure filings, and we homes 60 days or more delinquent, and millions more at high risk of foreclosure, sitting back and saying were going to let the market work itself out is a prescription for a long, protracted, or even a pretty sudden drop in home values. The fact of the matter is the programs are not doing exactly as wed like them to, but they are having a significant effect. The challenge is not that theyre doing nothing. Its that we need to step up the game on the foreclosure mitigation initiatives and really stem this foreclosure crise. And then the second part is we need not to ignore that the Housing Market needs to be rebuilt. The secondary market needs to be restructured. And we need to dive into that conversation and rebuild it so that people who are eligible for Home Ownership right now actually can access the system, which millions cant do now. Brown i assume parent of the politics here is one of these issues has been with us for years, which is the degree to which individuals are responsible for their own problem. And, therefore, to what extent the government or the rest of us should be helping them, people who might have borrowed too much. The economist in me is if you want to grow Family Wealth and income over the long run, the way to do it is you have to make labor more productive. Thats what drives wages and income. I worry that we got a series of essentially asset bubbles. We ran up house prices and now the feds and others are trying to run up stock prices. House prices dont make anybody more productive. They dont raise your wages in the long run. Housing is consumption. I think policies that try to make housing a great investment and consumption at the same time are in conflict. Ultimately, i worry that were rin vesting our nations resources in things that do not grow wages but simply make us feel wealthier. Its not actually sustainable in the long run. Brown we will have to leave it there but we raised the questions at least. Thank you both very much, Richard Mourdock, and jim carr. We will examine other misses issues in the coming days. Ifill the Campaign Spotlight may be missing some issues, but it is also missing some of the candidates, including four who are running for president. Last night they held their own debate in chicago. Kwame holman has our report. Reporter with the president ial race in a dead heat, between the two major contenders, third parties could draw just enough votes in some states to tip the balance. Look, there is only a couple of voices being heard here, and its tweedle dee and its tweedle dumb. Reporter the Libertarian Party nominee gary johnson was one of four alternative candidates featured in last nights debate at the chicago hilton hotel. Jill stein of the green party also took part, along with the constitution partys virgil goode and Rocky Anderson, nominee of the Justice Party. The Nonprofit Free and equal Elections Foundation hosted the debate, and former cnn host larry king moderated, with questions culled from social media. There was some momentary confusion at the outset. Lets go ahead and do opening statements. My apologies. I didnt know we had opening statements, i thought we were right to the questions. Reporter the candidates then proceeded to address everything from halting the war on drugs to reducing military spending to curbing the influence of money in politics. The Justice Party candidate, Rocky Anderson. The corrupting influence of money in this country is at the root of every major pub policy disaster. Its why we dont have healthcare for all as in rest of industrialized world, its why we arent providing International Leadership on the climate crisis, because all corrupting money coming from the fossil fuel industry. Reporter on that subject, gary johnson, a former republican governor of new mexico, said transparency is key. I think when it comes to Political Campaign contributions that candidates should have to wear nascarlike jackets with patches on the jackets. Reporter on the war on drugs, most of the candidates agreed its time to legalize marijuana and more. Green Party Candidate jill stein marijuana is a substance that is dangerous because its illegal. Its not illegal on account of it being dangerous, because its not dangerous at all. Reporter Rocky Anderson echoed that sentiment. We need to end drug prohibition just like we ended alcohol prohibition and treat drug use and abuse as a Public Health and education issue and get it entirely out of the criminal justice system. Reporter but virgil goode disagreed. The former congressman from virginia was once a democrat, then a republican before joining the constitution party. Lets be clear about my position on this. Unlike gary, rocky and jill, im not for legalizing drugs. If you want that, vote for one of them, dont vote for me. Reporter all of the candidates agreed on another proposition that the pentagons budget is too high. A Foreign Policy based on militarism and brut military force and wars for oil is making us less secure not more secure. We need to cut the budget and bring the troops home. And we need to end the drone wars. We should not bomb