GEOFF BENNETT: Good evening.

I'm Geoff Bennett.

AMNA NAWAZ: And I'm Amna Nawaz.

On the "NewsHour" tonight: The Supreme Court says colleges cannot consider race in admissions, a ruling that has widespread implications for the future of higher education.

GEOFF BENNETT: The Texas power grid struggles to cope with systemwide stresses caused by the brutal heat wave.

AMNA NAWAZ: Plus: Doctor burnout and high costs for patients lead more Americans to choose alternatives to insurance-based health care.

RUSSELL BACON, Patient: It honestly used to scare me to go into the hospital, not for the needles or the doctors or the sickness or anything, but just for the price of it.

(BREAK) AMNA NAWAZ: Welcome to the "NewsHour."

The U.S. Supreme Court today dealt a major blow to affirmative action in higher education, striking down race-conscious admissions programs at Harvard University and the University of North Carolina.

GEOFF BENNETT: In rulings divided along ideological lines, the court's six-justice conservative majority said the schools discriminated against white and Asian American applicants by using race-conscious policies that benefited students from underrepresented backgrounds.

Chief Justice John Roberts, who has long been skeptical of such policies, authored the majority opinion.

He wrote: "Many universities have concluded wrongly that the touchstone of an individual's identity is not challenges bested, skills built, or lessons learned, but the color of their skin.

Our constitutional history does not tolerate that choice."

AMNA NAWAZ: This afternoon at the White House, President Joe Biden criticized the rulings and said the country cannot abandon its pursuit of a more equal system of higher education.

JOE BIDEN, President of the United States: I know today's court decision is a severe disappointment to so many people, including me, but we cannot let the decision be a permanent setback for the country.

We need to keep an open door of opportunities.

GEOFF BENNETT: We start our coverage tonight with "NewsHour" Supreme Court analyst Marcia Coyle.

Marcia, it's great to have you here.

MARCIA COYLE: Nice to be here, Geoff.

GEOFF BENNETT: And we should say this ruling was not unexpected.

But the court twice upheld race-conscious college admissions programs in the past 20 years, to include as recently as 2016.

Help us understand how this ruling today upends decades of its own precedents.

MARCIA COYLE: Well, there has really been a fundamental divide on the court for almost 40 years on the constitutionality of race preferences.

The conservatives believe that they are unconstitutional.

The liberal justices feel that race preferences that are benign, that do give benefits, are good.

And the court has said that's one of the very, very few reasons that the Constitution will allow race preferences.

So that's why, today, it did upend, in a sense, what it had been doing for many decades.

GEOFF BENNETT: I want to read a bit more from Chief John Roberts' opinion.

In the majority opinion, he notes: "Nothing in this opinion should be construed as prohibiting universities from considering an applicant's discussion of how race affected his or her life, be it through discrimination, inspiration, or otherwise."

So some people have taken that to mean that an applicant can write an essay about how race affected his or her life.

But, in the court's opinion, how does the use of affirmative action in college admission practices run afoul of the Constitution?

MARCIA COYLE: Well, they cannot use it as a factor in admissions.

It can't be a dominant factor or the determinative factor.

It cannot be a plus factor.

It cannot be used in a negative way.

But the court did sort of leave the door open, and I think everyone's going to have to wait and see how this plays out, to admissions applications or essays in which an applicant talks about or discusses how race really affected that person's life, whether inspirational or not.

GEOFF BENNETT: Justice Ketanji Brown Jackson recused herself from the Harvard case, because she had served for years on one of Harvard's governing bodies, but she participated in the North Carolina case.

MARCIA COYLE: Yes.

GEOFF BENNETT: And she wrote a scathing dissent, part of which reads this way: "With let them eat cake obliviousness, today, the majority pulls the rip cord and announces colorblindness for all by legal fiat.

But deeming race irrelevant in law does not make it so in life."

Tell us more about what she wrote, alongside what we heard from Justice Sonia Sotomayor, who also dissented.

MARCIA COYLE: Well, both of them believe that there's nothing in the text of the 14th Amendment that prohibits racial preferences or race-conscious measures.

And they both oppose this idea of a colorblind Constitution.

This is something Justice Thomas has been advocating for decades.

In fact, today was sort of his crowning achievement that it's finally been recognized by the majority.

Justice Jackson used her dissent to very specifically address how the University of North Carolina's admissions policy worked and how it has -- its policy has really inured to the benefit of everybody, not just those students who were getting the racial preference.

And she also felt, as Justice Sotomayor did, that the court was ignoring the facts of life on the ground in order to impose this colorblind rule.

GEOFF BENNETT: Marcia Coyle, thank you so much for your analysis.

We appreciate it.

MARCIA COYLE: My pleasure, Geoff.

AMNA NAWAZ: The fallout of the court's decisions will have major implications on colleges and universities across the country.

But one university that knows the impact of ending race-based admissions all too well is the University of Michigan.

Joining me now to talk about all of this is University of Michigan President Santa Ono.

President Ono, welcome, and thanks for joining us.

Your university had scrapped your affirmative action plan years ago because of a Supreme Court decision earlier and a state ban.

So you haven't been taking race into account in admissions.

How is your institution impacted by today's ruling?

SANTA ONO, President, University of Michigan: Thank you very much.

That decision to ban on affirmative action here on race-conscious admissions happened in 2006.

It's about 17 years that we haven't been considering race in admissions.

We have been using multiple strategies, a holistic review, Pathways programs, and really looking for low-income, high-ability, and first-generation students to build a diverse class.

It has taken a lot of time.

We lost a lot of ground when affirmative action was banned.

