Harvard physician Atul Gawande says we need to change the nation's approach to aging and dying. How nursing homes can focus more on patients’ need for human connection, and how end-of-life treatment is actually shortening lives instead of extending them.
The government for the first time releases data on Medicare payments. President Obama vows to do more for war veterans at a memorial for Fort Hood shooting victims. And Senate Republicans block debate on an equal pay bill. A panel of journalists joins Diane for analysis of the week’s top national news stories.
- Olivier Knox chief Washington correspondent, Yahoo! News.
- Annie Lowrey economic policy reporter, The New York Times.
- Janet Hook congressional correspondent, The Wall Street Journal.
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During a discussion about the two executive orders President Barack Obama signed this week in an effort to close the gender wage gap, a caller asked Diane Rehm and panel of journalists Friday to disclose their salaries on air.
Diane, along with her three guests, declined, but the awkwardness of the question underscored a discussion about the psychology of discussing wages in the workplace–regardless of gender.
Watch the panel’s discussion below.
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MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Health and Human Services Secretary Kathleen Sebelius resigns after a five-year term. The Senate blocks debate over a Paycheck Fairness Bill for the third time. And officials search for a motive in a Pennsylvania High School stabbing that injured 22 people. Joining me for the domestic hour of the Friday News Roundup: Janet Hook of The Wall Street Journal, Olivier Knox of Yahoo News, and Annie Lowrey of The New York Times.
MS. DIANE REHMFeel free to be part of the program. Give us a call at 800-433-8850. Join us by email to email@example.com. Follow us on Facebook or send us a tweet. And Happy Friday to you.
MS. JANET HOOKHappy Friday.
MS. ANNIE LOWREYHappy Friday.
MR. OLIVIER KNOXHappy Friday, Diane.
REHMGood to see you all. Janet Hook, Kathleen Sebelius announces her resignation. How much blame does she get for the breakout of the Affordable Care Act? And how much applause does she get now that so many millions have signed up?
HOOKWell, she's been getting a lot of the blame for the flawed rollout, all the glitches and problems. And she accepted the responsibility when she testified before Congress several months ago. And I think there's been a lot of blame-laying on her just because she's been the most public face, and she kind of oversaw all of the work that actually was kind of on the ground at the root of the problem.
HOOKI think, unfortunately, she probably isn't getting much credit for the signups, if only because -- I mean, once President Obama came out and announced that they'd exceeded the $7 million -- (laughs) 7 million person enrollment goal, it was kind of more a relief than it was a cause for celebration. The celebration was, after such a crummy start, isn't it amazing that they reached the goal?
KNOXWell, she gets enough of the blame that when the president came out into the Rose Garden, not that long ago, she was neither at his side, nor was she acknowledged in his remarks. And I think that says a lot. The other reason she's getting some -- you know, getting more blame than credit is that they brought in several very prominent managerial hired guns to fix the place, you know, Jeffrey Zients, Phil Schiliro, people who came in and get more of the credit -- internally anyway at the White House -- for fixing the rollout. So she'll stick around until her replacement is named. And I don't expect to see her on Capitol Hill, but I think she's having kind of a rocky departure.
REHMAnd it sounds as though her successor is going to be named today, Sylvia Mathews Burwell. What do we know about her, Annie?
LOWREYSo she is somebody who came out of the Clinton White House. She's very well known as kind of an operator, sort of a Zients-like figure, somebody who comes in and fixes. She's like a manager, like a consultant. So she actually came out of the nonprofit world, but she's known as being, like, a very reliable kind of fixer within the White House. I think that she's thought of as doing a really, really good job at OMB, doing a lot of outreach to Capitol Hill.
LOWREYOne really important thing is that there's a feeling that she, of all people, is probably going to be one of the easiest to get through Congress. It was going to get really, really hard to get somebody confirmed to this position, for obvious reasons, 'cause there's so much Republican opposition to the law still. But she got confirmed 96-0 last year. And she spent a lot of time talking to Republicans on the Hill. And so even yesterday, there were fairly positive statements coming out about her.
LOWREYYeah, John McCain, exactly. And so, you know, there are a lot of really controversial people they could have named. And they chose instead, you know, Ms. Reliable, Ms. Trustworthy, Ms. Low Controversy.
HOOKBut I think you can assume, whoever is at the witness table for this confirmation hearing, the hearing itself will turn into a big, you know, circus about Obamacare, its strengths and weaknesses. And they won't have any trouble with the vote on the floor, no matter what, because you remember that Harry Reid changed the rules, the Senate rules, for confirmation of nominees.
HOOKHe only needs 51 votes, so he might even be able to let some vulnerable Democrats vote against her, if they want to. But I don't they will. I mean, that 96-0 vote isn't just a showboat. It reflected some pretty broad consensus and support behind her.