iran. We should get we should end war in afghanistan tomorrow, bring the troops home tomorrow. If im elected president ill balance the budget and part of the cuts have to be in the department of defense. We cannot do as mitt romney and paul ryan suggest, increase military funding by 2 trillion over the next decade. Reporter to get on the stage last night, the candidates had to be on the ballot in a minimum number of states. Or, they had to be polling at least 1 in any national survey. In the case of virgil goode, republicans tried to keep him off the ballot in virginia, fearing he might siphon votes from mitt romney. Goode took on both romney and president obama on Student Loans, pell grants and rising tuition costs. You might not get what you want to hear from me, but youll get straight talk. We cant afford more federal subsidized Student Loans and we cant afford more pell grants. Reporter but jill stein and Rocky Anderson argued that the real problem is that the obama and romney prescriptions for Higher Education dont go far enough. I think its time to make public Higher Education free, as it should be. We cannot afford not to provide a great education and an equality of opportunity for all of our young people in this country. Reporter gary johnson, however, said the loans and grants are to blame for the rising cost of Higher Education. That is another one of governments unintended consequences that have College Tuition at such a high rate. Reporter recent history suggests the independent standard bearers can have an effect. In 2000, green Party Candidate ralph nader took votes from democrat al gore in florida and other key states. And in 1992, ross perot captured nearly 19 of the total vote in his race with the first president george bush and bill clinton. 20 years later, hes endorsed mitt romney. Ifill you can watch the rest of the third Party Candidates debate online. Thats in the rundown. Brown now, a question you might not have pondered before what can a Medical Center learn from an auto manufacturer . Newshour Health Correspondent betty ann bowser has the answer. Reporter 63year old Robert Sherrell had no idea lower back pain could hurt so much. I was like wow what was that and it was tremendously weakening and just took me right down. Reporter sherrell is among the 80 of all americans who will have a bad back sometime in their lives. And when that happens, many patients undergo an m. R. I. , an expensive imaging test. But nine leading doctor specialty groups recently said m. R. I. S are often a waste of money and medically unnecessary. Doctors here at the virginia mason Medical Center in seattle take that to heart. They have use special software at the lower back pain clinic that rejects any order for an m. R. I. ,unless a long list of criteria has been met. If there is no evidence based indication, the test cannot be ordered. Reporter virginia masons dr. Robert mecklenburg says in just three years theyve eliminated unnecessary procedures and saved money. Weve seen well over 10,000 patients in this clinic and their return to work is twice as fast as the old style of back pain care that we delivered before. The patients satisfaction is much, much higher and the cost of delivering case is much less. Reporter the software is part of the Medical Centers war on waste that started more than ten years ago. At the time the Medical Center was losing money and dr. Gary kaplan had just been named c. E. O. Waste is all those things which add no value for the customer. Its embarrassing frankly because we find most processes 70 to 95 of time thats spent adds no value for the customer. The waste of wait, the waste of movement, the waste of over processing, the waste of excessive inventory. All that is waste and it had no value. Reporter kaplan learned that lesson from studying the philosophy behind the world famous toyota Production System. Its based on the idea that if waste is rooted out along the Assembly Line the result is better cars and lower costs. Some of what toyota does may sound like common sense. But when a little bit here and a little bit there is applied it can add up to big savings. That can mean anything from returning patient phone calls faster to moving supplies to where the patients actually are. The Prestigious Institute of medicine recently zeroed in on waste. In a new report it said 750 billion is wasted every year in the American Health care system. It also recommended more teamwork among doctors and nurses saying that would make care more efficient. At the kirkland clinic in suburban seattle team work is a mantra. Thats why rhonda chiuchta goes there for health care. I just go straight to the check in counters. They give me a card and you go straight to your room and within a couple of minutes a care nurse comes into the room and checks your weight, checks your height, Blood Pressure and then she calls the doctor in and we just update and talk about whats going on. Reporter and, chiuchta doesnt waste a lot of time waiting to see the doctor because there are no waiting rooms. Its just an embarrassing reminder of how inefficient we are in healthcare