June 12, 2018 • 20 mins
Rules about net neutrality were struck down Monday beginning a new debate in the policy. Kim Hart of Axios gives insight and breaks this complicated story down for us. Also, air ambulances are becoming more and more common as the cost for these emergency rides soar, Bloomberg's John Tozzi details what happened to a family after their toddler suffering a 107* fever took a more than $50,000 ride to save his life and what lawmakers are doing to fix this. Finally, we'll check in on the happenings in Singapore surrounding the summit between President Trump and Kim Jong Un with Alayna Treene who has been following the story for Axios.
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Episode Transcript
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Speaker 1 (00:00):
It's Tuesday, June twelve, and this is the Daily Dive.
It's the end of net neutrality, but maybe not forever.
The FCC has rolled back rules on Internet service providers
that would prevent them from blocking content, throttling the speeds
of data, and creating fast lanes for customers who paid premiums.
(00:21):
As the Internet continues to increase its importance in our lives,
advocates are still fighting to keep the rules in place.
We will speak to Axios Managing editor Kim Hart to
break down this repeal. Next, we will tell you a
story about a child with a one and seven degree
fever who was airlifted to another hospital for better treatment
and then got slapped with a bill for over forty dollars.
(00:41):
We'll speak to Bloomberg reporter John Tazzi about the air
ambulance business and the massive bills they are charging patients. Finally,
it has happened. President Trump and Kim Jong un met
face to face to hammer out a deal on d
nuclearization the Korean Peninsula. We'll speak to Elaine Natrine, reporter
for Axios, about this history at the moment and learn
more about the personality and quirks of the North Korean leader.
(01:05):
It's news without the noise. Let's dive in. Nothing about
the Internet was broken, nothing about the law had changed,
and there was not a rash of Internet service providers
blocking consumers from accessing the content, applications or services of
their choice. By taking these heavy handed rules off the table,
(01:25):
by establishing once again the bipartisan light touch approach that
we had for almost twenty years, we're going to see
a lot more competition joining us now is Kim Hart
Axios Managing editor. Thank you for joining us. Kim, the
net neutrality repeal is official. It happened yesterday. All the
rules have been taken away. Kim briefly tell us what
the idea of net neutrality is and then what were
(01:47):
the rules that were taken away. Net neutrality refers to
the concept that internet service providers, the companies like Verizon,
AT and T and Comcast, should have to treat all
traffic and content equally as it passes through their networks.
So that means that it wouldn't be able to give
preferential treatment to a Netflix show over a NBC show,
(02:09):
for example. This comes back all the way to the
early days of the Internet when the startups of the Internet.
The Googles of the world were concerned that the Internet
service providers could act as gateways to decide which traffic
got sped up and which traffic got slowed down, and
could therefore interfere with the consumer's experience. And with all
(02:30):
the new mergers between media companies and telecom companies, I mean,
this thing gets very complicated. Like you said, the worry
is would they be speeding up their own products versus
other people's. Ten years ago, when this debate really started
and earnest in Washington, you had two very separate industries
that relied on each other, but they were still pretty distinct.
(02:51):
You had the telecom companies like the phone and internet
companies that actually provided the pipes that take the Internet
service from or router the server all the way to
your home or your cell phone. And then you have
the content companies like the Hollywood studios, the programmers, the
cable channels, and then increasingly the Silicon Valley companies as
they're creating their own content. So really it's the content
(03:14):
companies needed to strike deals with the Internet providers in
order to make sure that their content was able to
get to the consumers on their laptops, on their phones,
on their smart TVs. But now you're seeing a lot
more of these companies start to merge together, so that
a one company might would probably own the pipes as
(03:34):
well as the content. This is what you started to
see with Comcast NBC Universal when those two companies merged
back in and also what you're seeing with a T
and T s attempt to buy Time Warner. The decision
for that actually comes out on Tuesday, so it's all
kind of coming to a head right at the same time.
So the rules are taking away the internet service providers,
(03:54):
they can't block content, they can't throttle customers anymore, and
the paid prioritization, which you know, giving their own products
more beneficial speeds there, but none of the stuff is
gonna be implemented right away. I mean a lot of
internet service providers have also pledged to not change anything recently.