KNOXI would predict that she would get confirmed easily. But I also think there will be a lot of Republicans voting against her, and they will be saying, you know, I like her personally. I think she's a great manager. But, you know, I cannot, in good conscience -- it'll become a stand-in for a repeal vote for Obamacare.
REHMSo what do you think is next for Kathleen Sebelius? Anybody know?
KNOXI hope it's a vacation.
LOWREYYeah, a vacation, maybe, like, some champagne, a hammock possibly.
REHMA good vacation. All right. Let's talk about the Civil Rights Summit. Three former presidents joined President Obama at the Civil Rights Summit this week. Common themes in their remarks, Olivier.
KNOXUnited position that what he did changed America for the better. You know, it was a controversial proposal in legislation at the time. Time has erased most of the controversy from that. I mean, we've -- they were -- all these presidents came out and said -- including Barack Obama, who basically said, I wouldn't be here if it hadn't been for LBJ pushing the Civil Rights Act.
LOWREYYeah. I think that that's right. And I think that there is also a sense -- there's been a lot of sort of soul searching, I think, and a lot of talk in Washington about whether this kind of legislation could pass in this sort of political environment.
LOWREYAnd on -- you know, on the one hand, it was only a couple years ago that the Affordable Care Act, which is a big controversial piece of legislation, passed. On the other hand, you know, since then, it's been very hard to pass anything. So I think that it's been a cause for reflection not just on the legacy of civil rights and race in America but also on how Washington's working.
REHMAnd, Janet, the president signed two executive orders having to do with the gender pay gap. What do these orders do? And how much impact are they actually going to have?
HOOKWell, the thing about executive orders is they only apply to federal contractors so that the -- it limits the scope of the impact. Basically, what it does is it basically prohibits employers from discriminating or taking retribution against employees who talk about and seek information about salaries, which is to say, for the purposes of comparing. You know, I ask Olivier, so how much are you paid?
HOOKYou've got the same amount of experience as me. And they -- the Democrats in the Senate actually tried to advance legislation this week that would do something similar. It's basically to prohibit retribution against employees who seek information about salaries. And it was blocked by a Republican filibuster. That would have, if it had passed, been -- had a far broader impact than just the executive order.
REHMNow, tell me how the two of you, as women, feel about your own salaries. Have you ever tried to compare them with men at The Wall Street Journal and New York Times who are doing the same kind of work you do? Annie?
LOWREYThe Times -- I can't speak for other papers. The Times is somewhat unusual in that we're all unionized employees, and there's actually a little bit of visibility into what other people are earning.
REHMHow much transparency?
LOWREYNot total transparency, right?
LOWREYBut, you know, I would say that I have actually asked colleagues how much they're making as part of my salary negotiations with my bosses. But it's a really awkward, hard thing to do. And I do think that there's a cultural element, you know, about asking and about having that kind of openness and visibility in saying, OK, well, should you be paid as much as somebody who's maybe working harder, may be more successful, than you?
LOWREYI think it's a really, really tough issue. But I think that the evidence is pretty compelling that there is a discrimination factor, and that probably affects women's work choices and that that's probably a really big factor, too. And so I think it's a very large issue. And I think that, you know, the Republican position on this is that there are other pieces of legislation that prevent discrimination. And I think that part of the White House is trying to do is say, look, we want a culture in which you're allowed to ask.
LOWREYAnd you should ask.
LOWREYAnd that's going to help us, you know, even if it's just a couple pennies on the dollar, that would be a good thing.
REHMJanet, how about The Wall Street Journal?
HOOKWell, I was only hired at the Journal about 3 1/2 years ago. And I'd like to say I'm a good reporter. And I asked around to find out how people who went to the Journal before me were paid. But Annie's exactly right. It's a really awkward conversation. And I didn't get the information by asking the people themselves.
HOOKIt's just it's something that, culturally, people are not comfortable saying what they're making. I worked at another place where there was an effort to get more transparency about salaries, and it wasn't a well-received effort. I mean, it's a very delicate subject.
REHMHmm. Indeed. And, Olivier, have you ever had the conversation about what you are making compared to your colleagues?
KNOXI have not, and I hope you won't leave your listeners with the impression that this is an easy conversation if you're a guy. It's not any easier.
KNOXI went from a place -- I actually went from a place, a news agency called AFP, where the salary scales were public. There was a little bit of room for merit raises, but basically everybody knew what everyone else was making, essentially to a place within individual negotiations -- complete culture clash. It is an extremely hard conversation to have. And I have not asked any of my co-workers how much they're making.
REHMAnd would you? Would you ever consider doing that?
KNOXNo. I do the job for the perks, like "The Diane Rehm Show."
KNOXNo. The serious answer is no. It's a very awkward conversation. Plus, you know, I'm half-French, and my people don't like to talk about money.
