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December 15, 2004

Host: Michael Grant
Topics:
Author Clay Thompson;
Arizona Health Care Forecast;
Radio talk-show host Charles Goyette
In-Studio Guests:
· Charles Goyette, talk show host, KXXT;
· Roger Hughes, Executive Director, St. Luke's Health Initiatives;
· Clay Thompson, author and Arizona Republic columnist



>> Michael Grant:
Tonight on "HORIZON," a local talk radio host is at the center of a controversy over station ownership and political opinions. Now Charles Goyette appears on a national news program to talk about it.

>>> Michael Grant:
Plus, critical healthcare policy decisions are facing Arizona in 2005 and beyond. A forecast of healthcare costs, coverage and work force issues.

>>> Michael Grant:
And no, it's not the famous statue of Rodin's "The Thinker," but, yes, it's "Arizona Republic" columnist Clay Thompson. He talks about his new book "The Valley 101 Great Book of Life." That's next on "HORIZON."

>> Announcer:
"HORIZON" is made possible by the friends of Cchannel 8, members who provide financial support to this Arizona PBS station. Thank you.

>> Michael Grant:
Good evening, I'm Michael Grant.

>>> Michael Grant:
Charles Goyette can be heard weekday mornings hosting a talk show on local KXXT. Goyette says one of his previous employers, KFYI, did not renew his contract because management didn't like some of his criticisms of the Bush Administration and the war in Iraq. On Friday, Goyette will be featured on Bill Moyers' final broadcast of "Now" to talk about dissenting voices in the media. Here with a preview is Charles Goyette. Charles, good to see you.

>> Charles Goyette:
Good to see you.

>> Michael Grant:
So you have a dissenting voice?

>> Charles Goyette
: I'm usually dissenting about something or another. That's my job in life.

>> Michael Grant:
You got in trouble at KFYI because you were critical of the war in Iraq?

>> Charles Goyette:
You know, I thought that a case had not been made that Iraq represented a serious military threat to the United States, and I featured a lot of guests that suggested that, for example, they weren't really capable of flying drones overseas. We talked about weapons of mass destruction and the possibility that they did not have the stock piles that the administration represented that they had, and ties to Al-Qaeda and the consequences of the war as well that are clear now not to have been well planned for. That didn't go down well in that period and it was a period, if people will recall, of really serious war hysteria that in my view was generated and cultivated by design by the administration.

>> Michael Grant:
You talked about some of the constitutional aspects of it as well, including but not limited to the failure to -- of Congress to declare war. Is it possible that you thought that your audience was conservative and it actually is Republican?

>> Michael Grant:
Did you miss that point?

>> Charles Goyette:
It's funny you should mention that I grew up in the Goldwater conservative movement in Arizona. The constitution, conservatives respect the constitution, we want judges that don't interpret the constitution, but enforce the constitution, so on, so forth. So when it came time to declare war, suddenly the conservatives were silent about a constitutional declaration of war. It's as though all of those years, all that reliance upon the constitution as the bedrock of modern day conservatism was thrown out the window. Because now it's our guys and our guys don't need to be restrained or tied down.

>> Michael Grant:
What is Bill Moyers after?

>> Charles Goyette:
He has been concerned about the consolidation of the media in the hands of just a few large corporation like Clear Channel communications which is the 800 pound gorilla in radio broadcasting. They own 1200 radio stations.

>> Michael Grant:
Actually it's 3-million radio station.

>> Charles Goyette:
And they own every one of them and they have a death grip on all of them. He's been concerned about that sort of thing. I'm more sane begin about that because I've seen the media from a different perspective. I get more information for a laid your talk show in an hour on the Internet now than I used to get in five or six hours of preparation and subscribing to three or four newspapers and half a dozen magazines. There are so many alternative sources of news and information that this consolidation or quasi monopoly that the broadcasters have now doesn't bother me as much as it bothers Bill Moyers.

>> Michael Grant:
I always thought there was a fiction here about well, you maintain this cacophony of local voices and different editorial viewpoints. And you and I both know that 90% of the broadcast band is doing entertainment, music and other things. So you can conceptualize that, but the reality doesn't track that.