So what is the what is the big worry right
(04:15):
now or how are people going to be impacted initially? Really,
there's not going to be a big y two came
moment if not, like a switch is going to be
flipped and all of a sudden, your internet service is
going to slow down. You're not going to be able
to get the same streaming shows that you're used to getting.
Nothing will really change for the consumers experience right now
the day after these rules go away. The big concern
(04:37):
is that if these Internet service providers are not bound
by federal rules, and they're not enforced by the Federal
Communication Commission, then you know, your Internet service providers might
try to enter into some interesting service arrangements with other companies,
or strike a deal so that a certain type of
content over the Internet. Maybe one app works better on
(05:00):
your cell phone than another app in exchange for a fee.
The concern is that internet that the public interest groups
and other public consumer advocates have raised is that it's
going to be really hard for the average consumer to
really be able to understand what's happening. If all of
a sudden they have an app on their phone or
a streaming online service, or they're trying to watch a
(05:20):
movie on on their laptop. If suddenly that becomes really slow,
it's hard to know is that just because I have
a bad connection, or is that because an I s
P has entered into some arrangement that I'm not sure about.
So I think the concern is that not right away?
Because I think all the I s p s are
going to be on their best behavior. They know the
world is watching. And but that as people start to
(05:40):
pay less attention, that it's going to be really hard
for consumers to know if there's some sort of funny
business or deals happening behind the scenes. A lot of
governors in in a number of states have past laws
and rules saying that we're going to keep the same
rules implemented already, so things wouldn't change. There would be
a weird situation, a global internet kind of taking a
(06:01):
different form from state to state. Now, what's happening on
Capitol Hill? A few things are happening. Uh, the Democrats
are really pushing to try to roll back the FCC's
action that took place on Monday and in order to
restore the net neutrality rules. This is under a small
provision called the c r A, and on Capitol Hill,
(06:22):
it's a it's a resolution of disapproval, So Congress can,
if it acts in a certain process and in a
certain time frame, overturn an FDC's decision. So the Senate
already passed this measure now goes to the House. Now
the House has a pretty steep climb to get the
number of votes that it needs. It needs a lot
of Republicans to sign on to this measure in order
(06:44):
to overturn what the FDC did on Monday, and a
lot of people are doubtful that they're going to be
able to pull it off. But the advocates are really
trying to at least get some Republican lawmakers on record
saying I support net neutrality, because they think that that
will help them in the future iteration of this fight
as it continues. There's also some there's been this long,
(07:04):
years long effort to try to come up with some
sort of compromise between Republicans the Democrats to put in
place some permanent net neutrality legislation so that the rules
at the FDC level aren't victim to the political ping
pong where they're changed depending on which party is in
power and what kind of administration um is in the
(07:25):
White House. Yeah, it's just really interesting. As the Internet
is such a huge part of our lives. A lot
of people's eyes glaze over when they here net neutrality,
but it's a very important issue and and really the
future of how we use this service Kim Hart, Axios
Managing editor, Thank you very much for joining us. Thank you.
(07:50):
Physicians at the local hospital decided that the child needed
to higher level of care. They called for a helicopter
to send him to a children's hospital and Charleston, West Virginia.
I believe after that the family got a bill for
forty five thousand some odd dollars. Their insurance plan, which
was the state public employees plan, had agreed to pay
(08:13):
about six thousand, seven hundred dollars. Joining us now is
John Tazzi, reporter for Bloomberg. So this is a very
interesting story. High medical bills are not unheard of, obviously,
but this is pretty crazy. This has to do with
air ambulances. So when an emergency happens and you need
to be airlifted out of somewhere in a helicopter taken
to a hospital, there was a family who was hit
(08:34):
with a forty five thousand dollar bill. What happened in
this case, So this is a family who had a toddler,
a three year old, who came down with a really
high fever. Went to their local hospital. It was in
a small town in West Virginia, and the positions at
the local hospital decided that the child needed a higher
level of care. He was burning up. They called for
(08:56):
a helicopter to send him to a higher level of
care at a children's hospital in Charleston, West Virginia, I believe,
and he was treated. Their stabilized spent a few days
in the hospital. After that, the family got a bill
from the air ambulance provider, a company called air Methods,
for forty five thousand some odd dollars. Their insurance plan,
(09:20):
which was a state public employees plan, had agreed to
pay about six thousand, seven hundred dollars, which they said
was equivalent to what Medicare would pay for the same services,
but bill was much higher, and the company build the
family for the rest, so the total cost was like
fifty two grand plus it was more than that. There's
a concern that there could be some brain damage with
(09:40):
such high fever. The kid had an hundred and seven
degree fever. So yes, you got to do these things
in an emergency. But then you started looking into the
big business of air ambulances, and they've doubled in sizes,
their costs have doubled in size, and what they charged,
like you said, for private insurances and Medicare and Medicaid.