REHMWell, you know, I do think it's a conversation that people need to begin to have, whether you're male or female, so that everybody does have greater transparency. What do you fear would happen, Janet?
HOOKWhat do I fear would happen if I asked a colleague?
HOOKI don't know. It's just sort of an awkward embarrassing thing. If you're making a lot less than the person you think you should be making the same amount for, you feel bad. And if you make more, you feel bad. And I don't know. It also doesn't feel like actionable information in the kind of workplace environments we have now.
REHMDo you think transparency would lead to an easier relationship and a better way for you to negotiate your salary?
HOOKRight. I mean, that's the point, is this isn't supposed to be about my comfort zone. It's supposed to be, I find out that the guy sitting next to me is making $20,000 a year more, that's information that you take to the boss.
REHMAbsolutely. Janet Hook, she's congressional correspondent for The Wall Street Journal. Olivier Knox is at Yahoo News. Annie Lowrey is with The New York Times. Short break, right back.
REHMAnd welcome back to the national hour of our Friday News Roundup this week with Annie Lowrey of The New York Times. She's economic policy reporter. Olivier Knox, he's chief Washington correspondent for Yahoo News, and Janet Hook, congressional correspondent for The Wall Street Journal. Talking about pay, Annie, there's a political fight over just how wide this pay gap is between men and women on the job. What do the studies tell us?
LOWREYSo there -- it is true that women are paid about 77 cents on the dollar nationally, but that's a little bit of a misleading number because it doesn't account for women -- the fact that women might have different educational attainment, years of experience, time on the job. They might be selecting different types of jobs.
LOWREYBut, nevertheless, researchers think that about a third of that is not explained by other factors. And so that's probably discrimination. And there's actually been sectoral studies, you know, showing how common it is that a woman who looks identical on paper to a man would be paid less. And it does seem that discrimination is still a major factor.
LOWREYSo that 77-cent number is probably not the greatest number. It's probably something more like 7 cents out of a hundred. But, again, it's going to vary really widely also depending on the industry and, you know, experience, whether somebody's paid by the hour or salary.
REHMSure. How big an issue is this likely to be in the 2014 and '16 campaigns, Olivier?
KNOXWell, there's something interesting going on, which is the American economy in 2014 is not racing and it's not slumping. It's kind of muddling through. And that's made it complicated for politicians to find an argument. They can't point to the economy as a disaster. They can't point to it as a roaring success story. And that's leading them to find issues that can kind of stand in for people's economic concerns. So, on the Democratic side, you have the minimum wage, and you have paycheck fairness. And that's a stand in. That's a way of saying, I understand that you're struggling.
KNOXHey, look, I have some ideas for helping you. On the Republican side, so far that's really been mostly about Obamacare and saying, you know, you're right to be worried about losing your insurance. You know, this is going to be a problem for the economy. And so you've got these sort of stand-in issues -- not to say that healthcare and wages are not economic issues. They are, but it's not sufficient this year just to point to the economy and say, you see, I told you so.
HOOKWell, and the key political dimension of this debate is that women voters are really the swing voters. And it's really important for the Democrats to jack up turnout of women because, if their turnout drops off in the midterms, as it often does, they're really going to be struggling. And so they've been focusing a lot, individual candidates in the part as a whole, on issues that speak directly to women. And that's really what this is all about, less the people will be voting on it than as a kind of a turnout generator.
LOWREYYeah, and I think it's worth noting that in some ways this year it's so quiet, right. You know, if you look at the past decades, we've had these crazy economic gyrations. We've had wars. We've had these really bitter partisan fights. You look at this year, and it's relatively, like, really calm, really quiet. And I do think that they're kind of seizing on these smaller issues for that reason.
REHMHmm. Hmm. All right.
LOWREYI don't think it'll be quiet in 2016 though. We'll see.
REHMYeah, quite right. What about this Medicare payment data release? How important is that to you and me personally, Annie?
LOWREYThis is amazing visibility into these numbers, and I think we owe some credit to The Wall Street Journal which -- and Dow Jones, I think, which led this campaign to get them to release the data. And I think that you can over-interpret it. You can say, oh my goodness, like, look, it's rife with fraud and abuse. And I don't think that that's true when you're looking over it.
LOWREYYou know, there is absolutely fraud and abuse in Medicare, but, you know, it's not a huge problem. But I do think that it gives us this great, you know, window into how the medical system works and how a lot of doctors might be gaming it, and just how crazy some of our payment systems are in the sense that the doctors are making a lot, a lot, a lot of money in some cases.
REHMIs this really going to make the entire healthcare industry more transparent?
HOOKI don't know about the entire industry, and there are real limits to this information. It's more than we'd ever imagined we would've gotten. Basically what it does is it tells you, like, how many times a doctor bills for a certain kind of procedure, which, you know, apart from the leads to fraud and abuse, if somebody's, like, going over the top with one kind of procedure. It does give consumers information of a more concrete variety.
