January 30, 2014
Host: Ted Simons
Affordable Care Act/State of the Union
- President Obama’s State of the Union speech is expected to touch on his Affordable Care Act. Mayo Clinic CEO Dr. John Noseworthy will be a guest at the speech. Local Mayo Clinic CEO Dr. Wyatt Decker will appear on Arizona Horizon to talk about Dr. Noseworthy’s impressions of what was discussed by President Obama.
- Dr. Wyatt Decker - CEO, Mayo Clinic
| Keywords: government
, affordable care act
, mayo clinic
Dr. Wyatt Decker: Ted, you mentioned one thing, it's primarily insurance reform, and focuses on primary care and access. That's been a good step forward. What remains to be seen is what is the impact of the high deductible and high out-of-pocket plans, so that individual from Gilbert, I can't speak to her case individually, but she may have substantial, thousands of dollars out-of-pocket, and that could still be a barrier to getting care, so there is more to this than meets the eye, and it hasn't unfolded yet.
Ted Simons: So as far as the impact on financial security, talk about that, and critics say that it's, it's raising costs out there. Supporters say no, it's not. What's the answer?
Dr. Wyatt Decker: It depends on the lens you look at it through. That's why we hear so many versions of, of the affordable care act, is it good or bad. Over 900 pages of single spaced law, and so, characterize it as all good or all bad, is unrealistic. There are parts of it that are helpful and parts that probably need more debate and refinement. For example, for medical centers, we're anticipating a substantial cut even through those getting insured, so they are getting insured but the reimbursement rates are below cost of providing that care. So, that, of course, presents an ongoing challenge to medical centers. It is estimated the cost of implementing the affordable care act over step years has been as high as $1 trillion. Of that, 80% or up to 800 billion will be absorbed by hospitals and doctors. So, for the medical community, it means we have got to, to deliver great care at an affordable cost. And at the Mayo Clinic and other organizations, we're working hard to bring down the cost of care because that's a critical component.
Ted Simons: If the ACA had not passed, if it were not existence right now, how does that change the formula?
Dr. Wyatt Decker: We have a fragmented health care system in the United States. That needs to be addressed. And so, one of the points that we're making at the Mayo Clinic, and one of our reactions to the speeches, we really only just have begun in our country to address the fragmented health care system of the United States. And we have an integrated system that communications around patients for complex care, not only can deliver care that's affordable but also excellent quality care, so that's what, what our message is. One comment, the Medicare system was unaddressed by the affordable care act, and is a huge portion of Federal spending and our budget. It rewards volume, but not quality. We would like to see the Government address Medicare and start paying for high quality care that lowers health care costs. That's what should be rewarded.
Ted Simons: When the President said it accomplished all the successes as he listed out, while adding years to Medicare's finances, while keeping Medicare premiums flat, is that accurate?
Dr. Wyatt Decker: It's debatable. What many economists have pointed out, that, that the economy has been in a slump since 2008, and that has driven down the utilization of health care services. And has increased the use of high deductible plants. So, many economists think that the major factor in leveling the cost of Medicare is not the affordable care act, but is, actually, a function of the economy. That's important because as the economy fires back up again, we might see Medicare costs climb. The other piece that's critical to consider is that every day in this country we have 10,000 citizens reaching the age of 65, and going on the rosters of med character so we have to address this and find a sustainable, affordable solution to our Medicare population.
Ted Simons: The President said that the law is helping millions while critics say it's helping those millions but it's limiting the personal choice of doctors, limiting personal choice of treatment.
Dr. Wyatt Decker: Yeah.
Ted Simons: And who is right?
Dr. Wyatt Decker: A little bit of everybody, and there is a bit of exaggeration with everybody. So, so, as you are seeing the theme, somewhere in the middle there is probably truth on both sides. So, for example, one of the challenges with the affordable care act is the insurance products out there are often creating what are called narrow networks. That means that I would be told, which doctors I can and can't see, it must be in a narrow network, and if I develop a complex condition, cancer, leukemia, for example, what if I want to a center of excellence, is that in my network? It might not be, so, we are advising at Mayo clinic, citizens to read the fine print carefully of any plan before they purchase it and make sure it includes the health care organizations that you want to be able to get to if you need them.
Ted Simons: A line of reasoning among supporters that say if your plan doesn't qualify, doesn't meet the standards of the affordable care act, your plan stinks. Is that an accurate assessment?