They don't over those costs. After that, it all goes
(10:02):
back to the patients. It's a really complicated area of healthcare.
This industry has grown up a lot in the past
fifteen years, certainly, and going back to the nineties, there
were only a handful of helicopters, a few dozen across
the country, mostly operated by hospitals. Now there are almost
a thousand medical helicopters in the United States, about nine
(10:23):
hundred or so. Many are controlled by for profit private companies.
Now that's not that different from hospitals, right there are
a lot of hospitals that are for profit, privately owned.
What's complicating factor in this part of the business is
that they have to respond by law when there's an emergency,
and patients aren't really in a position to shop for
(10:46):
services to compare prices. They're urgent medical situations, so a
lot of resolving the billing and payment happens after the fact.
And recent years we've seen sort of a growth in
this practice of months billing for patients with private insurance.
If the insurance won't pay for it all, the provider
will ask the patient to pay directly. As you said,
(11:10):
you don't really know what to expect in an emergency
when you need the service. Even the air ambulance companies,
they say the people that they fly a lot of
times are poorer patients, but they don't know exactly what
it is that it's not until days later whether they
know somebody can pay or not. And for the patient,
you're in an emergency, you need help quickly. You're not
(11:31):
necessarily concerned with the bill at that at that moment. Right.
One thing, it's important to notice that part of this
business is reimbursed by Medicaid, which is insurance basically a
state insurance program for lower income people, which generally pays
below costs, sometimes well below costs for these air ambulances,
and a lot of it is also Medicare, which pays
(11:53):
a little bit more. That's for generally Americans over sixty five.
But the industry says that that even Medicare rates don't
fully reimbursed for their costs of operating these helicopters at
the scale they have them. Now, what services do they
usually provide for? I mean, you think of an being
airlift at us somewhere, it's something in a remote location
(12:13):
or extreme emergency. So what they've expanded though to include
other services. Yeah so, And I mean you may have
an image in your mind of these mostly being picking
people up off the side of the road after a
motor vehicle acted. And actually it turns out most of
the transports are between hospitals, so they're taking people from
maybe a smaller rural hospital to a place with a
(12:35):
higher level of service, technologies or experts that aren't available
at the initial hospital where a patient is treated. And
they've respond to traumas like car accidents, but also heart attacks, strokes,
and other sort of time urgent situations. Is their regulation
coming or anything on the horizon to help patients who
(12:56):
get these huge medical bills. Yeah, so that's an inter
instinct question. I mean, one of the reasons that this
piece of the health care industry, and to be clear,
like balanced building is an issue in other areas of healthcare,
it's not exclusive to air ambulances. But one of the
reasons it seems to have turned up here a lot
is because states actually have no legal authority to regulate
(13:20):
the prices or the charges of these companies. And that's
because under the federal law in the nineteen seventies that
deregulated the airline industry. That was the law that said,
you know, the government's not going to set prices for
Delta or United, and you know that we're going to
have a private airline industry for commercial fight. Well, these
(13:42):
companies are counted under that law pre empt state regulation.
So you know, individual states have tried just to limit
how much, for example, a state workers compensation plan pays
for these services, and the courts have generally ruled that
they don't have the authority to make those kinds of regulations.
There is an effort in Washington to roll back some
(14:03):
of that exemption, but that's you know, there's nothing, nothing,
kind of concrete in the law yet to do that.
John Tazzi, reporter for Bloomberg, thank you very much for
joining us. Thanks h much. There's this picture that shows
(14:24):
he's this man who was prone to fits of anger
and was always kind of swaggering around with his classmates
and also kind of demanded this loyalty from other children then,
and that kind of foreshadowed the kind of leader he
is today. Joining us now is Eleana Trine, reporter for Axios.
She's covering all of the North Korean Summit news let's
(14:45):
start off. Because of time difference and everything, we'll we'll
join with you again tomorrow after all the dust settles
and get a final breakdown of what happened at the summit.