But we're really making significant progress right now with those mechanisms.

AMNA NAWAZ: You have made progress in some areas.

But critics will say you did see a drop in Black undergraduate enrollment over those years.

As you mentioned, the university pivoted to focusing on recruiting low-income students, rather than looking at race, but that hasn't really worked, right?

Why is that failing?

And what do you do now?

SANTA ONO: Well, that's because that approach is not as efficient and direct as an instrument or a lever to accomplish diversity.

So you're absolutely right.

The critics are right.

And we did lose quite a bit of ground.

But we have learned a lot in the interim.

And then we want to share that with other institutions that are facing this today.

AMNA NAWAZ: So what can you share?

Another thing that people point out is that other institutions that cannot consider race, like UCLA and Berkeley, have managed to improve Black enrollment.

So what are they doing that you haven't done yet?

SANTA ONO: Well, actually, we have also started to increase Black and Latino and Native American enrollment recently.

We have tried a number of different approaches.

They have taken some time to stand up, and we'd like to share that with other institutions.

So we are seeing that progress.

And we'd love to -- we'd love to share what's been difficult along the way.

AMNA NAWAZ: Are you speaking with other university and college leaders who are concerned about the impact of today's ruling?

What kind of concerns do they have and what do you tell them?

SANTA ONO: Well, we speak on a regular basis.

We speak with the Department of Education, with the Biden administration.

And so we are talking about things that work things, that are challenging, to your point.

We are all, as a higher education sector, committed to a diverse student body and the benefits that it provides to the educational experience.

And so we're sharing that.

We're sharing that with the DOE.

And we're working together.

AMNA NAWAZ: So what does work?

Can you give us a concrete example in terms of one step universities can be taking if they cannot take into account race when looking at admissions?

SANTA ONO: There are a number of things that work, for example, the Pathways program, where you actually go into communities that are diverse, you work with the school systems and the students and the families and prepare them for application to the institution.

They are then more successful in the application process and they matriculate at higher numbers.

That is very successful.

The other is to use a holistic admissions approach, and to look less at numbers of AP examinations or classes and look less at standardized tests and look more in a holistic way at what the individual student has accomplished in their own milieu.

AMNA NAWAZ: What about legacy admissions?

We do know those tend to privilege white students.

Should we get rid of those to equal out the opportunities?

SANTA ONO: I really believe that is something that colleges and universities should look at.

We do not have legacy admissions here at the University of Michigan.

And we know that, in several colleges, a large proportion of admits our legacy or development admits.

And that is a kind of admissions process that does not support diversifying the student body.

AMNA NAWAZ: You and your fellow leaders at the University of Michigan have said you have remained convinced racial diversity is one of the many important components of a broadly diverse student body and a culturally rich campus community.

There are people who will hear that statement and say, I'm not sure that is true.

In light of today's ruling, tell me what you have seen over your career that says to you this is a value higher education institutions should continue to hold up.

SANTA ONO: I can tell you, whether you're a college, or a news agency, or Fortune 500 company, a diverse team that looks at things from different points of view is a stronger team.

And it's true for the educational system as well.

If you go into a classroom or laboratory, you see a diverse student body.

I can see the interaction that occurs, and they learn from each other.

AMNA NAWAZ: That is Santa Ono, president of the University of Michigan, joining us tonight.

President Ono, thank you for your time.

SANTA ONO: Thank you very much.

GEOFF BENNETT: For a different perspective, we turn now to author and nonresident scholar at Georgetown Richard Kahlenberg.

He served as an expert witness for the plaintiffs in both cases and has long made the argument for what he calls the pitfalls of race-based affirmative action.

Thanks for being with us.

You have described this ruling as a step forward for the country.

In what ways?

RICHARD KAHLENBERG, Georgetown University: Well, I think this is a victory for low-income and working-class students of all races.

So Harvard and the University of North Carolina currently bring together fairly well-off students, economically well-off students, of all races, which is much better than an all-white, overwhelmingly privileged group, but they don't seek the socioeconomic diversity.

So, 71 percent of the students at Harvard who are underrepresented minorities, black, Hispanic, and Native American, come from the richest one-fifth of the black, Hispanic, and Native American populations nationally, and the white and Asian students are even richer.

So you have essentially 15 times as many rich students as low-income students at both Harvard and the University of North Carolina.

And what experience in states where affirmative action has been -- race-based affirmative action has been banned suggests is that universities won't just give up on racial diversity.

And, to their credit, they will find new ways to promote racial diversity.

And I think what we will see is that they will do the hard work of recruiting working-class students, providing them with financial aid, to make sure that the universities remain racially diverse and will become much more economically diverse as a result.

GEOFF BENNETT: Looking at the data though, accounting for an applicant's economic status does not work as well to racially diversify a student body as including some form of consideration of race in the admissions process, which is to say that it does not remedy the thing that affirmative action was established to resolve,which is discrimination based on race.

So how do you account for that?

RICHARD KAHLENBERG: Well, I have a different reading of the data.

So, in the Harvard and UNC cases, we ran models on what would happen if you stopped using race and instead provided a break to economically disadvantaged students and got rid of some of the unfair preferences for legacy applicants, for children of faculty, children of donors.

And you were able to produce robust levels of racial and ethnic diversity, much more economic diversity.

And we see in states where affirmative action was discontinued, that,in seven of the 10, they were able to get as much Black, Hispanic representation as they had in the past using race.

There are a couple of outliers, University of California, Berkeley, UCLA, University of Michigan.

But, in recent years, UCLA and U.C.

Berkeley have admitted their most diverse classes in 30 years, according to the universities themselves.