delivery. Its just a shame to see how we spend huge amounts of money for fancy waiting rooms. Reporter virginia mason is slowly getting rid of waiting rooms at all its facilities. Theyve been able to do this by taking calls for appointments as they come in instead of letting them back up at the end of the day. All of this has meant the staff has had to change the very basic ways they think about the delivery of health care. Here its the medical assistants, or m. A. S who control the work flow. This is the flow station, and this is the place where the provider and the m. A. Work together. The m. A. We call flow manager, and the flow manager is directing us. Reporter like a traffic cop . Like a traffic cop. Reporter dr. Richard furlong is medical director of the kirkland clinic. The physician takes directions from the m. A. And thats a change for providers to accept direction from an m. A. The work is spread across the chain and we are no longer the center of the universe, the patient is, and its the team thats delivering the care. Frankly i think it was hard for the m. A. S at first, but we broke that down and now i think if you watch them they actually enjoy bossing us around. Good morning. Reporter kaplan and his staff first got the idea for doing these sorts of changes when they started visiting toyota in japan back in 2002. They were convinced that some of big car makers philosophy would work in seattle, but it was a hard sell to the staff of 5,000. I would say in the beginning we maybe had 10 early of doctors you know really champions of this work and then were 10 over my dead body you know im not going there and then 80 in the middle. Reporter what the doctors didnt like was something that happens all the time on the toyota Assembly Line. Its really fascinating. They make 1,000 cars a day in the factory, there are 350 workers and if the worker doesnt have what he needs to do his job or sees something that hes concerned about he can pull the cork and stop the entire factory. It was mind blowing. Reporter today that is more than just an idea. Every employee is expected to report any serious safety concern they may have. Its helped reduce liability costs by 60 since 2004. Its also led to better patient care. The hospitals nursing staff has also part of the change. Charleen tachibana is senior Vice President and hospital administrator. We really started looking at where nurses were spending their time and we found that they werent spending it with patients. Reporter in fact, they were spending too much time collecting supplies and drugs ordered for patients by the staff. So patient supplies were removed from a Central Storage room and put into hospital rooms at bedside. Through a variety of changes we wound up taking about our nurses time from 35 in direct contact with patients to upwards of 90 of their time in contact with patients. Reporter but there have been bumps in the road. Some Traditional Health care thinkers say the Medical Center is practicing a one size fits all form of medicine. But kaplan and his staff remain committed. The case for change is compelling. The resistance to change and the anchoring in the status quo in still very strong and so thats our objective here. We talk at virginia mason about transforming healthcare and some may say well its delusions of grandeur and all we really want to do is show whats possible. Reporter a number of hospitals are now experimenting with toyota Production System principles. Meanwhile virginia mason was recently named hospital of the decade by a respected healthcare rating organization. Brown whats to blame for Rising Health care costs . We break down seven factors that drive up spending. And what could we buy with the billions of dollars wasted . Our infographic offers some examples. Plus, you can see a comparison of u. S. Spending on health care compared to other nations. All that is online. Ifill finally tonight, an inside look at the shrouded kingdom of saudi arabia. The country seemed an oasis of calm during the turbulent arab spring, but that stability is shifting. Within the last decade, there have been a number of terrorist attacks, including one in 2003, when suicide bombers struck a compound housing foreigners, killing nine americans. Pulitzer prize winning author Karen Elliott house has covered saudi arabia for 30 years, often getting rare access to a vast spectrum of its society. Judy woodruff talked with her recently about her new book on saudi arabia its people, past, religion, fault lines and future. Woodruff Karen Elliott house, thank you for being with us. Thank you for having me. Woodruff so the book on saudi arabia why is it important for americans to understand saudi arabia . Because its a country were very dependent upon for oil and dependent upon to keep the people from becoming terrorists and trying to kill us. So for both our life and our livelihood, we should try to understand the country. Woodruff theres such a sense of saudi arabia being the one stable country in the middle east. We dont know very much about it, but it seems to have things under control. But the title of your first chapter is