But what is the scene like they're leading up to
the summit, leading up to the actual meeting of President
Trump and Kim Jong un. It's still very unclear, and
I think there's a lot of question marks in the air.
The president and as well as administration both recognize this. Essentially,
(15:08):
the president going into this is really excited that there's
the potential of the deal. President Obama told President Trump
during the transition process that basically North Korea would be
his big moment, and he sees this as something that
he could really own, whereas he originally thought it would
be the peace deal in the Middle East. But now
he's looking at North Korea as his one big defining
moment of his presidency, at least these first four years.
(15:31):
They are expecting and hoping that they will be able
to reach some sort of deal. Of course, the new
lalization of the North Korean Peninsula is really what they're
hoping for, but they've really dialed back expectations. They aren't
saying that they think that will happen. The President said
last week during a press conference that he expects this
would be the first of many meetings if it goes well.
(15:52):
Of course, he all says the whole walk out of
the meeting if it doesn't go well. So it's unclear
what will happen. All eyes are on that thing, but
for now they're really being hopeful and something of this
magnitude is going to take multiple meetings, multiple engagements to
really nail down exactly what's going to happen. Last week,
there was talk of the attitude that President Trump was
(16:13):
going into this. Sources have told Axios that it's kind
of this thing of just get me in the room
with the guy and I'll figure it out. And that's
very true to President Trump's style. He's got to get
their assessed the scene and see if we can come
to something. If we're going to come to some type
of deal. It definitely speaks to President Trump's personality. He's
someone who came from a businessman world, who's used to
(16:34):
being the dealmaker, and he really thinks that he's not
going to know how to respond or to act until
he's in the room with Kim Jong un, and it
is really interesting to watch that we've reported that you
look at both of their personalities very unpredictable both leaders,
and so I think that the President is really planning
on kind of winging it in many senses. But he
(16:56):
is still going to use that charm and person quality
that he had during his years as a businessman in
real estate business to take a similar approach with Kim
Jong You mentioned the personalities. Trump definitely thinks it's going
to be a duel of personalities. He's been quizzing the
Secretary of State about his meetings. But who is Kim
Jong un? They said that in school and such, he
(17:18):
was prone to violence and a couple of other weird quirks. Well,
my colleague Jonathan Swan actually was able to get bits
and pieces from an intelligence profile that they put together
on Kim Jong un. It goes through extensive interviews with teachers, students,
others who have engaged with him, especially when he was
at this elite school in Switzerland but he attended during
(17:38):
his adolescence, and essentially one of what the profile says
is that there's this picture that shows he's this gluttonous
man who was prone to fits of anger and was
always kind of swaggering around with his classmates and also
kind of demanded this loyalty from other children then, and
that kind of foreshadowed the kind of leader he is today.
(17:58):
He also was prone to violent and um didn't really
do so well in school, was distracted by other things,
and mentioned that he thought he was always going to
be grow go on to become this great leader, and
you were kind of seeing that play out now essentially. Also,
you know, seeing that he has been in this family
where they've reigned for several years. So that is definitely
(18:20):
something that the president and the administration have been reviewing
in depth. And President Trump is also really shown this
liking to going through the intelligence and psychological profiles that
go along with Kim Jong Oon ahead of this meeting.
The other thing everybody's going to be really tuned into
is we found out who President Trump's first big interview
(18:40):
about the whole summit is going to be with. It's
gonna be with Sean Hannity later on tonight. Right, So,
my colleague Jonathan Swan and I scooped that actually we
had heard that Hannity was going to be the one
who Trump had promised to give this first interview too,
and it's not totally a surprise, as Sean Hannity is
one of President Trump's good friends and close confidence. But yeah,
(19:03):
so he'll have that first sit down with President Trump. UM.
And it's been confirmed five Fox News and it won't
air until nine pm Eastern Time on Tuesday. UM. But
these two personalities, we've seen President Trump and Handy speak together.
It should be very candid, more open. President Trump feels
very candid and very comfortable with Hannity. So hopefully we'll
(19:25):
get some a lot of color out of that interview again.
Exciting times. We'll join up with you again and see
what happens when all the dust settles. Elena Trene, reporter
for acxio. She's covering all of the North Korean summit news.
Thank you very much for joining us, Thanks for having me.