So, the amicus briefs, in some cases, tried to make the case that they hadn't done well.

In fact, they have done quite well.

GEOFF BENNETT: You mentioned legacy admissions.

We just heard the president of the University of Michigan say that schools should look at - - should look at that process.

How should colleges and universities rethink this issue of legacy admissions, in light of the Supreme Court striking down affirmative action in college admissions policies?

RICHARD KAHLENBERG: Yes, well, I edited a book back in 2010 called "Affirmative Action for the Rich" about legacy preferences.

I think they're very, very, very difficult to justify under any circumstances, but especially, today, after the U.S. Supreme Court's ruling on the use of race, I think it becomes even less defensible to use legacy preferences.

GEOFF BENNETT: The White House, I'm told, had been preparing for this outcome today.

And President Biden today, beyond criticizing the ruling, suggested that schools keep open the door of opportunity, and he offered an alternative path.

JOE BIDEN: What I propose for consideration is a new standard, where colleges take into account the adversity a student has overcome when selecting among qualified applicants.

Let's be clear: Under this new standard, just as was true under the earlier standard, students first have to be qualified applicants.

They need the GPA and test scores to meet the school's standards.

GEOFF BENNETT: So, the president says, once that standard is met, adversity should be considered.

Is that a suitable alternative, in your view?

RICHARD KAHLENBERG: Absolutely.

And I'm glad that President Biden made those remarks.

My contention is that a conservative U.S. Supreme Court decision today will, paradoxically, lead to a set of liberal public policy initiatives that make the system fair, that provide a break to economically disadvantaged students.

And the use of race has always been highly controversial in American politics, and the initiatives that were put forth in a number of states almost always passed, the anti-race-based affirmative action initiatives.

By contrast, there is strong public support for giving a preference in admissions to economically disadvantaged students and also for a number of the other important policies, getting rid of legacy preferences, increasing the number of community college students who transfer.

What's important is to make sure that we find ways to reflect the realities of race in this country, the history of racial oppression by considering things like the wealth of an applicant, because a low-wealth applicant who overcomes odds and does well, despite the obstacles, deserves a leg up.

And those will disproportionately be Black and Hispanic students, given the enormous wealth gap in -- by race and ethnicity in America.

GEOFF BENNETT: Richard Kahlenberg is an author and nonresident scholar at Georgetown University.

Thanks so much for your perspectives.

We appreciate it.

RICHARD KAHLENBERG: Thank you.

AMNA NAWAZ: In the day's other headlines: A former Florida sheriff's deputy was found not guilty of felony child neglect and other charges for failing to stop the Parkland school shooter and 2018.

Scott Peterson was overcome with emotion as the judge read the verdicts.

He was outside the building as the gunman killed 17 people inside Marjory Stoneman Douglas High School.

The charges carried a maximum sentence of nearly 100 years in prison.

Extreme heat scorching the South has claimed 14 lives and shows no signs of letting up.

Forecasters say the high temperatures and humidity will spread eastward in the coming days.

Farther north, smoke from Canadian wildfires is still blanketing parts of the Midwest and East Coast.

Washington, D.C., Detroit and Chicago recorded some of the worst air quality in the world.

The Pentagon confirmed a Chinese spy balloon did not collect any intelligence when it flew over the United States earlier this year.

The balloon spent eight days in North American airspace before President Biden gave military orders to shoot it down off the East Coast.

Officials said U.S. countermeasures taken at the time helped prevent surveillance during its flight.

France is bracing for a third night of protests and unrest following a fatal police shooting of a teenager in Paris.

Authorities have now charged the officer who pulled the trigger with voluntary homicide.

Lisa Desjardins has the latest.

LISA DESJARDINS: In this Paris suburb, outrage is growing, as are crowd numbers, with thousands today turning out to protest the police killing of a local young man.

The teenager's mother called for this march and helped lead it from a top a flatbed truck.

Her son's name echoed with local leaders and in this chant, "Justice for Nahel."

KARIMA KHATIM, Local Official (through translator): Young Nahel, his honor was saved, thanks to cameras.

By killing Nahel, they killed our child.

LISA DESJARDINS: The video of the killing by officers who stopped the car for an alleged traffic violation immediately sparked anger.

A policeman fired at close range as the car started to drive.

The 17-year-old has been publicly identified only as Nahel M. He was of North African descent.

For the third day in a row, demonstrators have taken over the streets of several Parisian suburbs, demanding justice, cars set ablaze.

Scores of police have been injured and protesters arrested.

A curfew is now in place in at least one area where a tram was set on fire.

And both outcry and violence have spread to at least three other cities in France.

French authorities announced 40,000 officers would be deployed across the country to contain further unrest.

EMMANUEL MACRON, French President (through translator): These acts are totally unjustifiable, and I want to thank all those who worked overnight, as the night before, to protect these institutions and bring back calm.

LISA DESJARDINS: But fueling the anger are long-running complaints of police mistreatment of minorities and the memories of riots in 2005, when two teenagers died running from police.

Nahel's death is the second police killing during traffic stops this year.

French prosecutors stress that a murder investigation is under way.

Meanwhile, flowers were laid near the site of the shooting, notes of grief and anger both on the rise.

For the "PBS NewsHour," I'm Lisa Desjardins.

AMNA NAWAZ: Former Vice President Mike Pence made a surprise visit to Kyiv today in a show of support as Ukraine fends off Russian aggression.

The Republican presidential nominee met with President Volodymyr Zelenskyy and later reiterated his pledge to arm Ukraine.