HOOKLike, when you have a particular kind of surgery, you want somebody who's well practiced at it. So it's kind of -- but you don't really know -- it doesn't tell you exactly why a doctor's doing a lot of this. So what the doctors were really concerned about, and why they fought so hard for so long against this kind of release of information, is that they see it as a violation of their privacy...
HOOK...and that it's so easy to misinterpret the information that you get. Now, right, I mean, all information can be misinterpreted. I think more information is almost always better.
REHMBut isn't it going to be difficult for me as a consumer? You know, I'm going to have to lay out spreadsheets of doctors in this area if I'm looking for a particular procedure. I mean, aren't I going to go instead to a friend who's had that kind of procedure and say, you know, what would you recommend? Am I really going to go in depth that way?
KNOXWell, I don't know about the spreadsheet, but you might look at your current healthcare providers and see where they fall on this list. You might go and say, you know, my ophthalmologist, let's see how he or she is doing with regard to Medicare. Are they billing for the more expensive treatment rather than going for the less expensive treatment because they're looking -- because they're treating me -- you know, they want (unintelligible) me.
REHMAnd how easily it is going to be for me to find that information?
KNOXProbably not that easy in the end, although the data's pretty -- is broken down pretty nicely. So it's...
REHMWhat do you think, Annie?
LOWREYAnd I think that there's been a couple widgets that news organizations have built. And I'm sure that we'll see a lot more of that going forward so that, you know, you can really easily plug in your doctor, you know, say I'm looking for this rare procedure in this area. And I do think that over time there'll probably be a lot more visibility into that.
REHMAnd what does the White House hope to gain from release of this material, Janet?
HOOKOh, gee, I don't know whether -- I mean, this was basically compelled by a legal action so that I don't think that this was, like, the White House gaming the system and saying, OK, now we can really get them. But it does give investigators new tools for helping to track down fraud and abuse. I mean, the fact is the government already had this information. It's not like they needed to release it to increase their knowledge. I mean, maybe it somehow will increase public pressure for abuse to be rooted out.
REHMAll right. Olivier, you were in College Station, Texas over the weekend when Jeb Bush spoke. Tell us about the reception he got.
KNOXWell, this was at the 25th anniversary of the George H.W. Bush presidency. And it really rallied a lot of the alums from the administration. There were the Brent Scowcrofts. There were the Stephen Hadleys. Condoleezza Rice made an appearance. But the headline event -- apart from my panel, of course. The headline event was...
KNOX...Jeb Bush doing a sit-down interview in which he talked at some length about a lot of the hot-button issues for 2016. He's obviously on the short list of -- you know, if anyone asks you, who's running in 2016, he's got to be on the list. And he made some news by really by coming out strongly for immigration reform and by talking about how undocumented immigrants are trying to unite their families and how this is not a crime, basically breaking pretty sharply with the base of the party.
REHMAnd how was that received?
KNOXWell, it's a little trite to say that Jeb Bush got a great warm reception from his father's friends. But that is kind of what it boils down to there. You know, everyone came out of that auditorium saying how great he was. But you've got to take that with a big grain of salt. It was relatively well received, but everyone starts wondering what that meant for his 2016 fortunes.
REHMAnd he's saying he won't say anything until the end of this year. Is that correct?
KNOXRight. That's right. So he's, you know -- but he obviously didn't -- he did nothing to tamp down the speculation. I think it's worth noting, you know, a lot of people said it's a big break with the base, therefore he can't do this. You know, just look back at 2012. It's obvious that the favorite candidate -- the nominee doesn't have to be the favorite candidate of the base.
REHMYou also heard a lot of talk or questions about Condoleezza Rice.
KNOXI did. I did. Over the course of the weekend, the minute anyone found out that I was a reporter, they asked me about 2016. But nobody asked me about Jeb. The only questions I got really were about Ben Carson, who was there at the event. But the vast majority of the questions were about Condi Rice and whether she would consider running and how great she is and why isn't she running. I mean, basically there was a lot of talk about her as a potential presidential candidate, which I have to say would shock me in the extreme.
REHMAnd, Annie, what about you? Would that shock you?
LOWREYI would be very, very, very surprised. I mean, it's interesting to think about. I can't imagine that this is something that she wants to do. It seems to me that there's a lot of other roles for her in the Republican Party. But going through a presidential election, I just don't see it. And what I think is interesting about what Olivier said about Jeb is that it does seem to me that it speaks to this really deep rift now over immigration.
LOWREYAnd I think it's going to be such an interesting litmus test, whether a candidate who breaks with a lot of the party but not all -- I think there's a lot of people who really feel like they need a more progressive stance on immigration here -- can get through some of these primaries. I think it's a fascinating question going forward.