(19:45):
All right, that's it for today. Join us on social
media at Daily Dive Pod on Twitter and Daily Dive
Podcast on Facebook. We love the feedback, so don't forget
to leave us a comment and give us a rating.
Follow The Daily Dive on I Heart Radio or subscribe
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(20:06):
In Los Angeles and this was your daily dive
It's Tuesday, June twelve, and this is the Daily Dive.
It's the end of net neutrality, but maybe not forever.
The FCC has rolled back rules on Internet service providers
that would prevent them from blocking content, throttling the speeds
of data, and creating fast lanes for customers who paid premiums.
(00:21):
As the Internet continues to increase its importance in our lives,
advocates are still fighting to keep the rules in place.
We will speak to Axios Managing editor Kim Hart to
break down this repeal. Next, we will tell you a
story about a child with a one and seven degree
fever who was airlifted to another hospital for better treatment
and then got slapped with a bill for over forty dollars.
(00:41):
We'll speak to Bloomberg reporter John Tazzi about the air
ambulance business and the massive bills they are charging patients. Finally,
it has happened. President Trump and Kim Jong un met
face to face to hammer out a deal on d
nuclearization the Korean Peninsula. We'll speak to Elaine Natrine, reporter
for Axios, about this history at the moment and learn
more about the personality and quirks of the North Korean leader.
(01:05):
It's news without the noise. Let's dive in. Nothing about
the Internet was broken, nothing about the law had changed,
and there was not a rash of Internet service providers
blocking consumers from accessing the content, applications or services of
their choice. By taking these heavy handed rules off the table,
(01:25):
by establishing once again the bipartisan light touch approach that
we had for almost twenty years, we're going to see
a lot more competition joining us now is Kim Hart
Axios Managing editor. Thank you for joining us. Kim, the
net neutrality repeal is official. It happened yesterday. All the
rules have been taken away. Kim briefly tell us what
the idea of net neutrality is and then what were
(01:47):
the rules that were taken away. Net neutrality refers to
the concept that internet service providers, the companies like Verizon,
AT and T and Comcast, should have to treat all
traffic and content equally as it passes through their networks.
So that means that it wouldn't be able to give
preferential treatment to a Netflix show over a NBC show,
(02:09):
for example. This comes back all the way to the
early days of the Internet when the startups of the Internet.
The Googles of the world were concerned that the Internet
service providers could act as gateways to decide which traffic
got sped up and which traffic got slowed down, and
could therefore interfere with the consumer's experience. And with all
(02:30):
the new mergers between media companies and telecom companies, I mean,
this thing gets very complicated. Like you said, the worry
is would they be speeding up their own products versus
other people's. Ten years ago, when this debate really started
and earnest in Washington, you had two very separate industries
that relied on each other, but they were still pretty distinct.
(02:51):
You had the telecom companies like the phone and internet
companies that actually provided the pipes that take the Internet
service from or router the server all the way to
your home or your cell phone. And then you have
the content companies like the Hollywood studios, the programmers, the
cable channels, and then increasingly the Silicon Valley companies as
they're creating their own content. So really it's the content
(03:14):
companies needed to strike deals with the Internet providers in
order to make sure that their content was able to
get to the consumers on their laptops, on their phones,
on their smart TVs. But now you're seeing a lot
more of these companies start to merge together, so that
a one company might would probably own the pipes as
(03:34):
well as the content. This is what you started to
see with Comcast NBC Universal when those two companies merged
back in and also what you're seeing with a T
and T s attempt to buy Time Warner. The decision
for that actually comes out on Tuesday, so it's all
kind of coming to a head right at the same time.
So the rules are taking away the internet service providers,
(03:54):
they can't block content, they can't throttle customers anymore, and
the paid prioritization, which you know, giving their own products
more beneficial speeds there, but none of the stuff is
gonna be implemented right away. I mean a lot of
internet service providers have also pledged to not change anything recently.
So what is the what is the big worry right
(04:15):
now or how are people going to be impacted initially? Really,
there's not going to be a big y two came
moment if not, like a switch is going to be
flipped and all of a sudden, your internet service is
going to slow down. You're not going to be able
to get the same streaming shows that you're used to getting.