MIKE PENCE (R), Presidential Candidate: As I learned from President Zelenskyy and his security team, the Ukrainian military is making steady advances against the Russians.

And I assured him that, for my part, we will continue to do everything in our power to make sure that we provide the Ukrainian military with the support they need.

AMNA NAWAZ: Mr. Pence is the first Republican presidential candidate to visit Ukraine during the campaign.

A British court of appeals struck down a U.K. government policy that would send asylum seekers 4,000 miles away to Rwanda.

The judges ruled that, while deportations to safe countries are legal, relocating migrants to Rwanda specifically is too unsafe.

IAN BURNETT, Lord Chief Justice, England and Wales: There is a real risk that persons sent to Rwanda will be returned to their home countries, where they face persecution or other inhumane treatment, when, in fact, they have a good claim for asylum.

In that sense, Rwanda is not a safe third country.

AMNA NAWAZ: The decision is a blow to British conservatives, who have pledged to stop migrants from making the dangerous journey to the U.K. by boat.

British Prime Minister Rishi Sunak said his government will appeal to the U.K.'s Supreme Court.

The U.S. economy is showing more signs of resilience.

The Commerce Department reported the American economy grew at a 2 percent annual rate in the first quarter of this year.

That's a sharp upgrade from the agency's previous 1.3 percent GDP estimate.

Meanwhile, the Labor Department said jobless claims fell by 26,000 last week to 239,000.

That's the largest drop since 2021.

That news boosted most stocks on Wall Street today.

The Dow Jones industrial average climbed 270 points to close at 34122.

The Nasdaq fell off a fraction of a point.

And the S&P 500 added 19.

A passing to note tonight.

Christine King Farris, Martin Luther King Jr.'s last living sibling, has died.

In the decades following her brother's 1968 assassination, she joined his widow, Coretta Scott King, to help promote his legacy.

She also helped build the King Center in Atlanta, Georgia, to help champion his philosophy of nonviolent resistance.

Christine King Farris was 95 years old.

And, finally, the New York Yankees are celebrating their pitch-perfect win against the Oakland A's.

Yankees right-hander Domingo German didn't let a single Oakland batter reach first base last night, leading his team to an 11-0 victory.

It was only the 24th perfect game in Major League Baseball history.

Still to come on the "NewsHour": burnout pushes an increasing number of doctors to leave the insurance-based system; a new cosmic discovery leads to greater understanding of the space-time continuum; "Sesame Street" supports Ukrainian children traumatized by war; plus much more.

GEOFF BENNETT: A record heat wave and its connections to climate change are highlighting again the growing concerns around America's electrical grid and whether it can withstand the added stress.

William Brangham focuses on that part of the story tonight.

WILLIAM BRANGHAM: As Texas and much of the South broils right now, more people are dialing up their air conditioning to stay safe.

In fact, in Texas, which operates its own electrical grid, demand for power there hit an all-time high this week.

That puts enormous stress on utilities and power lines, at the very moment that they're also being impacted by the extreme heat.

Michael Webber is a professor of energy resources at the University of Texas at Austin, author of several books on this topic, and also chief technology officer at the venture fund called Energy Impact Partners.

Michael Webber, thanks so much for being here.

Just some table-setting here.

When we talk about the grid, what specific infrastructure are we talking about?

Is it the utilities?

Is it power plants?

Is it the lines?

What is it?

MICHAEL WEBBER, University of Texas at Austin: It's all of that.

You got to.

It's the power plants that make the electricity, the transmission lines that move the electricity from the power plants to the cities, and then the distribution lines that move it around the city, and then eventually you get to our meters and our appliances, like our air conditioner.

So it's a whole system up to the meter that really is what we call the grid.

WILLIAM BRANGHAM: So, you are in Texas right now, which I mentioned has its own particular grid.

Almost all the climate models that we look at say we are going to see more and more intense heat waves of this kind.

Are our grids nationally able to handle this ongoing stress?

MICHAEL WEBBER: It's going to be a strain.

We basically built our grid for the weather of the past.

We built out the transmission system mostly from the 1930s, 1970s.

A lot of our modern power plants we built in the '70s and '80s.

There are some newer ones, but it was cooler then.

And we need to prepare the system for a hotter future, which means, as you said, more frequent and intense heat waves.

It also means longer-lasting heat waves.

The heat we're feeling now in Texas and the high temperatures and high demand for air conditioning might be the new normal.

Next year might be hotter.

So, we have to prepare for that, and that means making sure the power plant is reliable.

It also means that the transmission lines or power lines are reliable.

It also means things like more efficient air conditioners and better-insulated homes.

There are a lot of things we have to do to make the whole system robust.

WILLIAM BRANGHAM: One of the things I was struck by in my research is how Texas is really a leader in renewable energy, and solar farms growing like crazy in Texas and saving a ton of money for rate payers there.

But I understand that there's also a lot of conservative pushback, arguing that renewables are not reliable and they're not sturdy for the future.

What does the record show on that front?

MICHAEL WEBBER: That's a great point.

So we have built a lot of wind, a lot of solar, a lot of batteries.

So we're at the sort of front edge of this in many ways on the cleaner technologies.

We also have a lot of nuclear, coal and gas.

We have got a mix of just about everything in Texas.

And the political pushback really is pushing for this idea that wind and solar are not reliable.

But what we found in Winter Storm Uri, the February 2021 storm that led to the deaths of hundreds of people and a massive blackout, it was the natural gas infrastructure that froze up, and natural gas, coal and nuclear power plants that went offline.

And we're finding out that solar power plants really perform well when it's sunny outside, no surprise, and those are the same days as hot.