HOOKRight. And I think the way Jeb Bush broke with the party was so succinct and quotable that you know that he was really wanting to put down a marker. He said, this may be a felony, these illegal immigrants, but it is an act of love. I mean, that is not pulling any punches. He wants this to be remembered as his position.
REHMAnd do you think it will, both negatively and positively?
HOOKOh, absolutely. I mean, the initial reaction was very negative from conservatives. And, you know, you kind of wonder, was he just trying to kind of lay down the marker now? Because there had been all of this oh-Jeb-is-being-courted-by-the-establishment buzz going around for the last few weeks. And so this is him saying, OK, what you see is what you get.
KNOXHe couldn't -- I mean, the thing is he couldn't run from his already ample record on this issue.
KNOXIf he'd hedged in any way, that would've been probably a bad moment for him. I think, if he runs, he would look a little bit like Romney in this sense that he would have difficult fortunes throughout the primaries although the party's been moving to limit the influence of things like debates. But, you know, he's got to be considered fundamentally someone who can survive the ups and downs to the nomination, the way that Romney did.
REHMAll right. And let's talk about the stabbing in Pennsylvania this week. Do we know anything about motive? What do we know about this young man who apparently carried out the stabbing, Annie?
LOWREYWe know very little. It's very frustrating. At least from what I've seen, it's really just a big question mark. And it's a really horrible act. And, you know, I think that, because we've become sort of habituated to gun violence, what strikes me about this is you have to be really close to stab somebody. And it's a very visceral, horrible thing to have happened. And I think that we just don't know very much right now. And I don't know, you know, beyond motives and everything else, I think it's really hard to draw lessons or bigger conclusions.
REHMIs there any evidence he was being bullied or harassed by his classmates?
KNOXNo. The early reports don't -- the early reports are actually sort of shockingly clinical. You know, he's 16. He ran down 200 feet of hallway in his school with two knives between eight inches and 10 inches long and stabbed a number of his schoolmates. There's not a lot of evidence about that. You know, his -- one of the hardest things to watch was his father, you know, caught by the media in the driveway apologizing to the families of the victims.
KNOXBut there hasn't been anything to come out as yet about bullying. There's another element to this which is everyone has agreed he was shy. People didn't really know who he was. But Annie's right. You know, stabbing is a really personal act of passion. It's going to be interesting to see if anything lays any doubts to rest about what drove this kid.
REHMDoubts about guns versus knives.
HOOKRight. I mean, if he had been shooting with guns, he would have probably killed and hurt more people. That doesn't make this any less horrific. And I guess the other question mark is whether there was any -- there seems to have been no indication of mental illness, which is also kind of the next element that people are always talking about these days as in the...
REHMAnd yet he's going to be tried as an adult, at least so far.
HOOKRight, right. Yeah -- no, this may end up being also one of these -- you know, we've had so many calamities like this where you just wonder, what are these people thinking? And as in Fort Hood, we don't know because he then shot himself.
REHMAnd you're listening to "The Diane Rehm Show." Carry on that thought about Fort Hood, Janet. The president, of course, went to Fort Hood again to memorialize those who were killed on the base.
REHMHe made a commitment there to more mental health services. But you have to wonder how much more he can do with the limitations on the budget.
HOOKRight. And, you know, a lot of the problems of our mental health system aren't, you know, driven by federal policy. I mean, it really was just such a bracing and awful experience because this was the same place where this happened five years ago. And, you know, if you're not safe on a military base, where are you safe? I don't know. And, you know, President Obama is probably tired of being the consoler and chief for things like this.
KNOXI think that's right. That is the first place where he played that role. And, you know, it's raising all the other questions about post-traumatic stress disorder, which it doesn't appear that this guy had. It's raising questions about -- you know, I saw some stories this morning about military leave policy because it appears that one of the triggering events was a dispute over how the Army was handling a request for leave time.
KNOXAnd I think that it's hard to go wrong by promising more mental health and more care for veterans, even Ivan Lopez, who spent four months in Iraq and apparently never saw combat, but it's still an easy response. You know, these are people who come back from shocking experiences. And no one in D.C. would ever lose points for advocating more help and more resources for them.
REHMAnd, again, where is the money going to come from? OK. The decision by the House GOP to investigate Lois Lerner, what's that all about, Janet?
HOOKWell, actually they haven't -- they have been investigating Lois Lerner on the Hill. And what happened the other day was the Ways and Means Committee voted to ask the Justice Department to do a criminal investigation of her. And then, separately, the House Oversight Committee voted to hold Lois Lerner in contempt of Congress for invoking the Fifth -- her Fifth Amendment rights not to testify. So it's kind of like the -- this is an issue and a controversy that broke some time ago. And the Republicans sort of won't let it rest.