tranquil. How fragile . I think they do have serious problems. They have problems other countries have of unemployed youth, 60 of the population is under 20 years of age. They have a lot more money to deal with it. But it doesnt diminish the frustration young people feel now that they, threw the internet and satellite tv, have an understanding of what goes on, not only in their country but in the wider world. Woodruff hows that this regime you write so much about the history of what you call the house of asud. Asudhow have they managed to keep control for so long . They use a combination of divide and conquer. Make everyone fear everyone else. Religion. They teach their version of religion teaches that you must obey your rulers, even if theyre bad, because when god wants you to have better ones he will provide. So obey or otherwise you will have chaos. And the third thing is money. They give a lot of they have a lot of money, thanks to oil wealth, and they slather it across the country. But people still see that that their level of living is declining, and they know theres a lot of money in the country. So they get frustrated by that, too. So even the money has less and less utility. Woodruff and speaking of the frustrations, karen house, you spent five years in and out of saudi arabia working on this book. You had extraordinary access for a journalist and you were telling me a minute ago, the fact that you were a woman made it even it made it easier for you to get information. Yeah, most people think, oh, if youre a woman that must be very difficult. And its actually a big advantage because for a western woman, youre an honorary man in saudi arabia. I can talk to men, but i can also talk to women. And there are, clearly, a range of modern and sophisticated women in saudi arabia whose husbands allow them to talk to men to whom theyre not related, but thats not the norm, so i can really talk to women on the whole female spectrum from the very conservative i lived with a very religious conservative woman all the way to women who are running their own businesses and to men. Woodruff a country of contradictions. I mean, you write about the incredible wealth, the loo way y the government has given religious leaders to set down rules and you talked about how that has come back to bite the regime because it unleashed terrorists who were involved in 9 11. After the shah in iran, and the emergence of a religious theocracy there, the saudi royal family became very nervous about we mustnt be seen as worldly. We must be seen as religious. And basically, turned the country over to the fundamentalists. And then after 2003, when those people began blowing up things in saudi arabia, they realized theyd made a pact with the dech devil, and King Adbullah has tried to have a kinder, gentler version of islam, but it takes a long time to change the course that they bred into people for 20, 25 years, and longer. Woodruff how nervous is the regime itself do you think . And what do you see in the near term, the future for country . I think the regimes nervous about the conditions inside the country high unemployment, restless youth, more women wanting work, et cetera. Their biggestix of, i think, source of nervousness is iran. But their Biggest Issue is their own succession, the crown has gone from one brother to another. They are now neither the end of that line of brothers, so youre going to have elderly and infirmed leadership for they have had and they will continue to have because the youngest brother is 68, 69. And somewhere theyre going to have to pass to the next generation. And thats not so easy when there are 34 surviving brothers with braerch branches of familih many sons and all of whom could be king. So its a difficulty for them. Woodruff Karen Elliott house, the book is on sowdia its people, past,ings are. Ifill you can see more of judys conversation with Karen Elliott house about the lives of women in saudi arabia on our website. Brown again, the major developments of the day president obama and mitt romney logged thousands of miles, covering states where the election remains a dead heat. The Federal Reserve reported the economy is improving moderately, but hiring remains sluggish. And in the caribbean, late season Hurricane Sandy struck a blow at jamaica. Online we have a followup to our story about the automatic budget cuts that could affect virginias defense industry. Hari sreenivasan has the details. Sreenivasan hear what voters have to say about jobs, the economy and the ability for congress to find a compromise. Thats part of our battleground dispatches series. And on making sense, we announce the winner of our economics song contest. And the prize goes to deleveraging is hard to do to the tune of breaking up is hard to do. Find the lyrics on our business page. All that and more is on our web site newshour. Pbs. Org. Jeff . Brown and thats the newshour for tonight. On thursday, well have the latest on the president ial race. Im jeffrey brown. Ifill and im gwen ifill. Well see you online and again here tomorrow evening. 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