>> Charles Goyette
: The reality is there are never a lot of real edgy dissenting voices in the mainstream media. That's the reality. It's always been that way. In my experience and I'm sure in yours too, it's been interesting to see the established broadcasters use the power of the government to restrain competition. I mean, I grew up in Flagstaff. We watched channel 8 in Flagstaff on cable. There is no reason why Phoenix Arizona with even more dense population couldn't have been cabled many, many years before it was, but the existing television broadcasters wanted to keep the cable companies out. In turn, the cable companies, once they came into the market, they wanted to keep the telephone companies from providing programming down the telephone lines. So they try to keep the competition out.

>> Michael Grant:
Moyers has expressed a concern about a right-wing takeover of the media. I look at the "New York Times" and "Washington Post" and maybe the three major networks and those kinds of things, and I don't quite share his concern, but has there been a media, perhaps veer to the right?

>> Charles Goyette:
There has been this, I believe, Michael. Instead of watchdog journalism instead of journalism students waning to be woodwards and Bernsteins like in the '70s, we've seen journalism by government press handout. All of these things that should have been questioned by a watch dog press, all of the representations by mushroom clouds and smoking guns and Saddam Hussein tied into the 9/11 attacks, all of those stories that should have been looked at before the preemptive war should have been looked at. The overseas press was doing a good job, so I think Moyers may have a point that the American news media has not done its job.

>> Michael Grant:
The station you are on now bills itself as progressive. Do you fit?

>> Charles Goyette:
I don't fit in anywhere. I don't care whether somebody has an R or D after their name. I'm an equal opportunity watchdog.

>> Michael Grant:
Speak of watching, we'll watch on bill Moyers. Charles Goyette, thanks for stopping by.

>> Charles Goyette:
Thank you Michael, good to see you.

>> Michael Grant:
Healthcare experts recently gathered for a nonpartisan exploration of critical healthcare policy issues facing the state in 2005 and beyond. The rising cost of healthcare, the number of uninsured people in Arizona, and the shortage of healthcare workers in our state were among the issues discussed. Merry Lucero reports.

>> Speaker:
In the 2003/2004 session, the state emergency services coverage for physicians were also eliminated. Hospitals have gone out a year earlier. Eligibility for AHCCCS was reduced from 12 months to 6 months.

>> Merry Lucero:
The conference room was packed with people concerned with the future of Arizona's healthcare system. They were there to discuss healthcare policy issues. Three specific areas were covered. The rising cost of healthcare, the uninsured and Arizona's severe shortage of healthcare workers.

>> Carol Lockhart:
Well, one of the issues is we're a rapidly growing state, so we need more numbers, no matter what. And that means we've got to have more schools, more programs for nursing and allied health. We have a new medical school under development because there is some concern about shortages in certain physician areas. We need to be able to support those schools financially. We also need to be able to support students financially, so that they can get through school.

>> Merry Lucero:
Business leaders discussed better ways to provide healthcare coverage.

>> Chip U'Ren:
We essentially have been individual purchasers of healthcare for our employees. We need to create affiliations and collaborations among employers generally to really begin to think fundamentally about how we change the payment system and the value structure within the industry. So there is some emerging conversation going on, but it needs to be formalized in a much more focused way.

>> Merry Lucero:
State Senator Robert Cannell from Yuma is a physician. He is looking ahead to address policy issues in the new legislative session.

>> Robert Cannell:
I think as usual, the biggest bill will be the budget bill. How are we going to afford the healthcare that we already have? I think it's going to be another session in the budget format of trying to hold on to what we have. The fact is, even though we have a conservative legislature, Arizona has the best Medicaid system in the country. We cover almost a million people. I think that's a good thing. There are members of the legislature that aren't so sure that's a good thing. There may well be part of the budget process maybe trying to cap enrollments or bring in co-pays which we've dealt with before, trying to ratchet down some of the programs that we have. From my standpoint, I think most of it will be fighting to hang onto what we have.

>> Merry Lucero:
The conference sought to discuss what can be done to improve healthcare, hence, one of the themes "no whining."

>> Michael Grant:
Joining me now to talk more about the health futures forecast, Roger Hughes, Executive Director of St. Luke's health initiatives. So was there no whining?

>> Roger Hughes:
Well that lasted for about five seconds. Whenever you get a group of healthcare people together, there is invariably wining about the system.

>> Michael Grant:
I understand the attendance at the conference was bigger than expected.

