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Making NewsHour Weekend: From remote Maryland islands to the Salton Sea
In part three of our holiday series "Making NewsHour Weekend," producer and correspondent Megan Thompson and field producer Melanie Saltzman join Hari Sreenivasan to talk about some of their reporting in 2018, from prescription drug prices, to criminal justice and education reform, to advances in clothing design for people with disabilities.
As the year comes to an end, we've been sitting down with some of our production teams to get a peek behind the scenes of the stories we air on the NewsHour Weekend broadcasts each week.
Hari Sreenivasan recently spoke with producer Melanie Saltzman and correspondent Megan Thompson to get some perspective and insight into some their segments from 2018.
Megan, Melanie, thanks for joining us. Let's start with a couple of different stories that you've worked on — one that was fascinating was accessible fashion.
Every morning, Christina Mallon picks out an outfit for her job at a marketing firm in New York. Mallon loves fashion and wants to look her best. But deciding what to wear isn't the biggest issue.
For the last eight years, slowly both my arms and shoulders became paralyzed. They don't exactly know what I have. They think it's motor neuron disease, most similar to ALS.
When Mallon's muscles began to atrophy, her old clothes no longer fit or became too difficult for her to put on by herself.
Fashion is a way to express your soul and your personality, so me being a fashionista since I was a child, it was very difficult that I couldn't wear my remaining clothing because I felt like a part of my identity was dying.
Mallon went online and looked at clothes designed for people with a disability. But what she found was disappointing.
It was these really bold colors that I would never wear, a lot of fleeces, nothing fitted, a lot of Velcro, and that just wasn't me. It just made me really upset that I didn't even want to go out of the house.
Then, last year, Mallon found someone who could help.
Our mission has always been to make style accessible.
Grace Jun leads Open Style Lab, a nonprofit based at the Parsons School of Design in New York, one of the nation's premier fashion institutes. The Lab runs a summer program that trains participants to create clothing that is inclusive and accessible.
One out of five people identify having a disability in the United States, which means there's a whole untapped market that's marginalized and haven't been addressed.
Cristina Mallon's team made her a stylish coat free of charge.
Being able to put a coat on by myself was a difference between me having enough confidence to go to work. And things like that have such a big impact that people don't understand.
How did this story come about?
I heard about this lab at MIT where they were training designers to make clothing that was more accessible to people with disabilities. Earlier this year. I thought, 'you know, I wonder what's going on with that program,' and it turned out that they'd actually moved the program down to Parsons, which is just down the street from us. So we were able to tell the story in a whole different way. We were able to follow this story basically for the entire summer.
NewsHour Weekend followed Open Style Lab's 10-week summer program from day one to see how it works.
Lack of accessible clothing is a barrier to greater independence.
The participants were divided into teams. Each has a designer and an engineer.
I want you to hold it all the way in your palm.
Plus, there's an occupational or physical therapist.
They worked with residents of the Riverside Premier Rehabilitation and Healing Center in Manhattan. The first task, getting to know the residents' needs.
Sweater-type material is hard to put on because it's bulky.
How you're telling the story is very different than how we usually shoot. I mean, you're almost talking about a reality TV show going back and getting element after element after element, seeing how this whole course evolves.
I felt like I was doing reality TV. We kept making jokes like this is Project Runway. We wanted Tim Gunn to show up and say, 'Let's have a make-it-work moment.' He never did unfortunately. But … usually we are following one person and we do an interview, we film a little bit of b-roll afterwards. But for this, I mean the way that it worked was there were seven teams and they would get together a few times a week, all in one place, and so I would go in with Mori Rothman, sometimes Mike Regan, one of the other producers on the show, and we would all basically be filming at the same time because you don't know what's going to happen when. Right. And you're just sort of wandering around the room, trying to catch as much as you possibly can. We went back repeatedly over the summer. We probably shot about 10 days total. It's great, you get to follow a process from start to finish, which we rarely get to do. You also end up with hours and hours and hours of footage.
So how do you decide what to focus on after coming home with all that tape, so to speak?
Yeah, I mean you spend a lot of time sitting in front of the edit bay, watching all of this, and you know you basically assess what you caught, right. You start to make notes of the moments that are really interesting, the characters that you caught, the people who have the most to say or the interesting stories. We ended up profiling essentially three different pieces of clothing: a jacket, a dress and a pant suit.