HOOKThey feel like there are unanswered questions and that they have to be -- at this point, they're making the case that her involvement -- that Lois Lerner's involvement in the directing of extra audits of conservative groups in their request for nonprofit status amounted to a criminal act. So they're basically referring it to the Justice Department. Now, the Treasury inspector general has already looked into it and concluded that bad things were done that weren't politically motivated, and it wasn't her fault. So...
REHMWere not also liberal groups investigated, Annie?
LOWREYYes. That had happened, and, as Janet kind of put it, it's not clear that there was evidence of systemic problems or that this had to do with IRS being housed under Obama's treasury.
LOWREYBut it's very politically -- you know, it's a hot topic.
REHMAll right. Short break here. And when we come back, time to open the phones, read your email. I look forward to speaking with you.
REHMAnd welcome back. Time to open the phones. Let's go first to Brian in Kalamazoo, Mich. Hi there, Brian. Go right ahead.
BRIANHi, Diane. Thanks for taking my call.
BRIANI just wanted to make a quick comment about wage equity in the workplace. I just think generally that there is a psychology in the workplace that discourages employees from talking and being open about their wages, even beyond the gender issue, that generally you're kind of, you know, maybe told or influenced just not to talk about your wage. And that's about all I have to say. Thank you.
REHMAll right. Thanks for calling. Any comment?
LOWREYYeah, I think that that's absolutely right. And, you know, there's actually been some surveys that a lot of people are expressly told not to do this or discouraged from doing it. So on top of this sort of social awkwardness, I think that there might be some employer pressure, too.
REHMAll right. Here's an email from Sarah who says, "A rollout the size and complexity of Obamacare required not just the great managerial policy and political skills possessed by Kathleen Sebelius but also a techno-savviness less like to be present in and among baby boomers." What do you think of that?
KNOXI don't think the boomer analogy is actually right. I do think that, having talked to a lot of people who used to do -- worked in the information technology field, I keep hearing the same thing, which is that no one should have thought that a large IT project run by the federal government should run smoothly because of problems with procurement, with, you know, rules about taking the lowest bid, and the rest of it. I think that had more to do with it than Kathleen Sebelius' generational affiliation.
REHMAll right. To Brad here in Washington, D.C. You're on the air.
BRADThank you. I love your show.
BRADMy comment is about the Pennsylvania school stabbing. As horrific as an event that is, what frustrates me is the double standard that they have. Now, we want to find out the motive and the mental state of this child that did the stabbing, but nobody wants to talk about banning knives. But anytime there's a firearm involved, we immediately want to ban all firearms when the bottom line is they're inanimate objects. And the person that either stabbed or pulled the trigger is what we need to focus on.
HOOKWell, you know, I bet a lot of people are going to talk about keeping knives out of that school.
HOOKYou know, I guess this is a case where -- I don't know. I mean, I think that the reason why people -- I don't know. I guess I don't really have a good follow-up on that.
KNOXAs someone who has had a lot of friends go through the public school system as teachers, you know, let's not lose track of the fact that a lot of the magnetometers that were installed in various schools in the 1980s aimed to keep out razor blades and knives as well as guns and that the worse fights that my friends who are teachers have seen have involved bladed weapons, not guns. But I take Brad's point that there is sort of a reflex whenever we have a horrific mass shooting that says, wait, should we be doing more about gun control?
REHMWell, but we also, at the same time, tend to look at the mental state of the individual who carried out the either mass shooting or, in this case, the knives. So, well, let's go to Robin in Phoenix, Ariz. Hi there. Robin?
ROBIN...taking my call. I want to go back to the Medicare situation. And I really like the fact that these numbers are coming out and we're seeing it. I'm on Medicare. I also take care of my father, my 91-year-old father, who's on Medicare obviously. And he has a slew of medical problems. One of his problems is macular degeneration. And what happened with him is that he was being injected with the medication that's being used off-label for that.
ROBINIt exacerbated his heart. And he ended up back in the hospital. I was the one that made the connection, thanks to NPR shows, that this medication had a heart side effect. He was taken off of it and put on to a medication that is much more expensive and is definitely only for the eyes. And his HMO wouldn't pay for it, so we had to get other funds. But what I'm saying is that we need to look at the patient's needs and not just the numbers when we're looking at Medicare reimbursements.
REHMI fully agree with you. Thanks for calling. Any comment, Janet?
HOOKYeah, I think that's a good example of why when we are talking before about how there are certain limitations on what the data that's coming out of Medicare right now can tell us. I mean, there's a more expensive drug for this situation and a less expensive one. And just because a doctor went for the more expensive one doesn't mean just that he's trying to charge more. There are some circumstances where that's the medicine you need.
REHMTo Annandale, Va. Hi, Andrew. You're on the air.
ANDREWHi, Diane. Hi, panel. Thank you for taking my call.