So solar has been particularly helpful for us right now, especially since we have like eight to 10 gigawatts of thermal power plants, these traditional power plants like coal and gas, offline.

Solar is really helpful.

The hottest days, it's not so windy.

Wind is doing OK, but not great.

So it's good to have a mix of everything.

And renewables, in particular, have been stepping up in these heat waves and saving us a lot of money, while also avoiding a lot of emissions.

More importantly for Texas, the wind and solar power plants don't need water cooling.

And water is scarce in Texas.

So we're getting a lot of benefits from renewables, but, truthfully, we have a diverse mix, and that's really helpful.

WILLIAM BRANGHAM: So, operators of your grid in Texas have been urging people, in the midst of this heat wave, to cut back voluntarily on their usage of electricity.

You argued in a terrific column in The New York Times that that's -- you're skeptical of that idea.

And you argue that we ought to pay people to dial their electrical use.

Make that case.

MICHAEL WEBBER: Absolutely.

So, we can ask people, in their better angels, to voluntarily conserve, maybe dial back their air conditioner or turn off noncritical appliances.

And that will work a little bit.

Some people will do that.

But if we paid people, I don't know, $1 per afternoon or a couple dollars per afternoon, maybe as much as $15, people would absolutely dial back their conditioner or pre-cool their homes.

So, we can use financial incentives to encourage people to reduce their demand.

And turning down the demand is the same as turning up a power plant.

It helps balance the grid.

There are cities like Chicago with ComEd doing that right now.

They will pay you $1 per afternoon.

So we know this works.

We need this in a widespread way.

And turning off the demand would be a lot faster to deploy, a lot cleaner and a lot cheaper than building a bunch more power plants.

That's for sure.

WILLIAM BRANGHAM: I mean, going forward, though, we need, clearly, a much bigger investment in this infrastructure of the grid, more national, across the country.

Why is it that we have pushed off this critical investment for so many years?

MICHAEL WEBBER: For a lot of people, investment sounds like spending, and spending sounds bad.

But, in fact, it's investment for the future.

We need the grid.

We use it for water treatment.

We use it for food preservation.

We use it for air conditioning.

So, electricity is really central to what a modern economy is.

And if we look towards the future with growth of electric vehicles and induction stove tops and electric heat pumps, we're going to electrify many more things in the economy, especially as we decarbonize.

So we're looking at like doubling or tripling the grid.

That means a lot of investment.

I like this, because that means you're going to clean things up, we're going to create a lot of jobs and grow the economy, while making things more robust.

So, I think this is a great opportunity.

I think of it as investment, not spending.

But just people are reticent.

Sounds expensive.

But the benefit is, you will have a cheaper, cleaner grid.

And that's really useful.

WILLIAM BRANGHAM: And are you confident that we are going to do that in time to reap all those benefits that you're describing?

MICHAEL WEBBER: I think we will.

I'm always an optimist.

Engineers are often optimists, because we're problem solvers, and you have to be an optimist to believe a problem can be solved.

So I think we will do it.

I think it will start to take off more quickly, based -- people start to see the benefits of all the jobs that are created and all this sort of excitement around having a better system.

So I think that's going to start happening.

Frankly, it's already started to happen.

So, I think it's going to happen quickly and surprise us by how easy it was in the end.

WILLIAM BRANGHAM: All right, Michael Webber at the University of Texas, thank you so much for being here.

MICHAEL WEBBER: Thank you for having me.

AMNA NAWAZ: The American Medical Association says the U.S. faces a growing shortage of physicians, especially those in primary care fields, like internal medicine, mental health and pediatrics.

By 2034, the group predicts a shortfall, as much as 48,000 primary care doctors, driven by population and demographic trends and burnout.

Fred de Sam Lazaro found one doctor-patient model that may benefit both, one piece of the patient revolution.

The story is part of his series, Agents For Change.

FRED DE SAM LAZARO: Deep in Wisconsin's Northwoods, Kristen Dall-Winther is living her dream.

From the pancake breakfast, to seeing her kids off to school, Dall-Winther savors these moments before heading to work at Birchwood Family Medicine, a clinic she started two years ago.

DR. KRISTEN DALL-WINTHER, Birchwood Family Medicine: I grew up watching "Dr. Quinn, Medicine Woman," and, like, idolized her.

And I ended up forming a relationship with Patch Adams, the doctor, not Robin Williams, of course, who played him in the movie, but really just got, inspired around what -- how he delivers care in a way that really doesn't take cost too much into consideration.

FRED DE SAM LAZARO: Her first stop after med school was the Mayo Clinic, where she spent 10 years, financially rewarding, she says, but at great personal cost.

DR. KRISTEN DALL-WINTHER: It was beaten into you in training that you just need to work constantly.

I would work from 6:00 a.m. until midnight.

And I would put my babies to bed, and they'd say, "How many charts do you have left tonight, mommy?"

It's what we have always wanted to do.

FRED DE SAM LAZARO: Now she has time for both family and patients.

DR. KRISTEN DALL-WINTHER: When I was at Mayo, I certainly knew my patients, but I had 3,000 patients that said, she's my primary care doctor.

And, here, our practice closes at 600.

I have five times as much time with every patient.

FRED DE SAM LAZARO: It has had a cost, this time financial, a 60 percent pay cut, one she hopes to recover as the clinic grows to the 600-patient cap she has set.

It's now at just under 400.

DR. KRISTEN DALL-WINTHER: You changed your hair.

FRED DE SAM LAZARO: Adult patients pay $80 a month for what's called a membership.