Nothing will really change for the consumers experience right now
the day after these rules go away. The big concern
(04:37):
is that if these Internet service providers are not bound
by federal rules, and they're not enforced by the Federal
Communication Commission, then you know, your Internet service providers might
try to enter into some interesting service arrangements with other companies,
or strike a deal so that a certain type of
content over the Internet. Maybe one app works better on
(05:00):
your cell phone than another app in exchange for a fee.
The concern is that internet that the public interest groups
and other public consumer advocates have raised is that it's
going to be really hard for the average consumer to
really be able to understand what's happening. If all of
a sudden they have an app on their phone or
a streaming online service, or they're trying to watch a
(05:20):
movie on on their laptop. If suddenly that becomes really slow,
it's hard to know is that just because I have
a bad connection, or is that because an I s
P has entered into some arrangement that I'm not sure about.
So I think the concern is that not right away?
Because I think all the I s p s are
going to be on their best behavior. They know the
world is watching. And but that as people start to
(05:40):
pay less attention, that it's going to be really hard
for consumers to know if there's some sort of funny
business or deals happening behind the scenes. A lot of
governors in in a number of states have past laws
and rules saying that we're going to keep the same
rules implemented already, so things wouldn't change. There would be
a weird situation, a global internet kind of taking a
(06:01):
different form from state to state. Now, what's happening on
Capitol Hill? A few things are happening. Uh, the Democrats
are really pushing to try to roll back the FCC's
action that took place on Monday and in order to
restore the net neutrality rules. This is under a small
provision called the c r A, and on Capitol Hill,
(06:22):
it's a it's a resolution of disapproval, So Congress can,
if it acts in a certain process and in a
certain time frame, overturn an FDC's decision. So the Senate
already passed this measure now goes to the House. Now
the House has a pretty steep climb to get the
number of votes that it needs. It needs a lot
of Republicans to sign on to this measure in order
(06:44):
to overturn what the FDC did on Monday, and a
lot of people are doubtful that they're going to be
able to pull it off. But the advocates are really
trying to at least get some Republican lawmakers on record
saying I support net neutrality, because they think that that
will help them in the future iteration of this fight
as it continues. There's also some there's been this long,
(07:04):
years long effort to try to come up with some
sort of compromise between Republicans the Democrats to put in
place some permanent net neutrality legislation so that the rules
at the FDC level aren't victim to the political ping
pong where they're changed depending on which party is in
power and what kind of administration um is in the
(07:25):
White House. Yeah, it's just really interesting. As the Internet
is such a huge part of our lives. A lot
of people's eyes glaze over when they here net neutrality,
but it's a very important issue and and really the
future of how we use this service Kim Hart, Axios
Managing editor, Thank you very much for joining us. Thank you.
(07:50):
Physicians at the local hospital decided that the child needed
to higher level of care. They called for a helicopter
to send him to a children's hospital and Charleston, West Virginia.
I believe after that the family got a bill for
forty five thousand some odd dollars. Their insurance plan, which
was the state public employees plan, had agreed to pay
(08:13):
about six thousand, seven hundred dollars. Joining us now is
John Tazzi, reporter for Bloomberg. So this is a very
interesting story. High medical bills are not unheard of, obviously,
but this is pretty crazy. This has to do with
air ambulances. So when an emergency happens and you need
to be airlifted out of somewhere in a helicopter taken
to a hospital, there was a family who was hit
(08:34):
with a forty five thousand dollar bill. What happened in
this case, So this is a family who had a toddler,
a three year old, who came down with a really
high fever. Went to their local hospital. It was in
a small town in West Virginia, and the positions at
the local hospital decided that the child needed a higher
level of care. He was burning up. They called for
(08:56):
a helicopter to send him to a higher level of
care at a children's hospital in Charleston, West Virginia, I believe,
and he was treated. Their stabilized spent a few days
in the hospital. After that, the family got a bill
from the air ambulance provider, a company called air Methods,
for forty five thousand some odd dollars. Their insurance plan,
(09:20):
which was a state public employees plan, had agreed to
pay about six thousand, seven hundred dollars, which they said
was equivalent to what Medicare would pay for the same services,
but bill was much higher, and the company build the
family for the rest, so the total cost was like
fifty two grand plus it was more than that. There's
a concern that there could be some brain damage with
(09:40):
such high fever. The kid had an hundred and seven
degree fever. So yes, you got to do these things
in an emergency. But then you started looking into the
big business of air ambulances, and they've doubled in sizes,
their costs have doubled in size, and what they charged,
like you said, for private insurances and Medicare and Medicaid.