ANDREWI have two quick questions about the wage conversation, the first one being right to privacy issue, especially with the government monitoring cell phones illegally. I feel like that has to come up, that if public and/or private sectors are required to disclose wages, people are going to have a problem with that. And it could also cause discrimination in other areas in their lives socially possibly and even, again, in the workplace. That would be the first topic.
ANDREWThe second topic is the generational read-in for wage gaps. I'm sure we've seen the wage gap decrease through the decade and, you know, quite frankly, I want to say, just because older generations have a little bit more prejudice in them. Have we seen that? Are we still continuing to see that? And, well, that's about it.
REHMAll right. Thanks for calling. Annie?
LOWREYSo, to answer the second question first, yeah, there's evidence that, you know -- say that you're a college-educated man in a similar industry as a college-educated woman. That gap is very small. In some cases, women actually out-earn men. But that doesn't change the fact that broadly over the whole country there still remains evidence of discrimination in pay. To go to the privacy issue, you know, I think that that's a good one to bring up.
LOWREYThe way that companies are going to have to report these statistics, it should be a pretty hard to tell -- there should be, you know, still some covers or some privacy there. And I think that the federal government would say, look, like, you don't want to report these numbers, you don't need to contract with the federal government. And the greater good here is going to be in disclosure. But I think it's a good point.
REHMHere's an email from Clare who says, "One of the greatest gifts a co-worker and friend once gave me was to tell me her salary when I had doubts about mine. Turns out I was underpaid by $40,000, a deliberate cut to inflate the salaries of the bosses. After a prolonged fight, I got a $40,000 raise. Her generosity changed my life." It happens.
HOOKThere's a good case for disclosure right there.
REHMAbsolutely. And the more, the better. Let's go now to Dustin in Raleigh, N.C. Hi there. You're on the air.
DUSTINThank you. How are you guys doing today?
REHMI'm fine, thanks.
DUSTINThank you for taking my call. I was going to ask really quickly, in regards to Ms. Lois Lerner, how -- for someone that's not super involved with politics, how could she be forced to speak? And why would someone be upset if she does invoke her Fifth Amendment right? Isn't there -- did she say something that would say she did not invoke her Fifth Amendment rights? I know this is all legal work. And could you guys maybe explain upon that for the lay people?
REHMAll right. Thanks for calling. Janet?
HOOKI think what the -- one of the points that Oversight Committee made was that they said that, when Lois Lerner came to testify, she gave a statement declaring her innocence and then invoked her Fifth Amendment right. So it's kind of a legal question of whether you waive your Fifth Amendment rights when you -- if you've opened...
REHMIf you even say...
HOOK...by declaring your say.
REHMYou can't even do that?
HOOKYeah, that's the contention.
REHMThat voids the -- taking the Fifth?
KNOXI have a lawyer friend who says that, if you go testify before a congressional committee and they asked you what you had for breakfast that morning and it's your plan to invoke your Fifth Amendment rights, start invoking your Fifth Amendment rights rather than telling them, you know, scrambled eggs and a side of sausage. So I've heard that argument before.
REHMIt doesn't make sense. It doesn't make sense. Well, it's clearly something somebody wanted to go after, and they'd done it. Let's go to, let's see, Rain in Tampa, Fla. Hi there. You're on the air.
RAINDiane, I love your show.
RAINYeah, I would like to comment about the 16-year-old boy who stabbed all those classmates of his. There's just so many young people who have committed these horrible crimes. And I wonder what they all had in common. And I started thinking about two comments that were made to me about video games, about these video games having subliminal messages. And I was talking to a young girl who -- her fiancé, she told me, was a champion video game player.
RAINAnd he was, like, a national champion, which I didn't even know they had national championships for these video games. And I mentioned this comment to her about these video games having these subliminal, you know, especially the violent ones, having these subliminal messages. And she said, oh, yes, that's very true. And she explained to me about a video game that was out in the market now. And she told me the name of it, but I don't remember.
RAINShe's saying this video game, the graphics are so real they look like a movie. And in this video game, the player can kill anybody he wants, can do anything he wants in the world, and there are no consequences to that. And she says that video game is a very scary thing. So I just wonder why people aren't, you know, looking at this and seeing if this is true or not.
REHMYou know, we have done indeed done programs on exactly that point. And the problem is that, while there may be some underlying connection, nobody seems to have been able to make it concrete as yet and to say that game caused this person to do X, Y, or Z. I've never watched these violent video games. I bet you have.
KNOXI play them.
KNOXI do. I do. I play some violent video games. But the flipside is I also don't let my 8-year-old son play them or watch them.
REHMWell, why do you do that if you want to protect your 8-year-old from seeing them?
KNOXFor the same reason that I don't show him movies that are rated R. Now, some of that is, of course, parental convenience. I don't want to get a lot of questions about some of these behaviors.