Dr. Wyatt Decker: Well, there are plans that did not qualify that were considered bare bones plants. They also had lower premiums. So, some would say those plans didn't do a good job covering their, their customers, if you will. Others would argue that Americans have been denied a choice to have a bare bones plan that did not cover conditions that they don't need. So, there is debate on that, and again, you can take either side. But, I think that at the end of the day, we would like to see Americans who, who have access to an integrated health care system that's affordable and comprehensive in nature.
Ted Simons: And you mentioned integrated health system a number of times, that's a big deal for what's going on in the valley right now, isn't it?
Dr. Wyatt Decker: That's right. So, here in the valley, we have a lot of great collaborations going on that we think are going to, to help solve some of these health care challenges. And I'll share a couple of them with you. One is, at Mayo clinic we're working closely with ASU and the school of health solutions to, to develop the field of health, sciences, engineering to the point where we can design health care systems that create value, meaning high quality at an affordable cost. Quick example, we have deployed a telestroke network at Mayo Clinic to 0ver 12 hospitals, and in a matter of 90seconds, a rural Kingman Arizona rancher can be talking to a Mayo Clinic stroke expert as well as his doctor and nurse, and that is saving lives.
Ted Simons: All right, very good, doctor, thank you for your impressions on the speech. It's always a bit in the middle, isn't it? A gray area. It's good to have you here and thanks.
Dr. Wyatt Decker: Great to be here, and thank you very much.
Arizona Artbeat: Ground Cover Public Art Project
Category: The Arts
- An ambitious idea from a Phoenix artist attracted hundreds of volunteers who turned a vacant lot into a textile garden of desert flowers. The creation was part of a public art project that not only attracted knitters, crocheters and quilters from across Arizona, the United States and Canada, but also helped hundreds of people in need. You’ll meet artist and project manager Ann Morton along with a volunteer and beneficiary of this unique project.
| Keywords: the arts
Ted Simons: Tonight's edition of "Arizona Artbeat" looks at a unique project unveiled in Phoenix, as producer Christina Estes shows us the project involved one vacant lot and hundreds of hands.
Ann Morton: We're at 1st street and McKinley on the Northwest corner. There is really nothing here. And that's what we wanted.
Christina Estes: Where Most of us see a dirt lot, Ann Morton sees a clean palette.
Ann Morton: I am a maker, and I love the craft of that. But, at one point, it just made me feel like I was in my ivory tower making art. And it, it -- who cares. And except for me, of course.
Christina Estes: When the City of Phoenix put out the call for a public art project to bring attention to empty spaces along the lightrail line, Ann came up with an idea called "ground cover."
Ann Morton: And it's a play on words, when you think of ground cover, you think of, of plant materials that, that is planted to cover the ground but, it's also thought about covering people on the ground.
Allison Ringness: I am a knitter, I am a constant knitter.
Christina Estes: Soon Allison ringness can call herself an artist.
Allison Ringness: Each is played up 28 squares.
Christina Estes: Her blanket will join 299 others to complete the Grown cover art project.
Allison Ringness: Whoever will have this blanket is going to be homeless, and on the streets, hopefully, getting off the streets. But, they are going to have something that needs to be machine washed and will go on the ground, and on benches, and all over the place. And they are not going to want something that's going to unravel. The day after they get it.
Christina Estes: And while she makes her blanket in Phoenix, other volunteers are knitting, crocheting and quilting across Arizona, the U.S., and Canada.
Ann Morton: You know, most of us think of art as a painting on the wall, or a sculpture that we experience, and that's, that's terrific. But, there is a new way of thinking about art that, that it's, it's making context for a community or organizations, so artists will go in, and they might see a particular need or issue, or just a desire to engage with the public, and construct an Aesthetic experience or intervention in the public realm, and that's what socially engaged art is.
Allison Ringness: All these blankets inner good hands.
Christina Estes: The blanketeers paid for their own materials and shipped their creations to Anne.
Ann Morton: We will be putting it in rows going this way.
Christina Estes: Eight months after her idea took root --
Allison Ringness: All right, thank you, everyone. [Applause]
Christina Estes: The ground cover public art project is unveiled.
Ann Morton: Its 20 rows by 15.
Christina Estes: Its impressive to see 300 handmade blankets covering the ground.
Ann Morton: Each one has, has its own personality.
Christina Estes: It's more dramatic, seeing the view from above. Each blanket is carefully color-coded to reveal lush desert flowers, the image stretching 117 by 50 feet.