It buys unlimited clinic visits, 24/7 access to Dall-Winther, typically using a secure app, and significantly discounted imaging and labs tests done right in the clinic, like a comprehensive metabolic panel, or CMP, a blood test to check a patient's metabolism and chemical balance.

DR. KRISTEN DALL-WINTHER: The difference is astounding.

CMP, a metabolic panel, at Mayo, they're going to bill $134, around there, for a CMP.

Here, it's $4.50.

And that's true across the board for every lab, every X-ray or radiology exam.

FRED DE SAM LAZARO: The Birchwood clinic operates on a model that's become known as direct primary care, practices that avoid dealing with insurance companies if at all possible.

Across the United States, some 2,000 primary care clinics now operate on some variation of this model.

DR. KRISTEN DALL-WINTHER: Let me just check your others.

FRED DE SAM LAZARO: For patients like 25-year-old Russell Bacon, it's the difference between having and not having health care.

His job as a heavy machinery operator doesn't offer health insurance.

RUSSELL BACON, Patient: It honestly used to scare me to go into the hospital, not for the needles or the doctors or the sickness or anything, but just for the price of it.

They don't tell you how much you're -- they're going to charge you, and it could be $100, or it could be $1,500.

And that's a tough pill to swallow sometimes.

FRED DE SAM LAZARO: But 80 bucks is affordable for you.

RUSSELL BACON: Eighty bucks a month is very affordable.

And the amount of care that you get with that $80 is unbelievable.

DR. KRISTEN DALL-WINTHER: Have any issues with blood sugar?

FRED DE SAM LAZARO: That level of care is what draws patients like Tiana Kristensen.

She has health insurance, but opted to pay the clinic membership fee.

Now expecting her second child, she values the more personalized care here.

TIANA KRISTENSEN, Patient: Not that we didn't like the health care system we had before.

Like, they did great.

We had great physicians.

We had good care.

It's just, being such a big system, you fall through the cracks.

FRED DE SAM LAZARO: It might bring more satisfaction to patient and doctor, but small clinics like these likely add further stress to a system that's already stretched thin.

DR. ROBERT BERENSON, Urban Institute: One of the major problems in health care delivery is the shortage of primary care health professionals.

The Baby Boom generation, which makes up a significant portion of physicians, are retiring.

FRED DE SAM LAZARO: Robert Berenson, himself a retired primary care doctor, is now at the Urban Institute.

Besides retirements, he says fewer medical graduates now opt for primary care.

Aside from the daunting insurance paperwork, he says their work is valued far less than that of specialists by insurers, including the largest, Medicare.

DR. ROBERT BERENSON: The Medicare fee schedule assumes that a dermatologist takes 29 minutes to freeze a wart with liquid nitrogen, a service that is not even a procedure that takes about 15 seconds.

And the payment is as much or I think a little more than a physician spending 15 minutes with a patient with multiple chronic conditions.

FRED DE SAM LAZARO: And he says attempts to raise primary care reimbursement have proven difficult amid rising health care costs overall.

DR. ROBERT BERENSON: When I discuss this issue with private health insurers and say, why don't you increase the payment to primary care doctors, it will pay off in the long run, their basic answer is that we don't focus on the long run.

And so the Congress needs to step up in terms of Medicare, but it doesn't.

And that goes to the whole issue of election financing and all of those issues, which are above my pay grade.

FRED DE SAM LAZARO: So the trend is just the opposite of the Birchwood model.

Large group practices now employ about two-thirds of all primary care doctors in America.

Many are owned by insurers and even private equity investors.

DR. KRISTEN DALL-WINTHER: There are a lot of morally injured doctors who are living everyday with that conflict of what they believe and how they how they wanted to deliver care.

But they're up against a system where they feel trapped to some degree.

And they're having to just kind of play along to exist.

The people that I see here, I do an exhaustive dig into their old records.

It's shocking and kind of horrifying at how common I find things that have fallen through the cracks.

And that's just the nature of doing medicine in 15-minute increments.

FRED DE SAM LAZARO: In a system of ever-larger health care organizations, Dall-Winther says she feels fortunate to be able to practice medicine, as it traditionally has been in America, in a small independent clinic.

For the "PBS NewsHour," I'm Fred de Sam Lazaro in Birchwood, Wisconsin.

AMNA NAWAZ: Fred's reporting is a partnership with the Under-Told Stories Project at the University of St. Thomas in Minnesota.

GEOFF BENNETT: Let's expand our horizons a bit wider and look at important findings that are literally about space-time and the cosmos as we know it.

You might remember that Albert Einstein theorized that as heavy objects move through time and space, they create ripple effects in the fabric of our universe.

Now an international team of scientists have detected new evidence of that.

Researchers found new signs of gravitational waves, waves that are affected by huge movements, such as the collision of black holes.

These are no small matters.

Our science correspondent, Miles O'Brien, is here to break it down.

So, Miles, Albert Einstein was apparently, what, 100 years ahead of his time in predicting these gravitational waves.

What are they exactly?

MILES O'BRIEN: Well, they are in fact ripples in the fabric of time, and Einstein predicted them in 1915.

They were verified by a ground-based observatory based on lasers called LIGO in 2015, so 100 years later.

What this latest discovery does is prove they're more ubiquitous and found at much longer wavelengths.

We're talking about a project called the North American Nanohertz Observatory for Gravitational Waves.

We're going to call it NANOGrav from now on funded by the National Science Foundation.

They have been working on this for 15 years.

I do think it's worth spending a couple of more moments trying to understand gravitational waves before we go much further.

Jeffrey Hazboun helped me out with this.

He's at Oregon State University.