KNOXBut, you know, when you're eight, you process information completely differently than when you're 18. And so what I try to do -- I think it's important to guard against that. There will be a time -- in fact, it may be happening now without my knowing. There'll be a time when it will be appropriate for him to play these games. Maybe he will play these games. But it's just like anything else. You don't want them to read materials that are inappropriate or see materials that are inappropriate.
KNOXI just -- I don't think -- even though video games obviously have an interactivity that other media don't, I still don't think -- I don't think it's sufficient to say that a video game caused or triggered that person. I think you need to have a more broadly causal relationship. If a video game is causing multiple people to do something, let's talk.
LOWREYI think when Columbine happened and with some of these other really horrible school shootings or public, you know, shootings, there's been questions about, you know, how video games disassociate you from violence, you pull the trigger, and you can kill, you know, however many -- 50 zombies or whatever else it might be.
LOWREYAnd what's kind of horrible about this is, you know, to knife somebody, you have to be close to them. You have to hold it and -- but it seems to me that, you know, so many people do play these games and don't do things like this that I think there's a real question. I think you're right about the causal effect.
REHMAnd you're listening to "The Diane Rehm Show." Let's go to David in Charlotte, N.C. Hi there.
DAVIDHi. How are you doing?
DAVIDIf somebody asked me what I made, I would say it's none of your business because it's a rude question. And, by the way, I'd like to know how much you make, Diane. And how much do the panel make? I mean…
REHMI'm sure you would like to know that. But I am certainly not going to say that publicly. I don't know about anybody else. Would you care to?
HOOKNo. But I think the caller's challenge to us goes right to the point that we've been discussing, which is it's an awkward and not socially acceptable thing to discuss in public. But if in, as in the case of our earlier caller, in a private conversation...
HOOK...with a friend, you can be, you know, armed with ammunition to fight pay discrimination, that's not a bad thing.
LOWREYAnd it's worth remembering, you know, Lilly Ledbetter, she still doesn't know who passed her the note saying what her male colleagues were making, right? You know, somebody just let her know on the fly, as I remember it. I could be misremembering the testimony in the story there. But, you know, she had no idea, and I think she still doesn't know.
KNOXI mean, I think David's point -- but also, at the same time, we've been saying in this whole show how difficult this conversation is to have and how actually, you know, as I said, I would not be comfortable having that conversation and haven't had that conversation. You know, you can go to a couple of government websites and get a sense of the wages and salaries...
KNOX...in a given industry or given profession. If you look up a reporter, though, be prepared to be extremely depressed.
REHMBut to talk about it publicly on the air is very different from having a private conversation if a colleague approaches you, and therein lies a rather large difference. Let's finally go to Julian in Charlottesville, Va. You're on the air.
JULIANOh, hi, Diane.
JULIANThe comment that I have is for -- about the Medicare data dump. You know, it seems that the data isn't complete enough to really draw any conclusion. But my big worry is that the media, and in cooperation with, you know, the administration, are going to spin this information in order to create yet another wedge issue, which they've been so good at so far.
REHMWhat do you think about that, Janet?
HOOKGee, I don't know. I mean, the reporting I've seen on it so far has been pretty clinical and not political. I mean, it really is kind of a fascinating window onto medical practice. You know, I don't think it's quite obvious what kind of political issues you could draw from it. I mean, it's -- like I was saying before, I think it's a good tool for sending you in the direction of possibly fraudulent activities by doctors who are overdoing one kind of expensive procedure. It could be a tool for consumers to get more information about their own doctor. I don't see anything kind of insidious about it.
KNOXOh, I think it would highlight the appeal for a politician to do, say, congressional hearings into waste, fraud, and abuse. As somebody on the FBI emailing list, I can tell you that not a day goes by without an email telling me about this or that unbelievable Medicare fraud scheme. But I don't think it's a wedge issue.
KNOXI don't think -- you know, I've seen people turn it to political use. You know, one of the people profiled in the data is a prominent Democratic donor who ran into some legal trouble because of Medicare. But I just can't imagine this becoming a wedge issue.
REHMAll right. And that's the last word. Olivier Knox of Yahoo news, Janet Hook of The Wall Street Journal, Annie Lowrey of The New York Times, have a great weekend, everybody.
REHMAnd thanks for listening, all. I'm Diane Rehm.
ANNOUNCER"The Diane Rehm Show" is produced by Sandra Pinkard, Denise Couture, Susan Casey Nabors, Rebecca Kaufman, Lisa Dunn, Danielle Knight, and Allison Brody. The engineer is Toby Schreiner. Natalie Yuravlivker answers the phones. Visit drshow.org for audio archives, transcripts, and podcasts. Call 202-885-1200 for more information. Our email address is firstname.lastname@example.org, and we're on Facebook and Twitter. This program comes to you from American University in Washington, D.C. This is NPR.
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