>> Roger Hughes:
It was bigger than expected. We had a pretty good turnout from the legislative crowd; the media was there. We always have trouble attracting the business community, but with healthcare costs kind of increasing, harder to pass those onto anybody, except our own employees, so you are starting to get their attention, too.

>> Michael Grant:
Is affordability the number one issue at this point in time because we're reading all sorts of stories and for that matter, we're seeing in a lot of our paychecks the rising cost of healthcare, the premiums have gone through the roof.

>> Roger Hughes:
That's putting it mildly. You know, I can tell you in our own case, St. Luke's health initiatives, a small employer, family of four, the annual premium $18,000. 75% paid by the employer, 25% paid by the employee, in my own case that's a payment every month of over $400. That's a nice car payment.

>> Michael Grant:
Well that's right. There was a story in the paper about how many large employers are starting to back away from assuring healthcare benefits for their future retirees and also increasing the cost for their current retirees.

>> Roger Hughes:
That's exactly right. That's one of the things you are seeing. The other thing you are seeing is that among the uninsured in this state, which we estimate to be about 994,000 people, 80% of those folks are working. About 40% of that 80% are working for small employers, but you are seeing increasing number of people who actually work for large employers who aren't able to pay for the premium take-up rate, particularly if they are low income jobs. So, one of the questions I think we kind of have to talk about in the future is, you know, the advisability of continuing to tie health insurance to employment.

>> Michael Grant:
Well, here's another problem. The newspaper ran a story this morning about a hospital that charged $275 for a tee shirt. Now that doesn't help the premium costs either.

>> Roger Hughes:
No, no. That doesn't. That's like the $10 aspirin and some of the other stuff you may see on your bill. It's cost shifting. You know, hospitals charge those kinds of fees for the products and everything because Arizona hospitals, for example, in 2003 paid about $225 million in uncompensated and charity care. When uninsured people show up in emergency rooms, when people can't afford to pay their medical bills but they have to get medical care, they are required to by law, somebody has to pick up those bills, and it's no free lunch. Even though people get used to thinking there is a free lunch, if someone else is purchasing the product for them, and that's what's happening in healthcare, and frankly, very few people know what health care really costs. There is no transparency of information between the purchaser and the provider or the seller in this case.

>> Michael Grant:
Do we focus enough on sending price signals to people who do have insurance? I mean, obviously co-pays and those kinds of things are steps in that direction, but have we done enough with just simple things, such as price signals to help the situation?

>> Roger Hughes:
You know, we really haven't. I think one of the reasons we haven't is that there's a fairly intense middleman layer between the buyer and the seller.

>> Michael Grant:
Right.

>> Roger Hughes:
And it's the -- you know, it's the people that are paying for it, for example, the end users, who are really paying for it with higher prices, higher premiums and everything, who are going to have to be brought into the information marketplace and understand what the product really costs. But in order to do that, we have to have mechanisms in place that publish those prices, compare those prices, along quality and performance, among providers and make them publicly available. And frankly, that makes some people in the industry nervous.

>> Michael Grant:
Do we have enough products marketed? I mean, for example, there are the so-called large deductible or catastrophic plans where if you are reasonably healthy, maybe you want a deductible of $3,000 a year or $5,000 a year, you just don't want to be, if you get really sick or injured, you don't want to be hit at $25,000.

>> Roger Hughes:
That's right. You are going to see more of those health savings accounts and similar types of products rolling out in the market. You are not seeing a huge take-up rate among those among employers. They haven't caught on. But all of the experts are predicting they are going to increase in the years ahead. You have to consider that 70-80% of all of the healthcare costs in this country are utilized by 10% of the people, and for those folks, these kinds of plans aren't going to do anything. I mean, these are people facing bills of $100,000 $150,000, and until we start getting a look at the high end users, start focusing on chronic disease management and care, prevention care, the only way to lower costs in health care ultimately is to keep people out of the system.

>> Michael Grant:
Roger, this strikes me as a subject a lot like the weather. I cannot tell you how many times I've talked about this subject.

>> Roger Hughes:
We've been talking about this subject for about 40 years, and I mean, in a crisis mode, probably every year since 1975, you could have somebody on this program telling you that healthcare was in crisis, high prices, malpractice, worker shortage, General Motors paying more for health insurance than steel, et cetera, et cetera. And today, the difference is, in 1973, healthcare was 7, 8% of the GDP, $73 billion a year. Today $1.7 trillion, 15% of the GDP. It's a huge industry. People have a lot of vested interested in seeing that it continues to grow.