Allison Ringness: I’m the Orange blanket at the top center.
Christina Estes: Like most blanketeers, Alison shared a message for the person who will receive comfort from her craft.
Allison Ringness: Big things start small. I was thinking to myself of, of the blanket, they started out as bundles of cloth or stains of yarn. But, in the end, they became these big and warm blankets with a big impact.
Christina Estes: From this, the blankets are bundled and given to groups that work with homeless people like circle the city, a medical respite center in Phoenix.
Brandon Clark: What a cool way to tell people that, that they are important, and that we care about them.
Christina Estes: Reynaldo Garza got the message.
Reynaldo Garza: My card, what it says is, this is -- it's made by Kathy, but it has a happy face here. Basically, that's all it really has on there. But, that happy face makes me happy because it is the way that I feel, you know. It is like they knew who was going to go it, and they, they made my day. I feel as if the blanket will benefit me in so many ways especially because most of the time I live in a van, and this will be my bed cover, my everything, I will take really good care of it. It's the best gift that I could have ever had.
Ann Morton: Discovering what has to be done and what can be done is a first step in realizing that this problem exists.
Blanketeer: That one, and I'm pretty sure this corner one.
Christina Estes: Before this project, most of the blanketeers had never met.
Blanketeer: My original idea was to do different searches.
Christina Estes: Now they share a common thread.
Allison Ringness: This has been a wonderful experience, and a rewarding experience, so I will definitely be doing more, more, more projects like this in the future.
Ted Simons: The ground cover project was funded by the City of Phoenix public art program and the national endowment for the arts.
Golf Course Design
- With the 2014 Waste Management Phoenix Open golf tournament in full swing, we take a look at the art of golf course design with Forrest Richardson, a golf course architect.
- Forrest Richardson - Architect
| Keywords: sports
Ted Simons: With the waste management Phoenix open underway we revisit a conversation with golf course architect Forrest Richardson about the art of golf course design. Good to see you and thanks for joining us. We talk about the art of golf, and there is an art involved, isn't there?
Forrest Richardson: There is, there is art and science, and there is also the game. So, it's really three elements, but the art is an important part of it.
Ted Simons: And I know you described it as golf, it's a sculpture, like a massive sculpture.
Forrest Richardson: It is. And most people see one hole at a time, in an airplane, you can be 30,00 feet 20,000, feet and you could see the course but most people don't appreciate it that way, what I do, I have to look at it that way and the individual whole.
Ted Simons: How do you do that? Let's say you have a plot of land, I want a bunker here. How do you do that?
Forrest Richardson: I wish it were that easy, and it can be sometimes if you have the right site but, it all begins with the land. And appreciating what the land has to offer. Many of our modern golf courses didn't have, you know, they were not built on the beautiful, you know, fields of Scotland so we have had to create in the last, you know, generation of golf courses, the interest so the TPC course is an example of a completely man made environment, but, nonetheless, one that's very beautiful and has a lot of, has, you know, spectator opportunity.
Ted Simons: Sure. And so, when you, when you design it, you can see from the ground, you could see the fairway from -- you could see, you could see from the ground, you can kind of see overhead how it looks? Can you get that in your mind? Do you have to draw it out? How does it work?
Forrest Richardson: We spend a lot of time on the land. We spend time with the mapping, the top graphical maps and the aerial photos, and so it is a combination of things, but, in the end, it's all about trying to make it fit the, not only the land, but also, fit the region and the culture, so a golf course, for instance, in Phoenix is a lot different, as most people know, from a golf course in Minnesota, or one in Mexico or in Europe.
Ted Simons: And also, fit, fits the ability of, I would think, your average golfer, because for a time, they were building courses that were ridiculously difficult.
Forrest Richardson: The game is supposed to be fun. And this is something that, that we say all the time and that probably has turned people away from golf, the fact that we made courses too hard. So the best thing is to come out of it with a golf course that challenges the best players, but is really enjoyable for the casual golfer.
Ted Simons: Let's talk about the history of golf, and we have photos here, including the first one which shows what the first golf course design architect looked at.
Forrest Richardson: That's in Scotland, and that is a golf course that, in the last few years, has been rediscovered, it was closed during World War II, and it is just a beautiful course that, that literally were, was reminiscent of the way that, golf courses would have been in the 1600, you know, the s and whatever.
Ted Simons: And now we have St. Andrews is next, the old course.