They don't over those costs. After that, it all goes
(10:02):
back to the patients. It's a really complicated area of healthcare.
This industry has grown up a lot in the past
fifteen years, certainly, and going back to the nineties, there
were only a handful of helicopters, a few dozen across
the country, mostly operated by hospitals. Now there are almost
a thousand medical helicopters in the United States, about nine
(10:23):
hundred or so. Many are controlled by for profit private companies.
Now that's not that different from hospitals, right there are
a lot of hospitals that are for profit, privately owned.
What's complicating factor in this part of the business is
that they have to respond by law when there's an emergency,
and patients aren't really in a position to shop for
(10:46):
services to compare prices. They're urgent medical situations, so a
lot of resolving the billing and payment happens after the fact.
And recent years we've seen sort of a growth in
this practice of months billing for patients with private insurance.
If the insurance won't pay for it all, the provider
will ask the patient to pay directly. As you said,
(11:10):
you don't really know what to expect in an emergency
when you need the service. Even the air ambulance companies,
they say the people that they fly a lot of
times are poorer patients, but they don't know exactly what
it is that it's not until days later whether they
know somebody can pay or not. And for the patient,
you're in an emergency, you need help quickly. You're not
(11:31):
necessarily concerned with the bill at that at that moment. Right.
One thing, it's important to notice that part of this
business is reimbursed by Medicaid, which is insurance basically a
state insurance program for lower income people, which generally pays
below costs, sometimes well below costs for these air ambulances,
and a lot of it is also Medicare, which pays
(11:53):
a little bit more. That's for generally Americans over sixty five.
But the industry says that that even Medicare rates don't
fully reimbursed for their costs of operating these helicopters at
the scale they have them. Now, what services do they
usually provide for? I mean, you think of an being
airlift at us somewhere, it's something in a remote location
(12:13):
or extreme emergency. So what they've expanded though to include
other services. Yeah so, And I mean you may have
an image in your mind of these mostly being picking
people up off the side of the road after a
motor vehicle acted. And actually it turns out most of
the transports are between hospitals, so they're taking people from
maybe a smaller rural hospital to a place with a
(12:35):
higher level of service, technologies or experts that aren't available
at the initial hospital where a patient is treated. And
they've respond to traumas like car accidents, but also heart attacks, strokes,
and other sort of time urgent situations. Is their regulation
coming or anything on the horizon to help patients who
(12:56):
get these huge medical bills. Yeah, so that's an inter
instinct question. I mean, one of the reasons that this
piece of the health care industry, and to be clear,
like balanced building is an issue in other areas of healthcare,
it's not exclusive to air ambulances. But one of the
reasons it seems to have turned up here a lot
is because states actually have no legal authority to regulate
(13:20):
the prices or the charges of these companies. And that's
because under the federal law in the nineteen seventies that
deregulated the airline industry. That was the law that said,
you know, the government's not going to set prices for
Delta or United, and you know that we're going to
have a private airline industry for commercial fight. Well, these
(13:42):
companies are counted under that law pre empt state regulation.
So you know, individual states have tried just to limit
how much, for example, a state workers compensation plan pays
for these services, and the courts have generally ruled that
they don't have the authority to make those kinds of regulations.
There is an effort in Washington to roll back some
(14:03):
of that exemption, but that's you know, there's nothing, nothing,
kind of concrete in the law yet to do that.
John Tazzi, reporter for Bloomberg, thank you very much for
joining us. Thanks h much. There's this picture that shows
(14:24):
he's this man who was prone to fits of anger
and was always kind of swaggering around with his classmates
and also kind of demanded this loyalty from other children then,
and that kind of foreshadowed the kind of leader he
is today. Joining us now is Eleana Trine, reporter for Axios.
She's covering all of the North Korean Summit news let's
(14:45):
start off. Because of time difference and everything, we'll we'll
join with you again tomorrow after all the dust settles
and get a final breakdown of what happened at the summit.
But what is the scene like they're leading up to
the summit, leading up to the actual meeting of President
Trump and Kim Jong un. It's still very unclear, and
I think there's a lot of question marks in the air.