>> Michael Grant:
All right, Roger Hughes, thank you very much for joining us.

>> Roger Hughes:
My pleasure.

>> Michael Grant:
Why do plastic bags repel flies? Do birds have heart attacks? Why don't spiders get caught in their own webs? They are all questions that "Arizona Republic" columnist Clay Thompson is thankful for. That is because the answers he writes to those questions are what make up his daily column on the back of the "Arizona Republic's" Valley and State page. "Valley 101" is also part of the title of his new book, "The Valley 101 Great Book of Life." Joining me now, Clay Thompson. Clay, it's good to see you again.

>> Clay Thompson:
Thank you for having me.

>> Michael Grant:
Let's note the fact that you've got a web site on this book right on top.

>> Clay Thompson:
Claythompsonbooks.com. Now I'm off the hook with the publisher.

>> Michael Grant:
And we've got a link to that at the end. Did you really get a picture that was made up of drier lint?

>> Clay Thompson:
Yes, I did. Someone sent it to me. I forget exactly what it was. It was kind of abstract, but, yes, somebody collects drier lint out of their trap and the different colors and they used it to make a design of some sort.

>> Michael Grant:
Was it kind of gross?

>> Clay Thompson:
Yeah. Wouldn't you expect it to be kind of gross?

>> Michael Grant:
It wasn't so much gross as it was interesting.

>> Michael Grant:
Have you got an estimate on average, you know, how many questions you get in a day, a week?

>> Clay Thompson:
It comes and goes and I've never understood why. I get anywhere from 10 to 50 a week, and I've never understood the ebb and flow of those questions, why they all seem to come in at once and why then sometimes they slow down, why the same question seems to come in several times in a few days. I don't understand that either.

>> Michael Grant:
I'm going to take a shot and say that you know more about Google than probably the inventors of Google know.

>> Clay Thompson:
I doubt that but I would be dead in the water without Doug Google.

>> Michael Grant:
That was going to be my question. Could you do -- because you put ought a tremendous volume of work? Could you do a column like this 10 years ago when we didn't have the Internet or search engines like Google?

>> Clay Thompson:
If I actually had to work, yeah. I mean, if I actually worked real hard at it I probably could.

>> Michael Grant:
You can't find this stuff in encyclopedia Britannica.

>> Clay Thompson:
I have a list of experts I can call about different questions. And I have a big stack of reference books I've stolen out of the newspaper library on my desk and I do have Google and it's -- I always tell people it's what reporters do. Reporters know who to call and what questions to ask and so forth and I hope that that's what I'm still doing.

>> Michael Grant:
You know this is a fun book, and the thing that makes it, I think, most fun, clay, a complement to you, a lot of the questions.

>> Clay Thompson:
A compliment? I'll take it.

>> Michael Grant:
The questions are engaging, but you've got terrific asides. You've got terrific transitions. You really are just a very good writer.

>> Clay Thompson:
Well, I've been very fortunate that my editors and bosses have allowed me to write it in the way that I do, not the standard newspaper kind of style. I've been --

>> Michael Grant:
Your masters?

>> Clay Thompson:
My masters. I've been lucky that I'm allowed to do it in the way that I do.

>> Michael Grant:
It's broken into about five chapters or so. And it's interesting. You state that every one of the chapters is your favorite, so I won't go into that. Why does a plastic bag filled with water repel flies?

>> Clay Thompson:
Nobody seems to know for sure. One thing is -- one idea is that it might look like a hornet's nest and they prey on houseflies and that frightens them away. The reason I think it is is because it confuses their -- it messes up their vision, the light reflected through the water in the plastic bag messes up their vision and they get confused.

>> Michael Grant:
Actually until I read that column, I didn't even know the theory, but apparently it works.

>> Clay Thompson:
Until somebody asked me the question, I didn't know the theory either.

>> Michael Grant:
I've got a lot of water bags hanging around my patio.

>> Clay Thompson:
Do they work?

>> Michael Grant:
Works like a gangbuster. Do birds have heart attacks?

>> Clay Thompson:
Yes, birds under stress, especially poultry, chickens or turkeys or whatever that are confined in big pens or sort of industrial farms, if they get crowded or stressed they have heart attacks. Birds in the wild, I don't know if they have heart attacks or not. I've never seen a bird falling out of the sky clutching its chest but maybe they do. I don't know.