As the summer went on, Ada Stewart's outfits slowly took shape. The team tested different types of pleats for the pants and devised a pulley system that will gather up the pants for her. Making it easier to get her feet in. Ada's hands get cold so the team placed the pockets on her lap where her hands naturally lay. She told her team she wanted to get rid of her wheelchair one day. So they developed sensors that light up to remind her when it's time to exercise and give her feedback during the workout.
I love it. I love it. It's gonna be good.
Are designers in the industry stepping up?
The designers and stores that are addressing it are still few and far between, but it seems like this really is a moment when things are changing. So for instance, we profiled Tommy Hilfiger — he was the first major fashion label to launch a line specifically for people with disabilities. There's other stores like Target, Zappos. And when I asked people, 'wwhy now?' A lot of people said to me that they think it's kind of part of this moment we're having as a nation now. You know, we've seen things like the Black Lives Matter movement, we've seen obviously #MeToo, and there's just more of an awareness that we need to be sort of more inclusive and aware of other people's experiences in a very sort of large sense. The end game, the end sort of goal is that fashion is designed for all abilities and you don't have sort of a separate rack in the corner that's — here are the clothing for people who have a disability and here's the rest of our clothing. You know, the question is, and this is sort of a design question, is there a way that you can just design pieces of clothing that are just better for everybody?
One of the other areas that you guys are focused on very well is 'zero tolerance' policy in schools and you decided to take a look at this and how these kids are getting arrested. You know we called the school-to-prison pipeline, what made you want to do this?
You know, I think Megan and I are really interested in criminal justice issues in general, and when we found out that Philadelphia was tangibly addressing that problem on the ground, we thought it was a really good way to both look at the problem but also how people are addressing it. I mean, they've gone across Philadelphia into hundreds of schools and really changed their ways.
Harsh penalties for breaking school rules push kids, minorities disproportionately, into the criminal justice system.
Thirty years ago, you go through the academy, you lock them up and let someone else deal with those backend issues.
Kevin Bethel's spent eight years as the deputy police commissioner overseeing security in the Philadelphia public schools. He used to be in charge of locking kids up.
What I'm looking at is what we're locking up for. Things that I did as a kid. You know, I had my little Cub Scout knife, I got into fights in schools, I did all that stuff, but I'm locking up kids and I'm a deputy commissioner, I did those things. That was a moment for me and I turned to my bosses and say, 'Man, I can't do it anymore.'
Bethel started the diversion program in 2014 announcing that officers would arrest only when it was absolutely necessary.
And they're also collecting data, which is really rare. So we could see from a scientific standpoint is this actually working. It wasn't just anecdotal.
The hard part about criminal justice reform stories and with school stories is who goes on camera. How do you get over that hurdle?
I mean, it is tricky. You know, you're dealing with minors, you're dealing with institutions that could be wary of the media like school districts, like police departments. I reached out to them a year prior to filming, more than a year, just to build relationships and explain our intentions and say, 'this is what we'll need.' So I think over time you build that rapport and then you get on the ground and you try to be nimble. I got a call from an officer who I had been speaking with for over a year that said, 'Melanie, there's a diversion happening right now, you have to go to the school, you have to film it.' And the principal there knew me. The officers knew me already, so I could get my camera in this really sensitive situation with, you know, who kids had just been arrested for drug possession.
School security just found two students with several vials of marijuana. They've detained them in handcuffs until Philadelphia police officers arrive. It's a common scene in a neighborhood with high rates of poverty and crime. And just a few years ago under the school district's 'zero tolerance' policy, both students would have been arrested no questions asked. Today it's likely only one student will be arrested because he's already on probation wearing an ankle bracelet. But for the other student who has no record there is another option. Rather than being arrested, the student has put in the Philadelphia police school diversion program — a citywide initiative that aims to keep kids out of the criminal justice system for misdemeanors. Things like having drugs in school or bringing items that are banned, like pocket knives and B.B. guns.
What was surprising to you when you talk to these people?
I mean, one of the things that's really surprising going into a school like this, is you just really get a sense of how different the experiences are for our kids in America's public schools. I mean, you walk in and there are metal detectors just like you're at the airport. There are people who look like police officers, some of them are actually city cops, some are school security officers. You just really realize that certain kids in certain parts of this country have a very different experience walking into a school building every single day than other kids do.
Were you surprised at what they were being disciplined for, having what?
Yeah, I mean that was one of the things. And it goes both ways. I mean. one on one hand, you know, you're hearing stories about kids bringing knives and things they may really have been intended to use as a weapon to school. The same time you know there were things like hair picks or scissors.
We have a bottle opener, which can still be used as a weapon — it has a point.