Forrest Richardson: Yes.
Ted Simons: And that's what people think of.
Forrest Richardson: And that's really where the first seed of golf course design was born in the late 1700s, they decided to change the old course from holes 22 to 18. And no one knows why. It could have been slow play or the town was growing, but that was the time when all of a sudden, the hand print of man was, was, was brought to golf courses.
Ted Simons: And you talk about the hand print, the next photo shows the golf courses in some respects were close to buildings and towns and roads and the whole nine yards.
Forrest Richardson: They were like the greatest ski lodge and resort you could imagine, you finished golf and you were right there at the pub and the restaurant and where you spent your time. But, what happened is when golf came to the United States, in America, in the late 1800s, we did not really know what they were supposed to look like. So, the, my predecessors, the people that started designing courses would create these manufactured looks, so Oakmont in Pennsylvania is an example of an archaic looking golf course, not a lot natural about it. A lot of man made features.
Ted Simons: Yeah, that does not look normal.
Forrest Richardson: Those are the famous church pew bunkers.
Ted Simons: The next one is Robert Trent Jones? He's known, he's the Forrest Richardson of golf course design.
Forrest Richardson: Mr. Jones, Trent as we called him, he has two sons that now carried on his work, Reese and Bobby, but, the Wigwams, which is this picture, very typical of the post-world War II golf being built everywhere in the United States. Firestone. The Wigwam, and the 60s and 70s were rich with build more, build more.
Ted Simons: And signature courses meaning people know by certain details who --
Forrest Richardson: Mr. Jones coined the phrase of a signature golf course, and he said, hard parse, easy bogeys, so that's another one.
Ted Simons: Yeah, right. And we have a, a picture here of the seventh hole at stone harbor, and this looks like another signature Par 3 hole.
Forrest Richardson: Desmond was one of the truly right brain out there thinking gentlemen in golf course design, and in the 80s, Desmond created these really wild symbolistic courses, and he did a lot of them in Indonesia and Japan, but a few in the United States, and unfortunately, stone harbor doesn't survive all of the work that he did there, has been tamed down, but nonetheless, it was a time in golf course design when, when the art was really brought to a completely different level.
Ted Simons: And when you see the sod grass, that's the one that --
Forrest Richardson: Pete and Alice Dye and that's what really was the, the precursor to the TPC course in Scottsdale where we were creating courses for spectators.
Ted Simons: Let's look at some of your courses starting with the Arizona Grand. Now, when you designed this course, you got -- you got such a beautiful scenery to work with. How -- first of all, what do you try to emphasize on a course like this, and secondly, how do you keep it from standing out like a sore thumb in the beautiful desert environment?
Forrest Richardson: Well, it was a tough assignment. It was very controversial because we were using land that was adjoining and in the Phoenix mountain preserve, but, it turned out to be a win-win because we created a new habitat for the parks, so the exchange of land brought more land to the park, but, it's really all about integrating it with the land, and taking advantage of the great views and taking advantage of the terrain and, and making it feel like it's been there for 100 years.
Ted Simons: Got the hideout in Utah, same thing, only, the high country here. Is it easier?
Forrest Richardson: It is more difficult because you have a shorter growing season and other constraints. Again, the idea is to really fit the land to the golf and have the golfer feel they are in an environment like when people see pebble beach on TV, where they see any famous golf course, it's all about the land.
Ted Simons: And Las Palomos, you have the wind down there, and this is like a links' course down there.
Forrest Richardson: It's a links' course, and that particular hole, there was virtually nothing done to it, so it wasn't so much about designing, but going back to the very first slide, where the -- where the golf course was found and discovered, as opposed to being created.
Ted Simons: Last, we have a minute here, critics say golf courses, they say golf courses waste water, there is too many of them out there, they are a poor use of land, leave things in the natural state, what do you say?
Forrest Richardson: To some degree those are fair comments. However, most golf courses, not all of them, but most use reclaimed water, in Hawaii when we build them, they want us to -- they put more turf in because the land is so porous that having the reclaimed water filtered by the plant is a positive thing, and then most golf courses, anywhere, are serving a purpose of open space. They are serving for drainage, and, you know, a golf course has enough oxygen produced to maintain a city of about 100,000 people. So, golf courses are sustainable open space, and if they are designed properly and built properly, they can be terrific neighbors to a community.
Ted Simons: All right, very good. Forrest, thanks for joining us.
Forrest Richardson: Thanks for having me.