He gave me a little 101 which we can sink our teeth into.

JEFF HAZBOUN, Oregon State University: One way to think about is if you think about space-time as being Jell-O, right?

You have this.

It's a little bit more firm than regular Jell-O.

But you have Jell-O.

And the space in between the sides of the Jell-O gets jiggled by these really massive objects.

And so you can imagine smack it on one side of a big giant cube of Jell-O and a wave would pass through that cube of Jell-O.

And so things would compress and expand as that perturbation moves through the chunk of Jell-O.

GEOFF BENNETT: So he paints quite a mental picture there.

Help us understand the scientific significance of this.

MILES O'BRIEN: Well, so the Earth-based LIGO, that laser beam observatory that I was telling you about from 2015, that was akin to Galileo pointing his telescope at Jupiter.

Now we're talking about much more complicated and larger telescopes, if you will, looking at other wavelengths, in this case, a wavelength that can be a light-year-long or longer.

And scientists have long hypothesized that if there were gravitational waves, there'd be kind of this background hum of gravitational waves out there.

But it was impossible for them to detect them with any sort of ground-based observatory to see these sort of ripples in space-time at that magnitude.

GEOFF BENNETT: I'm really struck by the quixotic nature of their endeavor, trying to find out if there's a background hum rippling throughout the universe.

How did these scientists do their work?

MILES O'BRIEN: Geoff, if you can imagine an observatory about the size of half of our galaxy, if that even computes with you, they took advantage of pulsars.

Pulsars are dead stars.

They are very dense, about the density of our sun, the size of our city -- a city.

So, NANOGrav used a technique called pulsar timing array, which means they use pulsars, which are dead stars, which have predictable kind of rotating beacons, and you can really set your clock to it.

And if there's any change in those, you can infer there's something happening, in this case, a gravitational wave, which is changing it ever so slightly.

So, they trained several radio observatories on our planet at 68 of these pulsars and were able to pick up these subtle changes and thus identify what they infer to be these big gravitational waves.

GEOFF BENNETT: These ripples in the fabric of time, do scientists know what causes them?

MILES O'BRIEN: Well, they don't know for sure, but they think that big, supermassive black holes have something to do with it.

The universe is rough place, Geoff.

Things are bouncing around a lot, banging into each other, including black holes.

And the idea is that, as this happens, this is kicking out this -- these perturbations which create these gravitational waves.

But I am now officially getting in deep for a history major.

So let's go back to Jeff Hazboun, Oregon State University, for his best current hypothesis.

JEFF HAZBOUN: It's most likely from an ensemble of millions of black hole binaries, supermassive gargantuan-sized black holes that live at the centers of galaxies.

When two of them settle in after a galaxy merger, that's when they give off the gravitational waves that we're looking for.

But it -- we aren't there yet.

GEOFF BENNETT: So he says we aren't there yet.

So, what's next, Miles?

What questions do these scientists hope to answer?

MILES O'BRIEN: They have identified the chorus.

Now they want to home in on some individual singers.

And, in so doing, they hope to connect the dots a little better between these bouncing around massive black holes and these long gravitational waves and, in so doing, create sort of a cosmic archaeology, understand more about how the universe formed and where it's going, and doing that by listening to the hum of the universe.

GEOFF BENNETT: Miles O'Brien, always enjoy speaking with you.

Thanks for being with us.

MILES O'BRIEN: You're welcome, Geoff.

AMNA NAWAZ: The experience of war is an enduring trauma for anyone, but it is especially hard on children.

Death and displacement, doubts and fear acutely damage children's psyches and their ability to cope.

But trusted friends are now aiding Ukraine's children.

GEOFF BENNETT: The Sesame Workshop, which has produced the iconic children's program for decades, is being used in Ukraine to help children experiencing what none should ever have to withstand.

Special correspondent Jane Ferguson reports for our arts and culture series, Canvas.

JANE FERGUSON: Educating children at times of war demands much from teachers.

These Ukrainian children are some of the first to access videos created by the workshop of America's iconic children's program "Sesame Street."

They are made especially to help children learn to cope with strong emotions, communicate with each other, and escape the constant pressures of war, all in the Ukrainian language.

TATYANA SOROKOPUD, Ukrainian Teacher (through translator): Children are surrounded by constant information of the war, destruction, killing and death, and it affects them.

They become more anxious.

My clinic works also with children with special needs, and it affects them especially.

They become even more emotionally unstable.

JANE FERGUSON: Tatyana Sorokopud runs a small school near Kyiv.

As the war grinds on outside, she and her staff fight to help little minds grow, despite the undeniable stresses they must endure.

TATYANA SOROKOPUD (through translator): The videos "Sesame Street" provides for us are very interactive, and this is very good, because children are interested and pay attention.

These cartoons and other exercises evoke emotions from them, and it keeps them distracted from the horrors of war.

Because children have become more anxious and vulnerable due to the war, their attention span is limited.

It's around 10 minutes.

We have to change the activities for children to keep them interested, to keep them occupied.

This is why having games for them is helpful.

JANE FERGUSON: War impacts children differently from adults.

ESTEE BARDANASHVILI, Senior Director and Supervising Producer, Sesame Workshop: As we're hearing from research and from early childhood development experts, it is affecting the child's brain development.

The prolonged stress or exposure to trauma can delay development, can delay their health and well-being, mental well-being.

JANE FERGUSON: Estee Bardanashvili is the director of Sesame Workshop and oversees the creation of content that is most helpful to children of war.

So far, half-a-million Ukrainian children have watched this content since the project's launch in March, according to her.

ESTEE BARDANASHVILI: Content development happens with experts in the fields.