The president and as well as administration both recognize this. Essentially,
(15:08):
the president going into this is really excited that there's
the potential of the deal. President Obama told President Trump
during the transition process that basically North Korea would be
his big moment, and he sees this as something that
he could really own, whereas he originally thought it would
be the peace deal in the Middle East. But now
he's looking at North Korea as his one big defining
moment of his presidency, at least these first four years.
(15:31):
They are expecting and hoping that they will be able
to reach some sort of deal. Of course, the new
lalization of the North Korean Peninsula is really what they're
hoping for, but they've really dialed back expectations. They aren't
saying that they think that will happen. The President said
last week during a press conference that he expects this
would be the first of many meetings if it goes well.
(15:52):
Of course, he all says the whole walk out of
the meeting if it doesn't go well. So it's unclear
what will happen. All eyes are on that thing, but
for now they're really being hopeful and something of this
magnitude is going to take multiple meetings, multiple engagements to
really nail down exactly what's going to happen. Last week,
there was talk of the attitude that President Trump was
(16:13):
going into this. Sources have told Axios that it's kind
of this thing of just get me in the room
with the guy and I'll figure it out. And that's
very true to President Trump's style. He's got to get
their assessed the scene and see if we can come
to something. If we're going to come to some type
of deal. It definitely speaks to President Trump's personality. He's
someone who came from a businessman world, who's used to
(16:34):
being the dealmaker, and he really thinks that he's not
going to know how to respond or to act until
he's in the room with Kim Jong un, and it
is really interesting to watch that we've reported that you
look at both of their personalities very unpredictable both leaders,
and so I think that the President is really planning
on kind of winging it in many senses. But he
(16:56):
is still going to use that charm and person quality
that he had during his years as a businessman in
real estate business to take a similar approach with Kim
Jong You mentioned the personalities. Trump definitely thinks it's going
to be a duel of personalities. He's been quizzing the
Secretary of State about his meetings. But who is Kim
Jong un? They said that in school and such, he
(17:18):
was prone to violence and a couple of other weird quirks. Well,
my colleague Jonathan Swan actually was able to get bits
and pieces from an intelligence profile that they put together
on Kim Jong un. It goes through extensive interviews with teachers, students,
others who have engaged with him, especially when he was
at this elite school in Switzerland but he attended during
(17:38):
his adolescence, and essentially one of what the profile says
is that there's this picture that shows he's this gluttonous
man who was prone to fits of anger and was
always kind of swaggering around with his classmates and also
kind of demanded this loyalty from other children then, and
that kind of foreshadowed the kind of leader he is today.
(17:58):
He also was prone to violent and um didn't really
do so well in school, was distracted by other things,
and mentioned that he thought he was always going to
be grow go on to become this great leader, and
you were kind of seeing that play out now essentially. Also,
you know, seeing that he has been in this family
where they've reigned for several years. So that is definitely
(18:20):
something that the president and the administration have been reviewing
in depth. And President Trump is also really shown this
liking to going through the intelligence and psychological profiles that
go along with Kim Jong Oon ahead of this meeting.
The other thing everybody's going to be really tuned into
is we found out who President Trump's first big interview
(18:40):
about the whole summit is going to be with. It's
gonna be with Sean Hannity later on tonight. Right, So,
my colleague Jonathan Swan and I scooped that actually we
had heard that Hannity was going to be the one
who Trump had promised to give this first interview too,
and it's not totally a surprise, as Sean Hannity is
one of President Trump's good friends and close confidence. But yeah,
(19:03):
so he'll have that first sit down with President Trump. UM.
And it's been confirmed five Fox News and it won't
air until nine pm Eastern Time on Tuesday. UM. But
these two personalities, we've seen President Trump and Handy speak together.
It should be very candid, more open. President Trump feels
very candid and very comfortable with Hannity. So hopefully we'll
(19:25):
get some a lot of color out of that interview again.
Exciting times. We'll join up with you again and see
what happens when all the dust settles. Elena Trene, reporter
for acxio. She's covering all of the North Korean summit news.
Thank you very much for joining us, Thanks for having me.
(19:45):
All right, that's it for today. Join us on social
media at Daily Dive Pod on Twitter and Daily Dive
Podcast on Facebook. We love the feedback, so don't forget
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Follow The Daily Dive on I Heart Radio or subscribe
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(20:06):
In Los Angeles and this was your daily dive
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