And under 'zero tolerance,' no questions were asked – that could be used a hair pick, You know that could be it could be used as a weapon. You were arrested.
What about if some of these kids are coming from difficult neighborhoods, what about their own personal safety and security. What do they do?
I mean that came up with one of the students that we filmed with. You know, her mother had given her a taser as protection.
She gave it to me to protect myself. I used to go from school straight to work and from work to home, and I wasn't getting off until like 11, 12.
Officers at the school found it, and she would have been arrested if she wasn't diverted through this program. So it really is a balance of the schools needing to ensure public safety on the school grounds. But also coming up with a system that doesn't overly punish kids that are in those situations that looks at the context and says 'How can we address those problems without having long term effects on their lives?' You know it could go on their record, you know, to get into college, to get a job. It could follow them throughout their life.
So is it working?
Yeah, I mean so the data, you know, even the researcher that we spoke with in this story said that she's been studying things these types of programs all around the country and she said she had never seen the effects like this.
Throughout Philadelphia, student arrests have dropped by 71 percent. Recidivism rates have improved citywide too. Before the program began, the rate for youth arrested was 27 percent. Today, it's 14 percent for students who are diverted — and school safety improved. An average of 1,000 fewer serious incidents have been reported annually since the program began.
One of the stories that you did this year really took off, about pharmacy benefit managers — something most of us don't realize we already have. What are they? I guess just to bring people back up to speed. And what was the story about?
So pharmacy benefit managers are essentially middlemen.
PBM's act as middlemen between the insurance plans, drug makers and pharmacies. Most consumers have no idea there's a PBM, not an insurance company, managing their prescription drug plans.
There are three main PBM's that take up 85 percent of the market. You have Express Scripts, you have CVS Caremark and you have OptumRX.
Pharmacy benefit managers practices have come under scrutiny in recent years because they handle all facets of this chain and a lot of people accuse them of practices that may be inflating the cost of prescription drugs.
So give me an example, what kind of cost inflation are we talking about?
So one of the things we looked at in the story is something called a clawback,, and that is when you go into a pharmacy, you pay a copay. You assume — I mean it's called a copay, right? — you assume that you are sharing the cost of that drug. So let's say you pay a $10 copay. You know, I think that maybe the cost of that drug is maybe you know $15 or $20, insurance is kicking in some, but instead in some instances, the cost of that drug the cost of the drug to the pharmacy is actually much lower than that copay. And if you didn't use your insurance, if you just pay cash or out of pocket, you could actually be saving money. And often when this happens that money that the pharmacist is collecting is actually going back to the PBM. So you know we had an instance in a story where a gentleman who was helping his elderly aunt.
His aunt was taking eight generic drugs for things like dementia and high blood pressure. She was paying close to $103 in insurance copays for those drugs every month. Falkowitz found he could get those exact same drugs for $65 if he paid out of pocket at an independent pharmacy, not using his aunt's insurance plan at all. That's nearly 40 percent less. Falkowitz manages a medical practice and deals with insurance plans all the time. He says it was a total surprise.
I just couldn't understand it. This is a foreign concept. Never, never did it dawn on me, if you pay cash, do not submit to insurance, you save money.
The thing about these stories is it's very opaque, it's never quite clear where the money is going, but there's you know a pretty big chance it was going back to the PBM in the form of a clawback. And the thing also that we talked about in this story is that for a long time pharmacists were actually prohibited from telling you at the counter, 'hey, guess what, I can see that there's a clawback happening, you could save some money if you just pay out of pocket.'
So the story I remember you put online, it was, what was it, a $285 dollar drug that you could just pocket for 40 dollars.
Yeah, that was another example that we found. There's a gentleman in California, his PBM was Express Scripts and they actually have a mail-order pharmacy. They do a lot of their business just by mailing directly to the customer. He was paying for his wife's medications his copay was $285 dollars.
He walked into Costco and just happened to say, 'hey, if I paid out of pocket, how much would it cost?, and they said $40. So when we went to Express Scripts, they said, 'well, that's not a clawback.' There wasn't a pharmacist involved, so technically it wasn't a clawback, so we didn't use it in a broadcast story. But you can't not report on a story like that. And when you ask Express Scripts for an explanation, it's tough, quite frankly, to get a clear explanation. They're pointing at his insurance company, the insurance company's pointing back at them. But you know that particular story got a lot of … it's so absurd.
I mean, you know one of the guys in our story said something like it just defies logic it defies common sense. I mean you just almost can't believe this is happening and people don't realize that it is.
Megan, Melanie, thanks so much for joining us.
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