I'm a producer.

But it's the education team, it's our early childhood development experts, it's our cultural advisers, our linguistic advisers to really guide us to understand, what is it that kids really need?

Well, how do you address the needs of children as they're experiencing war, as they're being picked up in the middle of the night and off to another country or another city, and at the same time understanding that they're still learning.

They are still children.

They need those playful, fun, cheerful moments in their lives.

And how do we also create content for the parents to talk to their children?

JANE FERGUSON: Some of the answers to these questions comes from experience.

"Sesame Street" first launched an Arabic-language service catering to the unique needs of reunions of displaced Syrian children in 2018, from outreach programs in camps, to YouTube content and videos for use in classrooms.

That content focused not just a learning traditional school subjects, but also how to cope with overwhelming emotions and how to communicate them to others.

Over five million Syrian children accessed those videos, and the program was expanded to include Arabic characters.

In Ukraine, Sesame Workshop has also developed online content for families, profiling children living through the war, like 11-year-old Denys, who chose to talk about his passion for dance.

We caught up with Denys via zoom at his grandfather's house on the south coast of Ukraine.

Like so many Ukrainian children, just getting an education is a challenge.

Schools have been repeatedly closed due to the dangers.

DENYS ROMANIUK, Ukrainian Student (through translator): When there were attacks on Kyiv, I had to learn online at home.

After that, we tried to go back to school for two weeks, and then home for two weeks.

But, later, there were blackouts and no electricity.

So we had some difficulty with the Internet and learning, but I was still able to keep up somehow, and ended the school year with good grades.

There was an air raid alert during our graduation ceremony.

And we all had to run into the shelter.

JANE FERGUSON: For children like Denys, learning online has been crucial.

"Sesame Street"'s Ukrainian videos are available on YouTube, as well as the "Sesame Street" Web site.

DENYS ROMANIUK: For most all subjects, you can find videos about them.

You can find on YouTube, watch them, and learn something.

JANE FERGUSON: Learning online has become an opportunity for Ukrainian children not to let the war hold back their educations.

Having access to the Internet and materials and videos helps parents keep their minds engaged.

DENYS ROMANIUK: My favorite lesson is English, really?

(LAUGHTER) DENYS ROMANIUK: Yes, it's English.

I actually learned most of English, not from lessons, but from YouTube videos.

JANE FERGUSON: Really?

DENYS ROMANIUK: I watched a big lot of YouTube videos in English.

Almost all time, I watch videos about computers, because this is my hobby.

I have tons of memory cards, so I can experiment with different Windows versions.

JANE FERGUSON: And is that something you want to do when you grow up?

DENYS ROMANIUK: Yes, I want to become an I.T.

specialist.

JANE FERGUSON: Fantastic.

It sounds like you're already on your way.

DENYS ROMANIUK: Yes.

Yes.

JANE FERGUSON: Well, I... DENYS ROMANIUK: I already could code some little programs for Windows.

JANE FERGUSON: That's really impressive, Denys.

That's amazing.

Do you learn coding?

Does YouTube help with that?

DENYS ROMANIUK: Definitely.

JANE FERGUSON: Denys is not alone.

Many children and families feel the same, according to studies by Sesame Workshop's teams of experts.

ESTEE BARDANASHVILI: Everything we do is based on research.

And the for very early months, we had looked at the landscape.

Where are Ukrainians getting most of their content?

What are they comfortable showing their children, which platform status?

And what we found was that, predominantly, Ukrainians in Ukraine and outside were using YouTube content.

JANE FERGUSON: Another family-focused video shared by Sesame Workshop captures the life of a little boy called Platon.

His mother moved with him to the Carpathian Mountain region in Ukraine's southwest, far from the front line of fighting.

Their video explores life in this unique rural setting, says Platon's mother, Antonina.

ANTONINA SIPLIVCHAK, Mother of Platon (through translator): The main goal of the videos is to show that Ukraine is very big and diverse and rich in traditions, and that the influence of these different cultures cannot be underestimated.

The Carpathian Mountains region alone has three distinct cultural identities.

JANE FERGUSON: Even though they are far away from the front lines, the children are separated from their fathers helping with the war effort, and risk being constantly bombarded by news from the fighting.

ANTONINA SIPLIVCHAK (through translator): The first rule is for parents to take care of themselves and their own emotional health, because only when they have strength and resources can they take care of children.

I also don't think children should know certain things about the war, for example, how many people have been killed, how many have been injured.

They should just know the general information, that our country has been invaded, that our soldiers are defending our country, often at the cost of their lives.

JANE FERGUSON: Sesame Workshops are now developing more content for parents, where experts help them know what to do when children are afraid and how to cope themselves with the pressures of parenting during conflict.

The videos are also now being broadcast in partnership with Ukraine's largest children's TV channel.

Plans for them to move onto satellite channels are under way.

It's a rare blessing for children of war to so widely have access to the Internet and TV and an opportunity to mitigate just some of war's hardships and lessen its hold over their lives.

For the "PBS NewsHour," I'm Jane Ferguson.

AMNA NAWAZ: And, remember, there is much more online.

Follow us on TikTok, where John Yang further breaks down today's Supreme Court landmark affirmative action decision and what it means for college admissions going forward.

GEOFF BENNETT: And join us again here tomorrow night, when the Supreme Court is expected to issue a ruling on President Biden's student loan forgiveness plan.

That's the "NewsHour" for tonight.

I'm Geoff Bennett.

AMNA NAWAZ: And I'm Amna Nawaz.

On behalf of the entire "NewsHour" team, thank you for joining us.