>> Michael Grant:
In fact, on that one, I think you reported that -- at the major chicken farms that they have like about a 5% death rate.

>> Clay Thompson:
Something like that because of stress and so forth.

>> Michael Grant:
I loved the question on how come the lion Tamer has a chair.

>> Clay Thompson:
I did too. It was a great question, wasn't it?

>> Michael Grant:
Yeah.

>> Clay Thompson:
It turns out the four legs of the chair confuse the lion. It's hard for the lion to focus on more than one thing at a time just like for me. If you wave the chair at them they get confused so they forget about jumping off the thing and eating you.

>> Michael Grant:
All of this time we thought it was the whip or the gun and it actually was the chair that was doing the job.

>> Clay Thompson: The chair keeps them mixed up.

>> Michael Grant: Why don't spiders get caught in their own webs?

>> Clay Thompson:
What would bow the point, if spiders got caught in their own webs, we wouldn't have spiders. They have especially designed feet. They've got a walking claw or something that helps them slide along the sticky web without getting stuck in it. Like I said, if spiders got stuck in their own webs, we wouldn't have any spiders.

>> Michael Grant:
That's right. Now, the next chapter that is actually your favorite as contrasted to the creature's great and small chapter is about Arizona. I had never thought about this idea before, but you throw your Christmas tree into your swimming pool to make sure it's nice and fresh and well hydrated.

>> Clay Thompson:
I've never tried it myself. And I don't think I will this year because I don't have a pool at the moment, but supposedly if you toss your tree into the pool and leave it for a day or so, that -- it soaks up a lot of moisture and keeps it moist and fresh longer.

>> Michael Grant:
But as you pointed out, I don't know that it's going to be real good for the filtration system.

>> Clay Thompson:
Like you said, I don't have a pool so I don't particularly care about the filtration system.

>> Michael Grant:
A combination question, a couple of people wrote in and said why in Arizona do we have so few basements and why in Arizona do we have so few tall buildings.

>> Clay Thompson:
It's a spatial matter. We don't have very many basements because kind of because of the ground. The Sandy soil around here doesn't lend itself to digging down a basement needs in this kind of soil needs a lot of reinforcement and so forth. It's also cheaper -- they are very expensive to put in a basement. The reason we don't have a lot of tall buildings is because it's cheaper to build out, out onto the edge of town than it is to build up. And there is also some factors involved like the changing nature of corporate headquarters and communications and so forth. Basically it's cheaper to build out than up and to build on a slab than to put in a basement.

>> Michael Grant:
In reading that column, you reminded me of that story I had forgotten about, which was -- was it the Frenchman in the late 1980s.

>> Clay Thompson:
He was going to build the world's tallest building here in Phoenix.

>> Michael Grant:
120 stories.

>> Clay Thompson:
Nothing much came of that.

>> Michael Grant:
Spicy food cools you down?

>> Clay Thompson:
Yes, it does. And that's why so many spicy foods come from hot weather cull chewers, such as Mexico, Thailand or places like that. It's because it makes you sweat and sweating cools you off.

>> Michael Grant:
Resist the temptation to sing "it's a small world" to this, but there actually is a stuck song syndrome?

>> Clay Thompson:
Yes, there is. The German word for it means ear windstorm. It's a song that burrows into your mind and stays there. I don't remember the mechanics of this, but I'm told that smelling or eating cinnamon will make this go away.

>> Michael Grant:
You also warn people about going to the web site that you found on this, because they had several examples.

>> Clay Thompson:
Yes, and I kind of wish you hadn't mentioned "it's a small world after all" I have to have some cinnamon now.

>> Michael Grant:
Clay Thompson, it is a fun book.

>> Clay Thompson:
Thanks for having me.

>> Michael Grant:
For links to this program or see transcripts, visit our web site that address is www.azpbs.org, click "Horizon" and follow the links. The valley's housing market continues to sizzle and economists say it will continue to do so. And it looks like job creation is picking up some steam, but it's not all good news for the economy the dollar continues to sag and the federal deficit continues to grow. Join us for an economic update Thursday at 7:00 on "Horizon."

>> Michael Grant:
And tomorrow on "Horizon," stay tuned for "Horizonte." Thank you very much for joining us this evening. I'm Michael Grant. Have a great one. Good night. .

 

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